JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2014, Vol. 52 ›› Issue (8): 63-67.doi: 10.6040/j.issn.1671-7554.0.2013.730

Previous Articles     Next Articles

Difference of daily blood glucose profiles in hepatogenous diabetes and type 2 diabetes mellitus

XIAN Yuxin, SUN Ruixia, LI Li, LYU Wenshan, CAO Caixia, ZHANG Jietao, WANG Jing, GAO Yanyan   

  1. Department of Endocrinology and Metabolism, East Campus, The Affiliated Hospital of Qingdao University, Qingdao 266100, Shandong, China
  • Received:2013-12-03 Revised:2014-12-03 Online:2014-08-10 Published:2014-08-10

Abstract: Objective To study the characteristics of daily blood glucose profiles in hepatogenous diabetes (HD). Methods 20 newly diagnosed hepatogenous diabetes (HD group) and 20 newly diagnosed type 2 diabetes mellitus (DM2 group) patients were measured by continuous glucose monitoring system for 72 hours. Results There was no significant difference in the mean blood glucose in the two groups(P>0.05). In HD group, the levels of fasting plasma glucose and 3:00 blood glucose were significantly lower than those of DM2 group, and the levels of 2 h post-breakfast blood glucose(2 hPG) and postprandial glucose spike of breakfast were significantly higher than those of DM2 group (P<0.05). The standard deviation of blood glucose, mean amplitude of glycemic excursions and absolute means of daily difference were significantly higher in HD group than those of DM2 group(P<0.05). There was no significant difference in percentage of time spent in hyperglycemia above 11.1 mmol/L in the two groups(P>0.05); otherwise the area under the curve of postprandial glucose above 10 mmol/L in HD group was significantly higher than that of DM2 group (P<0.05). The level of fasting insulin in HD group was significantly higher than that of DM2 group (P<0.05), while there was no significant difference in the level of fasting C-peptide in the two groups(P>0.05). Conclusions Compared with type 2 diabetes mellitus, the hepatogenous diabetes have lower fasting plasma glucose and higher postprandial blood glucose. The time of postprandial glucose reaching peak is earlier, and the postprandial glucose spike of breakfast is higher than those of lunch and dinner. The daily blood glucose excursion is more obvious in the patients with hepatogenous diabetes.

Key words: Blood glucose excursion, Hepatogenous diabetes, Continuous glucose monitoring system(CGMS)

CLC Number: 

