目的探讨二甲双胍对2型糖尿病合并原发性亚临床甲状腺功能减退患者血清促甲状腺激素(TSH)水平的影响。方法选取2013年6月至2015年5月大连大学附属中山医院收治的125例2型糖尿病合并原发性亚临床甲状腺功能减退患者作为研究对象,按随机...目的探讨二甲双胍对2型糖尿病合并原发性亚临床甲状腺功能减退患者血清促甲状腺激素(TSH)水平的影响。方法选取2013年6月至2015年5月大连大学附属中山医院收治的125例2型糖尿病合并原发性亚临床甲状腺功能减退患者作为研究对象,按随机数字表法将其分为观察组(63例)和对照组(62例)。观察组患者采用二甲双胍进行治疗,对照组患者口服左旋甲状腺素钠片,比较两组患者治疗前后的空腹血糖(FBG)值、餐后2 h血糖(2 h PBG)及血清TSH水平。结果治疗后,观察组患者的FBG、2 h PBG均明显低于对照组,差异均有统计学意义(均P<0.05);治疗后,观察组患者的血清TSH水平为(1.3±0.8)m IU/L,明显低于对照组的(1.8±1.7)m IU/L,差异有统计学意义(t=7.1042,P<0.05)。结论二甲双胍可有效改善2型糖尿病合并原发性亚临床甲状腺功能减退患者血清TSH水平,降低血糖值,是2型糖尿病合并原发性亚临床甲状腺功能减退患者的理想治疗药物。展开更多
Background:Type 2 diabetes mellitus has been identified as one of the most challenging chronic illnesses to manage.Since the management of diabetes is mainly accomplished by patients and families,selfmanagement has be...Background:Type 2 diabetes mellitus has been identified as one of the most challenging chronic illnesses to manage.Since the management of diabetes is mainly accomplished by patients and families,selfmanagement has become the mainstay of diabetes care.However,a significant proportion of patients fail to engage in adequate self-management.A priority research question is how do interventions affect the self-management behaviors of persons with Type 2 diabetes?Purpose/Objectives:The purpose of this integrative review is to provide a summary and critique of interventions that support diabetes self-management in the patient with TypeⅡdiabetes mellitus.Design:An integrative review design,with a comprehensive methodological approach of reviews,allowing inclusion of experimental and non-experimental studies.Procedures:A comprehensive search was conducted via Ebscohost using databases of Academic Search Complete,CINAHL,Health Source:Nursing/Academic Edition,MEDLINE,PsycArtiCLES,and PsycInfo.The final number of papers used for this review were:motivational interviewing(6),peer support/coaching(10),problem solving therapy(3),technology-based interventions(30),lifestyle modification programs(7),patient education(11),mindfulness(3),and cognitive behavioral therapy(5).Results:Studies were examined from seventeen countries including a broad range of cultures and ethnicities.While interventions have shown mixed results in all interventional categories,many studies do support small to modest improvements in physiologic,behavioral,and psychological outcome measures.Considerable heterogeneity of interventions exists.The most commonly reported physiologic measure was HbA1c level.Outcome measures were collected mostly at 6 and 12 months.Duration of most research was limited to one year.Conclusions:Research exploring the impact of interventions for self-management has made major contributions to the care of persons with type 2 diabetes,from offering suggestions for improving care,to stimulating new questions for research.However,implications for clinical practice remain inconclusive,and limitations in existing research suggest caution in interpreting results of studies.展开更多
The aim of this paper is to detect, prevent and resolve DRP （drug-related problems） and NOM （negative outcomes associated with medication） in hospitalized patients with DM2 （type 2 diabetes） with HTN （hypertens...The aim of this paper is to detect, prevent and resolve DRP （drug-related problems） and NOM （negative outcomes associated with medication） in hospitalized patients with DM2 （type 2 diabetes） with HTN （hypertension） in a tertiary care clinic. Descriptive cross-sectional interventional study is used. DTM （drug therapy monitoring） was conducted in 73 patients using data obtained from clinical histories and interviews. NOM were detected based on symptoms and laboratory test results. The statistical significance was 0.05. It can be found that 23 DRP were detected, primarily in the category ＂likelihood of adverse effects＂ （30.43%） causing NOM in the ＂non-quantitative safety problem＂ category. The NOM detected were related to safety （62%）, effectiveness （24.5%） and necessity （13.5%）. Of the 68.57% of pharmacist interventions accepted, 48.57% were resolved and 20% were not resolved. A simple linear correlation （r = -0.34） analysis indicated a weak association between patient age and severity ofNOM. DTM made it＇possible to detect suspected DRP and NOM, which were then prevented or resolved, improving the control of HTN and DM2 and helping ensure better drug therapy outcomes for patients.展开更多
