Analysis of the Effect of Integrated Extended Care Model in Improving the Quality of Life of Elderly Patients with Type 2 Diabetes Mellitus

Objective: To analyze the impact of an integrated extended care model on improving the quality of life of elderly patients with Type 2 Diabetes Mellitus (T2DM). Methods: A total of 176 patients admitted to the hospital from March 2015 to February 2018 were selected and randomly assigned to an observation group and a control group, with 88 patients each. The control group implemented conventional nursing interventions, and the observation group carried out an integrated extended-care model. The level of glycemic control, quality of life, and daily medication adherence between both groups were compared. Results: The observation group showed significant improvement in the level of glycemic control, and their fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels were significantly lower as compared with those in the study group (P < 0.05). The quality of life of the patients in the observation group was higher than that of the control group (P < 0.05). The observation group had a higher compliance score (95.48 ± 7.45) than the control group (81.31 ± 8.72) (t = 8.909, P < 0.05). Conclusion: The integrated extended care model allows patients to receive comprehensive and individualized nursing services after discharge, which improves the effect of drug therapy and the quality of life of patients.

Analysis of the Application Effect of Family Collaborative Care Model on Elderly Patients with Type 2 Diabetes Mellitus and the Situation of Self-Care Ability

Objective: To study the application effect of the family collaborative care model on elderly patients with type 2 diabetes mellitus and its influence on self-care ability. Methods: The elderly type 2 diabetes mellitus patients (400 cases) treated in our hospital between March 2020 and July 2023 were divided into two groups by randomized grouping method;the control group received the conventional nursing program, while the observation group received the family collaborative nursing model. Blood glucose level, self-care ability, and quality of life were compared between the groups. Results: The blood glucose level of the observation group was lower than that of the control group (P < 0.05). The self- care ability and quality of life scores of the observation group were higher than those of the control group (P < 0.05). Conclusion: The family collaborative care model for elderly patients with type 2 diabetes mellitus can promote their self- care ability, improve the effect of glycemic control, and improve their quality of life, and is suitable for further promotion and application.

Diversity of Intestinal Flora in Elderly Patients with Type 2 Diabetes Mellitus with Early Nephropathy

Objective:To investigate the intestinal flora in elderly patients with type 2 diabetes mellitus with early nephropathy.Methods:43 elderly patients with type 2 diabetes mellitus with early nephropathy(diabetic nephropathy group)and 51 elderly patients with type 2 diabetes mellitus(type 2 diabetes mellitus group)admitted to our hospital from January 2021 to October 2022 were retrospectively analyzed,with 39 healthy people who underwent a physical examination in our hospital during the same period as the control group.The fecal specimens of the three groups were collected,and the 16S rDNAs of bacteria in the fecal samples were extracted,amplified,and sequenced for intestinal flora operational taxonomic unit(OTU)classification and Alpha diversity analysis.Results:(1)Intestinal flora OTUs:there were 545 intestinal flora OTUs unique to the control group,424 intestinal flora OTUs unique to diabetic nephropathy,and 321 intestinal flora OTUs unique to the type 2 diabetes group.There were 403 intestinal flora OTUs common to the control group and diabetic nephropathy group,256 intestinal flora OTUs common to the control group and type 2 diabetes group,and 298 intestinal flora OTUs common to the type 2 diabetes group and diabetic nephropathy group.235 intestinal flora OTUs were common to all 3 groups of subjects.(2)Alpha diversity:The statistical analysis indicated that there was a statistically significant difference(P<0.05)in the Alpha diversity of intestinal flora,as assessed by the Ace index and Simpson’s index,among the three subject groups.However,no statistical significance(P>0.05)was observed when comparing the Chao 1 index and Shannon index.Further observation of the Ace index and Simpson index in the three groups revealed that both the diabetic nephropathy group and the type 2 diabetes mellitus group had lower values than the control group.Conclusion:The diversity of intestinal flora decreases in elderly patients with type 2 diabetes mellitus with early nephropathy.

Prevalence and risk factors of diabetes mellitus among elderly patients in the Lugu community

BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.

