Influence of blood glucose fluctuations on chemotherapy efficacy and safety in type 2 diabetes mellitus patients complicated with lung carcinoma

BACKGROUND Patients with type 2 diabetes mellitus(T2DM)have large fluctuations in blood glucose(BG),abnormal metabolic function and low immunity to varying degrees,which increases the risk of malignant tumor diseases and affects the efficacy of tumor chemotherapy.Controlling hyperglycemia may have important therapeutic implications for cancer patients.AIM To clarify the influence of BG fluctuations on chemotherapy efficacy and safety in T2DM patients complicated with lung carcinoma(LC).METHODS The clinical data of 60 T2DM+LC patients who presented to the First Affiliated Hospital of Ningbo University between January 2019 and January 2021 were retrospectively analyzed.All patients underwent chemotherapy and were grouped as a control group(CG;normal BG fluctuation with a mean fluctuation<3.9 mmol/L)and an observation group(OG;high BG fluctuation with a mean fluctuation≥3.9 mmol/L)based on their BG fluctuations,with 30 cases each.BGrelated indices,tumor markers,serum inflammatory cytokines and adverse reactions were comparatively analyzed.Pearson correlation analysis was performed to analyze the correlation between BG fluctuations and tumor markers.RESULTS The fasting blood glucose and 2-hour postprandial blood glucose levels in the OG were notably elevated compared with those in the CG,together with markedly higher mean amplitude of glycemic excursions(MAGE),mean of daily differences,largest amplitude of glycemic excursions and standard deviation of blood glucose(P<0.05).In addition,the OG exhibited evidently higher levels of carbohydrate antigen 19-9,carbohydrate antigen 125,carcinoembryonic antigen,neuron-specific enolase,cytokeratin 19,tumor necrosis factor-α,interleukin-6,and highsensitivity C-reactive protein than the CG(P<0.05).Pearson analysis revealed a positive association of MAGE with serum tumor markers.The incidence of adverse reactions was significantly higher in the OG than in the CG(P<0.05).CONCLUSION The greater the BG fluctuation in LC patients after chemotherapy,the more unfavorable the therapeutic effect of chemotherapy;the higher the level of tumor markers and inflammatory cytokines,the more adverse reactions the patient experiences.

Increasing dietary fiber intake for type 2 diabetes mellitus management: A systematic review

BACKGROUND Type 2 diabetes is a chronic,non-communicable disease with a substantial global impact,affecting a significant number of individuals.Its etiology is closely tied to imbalanced dietary practices and sedentary lifestyles.Conversely,increasing die-tary fiber(DF)intake has consistently demonstrated health benefits in numerous studies,including improvements in glycemic control and weight management.AIM To investigate the efficacy of DF interventions in the management of type 2 diabetes mellitus(T2DM).METHODS A systematic literature review was conducted to explore the association between DF intake and the management of T2DM.Following the inclusion and exclusion criteria,a total of 26 studies were included in this review.RESULTS The main strategies implied to increased DF intake were:High DF diet plus acarbose(2 studies);DF supplements(14 studies);and high DF diets(10 studies).Overall,most studies indicated that increased DF intake resulted in im-provements in glycemic control and weight management in T2DM patients.CONCLUSION DF represents a valuable strategy in the treatment of type 2 diabetes,improving health outcomes.DF intake offers the potential to improve quality of life and reduce complications and mortality associated with diabetes.Likewise,through supplements or enriched foods,DF contributes significantly to the control of several markers such as HbA1c,blood glucose,triglycerides,low-density lipoprotein,and body weight.

Associations of serum D-dimer and glycosylated hemoglobin levels with third-trimester fetal growth restriction in gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and development.AIM To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM patients.METHODS The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the Obstetrics and Gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed retrospectively.Among these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative analysis.The diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic regression.RESULTS Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,respectively.The AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,respectively.High D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can indicate the occurrence of FGR in GDM patients in the third trimester of pregnancy to some extent,and their combination can be used as an important index for the early prediction of FGR.

