· AIM: to determine the frequency and causes of blindness in diabetic Africans. ·METHODS: The study was a cross-sectional survey carried out among known black diabetics consecutively admitted at the Teaching...· AIM: to determine the frequency and causes of blindness in diabetic Africans. ·METHODS: The study was a cross-sectional survey carried out among known black diabetics consecutively admitted at the Teaching Hospital, University of Kinshasa, between 2005 and 2007. Examination methods included interviewer -administered structured question - naire, eye examinations (visual acuity, tonometry, funduscopy), and fasting plasma glycaemia test. ·RESULTS: Of the 227 patients examined, 15.9% had blindness. Univariate analyses showed significant association between female, severity of diabetic retinopathy, Mayombian ethnic group, use of insulin treatment, low intake of vegetables, diabetic nephropathy, open angle glaucoma and blindness in all diabetics. After logistic regression, only diabetic nephropathy, use of insulin treatment, macular oedema, Mayombian ethnic group and vegetables low intake were the independent risk factors of blindness in all diabetics. However, after logistic regression in the sub -group with diabetic retinopathy, only open angle glaucoma and proliferative diabetic retinopathy were the independent determinants of blindness.·CONCLUSION: The majority of the causes of blindness in these diabetic Africans are avoidable. It is recommended that appropriate diabetes care, nutrition education, periodic eye examination and laser photocoagulation facilities should be provided for treating diabetics in sub-Saharan Africa. ·展开更多
The aim of the study was to evaluate the behavioral signs of diabetic rats after treatment by Artemisia herba-alba (AHA) and insulin. Method: Based on the induction of diabetes in wistar rats by intraperitoneal (I/P) ...The aim of the study was to evaluate the behavioral signs of diabetic rats after treatment by Artemisia herba-alba (AHA) and insulin. Method: Based on the induction of diabetes in wistar rats by intraperitoneal (I/P) injection of 60 mg/kg streptozotocin (STZ), then treated by AHA as 20 mg (I/P) and insulin subcutaneously (S/C). The samples of rats were: 1) Diabetic control, 2) Injected with insulin, 3) Injected with AHA, 4) Non diabetic rats, which were fostered for 21 day;then weighted and the behavioral tests were conducted. Results: The board hole tests (BHT) showed that: the induced diabetes reduced the cognition of the rats in view of Latency of the First Head Dipping (LFHD) in seconds, number of head dipping (NHD) and duration of head dipping (DHD) by 49.3%, while it’s improved in AHA and insulin treated rats by 52% and 69% in average respectively. The exploratory activity reduced in diabetic rats by 36%, while AHA and Insulin treated rats increased by 53% and 72% respectively. The rearing test showed an increase of anxiety among diabetic in form of duration of rearing, number of rearing and time spend in center by 51.7% in average respectively, while the anxiety reduced after treatment by AHA and insulin by 39% and 47.3% in average respectively. Also the diabetes increased the depression state by 106%, while the treatment by AHA and insulin reduced the depression state by 77% and 88% respectively. And VPT showed that: motor impairment occurred in diabetic cases and improved after AHA and insulin treatment.展开更多
Objective: The main aim of the survey was to assess diabetes treatment-related myths prevalent in the Indian population and if COVID-19 pandemic improved their knowledge about diabetes. Results: The survey was complet...Objective: The main aim of the survey was to assess diabetes treatment-related myths prevalent in the Indian population and if COVID-19 pandemic improved their knowledge about diabetes. Results: The survey was completed by 309 participants;66% did not have diabetes. The responses of people with diabetes and those without diabetes were similar. Survey results of the total population showed that the majority believed that diabetes treatment should start early (92.6%);87.4% believed that the treatment should start within three months of diagnosis with modern medicines;67.3% of the participants felt that allopathic medicines for diabetes were safe, 69.6% believed that if started these medications continue lifelong, and 40.5% thought they damaged all major organs. Insulin was thought to be safe by 65% of the surveyed population;60.8% believed that if they started insulin, they would need it life-long;51.5% thought that insulin was