BACKGROUND Progressive pancreaticβ-cell dysfunction is a fundamental part of the pathology of type 2 diabetes mellitus(T2DM).Cellular therapies offer novel opportunities for the treatment of T2DM to improve the funct...BACKGROUND Progressive pancreaticβ-cell dysfunction is a fundamental part of the pathology of type 2 diabetes mellitus(T2DM).Cellular therapies offer novel opportunities for the treatment of T2DM to improve the function of isletβ-cells.AIM To evaluate the effectiveness and safety of human umbilical cord-mesenchymal stem cell(hUC-MSC)infusion in T2DM treatment.METHODS Sixteen patients were enrolled and received 1×10^(6) cells/kg per week for 3 wk as intravenous hUC-MSC infusion.The effectiveness was evaluated by assessing fasting blood glucose,C-peptide,normal glycosylated hemoglobin A1c(HbA1c),insulin resistance index(homeostatic model assessment for insulin resistance),and isletβ-cell function(homeostasis model assessment ofβ-cell function).The dosage of hypoglycemic agents and safety were evaluated by monitoring the occurrence of any adverse events(AEs).RESULTS During the entire intervention period,the fasting plasma glucose level was significantly reduced[baseline:9.3400(8.3575,11.7725),day 14±3:6.5200(5.2200,8.6900);P<0.01].The HbA1c level was significantly reduced on day 84±3[baseline:7.8000(7.5250,8.6750),day 84±3:7.150(6.600,7.925);P<0.01].The patients’isletβ-cell function was significantly improved on day 28±3 of intervention[baseline:29.90(16.43,37.40),day 28±3:40.97(19.27,56.36);P<0.01].The dosage of hypoglycemic agents was reduced in all patients,of whom 6(50%)had a decrement of more than 50%and 1(6.25%)discontinued the hypoglycemic agents.Four patients had transient fever,which occurred within 24 h after the second or third infusion.One patient(2.08%)had asymptomatic nocturnal hypoglycemia after infusion on day 28±3.No liver damage or other side effects were reported.CONCLUSION The results of this study suggest that hUC-MSC infusion can improve glycemia,restore isletβ-cell function,and reduce the dosage of hypoglycemic agents without serious AEs.Thus,hUC-MSC infusion may be a novel option for the treatment of T2DM.展开更多
目的观察应用利格列汀联合门冬胰岛素50治疗肝源性糖尿病患者的疗效及胰岛素抵抗指数(HOMAIR)和胰岛β细胞功能指数(HOMA-β)水平的变化。方法2017年1月~2019年12月我院收治的98例非酒精性脂肪性肝病合并肝源性糖尿病患者被随机分为对照...目的观察应用利格列汀联合门冬胰岛素50治疗肝源性糖尿病患者的疗效及胰岛素抵抗指数(HOMAIR)和胰岛β细胞功能指数(HOMA-β)水平的变化。方法2017年1月~2019年12月我院收治的98例非酒精性脂肪性肝病合并肝源性糖尿病患者被随机分为对照组49例和观察组49例,分别给予门冬胰岛素50或门冬胰岛素50联合利格列汀治疗,两组均治疗观察12 w。使用血糖仪检测空腹血糖(FBG)和餐后2 h血糖(2 h PG)水平,采用胶体金法检测血清糖化血红蛋白(HbAlc)水平,并计算HOMA-IR和HOMA-β,使用全自动生化分析仪检测血清肝功能指标。结果在治疗后,观察组FPG水平为(6.3±3.9)mmol/L,显著低于对照组【(7.8±1.2)mmol/L,P<0.05】,2 h PG水平为(8.4±2.6)mmol/L,显著低于对照组【(11.5±2.8)mmol/L,P<0.05】,和HbAlc水平为(7.1±1.6)%,显著低于对照组【(8.3±1.9)%,P<0.05】;治疗后,观察组HOMA-IR为(1.5±0.2),显著低于对照组【(2.4±03),P<0.05】,而HOMA-β水平为(42.9±8.7),显著高于对照组【(33.5±7.2),P<0.05】;观察组血清谷丙转氨酶(ALT)水平为(53.9±13.7)U/L,显著低于对照组【(72.2±19.6)U/L,P<0.05】,谷草转氨酶(AST)水平为(22.1±6.3)U/L,显著低于对照组【(46.4±6.9)U/L,P<0.05】,两组谷氨酰转肽酶、总胆红素和白蛋白水平无显著变化(P>0.05)。结论应用利格列汀联合门冬胰岛素50治疗非酒精性脂肪性肝病合并肝源性糖尿病患者能显著改善血糖水平,有效降低HOMA-IR,升高HOMA-β,改善了胰岛β细胞功能,从而改善患者的肝功能,具有良好的治疗效果。展开更多
