Testosterone replacement therapy improves insulin sensitivity and decreases high sensitivity C-reactive protein levels in hypogonadotropic hypogonadal young male patients

Background Many clinical studies suggest the inverse relationship between testosterone levels and insulin sensitivity in men, however the causative relationship of these two events is still not determined. The purpose of this study was to investigate the effects of testosterone replacement therapy （TRT） on insulin sensitivity, body composition, serum lipid profiles and high sensitivity C-reactive protein （hsCRP） in hypogonadotropic hypogonadal （HH） puberty undeveloped male patients. Methods In this prospectively designed study, we compared homeostasis model assessment of insulin resistance （HOMA-IR）, insulin areas under the curves （AUC） of 3-hour oral glucose tolerance test （OGTT） and other metabolic parameters between 26 HH patients and 26 healthy men. The patients＇ HOMA-IR, insulin AUC, body composition, lipid profiles, hsCRP and other parameters were compared before and after nine-month TRT. Results The average levels of total testosterone （TT） in HH and healthy group were （0.9±0.6） nmol/L and （18.8±3.4） nmol/L, respectively. HOMA-IR in HH group was significantly higher than the healthy group （5.14±5.16 vs 2.00±1.38, P 〈0.005）. Insulin AUC in 3-hour OGTT in HH group was significantly higher than the healthy group （698.6±414.7 vs 414.2±267.5, P 〈0.01）. Fasting glucose level in H H group was significantly higher than control group （（5.1±0.6） mmol/L vs （4.7±0.3） mmol/l, P 〈0.005）. Height, weight and grasp strength of the patients were significantly increased after 9-month TRT. Significant reductions in HOMA-IR （from 5.14±5.16 to 2.97±2.16, P 〈0.01）, insulin AUC （from 698.6±414.7 to 511.7±253.9, P 〈0.01） and hsCRP （from （1.49±1.18） mg/L to （0.70±0.56） mg/L, P 〈0.05） were found after TRT. Serum total cholesterol, LDL-C, HDL-C and triglyceride were all decreased, albeit with no significant difference compared to the level prior to TRT. Conclusions HOMA-IR, insulin AUC and fasting glucose level in HH young male patients were significantly higher than those of the control group, which suggests that low level of testosterone in male adolescents might be a risk factor for insulin resistance. TRT can significantly improve patients＇ insulin sensitivity and suppress serum hsCRP, which in return suggests that TRT may prevent the HH patients from developing diabetes mellitus and cardiovascular diseases （CVD） in future.     

Evaluation of glucose metabolism in women with multiple ovarian follicles

Objective ：To investigate glucose metabolism in women with multiple ovarian follicles （MOF） and explore the relationship between glucose metabolism, insulin resistance and body weight. Methods：We evaluated 46 women with MFO and 30 normal women as controls. All the subjects were given 75g of glucose orally in order to perform the oral glucose tolerance test （OGTT） and insulin releasing test （IRT）, and they were also evaluated for insulin resistance using the insulin resistance index with homeostatic model assessment （HOMA）. Results：The occurrence of impaired glucose tolerance in women with MOF was 10.87%, which was significantly higher than that in the control group （3.33% ,P 〈 0.05）. The rate of insulin resistance was 30.43% in the study group as compared to 10.00% in the control group. The results showed that there was significant difference between the two groups（P 〈 0.05）. The levels of FSH,LH,PRL,E2,T and P between the two groups had no significant difference （P 〉 0.05）. BMI in women with impaired glucose tolerance was correlated positively to insulin resistance （r = 0.567, P 〈 0.05）. Conclusion：Abnormal glucose metabolism was observed in women with unitary multiple ovarian follicles, and this could be attributed to obesity and insulin resistance. Women with MOF and associated obesity should be subjected to OGTT so that their glucose levels can be monitored as a preventive measure.     

