Background: Impaired fasting glucose (IFG) is a prediabetic condition and is a high-risk state for developing diabetes and associated complications. The aim of this study was to explore the association of vitamin D wi...Background: Impaired fasting glucose (IFG) is a prediabetic condition and is a high-risk state for developing diabetes and associated complications. The aim of this study was to explore the association of vitamin D with insulin secretory function among the IFG subjects. Materials and Methods: This was a prospective cross-sectional study conducted in the Department of Biochemistry and Cell Biology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh;from June 2016 to May 2017, on forty-six (46) IFG subjects. Serum blood glucose was measured by glucose-oxidase method, Fasting serum lipid profile (Total cholesterol, TG and HDL-c);liver enzyme like alanine aminotransferase (ALT) was measured by enzymatic-colorimetric method;Serum creatinine was measured by colorimetric kinetic method;Serum Insulin and vitamin D [25(OH)D] were measured by ELISA method;insulin secretory capacity (HOMA%B) and insulin sensitivity (HOMA%S) were calculated by Homeostasis Model Assessment (HOMA) using HOMA-CIGMA software. Results: Among 46 IFG subjects, 22 (47.8%) were male and rest 24 (52.2%) were female and their mean age was 40 (±8) years. Mean fasting serum glucose level of the study subjects was 6.33 (±0.23) mmol/l and mean postprandial serum glucose level was 7.23 (±0.41) mmol/l. Mean serum vitamin D level of the study subjects was 26.54 (±8.83) ng/ml. Mean HOMA%S, HOMA%B and HOMA%IR of the total study subjects were 48.34 (±16.70), 102.16 (±23.13) and 2.28 (±0.70) respectively. Insulin secretory capacity (HOMA%B) was significantly higher (p = 0.047) in the subjects having higher vitamin D [25(OH)D level ≥ 20 ng/ml] compared to the subjects having lower vitamin D [25(OH)D levels Conclusion: High prevalence of hypovitaminosis D exists among IFG subjects. Vitamin D is associated with insulin secretory function in IFG subjects. Population based prospective studies using larger sample size should be done to confirm the results.展开更多
Introduction: Elevated serum ferritin levels are associated with insulin resistance, type 2 diabetes and metabolic syndrome (MetS) as well as systemic inflammation and cardiovascular disease. The associations between ...Introduction: Elevated serum ferritin levels are associated with insulin resistance, type 2 diabetes and metabolic syndrome (MetS) as well as systemic inflammation and cardiovascular disease. The associations between ferritin and hemoglobin levels with individual components of MetS are unclear. The aims of the study were 1) to compare the ferritin levels, and 2) to investigate the relationships between ferritin, high-sensitivity CRP (hs-CRP), fasting glucose, fasting insulin and homeostasis model assessment (HOMA-IR) levels in elderly patients. Subjects and Methods: Study population included 121 (mean age 64.3 ± 14.1 yrs) (80 female, 41 male) elderly patients. The study population was evaluated for MetS by Adult Treatment Panel III (ATPIII). Demographic and biochemical data such as fasting insulin, hs-CRP, fasting glucose and ferritin levels were evaluated. Biochemical data were evaluated retrospectively. Insulin resistance (IR) was estimated using the HOMA. Results: Metabolic syndrome was diagnosed in 39 elderly patients (32.2%). In elderly patients with MetS, mean levels of ferritin, hs-CRP, fasting glucose, fasting insulin and HOMA were found to be 72.9 ± 33.1 ng/ml, 0.90 ± 0.01, 99.1 ± 20.1 mg/dl, 13.4 ± 1.1 μU/l, 3.0 ± 0.1, respectively. However, mean levels of ferritin, hs-CRP, fasting glucose, fasting insulin and HOMA were found to be 54.1 ± 33.1 ng/ml, 0.67 ± 0.1, 91.9 ± 17.0 mg/dl, 8.4 ± 2.7 μU/l, 2.71 ± 0.9, in the other elderly patients, (p?= 0.0012), (p?= 0.70), (p?= 0.70), (p?= 0.003), (p?= 0.80) respectively. Mean levels of ferritin were positively correlated with diastolic (r = 0.850,?p =?0.03), systolic blood pressures (r = 0.700,?p =?0.02), and fasting insulin (r = 0.444,?p =?0.003) in elderly with MetS. Conclusions: Mean levels of ferritin were increased in elderly patients with metabolic syndrome. And also, ferritin levels were positively correlated with systolic and diastolic blood pressures as well as fasting insulin but not with hs-CRP levels in elderly patients with metabolic syndrome.展开更多