Relationship Between Postprandial Blood Glucose,Fasting Insulin,and Glycated Hemoglobin Levels and Early Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus

Objective:To investigate the relationship between postprandial blood glucose(PBG),fasting insulin(FINS),and glycated hemoglobin(HbA1c)levels and early diabetic nephropathy in patients with type 2 diabetes.Methods:96 cases of type 2 diabetes mellitus treated in our hospital from May 2021 to May 2022 were selected as the research subjects.The patients were divided into two groups according to the urinary albumin excretion rate(UAER),with 53 cases in the type 2 diabetes group(UAER<30μg/min)and 43 cases in the early diabetic nephropathy group(30μg/min≤UAER<300μg/min).PBG,FINS,and HbA1c levels were detected in 87 healthy patients.Results:The levels of PBG,FINS,and HbA1c in the early diabetic nephropathy group were higher than those in the control group(P<0.01)and the type 2 diabetes group(P<0.01).Conclusion:PBG,FINS,and HbA1c are factors affecting the occurrence of diabetic nephropathy in patients with type 2 diabetes;thus,controlling the levels of PBG,FINS,and HbA1c can effectively prevent the occurrence of diabetic nephropathy in type 2 diabetes mellitus.

Correlation between COVID-19 vaccination and diabetes mellitus:A systematic review

BACKGROUND Coronavirus disease 2019(COVID-19)is one of the current global public health threats and vaccination is the most effective tool to reduce the spread and decrease the severity of COVID-19.Diabetes is one of the important chronic diseases threatening human health and is a common comorbidity of COVID-19.What is the impact of diabetes on the immunization effect of COVID-19 vaccination?Conversely,does vaccination against COVID-19 exacerbate the severity of pre-existing diseases in patients with diabetes?There are limited and conflicting data on the interrelationship between diabetes and COVID-19 vaccination.AIM To explore the clinical factors and possible mechanisms underlying the interaction between COVID-19 vaccination and diabetes.METHODS We conducted a comprehensive search of PubMed,MEDLINE,EMBASE,and Reference Citation Analysis(https://www.referencecitationanalysis.com)online datab-ases,and medRxiv and bioRxiv gray literature using the keywords"SARSCoV-2","COVID-19","vaccine","vaccination","antibody",and"diabetes"individually or in combination,with a cut-off date of December 2,2022.We followed inclusion and exclusion criteria and after excluding duplicate publications,studies with quantifiable evidence were included in the full-text review,plus three manually searched publications,resulting in 54 studies being included in this review.RESULTS A total of 54 studies were included,from 17 countries.There were no randomized controlled studies.The largest sample size was 350963.The youngest of the included samples was 5 years old and the oldest was 98 years old.The included population included the general population and also some special populations with pediatric diabetes,hemodialysis,solid organ transplantation,and autoimmune diseases.The earliest study began in November 2020.Thirty studies discussed the effect of diabetes on vaccination,with the majority indicating that diabetes reduces the response to COVID-19 vaccination.The other 24 studies were on the effect of vaccination on diabetes,which included 18 case reports/series.Most of the studies concluded that COVID-19 vaccination had a risk of causing elevated blood glucose.A total of 12 of the 54 included studies indicated a"no effect"relationship between diabetes and vaccination.CONCLUSION There is a complex relationship between vaccination and diabetes with a bidirectional effect.Vaccination may contribute to the risk of worsening blood glucose in diabetic patients and diabetic patients may have a lower antibody response after vaccination than the general population.

