Improved insulin sensitivity in carbohydrate and lipid metabolism after physical training

To estimate physical training effects quantitatively, the relationship between tissue sensitivity to exogenous insulin (glucose metabolism determined by euglycemic insulin-clamp technique) and maximal oxygen uptake (VO2 max) was defined in 9 well-trained athletes and 14 untrained subjects with normal glucose tolerance. Tissue sensitivity to exogenous insulin in the athletes was significantly higher than in the controls (P less than 0.001). Seven untrained subjects continued the physical exercise program. After physical training for 1 month, glucose metabolism increased from 40.3 +/- 3.9 mumol/kg/min to 42.2 +/- 4.4 mumol/kg/min (P less than 0.05) and VO2 max also increased significantly (P less than 0.05). During euglycemic hyperinsulinemia, both plasma FFA (P less than 0.001) and glycerol (P less than 0.05) decreased rapidly after physical training. Glucose metabolism directly correlated with VO2 max (P less than 0.001). These results suggest that the euglycemic insulin-clamp technique provides a reliable estimate of training effects, tissue sensitivity to physiologic hyperinsulinemia is 46% higher in trained athletes, and physical training improves insulin sensitivity not only in glucose metabolism but also in lipid metabolism.     

Suicide by combined insulin and glipizide overdose in a non-insulin dependent diabetes mellitus physician: a case report

A case of self-injected insulin intoxication with an oral hypoglycaemic agent glipizide overdose in a type-II/non-insulin dependent diabetes mellitus (NIDDM) individual, a physician by profession, is presented with a review of the literature. The case demonstrates the need for thorough scene investigation, perusal of clinical details and complete autopsy to certify the death caused by combined insulin and glipizide overdose, and the manner of death. A meticulous search in the English literature reveals that hardly any fatal cases of combined insulin and glipizide overdose have been reported, with almost no cases from India, thus making this case report relevant and unique.     

Effects of exercise training on insulin response to intravenous glucose in pubertal rats.

This study was undertaken to evaluate the effects of exercise training on glucose tolerance and glucose-stimulated insulin response (GSIR) in 55- and 90-day-old peripubertal female rats. Intravenous glucose tolerance tests (0.5 g/kg) were done in: 1) 90-day-old rats exercised in swimming sessions for either 5 or 10 weeks and evaluated 48 h after the last exercise bout; 2) 55-day-old rats exercised for 5 weeks and evaluated either 24 h or 48 h after the last exercise bout and; 3) unexercised 55- and 90-day-old rats. The total area under the GSIR curve was suppressed in 55- and 90-day-old rats exercised since the age of 21 days. However, this decrease was observed 48 and only 24 h after the last exercise bout in the 90- and 55-day-old rats respectively. Exercise did not affect the GSIR curve for the 90-day-old rats subjected to 5 weeks of exercise training (started at 55 days of age) when evaluated 48 h after the last exercise bout. Nor did one single bout of swimming exercise (2 h) in the last 24 h affect the GSIR in unexercised 55-day-old rats. These results suggest that the shorter duration of the residual effects of exercise in the younger rats (55 days) was related to the shorter length of the training programme. Body weight was not significantly reduced with exercise in 55-day-old rats, whereas the same amount of exercise in 90-day-old rats caused body weight reduction of approximately 35 g (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Insulin sensitivity of protein and glucose metabolism in overweight female adolescents with type 1 diabetes mellitus: positive modulation by physical exercise

