目的探究老年糖尿病治疗中采用甘精胰岛素联合阿卡波糖的价值。方法选取上海市嘉定区迎园医院于2022年6月—2023年9月收治的106例糖尿病老年患者作为研究对象,按随机数表法分为对照组(53例,给予阿卡波糖治疗)、观察组(53例,给予甘精胰...目的探究老年糖尿病治疗中采用甘精胰岛素联合阿卡波糖的价值。方法选取上海市嘉定区迎园医院于2022年6月—2023年9月收治的106例糖尿病老年患者作为研究对象,按随机数表法分为对照组(53例,给予阿卡波糖治疗)、观察组(53例,给予甘精胰岛素联合阿卡波糖治疗)。比较两组临床疗效、血糖指标、体质指数(Body Mass Index,BMI)、不良反应发生情况以及胰岛功能。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);观察组空腹血糖(Fasting Blood Glucose,FBG)、餐后2 h血糖(2 Hour Post⁃prandial Blood Glucose,2 hBG)以及糖化血红蛋白(Hemoglobin A1c,HbA1c)均低于对照组,差异有统计学意义(P均<0.05);观察组体质指数高于对照组,差异有统计学意义(P<0.05);观察组不良反应总发生率与对照组比较,差异无统计学意义(P>0.05);观察组胰岛素抵抗指数(Homeostatic Model Assessment of Insulin Resis⁃tance,HOMA-IR)低于对照组,胰岛β细胞功能指数(Homeostasis Model Assessment-β,HOMA-β)高于对照组,差异有统计学意义(P均<0.05)。结论在老年糖尿病治疗中选择甘精胰岛素与阿卡波糖联合方案可降低血糖水平,改善体质指数及胰岛素功能,确保治疗有效性。展开更多
BACKGROUND Glycated hemoglobin A1c(HbA1c)is considered the most suitable for diabetes mellitus diagnosis due to its accuracy and convenience.However,the effect of HbA1c on diabetic retinopathy(DR)in the Han and Korean...BACKGROUND Glycated hemoglobin A1c(HbA1c)is considered the most suitable for diabetes mellitus diagnosis due to its accuracy and convenience.However,the effect of HbA1c on diabetic retinopathy(DR)in the Han and Korean populations in Jilin,China,remains inconclusive.AIM To determine the best cut-off of HbA1c for diagnosing DR among the Chinese.METHODS This cross-sectional study included 1933 participants from the Yanbian area of Jilin Province,China.Trained investigators employed a questionnaire-based survey,physical examination,laboratory tests,and fundus photography for the investigation.The best cut-off value for HbA1c was established via the receiver operating characteristic curve.The factors associated with HbA1c-associated risk factors were determined via linear regression.RESULTS The analysis included 887 eligible Chinese Han and Korean participants,591 of whom were assigned randomly to the training set and 296 to the validation set.The prevalence of DR was 3.27% in the total population.HbA1c of 6.2% was the best cut-off value in the training set,while it was 5.9% in the validation set.In both Chinese Han and Korean populations,an HbA1c level of 6.2% was the best cut-off value.The optimal cut-off values of fasting blood glucose(FBG)≥7 mmol/L and<7 mmol/L were 8.1% and 6.2% respectively in Han populations,while those in Korean populations were 6.9%and 5.3%,respectively.Age,body mass index,and FBG were determined as the risk factors impacting HbA1c levels.CONCLUSION HbA1c may serve as a useful diagnostic indicator for DR.An HbA1c level of 6.2% may be an appropriate cut-off value for DR detection in the Chinese population.展开更多
BACKGROUND Cognitive dysfunction is the main manifestation of central neuropathy.Although cognitive impairments tend to be overlooked in patients with diabetes mellitus(DM),there is a growing body of evidence linking ...BACKGROUND Cognitive dysfunction is the main manifestation of central neuropathy.Although cognitive impairments tend to be overlooked in patients with diabetes mellitus(DM),there is a growing body of evidence linking DM to cognitive dysfunction.Hyperglycemia is closely related to neurological abnormalities,while often disregarded in clinical practice.Changes in cerebral neurotransmitter levels are associated with a variety of neurological abnormalities and may be closely related to blood glucose control in patients with type 2 DM(T2DM).AIM To evaluate the concentrations of cerebral neurotransmitters in T2DM patients exhibiting different hemoglobin A1c(HbA1c)levels.METHODS A total of 130 T2DM patients were enrolled at the Department of Endocrinology of Shanghai East Hospital.The