Upshots of health education among patients with type 2 diabetes mellitus: A field study in Mysuru

Objective:This study was conducted to assess the impact of health education on lifestyle modification and disease status of diabetic patients for 6 months in rural Mysuru in Southern India.Materials and Methods:A quasi-experimental study was conducted among 104 patients with type 2 diabetes mellitus in rural Mysuru,India from July to December 2022.Participants were assigned to two groups:intervention(n=52)and control(n=52),and their data were collected.The intervention group was educated about the disease and its management and was given printed pamphlets containing information to be followed,whereas the participants in the control group were asked to continue their routine health checkups.The body mass index(BMI),weight,fasting blood sugar(FBS),knowledge about the disease,and behavior changes were recorded and compared between the two groups before and after 6 months.Results:The mean FBS value,BMI and weight decreased significantly in the intervention group after 6 months(FBS:164.79±47.59 mg/dL vs.141.92±25.63 mg/dL,P<0.001;BMI:22.97±3.75 kg/m2 vs.22.62±3.29 kg/m2,P<0.05;weight:62.82±11.92 kg vs.61.54±10.67 kg,P<0.05).The posttest period also showed an improvement in physical activity,diet,and medication adherence in the intervention group compared to the control group(P<0.05).The knowledge scores also improved postintervention which was statistically significant with the Wilcoxon signed-rank test(P<0.05).Conclusions:The effectiveness of the educational intervention was also supported by lower FBS levels and decrease in BMI and weight compared to before.The findings of this study may help and make it easier to plan studies on people with diabetes mellitus in various settings.

Diabetes mellitus:An overview of the types,prevalence,comorbidity,complication,genetics,economic implication,and treatment

Diabetes is one of the deadliest diseases.Due to its effects on the lives of people,it has attracted a lot of attention recently.The causes of the various forms of diabetes,including type 1 and type 2,were discussed along with how they affect those who have the disease.Younger people are more prone to type 1 diabetes than older people,who are more likely to develop type 2.The treatment options and strategies for the two forms of diabetes were also discussed in addition to how the disease affects the quality of life of people.Among several factors that were explained,it has been shown that people from low and middle-income countries are more prone to having diabetes.Additionally,the condition is more likely to affect some races more than others.It is associated with obesity.According to statistics,those who are poor are more severely affected by the disease.The progression of the disease over time has been associated with an increase in disability and mortality.

Effect of medicinal mushrooms on blood cells under conditions of diabetes mellitus

Diabetes mellitus(DM) is the third most common noninfectious disease leading to early disability and high mortality. Moreover, the number of patients is growing every year. The main symptom of DM is hyperglycemia. Increased levels of blood glucose activate polyol, hexosamine, and protein kinase metabolic pathways cause the intensification of non-enzymatic glycosylation and nitration of macromolecules. This, in turn, leads to the development of oxidative and nitrative stresses and secondary complications, such as different kinds of microand macroangiopathies. Metabolic disorders caused by insulin deficiency in diabetes significantly impede the functioning of a homeostasis system, which change the physical, biochemical, morphological, and functional properties of blood cells. As a result, the oxygen-transport function of red blood cells(RBCs), rheological properties of the blood, and functions of immunocompetent cells as well as the process of apoptosis are primarily affected. Modern pharmacotherapy focuses on the search for new preparations that aim to decrease blood glucose levels. Undesirable side effects and adverse reactions caused by synthetic medicines led to the search and investigation of new preparations of natural origin. Medicinal mushrooms play an important role among such new preparations. They are a source of a large number of high-and lowmolecular compounds with pronounced biological effects. Our investigations show pronounced hypoglycemic and anti-anemic action of submerged cultivated mycelium powder of medicinal mushrooms Agaricus brasiliensis(A. brasiliensis) and Ganoderma lucidum(G. lucidum) on streptozotocin-induced DM in rats. Also, we showed that mycelium powders have membrane protective properties as evidenced by the redistribution of RBC populations towards the growth of full functional cell numbers. Normalization of parameters of leukocyte formula and suppression of apoptosis of white blood cells in diabeticrats treated with A. brasiliensis and G. lucidum mycelia indicates pronounced positive effects of these strains of mushrooms. Thus, the use of medicinal mushrooms for treatment of DM and in prevention development of its secondary complications might be a new effective approach of this disease's cure. This article is aimed at summarizing and analyzing the literature data and basic achievements concerning DM type 1 treatment using medicinal mushrooms and showing the results obtained in our research.