目的:评价丹蛭降糖胶囊对2型糖尿病患者FINS和IRI作用的有效性。方法:计算机检索中国生物医学文献数据库、中国期刊全文数据库、万方期刊数据库等相关资料,按照Cochrane系统评价的方法,客观评价纳入研究的质量,提取有效数据,采用Rev Man...目的:评价丹蛭降糖胶囊对2型糖尿病患者FINS和IRI作用的有效性。方法:计算机检索中国生物医学文献数据库、中国期刊全文数据库、万方期刊数据库等相关资料,按照Cochrane系统评价的方法,客观评价纳入研究的质量,提取有效数据,采用Rev Man 5.2软件进行Meta分析。结果:共纳入5个随机对照试验,包括294例患者。结果显示,丹蛭降糖胶囊能降低2型糖尿病患者FINS[MD=1.24,95%CI(0.90,1.59),P<0.01],降低IRI[MD=0.20,95%CI(0.14,0.27),P<0.01]。结论:丹蛭降糖胶囊对2型糖尿病患者FINS和IRI作用是有效的。展开更多
Preoperative fasting is mandatory before anesthesia to reduce the risk of aspiration.However,the prescribed 6-8 h of fasting is usually prolonged to 12-16 h for various reasons.Prolonged fasting triggers a metabolic r...Preoperative fasting is mandatory before anesthesia to reduce the risk of aspiration.However,the prescribed 6-8 h of fasting is usually prolonged to 12-16 h for various reasons.Prolonged fasting triggers a metabolic response that precipitates gluconeogenesis and increases the organic response to trauma.Various randomized trials and meta-analyses have consistently shown that is safe to reduce the preoperative fasting time with a carbohydrate-rich drink up to 2 h before surgery.Benefits related to this shorter preoperative fasting include the reduction of postoperative gastrointestinal discomfort and insulin resistance.New formulas containing amino acids such as glutamine and other peptides are being studied and are promising candidates to be used to reduce preoperative fasting time.展开更多
AIMTo determine the short-term biochemical effects and clinical tolerability of intermittent fasting (IF) in adults with type 2 diabetes mellitus (T2DM).METHODSWe describe a three-phase observational study (baseline 2...AIMTo determine the short-term biochemical effects and clinical tolerability of intermittent fasting (IF) in adults with type 2 diabetes mellitus (T2DM).METHODSWe describe a three-phase observational study (baseline 2 wk, intervention 2 wk, follow-up 2 wk) designed to determine the clinical, biochemical, and tolerability of IF in community-dwelling volunteer adults with T2DM. Biochemical, anthropometric, and physical activity measurements (using the Yale Physical Activity Survey) were taken at the end of each phase. Participants reported morning, afternoon and evening self-monitored blood glucose (SMBG) and fasting duration on a daily basis throughout all study stages, in addition to completing a remote food photography diary three times within each study phase. Fasting blood samples were collected on the final days of each study phase.RESULTSAt baseline, the ten participants had a confirmed diagnosis of T2DM and were all taking metformin, and on average were obese [mean body mass index (BMI) 36.90 kg/m<sup>2</sup>]. We report here that a short-term period of IF in a small group of individuals with T2DM led to significant group decreases in weight (-1.395 kg, P = 0.009), BMI (-0.517, P = 0.013), and at-target morning glucose (SMBG). Although not a study requirement, all participants preferentially chose eating hours starting in the midafternoon. There was a significant increase (P < 0.001) in daily hours fasted in the IF phase (+5.22 h), although few attained the 18-20 h fasting goal (mean 16.82 ± 1.18). The increased fasting duration improved at-goal (< 7.0 mmol/L) morning SMBG to 34.1%, from a baseline of 13.8%. Ordinal Logistic Regression models revealed a positive relationship between the increase in hours fasted and fasting glucose reaching target values (χ<sup>2</sup> likelihood