started at the last stage of diabetes;and 58.6% believed that insulin caused kidney damage. A total of 58.6% believed that herbal medicines for diabetes were safer than allopathic;76.4% did not believe that the “diabetic cure” shown through television/newspapers was safe and effective;67.3% did not believe that ayurvedic medicines cured diabetes. Of the surveyed population, 67% felt that their knowledge about diabetes improved during the pandemic and 89.3% knew that PWDs have more serious problems with covid infection. Conclusions: Our survey shows that many diabetes treatment-related myths are prevalent in the Indian population even though the COVID-19 pandemic improved their knowledge about diabetes.展开更多
Type 1 Diabetes Mellitus remains one of the most complex chronic diseases in childhood. Although advances in knowledge and technology, as the use of insulin pumps or glucose sensors, have improved the quality of life ...Type 1 Diabetes Mellitus remains one of the most complex chronic diseases in childhood. Although advances in knowledge and technology, as the use of insulin pumps or glucose sensors, have improved the quality of life of patients, the onset of the disease, as well as long-term treatment and diet, are pitfalls for families and clinicians. It is important to bear in mind that acute, life-threatening consequences of uncontrolled diabetes are hyperglycemia with ketoacidosis, both in new diagnosis and in patients already on treatment, and may be hidden by other symptoms. Moreover, treatment with insulin and diet should always be tailored on lifestyle habits and age of the patient. Aim of this work is to briefly summarise and comment what are the worst insidious aspects of Diabetes and what are the best strategies to improve the management of the disease in childhood.展开更多
It is now widely recognized that chronic hepatitis C (CHC)is associated with insulin resistance(IR)and type 2 diabetes,so can be considered a metabolic disease.IR is most strongly associated with hepatitis C virus(HCV...It is now widely recognized that chronic hepatitis C (CHC)is associated with insulin resistance(IR)and type 2 diabetes,so can be considered a metabolic disease.IR is most strongly associated with hepatitis C virus(HCV)genotype 1,in contrast to hepatic steatosis, which is associated with genotype 3 infection.Apart from the well-described complications of diabetes,IR in CHC predicts faster progression to fibrosis and cirrhosis that may culminate in liver failure and hepatocellular carcinoma.More recently,it has been recognized that IR in CHC predicts a poor response to antiviral therapy. The molecular mechanisms for the association between IR and HCV infection are not well defined.This review will elaborate on the clinical associations between CHC and IR and summarize current knowledge regarding the molecular mechanisms that potentially mediate HCV-associated IR.展开更多
Insulin resistance is one of the pathological features in patients with hepatitis C virus(HCV) infection.Generally,persistence of insulin resistance leads to an increase in the risk of life-threatening complications s...Insulin resistance is one of the pathological features in patients with hepatitis C virus(HCV) infection.Generally,persistence of insulin resistance leads to an increase in the risk of life-threatening complications such as cardiovascular diseases.However,these complications are not major causes of death in patients with HCV-associated insulin resistance.Indeed,insulin resistance plays a crucial role in the development of various complications and events associated with HCV infection.Mounting evidence indicates that HCV-associated insulin resistance may cause(1) hepatic steatosis;(2) resistance to anti-viral treatment;(3) hepatic f ibrosis and esophageal varices;(4) hepatocarcinogenesis and proliferation of hepatocellular carcinoma;and(5) extrahepatic manifestations.Thus,HCV-associated insulin resistance is a therapeutic target at any stage of HCV infection.Although the risk of insulin resistance in HCV-infected patients has been documented,therapeutic guidelines for preventing the distinctive complications of HCV-associated insulin resistance have not yet been established.In addition,mechanisms for the development of HCV-associated insulin resistance differ from lifestyle-associated insulin resistance.In order to ameliorate HCV-associated insulin resistance and its complications,the eff icacy of the following interventions is discussed:a late evening snack,coffee consumption,dietary iron restriction,phlebotomy,and zinc supplements.Little is known regarding the effect of anti-diabetic agents on HCV infection,however,a possible association between use of exogenous insulin or a sulfonylurea agent and the development of HCC has recently been reported.On the other hand,insulin-sensitizing agents are reported to improve sustained virologic response rates.In this review,we summarize distinctive complications of,and therapeutic strategies for,HCVassociated insulin resistance.Furthermore,we discuss supplementation with branched-chain amino acids as a unique insulin-sensitizing strategy for patients with HCVassociated insulin resistance.展开更多
