Lowering fasting blood glucose with non-dialyzable material of cranberry extract is dependent on host genetic background,sex and diet

Background:Type 2 diabetes(T2D)is a polygenic metabolic disease,character-ized by high fasting blood glucose(FBG).The ability of cranberry(CRN)fruit to regulate glycemia in T2D patients is well known.Here,a cohort of 13 lines of the genetically diverse Collaborative Cross(CC)mouse model was assessed for the effect of non-dialyzable material(NDM)of cranberry extract in lowering fasting blood glucose.Methods:Eight-week-old mice were maintained on either a standard chow diet(con-trol group)or a high-fat diet(HFD)for 12 weeks,followed by injections of intraperi-toneal(IP)NDM(50 mg/kg)per mouse,three times a week for the next 6 weeks.Absolute FBG(mg/dl)was measured bi-weekly and percentage changes in FBG(%FBG)between weeks 0 and 12 were calculated.Results:Statistical analysis showed a significant decrease in FBG between weeks 0 and 12 in male and female mice maintained on CHD.However,a non-significant in-crease in FBG values was observed in male and female mice maintained on HFD dur-ing the same period.Following administration of NDM during the following 6 weeks,the results show a variation in significant levels of FBG lowering between lines,male and female mice and under the different diets.Conclusion:The results suggest that the efficacy of NDM treatment in lowering FGB depends on host genetic background(pharmacogenetics),sex of the mouse(phar-macosex),and diet(pharmacodiet).All these results support the need for follow-up research to better understand and implement a personalized medicine approach/uti-lization of NDM for reducing FBG.

Abnormality of peripheral nerve conduction velocity associated with illness course, symptoms and fasting blood glucose in patients with type 2 diabetes mellitus

BACKGROUND: It has shown that abnormality of peripheral nerve conduction velocity during onset of diabetes mellitus is not related to age and sex, but to symptoms, illness course and level of fasting blood glucose. OBJECTIVE: To measure correlation of abnormality of peripheral nerve conduction velocity with various illness courses, symptoms and levels of fasting blood glucose of patients with type 2 diabetes mellitus. DESIGN: Case analysis. SETTING: Department of Neurology, Central People's Hospital of Huizhou. PARTICIPANTS: A total of 128 patients who were diagnosed as type 2 diabetes mellitus were selected from Central People's Hospital of Huizhou from September 2001 to October 2005. There were 75 males and 53 females aged 32-83 years and the illness course ranged from 1 month to 20 years. METHODS: All 128 patients with type 2 diabetes mellitus received neuro-electrophysiological study and their clinical data were retrospectively analyzed to measure peripheral nerve conduction velocity and fasting blood glucose so as to investigate the correlation of peripheral nerve conduction velocity with clinical symptoms, illness course and levels of fasting blood glucose. MAIN OUTCOME MEASURES: Correlation of peripheral nerve conduction velocity with clinical symptoms, illness course and levels of fasting blood glucose. RESULTS: All 128 patients with type 2 diabetes mellitus were involved in the final analysis. ① Among 128 patients, 114 patients had abnormality of peripheral nerve conduction velocity; 110 patients had clinical symptoms, including 102 patients having abnormality of peripheral nerve conduction velocity; 18 patients did not have clinical symptoms, including 12 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=8.275, P =0.04). ② Among 128 patients, illness course of 75 patients was equal to or less than 5 years, including 27 patients having abnormality of peripheral nerve conduction velocity; illness course of 53 patients was more than 5 years, including 35 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=11.469, P =0.003). ③ Among 128 patients, levels of fasting blood glucose of 75 patients was equal to or lower than 11 mmol/L, including 41 patients having abnormality of peripheral nerve conduction velocity; levels of fasting blood glucose of 53 patients was higher than 11 mmol/L, including 38 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=4.023, P =0.134). CONCLUSION: ① Abnormality of peripheral nerve conduction velocity of patients with type 2 diabetes mellitus is related to illness courses and clinical symptoms. The longer the illness course is, the severer the abnormality of peripheral nerve conduction velocity is. Abnormality of peripheral nerve conduction velocity always occurs on patients who have clinical symptoms. ② Abnormality of peripheral nerve conduction velocity is not related to levels of fasting blood glucose.