Abstract Impairment of insulin sensitivity of glucose metabolism, a prominent feature of type 1 diabetes (DM), is also well documented in adolescence and obesity. Overweight is frequently present during adolescence in females. Spurt in growth is significantly reduced during puberty in females with type 1 DM, while it is normal in males. In this study we assessed the effect of the coexistence of type 1 DM, adolescence, overweight, and their possible interference with growth. Moreover, we evaluated whether dietetic control associated with physical exercise improved insulin sensitivity in adolescence. The study enrolled 11 female adolescents and young adults (aged 18.5±0.6 years), affected by type 1 DM for 8.3±0.9 years, who were overweight (BMI, 27.3±0.8 kg/m²) and receiving conventional insulin therapy (0.78±0.10 U/kg day). We used the euglycemic hyperinsulinemic clamp technique coupled to [²H₂]glucose and [¹³C]leucine infusion. The results show a striking increase in insulin resistance of glucose metabolism: the suppression of endogenous glucose production (EGP) was 59% in comparison to 90%–100% recorded by others at similar insulin levels in subjects at different periods of life. Insulin resistance in type 1 DM overweight adolescents was also present on protein metabolism: the postabsorptive plasma leucine (146.9±10.1 M) and the endogenous leucine flux (ELF, 88.8±4.5 µmol/kg min) were higher than in healthy controls. The suppression of ELF during hyperinsulinemia was defective in diabetic adolescents (27%, p<0.001) with respect to controls (36%). Only three of the 11 overweight diabetic subjects completed the 6-month physical exercise and diet program, and showed improvement of insulin sensitivity at the final evaluation. The EGP suppression by insulin shifted from 41% to 79%; ELF suppression increased from 26% to 34%. All the parameters of glucose metabolism correlated with the weight loss (BMI reduction from 27.8±1.9 to 25.6±1.2 kg/m²). In conclusion, overweight female adolescents with type 1 DM have an impaired insulin action on glucose and protein metabolism. Physical exercise and correct dietary regimen positively influence insulin sensitivity. The present preliminary data are relevant for an improved control of glucose homeostasis and a normal growth in adolescence.     

Exercise-induced alterations in muscle lipid metabolism improve insulin sensitivity

Exercise is a key component for the successful management of many obesity-related metabolic complications, including insulin resistance. This review addresses the effect of chronic and acute endurance exercise on insulin action in obesity and the role of exercise-induced alterations in fatty acid partitioning within the muscle cell on insulin sensitivity.     

Adiponectin oligomers in human serum during acute and chronic exercise: relation to lipid metabolism and insulin sensitivity

Beneficial effects of physical exercise include improved insulin sensitivity, which may be affected by a modulated release of adiponectin, which is exclusively synthesized in white adipose tissue and mediates insulin sensitivity. Adiponectin circulates in three different oligomers, which also have a distinct biological function. We therefore aimed to investigate the distribution of adiponectin oligomers in human serum in relation to physical activity. Thirty-eight lean and healthy individuals were investigated. Seven healthy women and 8 healthy men volunteered to investigate the effect of chronic exercise, at 3 different time points with different training intensities. These individuals were all highly trained and were compared to a control group with low physical activity (n = 15). For studying acute exercise effects, 8 healthy men participated in a bicycle test. Adiponectin was determined by ELISA, oligomers were detected by non-denaturating western blot. Total adiponectin and oligomers were unchanged by acute exercise. LDL cholesterol was significantly lower in the chronic exercise group (p = 0.03). Total adiponectin levels and oligomers were not different between these two groups and were unaltered by different training intensities. However, total adiponectin and specifically HMW oligomers correlated with HDL cholesterol (r = 0.459; p = 0.009). We conclude that acute and chronic exercise does not directly affect circulating adiponectin or oligomer distribution in lean and healthy individuals. Whether such regulation is relevant in individuals with a metabolic disorder remains to be determined. However, our data suggest that adiponectin oligomers have distinct physiological functions IN VIVO, and specifically HMW adiponectin is closely correlated with HDL cholesterol.     

Endurance training and obesity: effect on substrate metabolism and insulin sensitivity

PURPOSE: Obesity and type 2 diabetes mellitus are disease states associated with hallmark features such as insulin resistance and an impaired ability to oxidize lipids. It has recently been reported that an optimal exercise intensity for fat oxidation (FATmax) exists; we hypothesize that continuous exercise training at this specific intensity can lead to greater improvements in fat oxidation and insulin sensitivity than a eucaloric interval training program. METHODS: In a counterbalanced, crossover design, eight sedentary, obese, but otherwise healthy male participants performed two 4-wk blocks of endurance training, either at a predetermined intensity eliciting maximal fat oxidation (TPCON) or at 5-min intervals of +/- 20% FATmax (TPINT). During the week preceding the exercise training and 48 h after the final exercise bout, an OGTT, V O2max test, steady-state exercise, and measurements of body composition were undertaken. Diet was controlled the day before all trials (50% carbohydrate, 35% fat, and 15% protein; approximately 2900 kcal.d). Variables were compared using two-way repeated-measures analyses of variance. RESULTS: It was shown that fat oxidation rates were increased by 44% after TPCON (0.24 +/- 0.01 vs 0.35 +/- 0.03 g.min, P < 0.05) but not after TPINT, and the whole-body insulin sensitivity index was increased by 27% after TPCON (P < 0.05). These changes occurred despite no change in body weight, body mass index (BMI), waist to hip ratio (WHR), percent body fat (%BF), or V O2max. CONCLUSIONS: A continuous exercise training protocol that can elicit high rates of fat oxidation increases the contribution of fat to substrate oxidation during exercise and can significantly increase insulin sensitivity compared with a eucaloric interval protocol.     