ratio = 8.36, P = 0.004) but not for afternoon or evening SMBG (all P > 0.1). Postprandial SMBGs were also improved during the IF phase, with 60.5% readings below 9.05 mmol/L, compared to 52.6% at baseline, and with less glucose variation. Neither insulin resistance (HOMA-IR), nor inflammatory markers (C-reactive protein) normalized during the IF phase. IF led to an overall spontaneous decrease in caloric intake as measured by food photography (Remote Food Photography Method). The data demonstrated discernable trends during IF for lower energy, carbohydrate, and fat intake when compared to baseline. Physical activity, collected by a standardized measurement tool (Yale Physical Activity Survey), increased during the intervention phase and subsequently decreased in the follow-up phase. IF was well tolerated in the majority of individuals with 6/10 participants stating they would continue with the IF regimen after the completion of the study, in a full or modified capacity (i.e., every other day or reduced fasting hours).CONCLUSIONThe results from this pilot study indicate that short-term daily IF may be a safe, tolerable, dietary intervention in T2DM patients that may improve key outcomes including body weight, fasting glucose and postprandial variability. These findings should be viewed as exploratory, and a larger, longer study is necessary to corroborate these findings.展开更多
Objective:To quantify the prevalence of fasting during Ramadan month among diabetic patients and to observe the factors which were deferring between fasting and non-fasting diabetic patients.Methods:A cross-sectional ...Objective:To quantify the prevalence of fasting during Ramadan month among diabetic patients and to observe the factors which were deferring between fasting and non-fasting diabetic patients.Methods:A cross-sectional study was carried out at primary health care clinics.The diabetic patients were interviewed with a structured data form by trained research assistants.Patients’age,gender,marital status,weight and height,diabetes type,medication,compliance,follow up,self monitoring and any complication faced during the fasting were collected.Cardiovascular risk factors including smoking habit,hypertension,dyslipidemia and pre-existing cardiovascular diseases were also recorded.Results:Out of 920 diabetic patients,95%were suffering from DM type 2.Overall patients who fasted the whole month of Ramadan were 84%.The proportion of type 1 and type 2 was 71%and 85%respectively.About 63%of DM type 2 patients were treated with oral hypoglycemic agents(OHAs) alone and 2.4%with combination of OHAs and insulin.Only 42%of DM type 1 and 36%of DM type 2 patients has visited their physicians prior to their fast for advice.The significant differing factors which make non-fasting in diabetic patients,were medication(insulin),complications,hyperglycemia,retinopathy, neuropathy,nephropathy and vascular problems.Conclusions:This study has identified the factors in diabetic patients,were being compliant with medication,oral treatments and family support which lead to more likely to fast in Ramadan month.Factors which reduce fasting by these patients were acute and chronic complications,time since diagnosis and insulin treatment.Fasting would be acceptable for patients who are compliant with their diet and medication.展开更多
目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察...目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组给予硫辛酸治疗,观察组在对照组基础上加用益气化聚方治疗。比较2组患者在治疗后的临床疗效、血糖变化、代谢相关指标、周围神经病变及治疗期间不良反应发生情况。结果:治疗后,观察组患者治疗总有效率高于对照组,且高低密度脂蛋白胆固醇(HDL-C)水平、总神经运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)评分(正中神经和腓总神经)显著升高,差异有统计学意义(P<0.05),空腹血糖(FPG)、餐后2 h血糖(2 h PG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)与对照组比较显著降低(P<0.05)。观察组治疗期间出现血小板功能异常2例、脸色苍白1例,对照组治疗期间出现血小板功能异常2例、脸色苍白2例,2组治疗后不良反应发生情况差异无统计学意义。结论:采用益气化聚方联合硫辛酸治疗T2DM可更明显改善周围神经病变,降低血糖,控制血脂,且安全性良好。展开更多