Effect of electroacupuncture at ear and body acupoints on the instant fasting blood glucose level of machins with type 2 diabetes mellitus

Objective To observe the effect of electroacupuncture at ear and body acupoints for the instant fasting blood glucose of model machins with type 2 diabetes mellitus（T2DM）.Methods For 10 machins with type2 diabetes,the electroacupuncture was applied at ＂Zusanli＂（足三里 ST 36）,＂Sanyinjiao＂（三阴交 SP 6） and three ＂Jiangtangdian＂（降糖点） in the ear continuously for 5 days,with the frequency of 2/15 Hz（The 2 Hz and the 15 Hz were transferred every second） and current of2 mA.The treatment was given once every day for 30 min.The fasting blood glucose was measured before acupuncture,after acupuncture for15 min and 30 min in the 5 days.Results On the first day,after 30-minute acupuncture the fasting blood glucose was reduced obviously compared with that before treatment（P〈0.01）.On the third and the fifth days,after acupuncture for 15 min and 30 min the fasting blood glucose was apparently lower than that before acupuncture（all P〈0.05）.On the fourth day,after acupuncture for 30 min the fasting blood glucose was decreased markedly than that before acupuncture（P〈0.05）.After 30-minute acupuncture on the fifth day,the fasting blood glucose was lower obviously than that before treatment on the first day（P〈0.05）.Conclusion ①The electroacupuncture at ear and body acupoints can reduce the instant fasting blood glucose of T2 DM machins apparently.② There is time effect on instant fasting blood glucose of T2 DM machins treated by electroacupuncture.The efficacy of 30-minute stimulation is superior to that of 15-minute acupuncture.After acupuncture continuously for 4 days,the effect is better than that with acupuncture for3 days successively.

Modulation of fasting blood glucose by raw banana powder in alloxan-induced diabetic rats

This study aimed to observe the influence of raw banana powder(RBP)on fasting blood glucose(FBG),blood lipid and other biochemical indicators in type-2 diabetic rats and therefore to provide experimental evidences for developing suitable food from banana powder for diabetic patients.Eight Sprague-Dawley rats were selected randomly as the normal control group(NCG)before the experiment.After establishing type-2 diabetic rat models(11.1-16.7 mmoL/L)by alloxan,32 rats were divided into four groups:the diabetic control group(DCG,n=8),low-dose group(LDG,n=8),middle-dose group(MDG,n=8)and high-dose group(HDG,n=8).The LDG,MDG and HDG rats received gastric perfusion of RBP at the doses of 2 g/kg,4 g/kg and 6 g/kg per day,respectively.After four weeks,oral glucose tolerance test was carried out in each group,and then the FBG level,blood lipid,insulin,short chain fatty acids content,pH value of colon content and other biochemical indicators of rats in each group were determined and compared among the groups.Results showed that the levels of FBG significantly decreased in the LDG(11.97±0.83),MDG(8.95±0.45)and HDG(9.28±1.45),compared with their initial values(13.00±1.25,13.68±0.75 and 13.91±0.80,respectively).The FBG levels in these three groups were obviously lower than that in the DCG.However,there were no dramatic FBG changes in the NCG and DCG(5.77±0.59,14.14±0.72)compared with the initial stage(5.55±0.23,13.93±0.47).The RBP intervention increased insulin-sensitivity index and regulated postprandial blood glucose.Besides,RBP showed the positive effects on symptoms of type 2 diabetic rats,such as the reduction of weight gain and total cholesterol.

Investigation on Blood Glucose Control Nursing of ICU Severe Patients

Objective:To analyze the effect of blood glucose control mursing in intensive care umit (ICU)patients.Methods:The clinical data of 70 severe patients in ICU of ou hospital fom January 2019 to May 2020 were retrospectively analyzed.The climical data of 34 patients with routine intervention were divided into the control group,and the clinical data of 36 patients with routine intervention and blood glucose control mursing were divided into the observation group,all were intervened for 14 days.The blood glucose levels and prognosis of the two groups were compared before intervention and at the end of 14 days of intervention,the time required o achieve the standard blood glucose level of the two groups was recorded Results:After 14 days of intervention,the fasting blood glucose level of the observation group was lower than the control group,the difference was satisically significant(P<0.05);the time of blood glucose reaching the standard in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.05);on the 14th day of intervention,the sequential organ failure asessment score(SOFA)score of the two groups was lower than before intervention,the SOFA score of the observation group was lower than control group,the difference was statistically significant(P<0.05).Conclusion:The effect of blood glucose control mursing in ICU is better,which effectively controlled the blood glucose level of patients and improved the prognosis of patients.

