怎样判断糖尿病的病情轻&重?

糖尿病患者如何自我判断病情轻重呢?通常应根据自己的情况，结合临床检验来判断病情轻重。一般可分为轻、中、重三型。

小儿患上糖尿病怎么办

金湘萍读者：小儿糖尿病可分为轻型、中型和重型三种。轻型糖尿病患儿极少见，通常血糖不超过8．3毫摩尔／升，症状不明显，可不用胰岛素，通过饮食调节控制就能达到治疗目的。中型糖尿病患儿症状同成年人，表现为多食、多饮、多尿，并容易饥饿和消瘦，血糖一般在8．3～13．9毫摩尔／升。重型糖尿病患儿是最常见类型，也是最容易被忽略、

ABO blood type,diabetes and risk of gastrointestinal cancer in northern China

AIM:To explore the potential risk factors related to gastrointestinal cancer in northern China.METHODS:A total of 3314 cases of gastrointestinal cancer(esophageal,gastric,pancreatic and biliary) and 2223 controls(including healthy individuals,glioma and thyroid cancer) were analyzed by case-control study.Multivariable logistic regression analysis was applied to evaluate the association between different cancers and hepatitis B surface antigen,sex,age,blood type,diabetes,or family history of cancer.RESULTS:Type 2 diabetes was significantly associated with gastric,biliary and pancreatic cancer with an OR of 2.0-3.0.Blood type B was significantly associated with esophageal cancer [odd ratio(OR) = 1.53,95% confidence interval(CI) = 1.10-2.14] and biliary cancer(OR = 1.49,95% CI = 1.09-2.05).The prevalence of type 2 diabetes was significantly higher in gastric,biliary and pancreatic cancers compared with other groups,with ORs ranging between 2.0 and 3.0.Family history of cancer was strongly associated with gastrointestinal compared with other cancers.CONCLUSION:Blood type B individuals are susceptible to esophageal and biliary cancer.Type 2 diabetes is significantly associated with gastric,biliary and especially pancreatic cancer.

Effects of Fuscoporia obliqua on Postprandial Glucose Excursion and Endothelial Dysfunction in Type 2 Diabetic Patients

Postprandial hyperglycemia has been reported to elicit endothelial dysfunction and provoke future cardiovascular complications. A reduction of postprandial blood glucose levels by the glucosidase inhibitor Fuscoporia obliqua was associated with a risk reduction of cardiovascular complications, but the effects of Fuscoporia obliqua on endothelial function have never been elucidated. This study is aimed to assess the efficacy of Fuscoporia obliqua on postprandial metabolic parameters and endothelial function in type 2 diabetic patients. Postprandial peak glucose (14.47±1.27 vs. 8.50±0.53 mmol/liter), plasma glucose excursion (PPGE), and change in the area under the curve (AUC) glucose after a single loading of test meal (total 450 kcal; protein 15.3%; fat 32.3%; carbohydrate 51.4%) were significantly higher in the diet-treated type 2 diabetic patients (n=14) than the age-and sex-matched controls (n=12). The peak forearm blood flow response and total reactive hyperemic flow (flow debt repayment) during reactive hyperemia, indices of resistance artery endothelial function on strain-gauge plethysmography, were unchanged before and after meal loading in the controls. But those of the diabetics were significantly decreased 120 and 240 min after the test meal. A prior administration of Fuscoporia obliqua decreased postprandial peak glucose, PPGE, and AUC glucose. The peak forearm blood flow and flow debt repayment were inversely well correlated with peak glucose, PPGE, and AUC glucose, but not with AUC insulin or the other lipid parameters. Even a single loading of the test meal was shown to impair the endothelial function in type 2 diabetic patients, and the postprandial endothelial dysfunction was improved by a prior use of Fuscoporia obliqua. Fuscoporia obliqua might reduce macrovascular complication by avoiding endothelial injury in postprandial hyperglycemic status.

Role of Sclerostin in the Bone Loss of Postmenopausal Chinese Women with Type 2 Diabetes

Objective To evaluate the role of sclerostin in bone loss of postmenopausal Chinese women with type 2 diabetes me｜litus. Methods The postmenopausal patients suffering from type 2 diabetes mellitus and age, body mass index, and duration of menopause matched healthy controls were enrolled into this cross-sectional study according to criteria of inclusion and exclusion.

