BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCT...BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCTs).However,real-world data on the comparative efficacy and safety of individual SGLT-2i medications is sparse.AIM To study the comparative efficacy and safety of SGLT-2i using real-world clinical data.METHODS We evaluated the comparative efficacy data of 3 SGLT-2i drugs(dapagliflozin,canagliflozin,and empagliflozin)used for treating patients with type 2 diabetes mellitus.Data on the reduction of glycated hemoglobin(HbA1c),body weight,blood pressure(BP),urine albumin creatinine ratio(ACR),and adverse effects were recorded retrospectively.RESULTS Data from 467 patients with a median age of 64(14.8)years,294(62.96%)males and 375(80.5%)Caucasians were analysed.Median diabetes duration was 16.0(9.0)years,and the duration of SGLT-2i use was 3.6(2.1)years.SGLT-2i molecules used were dapagliflozin 10 mg(n=227;48.6%),canagliflozin 300 mg(n=160;34.3%),and empagliflozin 25 mg(n=80;17.1).Baseline median(interquartile range)HbA1c in mmol/mol were:dapagliflozin-78.0(25.3),canagliflozin-80.0(25.5),and empagliflozin-75.0(23.5)respectively.The respective median HbA1c reduction at 12 months and the latest review(just prior to the study)were:66.5(22.8)&69.0(24.0),67.0(16.3)&66.0(28.0),and 67.0(22.5)&66.5(25.8)respectively(P<0.001 for all comparisons from baseline).Significant improvements in body weight(in kilograms)from baseline to study end were noticed with dapagliflozin-101(29.5)to 92.2(25.6),and canagliflozin 100(28.3)to 95.3(27.5)only.Significant reductions in median systolic and diastolic BP,from 144(21)mmHg to 139(23)mmHg;(P=0.015),and from 82(16)mmHg to 78(19)mmHg;(P<0.001)respectively were also observed.A significant reduction of microalbuminuria was observed with canagliflozin only[ACR 14.6(42.6)at baseline to 8.9(23.7)at the study end;P=0.043].Adverse effects of SGLT-2i were as follows:genital thrush and urinary infection-20(8.8%)&17(7.5%)with dapagliflozin;9(5.6%)&5(3.13%)with canagliflozin;and 4(5%)&4(5%)with empagliflozin.Diabetic ketoacidosis was observed in 4(1.8%)with dapagliflozin and 1(0.63%)with canagliflozin.CONCLUSION Treatment of patients with SGLT-2i is associated with statistically significant reductions in HbA1c,body weight,and better than those reported in RCTs,with low side effect profiles.A review of large-scale real-world data is needed to inform better clinical practice decision making.展开更多
Gestational diabetes mellitus is the most common endocrine disorder in pregnancy and a cause of maternal and fetal morbidities and mortalities. The oral glucose tolerance test is the gold standard for diagnosing gesta...Gestational diabetes mellitus is the most common endocrine disorder in pregnancy and a cause of maternal and fetal morbidities and mortalities. The oral glucose tolerance test is the gold standard for diagnosing gestational diabetes mellitus. Nevertheless, the oral glucose tolerance test is time-consuming and requires patient preparation. On the contrary, Glycated albumin does not require patient preparation or administration of any substance. Most studies on glycated albumin in pregnancy were among the non-African population, and black Americans have higher glycated albumin levels than Caucasians. This study determined the use of glycated albumin in diagnosing gestational diabetes mellitus among pregnant women. The study was a prospective study of 160 pregnant women between 24 and 28 weeks of gestation at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was based on the World Health Organization 2013 criteria. The diagnostic value of glycated albumin was determined using the area under the receiver operator characteristic curve. The prevalence of gestational diabetes mellitus was 9.4% and the mean glycated albumin was 16.91% (±2.77). The area under the receiver operator characteristic curve for glycated albumin was 0.845 (95% CI 0.733 - 0.956;p = 0.0001). The optimal cut-off value of glycated albumin in the diagnosis of gestational diabetes mellitus was 18.9%. Glycated albumin was useful in the diagnosis of gestational diabetes mellitus at 24 to 28 weeks of gestation.展开更多