Upregulated inflammatory associated factors and blood-retinal barrier changes in the retina of type 2diabetes mellitus model

AIM： To examine the expression of high mobility group box-1（HMGB-1） and intercellular adhesion molecule-1（ICAM-1） in the retina and the hippocampal tissues; and further to evaluate the association of these two molecules with the alterations of blood-retinal barrier（BRB） and blood-brain barrier（BBB） in a rat model of type 2 diabetes.METHODS： The type-2 diabetes mellitus（DM） model was established with a high-fat and high-glucose diet combined with streptozotocin（STZ）. Sixteen weeks after DM induction, morphological changes of retina and hippocampus were observed with hematoxylin-eosin staining, and alternations of BRB and BBB permeability were measured using Evans blue method. Levels of HMGB-1 and ICAM-1 in retina and hippocampus were detected by Western blot. Serum HMGB-1 levels were determined by enzyme-linked immunosorbent assay（ELISA）.RESULTS： A significantly higher serum fasting blood glucose level in DM rats was observed 2wk after STZ injection（P 〈0.01）. The serum levels of fasting insulin,Insulin resistance homeostatic model assessment（IRHOMA）,total cholesterol（TC）, total triglycerides（TG） and low density lipoprotein cholesterol（LDL-C） in the DM rats significantly higher than those in the controls（all P 〈0.01）.HMGB-1（0.96±0.03, P 〈0.01） and ICAM-1（0.76±0.12, P 〈0.05） levels in the retina in the DM rats were significantly higher than those in the controls. HMGB-1（0.83±0.13, P 〈0.01） and ICAM-1（1.15 ±0.08, P 〈0.01） levels in the hippocampal tissues in the DM rats were alsosignificantly higher than those in the controls. Sixteen weeks after induction of DM, the BRB permeability to albumin-bound Evans blue dye in the DM rats was significantly higher than that in the controls（P 〈0.01）.However, there was no difference of BBB permeability between the DM rats and controls. When compared to the controls, hematoxylin and eosin staining showed obvious irregularities in the DM rats.CONCLUSION： BRB permeability increases significantly in rats with type-2 DM, which may be associated with the up-regulated retinal expression of HMGB-1 and ICAM-1.

Abnormality of peripheral nerve conduction velocity associated with illness course, symptoms and fasting blood glucose in patients with type 2 diabetes mellitus

