A Study on Enhancing Pancreatic Islet Function in Type 2 Diabetes and Coronary Heart Disease Patients with Liraglutide and Metformin Combination Therapy

Objective:To investigate the impact of combining liraglutide with metformin on the enhancement of pancreatic islet function in patients with type 2 diabetes and coronary heart disease.Methods:60 patients with type 2 diabetes and coronary heart disease admitted from February 2022 to August 2023 were selected as research subjects.They were randomly assigned to either control or treatment groups,with 30 patients in each.The control group received metformin alone,while the treatment group received liraglutide in combination with metformin.Various indicators,including blood sugar levels,pancreatic islet function,and cardiac function between the two groups were compared.Results:The results of FPG,2hPG,HbA1c,HOMA-IR,NT-proBNP,and LVEDD in the treatment group were lower than those in the control group,whereas the values of FINS,HOMA-β,E/A,and LVEF in the treatment group were higher than those in the control group(P<0.05).Conclusion:The use of liraglutide in combination with metformin significantly benefits patients with type 2 diabetes and coronary heart disease.It leads to improved pancreatic islet function,better blood sugar control,and enhanced cardiac function.This combination therapy is recommended for clinical adoption.

Effect of Renin Angiotensin System Blockade on the Islet Microvessel Density of Diabetic Rats and Its Relationship with Islet Function

To investigate the effects of rennin angiotensin system blockade on the microvessel density in islets of diabetic rats and its relationship with islet function, diabetes model was created by feeding of high-caloric laboratory chow plus intraperitoneal injection of a small dose of streptozotocin （30 mg/kg）. After 8 weeks intervention with perindopril （AE, n=10） or valsartan （AR, n=10）, the islet function of the animals was evaluated by intravenous insulin release test （IVIRT）. The pancreases were immunohistochemically stained to analyze the content of insulin and vascular endothelial growth factor （VEGF） in the islets. The microvessel density （MVD） of islets was detected by counting CD34 positive cells. The hypoxia inducible factor （HIF）-1α mRNA expression in the islets was detected by RT-PCR. Compared with normal control group （NC, n=10）, the area under the curve for insulin from 0 to 30 min （AUCI0-30） of diabetes group （DM, n=8） was decreased by 66.3%; the insulin relative concentration （IRC） of βcell was decreased significantly; the relative content of VEGF was increased obviously [（–4.21±0.13） vs （–4.06±0.29）]; MVD in islets was decreased by 71.4%; the relative expression of HIF-1α mRNA was increased by 1.19 times （all P〈0.01）. Compared with DM group, the AUCI0-30 of AE and AR group was increased by 44.6% and 34.9% respectively; IRC was also increased significantly; the relative content of VEGF was decreased by 21.2% and 21.7% respectively; MVD was increased by 62.5% and 75.0% respectively; the relative expression of HIF-1α was decreased by 27.2% and 29.0% respectively （all P〈0.01 or P〈0.05）. There were no significant differences in the said indexes between group AE and AR. It is concluded that the blockade of RAS may ameliorate islets function of diabetic rats by increasing the MVD in islets.

Influence of heme oxygenase-1 gene transfer on the viability and function of rat islets in in vitro culture