AIM To summarise the literature data on hepatitis C virus(HCV)-infected patients concerning the prevalence of glucose abnormalities and associated risk.METHODS We conducted a PubM ed search and selected all studies fo...AIM To summarise the literature data on hepatitis C virus(HCV)-infected patients concerning the prevalence of glucose abnormalities and associated risk.METHODS We conducted a PubM ed search and selected all studies found with the key words "HCV" or "hepatitis C virus" and "diabetes" or "insulin resistance". We included only comparative studies written in English or in French, published from January 2000 to April 2015. We collected the literature data on HCV-infected patients concerning the prevalence of glucose abnormalities [diabetes mellitus (DM) and insulin resistance (IR)] and associated risk [i.e., severe liver fibrosis, response to antivirals, and the occurrence of hepatocellular carcinoma(HCC)]. RESULTS HCV infection is significantly associated with DM/IR compared with healthy volunteers and patients with hepatitis B virus infection. Glucose abnormalities were associated with advanced liver fibrosis, lack of sustained virologic response to interferon alfa-based treatment and with a higher risk of HCC development. As new antiviral therapies may offer a cure for HCV infection, such data should be taken into account, from a therapeutic and preventive point of view, for liver and non-liver consequences of HCV disease. The efficacy of antidiabetic treatment in improving the response toantiviral treatment and in decreasing the risk of HCC has been reported by some studies but not by others. Thus, the effects of glucose abnormalities correction in reducing liver events need further studies.CONCLUSION Glucose abnormalities are strongly associated with HCV infection and show a negative impact on the main liver related outcomes.展开更多
AIM:To evaluate the impact on glucose variability(GLUCV)of an nurse-implemented insulin infusion protocol when compared with a conventional insulin treatment during the day-to-day clinical activity.METHODS:We enrolled...AIM:To evaluate the impact on glucose variability(GLUCV)of an nurse-implemented insulin infusion protocol when compared with a conventional insulin treatment during the day-to-day clinical activity.METHODS:We enrolled 44 type 2 diabetic patients(n=32 males;n=12 females)with acute coronary syndrome(ACS)and randomy assigned to standard a subcutaneous insulin treatment(n=23)or a nurse-implemented continuous intravenous insulin infusion protocol(n=21).We utilized some parameters of GLUCV representing well-known surrogate markers of prognosis,i.e.,glucose standard deviation(SD),the mean dailyδglucose(mean of daily difference between maximum and minimum glucose),and the coefficient of variation(CV)of glucose,expressed as percent glucose(SD)/glu-cose(mean).RESULTS:At the admission,first fasting blood glucose,pharmacological treatments(insulin and/or anti-diabetic drugs)prior to entering the study and basal glycated hemoglobin(HbA1c)were observed in the two groups treated with subcutaneous or intravenous insulin infusion,respectively.When compared with patients submitted to standard therapy,insulin-infused patients showed both increased first 24-h(median 6.9 mmol/L vs 5.7mmol/L P<0.045)and overall hospitalizationδglucose(median 10.9 mmol/L vs 9.3 mmol/L,P<0.028),with a tendency to a significant increase in first 24-h glycaemic CV(23.1%vs 19.6%,P<0.053).Severe hypoglycaemia was rare(14.3%),and it was observed only in 3 patients receiving insulin infusion therapy.HbA1c values measured during hospitalization and 3 mo after discharge did not differ in the two groups of treatment.CONCLUSION:Our pilot data suggest that no real benefit in terms of GLUCV is observed when routinely managing blood glucose by insulin infusion therapy in type 2 diabetic ACS hospitalized patients in respect to conventional insulin展开更多