Association of traditional Chinese exercises with glycemic responses in people with type 2 diabetes:A systematic review and meta-analysis of randomized controlled trials

Background： There is increasing evidence showing the health benefits of various forms of traditional Chinese exercises （TCEs） on the glycemic profile in people with type 2 diabetes. However, relatively little is known about the combined clinical effectiveness of these traditional exercises. This study was designed to perform a systematic review and meta-analysis of the overall effect of 3 common TCEs （Tai Ji Quan, Qigong, Ba Duan Jin） on glycemie control in adults with type 2 diabetes. Methods： We conducted an extensive database search in Cochrane Library, EMBASE, PubMed, Web of Science, EBSCO, and China National Knowledge Infrastructure on randomized controlled trials published between April 1967 and September 2017 that compared any of the 3 TCEs with a control or comparison group on glycemic control. Data extraction was performed by 2 independent reviewers. Study quality was evaluated using the Coehrane Handbook for Systematic Reviews of Interventions, which assessed the risk of bias, including sequence generation, allocation concealment, blinding, completeness of outcome data, and selective outcome reporting. The resulting quality of the reviewed studies was characterized in 3 grades representing the level of bias： low, unclear, and high. All analyses were performed using random effects models and heterogeneity was quantified. We a priori specified changes in biomarkers of hemoglobin A1 c （in percentage） and fasting blood glucose （mmol/L） as the main outcomes and triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein-cholesterol, 2-h plasma glucose, and fasting plasma glucose as secondary outcomes.Results： A total of 39 randomized, controlled trials （Tai Ji Quan = 11; Qigong= 6; Ba Duan Jin= 22） with 2917 type 2 diabetic patients （aged 41-80 years） were identified. Compared with a control or comparison group, pooled meta-analyses of TCEs showed a significant decrease in hemoglobin Alc （mean difference （MD）= -0.67%; 95% confidence interval （CI）：-0.86% to-0.48%; p 〈 0.00001） and fasting blood glucose （MD = -0.66 mmol/L; 95%CI： -0.95 to -0.37 mmol/L; p 〈 0.0001）. The observed effect was more pronounced for interventions that were medium range in duration （i.e., 〉3-〈 12 months）. TCE interventions also showed improvements in the secondary outcome measures. A high risk of bias was observed in the areas of blinding （i.e., study participants and personnel, and outcome assessment）. Conclusion： Among patients with type 2 diabetes, TCEs were associated with significantly lower hemoglobin Alc and fasting blood glucose. Further studies to better understand the dose and duration of exposure to TCEs are warranted.2018 Published by Elsevier B.V. on behalf of Shanghai University of Sport. This is an open access article under the CC BY-NC-ND license. （http：//creativecommons.org/licenses/by-nc-nd/4.0/）.

Retrospective study of Traditional Chinese Medicine treatment of type 2 diabetes mellitus

OBJECTIVE: To provide clinical evidence in support of Dahuang Huanglian Xiexin decoction(DHXD) to treat type 2 diabetes mellitus(T2DM) and to introduce a new treatment option for clinicians.METHODS: Retrospective analysis was used to evaluate DHXD for the treatment of T2DM by analyzing clinical records of 183 cases. Patients with T2DM who met the inclusion criteria between January 1,2013 and January 1, 2014 were enrolled. The effects of the treatment were evaluated by the changes in fasting blood-glucose(FBG), postprandial blood sugar(PBG), hemoglobin A1c(Hb Alc), blood lipid profiles and body mass index(BMI) at 1, 2, 3 and 6 months. The changes in main symptoms were alsoevaluated. The dosage of Huanglian(Rhizoma Coptidis) and related factors were analyzed.RESULTS: There was a significant improvement in mean Hb A1C at 3 and 6 months after DHXD treatment compared with the baseline level(P < 0.01).There were also significant improvements in FBG,PBG, blood lipid series and BMI. DHXD also improved the main symptoms of stomach and intestine excessive heat syndrome in patients with obese T2DM. Huanglian(Rhizoma Coptidis) was the most frequently used in 678 clinical visits, the dosage of Huanglian(Rhizoma Coptidis) was related to age, BMI, DM duration, the level of blood glucose,and use of Western hypoglycemic drugs.CONCLUSION: This study suggests that DHXD could decrease blood glucose and improve T2DM symptoms and reduce body weight. The use of DHXD may indicate a new optional treatment for T2 DM.

Efficacy observation on acupuncture for diabetic gastroparesis

Objective： To observe the effect of acupuncture on gastric motility, plasma motilin and serum gastrin in patients with diabetic gastroparesis （DGP） and evaluate its clinical efficacy. Methods： A total of 100 eligible cases were randomly allocated into an acupuncture group （n=50） and a control group （n=50）. Patients in the acupuncture group were treated by needling Zhongwan （CV 12）, Zusanli （ST 36） and Neiguan （PC 6）, whereas patients in the control group were treated with oral administration of Domperidone. The clinical efficacies of the two groups were compared; and changes in gastric motility, plasma motilin and serum gastrin in both groups were observed before and after treatment. Results： After treatment, the symptom scores, gastric motility and contents of plasma motilin and serum gastrin were significantly improved in both groups （P〈0.05）. There were between-group statistically significant differences in symptom scores, gastric motility and levels of plasma motilin and serum gastrin after treatment （all P〈0.05）. The total effective rate was 96% in the treatment group, versus 78% in the control group, showing a statistically significant difference （P〈0.05）. Conclusion： Acupuncture is effective for DGP and can reduce the levels of plasma motilin and serum gastrin.