文摘Background: Impaired fasting glucose (IFG) is a prediabetic condition and is a high-risk state for developing diabetes and associated complications. The aim of this study was to explore the association of vitamin D with insulin secretory function among the IFG subjects. Materials and Methods: This was a prospective cross-sectional study conducted in the Department of Biochemistry and Cell Biology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh;from June 2016 to May 2017, on forty-six (46) IFG subjects. Serum blood glucose was measured by glucose-oxidase method, Fasting serum lipid profile (Total cholesterol, TG and HDL-c);liver enzyme like alanine aminotransferase (ALT) was measured by enzymatic-colorimetric method;Serum creatinine was measured by colorimetric kinetic method;Serum Insulin and vitamin D [25(OH)D] were measured by ELISA method;insulin secretory capacity (HOMA%B) and insulin sensitivity (HOMA%S) were calculated by Homeostasis Model Assessment (HOMA) using HOMA-CIGMA software. Results: Among 46 IFG subjects, 22 (47.8%) were male and rest 24 (52.2%) were female and their mean age was 40 (±8) years. Mean fasting serum glucose level of the study subjects was 6.33 (±0.23) mmol/l and mean postprandial serum glucose level was 7.23 (±0.41) mmol/l. Mean serum vitamin D level of the study subjects was 26.54 (±8.83) ng/ml. Mean HOMA%S, HOMA%B and HOMA%IR of the total study subjects were 48.34 (±16.70), 102.16 (±23.13) and 2.28 (±0.70) respectively. Insulin secretory capacity (HOMA%B) was significantly higher (p = 0.047) in the subjects having higher vitamin D [25(OH)D level ≥ 20 ng/ml] compared to the subjects having lower vitamin D [25(OH)D levels Conclusion: High prevalence of hypovitaminosis D exists among IFG subjects. Vitamin D is associated with insulin secretory function in IFG subjects. Population based prospective studies using larger sample size should be done to confirm the results.
文摘Introduction: Elevated serum ferritin levels are associated with insulin resistance, type 2 diabetes and metabolic syndrome (MetS) as well as systemic inflammation and cardiovascular disease. The associations between ferritin and hemoglobin levels with individual components of MetS are unclear. The aims of the study were 1) to compare the ferritin levels, and 2) to investigate the relationships between ferritin, high-sensitivity CRP (hs-CRP), fasting glucose, fasting insulin and homeostasis model assessment (HOMA-IR) levels in elderly patients. Subjects and Methods: Study population included 121 (mean age 64.3 ± 14.1 yrs) (80 female, 41 male) elderly patients. The study population was evaluated for MetS by Adult Treatment Panel III (ATPIII). Demographic and biochemical data such as fasting insulin, hs-CRP, fasting glucose and ferritin levels were evaluated. Biochemical data were evaluated retrospectively. Insulin resistance (IR) was estimated using the HOMA. Results: Metabolic syndrome was diagnosed in 39 elderly patients (32.2%). In elderly patients with MetS, mean levels of ferritin, hs-CRP, fasting glucose, fasting insulin and HOMA were found to be 72.9 ± 33.1 ng/ml, 0.90 ± 0.01, 99.1 ± 20.1 mg/dl, 13.4 ± 1.1 μU/l, 3.0 ± 0.1, respectively. However, mean levels of ferritin, hs-CRP, fasting glucose, fasting insulin and HOMA were found to be 54.1 ± 33.1 ng/ml, 0.67 ± 0.1, 91.9 ± 17.0 mg/dl, 8.4 ± 2.7 μU/l, 2.71 ± 0.9, in the other elderly patients, (p?= 0.0012), (p?= 0.70), (p?= 0.70), (p?= 0.003), (p?= 0.80) respectively. Mean levels of ferritin were positively correlated with diastolic (r = 0.850,?p =?0.03), systolic blood pressures (r = 0.700,?p =?0.02), and fasting insulin (r = 0.444,?p =?0.003) in elderly with MetS. Conclusions: Mean levels of ferritin were increased in elderly patients with metabolic syndrome. And also, ferritin levels were positively correlated with systolic and diastolic blood pressures as well as fasting insulin but not with hs-CRP levels in elderly patients with metabolic syndrome.