Cut-off value of glycated hemoglobin A1c for detecting diabetic retinopathy in the Chinese population

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.

Associations of serum D-dimer and glycosylated hemoglobin levels with third-trimester fetal growth restriction in gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and development.AIM To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM patients.METHODS The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the Obstetrics and Gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed retrospectively.Among these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative analysis.The diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic regression.RESULTS Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,respectively.The AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,respectively.High D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can indicate the occurrence of FGR in GDM patients in the third trimester of pregnancy to some extent,and their combination can be used as an important index for the early prediction of FGR.

Prevalence of Abnormity of Blood Lipid and Associated Factors in Health Examination Population in Beijing

Objective To investigate the prevalence of abnormity of blood lipid and associated factors in healthy population in Beijing. Methods Totally, 38 462 individuals who received health examination were enrolled in our study. We divided them into eight groups according to their ages. The levels of serum total cholesterol, triglyceride, high density lipoprotein cholesterol, and low density lipoprotein cholesterol were tested, and the relationship of blood lipid abnormity with body mass index (BMI) and fasting blood glucose was analyzed. Results The incidences of hypercholesterolemia, hyperglyceridemia, low high-density lipoprotein cholesterolemia, and hyper low-density lipoprotein cholesterolemia presented increasing trend in this population. The incidence rate of abnormity of blood lipid in health examination population increased with BMI increase. The incidence of abnormity of blood lipid in overweight and obesity population was significantly higher than that in low weight and normal weight populations (P<0.05). Meanwhile, the trend of abnormal blood lipid incidence coincided with that of abnormal fasting blood glucose. Conclusions The prevalence of overweight, obesity, and abnormity of blood lipid in Beijing presents increasing trend. The incidence of abnormity of blood lipid increases with BMI increase, in coincidence with that of fasting blood glucose.

Instant effect of acupuncture on lowering blood glucose

Objective To observe blood sugar values were measured at respectively, in 40 patients with type lI instant effect of acupuncture on lowering blood glucose. Methods Fasting 7：30 and 8：00 a.m. on one day, two and three days before acupuncture, diabetes. Acupuncture was applied at Yishu （胰俞 Extra）, Feishu （肺俞BL 13）, Pisha which was （脾俞 BL 20）, Shenshu （肾俞 BL 23）, Sanyinjiao （三阴交 SP 6）, Taxixi （太溪 KI 3） and auxiliary points, followed by needle remaining for 30 minutes, for continuous 3 days. Blood glucose values measured immediately after acupuncture were compared with those obtained before acupuncture. Results Before acupuncture application, no significant differences were found between the values measured at 7：30 and 8：00 a.m. （P〉0.05） in fasting blood glucose values. Fasting blood glucose values measured at 8：00 were lower than those at 7：30 on the three days during acupuncture treatment （P〈O.05）, and they were also lower than those measured at 8：00 before acupuncture （P〈0.05）. Conclusion Acupuncture has immediate effect of lowering blood sugar.

Huangqi Guizhi Wuwu Decoction for treating diabetic peripheral neuropathy：a meta-analysis of 16 randomized controlled trials

