A Study of Factors Related to the Incidence of Cataract in Patients with Non-Insulin Dependent Diabetes Mellitus

Purpose: To investigate the factors related to the development of cataract in patientswith non-insulin dependent diabetes mellitus(NIDDM).Methods: 792 NIDDM patients received ophthalmologic examinations including visualacuity, external status of the eyes, slit lamp microscopy and ophthalmoscopy. Glucose,urea nitrogen (BUN), creatinine (Cr), urine acid (UA), N-acetyl-β2-D-glucosaminidase(NAG), β2-microglobulin(β2-MG) and serum albumin in blood were quantitativelytested. Glucose, pH value, protein, cells, cast and ketobodies in urine were assayed.Diagnosis of cataract was based on lens opacities classification system Ⅱ. Any patientmeeting "NⅡ", "CⅡ" or "PⅡ" level was diagnosed as cataract.Results: The incidence of cataract in this group of NIDDM was 62.37 % (494/792),which significantly related to the duration of the disease course, but not to the sex of thepatient. The occurrence rate of cataract in patients suffering from NIDDM of less thanfive years duration, from five to ten years, and more than ten years was 49.67 % (228/459), 71.84 % (125/174), and 88.68 % (141/159), respectively. The occurrence ofcataract in patients diagnosed of the disease from five to ten years and more than tenyears was much higher than that of those with the course of the disease less than fiveyears( P ＜ 0.05 and P ＜ 0. 001, respectively) . Rising concentrations of blood ureanitrogen, creatinine, glycosylated hemoglobin HbA1c(G-HbA1c), N-acetyl-β2-D-glucosaminidase(NAG) and β2-microglobulin(β2-MG) indicated malfunction of thekidneys, and the rate of cataract occurrence in these patients was higher.Conclusion: This study indicates that prolongation of the duration of non-insulindependent diabetes mellitus, renal dysfunction, as well as poor blood glucose control,may accelerate the development of cataract.

The relationship between obese protein and noninsulin-dependent diabetes mellitus

To explore the role of obese protein (OP), the product of the obese gene, in the development of non-insulin-dependent diabetes mellitus (NIDDM). Metbods: Plasma obese protein level was measured by radioimmunoassay in 21 normal subjects, 24 adult obese patients and 20 patients with NIDDM. Results: The levels of the plasma obese protein in NIDDM patients (81. 0±17. 5 pg/ml) were very significantly lower than those in normal subjects (194. 3±17. 7 pg/ml) and obese patients (109.1±16. 4 pg/ml ) (P<0.01). The levels of the plasma obese protein in non-obese NIDDM patients were very significantly lower than those in non-obese normal subjects (P<0.01), and the levels of the plasma obese protein in obese NIDDM patients were very significantly lower than those in obese patients (P<0. 01). The leve1s of the plasma obese protein in NIDDM patients were significantly correlated with polyphagia (P<0.05), but not correlated with the body weight indexes after strict dieting, and the plasma levels of cholesterol, triglyceride, fasting glucose, hemoglobiti A, and the insulin levels during glucose tolerance test (P>0.05). Couclusion: Low plasma level of obese protein is one of the important factors contributing to obesity,and plasma obese protein may be closely related to the generation of NIDDM.

糖尿病大鼠肾脏病变及其SnoN蛋白表达的变化

目的:复制2型糖尿病动物模型,并观察其肾脏病变及SnoN蛋白表达的变化。方法:SD大鼠随机分为正常对照组(NC)、高脂高糖组(HG)。高脂、高糖饮食12周后又随机分为高脂高糖对照组(HC)、糖尿病组(DM)。采用高脂、高糖饮食12周加小剂量链脲佐菌素注射(30 mg/kg)的方法复制2型糖尿病动物模型,成模大鼠随机分别于糖尿病8周(DM8)、12周(DM12)和16周(DM16)处死;Western印迹法检测肾皮质SnoN蛋白的水平;生物化学方法测血糖、血清胰岛素水平、甘油三酯、总胆固醇、血肌酐及24 h尿蛋白;光镜检查肾组织形态学改变。结果:DM组大鼠出现高血糖、高血脂、肾功能和肾组织形态学改变;HG组血清胰岛素水平、甘油三酯和总胆固醇明显升高,血糖与NC组相比差异无统计学意义;Western印迹检测发现DM8组肾组织中SnoN蛋白的表达明显低于NC组,且随病程进展逐渐减少,至DM16时减至NC组的64.20%。结论:成功复制了2型糖尿病动物模型;SnoN蛋白的表达变化可能参与了2型糖尿病肾脏病变的发生、发展过程。

