新诊断2型糖尿病患者外周单核细胞ROCK活性与胰岛素抵抗以及胰岛β细胞功能的关系

Clinical effect of subcutaneous insulin injection combined with metformin for type 2 diabetes mellitus in children

AIM: To explore the clinical effect of subcutaneous insulin injection combined with metformin for type 2 diabetes mellitus (T2DM) in children.

METHODS: Seventy children with T2DM were analyzed retrospectively. They were randomly divided into two groups: a control group and an experiment group. The control group was treated with metformin hydrochloride sustained-release tablets, and the experiment group was treated by subcutaneous injection insulin on the basis of treatment with metformin hydrochloride sustained-release tablets. FPG, 2hPG, TC, TG, HDL-C, LDL-C, HbAlC, FINS, HOMA-IR, F-CP and Homa-β were compared between the two groups.

RESULTS: Post-treatment levels of FPG and 2hPG were lower than pretreatment values (5.52 mmol/L ± 0.77 mmol/L vs 10.34 mmol/L ± 3.26 mmol/L, 6.86 mmol/L ± 1.35 mmol/L vs 15.17 mmol/L ± 3.89 mmol/L, 5.76 mmol/L ± 0.69 mmol/L vs 9.89 mmol/L ± 3.43 mmol/L, 7.02 mmol/L ± 1.08 mmol/L vs 14.33 mmol/L ± 2.82 mmol/L, P < 0.05 for all). There were no significant differences in FPG and 2hPG between the two groups (P > 0.05 for all). Post-treatment levels of TG, LDL-C, HbAlC and BMI were significantly lower than pretreatment values (1.92 mmol/L ± 0.91 mmol/L vs 4.06 mmol/L ± 1.09 mmol/L, 1.12 mmol/L ± 0.69 mmol/L vs 1.22 mmol/L ± 0.60 mmol/L, 4.81 mmol/L ± 1.30 mmol/L vs 8.22% ± 1.73%; 25.13 kg/m² ± 2.78 kg/m²vs 27.95 kg/m² ± 1.79 kg/m², 1.89 mmol/L ± 1.21 mmol/L vs 3.8 mmol/L ± 1.33 mmol/L, 1.31 mmol/L ± 0.49 mmol/L vs 1.20 mmol/L ± 0.59 mmol/L, 4.08% ± 1.51% vs 7.79% ± 2.83%, 24.76 kg/m² ± 2.61 kg/m²vs 28.62 kg/m² ± 1.68 kg/m², P < 0.05 or 0.01 for all). There were no significant differences in the levels of TC, HDL-C, TG, HDL-C, LDL-C, HbAlC or BMI between before and after treatment in both groups (P > 0.05 for all). Post-treatment levels of FINS, F-CP and Homa-β were significantly higher than pre-treatment values (18.32 mU/L ± 3.81 mU/L vs 13.30 mU/L ± 4. 13 mU/L, 5.95 mmol/L ± 1.26 mmol/L vs 2.72 mmol/L ± 1.30 mmol/L, 85.35 mU/L ± 62.22 mU/L vs 23.57 mU/L ± 16.81 mU/L, 15.58 mU/L ± 2.62 mU/L vs 12.97 mU/L ± 3.96 mU/L, 3.02 mmol/L ± 1.52 mmol/L vs 2.63 mmol/L ± 1.34 mmol/L, 63.88 ± 53.71 vs 21.35 ± 17.92, P < 0.05 or 0.01 for all), while the levels of HOMA-IR were significantly lower after treatment than before treatment (1.19 ± 0.37 vs 1.91 ± 0.56, 1.55 ± 0.33 vs 1.86 ± 0.57, P < 0.05 or 0.01 for all). The levels of FINS, F-CP and Homa-β in the experiment group were significantly higher than those in the control group (18.32 mU/L ± 3.81 mU/L vs 15.58 mU/L ± 2.62 mU/L, 5.95 mmol/L ± 1.26 mmol/L vs 3.02 mmol/L ± 1.52 mmol/L, 85.35 ± 62.22 vs 63.88 ± 53.71, P < 0.05 for all), while the level of HOMA-IR was significantly lower than the control group (1.19 ± 0.37 vs 1.55 ± 0.33, P < 0.05).

CONCLUSION: Subcutaneous insulin injection combined with metformin can improve serum indices and islet function in T2DM children.