OBJECTIVE：This meta-analysis was performed to systematically assess the efficacy and safety of the Chinese herbal medicine Huangqi Guizhi Wuwu Decoction（HGWWD） for treating diabetic peripheral neuropathy.DATA SOURCES：Six electronic databases,including the Cochrane Library,MEDLINE database,Chinese Biomedical Database,Chinese National Knowledge Infrastructure Database,Chinese Science and Technique Journals Database,and the Wanfang Database,were search ed on the internet for randomized controlled trials published up until 1 December 2015.The search terms included ＂Chinese herbal medicine＂,＂diabetic peripheral neuropathy＂ and ＂randomized controlled trials＂ in Chinese and in English.DATA SELECTION：We included randomized controlled trials using HGWWD/modified HGWWD for the treatment group,without restriction for the control group.We assessed literature quality in accordance with the Cochrane Review Handbook.A random or a fixed effects model was used to analyze outcomes using Rev Man 5.2 software.OUTCOME MEASURES：The primary outcomes were changes in symptoms and nerve conduction velocities.The secondary outcomeswere fasting blood glucose and hemorheological indexes.RESULTS：Sixteen randomized controlled trials,with a total of 1,173 patients,were included.Meta-analysis revealed that the efficacy of HGWWD for diabetic peripheral neuropathy was significantly superior compared with the control treatment（i.e.,control group）（risk ratio = 0.36,95% confidence interval（CI）：0.29–0.46,Z =8.33,P 〈 0.00001） Compared with the control group,there was an increase in median motor nerve conduction velocity（mean difference（MD） = 3.46,95%CI：1.88–5.04,Z = 4.30,P 〈 0.01） and median sensory nerve conduction velocity（MD = 3.30,95%CI：2.04–4.56,Z = 5.14,P 〈 0.01）.There was also an increase in peroneal motor nerve conduction velocity（MD = 3.22,95%CI：2.45–3.98,Z = 8.21,P 〈 0.01） and peroneal sensory nerve conduction velocity（MD = 3.05,95%CI：2.01–4.09,Z = 5.75,P 〈 0.01） in the treatment groups.No significant difference in fasting blood glucose was found between the treatment groups and the control groups（MD =-0.12,95%CI：-0.42–0.19,Z = 0.76,P = 0.45）.Plasma viscosity was significantly decreased after treatment（MD =-0.11,95%CI：-0.21 to-0.02,Z = 2.30,P = 0.02）.No significant difference in fibrinogen was detectable（MD =-0.53,95%CI：-1.28–0.22,Z = 1.38,P = 0.17）.Four trials reported that treatment groups experienced no adverse reactions.Adverse events were not mentioned in the other 12 trials.No trial reported the incidence of complications,quality of life outcomes,or health economics.CONCLUSION：HGWWD treatment improves diabetic neurologic symptoms and ameliorates nerve conduction velocities.Our study suggests that HGWWD may have significant therapeutic efficacy for the treatment of diabetic peripheral neuropathy.However,the methodological quality of the randomized controlled trials was generally low.Larger and better-designed randomized controlled trials are required to more reliably assess the clinical effectiveness of HGWWD.

Preventive effect of danhong huayu koufuye on diabetic retinopathy in rats

AIM: To study the effects of danhong huayu koufuye (DHK) on fasting blood glucose (FBG) and diabetic retinopathy (DR) in streptozotocin (517)-induced type 1 diabetic rats to facilitate the rational usage of this drug. METHODS: Diabetic rats were induced by injection of a single dose of STZ intraperitoneally at 50mg/kg. Flash electroretinogram (FERG) and oscillatory potentials (OPs) were used to measure retinal function. The microvascular perfusion of ears was performed to study the microcirculation in rats. FBG, body-weight, and 24-h urine volume, water intake and diet intake were also assessed. RESULTS: DHK had no effect on FBG in normal rats. However, STZ + DHK group were significantly different from those of Model and moved toward those of normal control. It reversed the increase in diet intake (P <= 0.05 vs model control) and the loss in body-weight (P <= 0.05 vs model control) in diabetic rats. DHK decreased the FBG of diabetic rats by 25.6% (P <= 0.05) and 37.9% P <= 0.01) after 14 and 21 days administration as compared with the model control, respectively. Moreover, DHK significantly increased the FERG b-wave amplitude by 80% (P <= 0.05 vs model control) and decreased the FERG b-wave latency by 15.3% (P <= 0.01 vs model control) after 24 days administration. The OP(1) and OP(2) amplitudes in DHK group were 2.6 (P <= 0.01) and 2.0 (P <= 0.01) times of model group after 24 days of DHK treatment, respectively. At the same time, OP(1) and OP(2) latencies in DHK group reduced by 16.0% (P <= 0.001) and 14.7% (P <= 0.001) as compared with the model control, respectively. Furthermore, the microvascular perfusion of DHK group was 2.4 times of model group (P <= 0.001) after 21 days administration. CONCLUSION: DHK had no effect on normal FBG. But it had antihyperglycemic activity, and had a preventive and therapeutic effect on DR in diabetic rats.