文摘· AIM: to determine the frequency and causes of blindness in diabetic Africans. ·METHODS: The study was a cross-sectional survey carried out among known black diabetics consecutively admitted at the Teaching Hospital, University of Kinshasa, between 2005 and 2007. Examination methods included interviewer -administered structured question - naire, eye examinations (visual acuity, tonometry, funduscopy), and fasting plasma glycaemia test. ·RESULTS: Of the 227 patients examined, 15.9% had blindness. Univariate analyses showed significant association between female, severity of diabetic retinopathy, Mayombian ethnic group, use of insulin treatment, low intake of vegetables, diabetic nephropathy, open angle glaucoma and blindness in all diabetics. After logistic regression, only diabetic nephropathy, use of insulin treatment, macular oedema, Mayombian ethnic group and vegetables low intake were the independent risk factors of blindness in all diabetics. However, after logistic regression in the sub -group with diabetic retinopathy, only open angle glaucoma and proliferative diabetic retinopathy were the independent determinants of blindness.·CONCLUSION: The majority of the causes of blindness in these diabetic Africans are avoidable. It is recommended that appropriate diabetes care, nutrition education, periodic eye examination and laser photocoagulation facilities should be provided for treating diabetics in sub-Saharan Africa. ·
文摘The aim of the study was to evaluate the behavioral signs of diabetic rats after treatment by Artemisia herba-alba (AHA) and insulin. Method: Based on the induction of diabetes in wistar rats by intraperitoneal (I/P) injection of 60 mg/kg streptozotocin (STZ), then treated by AHA as 20 mg (I/P) and insulin subcutaneously (S/C). The samples of rats were: 1) Diabetic control, 2) Injected with insulin, 3) Injected with AHA, 4) Non diabetic rats, which were fostered for 21 day;then weighted and the behavioral tests were conducted. Results: The board hole tests (BHT) showed that: the induced diabetes reduced the cognition of the rats in view of Latency of the First Head Dipping (LFHD) in seconds, number of head dipping (NHD) and duration of head dipping (DHD) by 49.3%, while it’s improved in AHA and insulin treated rats by 52% and 69% in average respectively. The exploratory activity reduced in diabetic rats by 36%, while AHA and Insulin treated rats increased by 53% and 72% respectively. The rearing test showed an increase of anxiety among diabetic in form of duration of rearing, number of rearing and time spend in center by 51.7% in average respectively, while the anxiety reduced after treatment by AHA and insulin by 39% and 47.3% in average respectively. Also the diabetes increased the depression state by 106%, while the treatment by AHA and insulin reduced the depression state by 77% and 88% respectively. And VPT showed that: motor impairment occurred in diabetic cases and improved after AHA and insulin treatment.
文摘Objective: The main aim of the survey was to assess diabetes treatment-related myths prevalent in the Indian population and if COVID-19 pandemic improved their knowledge about diabetes. Results: The survey was completed by 309 participants;66% did not have diabetes. The responses of people with diabetes and those without diabetes were similar. Survey results of the total population showed that the majority believed that diabetes treatment should start early (92.6%);87.4% believed that the treatment should start within three months of diagnosis with modern medicines;67.3% of the participants felt that allopathic medicines for diabetes were safe, 69.6% believed that if started these medications continue lifelong, and 40.5% thought they damaged all major organs. Insulin was thought to be safe by 65% of the surveyed population;60.8% believed that if they started insulin, they would need it life-long;51.5% thought that insulin was started at the last stage of diabetes;and 58.6% believed that insulin caused kidney damage. A total of 58.6% believed that herbal medicines for diabetes were safer than allopathic;76.4% did not believe that the “diabetic cure” shown through television/newspapers was safe and effective;67.3% did not believe that ayurvedic medicines cured diabetes. Of the surveyed population, 67% felt that their knowledge about diabetes improved during the pandemic and 89.3% knew that PWDs have more serious problems with covid infection. Conclusions: Our survey shows that many diabetes treatment-related myths are prevalent in the Indian population even though the COVID-19 pandemic improved their knowledge about diabetes.