In this study,the application of bovine serum albumin(BSA)as a carrier to glucose-sensitive materials for the detection of glucose was proposed.Au-Cu O bimetallic nanoclusters(Au-Cu O/BSA)were prepared using BSA as a ...In this study,the application of bovine serum albumin(BSA)as a carrier to glucose-sensitive materials for the detection of glucose was proposed.Au-Cu O bimetallic nanoclusters(Au-Cu O/BSA)were prepared using BSA as a template,the new sensing material(Au-Cu O/BSA/MWCNTs)was synthesized by mixing with multi-walled carbon nanotubes(MWCNT)and applied to non-enzymatic electrochemical sensors to detect glucose stably and effectively under neutral condition.The scanning electron microscopy was used to investigate the morphology of the synthesized nanocomposite.The electrochemical properties of the sensor were studied by cyclic voltammetry.Glucose detection experiments show that Au-Cu O/BSA/MWCNTs/Au electrode has good glucose detection ability,stability,accuracy,repeatability,and high selectivity in neutral environment.Unlike existing glucose-sensitive materials,due to the use of BSA,the composite material is firmly fixed to the electrode surface without a Nafion solution,which reduces the current blocking effect on the modified electrode.The composite materials can be effectively preserved for extremely long periods,higher than 80%activity is maintained at room temperature in a closed environment for 3 to 4 months,due to the special effects of BSA.In addition,the feasibility of using BSA in glucose-sensitive materials is confirmed.展开更多
Initial prodiabetic risk profiles were invented here with three female study groups consisting of primarily healthy women (A1: 1990-1999, n = 160;A2: 2009, n = 88;A: n = 248, 36 ± 14 years;B: 2014: n = 65, aged 3...Initial prodiabetic risk profiles were invented here with three female study groups consisting of primarily healthy women (A1: 1990-1999, n = 160;A2: 2009, n = 88;A: n = 248, 36 ± 14 years;B: 2014: n = 65, aged 37± 11 years). Significantly higher blood pressure was found comparing intolerance versus tolerance to glucose (p p p = 0.02), of fasting blood glucose (p = 0.07) and of urine pathology (p = 0.07). High LDL-C of women who reported smoking at baseline was correlated with diastolic hypertension whereby alcohol problems overlapped (p = 0.036, A). Unhealthy combinations were found consisting of LDL-related intolerance to glucose, LDL-related smoking, of alcohol-related hypertriglyceridemia or of combined drinking and smoking testing urine pathology over the course of time. Obese women were at direct risk for hypertension in the presence of high LDL-C and submaximal ratio of serum albumin to triglycerides (Alb/Trig). Obese women reacted highly sensitive to critical alcohol consumption showing then macroalbuminuria. Current participants who disowned daily alcohol consumption showed healthy morning urines and normal fasting blood glucose. Mild decrease of HDL-C was observed during heavy smoking of relatively young women who had normal biomarkers. Women with intolerance to glucose were at direct risk for hypertension whereby high LDL-C and/or smoking triggered prodiabetic risk profiles. Obese women had elevated LDL-C during hypertension and reacted highly sensitive to alcohol-related proteinuria and/or hematuria.展开更多
Objective: To provide scientific basis for the pathogenesis and prevention and control of diabetic retinopathy through studying on relationship between different stages of diabetic retinopathy and blood glucose, blood...Objective: To provide scientific basis for the pathogenesis and prevention and control of diabetic retinopathy through studying on relationship between different stages of diabetic retinopathy and blood glucose, blood lipid andother related factors. Mehods: Collected 196 type 2 diabetes patients in a hospital branch ,it could be divided into NDR (n=180), NPDR (n=11) and PDR (n=5) and collected 40 control cases. Each object were surveyed fundus colorized photographyorfundus fluorescence angiography examination, physical and blood tests, and the results were statistically analyzed. Results: BMI, SBP, HbAlc, FPG, P2hPG, TG, HDL, DN and urinary albumin/creatinine ratio (UACR) between the four groups were statistically difference;SBP, HbAlc, P2hPG, TG and UACR were positively correlated relationship with different stage of DR;HDL was negatively related with different stage of DR. Conclusion: SBP, HbAlc, P2hPG, HDL and UACR were factors of different stages of DR, the SBP, HbAlc, P2hPG and TG were more higher and the HDL was more lower, the DR was more serious.展开更多