Acute exercise: fuel homeostasis and glucose transport in insulin-dependent diabetes mellitus

Fuel homeostasis and blood glucose levels are remarkably well maintained during exercise in healthy individuals. However, in insulin-dependent diabetics, the very basis for fuel homeostasis adjustments, i.e., a normal endogenous insulin production, is absent. The metabolic alterations characterizing diabetes may, therefore, under certain circumstances lead to pertubations of fuel homeostasis. Thus, exercise in the hyperinsulinemic patients may result in hypoglycemic reactions and, in hypoinsulinemic patients, in increased blood glucose levels. In addition, diabetes mellitus is associated with peripheral insulin resistance, which may result in a deterioration of the overall glucose homeostasis and consequently make the treatment more difficult to manage. Regular physical activity has been shown to normalize the peripheral insulin resistance in insulin-dependent diabetics. Knowledge about these responses is important in order to enable this patient group to participate in physical activities on the same conditions as non-diabetics. However, advice on how insulin-dependent diabetics should adjust insulin or diet before exercise is difficult to give due to high interindividual variability in response to exercise. Thus, individualized recommendations for exact treatment modification in association with exercise are necessary.     

替米沙坦对老年2型糖尿病合并高血压患者糖脂代谢及胰岛素敏感性的影响

 目的 探讨血管紧张素受体拮抗药替米沙坦对老年2型糖尿病合并高血压患者糖脂代谢及胰岛素敏感性的作用.方法 48例老年2型糖尿病合并高血压患者按体重指数(body mass index,BMI)分为非肥胖组和肥胖组.每位患者每天空腹口服80 mg替米沙坦,共24周.测定治疗前后BMI、腰臀比(waist-to-hip ratio,WHR)、胰岛素、血糖、血脂、血压、肝功能、肾功能、血管紧张素Ⅱ,计算稳态模型胰岛素抵抗指数(HOMA-IR).结果 替米沙坦治疗前,与非肥胖组相比,肥胖组收缩压(SBP)、舒张压(DBP)、三酰甘油(triglyceride,TG)、胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,LDL-C)、空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素值(fasting insulin,FINS)、HOMA指数(homeostasis model assessment - insulin resistance index,HOMA-IR)和血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)均升高,差异有统计学意义(P<005).非肥胖组替米沙坦治疗后,SBP、FINS、HOMA-IR水平与治疗前相比均下降,ANGⅡ水平升高,差异有统计学意义.肥胖组替米沙坦治疗后,SBP、DBP、TG、TC、FPG、FINS、HOMA-IR水平与治疗前相比均下降,差异有统计学意义(P<005).结论 替米沙坦能够有效降低老年2型糖尿病合并高血压患者的血压,明显改善其糖、脂代谢状态,增强机体对胰岛素的敏感性.     

非胰岛素依赖型糖尿病患者骨密度变化的探讨

目的 研究非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者的骨密度变化,以了解ＮＩＤＤＭ患者是否易合并骨质疏松及其特点。方法 采用双能Ｘ线骨密度仪（简称为ＤＸＡ）,４８例ＮＩＤＤＭ患者及３５例３０￣３５岁正常人腰椎正侧位、髋部及全身骨密度。病例选择是根据１９８５年世界卫生组织（ＷＨＯ）糖尿病专家委员会提出的诊断和分型标准,结果均经统计学处理分析。结果 ４８例ＮＩＤＤＭ患者的骨密度都有不同程度下降,按ＳＨＯ推     