Gene Expression of Adiponectin and Adiponectin Receptor 1 in Type 2 Diabetic Rats and the Relationship with the Parameters of Glucose and Lipid Metabolism

In order to confirm whether the mRNA levels of adiponectin in adipose tissue and mRNA levels of AdipoR1 in the skeletal muscles were correlated with the serum parameters of glucose and lipid metabolism and to clarify the regulation of adiponectin receptor gene expression in diabetic states, serum adiponectin, mRNA levels of adiponectin in adipose tissue and mRNA levels of AdipoR1 in the skeletal muscles were examined in type 2 diabetic rats. The model of type 2 diabetes was prepared by feeding high fat diet and injecting low dosage of streptozotocin (STZ). The diabetic rats were screened out by oral glucose tolerance test. One group of type 2 diabetic rats received rosiglitazone. The serum adiponectin concentration was detected by using ELISA and mRNA levels were examined by RT-PCR. The serum adiponectin levels and mRNA levels of adiponectin in adipose tissue of type 2 diabetic rats were significantly decreased as compared with the normal control rats (P<0.05, P<0.01 respectively). No siglificant changes were observed in the expression of adiponectin receptor 1 in the skeletal muscle of type 2 diabetic rats. The mRNA levels of adiponectin in adipose tissue were reversely correlated with serum insulin (r=-0.66, P<0.05), triglyceride (r=-0.58, P<0.05), cholesterol (r=-0.49, P<0.05), interleukin-6 (r=-0.49, P<0.05) and tumor necrosis factor (r=-0.43, P<0.05). The expression of adiponectin receptors was not altered in the skeletal muscle of Type 2 diabetic rats. The decreased serum adiponectin was caused by the decreased expression of adiponectin mRNA in adipose tissue rather than the adiponectin receptors in the skeletal muscle, which could be improved by rosiglitazone.

Effects of Supplemented Taohe Chengqi Decoction (桃核承气汤) in Treating Insulin Resistance in Rats with Non-Insulin Dependent Diabetes Mellitus

Objective: To investigate the effect of supplemented Taohe Chengqi Decoction (桃核承气汤,STHCQD) in treating non-insulin dependent diabetes mellitus (NIDDM). Methods: The model of rats withNIDDM was formed with injection of streptozotocin and fed on high calorie diet to study the effects of STHCQDon the release of insulin sensitivity. Results: (l ) Fasting serum glucose, serum insulin, intake of food and waterwere significantly decreased (P < 0. 05 -- 0. 01 ) in STHCQD-treated diabetic rats as compared with untreated diabetic rats, while the insulin sensitivity was significantly increased (P < 0. 05 ). (2) The liver cell membranesfrom STHCQD-treated diabetic rats released the quantity of insulin receptor which inhibited adenylate cyclaseactivity, but this effect was blunted in untreated diabetic rats (P < 0. 05). (3) A significantly increased glucoseoxidation in adipocyte of STHCQD-treated diabetic rats was found as compared with those of untreated diabeticrats (P< 0. 05). Conclusions: STHCQD therapy Increased sensitivity and responsiveness of target cells to insulin, i. e. it might decrease insulin resistance at receptor sites and POst--receptor sites in rats with NIDDM, butcould not.reverse the insulin resistance.

Therapeutic Effect of Berberine on 60 Patients with Non－Insulin Dependent Diabetes Mellitus and Experimental Research

The effects of berberine on 60 cases with noninsulin dependent diabetes mellitus and ex-perimental research results were observed in this study. The results suggest berberine has significant ef-fects on noninsulin dependent diabetes mellitus patients and experimental diabetes in animals in the re-duction of blood glucose levels. The clinical symptoms basically disappeared and the level of serum insulinrose. The total effective rate was up to 90 percent and there were no signiticant side-effects. It was foundthat berberine has an effect on the recovery of pancreas islet cells, through pathological examination onthe animal subjects.