Research on the Effect of Humanistic Nursing Care on Elderly Type 2 Diabetes Mellitus Patients

Objective:To explore and analyze the effect of humanistic nursing care on elderly type 2 diabetes patients.Methods:100 elderly patients with type 2 diabetes who were treated in our hospital from May 2021-May 2023 were selected for this study.The patients were divided into an experimental group and a reference group by flipping a coin,with 50 cases in each group.The experimental group received humanistic nursing care,while the reference group received routine nursing care.The blood glucose level,compliance and nursing satisfaction were compared between the two groups.Results:Before the intervention,there was no statistically significant difference between the groups in pre-meal blood glucose,blood glucose 2 hours after eating,and glycosylated hemoglobin(P>0.05).After the intervention,pre-meal blood glucose,blood glucose 2 hours after eating,and glycosylated hemoglobin in the humanities group were significantly better than those in the reference group(P<0.05).Besides,before the intervention,there was no statistically significant difference in compliance with diet,medication,examination,and exercise between the groups(P>0.05).After the intervention,the compliance with diet,medication,examination,and exercise in the experimental group was significantly better than that of the reference group(P<0.05).The patients in the experimental group were significantly more satisfied with the nursing care received than the reference group(P<0.05).Conclusion:Humanistic nursing care can reduce blood sugar in elderly patients with type 2 diabetes,strengthen treatment compliance,and improve satisfaction.

Tear inflammation related indexes after cataract surgery in elderly patients with type 2 diabetes mellitus

BACKGROUND Quantitative studies on the changes in inflammation-related content in tears,especially the effect of diabetes,are lacking.In this study,we measured the preoperative and postoperative tear inflammatory mediator levels in cataract patients,focusing on the expression of inflammatory factors in postoperative cataracts in the diabetic,and investigated the effect of drugs on the control of postoperative inflammation.AIM To study the expression of inflammatory factors in elderly people with type 2 diabetes after cataract surgery.METHODS Patients with a mean age of 70.3±6.3 years were divided into group A(composed of elderly patients with cataracts and type 2 diabetes,n=20 eyes)and group B(patients with age-related cataract,n=20 eyes).Their tears were collected before each operation and on days 1 and 3,and weeks 1,2,3,and 4 post-surgery.Saline(150μL)was dropped into the conjunctival sac of the surgical eye,followed by oculogyration in four directions.The fluid in the conjunctival sac was extracted using a sterile syringe and stored in Eppendorf tubes at-80°C until measurement.The expression levels of matrix metalloproteinase-2(MMP-2),MMP-9,tissue inhibitor of metalloproteinase-1(TIMP-1),TIMP-2,interleukin-6(IL-6),and IL-20 in tear fluid were measured using enzyme-linked immunosorbent assays.RESULTS The postoperative expression levels of MMP-2,MMP-9,TIMP-2,IL-6,and IL-20 in group A were significantly higher than those in group B,whereas the concentration of TIMP-1 in group A remained lower than that in group B.The levels of MMP-2 and IL-6 in both groups continuously increased until the peak in the first postoperative week,and then gradually decreased over the next three weeks.Ultimately,MMP-2 declined to a lower level than that preoperatively at week 4,but IL-6 decreased to the same level as that preoperatively.The level of MMP-9 peaked in the first two weeks postoperative and then returned to the same level as 1-day post-operation.The concentration of TIMP-1 post-operation remained constant at a lower level than before surgery,and TIMP-2 Levels remained stable in both groups.IL-20 content started to increase in the third week after surgery.CONCLUSION Inflammatory factor levels in tears fluctuated before and post-operation,which indicated more severe postoperative inflammation in the first two weeks.

To Explore the Relationship between Lower Extremity Vascular Sclerosis and Osteoporosis in Elderly Men with Type 2 Diabetes Mellitus