Beta-cell dysfunction is the primary contributor to the early postpartum diabetes among Chinese women with history of gestational diabetes mellitus

Background Women with a history of gestational diabetes mellitus （GDM） are at higher risk of future development of diabetes. This study investigated the risk factors associated with early postpartum abnormal glucose regulation （AGR） among Chinese women with a history of GDM.
Methods A total of 186 women with a history of GDM were screened for early postpartum AGR at 6-8 weeks after delivery. Those with AGR were given lifestyle intervention therapy and reevaluated in 6-12 months. The demographic, anthropometric, prenatal and delivery data were recorded. The plasma high-sensitivity C-reactive protein （HsCRP） and lipid concentration were measured, and insulin secretion were analyzed. Insulinogenic index △ins30＇/△BG30＇, the homeostasis model assessment index （HOMA）-B, and HOMA-IR were calculated. Multiple regression analysis was performed to identify the risk factors.
Results Of the GDM women 28.0% （52/186） had AGR at 6-8 weeks after delivery; 45.2% （17/40） of these AGR women reminded abnormal after 6-12 month lifestyle intervention. Compared to the women who reverted to normal, women with consistent AGR showed significantly lower fasting insulin concentration, lower △ins30＇/△BG30＇ as well as lower HOMA-B. No significant differences in age, body mass index （BMI）, waist circumference, blood pressure, lipid level HsCRP and HOMA-IR were observed between the two groups. Pre-pregnancy BMI ≥25 kg/m^2, fasting glucose level ≥5.6 mmol/L and/or 75 g oral glucose tolerance test （OGTT） 2 hours glucose level ≥11.1 mmol/L during pregnancy were predictors for the AGR at 6-8 weeks after delivery. △ins30＇/△BG30≤1.05 was a significant risk contributor to the consistent early postpartum AGR.
Conclusion There is a high incidence of early postpartum AGR among Chinese woman with prior GDM. Beta-cell dysfunction, rather than insulin resistance or inflammation, is the predominant contributor to the early onset and consistent AGR after delivery.     

Effects of L-lysine monohydrochloride on insulin and blood glucose levels in spinal cord injured rats

Background Hyperglycemia in brain and spinal cord could aggravate neurologic impairment. Recent studies showed that L-lysine monohydrochlonde （LMH） could increase the insulin secretion and regulate the blood glucose level. The aim of the present study was to investigate the effects of LMH on pancreatic islet B cells, the levels of endogenous insulin and blood glucose in spinal cord injured rats.Methods Forty male Wistar rats were divided into four groups, namely, normal control group, model group, high-dose LMH group （621.5 mg/kg equal to LMH 1/8 LD50）, and low-dose LMH group （310.8 mg/kg equal to LMH 1/16 LD50）. The model of spinal cord injured rat was established by hemi-transection at the lower right thoracic spinal cord. LMH was administered via intraperitoneal injection once spinal cord injury was produced in rats. All rats were sacrificed 48 hours after spinal cord injured. The effects of LMH on pancreatic islet B cells, the content of endogenous insulin, end the level of blood glucose were observed with immunohistochemical method, radioimmunoassay method, end biochemical analyzer, respectively. Results The insulin immunohistochemical intensities of islet B cells were significantly weaker in model group then those in normal control group （P 〈0.01）. The levels of endogenous insulin were significantly lower and the blood glucose levels were significantly higher in model group than those in normal control group （P 〈0.01）. The insulin immunohistochemical intensities of islet B cells were significantly stronger in high-dose LMH group then those in model group （P〈0.05）. In addition, we found that the levels of endogenous insulin were significantly higher and the blood glucose levels were significantly lower in high-dose LMH group then those in model group （P 〈0.05）. There were no significant differences in the insulin immunohistochemical intensities of islet B cells, the levels of endogenous insulin and the blood glucose between low-dose LMH group and model group （P 〉0.05）. Conclusion LMH, but dose-dependent, might participate in the regulation of pancreatic islet B cells, and then reduce the blood glucose levels in the spinal cord injured rats.     

