Fasting plasma glucose(FPG) as a screening test for gestational diabetes mellitus(GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-cond...Fasting plasma glucose(FPG) as a screening test for gestational diabetes mellitus(GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-conducted studies. This review:(1) traces the history;(2) weighs the advantages and disadvantages;(3) addresses the significance in early pregnancy;(4) underscores the benefits after delivery; and(5) emphasizes the cost savings of using the FPG in the screening of GDM. It also highlights the utility of fasting capillary glucose and stresses the value of the FPG in circumventing the cumbersome oral glucose tolerance test. An understanding of all the caveats is crucial to be able to use the FPG for investigating glucose intolerance in pregnancy. Thus, all health professionals can use the patient-friendly FPG to simplify the onerous algorithms available for the screening and diagnosis of GDM-thereby helping each and every pregnant woman.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
目的分析糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)单一及联合检验诊断糖尿病的价值。方法以72例疑似有糖尿病的患者作为临床研究对象,均接受HbA1c、FPG、2 h PG检验,以糖耐量测定为诊断“金标准”。比较HbA1c、FPG、2 ...目的分析糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)单一及联合检验诊断糖尿病的价值。方法以72例疑似有糖尿病的患者作为临床研究对象,均接受HbA1c、FPG、2 h PG检验,以糖耐量测定为诊断“金标准”。比较HbA1c、FPG、2 h PG单一及联合检验的灵敏度、特异度、准确度。结果72例受检者中有58例患者确诊为糖尿病。联合检验的诊断灵敏度、特异度、准确度分别为94.83%、92.86%、94.44%;HbA1c检验的诊断灵敏度、特异度、准确度分别为75.86%、28.57%、66.67%;FPG检验的诊断灵敏度、特异度、准确度分别为81.03%、35.71%、72.22%;2 h PG检验的诊断灵敏度、特异度、准确度分别为77.59%、42.86%、70.83%。联合检验诊断的灵敏度、特异度及准确度均高于其他HbA1c、FPG、2 h PG单一诊断的灵敏度、特异度及准确度,具有统计学意义(P<0.05)。结论HbA1c、FPG、2 h PG联合检验相较单一检验诊断糖尿病具有较高的临床价值,能够为临床治疗提供有价值的参考依据。展开更多
Background:Gestational diabetes mellitus(GDM)is usually diagnosed between 24th and 28th gestational week using the 75-g oral glucose tolerance test(OGTT).It is difficult to predict GDM before 24th gestational week bec...Background:Gestational diabetes mellitus(GDM)is usually diagnosed between 24th and 28th gestational week using the 75-g oral glucose tolerance test(OGTT).It is difficult to predict GDM before 24th gestational week because fast plasma glucose(FPG)decreases as the gestational age increases.It is controversial that if FPG≥5.1 mmol/L before 24th gestational week should be intervened or not.The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy body mass index(BMI).Methods:This was a multi-region retrospective cohort study in China.Women who had a singleton live birth between June 20,2013 and November 30,2014,resided in Beijing,Guangzhou and Chengdu,and received prenatal care in 21 selected hospitals,were included in this study.Pre-pregnancy BMI,FPG before the 24th gestational week,and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical charts and analyzed.The pregnant women were classified into four groups based on pre-pregnancy BMI:Group A(underweight,BMI<18.5 kg/m^2),Group B(normal,BMI 18.5-23.9 kg/m^2),Group C(overweight,BMI 24.0-27.9 kg/m^2)and Group D(obesity,BMI≥28.0 kg/m^2).The trend of FPG before 24th week of gestation was described,and the sensitivity and specificity of using FPG before the 24th gestational week to diagnose GDM among different pre-pregnancy BMI groups were reported.Differences in the means between groups were evaluated using independent sample t-test and analysis of variance.Pearson Chi-square test was used for categorical variables.Results:The prevalence of GDM was 20.0%(6806/34,087)in the study population.FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week.FPG was higher in women with higher pre-pregnancy BMI.FPG before the 24th gestational week and pre-pregnancy BMI could be used to predict GDM.The incidence of GDM in women with FPG≥5.10 mmol/L in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG≥5.10 mmol/L and pre-pregnancy BMI<24.0 kg/m^2(78.5%[62/79]vs.52.9%[64/121],χ^2=13.425,P<0.001).Conclusions:FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week.Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week.FPG≥5.10 mmol/L between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.展开更多