Objective: To investigate the correlation between lower extremity vascular sclerosis and osteoporosis in elderly men with type 2 diabetes mellitus. Methods: A total of 359 elderly male patients with type II diabetes hospitalized in the First Affiliated Hospital of Chongqing Medical University from January 2018 to June 2023 were retrospectively collected. According to the BMD (Bone Density Value), the patients were categorized into osteoporotic (T ≤ -2.5, n = 248) and non-osteoporotic groups (T > -2.5, n = 111). T test and Chi-square test were used to evaluate the differences in clinical data, biochemical markers and ABI between two groups. Multivariate logistic regression was used to analyze the risk factors of osteoporosis in elderly men with type 2 diabetes mellitus. Results: Compared with the non-osteoporotic group, the differences in diabetes course, systolic blood pressure, ABI, BMI, uric acid, triglyceride, and HDL in the osteoporotic group were statistically significant (P < 0.05). Logistic multivariate regression analysis showed that lower extremity vascular sclerosis was an independent risk factor for osteoporosis in elderly men with type 2 diabetes mellitus (P Conclusion: Atherosclerosis of the lower extremities in elderly men with T2DM is closely related to osteoporosis, and can lead to a decrease in bone mass, and an increase in osteoporosis.

Effects of different doses of metformin on bone mineral density and bone metabolism in elderly male patients with type 2 diabetes mellitus

BACKGROUND Diabetes is a chronic disease,which may cause various complications.Patients with diabetes are at high risk of bone and joint disorders,such as osteoporosis and bone fractures.In addition,it became widely accepted that diabetes has an important impact on bone metabolism.Metformin is a commonly used and effective first-line treatment for type 2 diabetes.Some glucose-lowering agents have been found to have an effect on bone metabolism.The present study explored if different doses of metformin have an effect on bone mineral density(BMD)and bone metabolism in type 2 diabetes.AIM To investigate the effects of different doses of metformin on BMD and bone metabolism in elderly male patients with type 2 diabetes mellitus.METHODS A total of 120 elderly male outpatients with type 2 diabetes mellitus who were admitted to our hospital were included in the study from July 2018 to June 2019.They were randomly assigned to an experimental group and a control group with 60 patients in each group.Patients in the experimental group were given high dose metformin four times a day 0.5 g each time for 12 wk.Patients in the control group were given low dose metformin orally twice a day 0.5 g each time for 12 wk.The changes in bone mineral density and bone metabolism before and after treatment and the efficacy rate of the treatment were compared between the two groups.RESULTS There was no significant difference in the efficacy rate between the two groups(P>0.05).Before the treatment,there was no significant difference in BMD and bone metabolism between the two groups(P>0.05).However,after the treatment,BMD and bone metabolism were improved in the two groups.Moreover,BMD and 25-hydroxyvitamin D were significantly higher in the experimental group than in the control group,and N-terminal/midregion andβ-isomerized Cterminal telopeptides were significantly lower in the experimental group than in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION Both high and low dose metformin can effectively control the blood glucose levels in elderly male patients with type 2 diabetes mellitus.However,the benefits of high dose metformin in improving BMD and bone metabolism level was more obvious in patients with type 2 diabetes mellitus.

Prevalence and associated factors of hospitalization for dysglycemia among elderly type 2 diabetes patients: A nationwide study

BACKGROUND The prevalence of older individuals with type 2 diabetes mellitus (T2DM) is increasing due to the aging population and improved medical care. These patients are very susceptible to disease and treatment-related hospitalizations, resulting in higher health care costs, morbidity, and decreased quality of life. However, data of treatment-related complications, especially dysglycemiarelated hospitalizations, are lacking. AIM To assess the prevalence and associated factors for dysglycemia-related hospitalizations among elderly diabetic patients in Thailand using nationwide patient sample. METHODS T2DM patients aged ≥ 65 years who received medical care at public hospitals in Thailand in the year 2014 were included. The prevalence of hospitalization due to dysglycemia within one year was examined. Multivariable logistic regression was performed to assess the independent factors associated with hospitalization due to hypoglycemia and hyperglycemia RESULTS A total of 11404 elderly T2DM patients were enrolled in this study. The mean age was 72.9 ± 5.5 years. The prevalence of hospital admissions due to diabetic ketoacidosis, hyperosmolar hyperglycemic state, hyperglycemic dehydration syndrome, and hypoglycemia among elderly T2DM patients in the year 2014 was 0.1%, 0.1%, 1.7% and 3.1%, respectively. Increased hospitalization due to hypoglycemia was associated with older age, female sex, had hypertension, dementia, lower body mass index, elevated hemoglobin A1C (HbA1C), decreased kidney function, insulin use. Increased hospitalization due to hyperglycemia was associated with dementia, depression, lower body mass index, elevated HbA1C, and insulin use. CONCLUSION The prevalence of dysglycemia-related hospitalization in elderly T2DM patients in Thailand was 4.9%. Close monitoring of blood glucose should be provided in high-risk patients for prevention and early detection for these complications.