AIM: To examine the relations of alcohol consumption to the prevalence of metabolic syndrome in Shanghai adults. METHODS: We performed a cross-sectional analysis of data from the randomized multistage stratified clust...AIM: To examine the relations of alcohol consumption to the prevalence of metabolic syndrome in Shanghai adults. METHODS: We performed a cross-sectional analysis of data from the randomized multistage stratified cluster sampling of Shanghai adults, who were evaluated for alcohol consumption and each component of metabolic syndrome, using the adapted U.S. National Cholesterol Education Program criteria. Current alcohol consumption was defined as more than once of alcohol drinking per month. RESULTS: The study population consisted of 3953 participants (1524 men) with a mean age of 54.3 ± 12.1 years. Among them, 448 subjects (11.3%) were current alcohol drinkers, including 405 males and 43 females. After adjustment for age and sex, the prevalence of current alcohol drinking and metabolic syndrome in the general population of Shanghai was 13.0% and 15.3%, respectively. Compared with nondrinkers, the prevalence of hypertriglyceridemia and hypertension was higher while the prevalence of abdominal obesity, low serum high-density-lipoprotein cholesterol (HDL-C) and diabetes mellitus was lower in subjects who consumed alcohol twice or more per month, with a trend toward reducing the prevalence of metabolic syndrome. Among the current alcohol drinkers, systolic blood pressure, HDL-C, fastingplasma glucose, and prevalence of hypertriglyceridemia tended to increase with increased alcohol consumption. However, low-density-lipoprotein cholesterol concentration, prevalence of abdominal obesity, low serum HDL-C and metabolic syndrome showed the tendency to decrease. Moreover, these statistically significant differences were independent of gender and age.CONCLUSION: Current alcohol consumption is associated with a lower prevalence of metabolic syndrome irrespe- ctive of alcohol intake (g/d), and has a favorable influence on HDL-C, waist circumference, and possible diabetes mellitus. However, alcohol intake increases the likelihood of hypertension, hypertriglyceridemia and hyperglycemia. The clinical significance of these findings needs further investigation.展开更多
Nonalcoholic fatty liver disease(NAFLD) is a condition in which excess fat accumulates in the liver of a patient without a history of alcohol abuse.Nonalcoholic steatohepatitis(NASH),a severe form of NAFLD,can progres...Nonalcoholic fatty liver disease(NAFLD) is a condition in which excess fat accumulates in the liver of a patient without a history of alcohol abuse.Nonalcoholic steatohepatitis(NASH),a severe form of NAFLD,can progress to liver cirrhosis and hepatocellular carcinoma.NAFLD is regarded as a hepatic manifestation of metabolic syndrome and incidence has been increasing worldwide in line with the increased prevalence of obesity,type 2 diabetes,and hyperlipemia.Animal models of NAFLD/NASH give crucial information,not only in elucidating pathogenesis of NAFLD/NASH but also in examining therapeutic effects of various agents.An ideal model of NAFLD/NASH should correctly reflect both hepatic histopathology and pathophysiology of human NAFLD/NASH.Animal models of NAFLD/NASH are divided into genetic,dietary,and combination models.In this paper,we review commonly used animal models of NAFLD/NASH referring to their advantages and disadvantages.展开更多
The World Health Organization recommends that the daily intake of added sugars should make up no more than 10% of total energy.The consumption of sugarsweetened beverages is the main source of added sugars.Fructose,to...The World Health Organization recommends that the daily intake of added sugars should make up no more than 10% of total energy.The consumption of sugarsweetened beverages is the main source of added sugars.Fructose,together with glucose,as a component of high fructose corn syrups or as a component of the sucrose molecule,is one of the main sweeteners present in this kind of beverages.Data from prospective and intervention studies clearly point to high fructose consumption,mainly in the form of sweetened beverages,as a risk factor for several metabolic diseases in humans.The incidence of hypertension,nonalcoholic fatty liver disease(NAFLD),dyslipidemia(mainly hypertriglyceridemia),insulin resistance,type 2 diabetes mellitus,obesity,and the cluster of many of these pathologies in the form of metabolic syndrome is higher in human population segments that show high intake of fructose.Adolescent and young adults from lowincome families are especially at risk.We recently reviewed evidence from experimental animals and human data that confirms the deleterious effect of fructose on lipid and glucose metabolism.In this present review we update the information generated in the past 2 years about high consumption of fructose-enriched beverages and the occurrence of metabolic disturbances,especially NAFLD,type 2 diabetes mellitus,and metabolic syndrome.We have explored recent data from observational and experimental human studies,as well as experimental data from animal and cell models.Finally,using information generated in our laboratory and others,we provide a view of the molecular mechanisms that may be specifically involved in the development of liver lipid and glucose metabolic alterations after fructose consumption in liquid form.展开更多