participants were divided into four groups according to their HbA1c levels using the interquartile method,namely Q1(<7.875%),Q2(7.875%-9.050%),Q3(9.050%-11.200%)and Q4(≥11.200%).Clinical data were collected and measured,including age,height,weight,neck/waist/hip circumferences,blood pressure,comorbidities,duration of DM,and biochemical indicators.Meanwhile,neurotransmitters in the left hippocampus and left brainstem area were detected by proton magnetic resonance spectroscopy.RESULTS The HbA1c level was significantly associated with urinary microalbumin(mALB),triglyceride,low-density lipoprotein cholesterol(LDL-C),homeostasis model assessment of insulin resistance(HOMA-IR),and beta cell function(HOMA-β),N-acetylaspartate/creatine(NAA/Cr),and NAA/choline(NAA/Cho).Spearman correlation analysis showed that mALB,LDL-C,HOMA-IR and NAA/Cr in the left brainstem area were positively correlated with the level of HbA1c(P<0.05),whereas HOMA-βwas negatively correlated with the HbA1c level(P<0.05).Ordered multiple logistic regression analysis showed that NAA/Cho[Odds ratio(OR):1.608,95%confidence interval(95%CI):1.004-2.578,P<0.05],LDL-C(OR:1.627,95%CI:1.119-2.370,P<0.05),and HOMA-IR(OR:1.107,95%CI:1.031-1.188,P<0.01)were independent predictors of poor glycemic control.CONCLUSION The cerebral neurotransmitter concentrations in the left brainstem area in patients with T2DM are closely related to glycemic control,which may be the basis for the changes in cognitive function in diabetic patients.展开更多
Objective:To study the application effect of standardized nutritional care combined with exercise intervention in patients with gestational diabetes mellitus and the effect on fasting blood glucose(FPG),2-hour postpra...Objective:To study the application effect of standardized nutritional care combined with exercise intervention in patients with gestational diabetes mellitus and the effect on fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),and glycated hemoglobin(HbA1c)levels.Methods:Ninety cases of gestational diabetes mellitus diagnosed between June 2022 and June 2023 were selected and randomly divided into two groups of 45 cases each.The control group received conventional intervention,while the observation group received combined standardized nutritional care and exercise intervention.Blood glucose levels,adverse pregnancy outcomes,and adverse neonatal outcomes were compared.Results:On the day before delivery,the FPG,2hPG,and HbA1c levels of patients in the observation group were lower than those of patients in the control group(P<0.05).The incidence of adverse pregnancy outcomes(4.44%)and adverse neonatal outcomes(2.22%)in the observation group was lower than in the control group(P<0.05).Conclusion:The blood glucose levels of gestational diabetes mellitus patients can be controlled through standardized nutritional care and exercise interventions,leading to improved pregnancy and neonatal outcomes.展开更多
文摘目的探究老年糖尿病治疗中采用甘精胰岛素联合阿卡波糖的价值。方法选取上海市嘉定区迎园医院于2022年6月—2023年9月收治的106例糖尿病老年患者作为研究对象,按随机数表法分为对照组(53例,给予阿卡波糖治疗)、观察组(53例,给予甘精胰岛素联合阿卡波糖治疗)。比较两组临床疗效、血糖指标、体质指数(Body Mass Index,BMI)、不良反应发生情况以及胰岛功能。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);观察组空腹血糖(Fasting Blood Glucose,FBG)、餐后2 h血糖(2 Hour Post⁃prandial Blood Glucose,2 hBG)以及糖化血红蛋白(Hemoglobin A1c,HbA1c)均低于对照组,差异有统计学意义(P均<0.05);观察组体质指数高于对照组,差异有统计学意义(P<0.05);观察组不良反应总发生率与对照组比较,差异无统计学意义(P>0.05);观察组胰岛素抵抗指数(Homeostatic Model Assessment of Insulin Resis⁃tance,HOMA-IR)低于对照组,胰岛β细胞功能指数(Homeostasis Model Assessment-β,HOMA-β)高于对照组,差异有统计学意义(P均<0.05)。结论在老年糖尿病治疗中选择甘精胰岛素与阿卡波糖联合方案可降低血糖水平,改善体质指数及胰岛素功能,确保治疗有效性。
基金Supported by National Key R&D Program of China,No.2016YFC1305700.