Sensitivity of P300 auditory event-related potentials for assessing cognitive impairment in elderly type 2 diabetic patients

BACKGROUND：In previous studies, cognitive function in elderly type 2 diabetic patients was evaluated by psychometric tests. These studies have confirmed that P300 event-related potential is an objective way of assessing cognitive function. OBJECTIVE： To analyze the objectivity of P300 for assessment of cognitive function in elderly type 2 diabetic patients. DESIGN, TIME AND SETTING： This case-control experiment was performed at the Department of Endocrinology of the Fourth Affiliated Hospital, Guangxi Medical University from January 2004 to December 2006. PARTICIPANTS： Seventy-two patients （38 males and 34 females） with type 2 diabetes mellitus were enrolled in this study. The patients were divided according to those with diabetes alone （diabetes alone group） （n=38） and those with diabetes and cerebral ischemia （diabetes and cerebral ischemia group） （n=34）. A further 31 healthy individuals （16 males and 15 females）, who received health examinations over the same period, were included as normal controls （normal control group）. METHODS： All subjects were assessed by Mini-Mental State Examination （MMSE）. Abnormalities in cognitive functions were identified by analyzing the auditory P300 event-related potentials. MAIN OUTCOME MEASURES： Auditory event-related potentials and MMSE scores. Multiple linear regression analysis was conducted using the ＂enter method＂ with the 72 elderly patients with type 2 diabetes mellitus. P3 latency, P3 amplitude and N2 latency served as dependent variables. Age, sex, education, course of the disease, glycosylated hemoglobin, and ischemic brain damage were used as independent variables. RESULTS： No significant difference in scores of MMSE was detected between the diabetes alone and normal control groups （P 〉 0.05）. MMSE score was significantly lower in the diabetes and cerebral ischemia group （P 〈 0.01） than in the normal control group. N2 and P3 latencies of auditory event-related potential were significantly longer, and P3 amplitude was significantly lower in the diabetes alone and diabetes and cerebral ischemia groups （P 〈 0.01） than in the normal control group. N2 and P3 latencies were significantly longer in the diabetes and cerebral ischemia group than in the diabetes alone group （P 〈 0.01）, but amplitude was not significantly different. N2 and P3 latencies were negatively correlated with MMSE score in elderly type 2 diabetic patients （r=–0.421, –0.604; both P 〈 0.01）. P3 amplitude was positively related to the score of MMSE （r =0.517; P 〈 0.01）. P3 latency was positively associated with age, course of disease, glycosylated hemoglobin and ischemic brain damage in elderly type 2 diabetic patients （t=2.186 to 3.490; all P 〈 0.05）. P3 amplitude was negatively correlated with age, course of disease and glycosylated hemoglobin （t=–2.220, –2.491, and –2.024, respectively; all P 〈 0.05）. N2 latency was positively correlated with age, course of disease and ischemic brain damage （t=2.946, 2.511, and 2.331, respectively; P 〈 0.05）. CONCLUSION： The course of disease, glycosylated hemoglobin and ischemic brain damage are key influential factors for cognitive impairment in elderly type 2 diabetic patients. The P300 event-related potential is a sensitive index for objective assessment of cognitive impairment in elderly diabetic patients.

Relationship between platelet-lymphocyte ratio and carotid atherosclerosis in middle-aged and elderly patients with type 2 diabetes mellitus