AIM. To investigate the influence of heme oxygenase-1 （HO-1） gene transfer on the viability and function of cultured rat islets in vitro. METHODS： Islets were isolated from the pancreata of Sprague-Dawley rats by intraductal collagenase digestion, and purified by discontinuous Ficoll density gradient centrifugation. Purified rat islets were transfected with adenoviral vectors containing human HO-1 gene （Ad- HO-1） or enhanced green fluorescent protein gene （Ad- EGFP）, and then cultured for seven days. Transfection was confirmed by fluorescence microscopy and Western blot. Islet viability was evaluated by acridine orange/ propidium iodide fluorescent staining. Glucose-stimulated insulin release was detected using insulin radioimmunoassay kits and was used to assess the function of islets. Stimulation index （SI） was calculated by dividing the insulin release upon high glucose stimulation by the insulin release upon low glucose stimulation. RESULTS： After seven days culture, the viability of cultured rat islets decreased significantly （92% ± 6% vs 52% ± 13%, P 〈 0.05）, and glucose-stimulated insulin release also decreased significantly （6.47 ± 0.55 mIU/ L/30IEO vs 4.57 ± 0.40 mIU/L/3OIEO., 14.93 ± 1.17 mIU/L/30IEQ vs 9.63 ± 0.71 mIU/L/30IEQ, P 〈 0.05）. Transfection of rat islets with adenoviral vectors at an 1±10 of 20 was efficient, and did not impair islet function. At 7 d post-transfection, the viability of Ad-HO-1 transfected islets was higher than that of control islets（71% ± 15% vs 52% ± 13%, P 〈 0.05）. There was no significant difference in insulin release upon low glucose stimulation （2.8 mmol/L） among Ad-HO-1 transfected group, Ad-EGFP transfected group, and control group （P 〉 0.05）, while when stimulated by high glucose （16.7 mmol/L） solution, insulin release in Ad-HO-1 transfected group was significantly higher than that in Ad-EGFP transfected group and control group, respectively （12.50 ±2.17 mIU/L/30IEQ vs 8.87 ± 0.65 mIU/L/30IEQ, 12.50 ± 2.17 mIU/L/30IEQ vs 9.63 ± 0.71 mIU/L/30IEQ, P 〈 0.05）. The SI of Ad-HO-1 transfected group was also significantly higher than that of Ad-EGFP transfected group and control group, respectively （2.21 ± 0.02 vs 2.08 ± 0.05; 2.21 ± 0.02 vs 2.11 ± 0.03, P 〈 0.05）. CONCLUSION： The viability and function of rat islets decrease over time in in vitro culture, and heine oxygenase-1 gene transfer could improve the viability and function of cultured rat islets.

Small intestinal submucosa improves islet survival and function during in vitro culture

AIM： To evaluate the recovery and function of isolated rat pancreatic islets during in vitro culture with small intestinal submucosa （SIS）. METHODS： Pancreatic islets were isolated from Wistar rats by standard surgical procurement followed by intraductal collagenase distension, mechanical dissociation and Euroficoll purification. Purified islets were cultured in plates coated with multilayer SIS （SIS-treated group） or without multilayer SIS （standard cultured group） for 7 and 14 d in standard islet culture media of RPMI 1640. After isolation and culture, islets from both experimental groups were stained with dithizone and counted. Recovery of islets was determined by the ratio of counts after the culture to the yield of islets immediately following islet isolation. Viability of islets after the culture was assessed by the glucose challenge best with low （2.7 mmol/L） and high glucose （16.7 mmol/L） solution supplemented with 50 mmol/L 3-isobutyl-1- methylxanthine （IBMX） solution. Apoptosis of islet cells after the culture was measured by relative quantification of histone-complexed DNA fragments using ELISA. RESULTS： After 7 or 14 d of in vitro tissue culture, the recovery of islets in SIS-treated group was significantly higher than that cultured in plates without SIS coating. The recovery of islets in SIS-treated group was about twice more than that of in the control group. In SIS treated group, there was no significant difference in the recovery of islets between short- and long-term periods of culture （95.8±1.0% vs 90.8±1.5%, P〉0.05）. When incubated with high glucose （16.7 mmol/L） solution, insulin secretion in SIS-treated group showed a higher increase than that in control group after 14 d of culture （20.7±1.1 mU/L vs 11.8±1.1 mU/L, P〈0.05）. When islets were placed in high glucose solution containing IBMX, stimulated insulin secretion was higher in SlS-treated group than in control group. Calculated stimulation index of SlS-treated group was about 23 times of control group. In addition, the stimulation index of SlS-treated group remained constant regardless of short- and long- term periods of culture （9.5±0.2 vs 10.2±1.2, P〉0.05）. Much less apoptosis of islet cells occurred in SlS-treated group than in control group after the culture. CONCLUSION： Co-culture of isolated rat islets with native sheet-like SIS might build an extracellular matrix for islets and provide possible biotrophic and growth factors that promote the recovery and subsequent function of islets.