文摘BACKGROUND Glycated hemoglobin A1c(HbA1c)is considered the most suitable for diabetes mellitus diagnosis due to its accuracy and convenience.However,the effect of HbA1c on diabetic retinopathy(DR)in the Han and Korean populations in Jilin,China,remains inconclusive.AIM To determine the best cut-off of HbA1c for diagnosing DR among the Chinese.METHODS This cross-sectional study included 1933 participants from the Yanbian area of Jilin Province,China.Trained investigators employed a questionnaire-based survey,physical examination,laboratory tests,and fundus photography for the investigation.The best cut-off value for HbA1c was established via the receiver operating characteristic curve.The factors associated with HbA1c-associated risk factors were determined via linear regression.RESULTS The analysis included 887 eligible Chinese Han and Korean participants,591 of whom were assigned randomly to the training set and 296 to the validation set.The prevalence of DR was 3.27% in the total population.HbA1c of 6.2% was the best cut-off value in the training set,while it was 5.9% in the validation set.In both Chinese Han and Korean populations,an HbA1c level of 6.2% was the best cut-off value.The optimal cut-off values of fasting blood glucose(FBG)≥7 mmol/L and<7 mmol/L were 8.1% and 6.2% respectively in Han populations,while those in Korean populations were 6.9%and 5.3%,respectively.Age,body mass index,and FBG were determined as the risk factors impacting HbA1c levels.CONCLUSION HbA1c may serve as a useful diagnostic indicator for DR.An HbA1c level of 6.2% may be an appropriate cut-off value for DR detection in the Chinese population.
基金Supported by the Academic Leaders Training Program of Pudong Health Bureau of Shanghai,No.PWRd2023-03Clinical Research Fund of Shanghai Municipal Commission of Health,No.202040136+1 种基金National Natural Science Foundation of China,No.82070842Jiangxi Health Commission Science and Technology Plan Project,No.202212838 and No.202212852.
文摘BACKGROUND Cognitive dysfunction is the main manifestation of central neuropathy.Although cognitive impairments tend to be overlooked in patients with diabetes mellitus(DM),there is a growing body of evidence linking DM to cognitive dysfunction.Hyperglycemia is closely related to neurological abnormalities,while often disregarded in clinical practice.Changes in cerebral neurotransmitter levels are associated with a variety of neurological abnormalities and may be closely related to blood glucose control in patients with type 2 DM(T2DM).AIM To evaluate the concentrations of cerebral neurotransmitters in T2DM patients exhibiting different hemoglobin A1c(HbA1c)levels.METHODS A total of 130 T2DM patients were enrolled at the Department of Endocrinology of Shanghai East Hospital.The participants were divided into four groups according to their HbA1c levels using the interquartile method,namely Q1(<7.875%),Q2(7.875%-9.050%),Q3(9.050%-11.200%)and Q4(≥11.200%).Clinical data were collected and measured,including age,height,weight,neck/waist/hip circumferences,blood pressure,comorbidities,duration of DM,and biochemical indicators.Meanwhile,neurotransmitters in the left hippocampus and left brainstem area were detected by proton magnetic resonance spectroscopy.RESULTS The HbA1c level was significantly associated with urinary microalbumin(mALB),triglyceride,low-density lipoprotein cholesterol(LDL-C),homeostasis model assessment of insulin resistance(HOMA-IR),and beta cell function(HOMA-β),N-acetylaspartate/creatine(NAA/Cr),and NAA/choline(NAA/Cho).Spearman correlation analysis showed that mALB,LDL-C,HOMA-IR and NAA/Cr in the left brainstem area were positively correlated with the level of HbA1c(P<0.05),whereas HOMA-βwas negatively correlated with the HbA1c level(P<0.05).Ordered multiple logistic regression analysis showed that NAA/Cho[Odds ratio(OR):1.608,95%confidence interval(95%CI):1.004-2.578,P<0.05],LDL-C(OR:1.627,95%CI:1.119-2.370,P<0.05),and HOMA-IR(OR:1.107,95%CI:1.031-1.188,P<0.01)were independent predictors of poor glycemic control.CONCLUSION The cerebral neurotransmitter concentrations in the left brainstem area in patients with T2DM are closely related to glycemic control,which may be the basis for the changes in cognitive function in diabetic patients.
文摘Objective:To study the application effect of standardized nutritional care combined with exercise intervention in patients with gestational diabetes mellitus and the effect on fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),and glycated hemoglobin(HbA1c)levels.Methods:Ninety cases of gestational diabetes mellitus diagnosed between June 2022 and June 2023 were selected and randomly divided into two groups of 45 cases each.The control group received conventional intervention,while the observation group received combined standardized nutritional care and exercise intervention.Blood glucose levels,adverse pregnancy outcomes,and adverse neonatal outcomes were compared.Results:On the day before delivery,the FPG,2hPG,and HbA1c levels of patients in the observation group were lower than those of patients in the control group(P<0.05).The incidence of adverse pregnancy outcomes(4.44%)and adverse neonatal outcomes(2.22%)in the observation group was lower than in the control group(P<0.05).Conclusion:The blood glucose levels of gestational diabetes mellitus patients can be controlled through standardized nutritional care and exercise interventions,leading to improved pregnancy and neonatal outcomes.
