肺结核合并糖尿病患者血糖控制程度与抗结核治疗效果的关系研究

目的:研究肺结核合并糖尿病患者血糖控制程度与抗结核治疗效果的关系。方法选取我院收治的肺结核合并糖尿病患者120例,对其进行治疗,观察血糖控制程度与抗结核治疗效果的关系。结果控制理想组、控制尚可组咳嗽咳痰、纳差、乏力、心悸、气促、盗汗、咯血、胸膛、腹腔积液及气胸发生率与控制较差组比较,差异有统计学意义(P<0.05)。控制理想组咳嗽咳痰、纳差、乏力、心悸、气促、胸痛与控制尚可组比较,差异有统计学意义(P<0.05)。控制理想组、控制尚可组病灶吸收、空洞闭合、痰菌转阴率均高于控制较差组,差异有统计学意义(P<0.05)。控制理想组病灶吸收、痰菌转阴率均高于控制尚可组,差异有统计学意义(P<0.05)。结论肺结核合并糖尿病患者积极控制血糖的程度,对抗结核治疗效果有比较显著的影响,可以提高治疗效果。

糖化血红蛋白对评价血糖控制程度的意义

为探讨糖尿病患者血糖控制程度 ,采用微柱塑胶管法对 85例糖尿病患者进行糖化血红蛋白测定 ,结果浓度 <6 %者 30例 (35 .2 9% ) ,说明血糖已降至正常或无糖尿病水平 ;6 %～ 7%者 14例 (16 .45 % ) ,说明血糖接近正常范围 ;7.1%～ 10 %者 2 3例 (2 7.0 6 % ) ,说明血糖控制程度较好 ;>10 %者 18例 (2 1.1% ) ,说明血糖控制程度较差 ,易发生慢性病变 ,以此作为判断治疗中病情的好坏程度。认为该法比空腹血糖测定更能反映每天平均血糖浓度 ,反复检测有助于病情监控。

先兆子痫与妊娠糖尿病严重程度的关系:血糖控制程度的影响

Objectives We sought to determine if the rate of preeclampsia is related to the severity of gestational diabetes mellitus (GDM), and if it can be decreased by optimizing glycemic control. Study design A retrospective analysis of prospectively collective data of 1813 patients with GDM was performed to determine the rate of preeclampsia. Patients were stratified after treatment was begun by level of glycemic control (well controlled was defined as mean blood glucose < 95 mg/dL). The extent of hyperglycemia was analyzed by the level of the abnormality in the oral GTT and by the degree of abnormality of daily glucose control after treatment has begun. Severity of GDM was categorized using fasting plasma glucose (FPG) on a 3-hour oral GTT by 10 mg/dL increments. Results Overall, preeclampsia was diagnosed in 9.6%(174/1813) of diabetic patients. The GDM subjects who developed preeclampsia were significantly younger, had a higher nulliparity rate, were more obese, and gained significantly more weight during pregnancy. However, no difference was found in glycemic profile characteristics between the 2 groups. A comparison between patients with FPG <105 and FPG >105 revealed that the rate of preeclampsia increased significantly, 7.8%vs 13.8%, (O.R 1.81, 95%CI 1.3-2.51). For GDM patients with only mild hyperglycemia (FPG <105 mg/dL), no significant difference was found in the rate of preeclampsia. Preeclampsia rate was further evaluated in relation to level of glycemic control; for the wellcontrolled patients (mean blood glucose [MBG] <95 mg/dL, n=994), similar rates of preeclampsia were found between each category of FPG severity. In contrast, in poorly controlled patients (MBG >95 mg/dL, n=819), a comparison between severity threshold of FPG <115 and FPG >115 revealed that the preeclampsia rate was 9.8%vs 18%(O.R 2.56, 95%C.I. 1.5-4.3). In a logistic regression model, only prepregnancy BMI (O.R 2.3, 95%CI 1.16-2.30) and severity of GDM (O.R 1.7, 95%CI 1.21-2.38) were independently and significantly associated with an increased risk of preeclampsia. Conclusion The rate of preeclampsia is influenced by the severity of GDM and prepregnancy BMI. Optimizing glucose control during pregnancy may decrease the rate of preeclampsia, even in those with a greater severity of GDM.