  • R587
[1] Garcia C D, Jaquez Quintana J O, Gonzalez J A, et al. Liver cirrhosis and diabetes, risk factors, pathophysiology, clinical implication and management[J]. World J Gastroentorol, 2009, 15(3):280-288.
[2] El-Serag H B, Tran T, Everhart J E. Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma[J]. Gastroenterology, 2004, 126(2):460-468.
[3] Nishida T, Tsuji S, Tsujii M, et al. Oral glucose tolerance test predicts prognosis of patients with liver cirrhosis[J]. Am J Gastroenterol, 2006, 101(1):70-75.
[4] 姜丽萍,赵金满. 肝源性糖尿病的诊断与治疗[J]. 世界华人消化杂志, 2007, 15(6):617-621.
[5] 中华医学会传染病与寄生虫病学分会、肝病学分会. 病毒性肝炎防治方案[J]. 肝脏,2000, 5(4) :257-262.
[6] Xiao J M, Jie M P, Yu Q B, et al. Combined assessment of glycated albumin and fasting plasma glucose improves the detection of diabetes in Chinese subjects[J]. Clin Exp Pharmacol Physiol, 2010, 37:974-979.
[7] 肖强. 肝源性糖尿病56例临床分析[J].实用肝脏病杂志,2011, 14(1):58-60.
[8] Hung C H, Wang J H, Hu T H, et al. Insulin resistance is associated with hepatocellular carcinoma in chronic hepatitis C infection[J]. World J Gastroenterol, 2010, 16(18):2265-2271.
[9] Roddata D, Rosbach C, Buchwald A, et al. Fasting hyperglucagonemia in patients with intrahepatic portosystemic shunts (TIPs)[J]. Exp Clin Endocrinol Diabetes, 2008, 116(8):461-467.
[10] Jeon H K, Kim M Y, Baik S K, et al. Hepatogenous diabetes in cirrhosis is related to portal pressure and variceal hemorrhage[J]. Dig Dis Sci, 2013, 58(11):3335-3341.
[11] Petta S, Cammà C, Di Marco V, et al. Hepatic steatosis and insulin resistance are associated with severe fibrosis in patients with chronic hepatitis caused by HBV or HCV infection[J]. Liver Int, 2011, 31(4):507-515.
[12] Pazhanivel M, Jayanthi V. Diabetes mellitus and cirrhosis liver[J]. Minerva Gastroenterol Dietol, 2010, 56(1):7-11.
[13] 张萍,杨燕. 肝源性糖尿病的研究现况[J].华中科技大学学报:医学版, 2010, 39(1):136-139.
[14] Kim M G, Choi W C. Differential diagnosis of diabetes mellitus caused by liver cirrhosis and other type 2 diabetes mellitus[J]. Korean J Hepatol, 2006, 12(4):524-529.
[15] Holstein A, Hinze S, Thieben E, et al. Clinical implications of hepatogenous diabetes in liver cirrhosis[J]. J Gastroenterol Hepatol, 2002, 17(6):677-681.
[16] 吴邦富,林丽莉,胡品津.肝硬化患者口服葡萄糖耐量试验的变化[J].实用肝脏病杂志, 2004, 7(1):25-27.
[17] 王先令,陆菊明,潘长玉. 糖耐量低减者和新诊断2型糖尿病者动态血糖谱的特点[J]. 中华医学杂志, 2006, 86(10):674-677.
[18] Petrovski G, Dimitrovski C, Milenkovic T. Insulin pump therapy with continuous glucose monitoring improves metabolic control in brittle type 1 diabetes[J]. Prilozi, 2007, 28(1):129-135.
[19] 石红,胡彩虹,胡晓霞. 动态血糖监测对2型糖尿病患者全天血糖水平漂移变化的临床价值[J]. 临床荟萃, 2010, 25( 21):1897-1898.
[20] 颜磊,侯新国,孙磊. 动态血糖与微量血糖安静和运动时的相关性分析[J]. 山东大学学报:医学版,2007, 45(1):76-79.
[21] Guerci B. Asymptomatic glycemic instability: how to measure it and which clinical applications?[J]. Diabetes Metab, 2003, 29(2 Pt 1):179-188.
[22] Service F J, Obrien P C. The relation of glycemia to the risk of development and progression of retinopathy in the Diabetic Control and Complications Trial[J]. Diabetologia, 2001, 44(10):1215-1220.
[23] McCarter R J, Hempe J M, Chalew S A. Mean blood glucose and biological variation have greater influence on HbA1c levels than glucose instability: an analysis of data from the Diabetes Control and Complications Trial[J]. Diabetes Care, 2006, 29(2):352-355.
[24] Itou M, Kawaguchi T, Taniguchi E, et al. Altered expression of glucagon-like peptide-1 and dipeptidyl peptidase IV in patients with HCV-related glucose intolerance[J]. J Gastroenterol Hepatol, 2008, 23(2):244-251.
[1] LI Hongzhi, SHEN Yongchao, LIU Jieting, ZHAO Xiaojin, CHU Yanhui, YUAN Xiaohuan. An 11β-HSD1 inhibitor improves insulin sensitivity in db/db mice [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(10): 59-64.
[2] GONG Luwei, ZHOU Lizhen, SU Guohai. Perindopril ameliorates cardiac dysfunction via Akt-FoxO1 pathway in diabetic cardiomyopathy [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(10): 65-70.
[3] ZHANG Liang, XU Min, ZHUANG Xianghua, LOU Fuchen, LOU Nengjun, LÜ Li, GUO Wenjuan, ZHENG Fengjie, CHEN Shihong. An investigation of endoplasmic reticulum stress and apoptosis in diabetic peripheral neuropathy [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(8): 13-17.
[4] LI Jiangbing, SONG Xinhong, LIN Haiyan, ZHANG Dongzhi, LI Xiangyi, XU Yibo, WANG Li, XUE Fuzhong. The influencing factors of ischemic ECG abnormalities in a large health check-up population [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 77-81.
[5] SU Ping, YANG Yachao, YANG Yang, JI Jiadong, DAYIMU Alimu, LI Min, XUE Fuzhong, LIU Yanxun. Prediction models on the onset risks of type 2 diabetes among the health management population [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 82-86.
[6] ZHANG Zhentang, YANG Yang, HAN Fujun, CHEN Xianghua, JI Xiaokang, WANG Yongchao, WANG Shukang, SUN Yuanying, LI Min, CHEN Yafei, WANG Li, XUE Fuzhong, LIU Yanxun. A prediction model of 5-year CVD risks for type 2 diabetic patients: a prospective cohort study among Chinese community population [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 108-113.
[7] WANG Meijian, HOU Xinguo, LIANG Kai, CHEN Li. Serum lipids and lipoproteins in middle-aged and elderly Chinese in Shandong Province [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 70-75.
[8] YU Ning, GAO Yanyan, XIAN Yuxin, NIU Jiapeng, LI Li, WANG Jing, CAO Caixia. Effect of exenatide on serum chemerin level and liver fat contents in type 2 diabetes mellitus combined with non-alcoholic fatty liver disease patients [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(11): 51-55.
[9] YU Lu, LIU Qiang. Introvoxel incoherent motion MR imaging for the assessment of renal function of diabetes mellitus [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(11): 68-71.
[10] ZHAO Huichen, CHAI Jiachao, ZHANG Liang, YUAN Mingzhen, PENG Li, LIU Yuantao. Changes of hydrogen sulfide concentrations and synthetase expressions in the corpus cavernosum of diabetic rats [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(10): 25-28.
[11] CHEN Zhixin, WANG Ying, CAO Xinran, HEI Naihao, LI Junlong, DONG Bo, GUAN Guangju. Evaluation of the protective effect of AVE0991 on streptozotocin-induced diabetic nephropathy rats [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(10): 29-33.
[12] YANG Yang, ZHANG Guang, ZHANG Chengqi, SONG Xinhong, XUE Fuzhong, WANG Ping, WANG Li, LIU Yanxun. A prediction model for type 2 diabetes risks: a cohort study based on health examination [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(9): 69-72.
[13] SHI Rui, SUN Pei, WANG Lulu, DING Lin, XIA Jin, WANG Yan, PANG Shuguang. Vitamin D and mecobalamin combined with mouse nerve growth factor for diabetic peripheral neuropathy: a clinical observation [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(4): 64-67.
[14] Muhadasi TUERXUNYIMING, Patamu MOHEMAITI, Tuolanguli MAIMAITIKUERBAN. Association of CDKAL1 rs10946398 C/A polymorphism with type 2 diabetes [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(2): 75-85.
[15] XU Yi, ZHUANG Xianghua, LIU Yuantao, SUN Aili, LI Xiaobo, JIANG Dongqing, ZHANG Liang, XU Min, YAN Heng, CHEN Shihong. Over expression of lipin1 attenuates diabetic peripheral neuropathy in rats [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(9): 53-57.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!