Diabetes empowerment scores among type 2 diabetes mellitus patients and its correlated factors: A cross-sectional study in a primary care setting in Malaysia

BACKGROUND There are limited studies on diabetes empowerment among type 2 diabetes patients,particularly in the primary care setting.AIM To assess the diabetes empowerment scores and its correlated factors among type 2 diabetes patients in a primary care clinic in Malaysia.METHODS This is a cross sectional study involving 322 patients with type 2 diabetes mellitus(DM)followed up in a primary care clinic.Systematic sampling method was used for patient recruitment.The Diabetes Empowerment Scale(DES)questionnaire was used to measure patient empowerment.It consists of three domains:(1)Managing the psychosocial aspect of diabetes(9 items);(2)Assessing dissatisfaction and readiness to change(9 items);and(3)Setting and achieving diabetes goal(10 items).A score was considered high if it ranged from 100 to 140.Data analysis was performed using SPSS version 25 and multiple linear regressions was used to identify the predictors of total diabetes empowerment scores.RESULTS The median age of the study population was 55 years old.56%were male and the mean duration of diabetes was 4 years.The total median score of the DES was 110[interquartile range(IQR)=10].The median scores of the three subscales were 40 with(IQR=4)for"Managing the psychosocial aspect of diabetes";36 with(IQR=3)for"Assessing dissatisfaction and readiness to change";and 34 with(IQR=5)for"Setting and achieving diabetes goal".According to multiple linear regressions,factors that had significant correlation with higher empowerment scores among type 2 diabetes patients included an above secondary education level(P<0.001),diabetes education exposure(P=0.003),lack of ischemic heart disease(P=0.017),and lower glycated hemoglobin(HbA1c)levels(P<0.001).CONCLUSION Diabetes empowerment scores were high among type 2 diabetes patients in this study population.Predictors for high empowerment scores included above secondary education level,diabetes education exposure,lack of ischemic heart disease status and lower HbA1c.

Nerve growth factor and inducible nitric oxide synthase expression in the mesencephalon and diencephalon, as well as visual-and auditory-related nervous tissues, in a macaque model of type 2 diabetes

The present study detected distribution and expression of nerve growth factor and inducible nitric oxide synthase in the mesencephalon and diencephalon, as well as visual- and auditory-related nervous tissues, in a macaque model of type 2 diabetes using immunohistochemistry. Results showed that nerve growth factor expression decreased, but inducible nitric oxide synthase expression increased, in the mesencephalon and diencephalon, as well as visual- and auditory- related nervous tissues. These results suggested that nerve growth factor and inducible nitric oxide synthase play an important role in regulating the development of diabetic visual- and auditory-related diseases.

Correlation of the retinopathy degree with the change of ocular surface and corneal nerve in patients with type 2 diabetes mellitus

AIM:To investigate the change of ocular surface and corneal nerve and their correlation in patients suffering from type 2 diabetes mellitus under different degrees of retinopathy.METHODS:Totally 129 type 2 diabetes mellitus patients(257 eyes)were included.They were divided into three groups:no diabetic retinopathy(NDR)group(33 cases,66 eyes),non-proliferative diabetic retinopathy(NPDR)group(32 cases,64 eyes),and proliferative diabetic retinopathy(PDR)group(34 cases,67 eyes).Healthy normal individuals were enrolled as controls(30 cases,60 eyes).Ocular Surface Disease Index(OSDI)questionnaire was completed by all subjects,and dry eye analyzer was applied to examine tear meniscus height(TMH),first tear break-up time(FTBUT),average tear break-up time(ATBUT),tear film lipid layer thickness classification,and meibomian gland loss(MGL)score.Corneal nerve fiber density(CNFD),corneal nerve branch density(CNBD),corneal nerve fiber length(CNFL),and corneal nerve fiber tortuosity(CNFT)were examined by in vivo confocal microscopy(IVCM).The differences and correlation among these parameters were analyzed.RESULTS:Total OSDI score,TMH,FTBUT,ATBUT,tear film lipid layer thickness,MGL score,CNFD,CNBD,CNFL,and CNFT were statistically different among the four groups(P<0.05).In NDR group,CNFL was positively correlated with TMH(r=0.493,both P<0.01)and ATBUT(r=0.437,P<0.05).CNFL in NPDR group was positively correlated with TMH(r=0.642,P<0.01)and ATBUT(r=0.6,P<0.01).CNFL in PDR group was positively correlated with TMH(r=0.364,P<0.05)and ATBUT(r=0.589,P<0.01),with low negative correlation with MGL score(r=-0.331,P<0.05).CONCLUSION:With the progression of diabetic retinopathy,TMH,BUT,lipid layer thickness,CNFL,CNFD,and CNBD gradually decreased,while total OSDI score,MGL score,and CNFT increased.CNFL is correlated with TMH and ATBUT in diabetic patients.

Evidence in Primary Prevention of Type 2 Diabetes Mellitus—What It Means for Primary Prevention of Type 2 Diabetes Mellitus Epidemic in Papua New Guinea

Type 2 diabetes is in epidemic proportion in Papua New Guinea. Although many people are at high-risk of developing diabetes, there is no diabetes prevention policy and services in Papua New Guinea to address this problem. A literature search was carried out to assess the available evidence in the primary prevention of type 2 diabetes mellitus among the population with pre-diabetes. The result shows that the primary preventative studies conducted on lifestyle modification and the use of metformin in prediabetes patients reduced overt type 2 diabetes mellitus. The application of the evidence in the prevention of the type 2 diabetes epidemic in Papua New Guinea, driven by a policy is feasible to address the diabetes epidemic.

