RESUMEN
Objective To study the effect of chemotherapy on function of islet βcells in patients with breast cancer . Methods One hundred and fifty-six patients with breast cancer who had not received chemotherapy were enrolled from Sep 2012 to Aug 2013 at Chongqing Cancer Institute .One hundred and twenty-three cases completed 2 cycles of chemotherapy;one hundred and twelve cases completed 4 cycles;and, eighty-six cases completed 8 cycles.Height, weight, waist circum-ference(WC), hip circumference(HC) and blood pressure of each patient were measured .Waist-high ratio calculation (WHtR),waist-hip ratio(WHR) and body mass index(BMI) were calculated.All subjects underwent 75 g oral glucose tolerance test(OGTT)and insulin release test before chemotherapy,2 cycles,4 cycles and 8 cycles of chemotherapy, respec-tively.Besides, homeostasis model assessment of insulin resistance index ( HOMA-IR), Matsuda index and pancreatic βcells HOME(HOME-β) were calculated.Results Fasting blood glucose before chemotherapy and after 2 cycles, 4 cycles and 8 cycles of chemotherapy was (4.84 ±0.56), (4.78 ±0.61), (5.02 ±0.56) and (5.96 ±0.52) mmol/L, respec-tively.After therapy, the change in fasting blood glucose after 2 cycles and 4 cycles of chemotherapy was not statistically significant(P>0.05), but was significantly higher after 8 cycles than before therapy(P<0.05).2 h blood glucose before chemotherapy and after 2 cycles, 4 cycles and 8 cycles of chemotherapy was (5.43 ±0.50), (5.66 ±0.58), (8.30 ± 0.66) and (9.65 ±0.80) mmol/L, respectively.With chemotherapy treatment increased , the HOME-IR increased gradu-ally and the sharpest one was after 8 cycles, Matsuda index decreased gradually and the biggest drop was after 4 cycles,and HOME-βdecreased gradually after a transient increase .Conclusion Chemotherapy for breast cancer patients may lead to insulin resistance , pancreatic βcell function decline and the emergence of abnormal glucose tolerance .Four cycles of chemotherapy shoucd be followed by hypoglycemic drugs .
RESUMEN
Objective A multicenter, randomized, controlled and open-labled clinical trial was performed to compare the efficacy and safety of recombinant human insulin injection ( Yousilin R) and treated with Yousilin R versus Novolin R for 12 weeks respectively. Results Compared with baseline,the levels of glycosylated hemoglobin A1c ( HbA1c ) at the end of 12 weeks treatment decreased from 10. 77% to 7. 72% ( P ＜0. 05 ) in Yousilin R group and from 10. 33% to 7. 62% ( P ＜0. 05 ) in Novolin R group,2-hour postprandial plasma glucose ( 2hPG ) decreased from 15.49 mmol/L to 9. 72 mmol/L ( P ＜ 0. 05 ) in Yousilin R group and from 15.33 mmol/L to 10. 07 mmol/L( P ＜ 0. 05 ) in Novolin R group, and fasting plasma glucose (FPG) decreased from 10. 90 mmol/L to 7. 31 mmol/L( P ＜0. 05 ) in Yousilin R group and from 10. 22 mmol/L to 7.21 mmol/L (P ＜0. 05) in Novolin R group. The changes of HbA1c, 2hPG and FPG from baseline to endpoint in Yousilin R group was similar to those in Novolin R group ( P ＞ 0. 05 ).Furthermore, hypoglycemic events(26. 42% vs 30. 48% ), other adverse events( 13.21%vs 16. 19% ) ,and serious adverse events( 1.89%vs 1.90% )were comparable between Yousilin R and Novolin R groups(P ＞0. 05 ). Conclusions Yousilin R has similar efficacy, safety and compliance profiles to Novolin R group in the treatment of diabetic patients.