The State of Insulin Resistance in Patients with Nonalcoholic Fatty Liver and the Intervention with Gankangyin(肝康饮)

Objective: To explore the correlation of nonalcoholic fatty liver (NAFL) with insulin resistrandomly assigned into the treated group and the control group. They were treated with GKY and Silymarin for 3 months respectively. Oral glucose tolerance test (OGTT) and insulin release test (IRT) were conducted and insulin sensitivity indexes were determined before and after treatment. And 32 healthy nonalcoholic persons were enrolled and used as the healthy control group. Results: Before treatment, the levels of blood glucose and insulin at different time points in OGTT test, and the insulin resistance index (IRI) were significantly higher (P＜0.05 or P＜0.01) while insulin sensitivity index (ISI) and insulin active index (IAI) were lower ( P＜0.05 or P＜0. 01) in the NAFL patients than those in the healthy persons. After treatment, the abovementioned raised criteria were significantly Iowered ( P＜0. 05, P＜0.01) and the lowered criteria were significantly increased ( P＜0. 01) in the treated group, while in the control group all the criteria were insignificantly changed ( P ＞0.05 ). Conclusion: Evident insulin resistance exists in NAFL patients. GKY could increase the insulin sensitivity, thus improving the state of insulin resistance in NAFL patients.     

Trace glucose fluxes in individuals with prediabetes using stable isotopes

Background The glucose fluxes of individuals with prediabetes in Chinese population are not clear.This study was to determine whether the endogenous glucose production （EGP）,oral glucose rate of appearance （Ra） and glucose rate of disappearance （Rd） were different in Chinese individuals with prediabetes under fasting conditions and following an oral glucose challenge.Methods Five subjects with type 2 diabetes,5 subjects with prediabetes and 5 non-diabetic subjects matched for age,weight,fat free mass and body mass index underwent a 180 minute stable glucose isotope tracing （[6,6-2H2] glucose,[1-13C] glucose,and [U-13C] glucose） study under fasting and after ingestion of a 75 g oral glucose load.Isotope glucose enrichment was measured by gas chromatography-mass spectrometry.Insulin sensitivity was estimated using the oral glucose tolerance test （OGTT）-derived insulin sensitivity index,β cell function was determined by the insulinogenic index （△I30/△G30）.Results The insulin sensitivity index （P=0.043） and insulinogenic index （P=0.021） were decreased in subjects with prediabetes compared with non-diabetes.Fasting EGP was slightly higher （P=0.29） and postprandial EGP was comparable in subjects with prediabetes and non-diabetes during 120 minutes after glucose ingestion,but nadir EGP occurred later in prediabetic than non-diabetic subjects.Ra did not differ among the three groups.Rd was substantially lower in subjects with prediabetes than non-diabetes after glucose intake （P=0.013）.Conclusion The mild hyperglycemia observed among individuals with prediabetes may result from decreased Rd during the postprandial state.     

Effects of Fuscoporia obliqua on Postprandial Glucose Excursion and Endothelial Dysfunction in Type 2 Diabetic Patients

Postprandial hyperglycemia has been reported to elicit endothelial dysfunction and provoke future cardiovascular complications. A reduction of postprandial blood glucose levels by the glucosidase inhibitor Fuscoporia obliqua was associated with a risk reduction of cardiovascular complications, but the effects of Fuscoporia obliqua on endothelial function have never been elucidated. This study is aimed to assess the efficacy of Fuscoporia obliqua on postprandial metabolic parameters and endothelial function in type 2 diabetic patients. Postprandial peak glucose (14.47±1.27 vs. 8.50±0.53 mmol/liter), plasma glucose excursion (PPGE), and change in the area under the curve (AUC) glucose after a single loading of test meal (total 450 kcal; protein 15.3%; fat 32.3%; carbohydrate 51.4%) were significantly higher in the diet-treated type 2 diabetic patients (n=14) than the age- and sex-matched controls (n=12). The peak forearm blood flow response and total reactive hyperemic flow (flow debt repayment) during reactive hyperemia, indices of resistance artery endothelial function on strain-gauge plethysmography, were unchanged before and after meal loading in the controls. But those of the diabetics were significantly decreased 120 and 240 min after the test meal. A prior administration of Fuscoporia obliqua decreased postprandial peak glucose, PPGE, and AUC glucose. The peak forearm blood flow and flow debt repayment were inversely well correlated with peak glucose, PPGE, and AUC glucose, but not with AUC insulin or the other lipid parameters. Even a single loading of the test meal was shown to impair the endothelial function in type 2 diabetic patients, and the postprandial endothelial dysfunction was improved by a prior use of Fuscoporia obliqua. Fuscoporia obliqua might reduce macrovascular complication by avoiding endothelial injury in postprandial hyperglycemic status.     