Gut microbiota dysbiosis in Chinese children with type 1 diabetes mellitus:An observational study

BACKGROUND Gut microbiota dysbiosis is reportedly actively involved in autoimmune diseases such as type 1 diabetes mellitus(T1DM).However,the alterations in the gut microbiota and their correlation with fasting blood glucose(FBG)in Chinese children with T1DM remain unclear.AIM To investigate alterations in the gut microbiota in Chinese children with T1DM and their associations with clinical indicators.METHODS Samples from 51 children with T1DM and 47 age-matched and gender-matched healthy controls were obtained,to explore the structural and functional alterations in the fecal microbiota.The V3-V4 regions of the 16S rRNA gene were sequenced on a MiSeq instrument,and the association with FBG were analyzed.RESULTS We found that the bacterial diversity was significantly increased in the T1DMassociated fecal microbiota,and changes in the microbial composition were observed at different taxonomic levels.The T1DM-reduced differential taxa,such as Bacteroides vulgatus ATCC8482,Bacteroides ovatus,Bacteroides xylanisolvens,and Flavonifractor plautii,were negatively correlated with FBG,while the T1DMenriched taxa,such as Blautia,Eubacterium hallii group,Anaerostipes hadrus,and Dorea longicatena,were positively correlated with FBG.Bacteroides vulgatus ATCC8482,Bacteroides ovatus,the Eubacterium hallii group,and Anaerostipes hadrus,either alone or in combination,could be used as noninvasive diagnostic biomarkers to discriminate children with T1DM from healthy controls.In addition,the functional changes in the T1DM-associated fecal microbiota also suggest that these fecal microbes were associated with altered functions and metabolic activities,such as glycan biosynthesis and metabolism and lipid metabolism,which might play vital roles in the pathogenesis and development of T1DM.CONCLUSION Our present comprehensive investigation of the T1DM-associated fecal microbiota provides novel insights into the pathogenesis of the disease and sheds light on the diagnosis and treatment of T1DM.

Diagnosis and treatment of insulinoma: report of 105 cases

Objective: To study the methods for diagnosis andtreatment of insulinoma.Methods: Clinical data from 105 patients with insuli-noma who had been admitted to our hospital from Ju-ly 1966 to December 1999 were retrospectively re-viewed.Results: Fasting blood glucose values were less than2.75 mmol/L in all the patients. Fasting serum insulinvalues in 60 patients were higher than 25 mU/L, av-erage 65 mU/L. Before operation, carcinoma was de-tected in 2 of 45 patients by ultrasound scan, and in10 of 35 by CT. Enucleation of insulinoma was per-formed in 60 patients. Operations included insulinomaresection (35 patients), distal resection of the pancreas(8), and biopsy (2).Conclusion: Whipple's triad and the index of insulinrelease>0.3 are the major variables for diagno-sis Intraoperative exploration and ultrasound scan are themethods for the localization of insulinoma Enucleation ofbenign insulinoma is preferred, but proximal or distal re-sections of the pancreas are required only for large, deep ormultiple tumors

Hypoglycemic and anti-hyperglycemic study of Ocimum tenuiflorum L.leaves extract in normal and streptozotocin-induced diabetic rats