Objective To observe the effect of Mo-Rubbing abdomen manipulation on glucose metabolism and inflammatory factors in rats with type 2 diabetes mellitus(T2DM).Methods Sixty Sprague-Dawley rats were randomly divided int...Objective To observe the effect of Mo-Rubbing abdomen manipulation on glucose metabolism and inflammatory factors in rats with type 2 diabetes mellitus(T2DM).Methods Sixty Sprague-Dawley rats were randomly divided into a normal group(n=10)and a group for modeling(n=50)using the random number table method.Rats in the group for modeling were induced to form T2DM models by a high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin.Thirty successfully modeled rats were randomly divided into a model group,a Mo-Rubbing abdomen group,and a metformin group,with 10 rats in each group.Rats in the normal group and the model group received no intervention,those in the Mo-Rubbing abdomen group received Mo-Rubbing abdomen manipulation,and those in the metformin group received metformin by gavage.After 8-week intervention,fasting insulin(FINS),fasting plasma glucose(FPG),homeostasis model assessment for insulin resistance(HOMA-IR)and area under the curve at the oral glucose tolerance test(AUC-OGTT),as well as serum inflammatory factors interleukin(IL)-1β,IL-6,and tumor necrosis factor(TNF)-αwere detected,and the morphological changes of the pancreas were also observed.Results After the 8-week intervention,the levels of FINS,FPG,HOMA-IR,and AUC-OGTT of rats in the Mo-Rubbing abdomen group were significantly lower than those in the model group(P<0.05);the pancreatic injury degree in the Mo-Rubbing abdomen group and the metformin group was lower than that in the model group.Compared with the model group,the serum IL-1β,IL-6,and TNF-αlevels of rats in the Mo-Rubbing abdomen group were significantly decreased(P<0.05),and the serum IL-1βand TNF-αlevels of the metformin group showed a downward trend;the serum IL-6 and TNF-αlevels in the Mo-Rubbing abdomen group were significantly lower than those in the metformin group(P<0.01).There was a significant positive correlation between FPG with IL-1β,IL-6,and TNF-αin the T2DM rats(P<0.01).Conclusion Mo-Rubbing abdomen manipulation reduces the inflammatory response and improves the morphological changes of the pancreas in T2DM rats,thereby achieving the effect of lowering blood glucose.展开更多
文摘目的探讨二甲双胍对2型糖尿病合并原发性亚临床甲状腺功能减退患者血清促甲状腺激素(TSH)水平的影响。方法选取2013年6月至2015年5月大连大学附属中山医院收治的125例2型糖尿病合并原发性亚临床甲状腺功能减退患者作为研究对象,按随机数字表法将其分为观察组(63例)和对照组(62例)。观察组患者采用二甲双胍进行治疗,对照组患者口服左旋甲状腺素钠片,比较两组患者治疗前后的空腹血糖(FBG)值、餐后2 h血糖(2 h PBG)及血清TSH水平。结果治疗后,观察组患者的FBG、2 h PBG均明显低于对照组,差异均有统计学意义(均P<0.05);治疗后,观察组患者的血清TSH水平为(1.3±0.8)m IU/L,明显低于对照组的(1.8±1.7)m IU/L,差异有统计学意义(t=7.1042,P<0.05)。结论二甲双胍可有效改善2型糖尿病合并原发性亚临床甲状腺功能减退患者血清TSH水平,降低血糖值,是2型糖尿病合并原发性亚临床甲状腺功能减退患者的理想治疗药物。
基金This research did not receive any specific grant from funding agencies in the public,commercial,or not-for-profit sectors
文摘Background:Type 2 diabetes mellitus has been identified as one of the most challenging chronic illnesses to manage.Since the management of diabetes is mainly accomplished by patients and families,selfmanagement has become the mainstay of diabetes care.However,a significant proportion of patients fail to engage in adequate self-management.A priority research question is how do interventions affect the self-management behaviors of persons with Type 2 diabetes?Purpose/Objectives:The purpose of this integrative review is to provide a summary and critique of interventions that support diabetes self-management in the patient with TypeⅡdiabetes mellitus.Design:An integrative review design,with a comprehensive methodological approach of reviews,allowing inclusion of experimental and non-experimental studies.Procedures:A comprehensive search was conducted via Ebscohost using databases of Academic Search Complete,CINAHL,Health Source:Nursing/Academic