HDL atheroprotection by aerobic exercise training in type 2 diabetes mellitus

PURPOSE: In this study we analyzed the role played by aerobic exercise training in the plasma lipoprotein profile, prebeta 1-HDL concentration, and in the in vitro HDL3 ability to remove cholesterol from macrophages and inhibit LDL oxidation in type 2 diabetes mellitus (DM) patients and control subjects, in the fasting and postprandial states. METHODS: Healthy controls (HTC, N = 11; 1 M/10 F) and subjects with type 2 diabetes mellitus (DMT, N = 11; 3M/8F) were engaged in a 4-month aerobic training program, and compared with a group of sedentary subjects with type 2 diabetes mellitus (DMS, N = 10; 4 M/6 F). All groups were submitted to an oral fat load test to analyze all parameters, both at the beginning of the investigation protocol (basal) and at the end of the study period (final). RESULTS: Exercising did not modify body weight, BMI, plasma concentrations of total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides (TG), glucose, insulin, or HOMA-IR, but it reduced the waist circumference. The HDL3 composition did not change, and its ability to remove cell cholesterol was unaltered by aerobic training. In DMT but not in HTC, aerobic training improved 15% the HDL3 protective effect against LDL maximal oxidation rate in the fasting state, and reduced 24% the plasma prebeta 1-HDL concentration in the postprandial state, suggesting an enhanced prebeta 1-HDL conversion into larger, more mature HDL particles. In this regard, regular aerobic exercise enriched HDL2 with TG in the fasting and postprandial states in HTC and in the fasting phase in DMT. CONCLUSION: Our results show that aerobic exercise training in diabetes mellitus improves the HDL efficiency against LDL oxidation and favors HDL maturation. These findings were independent of changes in insulin resistance and of the rise of plasma HDL cholesterol concentration.     

Aerobic exercise training improves the role of high-density lipoprotein antioxidant and reduces plasma lipid peroxidation in type 2 diabetes mellitus

In this study, we analyzed the effect of aerobic exercise training (AET) and of a single bout of exercise on plasma oxidative stress and on antioxidant defenses in type 2 diabetes mellitus (DM) and in healthy control subjects (C). DM and C did not differ regarding triglycerides, high-density lipoprotein cholesterol (HDL-c), insulin, and HOMA index at baseline and after AET. To measure the lag time for low-density lipoprotein (LDL) oxidation (LAG) and the maximal rate of conjugated diene formation (MCD), participants' plasma HDL(2) and HDL(3) were incubated with LDL from pooled healthy donors' plasma. In the presence of HDL(3), both LAG and MCD were similar in C and DM, but only in DM did AET improve LAG and reduce MCD. In the presence of HDL(2), the lower baseline LAG in DM equaled C after AET. MCD was unchanged in DM after AET, but was lower than C only after AET. Furthermore, after AET plasma thiobarbituric acid-reactive substances were reduced only in DM subjects. Despite not modifying the total plasma antioxidant status and serum paraoxonase-1 activity in both groups, AET lowered the plasma lipid peroxides, corrected the HDL(2), and improved the HDL(3) antioxidant efficiency in DM independent of the changes in blood glucose, insulin, and plasma HDL concentration and composition.     

维生素C改善Ⅱ型糖尿病内皮依赖性血管舒张功能

目的：探讨维生素C对Ⅱ型糖尿病（non—insulin dependent diabetes，NIDD）患者血管内皮功能的保护作用。方法：选择新诊断的NIDD患者30例，随机分为2组（各15例），一组采用饮食、运动及胰岛素治疗（胰岛素组）。另一组在胰岛素组基础上加用维生素C 0．1，3／d（维生素C组）。治疗6个月。同期，选择14例健康个体作为对照。采用血管外超声法检测肱动脉血流介导的内皮依赖性血管舒展功能（EDD）和硝酸甘油（GNT）介导的内皮非依赖性血管舒展功能。结果：与对照组相比，NIDD患者治疗前空腹血糖（FPG）、2h血糖（2hPG）、胆固醇（TC）、三酯酰甘油（TG）明显增高（P〈0．05），且低密度脂蛋白胆固醇（LDL—C）亦明显增高（P〈0．05），而高密度脂蛋白胆固醇（HDL—C）明显降低（P〈0．05），同时伴随EDD明显降低（P〈0．05）。不论在维生素C组还是在胰岛素组，与治疗前比较，治疗后HbA1c、FPG、2hPG、TC、TG、LDL—C水平明显降低（P〈0．05），同时伴随EDD明显改善（P〈0．01），维生素C组治疗后EDD明显高于胰岛素组治疗后（P〈0．05）。结论：维生素C明显改善NIDD患者血管内皮功能。     

