Objective To investigate the relationship between interleukin-18(IL-18)and the pathogenesis of type 2 diabetes melli-tus.Methods 72 healthy Sprague-Dawlay male rats were randomly divided into four groups, NC group,NCS group,HF group and HFS group.At the end of the 8th week,NCS group and HFS group were injected with STZ(25mg/kg)into abdominal cavity.At the end of the 10th week,diabetic rats were screened by oral glucose tolerance test(OGTT).The blood sample was collected when the rats were killed at the end of the 14th and 20th week.The levels of serum IL-18,IL-6 and tumor necrosis factor-α(TNF-α)were assayed with ELISA.Results Most rats in HFS group were achieved the diagnostic standard of diabetic rat, and their insulin sensitivity index(ISI)were decreased.At the end of the 14th week and 20th week,the levels of serum IL-18,IL-6 and TNF-α in HFS group were significantly higher than those in NC group(P＜0.01).In HFS group,the levels of serum IL-18,IL-6 and TNF-α at the end of the 20th week were higher than those at the end of the 14th week,but it had no statistic significance(P＞0.05).Pearson linear correlation analysis showed that the level of serum IL-18 in HFS group was positive correlated with FBG,IL-6,and TNF-α(r=0.90,P＜0.01 or r≥0.73,P＜0.05),and negative correlated with ISI(r=-0.86,P＜0.01).Condusions Our results show that IL-18 is related with the pathogenesis of type 2 diabetes mellitus and chronic inflammation plays an important role in the development of type 2 diabetos mellitus.

Objective To compare efficacy of nateglinide or acarbose combined with metformin in patients with newly diagnosed type 2 diabetes.Methods Ninety-six patients with newly diagnosed type 2 diabetes in Metabolic Diseases Hospital of Tianjin Medical University,were randomly to receive nateglinide combined with metformin (group A,n =46) or acarbose combined with metformin (group B,n =42) for four months.Drug dose was adjusted every two weeks.Before and after treatment,oral glucose tolerance test and insulin release test were performed to observe changes of their glucose tolerance,homeostasis model assessment for insulin resistance (HOMA-IR) ,insulin secretion function of β-cells and glucose disposition index (DI) in the two groups.Results After four-month treatment,six patients restored to normal glucose tolerance and 13 patients returned to impaired glucose tolerance (IGT) in group A and 12 patients restored to IGT in group B.Their HOMA-IR was markedly improved compared with baseline in both groups,decreased to 7.1 ± 1.3 from 8.6 ± 1.2 in group A and to 6.9 ± 1.7 from 8.6 ± 1.7 in group B ( P ＜ 0.05 ).Compared with group B,early insulin secretion ( LN△I30/△G30 ) obviously improved in group A [( 1.9 ±0.8) vs.(1.6±0.6) mU/mmol] (P＜0.05) and DI also increased (1.05±0.25 vs.0.89±0.21,P＜0.05 ).Conclusions Nateglinide combined with metformin can obviously restore early insulin secretion and improve insulin resistance in patients with newly diagnosed type 2 diabetes,thus facilitate restoration of their glucose tolerance.