文摘目的:评价丹蛭降糖胶囊对2型糖尿病患者FINS和IRI作用的有效性。方法:计算机检索中国生物医学文献数据库、中国期刊全文数据库、万方期刊数据库等相关资料,按照Cochrane系统评价的方法,客观评价纳入研究的质量,提取有效数据,采用Rev Man 5.2软件进行Meta分析。结果:共纳入5个随机对照试验,包括294例患者。结果显示,丹蛭降糖胶囊能降低2型糖尿病患者FINS[MD=1.24,95%CI(0.90,1.59),P<0.01],降低IRI[MD=0.20,95%CI(0.14,0.27),P<0.01]。结论:丹蛭降糖胶囊对2型糖尿病患者FINS和IRI作用是有效的。
文摘Preoperative fasting is mandatory before anesthesia to reduce the risk of aspiration.However,the prescribed 6-8 h of fasting is usually prolonged to 12-16 h for various reasons.Prolonged fasting triggers a metabolic response that precipitates gluconeogenesis and increases the organic response to trauma.Various randomized trials and meta-analyses have consistently shown that is safe to reduce the preoperative fasting time with a carbohydrate-rich drink up to 2 h before surgery.Benefits related to this shorter preoperative fasting include the reduction of postoperative gastrointestinal discomfort and insulin resistance.New formulas containing amino acids such as glutamine and other peptides are being studied and are promising candidates to be used to reduce preoperative fasting time.
基金Supported by Department of Medicine,University of Saskat-chewan,and the College of Pharmacy and Nutrition,University of Saskatchewan
文摘AIMTo determine the short-term biochemical effects and clinical tolerability of intermittent fasting (IF) in adults with type 2 diabetes mellitus (T2DM).METHODSWe describe a three-phase observational study (baseline 2 wk, intervention 2 wk, follow-up 2 wk) designed to determine the clinical, biochemical, and tolerability of IF in community-dwelling volunteer adults with T2DM. Biochemical, anthropometric, and physical activity measurements (using the Yale Physical Activity Survey) were taken at the end of each phase. Participants reported morning, afternoon and evening self-monitored blood glucose (SMBG) and fasting duration on a daily basis throughout all study stages, in addition to completing a remote food photography diary three times within each study phase. Fasting blood samples were collected on the final days of each study phase.RESULTSAt baseline, the ten participants had a confirmed diagnosis of T2DM and were all taking metformin, and on average were obese [mean body mass index (BMI) 36.90 kg/m<sup>2</sup>]. We report here that a short-term period of IF in a small group of individuals with T2DM led to significant group decreases in weight (-1.395 kg, P = 0.009), BMI (-0.517, P = 0.013), and at-target morning glucose (SMBG). Although not a study requirement, all participants preferentially chose eating hours starting in the midafternoon. There was a significant increase (P < 0.001) in daily hours fasted in the IF phase (+5.22 h), although few attained the 18-20 h fasting goal (mean 16.82 ± 1.18). The increased fasting duration improved at-goal (< 7.0 mmol/L) morning SMBG to 34.1%, from a baseline of 13.8%. Ordinal Logistic Regression models revealed a positive relationship between the increase in hours fasted and fasting glucose reaching target values (χ<sup>2</sup> likelihood ratio = 8.36, P = 0.004) but not for afternoon or evening SMBG (all P > 0.1). Postprandial SMBGs were also improved during the IF phase, with 60.5% readings below 9.05 mmol/L, compared to 52.6% at baseline, and with less glucose variation. Neither insulin resistance (HOMA-IR), nor