Effect of hospital discharge plan for children with type 1 diabetes on discharge readiness,discharge education quality,and blood glucose control

BACKGROUND Type 1 diabetes is one of the most common chronic diseases in childhood.The number of type 1 diabetes patients in China still ranks fourth in the world.Therefore,children with type 1 diabetes in China are a group that needs attention.The management of type 1 diabetes mellitus(T1DM)involves many aspects of daily life.It is extremely challenging for children and their families.T1DM children have complex medical care needs.Despite the continuous development of therapeutic medicine and treatment technologies,blood glucose control in children with T1DM is still not ideal.They and their parents need to acquire more knowledge and skills before being discharged.AIM To explore the influence of hospital discharge plan based on parental care needs of children with T1DM on discharge readiness,quality of discharge education and blood glucose control level.METHODS In total,102 parents of children with type 1 diabetes were divided into control group and intervention group according to admission time.Fifty cases from February to June 2019 were selected as the control group,and 52 cases from July to October 2019 were selected as the intervention group to implement the discharge plan.The Readiness for Hospital Discharge Scale,Hospital Discharged Education Quality Scale and children's blood glucose metabolism indicators were used to compare the differences in discharge preparation,discharge education quality and blood glucose control between the two groups of children and their parents.RESULTS On the day of discharge,the two groups of children had the following scores of readiness for discharge:The intervention group score was 225.34±32.47,and the control group score was 208.68±29.31.The P value was 0.007,and the difference was statistically significant.The discharge education quality scores were as follows:The intervention group score was 135.11±19.86,the control group score was 124.13±15.56,the P value was 0.002 and the difference was statistically significant.Three months after discharge,the blood glucose metabolism indicator showed that the glycosylated hemoglobin value of the two groups was(7.45%±1.04%),and that of the control group was(8.04%±1.27%),P=0.012.Therefore,the improvement of parents'readiness for discharge,quality of discharge education and blood glucose metabolism indicators(glycosylated hemoglobin,fasting blood glucose and postprandial blood glucose)in the intervention group were better than those in the control group(P<0.05),and the difference was statistically significant.CONCLUSION The discharge plan for children with T1DM can help the children and their families realize the transition from hospital care to home self-management and improve the parents'readiness for discharge,thereby improving children’s blood glucose control levels.

Establishment of blood glucose control model in diabetic mice

AIM:To explore the established method of the diabetic mouse blood glucose control model and preliminar y observation of its influence on the retinas of diabetic mice.METHODS:The db/db BKS-DB(Lepr^(ko/ko))mice were randomly divided into two groups:the poor blood glucose control group(PG group,n=18)and the stable blood glucose control group(SG group,n=12),with BKS-DB(Lepr^(wt/wt))as the normal blood glucose control group(NG group,n=18).According to the blood glucose values for 5 intervals which were monitored during the period of adaption,the PG group was injected with insulin aspart twice daily,fasted for 2h and then returned to normal.The SG group was injected with insulin aspart twice and insulin glargine once daily and fed with a quantitative ration.Fundus images were collected after eight weeks.The glycosylated hemoglobin(Hb A1c),mean blood glucose level(MBG),standard deviation of blood glucose(SDBG),coefficient of variation of blood glucose(CVBG),and mean amplitude of glycemic excursion(MAGE)in each group were examined and calculated.RESULTS:The Hb A1c,MBG,SDBG,CVBG,and MAGE levels in the PG group were significantly higher than those in the NG and SG groups(all P<0.05).MBG,SDBG,CVBG,and MAGE levels in the SG group were higher than those in the NG group(all P<0.05).There was no significant difference in Hb A1c levels between the NG and SG groups(P>0.05).Preliminary observation of fundus images in the PG group and SG groups showed scattered retinal bleeding spots,while bleeding was more obvious in the PG group.CONCLUSION:The blood glucose control model of type 2 diabetes mellitus mice can be successfully established by subcutaneous injection of insulin aspart insulin glargine and rationed food,which is valuable for studying the mechanism of blood glucose fluctuations in diabetic complications in vivo.

Investigation on Blood Glucose Control Nursing of ICU Severe Patients

Objective:To analyze the effect of blood glucose control mursing in intensive care umit (ICU)patients.Methods:The clinical data of 70 severe patients in ICU of ou hospital fom January 2019 to May 2020 were retrospectively analyzed.The climical data of 34 patients with routine intervention were divided into the control group,and the clinical data of 36 patients with routine intervention and blood glucose control mursing were divided into the observation group,all were intervened for 14 days.The blood glucose levels and prognosis of the two groups were compared before intervention and at the end of 14 days of intervention,the time required o achieve the standard blood glucose level of the two groups was recorded Results:After 14 days of intervention,the fasting blood glucose level of the observation group was lower than the control group,the difference was satisically significant(P<0.05);the time of blood glucose reaching the standard in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.05);on the 14th day of intervention,the sequential organ failure asessment score(SOFA)score of the two groups was lower than before intervention,the SOFA score of the observation group was lower than control group,the difference was statistically significant(P<0.05).Conclusion:The effect of blood glucose control mursing in ICU is better,which effectively controlled the blood glucose level of patients and improved the prognosis of patients.

