The Failure Rate Of Pancreatic Islet Function In Patients With Type 2 Diabetes Mellitus And Its Influencing Factors

Objective:To analyze the islet function and insulin resistance in patients with type 2 diabetes mellitus,and to explore the influencing factors of islet failure rate.Methods:1685 patients with type 2 diabetes admitted between 2013 and 2017 treated in Department of Endocrinology,Affiliated Hospital of Qingdao University were enrolled in the study.Type 2 diabetes mellitus was diagnosed based on the criteria of the American Diabetes Association.The patients were divided into 5 groups according to the duration of disease:<1year group,1?duration<10 years group,10?duration<20 years group,20?duration<30 years group,duration?30 years group.In order to further compare the difference between islet function and diabetes mellitus,we selected normal subjects as normal control group.To collect the basic situation of each group of subjects,laboratory indicators,etc.,and calculate HOMA-?index and HOMA-IR index in accordance with the literature records.At the same time,the body mass index(BMI)?25kg/m2 was used as the cut point,and the subjects were stratified to compare the difference between the BMI of the disease group and the level of insulin resistance and insulin resistance in patients with low BMI.Results:1.HOMA-?index of normal control group,<1year group,1?duration<10 years group,10?duration<20 years group,20?duration<30 years group,duration?30 years group were9533.7±1136.9,4973.8±4144.9,4268.7±2851.8,4096.4±3155.7,3826.2±3289.6,3067.0±1434.6.HOMA-IR index of normal control group,<1year group,1?duration<10years group,10?duration<20 years group,20?duration<30 years group,duration?30 years group were 185.8±64.8,283.0±91.5,277.5±151.5,246.4±93.4,256.2±72.6,278.0±61.9.In<1year group,the HOMA-?index decreased significantly compared with the normal group,the average level decreased by nearly half,and with the disease progression,HOMA-?index also decreased but decreased significantly slower.In the HOMA-IR index,the HOMA-IR index was significantly increased within 1 year of diagnosis of diabetes mellitus,and there was no significant difference with the change of HOMA-IR index(P>0.05).2.With the BMI?25kg/m~2 as the tangent point,it can be seen that the level of fasting C peptide and HOMA-?index in patients with BMI?25kg/m~2 in 1-10 years and 10-20 years were significantly higher than those in BMI<25kg/m~2(P<0.05),while there was no significant difference between the 1 year group,the 20-30 year group and the 30 years group(P>0.05).The HOMA-IR index of patients with BMI?25kg/m~2 was significantly higher than that of the corresponding group BMI<25kg/m~2.Conclusion:Type 2 diabetes patients with insulin secretion with the duration of the gradual decline.In the first year of newly diagnosed type 2 diabetes mellitus,the islet function decreased significantly compared with the normal group,decreased by 47%.After 10 years,the function of islet decreased significantly.Also at the beginning of the disease,the level of insulin resistance was significantly increased,and after 10 years the level of insulin resistance was not significant.And high BMI patients with the ability to monitor and with the course of disease changes and low BMI patients there is a difference.