EFFECTS OF GLUCAGON ON ISLET β CELL FUNCTION IN PATIENTS WITH DIABETES MELLITUS

Objective To evaluate islet β cell response to intravenous glucagon （ a non-glucose secretagogue） stimulation in diabetes mellitus. Methods Nineteen patients with type 1 diabetes （T1 D） and 131 patients with type 2 diabetes （T2D） were recruited in this study. T2D patients were divided into two groups according to therapy： 36 cases treated with insulin and 95 cases treated with diet or oral therapy. The serum C-peptide levels were determined at fasting and six minutes after intra- venous injection of 1 mg of ghicagon. Results Both fasting and 6-minute post-ghicagon-stimulated C-peptide levels in T1D patients were significantly lower than those of T2D patients （0. 76±0. 36 ng/mL vs. 1.81±0. 78 ng/mL, P 〈 0.05 ; 0.88±0.42 ng/mL vs. 3.68±0. 98 ng/mL, P 〈 0. 05 ）. In T1D patients, the C-peptide level after injection of ghicagon was similar to the fasting level. In T2D, patients treated with diet or oral drug had a significantly greater fasting and stimulated C-peptide level than those patients received insulin therapy （2.45±0. 93 ng/mL vs. 1.61±0. 68 ng/mL, P 〈 0.05 ; 5.26±1.24 ng/mL vs. 2.15±0.76 ng/mL, P 〈 0.05 ）. The serum C-peptide level after ghicagon stimulation was positively correlated with C-peptide levels at fasting in all three groups （ r = 0.76, P 〈 0.05 ）. Conclusions The 6-minute ghicagon test is valuable in assessing the function of islet β cell in patients with diabetes mellitus. It is helpful for diagnosis and treatment of diabetes mellitus.

Relationship between Free Thyroxine and Islet Beta-cell Function in Euthyroid Subjects

Thyroid hormones have a specific effect on glucose-induced insulin secretion from the pancreas.We aimed to investigate the association between euthyroid hormones and islet betacell function in general population and non-treated type 2 diabetes mellitus(T2DM)patients.A total of 5089 euthyroid participants(including 4601 general population and 488 non-treated T2DM patients)were identified from a cross-sectional survey on the prevalence of metabolic diseases and risk factors in East China from February 2014 to June 2016.Anthropometric indices,biochemical parameters,and thyroid hormones were measured.Compared with general population,non-treated T2DM patients exhibited higher total thyroxine(TT4)and free thyroxine(FT4)levels but lower ratio of free triiodothyronine(T3):T4(P<0.01).HOMA-βhad prominently negative correlation with FT4 and positive relationship with free T3:T4 in both groups even after adjusting for age,body mass index(BMI)and smoking.When analyzed by quartiles of FT4 or free T3:T4,there were significantly decreased trend of HOMA-β going with the higher FT4 and lower free T3:T4 in both groups.Linear regression analysis showed that FT4 but not FT3 and free T3:T4 was negatively associated with HOMA-β no matter in general population or T2DM patients,which was independent of age,BMI,smoking,hypertension and lipid profiles.FT4 is independently and negatively associated with islet beta-cell function in euthyroid subjects.Thyroid hormone even in reference range could play an important role in the function of pancreatic islets.

Islet cell transplantation as a cure for insulin dependent diabetes: current improvements in preserving islet cell mass and function

OBJECTIVE: To review the current progress of islet cell transplantation in patients with insulin-dependent diabetes, emphasizing on the difficulties with recovering and preserving islet cell mass and function, 30% of which is lost during the peri-transplantation period. RESULTS: The islet-cell isolation technique is perfected, but improvements are still progressing in two major directions: preservation of islet cells and tolerance induction. Optimum islet cell viability and function depends on appropriate revascularization of the islet graft and blockade of thrombus formation as well as cytokine and free radical release. Conditioning the islet cells in-vitro prior to transplantation to either upregulate VEGF expression or downregulate NF-kappa B transcription factor has proven to improve revascularization and to prevent islet cell apoptosis and cytokine-mediated damage. Tolerance induction is currently being best achieved by selecting and combining immunosuppressive agents such as monoclonal antibodies which target the major signaling molecules during immune activation, but which are least toxic to islet cells. CONCLUSIONS: Patients with insulin-dependent diabetes will greatly benefit from current developments in effective approaches to protect islets during the peritransplant period. Emerging interest in stem cell biology and differentiation may provide the ultimate solution to the problem of organ scarcity and islet cell protection from the peritransplant induced damage.

玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病气阴两虚证患者临床疗效观察

目的:对玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病(T2DM)气阴两虚证患者的临床疗效进行探讨。方法:将60例T2DM患者随机分为对照组(n=30)和观察组(n=30),对照组采用二甲双胍联合德谷门冬双胰岛素治疗,观察组在此基础上应用玉液汤加减治疗,比较2组治疗后的中医证候积分、糖化血红蛋白(Hb Alc)、空腹血糖(FPG)、餐后2 h血糖(2h PG)、日内平均血糖波动幅度(MAGE)、胰岛素抵抗指数(HOMA-IR)和胰岛素分泌指数(HOMA-IS)。结果:治疗后,观察组总有效率显著高于对照组(93.33%vs 86.67%);观察组中医证候积分、Hb Alc、FPG、2h PG、MAGE和HOMA-IR等指标均低于对照组,HOMA-IS高于对照组(均P<0.05)。结论:玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病气阴两虚证患者疗效显著,可有效控制患者的血糖并改善胰岛功能。

2型糖尿病湿热困脾证合并血脂紊乱胰岛功能变化及其影响因素分析

目的探讨2型糖尿病湿热困脾证合并血脂紊乱患者胰岛功能变化及其影响因素。方法选择2020年1月—2020年12月医院收治的2型糖尿病湿热困脾证患者100例,根据美国ATPIII评估标准将其分为血脂紊乱组62例与血脂正常组38例。比较各组SF-36积分、胰岛素分泌功能(Homeostasis model assessment-β,HOMA-β)、胰岛素抵抗水平(Homeostasis model assessment-IR,HOMA-IR)、胰岛素敏感指数(Insulin sensitivity index,ISI)、空腹C肽和空腹胰岛素。应用单因素和多因素分析法研究血脂异常的相关因素。结果高甘油三酯组与混合型高脂组空腹胰岛素水平显著高于高胆固醇组与血脂正常组,差异有统计学意义(P<0.05)。高甘油三酯组空腹C肽水平显著高于高胆固醇组,差异有统计学意义(P<0.05)。混合型高脂组与高甘油三酯组的ISI水平低于高胆固醇组(P<0.05)。高甘油三酯组HOMA-β水平明显高于高胆固醇组与血脂正常组,差异有统计学意义(P<0.05)。高甘油三酯组及混合型高脂组HOMA-IR水平显著高于高胆固醇组,差异有统计学意义(P<0.05)。两组患者在躯体疼痛、整体健康、活力、社会功能和精神健康维度方面比较,差异有统计学意义(P<0.01)。多因素Logistic分析显示,喜食油腻、吸烟史、腰围和空腹胰岛素是2型糖尿病湿热困脾证患者血脂异常的危险因素,有氧运动是2型糖尿病湿热困脾证患者血脂异常的保护因素(P<0.05)。结论不同血脂紊乱类型对胰岛功能的影响并不相同,应针对相关因素积极预防,降低胰岛分泌负担,促使胰岛功能恢复。