BACKGROUND: It has shown that abnormality of peripheral nerve conduction velocity during onset of diabetes mellitus is not related to age and sex, but to symptoms, illness course and level of fasting blood glucose. OBJECTIVE: To measure correlation of abnormality of peripheral nerve conduction velocity with various illness courses, symptoms and levels of fasting blood glucose of patients with type 2 diabetes mellitus. DESIGN: Case analysis. SETTING: Department of Neurology, Central People's Hospital of Huizhou. PARTICIPANTS: A total of 128 patients who were diagnosed as type 2 diabetes mellitus were selected from Central People's Hospital of Huizhou from September 2001 to October 2005. There were 75 males and 53 females aged 32-83 years and the illness course ranged from 1 month to 20 years. METHODS: All 128 patients with type 2 diabetes mellitus received neuro-electrophysiological study and their clinical data were retrospectively analyzed to measure peripheral nerve conduction velocity and fasting blood glucose so as to investigate the correlation of peripheral nerve conduction velocity with clinical symptoms, illness course and levels of fasting blood glucose. MAIN OUTCOME MEASURES: Correlation of peripheral nerve conduction velocity with clinical symptoms, illness course and levels of fasting blood glucose. RESULTS: All 128 patients with type 2 diabetes mellitus were involved in the final analysis. ① Among 128 patients, 114 patients had abnormality of peripheral nerve conduction velocity; 110 patients had clinical symptoms, including 102 patients having abnormality of peripheral nerve conduction velocity; 18 patients did not have clinical symptoms, including 12 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=8.275, P =0.04). ② Among 128 patients, illness course of 75 patients was equal to or less than 5 years, including 27 patients having abnormality of peripheral nerve conduction velocity; illness course of 53 patients was more than 5 years, including 35 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=11.469, P =0.003). ③ Among 128 patients, levels of fasting blood glucose of 75 patients was equal to or lower than 11 mmol/L, including 41 patients having abnormality of peripheral nerve conduction velocity; levels of fasting blood glucose of 53 patients was higher than 11 mmol/L, including 38 patients having abnormality of peripheral nerve conduction velocity. There were significant differences between them (χ 2=4.023, P =0.134). CONCLUSION: ① Abnormality of peripheral nerve conduction velocity of patients with type 2 diabetes mellitus is related to illness courses and clinical symptoms. The longer the illness course is, the severer the abnormality of peripheral nerve conduction velocity is. Abnormality of peripheral nerve conduction velocity always occurs on patients who have clinical symptoms. ② Abnormality of peripheral nerve conduction velocity is not related to levels of fasting blood glucose.

Characteristic of Ambulatory Blood Pressure in Normotensive Subjects With Type 2 Diabetes Mellitus

Objectives To observe the characteristic of ambulatory blood pressure monitoring in normotensive diabetic subjects with normoalbuminuria or microalbuminuria. Methods Fifty-two normotensive patients with type 2 diabetes received ambulatory blood pressure monitoring were divided into normoalbuminuric and microalbuminuric groups according to their albumin excretion rate, the other 28 normotensive subjects without diabetes were contributed as control group. Ambulatory blood pressure monitoring was performed on a working day and measurement of blood pressure circadian rhythm was analyzed. Results Normotensive microalbuminuric diabetic patients had higher night-time systolic blood pressure and more blood pressure burden than normotensive normoalbuminuric diabetic patients. Additionally, the microalbuminuric patients had a higher frequency of non-dippers than normoalbuminuric ones, although they were all normotensive. Compared to the normotensive non-diabetic control subjects, the night- time systolic blood pressure and frequency of non- dippers of the normoalbuminuric diabetic patients were significantly higher. Conclusions Intensive attention should be paid in control of blood pressure in diabetic patients to prevent and limit damage of target organ including kidney, even in those normotensive subjects.

Effects of DPP-4 inhibitor combined with metformin on blood glucose control, oxidative stress and inflammatory response in patients with type 2 diabetes mellitus

Objective: To investigate the effects of DPP-4 inhibitor combined with metformin on blood glucose control, oxidative stress and inflammatory response in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 138 patients with newly diagnosed T2DM who were treated in the hospital between March 2016 and April 2017 were divided into routine group (n=69) and combined treatment group (n=69) by random number table method. Routine group were treated with metformin alone and combined treatment group received DPP-4 inhibitor combined with metformin therapy. The differences in blood glucose control as well as oxidative stress-related indicator and inflammatory factor contents were compared between the two groups before and after treatment. Results: Before treatment, the differences in blood glucose index levels in peripheral blood as well as the oxidative stress index and inflammatory mediator contents in serum were not statistically significant between the two groups. After 4 weeks of treatment, blood glucose indexes FBG and HOMA-IR levels in peripheral blood of combined treatment group were lower than those of routine group;oxidative stress indexes MDA and LHP contents in serum were lower than those of routine group whereas GSH-Px and T-AOC contents were higher than those of routine group;inflammatory mediators hs-CRP, IL-1 and IL-6 contents in serum were lower than those of routine group. Conclusion: DPP-4 inhibitor combined with metformin therapy can effectively control the blood glucose and suppress the systemic oxidative stress and inflammatory response in T2DM paients.