Objective:To investigate the relationship between platelet-lymphocyte ratio(PLR)and carotid atherosclerosis(CAS)in middle-aged and elderly patients with T2DM.Methods:A total of 420 middle-aged and elderly patients with T2DM who were hospitalized in the Endocrinology Department of our hospital from September 2018 to September 2020 and were examined by ultrasound were selected as the subjects.The carotid artery intima-media thickness(CIMT)was examined by color Doppler ultrasonography,including normal CIMT group(n=111),CIMT thickening group(n=103)and CAS plaque group(n=206).The differences of serum PLR levels among the three groups were compared.Multivariate Logistic regression was used to analyze the relationship between PLR and CAS plaque formation.The receiver operating curve(ROC)was used to evaluate the value of multivariate Logistic regression model(Logit P)in the diagnosis of CAS lesions.Results:The mean value of PLR in CAS plaque group(127.86±48.54)was significantly higher than that in CIMT normal group(109.15±48.35).Multivariate Logistic regression analysis showed that after adjusting for other confounding factors,the increase of PLR was an independent risk factor for the occurrence of CAS plaque.ROC showed that the efficacy of multivariate Logit P model in the diagnosis of CAS plaque was(AUC=0.807,95%CI=0.759-0.858).Conclusions:PLR is one of the important risk factors for the occurrence of CAS lesions.At the same time,the multivariate Logistic regression model established in this study has clinical reference value in predicting CAS lesions in middle-aged and elderly patients with T2DM.

Gait speed may predict development of Type 2 diabetes: A pilot study among elderly Japanese

Aims: Epidemiologic evidence suggests that physical activity is associated with reduced risk of Type 2 diabetes. Walking is simple, effective, and by far the most prevalent physical activity among older adults. However, it is difficult to recognize and evaluate performance-based parameters of physical activity. The purpose of this study was to evaluate the importance of performance-based gait speed among several physical measurements in the development of Type 2 diabetes using long-term community-based data on elderly Japanese persons. Methods: 10 baseline physical measurements, including habitual (HGS) and fast (FGS) gait speed, were examined in 102 elderly Japanese persons living independently in the community (mean age: 71.1 years old) who were not previously diagnosed with diabetes. The subjects then participated in a daily exercise program consisting of walking, stretching, muscle strengthening, and balance exercises and were followed for an average of 4.16 years. Using Cox proportional hazards models with adjustment for age, sex, and category of fasting glucose status, we investigated whether gait speed and/or other physical measurements are associated with development of Type 2 diabetes. Results: 9 subjects developed Type 2 diabetes. Among the 10 physical parameters examined, prolongation of HGS and FGS per second was the only statistically significant factors, with hazard ratios 1.83 (1.15 - 2.89, P = 0.010) and 2.93 (1.43 - 6.03, P = 0.003), respectively. Conclusions: We found a negative association between the development of Type 2 diabetes and gait speed among elderly Japanese people. We conclude that encouraging physical activity and preserving walking capacity may be beneficial for preventing Type 2 diabetes.

Sitagliptin for Elderly Patients Aged 75 Years or Older with Inadequately Controlled Type 2 Diabetes with Common Antidiabetes Treatments

Background: The purpose of this study was to evaluate the effects of sitagliptin in elderly patients with type 2 diabetes aged 75 years or older versus those aged 65 - 74 years. Methods: Outpatients aged 65 years or older with type 2 diabetes who received sitagliptin at a dose of 50 mg daily for 6 months were divided into two groups: those who were 75 years and older and those who were 65 - 74 years. The efficacy and safety were retrospectively evaluated by comparison of laboratory values before and after the administration of sitagliptin and by review of adverse events after treatment. Results: One hundred and twelve older patients with type 2 diabetes were studied. Six months after the initiation of sitagliptin, participants’ hemoglobin A1c was significantly decreased by 1.09% ± 0.8% in 65 - 74-year-olds (66 patients;mean age, 69.1 ± 3.0 years;mean HbA1c before administration, 8.4% ± 0.8%) and by 1.05% ± 0.8% in patients 75 years or older (46 patients;mean age, 79.8 ± 4.1 years;mean HbA1c before administration, 8.5% ± 0.7%). There was no significant difference in hemoglobin A1c between the two groups. Furthermore, sitagliptin was well tolerated in both age groups. Conclusions: In elderly patients (75 years or older) with type 2 diabetes, the effect of sitagliptin was similar that in older patients (younger than 75 years) with type 2 diabetes.