Clinical Study on Jiang Tang San（降糖散）in Treating Non－Insulin Dependent Diabetes Mellitus Patiente

The therapeutic effect of Jiang Tang San (JTS) on 30 cases with non-insulin dependent dia-betes mellitus (NIDDM) , was observed, whose fasting blood glucose ranged trom 11. 1 mmol/L to 13. 8mmol/L. The results suggested that JTS has significant effect on NIDDM patients in lowering blood glucose,blood lipid and blood pressure levels. Clinical symptoms and blood glucose improved rapidly. JTS promotedthe elevation of serum insulin level 1 hour after meal. The total effective rate of lowering blood glucosereached 86. 7% . The results showed JTS is better than berberine on lowering blood glucose ( P< 0. 01 ) andwhen patients failed to respond to other hypoglycemics or on recurrence JTS was still effective. There wereno marked side-effects during the course of treatment.

Effects of Xianzhen Tablet（仙贞片）on Na^+-K^+-ATPase and Ca^(2+)-Mg^(2+)-ATPase in Erythrocytic Membranes and Viscosity of Whole Blood in Non-Insulin-Dependent Diabetes Patients with Qi-Yin Deficiency, Kidney Deficiency and Blood Stasis

Objective: To assess the effects of Xianzhen tablet (XZT) on Na+-K+ -ATPase and Ca2+ Mg2+-ATPase on erythrocytic membranes, viscosity of whole blood, plasma glucose and clinical manifestations.Methods: Seventy-two cases of non-insulin-dependent diabetes mellitus (NIDDM) patients with deficiency of both Qi and Yin, deficiency of the Kidney and blood stasis were selected, and the effects of treatment on Na+ K + -ATPase, Ca2+-Mg2+ -ATPase, whole blood viscosity, blood sugar and clinical Symptoms were observed.Results: In XZT group (test group), activities of Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase rose significantly(P< 0. 01, P< 0. 05) after treatment. Viscosity of whole blood and clinical manifestations also improved obviously. The total effective rate in lowering plasma glucose was 77. 8 % with fasting blood glucose (FBG) and 69.4 % with 2 hours postprandial plasma blood glucose (2°PBG). In the control group, viscosity of whole blood andclinical manifestations had no significant improvement. Its total effective rate in lowering plasma glucose was41. 7% with FBG and 38. 9% with 2°PBG. Conclusions: XZT played a certain role in increasing activities ofNa+ -K + -ATPase and Ca2+-Mg2+ -ATPase, decreasing viscosity of whole blood and plasma glucose and improving clinical manifestations. Therefore, XZT was experimentally manifested as an effective drug in treating NIDDM patients with Qi-Yin deficiency, renal deficiency and blood stasis.

非胰岛素依赖型糖尿病患者对低血糖认知现状调查及影响因素分析

目的通过调查非胰岛素依赖型糖尿病患者对于低血糖认知情况,为医务人员给本型糖尿病患者精准制订健康教育计划及落实健康教育措施提供科学依据。方法采用自行设计的“非胰岛素依赖型糖尿病患者低血糖认知情况问卷”,对2020年6—8月于某中医药大学第一附属医院内分泌科住院的84例非胰岛素依赖型糖尿病患者进行面对面的问卷调查,其中80例问卷应答有效。结果80例患者对低血糖相关知识,认知相对不足。性别、文化程度、低血糖病史是2型糖尿病患者低血糖认知的影响因素(P<0.05)。结论临床上应为糖尿病患者制订全面、个性化的健康教育计划,进行低血糖的预防、临床表现、治疗护理、应急处理等多方面的健康知识宣教,以避免或降低低血糖发生率。并做到发生低血糖后,能及时识别并采取有效措施,降低低血糖对患者造成的伤害,提高患者的生活质量。

加味桃核承气汤对Ⅱ型糖尿病大鼠胰岛素抵抗的影响

目的：观察加味桃核承气汤对Ⅱ型糖尿病（ＮＩＤＤＭ）的影响。方法：采用链脲佐菌素和高热量饲料的方法模拟ＮＩＤＤＭ大鼠模型，研究加味桃核承气汤对ＮＩＤＤＭ大鼠肝细胞膜胰岛素介体释放、脂肪细胞葡萄糖氧化和胰岛素敏感性指数的影响。结果：加味桃核承气汤可明显降低空腹血糖、胰岛素、摄食量和饮水量（Ｐ＜０．０５～０．０１），提高胰岛素敏感性（Ｐ＜０．０５），增加肝细胞膜释放的抑制腺苷酸环化酶活力的胰岛素介体量（Ｐ＜０．０５），提高基础的和胰岛素刺激的大鼠脂肪细胞葡萄糖氧化能力（Ｐ＜０．０５）。结论：加味桃核承气汤治疗可提高ＮＩＤＤＭ大鼠靶细胞对胰岛素的敏感性和反应性，即可使受体和受体后胰岛素抵抗减轻，但不能使之完全逆转。