Spouses of patients with diabetes mellitus type 2 at increased risk of high blood glucose levels

Introduction: Diabetes mellitus type 2 is a growing threat in developing countries already burdened with high levels of infectious disease. Screening the general population has debatable advantages. This study aims to determine whether spouses of patients with diabetes mellitus have higher random blood glucose (RBG) levels as well as the benefit of RBG testing as a targetted screening tool. Methodology: The survey employed a cross-sectional comparative study of spouses’ of diabetics and non-diabetics attending the general out-patient department of the LagosStateUniversityTeaching Hospital (LASUTH), Ikeja. A modified WHO STEPS Surveillance Instrument and a one-touch Glucometer were used to collect data. Blood pressures and BMI were measured and correlated to blood glucose levels. Results: Prevalence of high RBG was found to be 7% among spouses of diabetics and 3.3% among spouses of non-diabetic patients. Mean RBG was 5.57 mmol/L and 7.7 mmol/L within the age group 40 - 49 years and 50 - 59 years respectively among spouses of diabetic patients compared to 5.4 mmol/L and 5.5 mmol/L within the same age group among the spouses non-diabetics. Spouses of patients with diabetes mellitus had higher systolic and diastolic blood pressures and BMI compared to spouses of non-diabetics. Conclusion: Being male, married to a diabetic patient, lower educational levels and higher body mass index are significantly associated with higher random blood glucose in the spouses of diabetic patients. Random blood glucose measurements are an effective screening tool and spouses of diabetic patients can benefit from targeted screening in controlled clinical settings.

Association between Socio-Demographic Factors and Blood Sugar Levels in Type 2 Diabetes Mellitus Patients in Bangladesh

Background: The aim of the current study was to evaluate the anthropometric and demographic factors and their correlation with type 2 diabetes mellitus (T2DM) in Bangladesh. Methods: One hundred fourteen patients (70 males and 44 females) between 30 and 75 years of age from various areas of Bangladesh were screened for T2DM. Fasting blood sugar (FBS) was analyzed by using laboratory kits and spectrophotometric technique. Anthropometric and socio-demographic data were collected using a structured questionnaire. Body mass index (BMI) was calculated from weight (kg) and height (m) of the individual respondents. Physical activity was categorized based on activity during daily work. Economic condition is defined by respective family income and education level is categorized into 3 levels: illiterate, 0 - 12 years of education and graduate or above. Results: According to the current study results, half of the patients were from the middle-class family with low physical activity and their age was within the range of 30 - 45 years. The male and female ratio of the study population was 60:40. Most of the patients were found to be obese and educated. Urban populations were more prone to have DM than the rural population. Age, education, the area of residence (urban and rural), physical activity and co-morbid diseases were significantly correlated with T2DM in Bangladesh (P Conclusion: Our study shows that different socio-demographic factors have a significant correlation with T2DM in Bangladesh. Diabetes awareness, early diagnosis, patient education and life-style modification can be initiated to manage T2DM efficiently.

Detection and significance of blood rheology and coagulation function index in elderly patients with type 2 diabetes mellitus complicated with cerebral infarction