Objective:To investigate the antidiabetic activity of Ocimum tenuiflorum L.(O.tenuiflorum) leaves used in the traditional medicine management of diabetes in Malaysia.Methods:O.tenuiflorum leaves were extracted sequentially with hexane,chloroform,ethyl acetate,methanol,and water.The extracts were evaluated in terms of antidiabetic activity by using acute,subcutaneous glucose tolerance,and sub-chronic tests in streptozotocininduced diabetic rats.The extracts were also subjected to phytochemical analyses.Results:With an acute dose(1 g/kg),the methanol extracts showed significant reduction(31%) in fasting blood glucose(FBG) of the streptozotocin-induced diabetic rats.The FBG-decreasing effect of ethyl acetate extract was more rapid than that of the other extracts;the decreasing rates were 20%after 2 h,21%after 3 h,and 8%after 5 and 7 h.After 7 h(31%),the effect of methanol extract on FBG was significantly lower than that of metformin.In the subcutaneous glucose tolerance test,only methanol and hexane extracts showed the similarity of metformin in diabetic rats.After 14 days,the effects of these extracts were similar to those of metformin(63.33%).The total flavonoid and phenolic contents of extracts decreased as the polarity of the extraction solvent increased.Conclusions:The results obtained provide support for a possible use of O.tenuiflorum leaves in managing hyperglycemia and preventing the complications associated with it in type 2 diabetic.

Initiation of Basal Insulin in Patients with Uncontrolled Type 2 Diabetes Mellitus

Type 2 diabetes mellitus is a growing health problem, characterized by insulin resistance progressing to beta cell dysfunction and insulin deficiency, most of these patients will need intensification of treatment and initiation of insulin to delay or prevent diabetic complications. Glycemic control is the most important aspect of management, and in reducing morbidity and mortality of the diseases. Control of plasma glucose in patients with diabetes can be assessed by HbA1c, FPG, PPG, but still HbA1c% remains the gold standard for assessment of glycemic control and follow up of diabetic patients. The aim of this study is to assess HbA1c% in patients on oral anti-diabetic drugs, with poor glycemic control before and after adding basal insulin, with titration of the dose of insulin depending on fasting blood sugar. 82 patients with uncontrolled type 2 diabetes (43.9% male, 56.1% female), with HbA1c more than 9%, on two types of oral diabetic medication or more, were started on basal insulin (glargine, lantus) and followed for three to six months. Overall 82 patients with type 2 diabetes mellitus were included in the study. The mean age of the study population was 58.4 years, the mean duration of the disease range was 13.4 years. All patients with HbA1c more than 9%, without organ failure, were included in the study. The mean HbA1c overall had decreased from mean of 11.15% before starting basal insulin to the mean of 8.43% within 3 to 6 month, after initiating basal insulin, this difference was significant at p < 0.001. There was no adverse effect on this medication in any of the study group. The addition of basal insulin to oral anti-diabetic medication in uncontrolled insulin-naïve type 2 diabetic patients resulted in significant improvement of glycemic control, with improved HbA1c level, without adverse effects.

High Sensitivity C-Reactive Protein Associated with Different Health Predictors in Middle-Aged and oldest old Chinese

Objective To describe the distribution of plasma high sensitivity C-reactive protein （hsCRP） and explore the relationship between hsCRP and metabolic risk factors among residents living in longevity areas of China. Methods 268 individuals aged between 40 and 59 years and 506 individuals aged over 90 years were selected from 5 longevity areas of China to participate in a cross section longitudinal cohort study. The participants were interviewed with general health related questionnaire to collect their demographic, behavioral and lifestyle data, as well as their chronic conditions, and meanwhile their physical and biomedical parameters including waist circumference （WC）, blood pressure （BP）, hsCRP, plasma lipids, and fasting blood glucose （FBG） were measured. Results The median of hsCRP was 0.99 mg/L in the middle-aged group and 2.76 mg/L in the oldest old group. No significant gender difference was observed between the above two groups. Among the oldest old individuals, 36.56% had an hsCRP level 〉3.0 mg/L. The prevalence of high hsCRP was 26.79% in the middle-aged group. The results of stepwise multiple linear regression analyses showed that HDL-C was independently associated with In （hsCRP） concentration in the middle-aged group, whereas In （TG）, HDL-C and FBG were correlated after adjustment for gender, study site, smoking, drinking, education and BMI in the oldest old group. Conclusion HDL-C is a stronger predictor of elevated hsCRP than other metabolic factors in the middle-aged population. For the oldest old persons, high TG, low HDL-C, and FBG predict elevated plasma hsCRP.