2型糖尿病血糖控制程度对血脂和C反应蛋白的影响

随着人们生活水平的提高，饮食结构和生活方式有所改变，以致糖尿病的患病率不断增加，并呈现年轻化的趋势，糖尿病及其并发症严重威胁着人们的健康。2型糖尿病患者往往同时存在糖、脂肪和蛋白质三大物质的代谢障碍，本研究旨在了解2型糖尿病患者血糖控制程度的不同是否会影响血脂和炎症标记物——高敏性C反应蛋白（high sensitivity C reactive protein，hs-CRP）的水平。

住院糖尿病患者CA199水平与血糖控制程度的关系

为了探讨糖尿病患者糖化血红蛋白（HbA1c）及糖化血清白蛋白（GA）对血清CA1997k平的影响，上海交通大学附属第六人民医院内分泌代谢科于浩泳等募集29例正常糖耐量（NGT）个体及371例住院糖尿病患者。

在控制糖尿病和并发症试验10年内对1型糖尿病患儿所出现的严重低血糖、代谢控制及对糖尿病处理方面的研究:一个大范围的多中心研究

Hypoglycaemia is frequently the limiting factor in achieving optimal glycaemic control.Therefore, insulin therapy, the incidence of hypoglycaemia, and glycaemic control were investigated in 6309 unselected children with type 1 diabetes in a large-scale multicentre study.Using standardised computerbased documentation, the incidence of severe hypoglycaemia, HbAlc levels, insulin regimen, diabetes duration, and the number of patients attending a treatment centrewere investigated for the age groups 0-< 5 years (n = 782), 5-< 7 years (n = 1053), and 7-< 9 years (n = 4474).The average HbAlc level was 7.6%(no significant difference between age groups).Young children had more severe hypoglycaemic events (31.2/100 patient years) as compared to older children (19.7; 21.7/100 patient years, P < 0.05) independent of the treatment regimen.Our data suggest that diabetes centres treating less than 50 patients per year have a higher incidence of hypoglycaemia in 0-< 5-year-old children (43.0/100 patient years) as compared to larger centres (24.1/100 patient years; P < 0.0001).Significant predictors of hypoglycaemia were younger age (P < 0.0001), longer diabetes duration (P < 0.0001), higher insulin dose/kg per day (P < 0.0001), injection regimen (P < 0.0005), and centre experience (P < 0.05).Conclusion:Despite modern treatment, young children have an elevated risk for developing severe hypoglycaemia compared to older children, especially when treated at smaller diabetes centres.The therapeutic goal of carefully regulating metabolic control without developing hypoglycaemia has still not been achieved.Further advances in diabetic treatment may result from giving more attention to hypoglycaemia in young children.

2型糖尿病患者血糖控制对脆性骨折预后的影响

目的:探究2型糖尿病患者血糖控制程度对髋部脆性骨折预后的影响。方法:选取东莞市南城医院2016年11月至2017年11月期间收治的2型糖尿病合并髋部脆性骨折患者32例作为研究对象,分为两组,血糖控制不良者为甲组,血糖控制良好者为乙组,比较组间预后效果。结果:乙组患者术前等待时间明显少于甲组,且骨折延迟愈合、骨折不愈合、骨折再移位、骨折内固定物松动、术后感染等并发症发生率明显低于甲组,组间比较,差异具有统计学意义(P <0.05)。结论:在2型糖尿病合并髋部脆性骨折患者中,其血糖控制程度会直接影响到预后效果,并致使一系列不良反应的发生,因此,需要对其血糖进行有效控制,以提升手术治疗安全性。