前列地尔对非胰岛素依赖型糖尿病病人胰岛素及血小板聚集率的影响

目的：探讨前列地尔对非胰岛素依赖型糖尿病（ＮＩＤＤＭ）病人胰岛素及血小板聚集率的影响。方法：应用前列地尔２００μｇ加入０．９％氯化钠注射液５００ｍＬ中静脉滴注，ｑｄ×１０ｄ，治疗５０例ＮＩＤＤＭ病人（男性２３例，女性２７例，年龄５８±ｓ１０ａ）。治疗前后测定空腹胰岛素、餐后２ｈ胰岛素及血小板聚集率。结果：前列地尔刺激胰岛素分泌增加和降低血小板聚集率。治疗后的餐后２ｈ胰岛素显著增加（Ｐ＜０．０１），血小板聚集率显著下降（Ｐ＜０．０１，Ｐ＜０．０５）。结论：前列地尔增加ＮＩＤＤＭ病人的胰岛素分泌。

针刺对2型糖尿病胰岛素抵抗影响的临床研究

目的 :观察针刺和降糖药对 2型糖尿病胰岛素抵抗的影响。方法 :观察组 60例 ,以针刺治疗 ,取穴中脘、曲池、合谷、足三里等。对照组 60例 ,以常规降糖药物口服优降糖治疗。结果 :两组血、尿糖水平明显下降 ,胰岛素敏感指数明显升高 ,外周组织对葡萄糖的摄取率显著增加。两组相比较 ,差异有显著性意义 (P <0 0 1 ,P <0 0 5 )。结论 :针刺能使

长期高脂饮食加小剂量链脲佐霉素建立人类普通2型糖尿病大鼠模型的研究

目的 建立类似人类普通 2型糖尿病大鼠模型。方法 采用长期高脂高能量饮食结合小剂量链脲佐霉素 (STZ)腹腔注射的方法。结果 模型大鼠有高血糖 (18 78± 1 97)mmol L、高甘油三酯血症 (10 95 4± 5 5 4 )mmol L、高胆固醇血症 (2 4 4 2± 0 74 )mmol L、脂肪肝、高胰岛素血症 (0 937± 0 2 6 )mmol L、胰岛素敏感性下降及不低于正常对照组的体重。结论 这是一种类似人普通

实验性NIDDM大鼠的胰岛素抗性

采用放射免疫分析及放射配基受体分析,观察实验性NIDDM大鼠血清胰岛素、红细胞中cAMP以及红细胞胰岛素受体最大结合力。结果表明链脲霉素与高热量饲料诱发的NIDDM大鼠有明显的胰岛素抗性,即在高胰岛素水平(25.29±8.34μU/ml,P<0.001)的同时伴有明显的糖耐量减低(P<0.001)及高脂血症(血清甘油三脂2.15±0.66mmol/L,P<0.001;血清胆固醇2.82±0.44mmol/L,P<0.001)。实验还进一步表明这种胰岛素抗性与红细胞胰岛素受体最大结合力的降低(693.51±149.55cpm/10~5红细胞,P<0.001)一致。据此推测胰岛素受体结合力的降低可能是NIDDM胰岛素抗性的主要原因。

实验性NIDDM大鼠模型及其胰岛素抵抗的初步研究

采用中剂量链脲佐菌素（３０ｍｇ／ｋｇ，ｑｄ×３）腹腔内注射及肥甘饮食持续喂养１０周的方法，模拟实验性ＮＩＤＤＭ大鼠模型，观察到该模型不仅有多饮、多食、多尿、超重、高血糖、高血脂的特点，而且还有高胰岛素血症和胰岛素抵抗的特征，其胰岛素抵抗表现为相对胰岛素敏感性、基础的和胰岛素刺激的脂肪细胞葡萄糖氧化能力显著降低。研究结果提示，该模型具有Ⅱ型糖尿病的临床特点和病理特征，尤其是存在受体和受体后缺陷所致胰岛素抵抗的特征，是实验研究中医药对胰岛素抵抗的影响的较好载体。