Protective effect of modified Yu-Ye decoction on type 2 diabetes mellitus rats

Background:Yu-Ye decoction is a classic prescription therapy that is widely used in the treatment of type 2 diabetes mellitus(T2DM).In this study,we evaluate and exhibit the protective effect of modified Yu-Ye decoction on T2DM rats.Methods:Sixty rats with T2DM were included in this study that was induced by high-fat high-glucose diet for 6 weeks.following 6 weeks later,1%streptozotocin 30 mg/kg was injected intraperitoneally,and the T2DM rats were randomly divided into the model group,the metformin(90 mg/kg)positive control group,and the modified Yu-Ye decoction(6.4 g/kg,12.7 g/kg,25.4 g/kg)group.In contrast,standard chow was provided to the 10 rats in the control group.The drug was administered for four weeks,and fasting blood glucose was monitored.After four weeks of treatment,oral glucose tolerance test experiments were carried out.Serum was collected for the detection of alanine aminotransferase,aspartate aminotransferase,creatinine,blood urea nitrogen,low density lipoprotein,high density lipoprotein,and total cholesterol,triglyceride.Hematoxylin-eosin staining was used to assess potential pathological changes in the liver,kidneys,and pancreas.Results:Results from fasting blood glucose monitoring and oral glucose tolerance test showed that modified Yu-Ye decoction could significantly improve the blood glucose concentration and insulin resistance,compared to the model group.In addition,modified Yu-Ye decoction could significantly reduce the serum levels of alanine aminotransferase,aspartate aminotransferase,creatinine,blood urea nitrogen,low density lipoprotein,total cholesterol,triglyceride,and increase the level of high density lipoprotein.At the same time,hematoxylin-eosin results exhibited that modified Yu-Ye decoction could increase the number of islet cells,reduce the volume of islet cells,improve liver edema and inflammation,and improve renal glomerular hypertrophy.Conclusion:This study shows that modified Yu-Ye decoction ameliorates T2DM because it can reduce fasting blood glucose concentration,improve glucose tolerance,protect liver and kidney function,and improve livers,kidneys,and pancreas tissue morphology.

Liuwei Dihuang Pills(六味地黄丸) Enhance the Effect of Western Medicine in Treating Type 2 Diabetes:A Meta-Analysis of Randomized Controlled Trials

Objective： To perform meta-analyses evaluating the efficacy of adding Liuwei Dihuang Pills （六味地黄丸 LDP） to Western medicine in improving treatment outcomes for type 2 diabetes. Methods： Medline, PubMed, Cochrane Library, and Chinese databases, including the Chinese National Knowledge Infrastructure were searched to identify eligible studies; i.e., if the study involved a randomized clinical trial in which the experimental group combined LDP with Western drugs and the control group used the corresponding Western drugs alone to treat type 2 diabetes. Outcomes were measured in terms of fasting blood glucose （FBG）, postprandial blood glucose （2hPG） and HbAlc level. Efficacy was also measured by using control and response rates. The combined odds ratio （OR）, mean difference （MD）, and 95% confidence intervals （95% CI） were calculated. Results： Studies included in the analysis were less adequate than expected in terms of methodological qualify. A total of 1,609 patients from 18 studies were included. We found that adding LDP can lower patients＇ FBG （MD=0.54 mmol/L, 95% CI [0.15, 0.93], P=0.007）, 2hPG （MD=1.05 mmol/L, 95% CI [0.29, 1.81], P〈0.01） and HbAlc （MD=0.23, 95% CI [0.02, 0.45], P=0.008）. There were also improvements in treatment response rates （OR=3.41, 95% CI [2.38, 4.90], P〈0.01） and control rates （OR=2.47, 95% CI [1.91, 3.20], P〈0.01）. Conclusion： Adding LDP to Western medicine might improve treatment outcomes of diabetes, including FBG, 2hPG, response rates and control rates.

