The effect and mechanism of transient continuous subcutaneous insulin infusion therapy on β cell function, insulin resistance and vascular endothelial injury in newly diagnosed type 2 diabetes
10.3760/cma.j.issn.0578-1426.2010.05.011
- VernacularTitle:短期持续皮下胰岛素输注对新诊断2型糖尿病患者胰岛功能、胰岛素抵抗和血管内皮细胞损伤的作用及其机制
- Author:
Shiping LIU
;
Hui MO
;
Bilian LIU
;
Weili TANG
;
Xiaoge DENG
;
Xin SU
;
Lan YAO
;
Jian LIN
;
Qiong FENG
;
Jian PENG
;
Zhiguang ZHOU
;
Yijun LI
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus,type 2;
Insulin-secreting cells;
Insulin resistance;
Endothelial cells;
Continuous subcutaneous insulin infusion,transient
- From:
Chinese Journal of Internal Medicine
2010;49(5):405-409
- CountryChina
- Language:Chinese
-
Abstract:
Objectives To explore the effect of transient continuous subcutaneous insulin infusion (CSII) on β cell function, insulin resistance and vascular endothelial injury in newly diagnosed type 2 diabetic patients and its potential mechanism. Methods Ten patients with newly diagnosed type 2 diabetes mellitus (T2DM) accepted CSII for two weeks. Intravenous glucose tolerance test (IVGTT) and hyperinsulinemia euglycemia clamp test were performed before and after CSII. Serum soluble E-selectin (sE-selectin) was used to evaluate the injury of vascular endothelial cell, while serum high sensitivity C reactive protein (hsCRP) and soluble CD_(14) (sCD_(14)) were both used to assess inflammatory condition. Results (1) Compared with those before treatment, the blood glucose levels of IVGTT, the area under the curve of the blood glucose, glycosylated hemoglobin, TC and LDL-C in the patients were decreased after CSII (P < 0. 05 or 0. 01). (2) Compared with those before treatment, the insulin levels of IVGTT (except the fasting insulin), the area under the curve of insulin and acute insulin response were all increased after CSII(P < 0.05 or 0.01). (3) Compared with that before treatment, the glucose infusion ratio in the clamp test [(3.46±1.66)mg·kg~(-1)·min~(-1) increased to (7.14±2.37)mg·kg~(-1)·min~(-1)]and HOMA-β elevated, while HOMA-IR declined (P <0. 05 or 0. 01 in all). (4) Compared with those before treatment, the levels of serum sE-selectin, sCD_(14) and hsCRP were decreased (P < 0. 01, except for hsCRP) . Conclusion Transient intensive insulin therapy in patients with newly diagnosed T2DM is useful to restore 13 cell function, attenuate insulin resistance, repair vascular endothelial injury and improve the disorder of blood sugar and lipid. The mechanism may be related with the inhibition of inflammation in patients.