AIM:To determine the effect of different Roux-en-Y gastric bypass procedures in gastric carcinoma patients with type 2 diabetes mellitus.METHODS:A retrospective analysis of the clinical data of 54 patients with gastri...AIM:To determine the effect of different Roux-en-Y gastric bypass procedures in gastric carcinoma patients with type 2 diabetes mellitus.METHODS:A retrospective analysis of the clinical data of 54 patients with gastric cancer and type 2 diabetes mellitus treated in the Department of General Surgery from January 2006 to June 2013 was conducted.The patients underwent gastrectomy using different Rouxen-Y gastric bypass procedures(traditional,n=26;modified,n=28).Fasting plasma glucose(FPG),two hour postprandial blood glucose(2 h PBG)and hemoglobin A1c(Hb A1c)were analyzed before surgery(0 mo)and 1,3 and 6 mo after surgery.RESULTS:FPG and 2 h PBG levels were significantlydecreased 1 mo after surgery in the traditional Rouxen-Y gastric bypass group(FPG 7.5±1.3 vs 10.7±1.2,P<0.05)(2 h PBG 10.2±1.8 vs 13.8±3.2,P<0.05).FPG and 2 h PBG levels were significantly decreased after surgery in the modified Roux-en-Y gastric bypass group(FPG 6.9±1.2 vs 10.5±1.1,6.5±1.3 vs 10.5±1.1,6.4±1.2 vs 10.5±1.1,P<0.05)(2 h PBG9.9±2.2 vs 14.1±2.9,9.2±2.4 vs 14.1±2.9,8.9±2.6 vs 14.1±2.9,P<0.05).Compared with the levels before surgery,Hb A1c levels were significantly decreased 3 and 6 mo after surgery(7.2±1.1 vs 10.5±1.1,5.5±1.1 vs 10.5±1.1,P<0.05).Significant differences between the two groups regarding FPG,2 h PBG and Hb A1c concentration were observed 3 and 6mo after surgery(FPG 10.1±1.5 vs 6.5±1.3,10.3±1.4 vs 6.4±1.2,P<0.05)(2 h PBG 13.1±2.8 vs 9.2±2.4,13.6±3.1 vs 8.9±2.6,P<0.05)(Hb A1c 10.1±1.4 vs 7.2±1.1,10.5±1.3 vs 5.5±1.1,P<0.05).CONCLUSION:Modified Roux-en-Y gastric bypass can improve glucose metabolism in type 2 diabetic patients with gastric cancer.展开更多
Background Type 2 diabetes is a chronic disease characterized by a progressive loss of beta cell functions. However, the evaluation of beta cell functions is either expensive or inconvenient for clinical practice. We ...Background Type 2 diabetes is a chronic disease characterized by a progressive loss of beta cell functions. However, the evaluation of beta cell functions is either expensive or inconvenient for clinical practice. We aimed to elucidate the association between the changes of insulin responsiveness and the fasting plasma glucose （FPG） during the development of diabetes. Methods A total of 1192 Chinese individuals with normal blood glucose or hyperglycemia were enrolled for the analysis. The early insulinogenic index （△I30/△G30）, the area under the curve of insulin （AUC-Ⅰ）, and homeostasis model assessment were applied to evaluate the early phase secretion, total insulin secretion, and insulin resistance respectively. Polynomial regression analysis was performed to estimate the fluctuation of beta cell functions. Results The △I30/△G30 decreased much more rapidly than the AUC-Ⅰ accompanying with the elevation of FPG. At the FPG of 110 mg/dl （a pre-diabetic stage）, the AI30/AG30 lost 50% of its maximum while the AUC-Ⅰ was still at a compensated normal level. The AUC-Ⅰ exhibited abnormal and decreased gradually at the FPG of from 130 mg/dl to higher （overt diabetes）, while the △I30/△G30 almost remained at 25% of its maximum value. When hyperglycemia continuously existed at 〉 180 mg/dl, both the AI30/AG30 and AUC-Ⅰ were totally lost. Conclusion The increased fasting plasma glucose reflects progressive decompensation of beta cell functions, and could be used to guide the strategy of clinical treatments.展开更多
文摘Fasting plasma glucose(FPG) as a screening test for gestational diabetes mellitus(GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-conducted studies. This review:(1) traces the history;(2) weighs the advantages and disadvantages;(3) addresses the significance in early pregnancy;(4) underscores the benefits after delivery; and(5) emphasizes the cost savings of using the FPG in the screening of GDM. It also highlights the utility of fasting capillary glucose and stresses the value of the FPG in circumventing the cumbersome oral glucose tolerance test. An understanding of all the caveats is crucial to be able to use the FPG for investigating glucose intolerance in pregnancy. Thus, all health professionals can use the patient-friendly FPG to simplify the onerous algorithms available for the screening and diagnosis of GDM-thereby helping each and every pregnant woman.
