Numerous studies have shown that many patients who suffer from type 2 diabetes mellitus exhibit cognitive dysfunction and neuronal synaptic impairments. Therefore, growing evidence suggests that type 2 diabetes mellit...Numerous studies have shown that many patients who suffer from type 2 diabetes mellitus exhibit cognitive dysfunction and neuronal synaptic impairments. Therefore, growing evidence suggests that type 2 diabetes mellitus has a close relationship with occurrence and progression of neurodegeneration and neural impairment in Alzheimer＇s disease. However, the relationship between metabolic disorders caused by type 2 diabetes mellitus and neurodegeneration and neural impairments in Alzheimer＇s disease is still not fully determined. Thus, in this study, we replicated a type 2 diabetic animal model by subcutaneous injection of newborn Sprague-Dawley rats with monosodium glutamate during the neonatal period. At 3 months old, the Barnes maze assay was performed to evaluate spatial memory function. Microelectrodes were used to measure electrophysiological function in the hippocampal CA1 region. Western blot assay was used to determine expression levels of glutamate ionotropic receptor NMDA type subunit 2 A（GluN2A） and GluN2B in the hippocampus. Enzyme-linked immunosorbent assay was used to determine levels of interleukin-1β, tumor necrosis factor α, and interleukin-6 in the hippocampus and cerebral cortex, as well as hippocampal amyloid beta（Aβ）1-40 and Aβ_（1-42） levels. Our results showed that in the rat model of type 2 diabetes mellitus caused by monosodium glutamate exposure during the neonatal period, latency was prolonged and the number of errors increased in the Barnes maze. Further, latency was increased and time in the escape platform quadrant shortened. Number of times crossing the platform was also reduced in the Morris water maze. After high frequency stimulation of the hippocampus, synaptic transmission was inhibited, expression of GluN2A and GluN2B were decreased in the hippocampus, expression of interleukin 1β, interleukin 6, and tumor necrosis factor α was increased in the hippocampus and cortex, and levels of Aβ_（1-40） and Aβ_（1-42） were increased in the hippocampus. These findings confirm that type 2 diabetes mellitus induced by neonatal monosodium glutamate exposure results in Alzheimer-like neuropathological changes and further causes cognitive deficits and neurodegeneration in young adulthood.展开更多
Background Currently, there are no uniform standards and methods for perioperative glycemic control in bone fracture patients with Type 2 diabetes mellitus （T2DM）. We retrospectively analyzed the efficacy and safety...Background Currently, there are no uniform standards and methods for perioperative glycemic control in bone fracture patients with Type 2 diabetes mellitus （T2DM）. We retrospectively analyzed the efficacy and safety of two intensive insulin therapy regimens administered to bone fracture patients with T2DM in the perioperative period, to explore the best method of achieving perioperative glycemic control. Methods A number of 159 bone fracture patients with T2DM were divided into two groups. One group （n=81） received multiple subcutaneous insulin injections （MSII group） and the other （n=78） received continuous subcutaneous insulin infusion （CSII group）. Blood glucose （BG） levels, time to achieve glycemic target, insulin dosage, and the incidence of hypoglycemia and complications were compared between groups. Results Both regimens reduced BG to desired levels before surgery. The time to reach glycemic target in CSII group （2.5 days） was significantly shorter than that in the MSII group （7.3 days; P〈0.001）. Mean insulin dosage in the CSII group （0.66 IU·kg^-1·d^-1） was significantly lower than that in the MSII group （0.74 IU·kg^-1·d^-1; P=0.005）, as were the incidences of hypoglycemia （15.4% vs 32.1%） and infection （6.4% vs. 23.5%）. Multiple regression analysis showed that the time to reach glycemia target was associated with the insulin therapy regimen and dosage. The insulin dosage on reaching glycemia target was positively associated with body mass index （BMI）, diabetes mellitus course, glycated hemoglobin Alc （HbAlc）, and β-hydroxybutyric acid, and was negatively associated with age. Conclusion The efficacy and safety of CSII was superior to that achieved with MSII, suggesting that CSII should be considered as initial therapy to control perioperative BG in bone fracture patients with T2DM.展开更多
