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The purpose of type 2 diabetes mellitus (T2DM) increase morbidity and age significantly correlated and showed an increasing trend. In 2010, the number of diabetics in China for nearly 100 million much. T2DM macrovascular complications can affect the whole body large and medium-sized arteries and vital organs of blood supply, is its main maimed, one of the cause of death. Therefore, it is particularly important for the prevention and treatment of T2DM macroangiopathy. At present, a large number of clinical treatment mainly divided into conventional treatment and intensive therapy for comparing different treatment of different role in the prevention of T2DM macroangiopathy, some researchers began to conduct relevant research participants, follow-up time is often compared to the number less, so that the results of clinical value is limited. Therefore, we follow-up study of 132 patients with newly diagnosed T2DM patients 5 years to the conventional treatment for the control group, explore intensive glucose, blood pressure, lipid control to delay the effect of macrovascular disease process. Combined with previous research, one of the mechanism as of diabetes progress and complications in patients with T2DM in vivo environment of the high sugar, protein or lipid non-enzymatic glycosylation formation of advanced glycation end product (AGEs) T2DM patients with serum AGEs and its soluble receptor (sRAGE) levels has not been clearly reported relationship with the severity of diabetic vascular complications. Therefore, the experimental evaluation of serum advanced glycation end products and its soluble receptor levels in the study endpoint media thickness (IMT) in the large arteries. Necessity and macrovascular disease risk factors of T2DM early intensive treatment for clinical judgment to provide a scientific basis. Method 1, select Shanghai Changhai Hospital, endocrine outpatient diagnosis of T2DM duration of 160 cases of patients within 1 year. According to the different interventions are divided into three groups: A. strengthen blood sugar, blood pressure control group (33 people), B. strengthen blood sugar, blood pressure, lipid control group (88 people), C. conventional treatment group (39 people). 2, record the patient's age, sex, height, weight, previous history of hypertension, dyslipidemia, smoking history. Intensive therapy group in the follow-up check once a month fasting blood glucose, blood pressure; checked once every six months, blood lipids, glycosylated hemoglobin, liver and kidney function, fasting insulin, BMI. Conventional treatment group check once every six months fasting blood glucose, blood pressure, blood lipids, glycosylated hemoglobin, liver and kidney function, fasting insulin, BMI. Three groups were checked once a year carotid, iliac, femoral artery IMT, for 5 years. Artery IMT and other related indicators of the level of change in the groups were compared. 3 end of the experiment comparing serum AGEs and sRAGE level, to examine two indicators with the end of the experiment artery IMT, as well as the correlation with the forward blood sugar fluctuations. 1, through the first three years of intensive control, common iliac, femoral artery IMT 2hPG, TC, TG levels before treatment significantly reduced FINS levels significantly higher than before treatment, the difference had statistical significance (P lt; 0.05 ). 2, three groups of patients after 5 years of treatment, at the end of the experiment, the indicators found that blood pressure showed no significant difference. The blood sugar of the conventional treatment group C, FINS, HbA1c level strong Control of A and B group was significantly higher (P lt; 0.05), HDL-C levels were significantly lower (P lt; 0.05). 3, serum sRAGE group differences among the groups was not statistically significant (P = 0.427) of AGEs differences among the groups was statistically significant (P = 0.009). Conventional therapy group C levels of AGEs strong A, group B was significantly higher (P lt; 0.01). 4,5 years of conventional therapy group C carotid and femoral artery IMT strong Control of A, group B was significantly thicker (P lt; 0.05), iliac artery IMT change among the three groups showed no significant difference (P gt; 0.05 ). 5, the use of multiple linear stepwise regression analysis of the factors affecting the film thickness Tip: an independent risk factor of AGEs, SBP and age for the femoral artery IMT, which AGEs femoral artery IMT is closely related to the thickness of the (β = 0.163, P = 0.091). An independent risk factor for the age of the carotid arteries, HDL-C, 2hPG. An independent risk factor for the age of the common iliac artery, Scr. 6, sRAGE/HbA1c (this value study endpoint HbA1c level) and 5 years, HbA1c 'number was a significant negative correlation (r = -0.417, P lt; 0.001), and 5 years, HbA1c' fluctuations also was negatively related (r = -0.309, P lt; 0.001). Conclusion early intensive intervention, newly diagnosed patients with T2DM can 2hPG TC, TG levels were significantly lower, and change the trend of the patient's artery IMT change to some extent. 2, strengthening treatment than conventional treatment can significantly improve blood sugar of newly diagnosed patients with T2DM, FINS, HbA1c, HDL-C levels, and significant inhibition of thickening of the carotid and femoral artery IMT. Iliac artery thickening, strengthening treatment and conventional treatment was no significant difference in efficacy. Therefore confirms an important role in the protection of the large blood vessels of intensive treatment of diabetes. 3, AGEs, SBP, age is an independent risk factor for femoral artery IMT, long-term intensive treatment compared with conventional treatment can significantly reduce the accumulation of AGEs in vivo. For newly diagnosed patients with T2DM, especially in the elderly population, early and aggressive intervention blood pressure, Scr, 2hPG may help to slow the process of diabetic macroangiopathy. 4, 5-year mean glycated hemoglobin research the endpoint sRAGE/HbA1c with participants who showed significant negative correlation and volatility. Joint serum sRAGE level calculation of sRAGE / HbA1c ratio than the single HbA1c for long-term blood sugar fluctuations more guidance value. More accurate assessment of long-term blood sugar control in diabetics before visiting. 5, no abnormal liver and kidney function affects strengthen treatment with conventional treatment.
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