目的通过分析血清胱抑素C(Cys-C)、β2微球蛋白(β2-MG)、尿酸(UA)等联合项目与糖尿病肾病(DN)的相关性,从而找出准确诊断DN的相关因素。方法选取259名糖尿病(DM)患者,收集Cys-C、β2-MG、UA等相关项目指标,运用相应的统计学方法分析相...目的通过分析血清胱抑素C(Cys-C)、β2微球蛋白(β2-MG)、尿酸(UA)等联合项目与糖尿病肾病(DN)的相关性,从而找出准确诊断DN的相关因素。方法选取259名糖尿病(DM)患者,收集Cys-C、β2-MG、UA等相关项目指标,运用相应的统计学方法分析相关项目与尿白蛋白/肌酐比值(UACR)的关系。结果UACR≥30 mg/g作为DN的诊断临界点时,显示Cys-C、β2-MG、UA、收缩压(SBP)、餐后2 h血糖(2 h PG)、病程等6个项目是UACR的独立危险因素,当某一DM患者Cys-C≥1.435 mg/L、β2-MG≥2.055 mg/L、UA≥320μmol/L、SBP≥145 mmHg、2 h PG≥8.5 mmol/L、病程≥4.5年时,患者发展成早期DN的风险较大,相对应的临界值患病概率为81.5%。结论联合检测Cys-C、β2-MG、UA、SBP、2 h PG、病程等6个项目可以较好预测DN的发生。展开更多
文摘BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCTs).However,real-world data on the comparative efficacy and safety of individual SGLT-2i medications is sparse.AIM To study the comparative efficacy and safety of SGLT-2i using real-world clinical data.METHODS We evaluated the comparative efficacy data of 3 SGLT-2i drugs(dapagliflozin,canagliflozin,and empagliflozin)used for treating patients with type 2 diabetes mellitus.Data on the reduction of glycated hemoglobin(HbA1c),body weight,blood pressure(BP),urine albumin creatinine ratio(ACR),and adverse effects were recorded retrospectively.RESULTS Data from 467 patients with a median age of 64(14.8)years,294(62.96%)males and 375(80.5%)Caucasians were analysed.Median diabetes duration was 16.0(9.0)years,and the duration of SGLT-2i use was 3.6(2.1)years.SGLT-2i molecules used were dapagliflozin 10 mg(n=227;48.6%),canagliflozin 300 mg(n=160;34.3%),and empagliflozin 25 mg(n=80;17.1).Baseline median(interquartile range)HbA1c in mmol/mol were:dapagliflozin-78.0(25.3),canagliflozin-80.0(25.5),and empagliflozin-75.0(23.5)respectively.The respective median HbA1c reduction at 12 months and the latest review(just prior to the study)were:66.5(22.8)&69.0(24.0),67.0(16.3)&66.0(28.0),and 67.0(22.5)&66.5(25.8)respectively(P<0.001 for all comparisons from baseline).Significant improvements in body weight(in kilograms)from baseline to study end were noticed with dapagliflozin-101(29.5)to 92.2(25.6),and canagliflozin 100(28.3)to 95.3(27.5)only.Significant reductions in median systolic and diastolic BP,from 144(21)mmHg to 139(23)mmHg;(P=0.015),and from 82(16)mmHg to 78(19)mmHg;(P<0.001)respectively were also observed.A significant reduction of microalbuminuria was observed with canagliflozin only[ACR 14.6(42.6)at baseline to 8.9(23.7)at the study end;P=0.043].Adverse effects of SGLT-2i were as follows:genital thrush and urinary infection-20(8.8%)&17(7.5%)with dapagliflozin;9(5.6%)&5(3.13%)with canagliflozin;and 4(5%)&4(5%)with empagliflozin.Diabetic ketoacidosis was observed in 4(1.8%)with dapagliflozin and 1(0.63%)with canagliflozin.CONCLUSION Treatment of patients with SGLT-2i is associated with statistically significant reductions in HbA1c,body weight,and better than those reported in RCTs,with low side effect profiles.A review of large-scale real-world data is needed to inform better clinical practice decision making.
文摘Gestational diabetes mellitus is the most common endocrine disorder in pregnancy and a cause of maternal and fetal morbidities and mortalities. The oral glucose tolerance test is the gold standard for diagnosing gestational diabetes mellitus. Nevertheless, the oral glucose tolerance test is time-consuming and requires patient preparation. On the contrary, Glycated albumin does not require patient preparation or administration of any substance. Most studies on glycated albumin in pregnancy were among the non-African population, and black Americans have higher glycated albumin levels than Caucasians. This study determined the use of glycated albumin in diagnosing gestational diabetes mellitus among pregnant women. The study was a prospective study of 160 pregnant women between 24 and 28 weeks of gestation at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was based on the World Health Organization 2013 criteria. The diagnostic value of glycated albumin was determined using the area under the receiver operator characteristic curve. The prevalence of gestational diabetes mellitus was 9.4% and the mean glycated albumin was 16.91% (±2.77). The area under the receiver operator characteristic curve for glycated albumin was 0.845 (95% CI 0.733 - 0.956;p = 0.0001). The optimal cut-off value of glycated albumin in the diagnosis of gestational diabetes mellitus was 18.9%. Glycated albumin was useful in the diagnosis of gestational diabetes mellitus at 24 to 28 weeks of gestation.
