Effect of continuous substaneous insulin infusion on islet beta cell function in newly diagnosed diabetic patients / 中国基层医药

ABSTRACT

Objective:To investigate the effects of continuous substaneous insulin infusion (CSII) on islet β cell function in newly diagnosed diabetic patients.Methods:Forty-six newly diagnosed diabetic patients who received treatment in Taishan People's Hospital from July 2011 to June 2014 were included in this study. They were treated with CSII for 14 days and followed up for 5 years. Before and after treatment, fasting blood glucose (FPG), 2-h postprandial blood glucose (2hPG), triglyceride (TG), fasting insulin (FINS), 2-h postprandial insulin (2hINS), glycosylated hemoglobin (HbA1c), superoxide dismutase (SOD), malondialdehyde (MDA) and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index, Homeostasis Model Assessment for beta-cell function (HOMA-β) index were compared between before treatment and 5 years after treatment.Results:Five years after treatment, the levels of FPG, 2hPG, TG, HbA1c, MDA and HOMA-IR were lower than those before treatment [FPG (11.3 ± 1.2) mmol/L vs. (5.9 ± 0.4) mmol/L, t = 15.35, P < 0.01; 2hPG (18.1 ± 4.2) mmol/L vs. (8.1 ± 1.6) mmol/L, t = 16.83, P < 0.01; TG (2.9 ± 1.1) mmol/L vs. (1.5 ± 0.6) mmol/L, t = 9.81, P < 0.01; HbA1c (11.2 ± 2.5)% vs. (5.6 ± 1.0)%, t = 11.48, P < 0.01; MDA (4.6 ± 1.2) μmol/L vs. (2.7 ± 0.9) μmmol/L, t = 16.37, P < 0.01; HOMA-IR (2.81 ± 0.35) vs. (1.87 ± 0.32), t = 9.37, P < 0.01]. Five years after treatment, the levels of FINS, 2hINS, SOD and HOMA-β were significantly higher than those before treatment [FINS (5.6 ± 1.3) mU/L vs. (7.4 ± 1.5) mU/L, t = - 6.15, P < 0.01; 2hINS (15.8 ± 7.5) mU/L vs. (25.8 ± 9.1) mU/L, t = - 5.65, P < 0.01; SOD (28.9 ± 7.6) U/L vs. (39.6 ± 7.8) U/L, t = - 7.93, P < 0.01; HOMA-β (14.36 ± 3.82) vs. (65.67 ± 6.67), t = - 18.72, P < 0.01]. Linear regression analysis showed that HOMA-β was positively correlated with SOD level ( R2 = 0.319, P < 0.01). Five years after treatment, the final outcome was insulin therapy in 3 cases (6.5%), oral medication in 25 cases (54.4%), and lifestyle intervention in 18 cases (39.1%). Conclusion:CS II for the treatment of newly diagnosed diabetes mellitus can effectively inhibit oxidative stress, improve the function of islet β cells, and exhibit long-term effects.