饮食运动等生活方式干预对初发2型糖尿病患者糖脂代谢和体重的影响

目的探讨饮食、运动等生活方式干预对初发2型糖尿病(T2DM)患者糖脂代谢和体重的影响。方法将85例初发2型糖尿病患者随机分为两组,即干预组和对照组。干预组43例,在药物治疗的同时,对患者进行饮食和运动等生活方式干预治疗;对照组42例,按医嘱应用药物治疗,只做一般的健康教育。两组治疗前后分别检测空腹血浆葡萄糖(FPG)、餐后2 h血糖(PSG)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC),检测患者身高、体质量,比较两组代谢指标及其体质指数(body ass index BMI)。结果干预组FPG、PSG、HbA1c、TG、TC、BMI等水平均显著低于干预前(P<0.01),高密度脂蛋白胆固醇(HDL-C)水平明显提高(P<0.01)。对照组FPG、PSG、TG、TC等水平均显著低于干预前(P<0.05);治疗后两组比较FPG、PSG、HbA1c、BMI、TG、TC等差异具有统计学意义(P<0.01,P<0.05)。结论对初发2型糖尿病患者饮食和运动等生活方式干预时间越早,患者糖脂代谢和体质指数改善越明显。

A preliminary evaluation of VEGF-A, VEGFR1 and VEGFR2 in patients with well-controlled type 2 diabetes mellitus

Objective： Decompensated chronic hyperglycemia often leads to late microvascular complications such as retinopathy, diabetic foot syndrome, and diabetic kidney disease. The aim of this study was to determine the concentration of vascular endothelial growth factor A （VEGF-A） and its receptors in patients with well-controlled diabetes. Methods： The study was conducted on 31 patients with well-controlled type 2 diabetes without microor macroangiopathy. Thirty healthy volunteers were enrolled in a control group. Serum concentrations of VEGF-A, VEGF receptors 1 and 2 （VEGFR1 and VEGFR2）, fasting glucose, and lipid profiles were measured, and the plasma concentration of glycated hemoglobin （HbAlc） was determined. Results： No significant differences were observed between the concentration of VEGF-A, VEGFR1 or VEGFR2 in the subject group and that in the control group. Positive correlations were noted between the levels of VEGF-A, VEGFR2, and triglyceride, and there was a negative correlation between the levels of VEGFR2 and high-density lipoprotein （HDL）-cholesterel in the study group. Conclusions： The concentrations of VEGF-A and its receptors 1 and 2 in patients with well-controlled diabetes are comparable to those of healthy individuals, which may indicate that appropriate control of glucose levels delays the occurrence of vascular complications. A negative correlation between VEGFR2 and HDL-cholesterol levels, and positive correlations between VEGF-A, VEGFR2, and triglyceride levels, suggest that lipid abnormalities occurring in diabetes may be involved in the modulation of angiogenesis.

Self-Management of Type 2 Diabetes in Middle-Aged Population of Pakistan and Saudi Arabia

This research protocol design is aimed at exploring the qualitative health research in self-management of Type 2 diabetes and patient’s perceptions and experiences of undertaking physical activity and eating behaviour as part of their diabetes self-management. In addition, the study would analyze how the health issue related to diabetes is viewed and addressed in the community (Pakistan and Saudi Arabia) and would use the concepts of socio-ecological approach to self-management of Type 2 diabetes and explore the factors affecting the self-management practices in these countries. The other objective of this protocol is to examine the role of physical inactivity and obesity in the development of Type 2 diabetes and its self-management in middle-aged population living in rural area of Pakistan and to evaluate a lifestyle intervention (Physical Activity and Diet) in the management of Type 2 diabetes. The brief review conducted in this protocol design will identify the potential areas of health care which need attention including the overall functioning of community healthcare clinics to diabetes care in terms of recognizing the symptoms of diabetes to early detection and diagnosis, easy access to community doctors. This review will impress upon the need to recognize that in developing strategies and interventions to address diabetes, self-care, family support, community education and community ownership are important and it will be demonstrated by the comparison of two culturally diversified populations of Pakistan and Saudi Arabia in relation to the self-management of Type 2 diabetes.

2型糖尿病患者血清甲状腺激素检测的临床意义

目的探讨2型糖尿病患者血清甲状腺激素的变化情况及其与糖化血红蛋白、C肽的相关性。方法将84例2型糖尿病患者按空腹血糖值(FBG)分为3组:A组轻度增高组(6.10 mmol/L≤FBG<8.0 mmol/L)、B组中度增高组(8.0 mmol/L≤FBG<12.0 mmol/L)、C组重度增高组(FBG≥12.0 mmol/L),测定3组2型糖尿病患者和36名健康对照组血清甲状腺激素(FT3、T3、FT4、T4、TSH)、C肽、糖化血红蛋白(HbA1c)水平,观察2型糖尿病患者各分组中甲状腺激素水平变化特点,并分析其与HbA1c、C肽相关性。结果 2型糖尿病患者血清游离甲状腺原氨酸和甲状腺原氨酸(FT3、T3)水平明显低于对照组(F值分别为51.101、31.193,P<0.01),而其他甲状腺激素(FT4、T4、TSH)水平与对照组差异无统计学意义(P>0.05)。3组2型糖尿病患者分组比较,C组FT3、T3水平较A组显著降低(P<0.01),其他甲状腺激素与另两组相比差异无统计学意义(P>0.05)。FT3与HbA1c呈负相关(r=-0.422,P<0.01),与C肽呈正相关(r=0.378,P<0.05)。结论 2型糖尿病患者随空腹血糖升高,血清FT3、T3水平呈下降趋势,测定甲状腺激素可反映患者糖代谢紊乱的程度。

即时糖化血红蛋白检验的临床应用

目的评价糖化血红蛋白(HbA1c)即时检验(POCT)法和高效液相色谱(HPLC)法的一致性,探讨POCT法测定HbA1c临床应用的可能性。方法随机选取42例门诊糖尿病患者进行HbA1c的HPLC法和POCT法测定,评价2种方法的一致性和HbA1c POCT法临床应用的可行性。结果对2种测定方法进行配对t检验:不分组、HbA1c≤8.0%组、HbA1c>8.0%组,P值分别为0.226、0.899、0.080,两者之间差异无统计学意义;相关分析显示2种方法相关性良好(P<0.05);Bland-Altman一致性分析显示不分组、HbA1c≤8.0%组、HbA1c>8.0%组分别有97.62%、95.45%、95.00%的点位于界限以内。结论 HPLC法与POCT法检测HbA1c结果一致性好;POCT法能满足临床应用的需求,可以作为门诊快速检测HbA1c的较好方法。