Role of a family history on first-phase insulin secretion in newly diagnosed type 2 diabetic patients with insulin pump therapy

Objective To observe the different effects between patients with or without family history of diabetes with insulin pump therapy, and explore the genetic background of early insulin secretion function. Methods A total of 158 newly diagnosed type 2 diabetic patients from July 1st 2008 to December 1st 2011 were recruited. According to the presence or absence of family history of diabetes, they were divided into 2 group: one was with a family history group(FH+ DM group) and another was without a family history group(FH-DM group). All the patients were treated with continuous subcutaneous insulin infusion (CSII) for 10 days. L-arginine (L-ARG) stimulating test was used to test the insulin values before and after intensive insulin therapy. t test was used between 2 groups. Analysis of multiple variables using multiple regression analysis. Results (1)The peak of insulin secretion: before intensive insulin therapy, the multiples of the peak of the FH+ DM group and FH-DM group were 5.0±2.5, 5.2±2.5, respectively. After the therapy, they were increased by 14.3% and 16.1%. (2) The first phase of insulin secretion: before the therapy, the level of 2 min insulin incretion and the first phase of insulin secretion in FH+ DM group was lower than FH-DM.After the therapy, the level of first phase insulin secretion were 20.41 mU/L and 22.39 mU/L of the two groups.They were lowered by 18.4% and 20%, and FH-DM had a more obvious reduction.(3) HOMA-IR: HOMA-IR in the two groups were both lower than before.They were 4.26 vs 2.02, and 5.14 vs 2.15(P<0.05). Conclusion Insulin pump therapy has positive effects on the first phase function of islet β-cell.And the result is more obvious in the group without family history. Key words: Diabetes mellitus, type 2; Family, history; Insulin; First phase function; L-arginine