Zhongguo linchuang yanjiu (Dec 2023)
Effect of taking metformin tablets before bedtime on islet cell function in type 2 diabetes mellitus patients with frequent dawn phenomenon
Abstract
Objective To investigate the effect of metformin tablets before bedtime and its effect on islet cell function in elderly type 2 diabetes mellitus (T2DM) patients with frequent dawn phenomenon. Methods A total of 160 elderly patients with T2DM in The First People's Hospital of Chuzhou from May 2018 to April 2021 were selected. They were divided into the control group (n=80) and the observation group (n=80) randomly. The control group was given intensive treatment with insulin aspart, while the observation group was given an additional 500 mg of before bedtime metformin tablets on this basis. Both groups were treat contimuously for 12 weeks. The changes in blood glucose, islet cell function, dawn phenomenon before and after treatment were compared. ORACLE 10 g tool was used to construct a random walking model for evaluating the effect of taking metformin tablets before bedtime on the function of pancreatic islet cells in elderly T2DM patients with frequent dawn phenomenon. Results After treatment, fasting plasma glucose (FPG), 2 h postprandial glucose (2hPG) and coefficient of variation (CV) in the control group reduced, while FPG, 2hPG, blood glucose before bedtime and CV in the observation group reduced (P<0.05). The FPG, 2hPG and CV in the observation group were lower than those in the control group (P<0.05). Compared with those before treatment, fasting C-Peptide (FC-P), 2 h postprandial C-Peptide (2hPC-P), HOMA-β decreased, and HOMA-IR increased in two groups (P<0.05), and the improvement effect in observation group were better than the control group (P<0.05). The incidence of dawn phenomenon in the observation group was 30.00% (18/60), lower than 65.00% (39/60) in the control group (χ2=14.737, P<0.01). The evaluation results of random walking model showed that the improvement effect of islet cell function in the observation group was better than that in the control group. Conclusion On the basis of shorttime intensive insulin therapy, taking metformin tablets before bedtime can effectively control the blood sugar level of elderly T2DM patients with frequent dawn phenomenon and improve the function of islet cells.
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