目的通过对单侧股骨颈骨折合并新发2型糖尿病患者的短期强化降糖治疗,比较持续皮下胰岛素泵输注(CSII)与长效+速效胰岛素类似多次皮下注射(MSII)两种治疗方式的疗效及医疗费用。方法随机将64例单侧股骨颈骨折合并新发2型糖尿病患者分为...目的通过对单侧股骨颈骨折合并新发2型糖尿病患者的短期强化降糖治疗,比较持续皮下胰岛素泵输注(CSII)与长效+速效胰岛素类似多次皮下注射(MSII)两种治疗方式的疗效及医疗费用。方法随机将64例单侧股骨颈骨折合并新发2型糖尿病患者分为两组,分别给予CSII治疗(33例)和MSII治疗(31例)对血糖达标时间、胰岛素使用剂量、手术并发症、住院费用、住院时间等指标进行比较。结果 CSII组的空腹血糖达标时间(TTF)、餐后血糖达标时间(TTP)、空腹及餐后同时达标时间(TTB)都较MSII短(46.18±25.0h vs 88.9±41.0h、64.1±25.6h vs 103.9±46.9h、66.2±24.7h vs 115.5±72.1h,P<0.05);CSII组的达标时胰岛素总量、基础胰岛素用量、餐时胰岛素用量也均较MDII组少(0.65±0.11 IU/kg vs 0.80±0.19 IU/kg、0.32±0.07 IU/kg vs 0.37±0.12 IU/kg、0.33±0.06 IU/kg vs 0.44±0.10 IU/kg,P<0.05)。平均每日基础胰岛素增减剂量CSII组较MSII组大[0.08±0.07IU/(kg·d)vs 0.05±0.04IU/(kg·d),P<0.05],平均每日餐时胰岛素增减剂量CSII组较MSII组小[0.01±0.03 U/(kg·d)vs 0.03±0.03 U/(kg·d),P<0.05]。两组间住院总费用、手术费用及非手术费用两者均无差别,而CSII组较MSII组住院时间短、术后低蛋白血症减少(13.6±2.7天vs 15.7±3.4天,1例vs 6例,P<0.05)。MSII组TTB影响因素是达标基础量、基础步长(β值为0.875、-0.677,P<0.05),非手术费用的影响因素是住院时间、下肢深静脉血栓、术后低蛋白血症(β值为0.445、0.392、0.389,P<0.05),住院天数的影响因素是术后低蛋白血症、TTB(β值为0.400、0.288,t值为3.596、2.101,P<0.05);CSII组TTB影响因素是达标餐时量、餐时步长(β值为0.763、-0.896,P<0.05),非手术费用的影响因素是住院时间、下肢深静脉血栓(β值为0.453、0.372,P<0.05),住院天数的影响因素是TTB(β=0.450,P<0.05)。结论在单侧股骨颈骨折合并新发2型糖尿病患者的术前血糖控制方面,持续皮下胰岛素泵输注疗法优于长效+速效胰岛素类似多次皮下注射疗法。住院费用两者相同,但持续皮下胰岛素泵输注疗法可能通过减少住院时间进一步节省社会资源。展开更多
基金principally supported by the Initial Funding of PhD Research from Henan Medical College of China,No.1001/0106in parts by the Science and Technology Project of Henan Province of China,No.172102310105
文摘Numerous studies have shown that many patients who suffer from type 2 diabetes mellitus exhibit cognitive dysfunction and neuronal synaptic impairments. Therefore, growing evidence suggests that type 2 diabetes mellitus has a close relationship with occurrence and progression of neurodegeneration and neural impairment in Alzheimer＇s disease. However, the relationship between metabolic disorders caused by type 2 diabetes mellitus and neurodegeneration and neural impairments in Alzheimer＇s disease is still not fully determined. Thus, in this study, we replicated a type 2 diabetic animal model by subcutaneous injection of newborn Sprague-Dawley rats with monosodium glutamate during the neonatal period. At 3 months old, the Barnes maze assay was performed to evaluate spatial memory function. Microelectrodes were used to measure electrophysiological function in the hippocampal CA1 region. Western blot assay was used to determine expression levels of glutamate ionotropic receptor NMDA type subunit 2 A（GluN2A） and GluN2B in the hippocampus. Enzyme-linked immunosorbent assay was used to determine levels of interleukin-1β, tumor necrosis factor α, and interleukin-6 in the hippocampus and cerebral cortex, as well as hippocampal amyloid beta（Aβ）1-40 and Aβ_（1-42） levels. Our results showed that in the rat model of type 2 diabetes mellitus caused by monosodium glutamate exposure during the neonatal period, latency was prolonged and the number of errors increased in the Barnes maze. Further, latency was increased and time in the escape platform quadrant shortened. Number of times crossing the platform was also reduced in the Morris water maze. After high frequency stimulation of the hippocampus, synaptic transmission was inhibited, expression of GluN2A and GluN2B were decreased in the hippocampus, expression of interleukin 1β, interleukin 6, and tumor necrosis factor α was increased in the hippocampus and cortex, and levels of Aβ_（1-40） and Aβ_（1-42） were increased in the hippocampus. These findings confirm that type 2 diabetes mellitus induced by neonatal monosodium glutamate exposure results in Alzheimer-like neuropathological changes and further causes cognitive deficits and neurodegeneration in young adulthood.
