Kong De-Xian, Xiao Yan-Xin, Zhang Zhen-Xi, Liu Ya-Bin
De-Xian Kong, Department of Endocrinology, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China.
Yan-xin Xiao, Department of Endocrinology, Baoding No.1 Central Hospital, Baoding, Hebei, 071000, P.R. China.
Pak J Med Sci. 2020 Nov-Dec;36(7):1523-1528. doi: 10.12669/pjms.36.7.3027.
To observe the changes of lipid metabolism, blood glucose level and insulin sensitivity in patients with Type-2 diabetes after progressive weight loss of their body weight, so as to lay a theoretical foundation for diabetes treatment and education in the future.
One hundred obese patients with Type-2 diabetes (BMI ≥ 25 kg/m) who visited the endocrinology department of our hospital from April 2017 to April 2018 were given diabetes health education, diabetic diet, exercise and other measures to control their weight. The changes of blood glucose, blood lipid, insulin level and insulin release test before weight loss (T1), and at the time points of weight loss reached 5% (T2), 10% (T3) and 15% (T4) were recorded respectively to understand the influence of progressive weight loss on relevant indexes of patients.
With the decrease of body weight, the differences of TC, TG, LDL-C and HDL-C at different weight loss points were significant (p < 0.05), and the changes of fasting blood glucose in 5% and 10% weight loss were significant (p = 0.02). The 2h postprandial blood glucose showed the most significant difference when the weight loss reached 15% (p = 0.00). There was no statistical difference in the change of glycosylated hemoglobin among different weight loss points (p = 0.08). When the weight loss reached 10%, the blood insulin level was significantly lower than that before the weight loss, while the insulin level was not significantly changed when the weight loss reached 15%, but the peak of secretion was shifted forward. It is suggested that insulin sensitivity gradually increases with weight loss.
Obese patients with Type-2 diabetes can benefit from weight loss, with abnormal blood glucose and lipid metabolism improved, insulin resistance relieved, and insulin sensitivity increased.
观察2型糖尿病患者体重逐步减轻后脂质代谢、血糖水平及胰岛素敏感性的变化,为今后糖尿病的治疗和教育奠定理论基础。
选取2017年4月至2018年4月来我院内分泌科就诊的100例肥胖2型糖尿病患者(BMI≥25kg/m),给予糖尿病健康教育、糖尿病饮食、运动等措施控制体重。分别记录体重减轻前(T1)、体重减轻达5%(T2)、10%(T3)和15%(T4)时的血糖、血脂、胰岛素水平及胰岛素释放试验的变化,了解体重逐步减轻对患者相关指标的影响。
随着体重的下降,不同体重减轻点的TC、TG、LDL-C和HDL-C差异有统计学意义(p<0.05),体重减轻5%和10%时空腹血糖变化有统计学意义(p=0.02)。体重减轻达15%时餐后2h血糖差异最显著(p=0.00)。不同体重减轻点糖化血红蛋白变化无统计学差异(p=0.08)。体重减轻达10%时血胰岛素水平显著低于体重减轻前,体重减轻达15%时胰岛素水平无显著变化,但分泌高峰提前。提示胰岛素敏感性随体重减轻逐渐增加。
肥胖2型糖尿病患者体重减轻有益,血糖和脂质代谢异常改善,胰岛素抵抗减轻,胰岛素敏感性增加。