Blood glucose response after oral lactulose intake in type 2 diabetic individuals

BACKGROUND Lactulose is approved for the symptomatic treatment of constipation,a gastrointestinal(GI)complication common in individuals with diabetes.Lactulose products contain carbohydrate impurities(e.g.,lactose,fructose,galactose),which occur during the lactulose manufacturing process.These impurities may affect the blood glucose levels of individuals with type 2 diabetes mellitus(T2DM)using lactulose for the treatment of mild constipation.A previous study in healthy subjects revealed no increase in blood glucose levels after oral lactulose intake.However,it is still unclear whether the intake of lactulose increases blood glucose levels in individuals with diabetes.AIM To evaluate the blood glucose profile after oral lactulose intake in mildly constipated,non-insulin-dependent subjects with T2DM in an outpatient setting.METHODS This prospective,double-blind,randomized,controlled,single-center trial was conducted at the Clinical Research Center at the Medical University of Graz,Austria,in 24 adult Caucasian mildly constipated,non-insulin-dependent subjects with T2DM.Eligible subjects were randomized and assigned to one of six treatment sequences,each consisting of four treatments stratified by sex using an incomplete block design.Subjects received a single dose of 20 g or 30 g lactulose(crystal and liquid formulation),water as negative control or 30 g glucose as positive control.Capillary blood glucose concentrations were measured over a period of 180 min post dose.The primary endpoint was the baseline-corrected area under the curve of blood glucose concentrations over the complete assessment period[AUC_(baseline_c(0-180 min))].Quantitative comparisons were performed for both lactulose doses and formulations vs water for the equal lactulose dose vs glucose,as well as for liquid lactulose vs crystal lactulose.Safety parameters included GI tolerability,which was assessed at 180 min and 24 h post dose,and adverse events occurring up to 24 h post dose.In 24 randomized and analyzed subjects blood glucose concentration-time curves after intake of 20 g and 30 g lactulose were almost identical to those after water intake for both lactulose formulations despite the different amounts of carbohydrate impurities(≤3.0%for crystals and approx.30%for liquid).The primary endpoint[AUC_(baseline_c(0-180 min))]was not significantly different between lactulose and water regardless of lactulose dose and formulation.Also with regard to all secondary endpoints lactulose formulations showed comparable results to water with one exception concerning maximum glucose level.A minor increase in maximum blood glucose was observed after the 30 g dose,liquid lactulose,in comparison to water with a mean treatment difference of 0.63 mmol/L(95%confidence intervals:0.19,1.07).Intake of 30 g glucose significantly increased all blood glucose endpoints vs 30 g liquid and crystal lactulose,respectively(all P<0.0001).No differences in blood glucose response were observed between the different lactulose formulations.As expected,lactulose increased the number of bowel movements and was generally well tolerated.Subjects experienced only mild to moderate GI symptoms due to the laxative action of lactulose.CONCLUSION Blood glucose AUC_(baseline_c(0-180 min))levels in mildly constipated,non-insulin dependent subjects with T2DM are not affected by the carbohydrate impurities contained in 20 g and 30 g crystal or liquid lactulose formulations.

Health Status of Urban Medium-Low-Income Elderly at the Community

Background: Nonagenarians are uncommon in our population. The study aim was to profile physical mobility, declared health problems, hypertension and diabetes frequency, awareness, treated and good control in urban low-income elders. Method: The study had cross-sectional design in population sample. Subjects were urban men and women older than 59 years at the medium low income stratum at a developing country. Survey was carried out from October 2008 to October 2009. All elder dwellers in randomly selected houses were surveyed;clinical exam after consent. Good Control: Systolic/Diastolic Results: There were 162 elders, 53 (32.7%) were male, 99 (61.1%) were younger than 70 years. Forty nine (30.2%) had impaired mobility;among them 20 (55.6%) were bed or home restricted, and 29 (44.4%) needed help to go out. Unstable health condition was found in 36 (22.2%), with significantly more men 19 (52.8%) vs 34 (27.0%), X2 = 8.5, df1, P 0.05. The frequency, proportions for: known diagnosis, on treatment, and good control were 75 (69.4%), 55 (73.3%), 45 (60.0%) and 12 of 45 (26.7%) for hypertension;53 (49.1%), 47 (88.7%), 42 (79.2%) and 9 of 42 (21.4%) for diabetes. The most frequent unstable conditions were cardiovascular. Conclusions: Data suggest unstable health no association with the oldest old. The small proportion in good control of Diabetes and/or hypertension could explain the large frequency of elders with unstable health and prevention of reaching nonagenarian age.