应用胰岛素敏感性指数研究中药对Ⅱ型糖尿病人胰岛素抵抗的作用

本文运用一项新的检测人群胰岛素敏感性的指数——空腹血浆胰岛素(FINS)与空腹血糖(FPG)乘积的倒数,研究了中药“世良降糖散”在治疗Ⅱ型糖尿病中,对病人胰岛素敏感性的影响。结果显示治疗后较治疗前胰岛素敏感性增加(P<0.05),说明该药能降低Ⅱ型糖尿病人的胰岛素抵抗。

眉豆、绿豆及赤小豆对餐后血糖影响的研究

目的了解眉豆、绿豆、赤小豆及馒头对II型糖尿病病人餐后血糖的影响。方法动态观察40例NIDDM病人空腹及进食眉豆、绿豆、赤小豆及馒头后30、60、120、180min的血糖水平、每种食物均含50g碳水化物。结果4种试验食物血糖峰值均出现在餐后120min；4种食物餐后30min的血糖值无显著性差异；在餐后60min、120min及180mins时，赤小豆的血糖值明显低于馒头、眉豆、绿豆。结论赤小豆维持餐后血糖稳定的能力较强，可作为糖尿病病人食用的较理想的主食之一。

84例NIDDM辨证分型与IR Glucagon的关系

非胰岛素依赖型糖尿病（ＮＩＤＤＭ）的病因目前尚不十分清楚，近年的研究表明，胰岛素抵抗（Ｉｎｓｕｌｉｎｒｅｓｉｓｔａｎｃｅ，ＩＲ）、胰升糖素（Ｇｌｕｃａｇｏｎ）分泌异常与ＮＩＤＤＭ的发生、发展密切相关。笔者观察了８４例ＮＩＤＤＭ患者临床辨证分型的情况及其与胰岛素抵抗、胰升糖素分泌异常的关系，并与正常组作了对比。结果表明：①气阴两虚型是ＮＩＤＤＭ的常见证型。阴虚热盛型、气阴两虚型与阴阳两虚型均存在胰岛素抵抗和胰升糖素分泌异常，但各证型在程度上存在不同，提示各证型有着不同的病理生理特点。②对气阴两虚型的进一步观察证实，即使是同一证型，由于兼挟证的不同，其病理生理改变亦存在不同。气阴两虚兼燥热偏盛型其胰岛素抵抗、胰岛素分泌缺陷和胰升糖素分泌异常均较气阴两虚非燥热偏盛型更为明显。提示燥热偏盛与上述三者的改变有一定的联系。

心理社会因素在型糖尿病发生中作用的多因素分析

目的:探讨心理社会因素在人类型糖尿病发生过程中作用及其相互作用。方法:对131名糖耐量低减和91名糖耐量正常者平均追踪18个月,对影响血糖变化和糖尿病发生的心理社会因素及年龄、体重指数进行Logistic回归分析和路径分析。结果:年龄、体重指数、生活事件强度在糖耐量正常和低减转糖尿病过程中均具有显著的作用;在本研究所选择的心理社会因素中,紧张性生活事件对样本血糖变化直接影响效应最大,积极应对方式和社会支持利用度既有一定的直接影响效应,也有一定的间接影响效应。

人血浆瘦素水平与肥胖及血浆胰岛素水平的关系

目的 :探讨人血浆瘦素水平与肥胖、血糖、胰岛素浓度的关系。方法 :免疫放射法测定 171例疑有糖尿病者 (男性 90例 ,女性 81例 )的空腹血浆瘦素水平 ,并行口服葡萄糖耐量试验 ,测定血浆葡萄糖和胰岛素浓度 ,同时测量身高、体重 ,计算体重指数 (bodymassindex ,BMI)。 结果 :空腹血浆瘦素水平与体重指数呈正相关 (男性r =0 .6 772 ,P <0 .0 1;女性r=0 .7191,P <0 .0 1) ,但女性血浆瘦素水平是男性的 2～ 3倍 ,性别差异有显著性。采用多元逐步回归法分析 ,去除体重指数等因素的影响后 ,瘦素与胰岛素曲线下面积呈正相关 ,与血糖浓度无相关性。结论 :肥胖者空腹血浆瘦素升高 ,血浆高瘦素水平与高胰岛素血症的相关性提示瘦素可能在 2型糖尿病的发病中起一定作用。