Analysis Of Risk Factors Of Early Onset Type 2 Diabetes With Microvascular Diseases

Objective:To analyze the related risk factors of early onset type 2 diabetes with microvascular diseases,and to provide evidence for early clinical intervention.Method:From November 2017 to November 2019,522 patients with T2 DM who were hospitalized in our hospital and aged 18-40 years old(including 18 and 40 years old)were randomly divided into two groups according to whether they were combined with microvascular diaeases(this study mainly observed diabetic retinopathy,diabetic kidney disease): EODM combined with microvascular diaeases group(EODM+MVD group,250 cases),EODM without microvascular diaeases group(EODM group,272 cases).All enrolled patients were given 72-hour continuous glucose monitoring system(CGMS)to assess blood glucose variability,mean amplitude of glycemic excursions(MAGE)and time in range of glucose(TIR)were recorded.General information and related blood biochemical indexes of the two groups were recorded as well,including age,diabetes course,gender,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),fasting plasma glucose(FPG),2h plasma glucose(2hPG),fasting Insulin(FINS),glycosylated hemoglobin A1c(HbA1c),glomerular filtration rate(eGFR),uric Acid(UA)and serum creatinine(SCr).Insulin resistance index was calculated according to homeostasis model assessment of insulin resistance(HOMA-IR).In addition,we also collected medical history data of the two groups,including smoking history and family history of diabetes.SPSS24.0 was used to analyze the above indexes of the two groups statistically.Results:1.This study shows that compared with EODM group,EODM+MVD group has greater all-day blood glucose variability,more serious metabolic disorders,which are mainly manifested as glucose,lipid and uric acid metabolism disorders,such as lower TIR,higher MAGE,higher FPG,2hPG,HbA1 c,TG,TC,SBP,DBP,UA,SCr,lower eGFR,and EODM+MVD group also has higher BMI,a larger proportion of patients with family history of diabetes,higher HOMA-IR,the difference was statistically significant(p<0.05),while the course of disease,smoking history,HDL-C,LDL-C,FINS had no significant difference(p>0.05).2.The results of multivariate regression analysis displayed that TIR,MAGE,FPG,SBP,SCr,eGFR were independent risk factors for microvascular diseases of EODM.Conclusion:1.TIR,MAGE,FPG,SBP,SCr and eGFR were independent risk factors for microvascular diseases of EODM.2.MAGE and TIR can be used as sensitive indexes for clinical evaluation of short-term blood glucose variability,as more intuitive indexes of blood glucose optimization,the two can complement each other with HbA1 c,providing a new idea for prevention and control of EODM combined with microvascular diseases.