西藏门巴族人群胰岛细胞功能、脂质代谢、炎症反应与中医体质的相关性研究

目的探讨西藏门巴族人群胰岛细胞功能、脂质代谢和炎症反应与中医体质的相关性。方法选取2023年1月—2023年6月墨脱村、亚东村、朗杰岗村、巴日村、德吉村、玛迪村6个门巴族乡的门巴族人群进行调查,共计237例。分析人群中医体质分布情况,同时比较前三位中医体质人群的胰岛细胞功能、脂质代谢和炎症因子水平。结果中医体质类型中以痰湿质、湿热质和气虚质为主,分别占32.07%、26.16%和18.57%。痰湿质组、湿热质组和气虚质组性别、年龄、体质量指数比较,差异均无统计学意义(P>0.05)。湿热质组空腹血糖和胰岛素抵抗指数分别为(4.98±0.83)mmol/L和(1.75±0.32),均低于痰湿质组和气虚质组(P<0.05),湿热质组胰岛β细胞功能指数为(94.45±9.11),均高于痰湿质和气虚质组(P<0.05);湿热质组总胆固醇和甘油三酯分别为(3.98±0.99)mmol/L和(1.02±0.29)mmol/L,均低于痰湿质组和气虚质组(P<0.05),湿热质组高密度脂蛋白胆固醇为(1.26±0.20)mmol/L,均高于痰湿质组和气虚质组(P<0.05)。痰湿质、湿热质和气虚质组血清白细胞介素-6、超敏c反应蛋白、肿瘤坏死因子-α比较,差异均无统计学意义(P>0.05)。结论西藏门巴族人群中医体质以痰湿质、湿热质和气虚质为主,其中湿热质人群胰岛细胞功能、脂质代谢优于痰湿质和气虚质人群,炎症因子比较无差异。

葛根芩连汤加减联合二甲双胍对2型糖尿病胃肠湿热证患者中医证候积分及胰岛功能的影响

目的探讨葛根芩连汤加减联合二甲双胍对2型糖尿病(type 2 diabetes mellitus,T2DM)胃肠湿热证患者的影响。方法选取2022年4月—2023年12月深圳市中医院收治的78例T2DM胃肠湿热证患者为研究对象,根据不同治疗方法分为对照组和观察组,各39例。对照组口服盐酸二甲双胍片,观察组在对照组基础上给予葛根芩连汤加减治疗。对比两组的中医证候积分、血糖水平(空腹血糖、餐后2 h血糖、糖化血红蛋白)、胰岛功能(胰岛素抵抗指数、胰岛β细胞功能指数)、不良反应。结果治疗后,观察组的中医证候积分低于对照组,差异有统计学意义(P<0.05)。观察组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于对照组,差异有统计学意义(P均<0.05)。治疗后,两组胰岛素抵抗指数水平均降低,且观察组低于对照组,两组胰岛β细胞功能指数均提高,且观察组高于对照组,差异有统计学意义(P均<0.05)。结论在T2DM胃肠湿热证患者中使用葛根芩连汤加减与二甲双胍联合治疗,可有效改善中医证候、血糖水平及胰岛功能,安全性高。

益气养阴汤加减联合达格列净、二甲双胍对初诊2型糖尿病患者的疗效及血压、血尿酸水平的影响

目的:观察益气养阴汤加减联合达格列净、二甲双胍对初诊2型糖尿病(T2DM)的疗效及对患者血压、血尿酸(UA)水平的影响。方法:将2020年3月—2023年3月于仙桃市第一人民医院就诊且符合纳入条件的92例初诊T2DM患者作为对象,根据随机数字表法分为西药组和中西结合组。西药组45例给予达格列净、二甲双胍治疗,中西结合组47例给予益气养阴汤加减联合达格列净、二甲双胍治疗,两组均治疗12周。检测并比较两组胰岛功能指标、糖代谢指标、血压指标及血尿酸(UA)、载脂蛋白B/A1(ApoB/A1)、白脂素(Asprosin)水平,统计两组不良反应情况。结果:治疗前,两组胰岛功能指标、糖代谢指标、血压指标比较,差异无统计学意义(P>0.05)。治疗后,两组胰岛素样生长因子1(IGF-1)、胰岛β细胞功能指数(HOMA-β)升高(P<0.01),中西结合组高于西药组(P<0.01);两组糖代谢指标、胰岛素抵抗指数(HOMA-IR)、血压指标降低(P<0.05,P<0.01),中西结合组低于西药组(P<0.05,P<0.01);两组血压指标比较,差异无统计学意义(P>0.05)。治疗前,两组UA、Apo-A1、Asprosin比较,差异无统计学意义(P>0.05)。治疗后,两组UA、Apo-A1、Asprosin降低(P<0.05,P<0.01),中西结合组低于西药组(P<0.05,P<0.01)。治疗前,两组中医证候评分(包括3项主症和5项次症)比较,差异无统计学意义(P>0.05)。治疗后,两组3项主症和5项次症评分降低(P<0.01),中西结合组低于西药组(P<0.01)。西药组发生低血糖2例,胃肠道反应和生殖道感染各1例,中西结合组发生胃肠道反应2例。两组不良反应比较,差异无统计学意义(P>0.05)。结论:益气养阴汤加减联合达格列净、二甲双胍治疗初诊T2DM可有效控制血糖和血压,调节UA、Apo-A1、Asprosin的表达,改善胰岛功能,且不增加其不良反应。