双歧杆菌三联活菌联合乳果糖、四磨汤治疗老年2型糖尿病便秘的临床效果

目的探究双歧杆菌三联活菌联合乳果糖、四磨汤治疗老年2型糖尿病(T2DM)便秘的效果。方法选取2022年5月—2023年5月收治的老年T2DM便秘100例,随机分为对照组、研究组,各50例。2组均予以乳果糖、四磨汤治疗,研究组在此基础上予以双歧杆菌三联活菌治疗。比较2组治疗效果、便秘症状评分、肠道菌群、肠道屏障功能指标[内毒素脂多糖(LPS)、二胺氧化酶(DAO)、D-乳酸(DLA)]、胃肠动力指标[口-结肠转运时间(OCTT)、生长抑素(SS)、胃动素(MTL)]、不良反应。结果研究组总有效率[96.00%(48/50)]高于对照组[82.00%(41/50)](P<0.05)。治疗2周后、4周后,研究组大便干结、排便不尽、排便间隔时间延长、排便疼痛评分低于对照组(P<0.01);治疗2周后、4周后,研究组双歧杆菌、乳杆菌菌落数高于对照组,球杆菌、肠杆菌菌落数低于对照组(P<0.01);治疗2周后、4周后,研究组血清LPS、DAO、DLA水平低于对照组(P<0.01);治疗2周后、4周后,研究组OCTT、血浆SS水平低于对照组,血浆MTL水平高于对照组(P<0.01)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论双歧杆菌三联活菌联合乳果糖、四磨汤治疗老年T2DM便秘效果显著,且能更有效改善患者肠道菌群、肠道屏障功能及胃肠动力。

便通片联合乳果糖、双歧杆菌三联活菌治疗老年2型糖尿病功能性便秘临床观察

目的观察便通片联合乳果糖、双歧杆菌三联活菌治疗老年2型糖尿病功能性便秘临床疗效。方法将79例老年2型糖尿病功能性便秘脾肾阳虚型患者按照随机数字表法分为2组。对照组38例予便通片治疗,治疗组41例在对照组治疗基础上加乳果糖、双歧杆菌三联活菌肠溶胶囊治疗。2组均连续治疗4周,停药后4、8、12周随访。比较2组治疗前后临床症状评分变化及停药4、8、12周便秘复发情况,治疗期间2组不良反应发生率。结果治疗组总有效率92.7%(38/41),高于对照组的68.4%(26/38)(P<0.05)。治疗后,2组各项临床症状评分均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。停药4、8、12周时,治疗组复发率分别为7.32%、9.76%和17.07%,对照组分别为7.89%、28.95%和36.84%,停药8、12周时治疗组复发率明显低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论便通片联合乳果糖、双歧杆菌三联活菌治疗老年2型糖尿病功能性便秘疗效确切,可显著改善患者的便秘症状,且不良反应和复发率低。

Prevalence of stroke and metabolic disorders in the middle-aged and elderly Chinese with type 2 diabetes

Background Stroke is now the most prevalent and debilitating disease affecting diabetic population in China. The study aimed to investigate the prevalence of stroke and metabolic disorders in the middle-aged and elderly Chinese with type 2 diabetes. Methods A total of 4 629 subjects with type 2 diabetes （males： 1 917; females： 2 712） aged ≥ 40 years from Shijingshan district, Beijing, China from November 2011 to August 2012 were included in the study. Data on demographic information, lifestyle, history of diabetes mellitus, stroke, coronary heart disease, hypertension, and dyslipidemia were collected. The oral glucose tolerance test or a standard meal test was performed. Non-fatal stroke was reported by the subjects. The 2-tailed test was used, and P 〈0.05 was regarded as statistically significant. Results Prevalence of stroke in the subjects with type 2 diabetes was 5.5%. The prevalence of smoking, overweight or obesity, hypertension, and dyslipidemia was 41.0%, 65.8%, 67.4%, and 52.0% in males, and 2.2%, 65.5%, 69.5%, and 57.6% in females. Multivariate Logistic regression analysis showed that increased age, hypertension, diabetic duration, and overweight or obesity were positively correlated with stroke in the population with type 2 diabetes, whereas high- density lipoprotein cholesterol level was negatively correlated with stroke. After adjustment for age and gender, the odds ratio values of stroke in subjects having 1,2 or ≥3 of 4 risk factors, including smoking, overweight or obesity, hypertension and dyslipidemia, were 2.302 （95% CI： 0.789-6.712）, 4.089 （95% CI： 1.470-11.373）, 6.023 （95% CI： 2.176-16.666）, compared with subjects without any of the above 4 risk factors. Conclusions The prevalence of stroke was higher in middle-aged and eldedy Chinese with type 2 diabetes than that in the general population. With the aggregation of risk factors, the prevalence of stroke increased.