Effect of Prepared Rhubarb on Insulin Resistance in Patients With Pregnancy Induced Hypertension

Objective: To investigate the effect of prepared rhubarb on insulin resistance in patients with pregnancy induced hypertension (PIH) and its mechanism. Methods: All the 92 patients accepted 75 g oral glucose tolerance test (OGTT) and insulin release test before and after treatment. These patients were divided into two groups (treated group and control group). Prepared rhubarb and nifedipine were given to the treated group, while nifedipine was given to the control group alone. Circulating endothelial cell (CEC), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) were measured and glucose area under curve (GAUC), insulin area under curve (IAUC), insulin sensitivity index (ISI) were calculated. And 30 normal pregnant women were selected as the healthy group. Results: CEC, TNF-a, IL-6, GAUC and IAUC of PIH patients were significantly higher than those of the normal healthy group; while ISI of PIH patients was significantly lower than that of the healthy group. ISI was significantly negatively correlat     

The Influence of the Prol2Ala Mutation of PPARγ2 Receptor Gene on β-cells Restoration and Insulin Resistance in Type 2 Diabetes with Hypertension

The aim of this investigation was to determine whether a PPAR72 Prol2Ala polymorphism was associated with insulin resistance, β-cellfunction and hypertension in Chinese populations. 289 unrelated Chinese subjects first diagnosed Type 2 diabetes （HbAC1〈6.0） were investigated, including 132 hypertensive diabetic （HTD） subjects, 157 normotensive diabetic （NTD） subjects. Blood pressure and anthropometric measurements were collected from all participants, as well as several venous blood samples during oral glucose tolerance test （OGTT）. Biochemical measurements （high-density lipoprotein （HDL） and low-density lipoprotein-cholesterol （LDL）, triglycerides） and PPARγ2 Pro12Ala genotype were also determined. And insulin resistance and β-cells function was assessed by HOMA-IR and HOMA-β respectively. The frequency of subjects bearing the Pro12Ala was lower in the hypertension group （3. 03 %） than in the non-hypertension group （5.7 %） （P〈0.05） after adjusted for age, BMI and gender. Hypertensive diabetic Pro12Ala subjects had lower fasting plasma glucose level （P=0. 0127）, and better glucose tolerance 60 min after oral glucose （P=0. 0361）. Moreover, plasma insulin concentrations at 60 min was lower than those without A variant （P = 0. 0275）, and both hypertensive Ala/Pro in HOMA-β （P ： 0. 0455） and AUC for insulin （P=0. 0473） were higher, and HOMA-IR was lower （P=0. 0375） as compared with hypertensive Pro/Pro subjects. No association was observed between Prol2Ala genotype and BMI, total cholesterol, HDL- cholesterol or triglycerides in either group. Our findings suggested that the Ala 12 allele of the PPARγ2 gene may improve insulin resistance and ameliorate β-cell function reserves in T2DM with hypertension, and protect patients from hypertension in T2DM. As an important thrifty gene, environment factors may exerts an effect of PPARγ2 on glucose homeostasis and insulin resistance.     

谷赖胰岛素与门冬胰岛素治疗胰岛β细胞功能衰竭2型糖尿病的疗效与安全性比较

目的探讨谷赖胰岛素与门冬胰岛素联合甘精胰岛素在治疗胰岛β细胞功能衰竭2 型糖尿病的疗效与安全性差异。方法选取2015 年12 月-2016 年6 月于吉林大学第二医院内分泌科住院及门诊治疗的胰岛β细胞功能衰竭的2 型糖尿病患者68 例。所有入选患者进行糖尿病宣传教育、饮食及运动控制,监测每日空腹、餐前、三餐后2 h及睡前血糖。入选患者随机分为两组,实验组给予谷赖胰岛素联合甘精胰岛素皮下注射降糖治疗,对照组给予门冬胰岛素联合甘精胰岛素皮下注射降糖治疗,比较两组在治疗前后空腹、餐前、三餐后2 h 睡前血糖变化、日需胰岛素剂量、糖化血红蛋白（HbA1c）变化及低血糖发生次数。结果①经过3 个月的治疗随访观察,两组在空腹、餐前、三餐后2 h、睡前血糖及糖化血红蛋白上均较治疗前有下降（P <0.05）;②两组在控制血糖达标所需日胰岛素剂量比较差异无统计学（P >0.05）;③对照组在餐前及夜间血糖控制上优于实验组（P <0.05）;④实验组在控制餐后2 h血糖上优于对照组（P <0.05）;⑤两组在糖化血红蛋白控制上差异无统计学（P >0.05）;⑥实验组的低血糖次数少于对照组,差异有统计学意义（P <0.05）。结论谷赖胰岛素联合甘精胰岛素较门冬胰岛素联合甘精胰岛素能更好控制胰岛β细胞功能衰竭2 型糖尿病的血糖,耐受好、低血糖发生次数少及降低血糖波动,减少或延缓糖尿病的各种急慢性并发症发生。     