Research Progress on Non-Drug Treatment for Blood Glucose Control of Type 2 Diabetes Mellitus

Type 2 diabetes mellitus （T2DM） is one of the common endocrinology diseases that greatly affects the health care sector and economy. Application of hypoglycemic drugs has its own drawbacks and the use of non-drug therapy on treating T2DM has drawn much attention recently. This paper reviewed the research development of the non-pharmacological interventions on T2DM in recent years, including dietary therapy, exercise therapy, psychotherapy, acupuncture and moxibustion therapies and so on. The authors mentioned the problems in the research of non-drug treatment for blood glucose control of T2DM and put forward new ideas for the research in the future. Further well-designed trials with large sample size and long-term follow-up are needed to confirm current conclusions.

Analysis on the Correlation between Fasting Blood-glucose and Gestational Diabetes Mellitus

Objective： The correlation between the fasting blood-glucose （FBG） in early pregnancy and the gestational diabetes mellitus （GDM） was studied. Methods： The clinical data of 300 pregnant women receiving a treatment from Yongqing Hospital of Traditional Chinese Medicine and Langfang Health Vocational College from September 2012 to September 2013 was chosen; these cases were divided into group 6.9-6.0 mmol/L （35 cases）, group 5.9~5.0 mmol/L （58 cases）, group 4.9~4.5 mmol/L （120 cases）, and group 4.4~4.0mmol/L （108 cases） according to the range of the normal FBG. The proportional differences among the pregnant women diagnosed with GDM in different groups during the late pregnancy as well as the maternal and fetal prognosis were compared. Results： The proportion of the pregnant women diagnosed with GDM in group 6.9-6.0 mmol/L and group 5.9-5.0 mmol/L during the middle-late pregnancy was significantly higher than that of group 4.9-4.5 mmol/L and group 4.4-4.0mmol/L; there was no significant proportional difference among the pregnant women diagnosed with GDM in group 6.9~6.0 mmol/L and group 5.9-5.0 mmol/L during the middle-late pregnancy; there was no significant proportional difference among the pregnant women diagnosed with GDM in group 4.9-4.5 mmol/L and group 4.4-4.0mmol/L during the middle-late pregnancy. Conclusion： The risk of the pregnant women with FBG is higher than that of the normal pregnant women in suffering GDM during the early pregnancy, so attention should be paid to early blood glucose test and the blood glucose level should be positively controlled once they are defmitely diagnosed with GDM, and then the perinatal and maternal survival quality can be improved.

The Effect of Baihu Decoction (白虎汤) on Blood Glucose Levels in Treating Systemic Inflammatory Response Syndrome

In this paper we investigated the mechanisms of Baihu Decoction （白虎汤, BH） and Baihu with Radix Ginseng （BHG） in treating systemic inflammatory response syndrome （SIRS） and sepsis in humans and animals. By reviewing published data on the effects of BH and BHG and the control of blood glucose in treating SIRS and sepsis, we found that （1） BH and BHG were beneficial in the treatment of SIRS and sepsis in humans and animals; （2） BH and BHG also had great effect in lowering blood glucose level; and （3） the tight control of blood glucose during critical illness substantially improved the outcome. Considering these data together, we hypothesize that one of the major mechanisms of BH and BHG in treating SIRS and sepsis is to lower the blood glucose level. The findings also suggest that the application of BH and BHG can extend to many acute illnesses and injuries, which commonly cause hyperglycemia.

Glucose-responsive erythrocyte-bound nanoparticles for continuously modulated insulin release

Glucose-responsive closed-loop insulin delivery systems represent a promising treatment strategy for diabetes,but current systems generally cannot achieve long-term effects.In this study,we designed an erythrocyte-biomimetic glucose-responsive system(EGRS)by coupling glucose-responsive nanoparticles(GRNs)to red blood cells;these nanoparticles exhibited the dual functions of glucose-responsiveness and persistent presence in circulation.GRNs are generated by encapsulating with insulin through ion crosslinking,followed by coloading with glucose oxidase(GOx)and catalase(CAT),a process that endows the nanoparticles with glucose-responsiveness.Simultaneously,the GRNs are coupled with red blood cells to camouflage them from the immune system,therefore,these erythrocyte-coupled GRNs can circulate in the blood for a long time.Under conditions of hyperglycemia,GOx acts on blood glucose to produce gluconic acid,which causes the rupture of GRNs and efficient release of insulin.Conversely,insulin is only released at the basic rate during hypoglycemia.Thus,EGRS can efficiently and continuously respond to hyperglycemia to maintain blood glucose levels within the normal range.