Effects of resistance training on insulin sensitivity in overweight Latino adolescent males

PURPOSE: Insulin resistance is thought to be a core defect in the pathophysiology of obesity-related comorbidities in children, such as type 2 diabetes. Exercise training is known to improve insulin resistance and reduce the risk of type 2 diabetes in adults. However, very little is known regarding the effects of exercise on insulin resistance in youth. Therefore, we examined the effects of a 16-wk resistance training exercise intervention on insulin sensitivity in youth at high risk for developing type 2 diabetes. METHODS: Twenty-two overweight Latino adolescent males were randomly assigned to either a twice-per-week resistance training group (RT=11) or a nonexercising control group (C=11) for 16 wk. Strength was assessed by one-repetition maximum, body composition was quantified by dual-energy x-ray absorptiometry, and insulin sensitivity was determined by the frequently sampled intravenous glucose tolerance test with minimal modeling. RESULTS: Significant increases in upper- and lower-body strength were observed in the RT compared with the C group. The RT group significantly increased insulin sensitivity compared with the C group (P<0.05), and this increase remained significant after adjustment for changes in total fat mass and total lean tissue mass (P<0.05). Compared with baseline values, insulin sensitivity increased 45.1+/-7.3% in the RT group versus -0.9+/-12.9% in controls (P<0.01). CONCLUSION: A twice-per-week 16-wk resistance training program can significantly increase insulin sensitivity in overweight Latino adolescent males independent of changes in body composition.     

Influence of diabetes mellitus on regional cerebral glucose metabolism and regional cerebral blood flow

Previous studies have shown both increased and decreased regional cerebral glucose metabolism-blood flow (rMRGlu-rCBF) values in diabetes. We sought to elucidate the influence of diabetes on rMRGlu-rCBF in 57 patients with pure cerebral microangiopathy. Sixteen of 57 patients had diabetes requiring therapy (11 NIDDM, 5 IDDM). Using a special head-holder for exact repositioning, rMRGlu (PET) and rCBF (SPET) were imaged and measured in slices, followed by MRI. White matter and cortex were defined within regions of interest taken topographically from MRI (overlay). Diabetic and non-diabetic microangiopathy patients were compared to 19 age-matched controls. The diabetic patients showed significantly lower rMRGlu-rCBF values in all regions than controls, whereas non-diabetic patients did not. There were no significant NIDDM-IDDM differences. rMRGlu-rCBF did not depend on venous blood glucose levels at the time of the PET examination. However, analysis of variance with the factors diabetes, atrophy and morphological severity of microangiopathy showed that lowered rMRGlu-rCBF in the diabetic group was due to concomitant atrophy only (P < 0.005), while neither diabetes nor microangiopathy had any influence on rMRGlu-rCBF (all P > 0.2). These results were confirmed by multivariate factor analysis. It can thus be concluded that a supposed decrease in rMRGlu-rCBF in diabetes mellitus is in fact only an artefact produced by the concomitant atrophy. All previous studies failed to correct for atrophy, and a critical reappraisal is required.     

Weight loss and exercise: implications for muscle lipid metabolism and insulin action

Implications for Muscle Lipid Metabolism and An accumulation of intramuscular lipid has been reported with obesity and linked with insulin resistance. The purpose of this paper is to discuss: 1) mechanisms that may be responsible for intramuscular lipid accumulation with obesity, and 2) the effects of common interventions (weight loss or exercise) for obesity on skeletal muscle lipid metabolism and intramuscular lipid content. Data suggest that the skeletal muscle of morbidly obese humans is characterized by the preferential partitioning of lipid toward storage rather than oxidation. This phenotype may, in part, contribute to increased lipid deposition in both muscle and adipose tissue, and promote the development of morbid obesity and insulin resistance. Weight loss intervention decreases intramuscular lipid content, which may contribute to improved insulin action. On the other hand, exercise training improves insulin action and increases fatty acid oxidation in the skeletal muscle of obese/morbidly obese individuals. In summary, the accumulation of intramuscular lipid appears to be detrimental in terms of inducing insulin resistance; however, the accumulation of lipid can be reversed with weight loss. The mechanism(s) by which exercise enhances insulin action remains to be determined.     