Objective: To investigate the level of blood rheology and coagulation function in elderly patients with type 2 diabetes mellitus (T2DM) and cerebral infarction and its significance. Methods: A total of 81 elderly patients with T2DM and cerebral infarction were selected as the observation group, 80 cases of T2DM patients without cerebral infarction were selected as T2DM group, and 80 healthy elderly people as control group. According to the Adama classification, the patients in the observation group were divided into three groups: lacunar infarction group (n=28), small infarction group (n=39) and large infarction group (n=14). The blood rheology and coagulation function indexes levels among the groups were compared. Results: The single factor variance analysis showed that the differences of the high shear whole blood viscosity, plasma viscosity, low shear whole blood viscosity, APTT, PT, FIB and D-D levels among the control group were significant, T2DM group and observation group were statistically significant. Compared with the control group, the high shear whole blood viscosity, plasma viscosity, low shear whole blood viscosity, FIB and D-D levels in the T2DM group and observation group were significantly increased, PT and APTT were decreased sharply, and in the observation group high shear whole blood viscosity, plasma viscosity, low shear whole blood viscosity, FIB and D-D levels were significantly higher than that of T2DM group APTT, and PT were significantly lower than those of T2DM group. Lacunar infarction group, small infarction group and large infarction group with increased infarct size, with high shear whole blood viscosity, plasma viscosity, low shear whole blood viscosity, FIB and D-D levels were significantly increased, while APTT and PT were significantly decreased. Conclusion: T2DM and cerebral infarction patients with abnormal blood rheology and coagulation function, the index examination has important clinical value for cerebral infarction area evaluation.

Effect of liraglutide combined with basal insulin on blood glucose control, lipid metabolism and oxidative stress in patients with newly diagnosed type 2 diabetes mellitus complicated by obesity

Objective:To investigate the effect of liraglutide combined with basal insulin on blood glucose control, lipid metabolism and oxidative stress in patients with newly diagnosed type 2 diabetes mellitus complicated by obesity.Methods: A total of 58 patients with newly diagnosed type 2 diabetes mellitus complicated by obesity who were diagnosed and treated in Xi'an No. 4 Hospital between February 2017 and August 2017 were divided into the control group (n=29) who received basal insulin therapy and the liraglutide group (n=29) who received liraglutide combined with basal insulin therapy according to random number table. The differences in the levels of glycolipid metabolism indexes and the contents of oxidative stress indexes were compared between the two groups before and after treatment.Results: Before treatment, the differences in the levels of glycolipid metabolism indexes in peripheral blood and the contents of oxidative stress indexes in serum were not statistically significant between the two groups. After 1 month of treatment, glucose metabolism indexes FBG and HOMA-IR levels in peripheral blood of liraglutide group were lower than those of control group;lipid metabolism indexes TC, TG, ApoB levels in peripheral blood were lower than those of control group, ApoA1 level was higher than those of control group;serum oxidation indexes MDA and LHP contents were lower than those of control group whereas anti-oxidation indexes GSH-Px and T-AOC contents were higher than those of control group.Conclusion: Liraglutide combined with basal insulin therapy can further control the glucolipid metabolism levels and inhibit the systemic oxidative stress response in patients with newly diagnosed type 2 diabetes mellitus complicated by obesity.

Blood glucose response to aerobic exercise training programme among patients with type 2 diabetes mellitus at the University of Nigeria Teaching Hospital, Enugu South-East, Nigeria

The following article has been retracted due to the conflicts between the authors. The scientific community takes a very strong view on this matter, and HEALTH treats all unethical behavior seriously. This paper published in Vol.5 No.11, 1796-1802 (2013) has been removed from this site. Title: Blood glucose response to aerobic exercise training programme among patients with type 2 diabetes mellitus at the University of Nigeria Teaching Hospital, Enugu South-East, Nigeria Authors: Charles Ikechukwu Ezema, Amarachi Akuegbu Onwunali, Sikiru Lamina, Uche Anthonia Ezugwu, Augustine Amaeze Amaeze, Maduabuchukwu Joseph Nwankwo, Florence Ngozi

Gut microbiota dysbiosis in Chinese children with type 1 diabetes mellitus:An observational study