青年与中老年2型糖尿病并发急性胰腺炎患者临床特点分析

目的探讨青年和中老年2型糖尿病并发急性胰腺炎患者的临床特点,为临床防治提供参考。方法选取2015年1月—2021年1月于北京积水潭医院急诊科确诊为2型糖尿病(T2DM)并发急性胰腺炎(AP)患者的病例资料,根据年龄分为青年组(<40岁,65例)和中老年组(≥40岁,71例)。分析比较两组患者的基本资料、入院当日的症状、体征及实验室检查指标、在院期间治疗过程、急性生理学与慢性健康状况评估系统Ⅱ(APACHEⅡ)评分等。分析影响青年和中老年2型糖尿病并发急性胰腺炎患者的独立危险因素。结果青年组T2DM患者并发AP的病因以高脂血症为主,中老年组病因以胆道疾病为主。青年组较中老年组患者的体质量指数(BMI)更高[kg/m^(2),28.0(24.4,30.9)vs 24.4(22.3,26.1),P<0.001],心率更快[次/min,101(86.0,110)vs 85.1(74.0,94.5),P<0.001],胰岛素治疗率更高[30(46.2%)vs 7(9.9%),P<0.001]。青年组患者的血糖、糖化血红蛋白、血红蛋白、血细胞比容、白细胞、血小板、淋巴细胞、中性粒细胞、尿酸、甘油三酯、胆固醇、胆碱酯酶、血钾水平均显著高于中老年组,差异均具有统计学意义(均P<0.05)。中老年组患者的谷丙转氨酶、总胆红素、谷草转氨酶、直接胆红素、血尿淀粉酶、碱性磷酸酶、尿素、谷氨酰转肽酶、血钠、血氯、D-二聚体水平均显著高于青年组,差异均有统计学意义(P<0.05)。青年组并发糖尿病酮症酸中毒(DKA)者更多(35.4%vs 5.6 P<0.001)。中老年组APACHEⅡ高于青年组[3.17分(0,4.00)vs 6.06分(3.00,8.00),P<0.001]及简化急性生理学评分Ⅱ(SAPSⅡ)评分高于青年组[6.49分(0,9.00)vs 14.5分(7.00,18.0),P<0.001]。根据危险因素分析结果绘制受试者工作特征曲线(ROC),计算各危险因素临界值。血糖、甘油三酯、尿酸、尿素曲线下面积分别为0.862(95%CI:0.798~0.927)、0.813(95%CI:0.739~0.886)、0.798(95%CI:0.720~0.876)、0.364(95%CI:0.270~0.458)。临界值分别为血糖13.95 mmol/L、甘油三酯3.20 mmol/L、尿酸465.00 mmol/L、尿素23.95 mmol/L。结论青年与中老年T2DM并发AP患者在病因及临床表现、实验室检查、住院天数等均有其特点。青年T2DM患者多并发脂源性AP,中老年T2DM多并发胆源性AP。甘油三酯、血糖和尿酸是青年人T2DM并发AP的独立危险因素,尿素是中老年人T2DM并发AP的独立危险因素。

Effect of Atorvastatin on the levels of adiponectin and leptin and adiponectin-leptin ratio in the elderly and middle-aged patients with type 2 diabetes and combined hyperlipidemia

Objective To evaluate effects of Atorvastatin on the levels of adiponectin and leptin and adiponectin-leptin ratio in the elderly and middle-aged patients with type 2diabetes and combined hyperlipidemia.Methods Totally80 elderly and middle-aged patients with type 2 diabetes and combined hyperlipidemia were treated with Atorvastatin(10 mg/d)for 12 weeks.Fasting plasma levels