动态血糖监测在妊娠合并糖尿病中的应用

一、背景 随着社会经济的发展、生活方式的改变以及肥胖和超重妇女比例的不断增加，妊娠合并糖尿病的发病率逐年增加，这其中包括在原有糖尿病基础上合并妊娠（pregestational diabetes mellitus, PGDM ）和妊娠期糖尿病（gestational diabetes mellitus, GDM），前者占妊娠合并糖尿病总数的10%～20%，GDM 占80%～90%[1]。对于PGDM，胎儿先天畸形发生率、自然流产率增高，并且发生率高低与妊娠早期血糖控制程度密切相关。全球多中心研究显示，妊娠中、晚期高血糖与大于胎龄儿、首次剖宫产分娩、新生儿低血糖、胎儿高胰岛素血症等不良母婴结局呈连续线性相关关系[2]。因此孕期血糖监测与控制在妊娠合并糖尿病治疗中有非常重要的意义。

血糖波动与2型糖尿病视网膜病变的关系

糖尿病视网膜病变（diabetic retinopathy,DR）在糖尿病并发症中很常见,是糖尿病致盲致残的主要原因之一。糖化血红蛋白（HbA1c）是常用的判断血糖控制程度的指标之一。目前很多研究证实在糖化血红蛋白相同的2型糖尿病患者中常有不同的糖尿病眼底病变,这就说明影响糖尿病视网膜病变等慢性并发症的因素除平均血糖外还有血糖的波动情况[1]。

无先兆子痫的正常白蛋白尿、糖尿病妇女的早产:代谢控制的作用

The aim of this study was to examine the importance of glycemic regulation on the risk of preterm delivery in women with normoal buminuria and no preeclampsia later in pregnancy. Study design and methods: A prospective study of 71 women with type 1 diabetes mellitus where complete data were collected on HbA1c, insulin dose, and albumin excretion rate from week 12 and every second week hereafter. Fundus photography was performed and diurnal blood pressure measured three times during pregnancy. Results: The preterm rate was 23% and women delivering preterm showed higher HbA1c throughout pregnancy. At regression analysis HbA1c was the strongest predictor for preterm delivery from week 6 to 32, also when including insulin dose, BMI, age, duration of diabetes, and diurnal blood pressure. The risk of delivering preterm was more than 40% when HbA1c was above 7.7% in week 8. Diurnal blood pressure was not found associated with preterm delivery. Conclusion: The quality of glycemic regulation in the early and mid pregnancy is a major, independent risk factor for preterm delivery in normoalbuminuric diabetic women without preeclampsia.

妊娠期糖尿病早期诊断和治疗

妊娠期糖尿病（GDM）是指妊娠期间首次发生或发现的糖尿病及妊娠前已有的糖尿病（DM）,GDM可使孕妇及婴儿的患病率及死亡率增加。临床经过复杂,对母儿均有较大危害,须引起重视。其危害程度和DM血糖控制程度密切相关,现临床分析如下。

糖尿病的实验室检查

糖尿病是一种终生性疾病,现已成为危害人们、尤其是中老年健康的严重疾病。糖尿病的主要危害是其急性并发症(酮症酸中毒、高渗性昏迷等)和慢性并发症(视网膜病变、肾病、神经病变和心血管病变等)。这些并发症出现与否及程度和糖尿病血糖控制程度及其相应指标水平有密切关系。因此。糖尿病人必须接受基础医学教育和掌握一定的自我管理技术。对糖尿病的一些常用的实验室检查、结果及意义也应有所了解。

运动控血糖 打打太极拳

太极拳是一种将意识、呼吸、动作三者结合为一的运动，非常适合糖尿病人。一项最新的调查报告显示，打太极拳可以帮助2型糖尿病患者，刺激免疫功能和提高血糖控制程度。

肺结核合并糖尿病的健康教育

近年来，肺结核合并糖尿病病例有显著上升趋势。糖尿病与肺结核互相影响，结核病治疗的成败与血糖控制程度有关，在此治疗中出现血糖控制不理想，长时间排菌或反复小量咯血不止，给病人造成很大的思想上与经济上的负担。2005年7月-2006年7月我院对56例肺结核合并糖尿病人进行科学有效的健康教育，减轻了病人及家属的负担，为疾病的尽快治愈起到重要的作用。