文摘目的 分析2型糖尿病(T2DM)采取长效胰岛素+口服降糖药治疗的效果。方法 96例T2DM患者,随机分为观察组和对照组,每组48例。对照组给予口服降糖药治疗,观察组给予长效胰岛素+口服降糖药治疗。比较两组患者治疗前后的血糖[糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h PG)、空腹血糖(FPG)]水平、生活质量(总体健康、精力、社会功能、心理健康、躯体疼痛、躯体角色功能、情绪角色功能、躯体健康)评分以及不良反应发生情况(体重增加、低血糖)、治疗效果。结果 治疗后,观察组患者HbA1c(6.20±0.91)%、2 h PG(8.63±1.37)mmol/L、FPG(5.83±0.72)mmol/L均低于对照组的(8.34±1.15)%、(9.56±1.60)mmol/L、(7.91±1.31)mmol/L,差异具有统计学意义(P<0.05)。观察组不良反应发生率2.08%(1/48)低于对照组的14.58%(7/48),差异具有统计学意义(χ^(2)=4.909,P<0.05)。治疗后,观察组患者总体健康评分(63.25±4.48)分、精力评分(74.25±4.54)分、社会功能评分(83.67±3.91)分、心理健康评分(81.48±4.25)分、躯体疼痛评分(74.48±6.38)分、躯体角色功能评分(73.54±4.18)分、情绪角色功能评分(84.54±3.67)分、躯体健康评分(71.37±4.28)分;对照组患者总体健康评分(54.54±3.25)分、精力评分(61.22±4.01)分、社会功能评分(76.32±2.75)分、心理健康评分(61.24±3.75)分、躯体疼痛评分(66.58±4.70)分、躯体角色功能评分(61.24±4.42)分、情绪角色功能评分(73.05±2.50)分、躯体健康评分(52.31±2.76)分。观察组患者总体健康、精力、社会功能、心理健康、躯体疼痛、躯体角色功能、情绪角色功能、躯体健康评分均高于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率95.83%高于对照组的79.17%,差异具有统计学意义(P<0.05)。结论 长效胰岛素联合口服降糖药物对T2DM治疗可有效改善血糖水平,降低不良反应发生率,提升疗效。
文摘Type 1 Diabetes Mellitus remains one of the most complex chronic diseases in childhood. Although advances in knowledge and technology, as the use of insulin pumps or glucose sensors, have improved the quality of life of patients, the onset of the disease, as well as long-term treatment and diet, are pitfalls for families and clinicians. It is important to bear in mind that acute, life-threatening consequences of uncontrolled diabetes are hyperglycemia with ketoacidosis, both in new diagnosis and in patients already on treatment, and may be hidden by other symptoms. Moreover, treatment with insulin and diet should always be tailored on lifestyle habits and age of the patient. Aim of this work is to briefly summarise and comment what are the worst insidious aspects of Diabetes and what are the best strategies to improve the management of the disease in childhood.
基金Supported by Australian National Health and Medical Research Council and the Robert W Storr Bequest to the University of Sydney
文摘It is now widely recognized that chronic hepatitis C (CHC)is associated with insulin resistance(IR)and type 2 diabetes,so can be considered a metabolic disease.IR is most strongly associated with hepatitis C virus(HCV)genotype 1,in contrast to hepatic steatosis, which is associated with genotype 3 infection.Apart from the well-described complications of diabetes,IR in CHC predicts faster progression to fibrosis and cirrhosis that may culminate in liver failure and hepatocellular carcinoma.More recently,it has been recognized that IR in CHC predicts a poor response to antiviral therapy. The molecular mechanisms for the association between IR and HCV infection are not well defined.This review will elaborate on the clinical associations between CHC and IR and summarize current knowledge regarding the molecular mechanisms that potentially mediate HCV-associated IR.
基金Supported by (in part) A Grant-in-Aid for Young Scientists (B),No. 19790643 to Kawaguchi Ta Grant-in-Aid for Scientif ic Research (C),No. 21590865 to Sata M,from the Ministry of Education,Culture,Sports,Science and Technology of Japan+1 种基金Health and Labour Sciences Research Grants for Research on Hepatitis from the Ministry of Health,Labour and Welfare of Japana Grant for Cancer Research from Fukuoka Cancer Society
文摘Insulin resistance is one of the pathological features in patients with hepatitis C virus(HCV) infection.Generally,persistence of insulin resistance leads to an increase in the risk of life-threatening complications such as cardiovascular diseases.However,these complications are not major causes of death in patients with HCV-associated insulin resistance.Indeed,insulin resistance plays a crucial role in the development of various complications and events associated with HCV infection.Mounting evidence indicates that HCV-associated insulin resistance may cause(1) hepatic steatosis;(2) resistance to anti-viral treatment;(3) hepatic f ibrosis and esophageal varices;(4) hepatocarcinogenesis and proliferation of hepatocellular carcinoma;and(5) extrahepatic manifestations.Thus,HCV-associated insulin resistance is a therapeutic target at any stage of HCV infection.Although the risk of insulin resistance in HCV-infected patients has been documented,therapeutic guidelines for preventing the distinctive complications of HCV-associated insulin resistance have not yet been established.In addition,mechanisms for the development of HCV-associated insulin resistance differ from lifestyle-associated insulin resistance.In order to ameliorate HCV-associated insulin resistance and its complications,the eff icacy of the following interventions is discussed:a late evening snack,coffee consumption,dietary iron restriction,phlebotomy,and zinc supplements.Little is known regarding the effect of anti-diabetic agents on HCV infection,however,a possible association between use of exogenous insulin or a sulfonylurea agent and the development of HCC has recently been reported.On the other hand,insulin-sensitizing agents are reported to improve sustained virologic response rates.In this review,we summarize distinctive complications of,and therapeutic strategies for,HCVassociated insulin resistance.Furthermore,we discuss supplementation with branched-chain amino acids as a unique insulin-sensitizing strategy for patients with HCVassociated insulin resistance.
