Insulin resistance (IR) refers to subnormal response to a certain amount of insulin and is the most characteristic phenomenon in non-insulin dependent diabetes mellitus (NIDDM). It is also an element of the pathogenic...Insulin resistance (IR) refers to subnormal response to a certain amount of insulin and is the most characteristic phenomenon in non-insulin dependent diabetes mellitus (NIDDM). It is also an element of the pathogenic mechanism shared with obesity, systemic hypertension, abnormal lipid metabolism and atherosclerosis. In recent years, studies on its treatment with traditional Chinese medicine (TCM) have gradually been carried out and the following is a report of them.Mechanisms of Diabetic IR in TCM TermsAction of insulin antagonizing hormones in peripheral tissues is one of the causes of diabetic IR. Cyclic nucleosides cAMP and cGMP, important intracellular messengers, are considered to be the second messenger of insulin, and cAMP is related to the amount of insulin receptors. Early in 1980s, some authors investigated the relationship among the symptoms of diabetes and such hormones and cAMP/cGMP ratio. Although they did not give due attention to IR, their studies provided evidences for differentiation of symptoms and signs in IR typing.展开更多
The incidence and prevalence of youth-onset type 2 diabetes mellitus(T2DM)are increasing.The rise in frequency and severity of childhood obesity,inclination to sedentary lifestyle,and epigenetic risks related to prena...The incidence and prevalence of youth-onset type 2 diabetes mellitus(T2DM)are increasing.The rise in frequency and severity of childhood obesity,inclination to sedentary lifestyle,and epigenetic risks related to prenatal hyperglycemia exposure are important drivers of the youth-onset T2DM epidemic and might as well be responsible for the early onset of diabetes complications.Indeed,youth-onset T2DM has a more extreme metabolic phenotype than adult-onset T2DM,with greater insulin resistance and more rapid deterioration of beta cell function.Therefore,intermediate complications such as microalbuminuria develop in late childhood or early adulthood,while end-stage complications develop in mid-life.Due to the lack of efficacy and safety data,several drugs available for the treatment of adults with T2DM have not been approved in youth,reducing the pharmacological treatment options.In this mini review,we will try to address the present challenges and pitfalls related to youth-onset T2DM and summarize the available interventions to mitigate the risk of microvascular and macrovascular complications.展开更多
目的研究糖预处理联合胰岛素强化治疗对减轻开腹手术术后胰岛素抵抗的价值。方法选择160例在普外科择期行开腹大手术的患者,随机分为空白对照组、糖预处理组、强化治疗组及联合治疗组,每组各40例,其中空白组及强化治疗术前禁饮食方法按...目的研究糖预处理联合胰岛素强化治疗对减轻开腹手术术后胰岛素抵抗的价值。方法选择160例在普外科择期行开腹大手术的患者,随机分为空白对照组、糖预处理组、强化治疗组及联合治疗组,每组各40例,其中空白组及强化治疗术前禁饮食方法按国内外科学常规进行;糖预处理组及联合治疗组采用术前12h禁食,术前3h口服50%GS 100m L;强化治疗组及联合治疗组术后采用Leuven强化治疗方案治疗。手术当日清晨空腹、术后当天、及术后第1、3、7天空腹采取静脉血标本,监测空腹血糖(FBG),空腹胰岛素定量(FINS),稳态模式评估法(HOMA-2)计算胰岛素抵抗指数,记录术后肠鸣音恢复及首次肛门排气时间,记录并发症。结果联合治疗组与其他三组比较,术后当天、术后第1天、术后第3天的胰岛素抵抗指数明显低于其他三组,差异有统计学意义(P<0.05)。联合治疗组与其他三组比较,肛门排气时间提前,并发症发生率降低,差异有统计学意义(P<0.05)。结论联合术前糖预处理及术后的胰岛素强化治疗处理围手术期患者,较单独应用单一方法更能收到减轻围手术期胰岛素抵抗的目的,且对加快术后排气及减少术后并发症有一定疗效。展开更多
【目的】观察养阴益气法联合胰岛素泵强化治疗对改善气阴两虚型2型糖尿病患者胰岛素抵抗状态的疗效。【方法】将60例2型糖尿病气阴两虚型患者随机分为2组,每组各30例。治疗组给予胰岛素泵强化治疗加服养阴益气方(由太子参、葛根、麦冬...【目的】观察养阴益气法联合胰岛素泵强化治疗对改善气阴两虚型2型糖尿病患者胰岛素抵抗状态的疗效。【方法】将60例2型糖尿病气阴两虚型患者随机分为2组,每组各30例。治疗组给予胰岛素泵强化治疗加服养阴益气方(由太子参、葛根、麦冬、五味子、花粉、知母、黄芪、生地、玄参、丹参、山药、苍术组成),对照组单纯采用胰岛素泵强化治疗,疗程均为2周。观察2组临床综合疗效以及空腹血糖(FBG)、空腹胰岛素(FINS)、餐后2 h血糖(2 h PG)、血脂[总胆固醇(TC)、甘油三酯(TG)]、血液流变学(全血黏度、血浆黏度)、胰岛素抵抗指数(HOMA-IR)等指标的变化,记录胰岛素用量、血糖达标时间。【结果】2组临床综合疗效比较,差异无显著性意义(P>0.05),但在中医证候疗效方面,治疗组明显优于对照组(P<0.05)。治疗后2组的FBG、2 h PG、FINS、HOMA-IR均明显下降(与治疗前比较,P<0.05或P<0.01),但治疗组FINS、HOMA-IR的下降作用明显优于对照组(P<0.05)。治疗后2组的血脂和血液流变学指标均明显下降(与治疗前比较,P<0.01),但治疗后组间比较,差异均无显著性意义(P>0.05)。治疗过程中治疗组胰岛素平均用量较对照组少,血糖达标时间较对照组快(均P<0.05)。治疗过程中除了少数的低血糖反应,均未出现其他明显不良反应。【结论】养阴益气法联合胰岛素泵强化治疗对2型糖尿病气阴两虚型患者中医证候改善作用显著,且胰岛素用量减少,血糖达标更快、更平稳,低血糖发生次数更少。展开更多
文摘Insulin resistance (IR) refers to subnormal response to a certain amount of insulin and is the most characteristic phenomenon in non-insulin dependent diabetes mellitus (NIDDM). It is also an element of the pathogenic mechanism shared with obesity, systemic hypertension, abnormal lipid metabolism and atherosclerosis. In recent years, studies on its treatment with traditional Chinese medicine (TCM) have gradually been carried out and the following is a report of them.Mechanisms of Diabetic IR in TCM TermsAction of insulin antagonizing hormones in peripheral tissues is one of the causes of diabetic IR. Cyclic nucleosides cAMP and cGMP, important intracellular messengers, are considered to be the second messenger of insulin, and cAMP is related to the amount of insulin receptors. Early in 1980s, some authors investigated the relationship among the symptoms of diabetes and such hormones and cAMP/cGMP ratio. Although they did not give due attention to IR, their studies provided evidences for differentiation of symptoms and signs in IR typing.