Edition,MEDLINE,PsycArtiCLES,and PsycInfo.The final number of papers used for this review were:motivational interviewing(6),peer support/coaching(10),problem solving therapy(3),technology-based interventions(30),lifestyle modification programs(7),patient education(11),mindfulness(3),and cognitive behavioral therapy(5).Results:Studies were examined from seventeen countries including a broad range of cultures and ethnicities.While interventions have shown mixed results in all interventional categories,many studies do support small to modest improvements in physiologic,behavioral,and psychological outcome measures.Considerable heterogeneity of interventions exists.The most commonly reported physiologic measure was HbA1c level.Outcome measures were collected mostly at 6 and 12 months.Duration of most research was limited to one year.Conclusions:Research exploring the impact of interventions for self-management has made major contributions to the care of persons with type 2 diabetes,from offering suggestions for improving care,to stimulating new questions for research.However,implications for clinical practice remain inconclusive,and limitations in existing research suggest caution in interpreting results of studies.
文摘The aim of this paper is to detect, prevent and resolve DRP （drug-related problems） and NOM （negative outcomes associated with medication） in hospitalized patients with DM2 （type 2 diabetes） with HTN （hypertension） in a tertiary care clinic. Descriptive cross-sectional interventional study is used. DTM （drug therapy monitoring） was conducted in 73 patients using data obtained from clinical histories and interviews. NOM were detected based on symptoms and laboratory test results. The statistical significance was 0.05. It can be found that 23 DRP were detected, primarily in the category ＂likelihood of adverse effects＂ （30.43%） causing NOM in the ＂non-quantitative safety problem＂ category. The NOM detected were related to safety （62%）, effectiveness （24.5%） and necessity （13.5%）. Of the 68.57% of pharmacist interventions accepted, 48.57% were resolved and 20% were not resolved. A simple linear correlation （r = -0.34） analysis indicated a weak association between patient age and severity ofNOM. DTM made it＇possible to detect suspected DRP and NOM, which were then prevented or resolved, improving the control of HTN and DM2 and helping ensure better drug therapy outcomes for patients.
基金The Grant-in-Aid from Shanghai Science and Technology Community Fund, No. 01ZD001
文摘AIM: To examine the relations of alcohol consumption to the prevalence of metabolic syndrome in Shanghai adults. METHODS: We performed a cross-sectional analysis of data from the randomized multistage stratified cluster sampling of Shanghai adults, who were evaluated for alcohol consumption and each component of metabolic syndrome, using the adapted U.S. National Cholesterol Education Program criteria. Current alcohol consumption was defined as more than once of alcohol drinking per month. RESULTS: The study population consisted of 3953 participants (1524 men) with a mean age of 54.3 ± 12.1 years. Among them, 448 subjects (11.3%) were current alcohol drinkers, including 405 males and 43 females. After adjustment for age and sex, the prevalence of current alcohol drinking and metabolic syndrome in the general population of Shanghai was 13.0% and 15.3%, respectively. Compared with nondrinkers, the prevalence of hypertriglyceridemia and hypertension was higher while the prevalence of abdominal obesity, low serum high-density-lipoprotein cholesterol (HDL-C) and diabetes mellitus was lower in subjects who consumed alcohol twice or more per month, with a trend toward reducing the prevalence of metabolic syndrome. Among the current alcohol drinkers, systolic blood pressure, HDL-C, fastingplasma glucose, and prevalence of hypertriglyceridemia tended to increase with increased alcohol consumption. However, low-density-lipoprotein cholesterol concentration, prevalence of abdominal obesity, low serum HDL-C and metabolic syndrome showed the tendency to decrease. Moreover, these statistically significant differences were independent of gender and age.CONCLUSION: Current alcohol consumption is associated with a lower prevalence of metabolic syndrome irrespe- ctive of alcohol intake (g/d), and has a favorable influence on HDL-C, waist circumference, and possible diabetes mellitus. However, alcohol intake increases the likelihood of hypertension, hypertriglyceridemia and hyperglycemia. The clinical significance of these findings needs further investigation.