成人糖尿病发生模式的探讨

目的：探讨我国成年人糖尿病的发病模式和胰岛素抵抗及β细胞胰岛素分泌功能损害在发病中的作用。方法：对以标准葡萄糖耐量试验筛查诊断的糖耐量减低（IGT）307例和糖耐量正常（NGT）126例（年龄25－74岁）进行6年随访,初访时测定口服糖耐量试验（OGTT）0,60,120min之血糖及血浆胰岛素浓度,每2年重复做OGTT,空腹血糖大于等于7．8mmol/L及／或OGTT试验2h血糖≥11．1mmol/L诊为糖尿病,以t检验,x^2检验及多因素回归分析胰岛素抵抗及β细胞功能对糖尿病发病率的影响。 结果：6年随访中发展为糖尿病的IGT有约70％来自胰岛素抵抗人群,另有约30％糖尿病患者在其IGT阶段并无明显胰岛素抵抗,多因素回归分析结果显示,IGT组基线胰岛 敏感性及胰岛素分泌功能与随访发生糖悄病者呈显著负相关I（OR值为0．41及0．39,P＜0．01）,在NGT人群中,胰岛素抵抗亚组6年后糖耐量恶化率远高于非胰岛素抵抗组（34．5％比13．4％,P＜0．05）,多因素逐步回归分析结果仅胰岛素抵抗与糖耐量恶化呈显著正相关（P＝0．01）,结论：我国大部分成人糖尿病发病呈2个阶段模式;第一阶段从NGT发展为IGT,在此阶段胰岛素抵抗起主要作用;第二阶段从IGT发展为糖尿病,在此阶段胰岛 抵抗和β细胞胰岛素分泌功能受损都起重要作用。β．     

初诊2型糖尿病患者中肝脏胰岛素清除率与临床特点及胃肠激素相关性的初步分析

目的 探讨我国初诊2型糖尿病患者中肝脏胰岛素清除率(hepatic insulin clearance,HIC)与胰岛素抵抗、胰岛功能及胃肠激素的相关性。方法 纳入首都医科大学附属北京世纪坛医院内分泌科初诊2型糖尿病患者112例,收集临床资料,行120 min口服葡萄糖耐量(oral glucose tolerance test, OGTT)试验,同时检测0、3、60及120 min葡萄糖、胰岛素及C肽浓度,并采用多重检测系统测定血清中肠抑胃肽(gastric inhibitory polypeptide, GIP)、胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)及饥饿素(ghrelin)的浓度。根据OGTT实验结果,计算患者HIC值。再依据HIC值的中位数将患者分为高HIC组与低HIC组,比较两组患者临床特征及胃肠激素浓度的差异。结果 高HIC组患者OGTT后血糖明显高于低HIC组 (P<0.05);胰岛素抵抗方面,低HIC组患者稳态模型胰岛素抵抗指数(homeostasis model assessment-IR, HOMA-IR)较高、反映胰岛素敏感性的Matsuda指数较低(P<0.05);高HIC组患者稳态模型胰岛β细胞功能指数(homeostasis model assessment-β,HOMA-β)等评估胰岛功能的指标明显降低(P<0.05);高HIC组患者空腹ghrelin降低,葡萄糖负荷后120 min对ghrelin的抑制程度显减弱 (P<0.05);但两组患者空腹及葡萄糖负荷后的GIP与GLP-1浓度差异无统计学意义(P>0.05)。结论 在汉族2型糖尿病患者中,较高的肝脏胰岛素清除率与较差的胰岛功能相关,较低的肝脏胰岛素清除率与相对严重的胰岛素抵抗相关,同时胃肠激素ghrelin可能与患者肝脏胰岛素清除率存在相关性,为我国T2DM患者防治工作提供新的理论依据。     