inflammatory markers (C-reactive protein) normalized during the IF phase. IF led to an overall spontaneous decrease in caloric intake as measured by food photography (Remote Food Photography Method). The data demonstrated discernable trends during IF for lower energy, carbohydrate, and fat intake when compared to baseline. Physical activity, collected by a standardized measurement tool (Yale Physical Activity Survey), increased during the intervention phase and subsequently decreased in the follow-up phase. IF was well tolerated in the majority of individuals with 6/10 participants stating they would continue with the IF regimen after the completion of the study, in a full or modified capacity (i.e., every other day or reduced fasting hours).CONCLUSIONThe results from this pilot study indicate that short-term daily IF may be a safe, tolerable, dietary intervention in T2DM patients that may improve key outcomes including body weight, fasting glucose and postprandial variability. These findings should be viewed as exploratory, and a larger, longer study is necessary to corroborate these findings.
文摘Objective:To quantify the prevalence of fasting during Ramadan month among diabetic patients and to observe the factors which were deferring between fasting and non-fasting diabetic patients.Methods:A cross-sectional study was carried out at primary health care clinics.The diabetic patients were interviewed with a structured data form by trained research assistants.Patients’age,gender,marital status,weight and height,diabetes type,medication,compliance,follow up,self monitoring and any complication faced during the fasting were collected.Cardiovascular risk factors including smoking habit,hypertension,dyslipidemia and pre-existing cardiovascular diseases were also recorded.Results:Out of 920 diabetic patients,95%were suffering from DM type 2.Overall patients who fasted the whole month of Ramadan were 84%.The proportion of type 1 and type 2 was 71%and 85%respectively.About 63%of DM type 2 patients were treated with oral hypoglycemic agents(OHAs) alone and 2.4%with combination of OHAs and insulin.Only 42%of DM type 1 and 36%of DM type 2 patients has visited their physicians prior to their fast for advice.The significant differing factors which make non-fasting in diabetic patients,were medication(insulin),complications,hyperglycemia,retinopathy, neuropathy,nephropathy and vascular problems.Conclusions:This study has identified the factors in diabetic patients,were being compliant with medication,oral treatments and family support which lead to more likely to fast in Ramadan month.Factors which reduce fasting by these patients were acute and chronic complications,time since diagnosis and insulin treatment.Fasting would be acceptable for patients who are compliant with their diet and medication.
文摘目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组给予硫辛酸治疗,观察组在对照组基础上加用益气化聚方治疗。比较2组患者在治疗后的临床疗效、血糖变化、代谢相关指标、周围神经病变及治疗期间不良反应发生情况。结果:治疗后,观察组患者治疗总有效率高于对照组,且高低密度脂蛋白胆固醇(HDL-C)水平、总神经运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)评分(正中神经和腓总神经)显著升高,差异有统计学意义(P<0.05),空腹血糖(FPG)、餐后2 h血糖(2 h PG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)与对照组比较显著降低(P<0.05)。观察组治疗期间出现血小板功能异常2例、脸色苍白1例,对照组治疗期间出现血小板功能异常2例、脸色苍白2例,2组治疗后不良反应发生情况差异无统计学意义。结论:采用益气化聚方联合硫辛酸治疗T2DM可更明显改善周围神经病变,降低血糖,控制血脂,且安全性良好。