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。
文摘目的分析糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)单一及联合检验诊断糖尿病的价值。方法以72例疑似有糖尿病的患者作为临床研究对象,均接受HbA1c、FPG、2 h PG检验,以糖耐量测定为诊断“金标准”。比较HbA1c、FPG、2 h PG单一及联合检验的灵敏度、特异度、准确度。结果72例受检者中有58例患者确诊为糖尿病。联合检验的诊断灵敏度、特异度、准确度分别为94.83%、92.86%、94.44%;HbA1c检验的诊断灵敏度、特异度、准确度分别为75.86%、28.57%、66.67%;FPG检验的诊断灵敏度、特异度、准确度分别为81.03%、35.71%、72.22%;2 h PG检验的诊断灵敏度、特异度、准确度分别为77.59%、42.86%、70.83%。联合检验诊断的灵敏度、特异度及准确度均高于其他HbA1c、FPG、2 h PG单一诊断的灵敏度、特异度及准确度,具有统计学意义(P<0.05)。结论HbA1c、FPG、2 h PG联合检验相较单一检验诊断糖尿病具有较高的临床价值,能够为临床治疗提供有价值的参考依据。
文摘Background:Gestational diabetes mellitus(GDM)is usually diagnosed between 24th and 28th gestational week using the 75-g oral glucose tolerance test(OGTT).It is difficult to predict GDM before 24th gestational week because fast plasma glucose(FPG)decreases as the gestational age increases.It is controversial that if FPG≥5.1 mmol/L before 24th gestational week should be intervened or not.The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy body mass index(BMI).Methods:This was a multi-region retrospective cohort study in China.Women who had a singleton live birth between June 20,2013 and November 30,2014,resided in Beijing,Guangzhou and Chengdu,and received prenatal care in 21 selected hospitals,were included in this study.Pre-pregnancy BMI,FPG before the 24th gestational week,and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical charts and analyzed.The pregnant women were classified into four groups based on pre-pregnancy BMI:Group A(underweight,BMI<18.5 kg/m^2),Group B(normal,BMI 18.5-23.9 kg/m^2),Group C(overweight,BMI 24.0-27.9 kg/m^2)and Group D(obesity,BMI≥28.0 kg/m^2).The trend of FPG before 24th week of gestation was described,and the sensitivity and specificity of using FPG before the 24th gestational week to diagnose GDM among different pre-pregnancy BMI groups were reported.Differences in the means between groups were evaluated using independent sample t-test and analysis of variance.Pearson Chi-square test was used for categorical variables.Results:The prevalence of GDM was 20.0%(6806/34,087)in the study population.FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week.FPG was higher in women with higher pre-pregnancy BMI.FPG before the 24th gestational week and pre-pregnancy BMI could be used to predict GDM.The incidence of GDM in women with FPG≥5.10 mmol/L in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG≥5.10 mmol/L and pre-pregnancy BMI<24.0 kg/m^2(78.5%[62/79]vs.52.9%[64/121],χ^2=13.425,P<0.001).Conclusions:FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week.Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week.FPG≥5.10 mmol/L between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.