Effect on glycemia in rats with type 2 diabetes induced by streptozotocin: low-frequency electro-pulse needling stimulated Weiwanxiashu(EX-B 3) and Zusanli(ST 36)

OBJECTIVE: To investigate the effect of low frequency electro-pulse acupuncture(EA) on blood glucose in rats with streptozotocin-induced type 2diabetes, and the possible mechanism underlying the action.METHODS: Rat models were established with high fat feeding and intraperitoneal injection of streptozotocin(STZ)(30 mg/kg). Rats with a random blood glucose > 16.7 mmol/L and blood glucose at 2 h-point of oral glucose tolerance test(OGTT) > 11.1 mmol/L were included as diabetic rats, and randomly divided into model group, EA Weiwanxiashu(EX-B 3) group, EA Zusanli(ST 36)group, glimepiride group, and EA non-acupoint group(n = 12). EA(2 Hz continuous wave, 2 m A,20 min/day, 6 days/week, 4 weeks) and intra-gastric administration of glimepiride were applied as interventions. With fasting blood glucose and OGTT tested at the end of the intervention, thestudy observed the patterns of hypoglycemic effects. For mechanism study, it observes hematoxylin and eosin staining and Masson staining of pancreas paraffin sections, protein expression of glucagon-like peptide 1 receptor(GLP-1R) in the pancreas and skeletal muscle, glucose transporter 4(GLUT4) protein expression in skeletal muscle membrane, to detect whether EA controls blood glucose via regulation of GLP-1R.RESULTS: EA Weiwanxiashu(EX-B 3) significantly increased model rats' pancreas GLP-1R, and GLUT4 of skeletal muscle membrane; the therapy significantly decreased model rats' skeletal muscle GLP-1R, restored pancreas morphology, and reduced fasting blood glucose and insulin resistance indices.CONCLUSION: EA Weiwanxiashu(EX-B 3) alone has significant effect on glycemia. EA Weiwanxiashu(EX-B 3) plus glimepiride further strengthen the effect. The regulation of the GLP-1R in pancreas and skeletal muscle might be mechanism underpinning the effect.

Effects of L-arginine supplementation on glycemic profile: Evidence from a systematic review and meta-analysis of clinical trials

Background:The effects of l-arginine supplementation on indices of glycemic control and the role of many factors influencing this intervention have been controversial in clinical trials.Objective:This meta-analysis was performed to assess the effects of l-arginine supplementation on indices of glycemic control,including fasting blood glucose(FBG),hemoglobin A1c(HbA1c),serum insulin and homeostatic model assessment of insulin resistance(HOMA-IR)levels in randomized controlled trials(RCTs).Search strategy:This study conducted a systematic review of RCTs published in PubMed,Scopus,Web of Science,Cochrane Library and Embase,up to 5 May,2018.Inclusion criteria:Studies were included in this meta-analysis if they were RCTs with parallel design and reported sufficient data on participants before and after intervention,and outcomes of glycemic profile parameters in both the arginine supplementation and control groups.Data extraction and analysis:The screening of titles and abstracts was performed independently by two reviewers.Selected articles were considered if they met the study’s inclusion criteria.The quality of included studies was assessed by using the Cochrane Collaboration modified tool.From 710 articles retrieved in the initial search,only 10 trials were suitable for pooling the effects of arginine supplementation on serum glucose,insulin,HOMA-IR and HbA1c levels,with effect sizes of nine,eight,five and five,respectively.Results:Pooled random-effect analysis revealed that l-arginine supplementation could significantly decrease FBG level(weighted mean difference[WMD]:3.35 mg/dL;95%confidence interval[CI]=[−6.55,−0.16];P=0.04)and serum insulin level(WMD:−2.19μIU/mL;95%CI=[−3.70,−0.67];P=0.005).However,the effects of l-arginine supplementation on HOMA-IR and HbA1c were not significant.Results of subgroup analysis showed that supplementation with l-arginine could significantly decrease serum insulin levels when the dosage of l-arginine is>6.5 g/d(WMD:−3.49μIU/mL;95%CI=[−5.59,−1.38];P=0.001),when the duration of supplementation is≤12.8 weeks(WMD:−3.76;95%CI=[−6.50,−0.98];P=0.008),when the participants are not diabetic patients(WMD:−2.54μIU/mL;95%CI=[−4.50,−0.50];P=0.01)and when the baseline serum level of insulin was>20μIU/mL(WMD:−3.98;95%CI=[−6.31,−1.65];P=0.001).Conclusion:Although the results of this study confirmed that supplementation with l-arginine could have significant effects on some glycemic profile indices of participants in clinical trials,the clinical importance of this reduction may not be meaningful.