基金supported by the National Natural Science Foundation of China(No.61704035)the Natural Science Foundation of Guangxi Province(2017GXNSFBA198125)the Guangxi Technology Projects(No.AD19110076 and No.AD19110063)。
文摘In this study,the application of bovine serum albumin(BSA)as a carrier to glucose-sensitive materials for the detection of glucose was proposed.Au-Cu O bimetallic nanoclusters(Au-Cu O/BSA)were prepared using BSA as a template,the new sensing material(Au-Cu O/BSA/MWCNTs)was synthesized by mixing with multi-walled carbon nanotubes(MWCNT)and applied to non-enzymatic electrochemical sensors to detect glucose stably and effectively under neutral condition.The scanning electron microscopy was used to investigate the morphology of the synthesized nanocomposite.The electrochemical properties of the sensor were studied by cyclic voltammetry.Glucose detection experiments show that Au-Cu O/BSA/MWCNTs/Au electrode has good glucose detection ability,stability,accuracy,repeatability,and high selectivity in neutral environment.Unlike existing glucose-sensitive materials,due to the use of BSA,the composite material is firmly fixed to the electrode surface without a Nafion solution,which reduces the current blocking effect on the modified electrode.The composite materials can be effectively preserved for extremely long periods,higher than 80%activity is maintained at room temperature in a closed environment for 3 to 4 months,due to the special effects of BSA.In addition,the feasibility of using BSA in glucose-sensitive materials is confirmed.
文摘Initial prodiabetic risk profiles were invented here with three female study groups consisting of primarily healthy women (A1: 1990-1999, n = 160;A2: 2009, n = 88;A: n = 248, 36 ± 14 years;B: 2014: n = 65, aged 37± 11 years). Significantly higher blood pressure was found comparing intolerance versus tolerance to glucose (p p p = 0.02), of fasting blood glucose (p = 0.07) and of urine pathology (p = 0.07). High LDL-C of women who reported smoking at baseline was correlated with diastolic hypertension whereby alcohol problems overlapped (p = 0.036, A). Unhealthy combinations were found consisting of LDL-related intolerance to glucose, LDL-related smoking, of alcohol-related hypertriglyceridemia or of combined drinking and smoking testing urine pathology over the course of time. Obese women were at direct risk for hypertension in the presence of high LDL-C and submaximal ratio of serum albumin to triglycerides (Alb/Trig). Obese women reacted highly sensitive to critical alcohol consumption showing then macroalbuminuria. Current participants who disowned daily alcohol consumption showed healthy morning urines and normal fasting blood glucose. Mild decrease of HDL-C was observed during heavy smoking of relatively young women who had normal biomarkers. Women with intolerance to glucose were at direct risk for hypertension whereby high LDL-C and/or smoking triggered prodiabetic risk profiles. Obese women had elevated LDL-C during hypertension and reacted highly sensitive to alcohol-related proteinuria and/or hematuria.
文摘Objective: To provide scientific basis for the pathogenesis and prevention and control of diabetic retinopathy through studying on relationship between different stages of diabetic retinopathy and blood glucose, blood lipid andother related factors. Mehods: Collected 196 type 2 diabetes patients in a hospital branch ,it could be divided into NDR (n=180), NPDR (n=11) and PDR (n=5) and collected 40 control cases. Each object were surveyed fundus colorized photographyorfundus fluorescence angiography examination, physical and blood tests, and the results were statistically analyzed. Results: BMI, SBP, HbAlc, FPG, P2hPG, TG, HDL, DN and urinary albumin/creatinine ratio (UACR) between the four groups were statistically difference;SBP, HbAlc, P2hPG, TG and UACR were positively correlated relationship with different stage of DR;HDL was negatively related with different stage of DR. Conclusion: SBP, HbAlc, P2hPG, HDL and UACR were factors of different stages of DR, the SBP, HbAlc, P2hPG and TG were more higher and the HDL was more lower, the DR was more serious.
文摘目的通过分析血清胱抑素C(Cys-C)、β2微球蛋白(β2-MG)、尿酸(UA)等联合项目与糖尿病肾病(DN)的相关性,从而找出准确诊断DN的相关因素。方法选取259名糖尿病(DM)患者,收集Cys-C、β2-MG、UA等相关项目指标,运用相应的统计学方法分析相关项目与尿白蛋白/肌酐比值(UACR)的关系。结果UACR≥30 mg/g作为DN的诊断临界点时,显示Cys-C、β2-MG、UA、收缩压(SBP)、餐后2 h血糖(2 h PG)、病程等6个项目是UACR的独立危险因素,当某一DM患者Cys-C≥1.435 mg/L、β2-MG≥2.055 mg/L、UA≥320μmol/L、SBP≥145 mmHg、2 h PG≥8.5 mmol/L、病程≥4.5年时,患者发展成早期DN的风险较大,相对应的临界值患病概率为81.5%。结论联合检测Cys-C、β2-MG、UA、SBP、2 h PG、病程等6个项目可以较好预测DN的发生。