枸橼酸氯米芬+二甲双胍对多囊卵巢综合征不孕症患者的疗效及其性激素水平的影响

目的探究多囊卵巢综合征不孕症的联合疗法,分析枸橼酸氯米芬、二甲双胍联用的价值。方法随机选取滕州市妇幼保健院于2022年3月—2023年6月收治的60例多囊卵巢综合征不孕症患者为研究对象,经信封法分为对照组(n=30,枸橼酸氯米芬治疗)、观察组(n=30,枸橼酸氯米芬+二甲双胍治疗),比较两组性激素、血糖及胰岛功能、排卵率、妊娠率、治疗有效率、不良反应发生率。结果治疗后,观察组性激素、血糖及胰岛功能、排卵率、妊娠率、治疗有效率均优于对照组,差异有统计学意义(P均<0.05);两组不良反应发生率(13.33%vs 10.00%)对比,差异无统计学意义(χ^(2)=0.162,P=0.688)。结论多囊卵巢综合征不孕症联合应用枸橼酸氯米芬、二甲双胍治疗具有显著效果,可有效改善患者的性激素、血糖、胰岛功能、排卵情况及妊娠情况,保障临床治疗安全性。

达格列净联合阿托伐他汀治疗糖尿病肾病的效果及对患者胰岛功能和机体微炎症状态的影响

目的探究达格列净联合阿托伐他汀治疗糖尿病肾病(DN)的效果及对患者胰岛功能和机体微炎症状态的影响。方法选取2021年2月至2022年2月海南省海口市人民医院收治的DN患者116例,按随机数字表法分为对照组和观察组,各58例。对照组采用阿托伐他汀钙片治疗,观察组在对照组基础上联合达格列净片治疗,2组均治疗3个月。比较治疗总有效率,治疗前后肾功能、胰岛功能指标和炎症因子水平。结果观察组总有效率显著高于对照组[93.1%(54/58)比77.6%(45/58)],差异有统计学意义(χ^(2)=5.583,P=0.018)。治疗后2组血尿素氮、血肌酐、24 h尿蛋白定量均明显低于治疗前,且观察组均低于对照组,差异均有统计学意义(均P<0.001)。治疗后2组稳态模型胰岛素抵抗指数均显著低于治疗前且观察组低于对照组[(2.43±0.28)比(2.67±0.31)],稳态模型胰岛β细胞功能指数均显著高于治疗前且观察组高于对照组[(13.4±3.8)比(10.5±3.3)],差异均有统计学意义(均P<0.05)。治疗后2组白细胞介素6、肿瘤坏死因子α、高敏C反应蛋白水平均显著低于治疗前且观察组低于对照组,差异均有统计学意义(均P<0.05)。结论达格列净联合阿托伐他汀治疗DN临床效果较好,可以有效改善患者胰岛功能,减轻机体的微炎症状态。