Effects of tennis training on lipid metabolism and lipoproteins in recreational players.

OBJECTIVE: To investigate the short term effects of tennis training on lipid metabolism and to find out if a typical tennis training programme has positive longitudinal effects on cardiovascular risk factors in recreational players. METHODS: The experimental design consisted of an exercise study and a subsequent longitudinal study. In the exercise study the short term metabolic effects of a two hour technically orientated tennis training (TT) session and a running intensive tennis training (RIT) session were investigated in 16 recreational tennis players (eight men: 46 (SD 7) years, 177 (6) cm, 81 (10) kg; and eight women: 44 (5) years, 165 (5) cm, 64 (6) kg). In the longitudinal study the long term effects of a six week RIT programme in 22 players (11 men and 11 women) of similar characteristics were compared with those in 16 control subjects (eight men and eight women). The results of the exercise study (higher lipolytic activity and cardiopulmonary demand, as well as acceptance by the players) led to the RIT method being chosen for all training sessions in the longitudinal study. RESULTS: In RIT, significantly higher values for heart rate (148 (SD 10) v 124 (11) beats/minute) and lactate (2.8 (1.1) v 1.5 (0.6) mmol/l), significantly higher post exercise concentrations of serum glycerol (0.37 (0.15) v 0.29 (0.14) mmol/l) and high density lipoprotein cholesterol (1.31 (0.55) v 1.20 (0.50) mmol/l) and a higher acceptance than in TT (15 of the 16 players preferred RIT) were found. During the six week tennis training programme the changes in body weight (-1.41 (1.56) v 0.00 (1.50) kg) and anaerobic threshold (1.04 (0.84) v -0.08 (0.92) km/h) were significantly different between the training and control group. In the training group several parameters of the lipoprotein profile tended to change in an antiatherosclerotic direction. CONCLUSIONS: The results indicate that typical regular tennis training influences cardiovascular risk factors in a positive manner and can be suggested as an attractive alternative to other current health orientated sports programmes. A more frequent use of running intensive exercises during tennis training is recommended.     

Overview of diabetes mellitus and exercise

Diabetes mellitus is a common chronic disorder the primary therapeutic principles of which have long been based on the combination of physical activity with appropriate diet. Although exercise in insulin-dependent diabetes mellitus (IDDM) may be associated with metabolic deterioration in the case of lack of adequate provision of insulin and carbohydrate in balanced amounts, the beneficial effects of exercise in diabetes are numerous. Exercise facilitates the utilization of glucose as the main source of energy for contracting muscles and decreases peripheral insulin resistance. Limited epidemiological studies have demonstrated that lack of physical activity may be involved in the epidemic outburst of non-insulin-dependent diabetes mellitus (NIDDM) in some unusual populations. Long-term studies are still needed to show that lifelong physical training and exercise reduce morbidity and mortality in diabetes.     

对罗格列酮联合胰岛素治疗2型糖尿病的评价

目的:观察罗格列酮对2型糖尿病(type 2diabetesmellitus ,T2DM)患者胰岛素治疗时的胰岛素用量,及其对血清尿酸水平、白细胞计数的影响。方法:磺脲类药物继发失效的T2DM患者80例,分为罗格列酮联合胰岛素治疗组(A组)和单纯胰岛素治疗组(B组)。观察两组治疗前后空腹血糖、餐后2h血糖、血尿酸水平、白细胞计数,及治疗12周后全天胰岛素用量。结果:A组和B组能同样有效地降低血糖,但A组胰岛素用量低于B组(2 2 .9±5 .3)U比(2 6 .4±6 .8)U ,P <0 .0 5 ,治疗后A组尿酸水平显著下降,由治疗前的(2 71.4±10 7.2 ) μmol/L降为(2 2 3.1±78.5 ) μmol/L ,P <0 .0 5 ,同时其白细胞计数的对数值亦显著降低(9.6 3±0 .0 9)比(9.72±0 .13) ,P <0 .0 1。结论:罗格列酮能减少T2DM患者胰岛素治疗时胰岛素用量,同时降低其血清尿酸水平和白细胞计数;提示罗格列酮在减少T2DM患者胰岛素使用量的同时,对体内炎性反应有一定的改善作用。