文摘The incidence and prevalence of youth-onset type 2 diabetes mellitus(T2DM)are increasing.The rise in frequency and severity of childhood obesity,inclination to sedentary lifestyle,and epigenetic risks related to prenatal hyperglycemia exposure are important drivers of the youth-onset T2DM epidemic and might as well be responsible for the early onset of diabetes complications.Indeed,youth-onset T2DM has a more extreme metabolic phenotype than adult-onset T2DM,with greater insulin resistance and more rapid deterioration of beta cell function.Therefore,intermediate complications such as microalbuminuria develop in late childhood or early adulthood,while end-stage complications develop in mid-life.Due to the lack of efficacy and safety data,several drugs available for the treatment of adults with T2DM have not been approved in youth,reducing the pharmacological treatment options.In this mini review,we will try to address the present challenges and pitfalls related to youth-onset T2DM and summarize the available interventions to mitigate the risk of microvascular and macrovascular complications.
文摘目的研究糖预处理联合胰岛素强化治疗对减轻开腹手术术后胰岛素抵抗的价值。方法选择160例在普外科择期行开腹大手术的患者,随机分为空白对照组、糖预处理组、强化治疗组及联合治疗组,每组各40例,其中空白组及强化治疗术前禁饮食方法按国内外科学常规进行;糖预处理组及联合治疗组采用术前12h禁食,术前3h口服50%GS 100m L;强化治疗组及联合治疗组术后采用Leuven强化治疗方案治疗。手术当日清晨空腹、术后当天、及术后第1、3、7天空腹采取静脉血标本,监测空腹血糖(FBG),空腹胰岛素定量(FINS),稳态模式评估法(HOMA-2)计算胰岛素抵抗指数,记录术后肠鸣音恢复及首次肛门排气时间,记录并发症。结果联合治疗组与其他三组比较,术后当天、术后第1天、术后第3天的胰岛素抵抗指数明显低于其他三组,差异有统计学意义(P<0.05)。联合治疗组与其他三组比较,肛门排气时间提前,并发症发生率降低,差异有统计学意义(P<0.05)。结论联合术前糖预处理及术后的胰岛素强化治疗处理围手术期患者,较单独应用单一方法更能收到减轻围手术期胰岛素抵抗的目的,且对加快术后排气及减少术后并发症有一定疗效。
文摘【目的】观察养阴益气法联合胰岛素泵强化治疗对改善气阴两虚型2型糖尿病患者胰岛素抵抗状态的疗效。【方法】将60例2型糖尿病气阴两虚型患者随机分为2组,每组各30例。治疗组给予胰岛素泵强化治疗加服养阴益气方(由太子参、葛根、麦冬、五味子、花粉、知母、黄芪、生地、玄参、丹参、山药、苍术组成),对照组单纯采用胰岛素泵强化治疗,疗程均为2周。观察2组临床综合疗效以及空腹血糖(FBG)、空腹胰岛素(FINS)、餐后2 h血糖(2 h PG)、血脂[总胆固醇(TC)、甘油三酯(TG)]、血液流变学(全血黏度、血浆黏度)、胰岛素抵抗指数(HOMA-IR)等指标的变化,记录胰岛素用量、血糖达标时间。【结果】2组临床综合疗效比较,差异无显著性意义(P>0.05),但在中医证候疗效方面,治疗组明显优于对照组(P<0.05)。治疗后2组的FBG、2 h PG、FINS、HOMA-IR均明显下降(与治疗前比较,P<0.05或P<0.01),但治疗组FINS、HOMA-IR的下降作用明显优于对照组(P<0.05)。治疗后2组的血脂和血液流变学指标均明显下降(与治疗前比较,P<0.01),但治疗后组间比较,差异均无显著性意义(P>0.05)。治疗过程中治疗组胰岛素平均用量较对照组少,血糖达标时间较对照组快(均P<0.05)。治疗过程中除了少数的低血糖反应,均未出现其他明显不良反应。【结论】养阴益气法联合胰岛素泵强化治疗对2型糖尿病气阴两虚型患者中医证候改善作用显著,且胰岛素用量减少,血糖达标更快、更平稳,低血糖发生次数更少。