2型糖尿病伴桥本甲状腺炎患者甲状腺抗体滴度与胰岛功能的相关性研究

目的 探究2型糖尿病(T2DM)伴甲状腺功能正常的桥本甲状腺炎(HT)患者的甲状腺特异性抗体滴度与胰岛功能的相关性。方法 选择2021年1月至2023年5月于安徽医科大学附属安庆市立医院内分泌科就诊的92例甲状腺功能正常的HT伴T2DM患者,根据C肽水平将其分为低C肽水平组(50例)和高C肽水平组(42例)。比较两组性别、年龄、糖尿病病程、糖化血红蛋白(Hb A1c)、体重指数(BMI)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、25羟维生素D[25(OH)D]等指标。采用二元logistic回归模型分析胰岛功能的独立危险因素。结果 两组TPOAb、TGAb、糖尿病病程、25(OH)D、Hb A1c、BMI比较,差异有统计学意义(P<0.05)。二元logistic回归分析结果显示,TPOAb(OR=1.005,95%CI:1.001~1.009)、TGAb(OR=1.007,95%CI:1.000~1.014)、糖尿病病程(OR=1.455,95%CI:1.118~1.895)、BMI(OR=0.693,95%CI:0.517~0.928)、25(OH)D(OR=0.848,95%CI:0.726~0.991)是胰岛功能的影响因素(P<0.05)。结论 在T2DM合并HT患者中,TPOAb、TGAb的滴度水平与胰岛功能损伤有关,甲状腺自身免疫性抗体滴度是胰岛功能衰竭的独立危险因素。

甘精胰岛素U300联合口服降糖药治疗2型糖尿病的临床效果观察

目的探讨甘精胰岛素U300联合口服降糖药治疗2型糖尿病的临床效果。方法选择2021年10月—2023年1月广东省吴川市人民医院收治的79例2型糖尿病患者,随机分为非甘精组(39例)和U300组(40例)。非甘精组口服降糖药物治疗,在此之上,U300组增加甘精胰岛素U300治疗,持续治疗3个月,对比2组血糖及相关指标变化,并监测患者胰岛素功能相关指标改善情况,评估低血糖反应等不良反应情况。结果治疗后,U300组血糖指标、血糖波动指标均显著低于非甘精组,差异有统计学意义(P<0.05)。U300组治疗后胰岛素功能指标均显著优于非甘精组,空腹及餐后2 h C肽均显著高于非甘精组,差异有统计学意义(P<0.05)。U300组低血糖反应发生率(2.50%,1/40)和不良反应总发生率(20.00%,8/40)与非甘精组(2.56,1/39;17.95%,7/39)比较,差异无统计学意义(P>0.05)。结论增加甘精胰岛素U300治疗,可更好地提升患者血糖管理效果,并可改善胰岛功能,有利于稳定控制血糖,有助于提高患者病情控制效果,应用效果安全可靠。

有氧运动联合抗阻运动对妊娠期糖尿病患者胰岛细胞功能及糖脂代谢的影响

目的:探究有氧运动联合抗阻运动对妊娠期糖尿病患者胰岛细胞功能及糖脂代谢的影响。方法:将2021年5月—2023年6月松滋市人民医院的100例妊娠期糖尿病患者依据随机数字表法分为对照组50例和观察组50例。对照组进行常规妊娠期糖尿病干预,观察组则在对照组的基础上加用有氧运动联合抗阻运动。比较两组的干预总有效率、干预前后的胰岛细胞功能[稳态模型评估胰岛素抵抗指数(HOMA-IR)及稳态模型评估β细胞功能指数(HOMA-β)]、糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)]及脂代谢指标[总胆固醇(TC)、三酰甘油(TG)及低密度脂蛋白胆固醇(LDL-C)]。结果:观察组的干预总有效率高于对照组(P<0.05)。干预前两组的胰岛细胞功能、糖代谢指标及脂代谢指标比较,差异均无统计学意义(P>0.05),干预4、8周后,两组的HOMA-β均高于干预前,且观察组均高于对照组,两组的HOMA-IR、糖代谢指标及脂代谢指标均低于干预前,且观察组均低于对照组(P<0.05)。结论:有氧运动联合抗阻运动在妊娠期糖尿病患者中的应用效果较好,且可显著改善患者的胰岛细胞功能及糖脂代谢状态。