文摘Background Currently, there are no uniform standards and methods for perioperative glycemic control in bone fracture patients with Type 2 diabetes mellitus （T2DM）. We retrospectively analyzed the efficacy and safety of two intensive insulin therapy regimens administered to bone fracture patients with T2DM in the perioperative period, to explore the best method of achieving perioperative glycemic control. Methods A number of 159 bone fracture patients with T2DM were divided into two groups. One group （n=81） received multiple subcutaneous insulin injections （MSII group） and the other （n=78） received continuous subcutaneous insulin infusion （CSII group）. Blood glucose （BG） levels, time to achieve glycemic target, insulin dosage, and the incidence of hypoglycemia and complications were compared between groups. Results Both regimens reduced BG to desired levels before surgery. The time to reach glycemic target in CSII group （2.5 days） was significantly shorter than that in the MSII group （7.3 days; P〈0.001）. Mean insulin dosage in the CSII group （0.66 IU·kg^-1·d^-1） was significantly lower than that in the MSII group （0.74 IU·kg^-1·d^-1; P=0.005）, as were the incidences of hypoglycemia （15.4% vs 32.1%） and infection （6.4% vs. 23.5%）. Multiple regression analysis showed that the time to reach glycemia target was associated with the insulin therapy regimen and dosage. The insulin dosage on reaching glycemia target was positively associated with body mass index （BMI）, diabetes mellitus course, glycated hemoglobin Alc （HbAlc）, and β-hydroxybutyric acid, and was negatively associated with age. Conclusion The efficacy and safety of CSII was superior to that achieved with MSII, suggesting that CSII should be considered as initial therapy to control perioperative BG in bone fracture patients with T2DM.
文摘目的通过对单侧股骨颈骨折合并新发2型糖尿病患者的短期强化降糖治疗,比较持续皮下胰岛素泵输注(CSII)与长效+速效胰岛素类似多次皮下注射(MSII)两种治疗方式的疗效及医疗费用。方法随机将64例单侧股骨颈骨折合并新发2型糖尿病患者分为两组,分别给予CSII治疗(33例)和MSII治疗(31例)对血糖达标时间、胰岛素使用剂量、手术并发症、住院费用、住院时间等指标进行比较。结果 CSII组的空腹血糖达标时间(TTF)、餐后血糖达标时间(TTP)、空腹及餐后同时达标时间(TTB)都较MSII短(46.18±25.0h vs 88.9±41.0h、64.1±25.6h vs 103.9±46.9h、66.2±24.7h vs 115.5±72.1h,P<0.05);CSII组的达标时胰岛素总量、基础胰岛素用量、餐时胰岛素用量也均较MDII组少(0.65±0.11 IU/kg vs 0.80±0.19 IU/kg、0.32±0.07 IU/kg vs 0.37±0.12 IU/kg、0.33±0.06 IU/kg vs 0.44±0.10 IU/kg,P<0.05)。平均每日基础胰岛素增减剂量CSII组较MSII组大[0.08±0.07IU/(kg·d)vs 0.05±0.04IU/(kg·d),P<0.05],平均每日餐时胰岛素增减剂量CSII组较MSII组小[0.01±0.03 U/(kg·d)vs 0.03±0.03 U/(kg·d),P<0.05]。两组间住院总费用、手术费用及非手术费用两者均无差别,而CSII组较MSII组住院时间短、术后低蛋白血症减少(13.6±2.7天vs 15.7±3.4天,1例vs 6例,P<0.05)。MSII组TTB影响因素是达标基础量、基础步长(β值为0.875、-0.677,P<0.05),非手术费用的影响因素是住院时间、下肢深静脉血栓、术后低蛋白血症(β值为0.445、0.392、0.389,P<0.05),住院天数的影响因素是术后低蛋白血症、TTB(β值为0.400、0.288,t值为3.596、2.101,P<0.05);CSII组TTB影响因素是达标餐时量、餐时步长(β值为0.763、-0.896,P<0.05),非手术费用的影响因素是住院时间、下肢深静脉血栓(β值为0.453、0.372,P<0.05),住院天数的影响因素是TTB(β=0.450,P<0.05)。结论在单侧股骨颈骨折合并新发2型糖尿病患者的术前血糖控制方面,持续皮下胰岛素泵输注疗法优于长效+速效胰岛素类似多次皮下注射疗法。住院费用两者相同,但持续皮下胰岛素泵输注疗法可能通过减少住院时间进一步节省社会资源。