基金Supported by The Basic Research Projects of Shenzhen R&D Funding in Science and Technology,No.JCYJ20130402113802233 and No.JC201005260209A
文摘AIM:To determine the effect of different Roux-en-Y gastric bypass procedures in gastric carcinoma patients with type 2 diabetes mellitus.METHODS:A retrospective analysis of the clinical data of 54 patients with gastric cancer and type 2 diabetes mellitus treated in the Department of General Surgery from January 2006 to June 2013 was conducted.The patients underwent gastrectomy using different Rouxen-Y gastric bypass procedures(traditional,n=26;modified,n=28).Fasting plasma glucose(FPG),two hour postprandial blood glucose(2 h PBG)and hemoglobin A1c(Hb A1c)were analyzed before surgery(0 mo)and 1,3 and 6 mo after surgery.RESULTS:FPG and 2 h PBG levels were significantlydecreased 1 mo after surgery in the traditional Rouxen-Y gastric bypass group(FPG 7.5±1.3 vs 10.7±1.2,P<0.05)(2 h PBG 10.2±1.8 vs 13.8±3.2,P<0.05).FPG and 2 h PBG levels were significantly decreased after surgery in the modified Roux-en-Y gastric bypass group(FPG 6.9±1.2 vs 10.5±1.1,6.5±1.3 vs 10.5±1.1,6.4±1.2 vs 10.5±1.1,P<0.05)(2 h PBG9.9±2.2 vs 14.1±2.9,9.2±2.4 vs 14.1±2.9,8.9±2.6 vs 14.1±2.9,P<0.05).Compared with the levels before surgery,Hb A1c levels were significantly decreased 3 and 6 mo after surgery(7.2±1.1 vs 10.5±1.1,5.5±1.1 vs 10.5±1.1,P<0.05).Significant differences between the two groups regarding FPG,2 h PBG and Hb A1c concentration were observed 3 and 6mo after surgery(FPG 10.1±1.5 vs 6.5±1.3,10.3±1.4 vs 6.4±1.2,P<0.05)(2 h PBG 13.1±2.8 vs 9.2±2.4,13.6±3.1 vs 8.9±2.6,P<0.05)(Hb A1c 10.1±1.4 vs 7.2±1.1,10.5±1.3 vs 5.5±1.1,P<0.05).CONCLUSION:Modified Roux-en-Y gastric bypass can improve glucose metabolism in type 2 diabetic patients with gastric cancer.
文摘Background Type 2 diabetes is a chronic disease characterized by a progressive loss of beta cell functions. However, the evaluation of beta cell functions is either expensive or inconvenient for clinical practice. We aimed to elucidate the association between the changes of insulin responsiveness and the fasting plasma glucose （FPG） during the development of diabetes. Methods A total of 1192 Chinese individuals with normal blood glucose or hyperglycemia were enrolled for the analysis. The early insulinogenic index （△I30/△G30）, the area under the curve of insulin （AUC-Ⅰ）, and homeostasis model assessment were applied to evaluate the early phase secretion, total insulin secretion, and insulin resistance respectively. Polynomial regression analysis was performed to estimate the fluctuation of beta cell functions. Results The △I30/△G30 decreased much more rapidly than the AUC-Ⅰ accompanying with the elevation of FPG. At the FPG of 110 mg/dl （a pre-diabetic stage）, the AI30/AG30 lost 50% of its maximum while the AUC-Ⅰ was still at a compensated normal level. The AUC-Ⅰ exhibited abnormal and decreased gradually at the FPG of from 130 mg/dl to higher （overt diabetes）, while the △I30/△G30 almost remained at 25% of its maximum value. When hyperglycemia continuously existed at 〉 180 mg/dl, both the AI30/AG30 and AUC-Ⅰ were totally lost. Conclusion The increased fasting plasma glucose reflects progressive decompensation of beta cell functions, and could be used to guide the strategy of clinical treatments.