卡格列净联合洛塞那肽对2型糖尿病胰岛素抵抗患者胰岛功能、YKL-40、PPARγ的影响

目的研究卡格列净联合洛塞那肽对2型糖尿病胰岛素抵抗患者疗效,及对胰岛功能、血清YKL-40、过氧化物酶体增殖物激活受体γ(PPARγ)的影响。方法选择2型糖尿病患者98例,随机均分为对照组(洛塞那肽治疗)和联合组(卡格列净联合洛塞那肽治疗),比较两组临床疗效、胰岛功能、血清YKL-40、PPARγ水平、血糖指标及不良反应发生率。结果联合组治疗总有效率高于对照组(P<0.05)。两组不良反应总发生率比较差异无显著性(P>0.05)。与治疗前比较,两组治疗后胰岛素曲线下面积、胰岛β细胞功能指数、PPARγ升高,胰岛素抵抗指数、YKL-40、空腹血糖、2 h餐后血糖、糖化血红蛋白、体质指数降低;且联合组变化更为显著(P<0.05)。结论卡格列净联合洛塞那肽治疗可有效提高2型糖尿病胰岛素抵抗患者胰岛功能,并显著改善YKL-40、PPARγ水平。

二甲双胍联合西格列汀治疗2型糖尿病患者的效果及对胰岛功能的作用

目的探讨盐酸二甲双胍联合磷酸西格列汀治疗2型糖尿病(T2DM)患者的降糖效果和对胰岛功能的影响。方法选取2020年3月-2023年3月在本院诊治的T2DM患者94例,随机分为对照组(47例)和观察组(47例)。其中对照组服用磷酸西格列汀治疗,观察组在对照组的基础上联用盐酸二甲双胍治疗,两组连续治疗3个月。比较两组治疗前后血糖指标变化、血糖控制达标情况、血脂指标变化、空腹胰岛素水平(FINS)、胰岛素抵抗指数(HOMA-IR)、胰岛C肽及不良反应差异。结果治疗后,观察组患者血清糖化血红蛋白水平(HbA 1c)、空腹血糖(FBG)、餐后2 h血糖(2 hPG)均明显低于对照组,24 h葡萄糖达标时间百分比(TIR)明显高于对照组(P<0.05);观察组FPG<7.0 mmol及HbA 1c<6.5%占比明显高于对照组(P<0.05);观察组TG、TC、LDL-C均低于对照组,而HDL-C高于对照组(P<0.05);观察组FINS及胰岛C肽水平高于对照组,而HOMA-IR低于对照组(P<0.05)。观察组治疗后miR-147表达水平高于对照组水平,miR-96表达水平低于对照组(P<0.05)。两组不良反应差异无统计学意义(P>0.05)。结论盐酸二甲双胍联合磷酸西格列汀治疗T2DM可明显提高疗效,降低血糖,调节血脂,改善胰岛功能。

度拉糖肽联合运动疗法对肥胖2型糖尿病患者糖脂代谢的影响

目的 探讨度拉糖肽联合运动疗法对肥胖2型糖尿病(type 2 diabetes mellitus,T2DM)患者糖脂代谢及胰岛素功能的影响。方法 选取100例T2DM患者,用随机数字表法分为研究组和对照组,每组50例。对照组用度拉糖肽治疗,研究组在对照组治疗的基础上联合使用运动疗法。比较2组的糖脂代谢水平、胰岛功能指标及临床疗效。结果 治疗8周后,2组空腹血糖(fasting plasma glucos,FPG)、餐后2 h血糖(2-hours post prandial glucos,2 hPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、胰岛素抵抗指数(homeostatic model assessment of insulin resistan,HOMA-IR)、总胆固醇(total cholesterol,TC)和三酰甘油(triglyceride,TG)较治疗前均降低(P<0.05);研究组的FPG、2 hPG、HbA1c、TC、TG和HOMA-IR较对照组更低(P<0.05);2组的胰岛β细胞功能指数(homeostasis model assessment of β-cell insulin secretion,HOMA-β)较治疗前均升高,且研究组更高(P<0.05);研究组的治疗总有效率高于对照组(P<0.05)。结论 度拉糖肽联合运动疗法能有效控制肥胖T2DM患者的血糖,降低患者的血脂水平,促进糖脂代谢,改善胰岛功能,疗效较好。