A systematic survey on the diagnosis strategy and patient management of type 1 diabetes by Chinese physicians

The qualification of physicians is a key factor in controlling type 1 diabetes(T1 D) since they provide crucial information to their patients about self-management. To investigate whether Chinese physicians' medical strategies influence the control of T1 D in their patients, we designed a questionnaire to survey Chinese physicians, which covered their diagnosis and patient-management strategies for T1 D. A total of 442 completed questionnaires were received from 35 public hospitals in 12 cities. The results showed Chinese physicians mainly diagnosed T1 D based on the clinical features and islet dysfunction. One-third of physicians in this study still prescribed non-basal-bolus insulin regimens to their T1 D patients. More than 80% of the doctors prescribed alpha-glucosidase inhibitors as adjunctive therapy, in addition to insulin therapy. Moreover, most of the physicians in China did not pay attention to identify coexistent autoimmune diseases. T1 D patients in China were not armed with self-management knowledge and skills, which should be provided by their doctors. One of the circumstances leading to insufficient disease control in Chinese T1 D patients is the ineffective therapeutic strategy prescribed by their physicians. We need to promote knowledge of efficient strategies among physicians in China to achieve better disease control in Chinese T1 D patients in the future.

Successful treatment of latent autoimmune diabetes in adults with Traditional Chinese Medicine: a case report

INTRODUCTION： Latent autoimmune diabetes in adults （LADA） is regarded as one of the Insulin-de- pendent diabetes mellitus that progress slowly. It gradually became understood since 1970s. The on- set usually appears in adulthood, the islet autoanti- bodies are positive and the function of 13 cell is de- clined rapidly. The treatment is insulin injection. CASE PRESENTATION： The case reported followed is a 37-year-old male patient who was newly diag- nosed with type 2 diabetes. He abandoned oral hy- poglycemic agents since they caused stomach in- disposed. Before visiting, his islet autoantibodies were detected positive and he had never injected insulin before. We treated him with traditional Chi- nese herbals under the guidance of Traditional Chi- nese Medicine and differentiation, and achieved fine efficacy. CONCLUSION： Because the initial presentation of LADA is similar to Type 2 Diabetes Mellitus and ex- amination is not in common use, misdiagnosis isnot rare. Once LADA is diagnosed, the therapy must be adjusted. This case report indicated that Traditional Chinese Medicine might be an alterna- tive treatment for LADA.

Effect of conventional medical treatment plus Qigong exercise on type 2 diabetes mellitus in Chinese patients： A Meta-analysis

OBJECTIVE: To systematically evaluate the effect of conventional medical treatment plus Qigong exercise on type 2 diabetes mellitus(T2 DM) in Chinese patients.METHODS: A literature search was conducted in Pub Med, Medline, Embase, China National Knowledge Infrastructure Database, Wanfang and China Science and Technology Journal Database until on January 2017. In this Meta-analysis, enrolled were the studies, including experimental group(with conventional medical treatment plus Qigong therapy) and control group(with conventional medicaltreatment plus diet control or other exercises).Then, the standardized mean differences(SMDs) of fasting blood-glucose(FBG), 2-hplasmaglucose(2 h PG), hemoglobin Alc(Hb Alc), triglyceride(TG),total cholesterol(TC), high-density lipoprotein(HDL) and low density lipoprotein(LDL), as well as their 95% confidence interval(CIs) were calculated to evaluate the effect of Qigong on patients with T2 DM by Rev Man 5.2 and Stata 11.0 software.RESULTS: Totally 834 cases of T2 DM from 11 studies were included in this review. The pooled SMDs with its 95% CIs of FBG, 2 h PG, Hb Alc, TG,TC, HDL and LDL were-0.70(-0.93,-0.47),-0.66(-1.11,-0.21),-0.73(-0.96,-0.50),-1.05(-1.67,-0.43),-0.42(-1.12, 0.28), 0.69(0.19, 1.19), and-0.26(-0.69, 0.18), respectively.The pooled data showed significantly difference between Qigong and the levels of FBG, 2 h PG, Hb A1 c,TG, and HDL in patients with T2 DM(P < 0.05).CONCLUSION: Combining with conventional medical treatment, Qigong exercise might have significant effect on T2 DM in Chinese patients.