BACKGROUND Gut microbiota dysbiosis is reportedly actively involved in autoimmune diseases such as type 1 diabetes mellitus(T1DM).However,the alterations in the gut microbiota and their correlation with fasting blood glucose(FBG)in Chinese children with T1DM remain unclear.AIM To investigate alterations in the gut microbiota in Chinese children with T1DM and their associations with clinical indicators.METHODS Samples from 51 children with T1DM and 47 age-matched and gender-matched healthy controls were obtained,to explore the structural and functional alterations in the fecal microbiota.The V3-V4 regions of the 16S rRNA gene were sequenced on a MiSeq instrument,and the association with FBG were analyzed.RESULTS We found that the bacterial diversity was significantly increased in the T1DMassociated fecal microbiota,and changes in the microbial composition were observed at different taxonomic levels.The T1DM-reduced differential taxa,such as Bacteroides vulgatus ATCC8482,Bacteroides ovatus,Bacteroides xylanisolvens,and Flavonifractor plautii,were negatively correlated with FBG,while the T1DMenriched taxa,such as Blautia,Eubacterium hallii group,Anaerostipes hadrus,and Dorea longicatena,were positively correlated with FBG.Bacteroides vulgatus ATCC8482,Bacteroides ovatus,the Eubacterium hallii group,and Anaerostipes hadrus,either alone or in combination,could be used as noninvasive diagnostic biomarkers to discriminate children with T1DM from healthy controls.In addition,the functional changes in the T1DM-associated fecal microbiota also suggest that these fecal microbes were associated with altered functions and metabolic activities,such as glycan biosynthesis and metabolism and lipid metabolism,which might play vital roles in the pathogenesis and development of T1DM.CONCLUSION Our present comprehensive investigation of the T1DM-associated fecal microbiota provides novel insights into the pathogenesis of the disease and sheds light on the diagnosis and treatment of T1DM.

Sleep quality and its impact on glycaemic control in patients with type 2 diabetes mellitus

Purpose:To investigate the sleep quality of patients with type 2 diabetes(T2D)and its impact on glycaemic control.Methods:Using a convenience sampling method,220 patients with T2D were recruited.The Pittsburgh Sleep Quality Index(PSQI)was used to evaluate the sleep quality with threshold at PSQI
8.The glycosylated haemoglobin A1c(HbA1c)test was used to measure the glycaemic control with threshold at HbA1c<7%.Results:The PSQI score was 8.30±4.12.The sleep disorder incidence rate was 47.1%.Patients with HbA1c
7%had significantly lower PSQI global and factor scores(p<0.01)versus the control group.Sleep latency,sleep disturbance,and daytime dysfunction were the risk factors for poor glycaemic control.Conclusion:Patients with T2D have high sleep disorder rate negatively impacting glycaemic control.Health care providers should pay close attention to the sleep quality of T2D patients,and provide them with appropriate educational material.

Correlation of anxiety state with blood glucose control, microinflammation and oxidative stress in patients with type 2 diabetes mellitus

Objective:To study the correlation of anxiety state with blood glucose control, microinflammation and oxidative stress in patients with type 2 diabetes mellitus.Methods:A total of 138 patients with type 2 diabetes mellitus were divided into the non-anxiety group (n=43) (SAS score < 50 points), mild-to-moderate anxiety group (n=71) (SAS score 50-69 points) and severe anxiety group (n=24) (SAS score 70 points) according to the self-rating anxiety scale (SAS) score. The differences in levels of glucose metabolism indexes, microinflammation indexes and oxidative stress indexes were compared among the three groups.Results: Peripheral blood FPG, P2hPG, HOMA-IR, CRP, ASAA, IL-6, MDA and ROS levels of mild-to-moderate anxiety group and severe anxiety group were higher than those of non-anxiety group while CAT and GSH-Px contents were lower than those of non-anxiety group;peripheral blood FPG, P2hPG, HOMA-IR, CRP, ASAA, IL-6, MDA and ROS levels of severe anxiety group were higher than those of mid-to-moderate anxiety group while CAT and GSH-Px contents were lower than those of mid-to-moderate anxiety group.Conclusion:The increase of anxiety in patients with type 2 diabetes mellitus is a direct factor leading to the abnormal glucose metabolism as well as the aggravation of microinflammatory state and oxidative stress state.