Shaerhetihan Kulixila*, Jing Hu, Jianfang Huang
Department of Outpatient Comprehensive Treatment Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830000, China
Introduction: To clarify the value of combined detection of glycosylated hemoglobin (HbA1c), C-peptide (CP) and insulin (INS) in evaluating disease progression of elderly type 2 diabetes mellitus (T2DM) patients.
Materials and methods: A total of 126 T2DM patients receiving treatment in our hospital from January 2019 to January 2021 were chosen. All patients were divided into groups I, II, II and IV according to disease course. Disease course in group I was within one year, with 32 cases in total; disease course in group II was 1-5 years, with 32 cases in total; disease course in group III was 6-10 years, with 32 cases in total, and that in group IV was over 10 years, with 30 cases in total. All participants received treatment with regular diet and hypoglycemic drugs during hospitalization. After their blood glucose level stabilized, they fasted at 22:00 on the same day, and took fasting elbow vein blood in the morning of the next day. Fasting blood glucose (FBG), fasting CP and fasting INS (FINS) were measured. CP level and area under CP curve (CPAUC) in four groups in different periods of taking glucose were analyzed. FBG, FINS, homeostasis model assessment-β (HOMA-β), homeostasis model assessment for INS resistance (HOMA-IR) and homeostasis model assessment for INS sensitivity index (HOMA-IS) in four groups were observed and compared.
Results: HbA1c and FINS levels in diabetic group presented elevation relative to those in control group; FBG and 2 h blood glucose (2 hBG) levels in diabetic group were better relative to those in control group; serum CP level in diabetic group presented depletion relative to that in control group; the more severe the disease was, the more obvious the difference was, with statistical significance (P<0.05). FBG, FINS and HOMA-β levels in groups II, III and IV presented elevation relative to those in group I (P<0.05). FBG, FINS and HOMA-β levels in groups II, III presented depletion relative to those in group IV (P<0.05). Logistic regression analysis depicted that HbA1c, CP and INS levels were influencing factors of diabetes (P<0.05). ROC curve depicted that the AUC of HbA1c, CP and INS in the combined detection of T2DM was 0.918 (95% CI: 0.848-0.963), which was superior to that of HbA1c, CP and INS alone (P<0.05). FBG, 2 hBG and HbAlc levels in HbA1c/CP/INS-positive patients presented elevation relative to those in negative patients (P<0.05).
Conclusion: The lower the serum CP level, the higher the Hb1Ac level. Moreover, there are persistent impairment of islet β secretory function and INS resistance. It is necessary to take timely therapeutic measures to facilitate INS secretion and attenuate INS resistance.
Type 2 diabetes mellitus, glycosylated hemoglobin, C-peptide, insulin.