Short-term insulin intensive therapy decreases MCP-1 and NF-κB expression of peripheral blood monocyte and the serum MCP-1 concentration in newlydiagnosed type 2 diabetics

ABSTRACT Objective To observe the effect of short-term insulin intensive treatment on the monocyte chemoattractant protein-1 (MCP-1) as well as on the nuclear factor-kappa B (NF-κB) expression of peripheral blood monocyte. This is also in addition to observing the serum MCP-1 level in newlydiagnosed type 2 diabetic patients and probing its anti-inflammation effects. Subjects and methods Twenty newly-diagnosed type 2 diabetic patients were treated with an insulin intensive treatment for 2 weeks. MCP-1 and NF-κB expression on the monocyte surface were measured with flow cytometry, the serum MCP-1 level was measured by enzyme linked immunosorbent assay (ELISA) during pretreatment and post-treatment. Results After 2 weeks of the treatment, MCP-1 and NF-κB protein expression of peripheral blood monocyte and serum MCP-1 levels decreased significantly compared with those of pre-treatment, which were (0.50 ± 0.18)% vs (0.89 ± 0.26)% (12.22 ± 2.80)% vs (15.53 ± 2.49)% and (44.53 ± 3.97) pg/mL vs (49.53 ± 3.47) pg/mL, respectively (P < 0.01). The MCP-1 expression on monocyte surface had a significant positive relationship with serum MCP-1 levels (r = 0.47, P < 0.01). Conclusions Short-term insulin intensive therapy plays a role in alleviating the increased inflammation reaction in type 2 diabetics.

The situation and feature of the intensive insulin therapy in a group of hyperglycemic patients during pregnancy / 中华内分泌代谢杂志

Relevant clinical data of 141 cases diagnosed pregestational diabetes mellitus(PGDM),diabetes mellitus in pregnancy(DIP), gestational diabetes mellitus(GDM), and type 2 diabetes mellitus(T2DM) were collected. The blood glucose control rate,insulin dose,and episode of hypoglycemia in the insulin intensive therapy were retrospectively analyzed. The results showed that there was no significant difference in the control rate among the four groups(P=0.906). The insulin dose/weight in GDM was significantly lower than those in PGDM,DIP,and T2DM groups[0.65(0.47-1.00),0.67(0.38-1.05),0.65(0.52-0.82)vs 0.45(0.29-0.61)U·kg-1·d-1,P<0.05 or P<0.01]. There was no significant difference in episode or incidence rate of hypoglycemia among the overall four groups(P=0.339). However in the patients with blood glucose reaching the control standard,the rate of hypoglycemia in T2DM was significantly higher than those in PGDM,DIP,and GDM(P<0.05 or P<0.01).

Application of hyperinsulinemic euglycemic clamp in the diagnosis and treatment of newly-onset diabetic patients / 中华临床营养杂志

Objective To evaluate the application value of hyperinsulinemic euglycemic clamp in the diagnosis and treatment of newly-onset diabetic patients. Methods Totally 11 newly-onset diabetic inpatients (10 patients with type 2 diabetes mellitus and 1 patient with latent autoimmune diabetes of adulthood) who were diagnosed in the Department of Endocrinology of Peking Union Medical College Hospital from January 2009 to August 2009 were included in this study. Hyperinsulinemic euglycemic clamp was applied to measure the glucose disposal rate (M value). Afterwards insulin pump therapy was applied and the total insulin dosage per day to get to the target of the fasting and postprandial blood glucose was calculated. Final]y the relationships between insulin dosage per day and the M value, body mass index (BMI) , fasting blood glucose, fasting insulin level were separately analyzed. Results The insulin dosage was only negatively correlated with M value (r = - 0. 83, P = 0. 003), and was not significantly correlated with BMI (r = 0.54, P = 0.106), fasting blood glucose (r = - 0. 16, P =0. 657) , and fasting insulin (r = 0. 16, P = 0. 659). The formula of insulin dosage and M value according to the mathematic model as follows: insulin dosage per day = - 3. 327 M + 49. 849. Conclusion Hyperinsulinemic euglycemic clamp can effectively evaluate the insulin sensitivity in the newly-onset type 2 diabetic patients, and thus can be a useful tool in deciding the clinical insulin dosage.

OBSERVATION OF INSULIN INTENSIVE THERAPY BY INSULIN PEN INJECTORS ON IDDM PATIENTS / 中华内分泌代谢杂志

Seven cases of unstable Type 1 diabetic patients were treated with IIT (intensive insulin therapy) -multi-injection insulin regimen. The short-acting insulin (Actrapid HM) administered by insulin-pen injector (NOVO-Pen 1) before meals as meal-related incremental insulin. The long-acting insulin (Ultratard HM) injected at 10 p.m. as basal insulin. After run-in period of 4 weeks then the IIT-period ran for 12 weeks. The results showed that the mean fasting/post-prandial glucose concentration was normalized from 10.6?2.5/16.2?3.9 mmol/L to6.5?0.9/7.0?2.2mmol/L. The mean HbA, fell from 10.2% to 8.2% (normal 6-8%) during the three months period. It can be concluded that the IIT-multi-injecdon insulin regimen improves metabolic control. The NOVO-Pen seems to be better than the traditional syringe as besides its painless injection, it is easy to use and carry; thus makes the multiple injection regimen more attractive.