Effect of ke-tang-Ling administration on the function of pancreatic islets cells in non-insulin-dependent diabetes mellitus

Radioimmunoassay methods were modified for insulin(IRI), C-peptide (IRCP) and glucagon (IRG) in the clinical investigation on normal subjects and 38 patients with non-insulin-dependent diabetes mellitus (NIDDM). In the control group, the peaks of glucose and IRI appeared 1 hour after glucose was taken. IRCP peak, however, appeared 1 hour later. IRG showed its maximum value on fasting and then reached its lowest point at the second hour after glucose loading. The authors' interests were focused on the changes of blood glucose, IRI, IRCP, and IRG in oral glucose tolerance test (OGTT) before and after Ke-Tang-Ling (KTL) was administered in NIDDM. The results demonstrate that the glucose levels and undercure areas at various phases in OGTT were significantly decreased (P less than 0.01) in comparison of before and after the treatment with KTL in NIDDM (including obese and non-obese groups). In non-obese group, however, IRI, IRCP, and their undercure were remarkably increased (P less than 0.01). In obese group their values were decreased. It suggests that KTL plays a therapeutic role in decreasing blood glucose in non-obese NIDDM. The mechanism involved in this process may be related to its stimulating effect. IRG levels were decreased also (P less than 0.01) after the treatment with KTL in both obese and non-obese NIDDM, suggesting an inhibitory effect on glucagon secretion from alpha cells in pancrease.     

胃转流手术治疗Ⅱ型糖尿病的治疗体会

目的探讨胃转流手术治疗2型糖尿病的临床疗效.方法回顾性分析5例接受胃空肠转流术治疗2型糖尿病患者的临床资料,分析手术前后口服糖耐量及空腹血糖、体重指数及胰岛素抵抗指数的变化.结果术后1月患者的口服糖耐量,体重指数及胰岛素抵抗指数均较术前有显著好转（P〈0.01）,空腹胰岛素无明显的统计学意义（P〉0.05）.术后随访,3例血糖控制在正常范围,不需药物控制,2例明显好转,血糖值〈1/2（术前血糖值-治愈标准值）.结论胃转流手术能有效的治疗2型糖尿病.     

妊娠糖尿病患者血清鸢尾素与胰岛β细胞功能的相关性

目的 探讨妊娠糖尿病(GDM)患者空腹血清鸢尾素(Irisin)与胰岛细胞功能之间的关系。方法 选取2014年10月至2015年4月安徽医科大学第一附属医院妊娠24~32周孕妇100例,根据口服葡萄糖耐量试验(OGTT)结果分为GDM组和正常对照组(NGT),采用酶联免疫吸附法(ELISA)检测各组空腹血清Irisin水平,同时测定各受试者身高、体质量、血脂及OGTT各点血糖指标,并计算胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能指数(HOMA-β),分析这些指标与血清Irisin之间的关系。结果 与NGT组相比,GDM组空腹血清Irisin水平明显降低,差异有统计学意义(P<0.05)。空腹血清Irisin与HOMA-β及高密度脂蛋白呈正相关,与孕前体重指数(BMI)及空腹血糖、1小时血糖、2小时血糖、空腹C肽、HOMA-IR、三酰甘油、极低密度脂蛋白呈负相关。空腹血糖为空腹血清Irisin的独立影响因素。结论 GDM妇女血清Irisin水平下降,与胰岛β细胞功能正相关,和胰岛素抵抗有关,可能参与了GDM的发生发展过程。     

