The impact of insulin pump therapy to oxidative stress in patients with diabetic nephropathy

Xing-Guang Zhang, Yan-Qi Zhang, Qian-Peng Cheng, Yi Cao, Jian-Min Sun, Xiao-Feng Lv, Xing-Guang Zhang, Yan-Qi Zhang, Qian-Peng Cheng, Yi Cao, Jian-Min Sun, Xiao-Feng Lv

Abstract

Background: The oxidative stress resulting from increased production of ROS plays a crucial role in the development of diabetic complications. We aim to explore the relationships between oxidative stress, diabetic nephropathy (DN) and short-term insulin pump intensive therapy (insulin therapy).

Methods: Levels of 8-hydroxy-deoxyguanosine (8-OHdG), 3-nitrotyrosine (3-NT), glutathione (GSH), superoxide dismutase (SOD) and Interleukin-6 (IL-6) were estimated before and after 2 weeks of insulin therapy in normal group (NC) and type 2 diabetic (DM) with normal albuminuria (NA), microalbuminuria (MA) and clinical albuminuria (CA).

Results: In DM group, levels of 8-OHdG and 3-NT were higher than those in NC group (P < 0.05); GSH and SOD were lower (P < 0.05). And their levels changed with urine albumin-creatinine ratio (P < 0.05). After insulin therapy, these derangements were significantly ameliorated and the changes in NA and MA groups were more significant than CA group (P < 0.05). Correlation analysis showed glycated hemoglobin, the course of disease, the HOME-IR and fasting plasma glucose were positively correlated with 8-OHdG and 3-NT, but negatively correlated with GSH and SOD.

Conclusions: The oxidative stress gradually increased with the magnitude of DN, and insulin pump intensive therapy can significantly ameliorate the derangements in the early stage of DN. Trial registration NCT03174821.

Keywords: Diabetic nephropathy; Insulin pump intensive therapy; Oxidative stress.

Figures

Fig. 1
Fig. 1
The comparison of SOD (a), 3-NT (b), 8-OHdG (c), GSH (d), CRP (e) and IL-6 (f) levels among NC, NA, MA and CA groups before insulin pump therapy
Fig. 2
Fig. 2
The comparison of the levels of GSH (a) and SOD (b), 3-NT (c) and 8-OHdG (d) in NA, MA and CA groups before and after insulin pump therapy
Fig. 3
Fig. 3
The relation assessment between 8-OHdG and parameters such as glycated hemoglobin (a), fasting plasma glucose (b), the course of disease (c), and the HOME-IR (d)
Fig. 4
Fig. 4
The relation assessment between 3-NT and parameters such as glycated hemoglobin (a), fasting plasma glucose (b),the course of disease (c), and the HOME-IR (d)
Fig. 5
Fig. 5
The relation assessment between SOD and parameters such as glycated hemoglobin (a), fasting plasma glucose (b), the course of disease (c) and the HOME-IR (d)
Fig. 6
Fig. 6
The relation assessment between GSH and parameters such as glycated hemoglobin (a), fasting plasma glucose (b), the course of disease (c), and the HOME-IR (d)

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