文摘AIM To summarise the literature data on hepatitis C virus(HCV)-infected patients concerning the prevalence of glucose abnormalities and associated risk.METHODS We conducted a PubM ed search and selected all studies found with the key words "HCV" or "hepatitis C virus" and "diabetes" or "insulin resistance". We included only comparative studies written in English or in French, published from January 2000 to April 2015. We collected the literature data on HCV-infected patients concerning the prevalence of glucose abnormalities [diabetes mellitus (DM) and insulin resistance (IR)] and associated risk [i.e., severe liver fibrosis, response to antivirals, and the occurrence of hepatocellular carcinoma(HCC)]. RESULTS HCV infection is significantly associated with DM/IR compared with healthy volunteers and patients with hepatitis B virus infection. Glucose abnormalities were associated with advanced liver fibrosis, lack of sustained virologic response to interferon alfa-based treatment and with a higher risk of HCC development. As new antiviral therapies may offer a cure for HCV infection, such data should be taken into account, from a therapeutic and preventive point of view, for liver and non-liver consequences of HCV disease. The efficacy of antidiabetic treatment in improving the response toantiviral treatment and in decreasing the risk of HCC has been reported by some studies but not by others. Thus, the effects of glucose abnormalities correction in reducing liver events need further studies.CONCLUSION Glucose abnormalities are strongly associated with HCV infection and show a negative impact on the main liver related outcomes.
基金Supported by Fondazione CNR/Regione Toscana G Monasterio
文摘AIM:To evaluate the impact on glucose variability(GLUCV)of an nurse-implemented insulin infusion protocol when compared with a conventional insulin treatment during the day-to-day clinical activity.METHODS:We enrolled 44 type 2 diabetic patients(n=32 males;n=12 females)with acute coronary syndrome(ACS)and randomy assigned to standard a subcutaneous insulin treatment(n=23)or a nurse-implemented continuous intravenous insulin infusion protocol(n=21).We utilized some parameters of GLUCV representing well-known surrogate markers of prognosis,i.e.,glucose standard deviation(SD),the mean dailyδglucose(mean of daily difference between maximum and minimum glucose),and the coefficient of variation(CV)of glucose,expressed as percent glucose(SD)/glu-cose(mean).RESULTS:At the admission,first fasting blood glucose,pharmacological treatments(insulin and/or anti-diabetic drugs)prior to entering the study and basal glycated hemoglobin(HbA1c)were observed in the two groups treated with subcutaneous or intravenous insulin infusion,respectively.When compared with patients submitted to standard therapy,insulin-infused patients showed both increased first 24-h(median 6.9 mmol/L vs 5.7mmol/L P<0.045)and overall hospitalizationδglucose(median 10.9 mmol/L vs 9.3 mmol/L,P<0.028),with a tendency to a significant increase in first 24-h glycaemic CV(23.1%vs 19.6%,P<0.053).Severe hypoglycaemia was rare(14.3%),and it was observed only in 3 patients receiving insulin infusion therapy.HbA1c values measured during hospitalization and 3 mo after discharge did not differ in the two groups of treatment.CONCLUSION:Our pilot data suggest that no real benefit in terms of GLUCV is observed when routinely managing blood glucose by insulin infusion therapy in type 2 diabetic ACS hospitalized patients in respect to conventional insulin