目的探讨艾塞那肽结合胰岛素在血糖控制不佳的2型糖尿病患者中的应用效果。方法180例血糖控制不佳的2型糖尿病患者,以随机数字表法分为观察组和对照组,每组90例。对照组采用胰岛素联合二甲双胍治疗,观察组采用艾塞那肽联合胰岛素治疗。...目的探讨艾塞那肽结合胰岛素在血糖控制不佳的2型糖尿病患者中的应用效果。方法180例血糖控制不佳的2型糖尿病患者,以随机数字表法分为观察组和对照组,每组90例。对照组采用胰岛素联合二甲双胍治疗,观察组采用艾塞那肽联合胰岛素治疗。比较两组患者临床疗效及治疗前后血糖指标[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]与胰岛功能指标[胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]。结果观察组患者临床总有效率为96.67%,高于对照组的86.67%,差异具有统计学意义(P<0.05)。治疗后,观察组患者FBG、2 h PG、HbA1c水平分别为(7.12±1.36)mmol/L、(8.63±1.75)mmol/L、(7.26±0.94)%,均低于对照组的(8.65±1.26)mmol/L、(10.02±2.14)mmol/L、(8.53±1.03)%,差异具有统计学意义(P<0.05)。治疗后,观察组患者HOMA-β(63.25±13.21)%高于对照组的(59.32±11.30)%,HOMA-IR(3.21±0.98)低于对照组的(3.96±1.32),差异具有统计学意义(P<0.05)。结论对于血糖控制不佳的2型糖尿病患者,采用艾塞那肽结合胰岛素治疗能够降低患者血糖水平,提高治疗效果,改善患者胰岛功能及预后,值得临床推广。展开更多
基金Supported by Shenzhen Science and Technology Innovation Committee Projects,No.JCYJ20170816105416349Shenzhen High-level Hospital Construction FundShenzhen Key Medical Discipline Construction Fund,No.SZXK010.
文摘BACKGROUND Progressive pancreaticβ-cell dysfunction is a fundamental part of the pathology of type 2 diabetes mellitus(T2DM).Cellular therapies offer novel opportunities for the treatment of T2DM to improve the function of isletβ-cells.AIM To evaluate the effectiveness and safety of human umbilical cord-mesenchymal stem cell(hUC-MSC)infusion in T2DM treatment.METHODS Sixteen patients were enrolled and received 1×10^(6) cells/kg per week for 3 wk as intravenous hUC-MSC infusion.The effectiveness was evaluated by assessing fasting blood glucose,C-peptide,normal glycosylated hemoglobin A1c(HbA1c),insulin resistance index(homeostatic model assessment for insulin resistance),and isletβ-cell function(homeostasis model assessment ofβ-cell function).The dosage of hypoglycemic agents and safety were evaluated by monitoring the occurrence of any adverse events(AEs).RESULTS During the entire intervention period,the fasting plasma glucose level was significantly reduced[baseline:9.3400(8.3575,11.7725),day 14±3:6.5200(5.2200,8.6900);P<0.01].The HbA1c level was significantly reduced on day 84±3[baseline:7.8000(7.5250,8.6750),day 84±3:7.150(6.600,7.925);P<0.01].The patients’isletβ-cell function was significantly improved on day 28±3 of intervention[baseline:29.90(16.43,37.40),day 28±3:40.97(19.27,56.36);P<0.01].The dosage of hypoglycemic agents was reduced in all patients,of whom 6(50%)had a decrement of more than 50%and 1(6.25%)discontinued the hypoglycemic agents.Four patients had transient fever,which occurred within 24 h after the second or third infusion.One patient(2.08%)had asymptomatic nocturnal hypoglycemia after infusion on day 28±3.No liver damage or other side effects were reported.CONCLUSION The results of this study suggest that hUC-MSC infusion can improve glycemia,restore isletβ-cell function,and reduce the dosage of hypoglycemic agents without serious AEs.Thus,hUC-MSC infusion may be a novel option for the treatment of T2DM.