文摘Nonalcoholic fatty liver disease(NAFLD) is a condition in which excess fat accumulates in the liver of a patient without a history of alcohol abuse.Nonalcoholic steatohepatitis(NASH),a severe form of NAFLD,can progress to liver cirrhosis and hepatocellular carcinoma.NAFLD is regarded as a hepatic manifestation of metabolic syndrome and incidence has been increasing worldwide in line with the increased prevalence of obesity,type 2 diabetes,and hyperlipemia.Animal models of NAFLD/NASH give crucial information,not only in elucidating pathogenesis of NAFLD/NASH but also in examining therapeutic effects of various agents.An ideal model of NAFLD/NASH should correctly reflect both hepatic histopathology and pathophysiology of human NAFLD/NASH.Animal models of NAFLD/NASH are divided into genetic,dietary,and combination models.In this paper,we review commonly used animal models of NAFLD/NASH referring to their advantages and disadvantages.
基金Supported by Fundació Privada Catalana de Nutrició i Lípids and Grant SAF2010-15664 from the Spanish Ministry of Sci ence and Innovation
文摘The World Health Organization recommends that the daily intake of added sugars should make up no more than 10% of total energy.The consumption of sugarsweetened beverages is the main source of added sugars.Fructose,together with glucose,as a component of high fructose corn syrups or as a component of the sucrose molecule,is one of the main sweeteners present in this kind of beverages.Data from prospective and intervention studies clearly point to high fructose consumption,mainly in the form of sweetened beverages,as a risk factor for several metabolic diseases in humans.The incidence of hypertension,nonalcoholic fatty liver disease(NAFLD),dyslipidemia(mainly hypertriglyceridemia),insulin resistance,type 2 diabetes mellitus,obesity,and the cluster of many of these pathologies in the form of metabolic syndrome is higher in human population segments that show high intake of fructose.Adolescent and young adults from lowincome families are especially at risk.We recently reviewed evidence from experimental animals and human data that confirms the deleterious effect of fructose on lipid and glucose metabolism.In this present review we update the information generated in the past 2 years about high consumption of fructose-enriched beverages and the occurrence of metabolic disturbances,especially NAFLD,type 2 diabetes mellitus,and metabolic syndrome.We have explored recent data from observational and experimental human studies,as well as experimental data from animal and cell models.Finally,using information generated in our laboratory and others,we provide a view of the molecular mechanisms that may be specifically involved in the development of liver lipid and glucose metabolic alterations after fructose consumption in liquid form.
文摘Objective To observe the effect of Mo-Rubbing abdomen manipulation on glucose metabolism and inflammatory factors in rats with type 2 diabetes mellitus(T2DM).Methods Sixty Sprague-Dawley rats were randomly divided into a normal group(n=10)and a group for modeling(n=50)using the random number table method.Rats in the group for modeling were induced to form T2DM models by a high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin.Thirty successfully modeled rats were randomly divided into a model group,a Mo-Rubbing abdomen group,and a metformin group,with 10 rats in each group.Rats in the normal group and the model group received no intervention,those in the Mo-Rubbing abdomen group received Mo-Rubbing abdomen manipulation,and those in the metformin group received metformin by gavage.After 8-week intervention,fasting insulin(FINS),fasting plasma glucose(FPG),homeostasis model assessment for insulin resistance(HOMA-IR)and area under the curve at the oral glucose tolerance test(AUC-OGTT),as well as serum inflammatory factors interleukin(IL)-1β,IL-6,and tumor necrosis factor(TNF)-αwere detected,and the morphological changes of the pancreas were also observed.Results After the 8-week intervention,the levels of FINS,FPG,HOMA-IR,and AUC-OGTT of rats in the Mo-Rubbing abdomen group were significantly lower than those in the model group(P<0.05);the pancreatic injury degree in the Mo-Rubbing abdomen group and the metformin group was lower than that in the model group.Compared with the model group,the serum IL-1β,IL-6,and TNF-αlevels of rats in the Mo-Rubbing abdomen group were significantly decreased(P<0.05),and the serum IL-1βand TNF-αlevels of the metformin group showed a downward trend;the serum IL-6 and TNF-αlevels in the Mo-Rubbing abdomen group were significantly lower than those in the metformin group(P<0.01).There was a significant positive correlation between FPG with IL-1β,IL-6,and TNF-αin the T2DM rats(P<0.01).Conclusion Mo-Rubbing abdomen manipulation reduces the inflammatory response and improves the morphological changes of the pancreas in T2DM rats,thereby achieving the effect of lowering blood glucose.