脂多糖诱导2型糖尿病大鼠模型的建立

目的：探讨通过单一皮下注射脂多糖（LPS）诱导产生慢性炎症的方法建立2型糖尿病（T2DM）大鼠模型的可行性。方法将30只雄性 Wistar 大鼠分成对照组（n＝10）和造模组（n＝20）。造模组以 LPS（300μg·kg－1·d－1）皮下注射8周,对照组予以皮下注射等容量生理盐水。每周对大鼠一般情况、体质量、空腹血糖进行监测,8周后对两组大鼠血清中肿瘤坏死因子-α（TNF-α）、IL-1、IL-6、单核细胞趋化蛋白-1（MCP-1）及空腹胰岛素（FINS）进行测定,另外进行口服糖耐量试验（OGTT）和胰岛素释放试验（IRT）。以空腹血糖大于或等于1．1 mmol／L 为造模成功。结果第6周开始 T2DM 造模组大鼠血糖显著高于对照组（P ＜0．05）,达到 T2DM 大鼠模型的成模标准。与对照组比较,造模组大鼠血清中 TNF-α、IL-1、IL-6、MCP-1、FINS 水平均显著升高,差异有统计学意义（P ＜0．05）;OGTT 试验,造模组血糖水平高于对照组,胰岛素峰值低于对照组,（P ＜0．05）。结论通过皮下注射小剂量 LPS 成功地建立了 T2DM 大鼠模型,为糖尿病的病因研究提供了一定的帮助。     

地特胰岛素联合格列美脲对2型糖尿病的疗效观察

目的探讨地特胰岛素联合格列美脲治疗2型糖尿病的临床疗效。方法选取2011年3月～2012年3月我院收治住院的诊断为2型糖尿病的患者70例,将其随机分为观察组和对照组,各35例,观察组采用地特胰岛素（Det）联合格列美脲治疗,对照组采用中性低精蛋白锌人胰岛素（NPH）联合格列美脲治疗,均治疗6个月,监测两组治疗前后体重、空腹血糖（FBG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）、体质量指数（BMI）的变化,记录血糖达标时间、低血糖发生率及胰岛素用量,计算胰岛B细胞功能（Homa-B）和胰岛素抵抗（Homa-IR）。结果治疗前两组患者的FBG、2 h PG、HbA1c、BMI及Homa-B和Homa-IR差异均无统计学意义（P〉0.05）;治疗后两组FBG、2 h PG及HbA1c均明显下降,治疗前后差异有统计学意义（P〈0.05）;观察组BMI下降较对照组明显,差异有统计学意义（P〈0.05）。观察组血糖达标时间、低血糖发生率及胰岛素用量均低于对照组,差异有高度统计学意义（P〈0.01）。结论与中性低精蛋白锌人胰岛素相比,地特胰岛素治疗2型糖尿病疗效更显著,低血糖发生率较低,能较好地控制患者体重,方法简单易行、安全有效,值得临床推广应用。     

妊娠期糖耐量试验对妊娠糖尿病的临床意义

目的:探讨妊娠糖尿病(GDM)孕妇妊娠期口服糖耐量试验(OGTT)的价值。方法:对2008年5月～2010年5月产前检查孕24～34周经口服50g葡萄糖筛查1小时血糖>7.8mmol/L的孕妇进行OGTT试验。结果:孕24～28周与孕30～34周两组比较,50g糖筛查率差异无统计学意义(P>0.05),OGTT异常率、GDM率差异有统计学意义(P<0.05)。结论:口服糖耐量试验可用于确诊妊娠糖尿病,了解血糖波动范围,分析妊娠糖尿病稳定程度。     

冠心病患者并发Ⅱ型糖尿病所占比例的胰岛素水平分析

目的探讨冠心病(CHD)患者中,发生Ⅱ型糖尿病(NIDDM)的比例及其临床意义.方法用放射免疫分析法检测166例临床已确诊为冠心病患者和24例健康者的空腹及餐后2 h血胰岛素水平,根据病史、症状、血糖及胰岛素的水平,将166例冠心病患者划分为冠心病合并Ⅱ型糖尿病(CHD合并NIDDM)组和冠心炳未合并Ⅱ型糖尿病组(CHD未合并NIDDM).结果100例CHD合并NIDDM组空腹及餐后2 h的血胰岛素水平都极显著高于对照组(P＜0.01).Ⅱ型糖尿病患者所占的比例达60.4%.66例CHD未合并NIDDM组空腹及餐后胰岛素水平亦明显高于对照组(P＜0.01).结论在冠心病患者中存在高血胰岛素血症,但以合并Ⅱ型糖尿病所占比例为明显较高.检测血胰岛素,对冠心病患者合并糖尿病的预防、诊断、疗效评估均有重要的临床意义.