Association between glucose-lowering drugs and circulating insulin antibodies induced by insulin therapy in patients with type 2 diabetes

BACKGROUND Insulin antibodies(IAs)affect blood glucose control in patients receiving insulin therapy.AIM To investigate the relationship between different hypoglycemic treatments and IAs in patients with type 2 diabetes mellitus(T2DM).METHODS This cross-sectional,retrospective study included 1863 patients with T2DM who were receiving exogenous insulin therapy.All patients received stable antidiabetic therapy in the last 3 months and IA levels were measured using an iodine-125 array.RESULTS A total of 1863 patients were enrolled.There were 902(48.4%)patients who had positive IAs(IA level>5%),with a mean IA level of 11.06%(10.39%-11.72%).IA levels were positively correlated with high fasting blood glucose(odds ratio=1.069,P<0.001).The proportion of positive IAs was lowest in patients using glargine only(31.9%)and highest in patients using human insulin only(70.3%),P<0.001.The IA levels in patients using sulfonylureas/glinides(8.3%),metformin(9.6%),and dipeptidyl peptidase-4 inhibitors(8.2%)were all lower than in patients without these drugs(all P<0.05).CONCLUSION Nearly half of patients on insulin therapy have positive IA antibodies,and IA antibody levels are associated with blood glucose control.Insulin glargine and a combination of oral glucose-lowering drugs were correlated with lower IA levels.

Effect of low-frequency electroacupuncture on pancreatic endocrine system in patients with simple obesity

Objective： To observe different efficacies of low-frequency electroacupuncture（EA） on pancreatic endocrine system in male and female patients with simple obesity due to spleen deficiency-related dampness. Methods： A total of 80 simple obesity patients were assigned to a male group（n=37） and a female group（n=43）. Both groups received a 30-minute low-frequency EA at Yinlingquan（SP 9）, Sanyinjiao（SP 6）, Zusanli（ST 36）, Fenglong（ST 40）, Quchi（LI 11）, Tianshu（ST 25）, Zhongwan（CV 12）, Shuifen（CV 9）, Qihai（CV 6） and Guanyuan（CV 4）. The treatment was done once a day, and 10 times made up a course of treatment. Patients in both groups were treated for 2 courses. Then the changes in body mass index（BMI）, serum insulin, insulin antibodies and leptin level in the two groups were observed and analyzed. Results： After treatment, the BMI, serum insulin, insulin antibodies and leptin levels were significantly reduced in both groups（P〈0.01 or P〈0.05）; the BMI and serum insulin concentration were more significantly reduced in the male group than those in the female group（both P〈0.01）; and the leptin level was more significantly reduced in the female group than that in the male group（P〈0.01）. Conclusion： EA can significantly regulate BMI and pancreatic endocrine system in both men and women with simple obesity; however, there is a gender difference： better effect for men in reducing BMI and serum insulin and better effect for women in reducing serum leptin level.