Type 2 diabetes （T2D） is common in the elderly and more than half of the people with diabetes are over 65 years old. Elderly diabetic patients have a higher frequency of hypertension, coronary artery disease and chr...Type 2 diabetes （T2D） is common in the elderly and more than half of the people with diabetes are over 65 years old. Elderly diabetic patients have a higher frequency of hypertension, coronary artery disease and chronic kidney disease than non-diabetic elderly patients and the risk of these complications increases with patient age, duration of the dia- betes and glycated hemoglobin values. Besides the known classical factors of renal disease progression,展开更多
To assess the efficacy of pharmacist lead insulin management in improvement of HbAlc. Patients were referred to the LMttS （Licking Memorial Health Systems） Outpatient Medication Therapy Insulin Clinic by their physi...To assess the efficacy of pharmacist lead insulin management in improvement of HbAlc. Patients were referred to the LMttS （Licking Memorial Health Systems） Outpatient Medication Therapy Insulin Clinic by their physician during the time periods of July 2012 through March 2013 and August 2014 through December 2014. Physician authorization permitted pharmacists to provide clinical monitoring in order to evaluate and adjust insulin, GLP-I agonist and amylin mimetic doses by adhering to approved dosing guidelines and policy and procedures. Hemoglobin Atc values were obtained from the patients electronic medical records. Patients achieved an average decrease in HbAlc of 0.8 percentage points over a mean of 83 days. Pharmacist insulin management is an innovative pharmacy service through which clinical pharmacists can have an impact on patients＇ HbAtc.展开更多
Objective： Decompensated chronic hyperglycemia often leads to late microvascular complications such as retinopathy, diabetic foot syndrome, and diabetic kidney disease. The aim of this study was to determine the conc...Objective： Decompensated chronic hyperglycemia often leads to late microvascular complications such as retinopathy, diabetic foot syndrome, and diabetic kidney disease. The aim of this study was to determine the concentration of vascular endothelial growth factor A （VEGF-A） and its receptors in patients with well-controlled diabetes. Methods： The study was conducted on 31 patients with well-controlled type 2 diabetes without microor macroangiopathy. Thirty healthy volunteers were enrolled in a control group. Serum concentrations of VEGF-A, VEGF receptors 1 and 2 （VEGFR1 and VEGFR2）, fasting glucose, and lipid profiles were measured, and the plasma concentration of glycated hemoglobin （HbAlc） was determined. Results： No significant differences were observed between the concentration of VEGF-A, VEGFR1 or VEGFR2 in the subject group and that in the control group. Positive correlations were noted between the levels of VEGF-A, VEGFR2, and triglyceride, and there was a negative correlation between the levels of VEGFR2 and high-density lipoprotein （HDL）-cholesterel in the study group. Conclusions： The concentrations of VEGF-A and its receptors 1 and 2 in patients with well-controlled diabetes are comparable to those of healthy individuals, which may indicate that appropriate control of glucose levels delays the occurrence of vascular complications. A negative correlation between VEGFR2 and HDL-cholesterol levels, and positive correlations between VEGF-A, VEGFR2, and triglyceride levels, suggest that lipid abnormalities occurring in diabetes may be involved in the modulation of angiogenesis.展开更多
OBJECTIVE: To explore the laws governing the distribution ofTraditional Chinese Medicine (TCM) syndrome elements (SEs) of senile diabetes (SD) and their relationship to relevant factors. METHODS: An investigation of p...OBJECTIVE: To explore the laws governing the distribution ofTraditional Chinese Medicine (TCM) syndrome elements (SEs) of senile diabetes (SD) and their relationship to relevant factors. METHODS: An investigation of patients who met the inclusion criteria was conducted by trained doctors, using case report forms. All related data were collected, including body mass index, glycated hemoglobin, illness course, complications, symptoms, and tongue and pulse manifestation. The SEs of each patient were judged by three qualified associate chief physicians independently. RESULTS: The main SEs of SD are Yin deficiency, Qi deficiency, blood stasis, and phlegm turbidity. Yindeficiency, Qi deficiency, blood stasis, and phlegm turbidity are most commonly seen among 4-SE combinations. Yang deficiency is typically related to illness course and BMI, phlegm turbidity to hypertension and hyperlipidemia, excessive heat to diabetic microangiopathy, and blood stasis to illness course and diabetic macroangiopathy. CONCLUSION: SD pathogenesis has a deficiency in origin and excess in superficiality. Deficiency syndrome mainly manifests as deficiency of both Qi and Yin, and concurrently in Yang deficiency. Excess syndrome is characterized by blood stasis and phlegm turbidity. SEs analysis provides a basis for the prevention and treatment of SD with TCM and lays the foundation for objectively evaluating multicentric clinical research for SD inTCM.展开更多
文摘Type 2 diabetes （T2D） is common in the elderly and more than half of the people with diabetes are over 65 years old. Elderly diabetic patients have a higher frequency of hypertension, coronary artery disease and chronic kidney disease than non-diabetic elderly patients and the risk of these complications increases with patient age, duration of the dia- betes and glycated hemoglobin values. Besides the known classical factors of renal disease progression,
文摘To assess the efficacy of pharmacist lead insulin management in improvement of HbAlc. Patients were referred to the LMttS （Licking Memorial Health Systems） Outpatient Medication Therapy Insulin Clinic by their physician during the time periods of July 2012 through March 2013 and August 2014 through December 2014. Physician authorization permitted pharmacists to provide clinical monitoring in order to evaluate and adjust insulin, GLP-I agonist and amylin mimetic doses by adhering to approved dosing guidelines and policy and procedures. Hemoglobin Atc values were obtained from the patients electronic medical records. Patients achieved an average decrease in HbAlc of 0.8 percentage points over a mean of 83 days. Pharmacist insulin management is an innovative pharmacy service through which clinical pharmacists can have an impact on patients＇ HbAtc.