文摘目的观察应用利格列汀联合门冬胰岛素50治疗肝源性糖尿病患者的疗效及胰岛素抵抗指数(HOMAIR)和胰岛β细胞功能指数(HOMA-β)水平的变化。方法2017年1月~2019年12月我院收治的98例非酒精性脂肪性肝病合并肝源性糖尿病患者被随机分为对照组49例和观察组49例,分别给予门冬胰岛素50或门冬胰岛素50联合利格列汀治疗,两组均治疗观察12 w。使用血糖仪检测空腹血糖(FBG)和餐后2 h血糖(2 h PG)水平,采用胶体金法检测血清糖化血红蛋白(HbAlc)水平,并计算HOMA-IR和HOMA-β,使用全自动生化分析仪检测血清肝功能指标。结果在治疗后,观察组FPG水平为(6.3±3.9)mmol/L,显著低于对照组【(7.8±1.2)mmol/L,P<0.05】,2 h PG水平为(8.4±2.6)mmol/L,显著低于对照组【(11.5±2.8)mmol/L,P<0.05】,和HbAlc水平为(7.1±1.6)%,显著低于对照组【(8.3±1.9)%,P<0.05】;治疗后,观察组HOMA-IR为(1.5±0.2),显著低于对照组【(2.4±03),P<0.05】,而HOMA-β水平为(42.9±8.7),显著高于对照组【(33.5±7.2),P<0.05】;观察组血清谷丙转氨酶(ALT)水平为(53.9±13.7)U/L,显著低于对照组【(72.2±19.6)U/L,P<0.05】,谷草转氨酶(AST)水平为(22.1±6.3)U/L,显著低于对照组【(46.4±6.9)U/L,P<0.05】,两组谷氨酰转肽酶、总胆红素和白蛋白水平无显著变化(P>0.05)。结论应用利格列汀联合门冬胰岛素50治疗非酒精性脂肪性肝病合并肝源性糖尿病患者能显著改善血糖水平,有效降低HOMA-IR,升高HOMA-β,改善了胰岛β细胞功能,从而改善患者的肝功能,具有良好的治疗效果。
文摘目的探讨艾塞那肽结合胰岛素在血糖控制不佳的2型糖尿病患者中的应用效果。方法180例血糖控制不佳的2型糖尿病患者,以随机数字表法分为观察组和对照组,每组90例。对照组采用胰岛素联合二甲双胍治疗,观察组采用艾塞那肽联合胰岛素治疗。比较两组患者临床疗效及治疗前后血糖指标[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]与胰岛功能指标[胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]。结果观察组患者临床总有效率为96.67%,高于对照组的86.67%,差异具有统计学意义(P<0.05)。治疗后,观察组患者FBG、2 h PG、HbA1c水平分别为(7.12±1.36)mmol/L、(8.63±1.75)mmol/L、(7.26±0.94)%,均低于对照组的(8.65±1.26)mmol/L、(10.02±2.14)mmol/L、(8.53±1.03)%,差异具有统计学意义(P<0.05)。治疗后,观察组患者HOMA-β(63.25±13.21)%高于对照组的(59.32±11.30)%,HOMA-IR(3.21±0.98)低于对照组的(3.96±1.32),差异具有统计学意义(P<0.05)。结论对于血糖控制不佳的2型糖尿病患者,采用艾塞那肽结合胰岛素治疗能够降低患者血糖水平,提高治疗效果,改善患者胰岛功能及预后,值得临床推广。