基金Project supported by the Collegium Medicum in Bydgoszcz,Nicolaus Copernicus University in Toruń,Poland
文摘Objective： Decompensated chronic hyperglycemia often leads to late microvascular complications such as retinopathy, diabetic foot syndrome, and diabetic kidney disease. The aim of this study was to determine the concentration of vascular endothelial growth factor A （VEGF-A） and its receptors in patients with well-controlled diabetes. Methods： The study was conducted on 31 patients with well-controlled type 2 diabetes without microor macroangiopathy. Thirty healthy volunteers were enrolled in a control group. Serum concentrations of VEGF-A, VEGF receptors 1 and 2 （VEGFR1 and VEGFR2）, fasting glucose, and lipid profiles were measured, and the plasma concentration of glycated hemoglobin （HbAlc） was determined. Results： No significant differences were observed between the concentration of VEGF-A, VEGFR1 or VEGFR2 in the subject group and that in the control group. Positive correlations were noted between the levels of VEGF-A, VEGFR2, and triglyceride, and there was a negative correlation between the levels of VEGFR2 and high-density lipoprotein （HDL）-cholesterel in the study group. Conclusions： The concentrations of VEGF-A and its receptors 1 and 2 in patients with well-controlled diabetes are comparable to those of healthy individuals, which may indicate that appropriate control of glucose levels delays the occurrence of vascular complications. A negative correlation between VEGFR2 and HDL-cholesterol levels, and positive correlations between VEGF-A, VEGFR2, and triglyceride levels, suggest that lipid abnormalities occurring in diabetes may be involved in the modulation of angiogenesis.
基金Supported by The Special Scientific Research Program of State Administration of Traditional Chinese Medicine: Methodological Evaluation of Treating Type 2 Diabetes with Syndrome Differentiation Methods Based on Three Stages In TCM(No. 06-07LP42)
文摘OBJECTIVE: To explore the laws governing the distribution ofTraditional Chinese Medicine (TCM) syndrome elements (SEs) of senile diabetes (SD) and their relationship to relevant factors. METHODS: An investigation of patients who met the inclusion criteria was conducted by trained doctors, using case report forms. All related data were collected, including body mass index, glycated hemoglobin, illness course, complications, symptoms, and tongue and pulse manifestation. The SEs of each patient were judged by three qualified associate chief physicians independently. RESULTS: The main SEs of SD are Yin deficiency, Qi deficiency, blood stasis, and phlegm turbidity. Yindeficiency, Qi deficiency, blood stasis, and phlegm turbidity are most commonly seen among 4-SE combinations. Yang deficiency is typically related to illness course and BMI, phlegm turbidity to hypertension and hyperlipidemia, excessive heat to diabetic microangiopathy, and blood stasis to illness course and diabetic macroangiopathy. CONCLUSION: SD pathogenesis has a deficiency in origin and excess in superficiality. Deficiency syndrome mainly manifests as deficiency of both Qi and Yin, and concurrently in Yang deficiency. Excess syndrome is characterized by blood stasis and phlegm turbidity. SEs analysis provides a basis for the prevention and treatment of SD with TCM and lays the foundation for objectively evaluating multicentric clinical research for SD inTCM.