Strategies for recruiting a sample of adults with type 2 diabetes from primary care clinics in rural Appalachia: Incorporating cultural competence

Background:Recruiting research participants from primary care in rural Appalachia is a major challenge and can be influenced by cultural characteristics,making it critically important to incorporate strategies of cultural competence in the overall design of clinical research.Objectives:The purpose of this paper is to describe culturally competent strategies used for recruitment and data collection with a sample of adults with type 2 diabetes from primary care settings in Appalachia.Design:The Purnell model of cultural competence and relevant literature served as a framework for study design.Four overarching approaches informed the organization of recruitment strategies and development of the data collection plan.Procedures:The approaches included selection of research sites,establishing collaborations,sustaining collaborative relationships,and enhancing understanding of benefits of participation.Four recruitment sites were selected based on potential to enhance diversification of participants;multiple steps were included in each of the three remaining approaches to build relationships and gain participation.A study log was maintained to provide evaluation data.Results:Recruitment took 14 months and a sample of 102 subjects provided consent with 101 participants providing complete data.Demographics were representative of the region except that African American participation was higher(6.9%)compared to current north central Appalachia(3%).Over 72%of participants indicated they would be interested in participating in future studies.Conclusions:These findings emphasize the importance of employing strategies for cultural competence in study design.Use of concepts from the Purnell model led to enhanced representativeness and potential for subsequent generalizability.

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.

Competences for self-care and self-control in diabetes mellitus type 2 in primary health care

The purpose of the guidelines of self-care and self-control of type 2 diabetes mellitus proposed by the Brazilian Ministry of Health is to strengthen and qualify users and health care professionals through the integrality and longitudinality of care with this disease.This article aims to present the self-care and self-control of people with type 2 diabetes mellitus in objective terms,taking into account the current recommen-dations based on scientific evidence and also from the subjective point of view,that is,emphasizing the aspects related to experience and subjectivity of these people.Next,we present the essential skills for self-care and self-control of users and professionals working in primary health care.

Primary Healthcare System of Pakistan: Challenges to Self-Management of Type 2 Diabetes

This review article is aimed at describing the primary healthcare system of Pakistan and its challenges in the face of epidemic of type 2 diabetes, focusing particularly on the middle-aged population of rural area of Pakistan. The main concern in Pakistan is that its middle-aged population is facing the onslaught of obesity and overweight due to lack of physical activity. In addition unhealthy eating habits making it more difficult for this population to control their weight. All these factors are contributing to a high risk of type 2 diabetes for the population of Pakistan. This article provides insight into the primary health care system of Pakistan and highlights its deficiencies by identifying that its primary healthcare system has a poor utilization of health care services, the poor accessibility to health system and poor management of diabetes by the healthcare system, gender disparity and inequity in the health care system. The primary objective of this study is to provide an overview of self-management of diabetes among the middle-aged population of Pakistan and to identify the overall deficiencies in the primary healthcare system, its delivery and access to the system, barriers to self-management of diabetes and quality of life in that region.

The correlation of deceleration capacity of rate with the cardiac function and micro-inflammatory state in patients with both primary hypertension and type 2 diabetes mellitus

Objective:To study the correlation of deceleration capacity of rate with the cardiac function and micro-inflammatory state in patients with both primary hypertension and type 2 diabetes mellitus.Methods: A total of 60 patients with both primary hypertension and type 2 diabetes mellitus who were treated in our hospital between May 2012 and February 2016 were collected as the observation group, and 50 patients with primary hypertension who were treated in our hospital during the same period were selected as the control group. According to the median of deceleration capacity of rate (DC), the observation group of patients were further divided into high DC group and low DC group (n=30). The 24 h dynamic electrocardiogram of the included patients were obtained to calculate the DC value;color Doppler diasonograph was used to measure the echocardiogram of the two groups, and obtain the left cardiac function indexes and strain rate indexes;enzyme-linked immunosorbent assay (ELISA) was used to detect the contents of serum pro-inflammatory factors and anti-inflammatory factors.Results: The DC value of observation group was lower than that of control group;left cardiac function indexes IVSTd, LVIDd and LVIDs levels of low DC group and high DC group were higher than those of control group, strain rate indexes SRs, SRe and Sra levels were lower than those of control group, and serum pro-inflammatory factors CRP, IL-6, IL-18 and PCT contents were higher than those of control group while anti-inflammatory factors IL-10 and IL-13 contents were lower than those of control group;IVSTd, LVIDd and LVIDs levels of low DC group were higher than those of high DC group, SRs, SRe and Sra levels were lower than those of high DC group, and serum CRP, IL-6, IL-18 and PCT contents were higher than those of high DC group while IL-10 and IL-13 contents were lower than those of high DC group.Conclusion:DC value is lower in patients with both primary hypertension and type 2 diabetes mellitus, and can intuitively reflect the cardiac function and systemic micro-inflammatory state.

Cognitive deficits and Alzheimer-like neuropathological impairments during adolescence in a rat model of type 2 diabetes mellitus

Numerous studies have shown that many patients who suffer from type 2 diabetes mellitus exhibit cognitive dysfunction and neuronal synaptic impairments. Therefore, growing evidence suggests that type 2 diabetes mellitus has a close relationship with occurrence and progression of neurodegeneration and neural impairment in Alzheimer＇s disease. However, the relationship between metabolic disorders caused by type 2 diabetes mellitus and neurodegeneration and neural impairments in Alzheimer＇s disease is still not fully determined. Thus, in this study, we replicated a type 2 diabetic animal model by subcutaneous injection of newborn Sprague-Dawley rats with monosodium glutamate during the neonatal period. At 3 months old, the Barnes maze assay was performed to evaluate spatial memory function. Microelectrodes were used to measure electrophysiological function in the hippocampal CA1 region. Western blot assay was used to determine expression levels of glutamate ionotropic receptor NMDA type subunit 2 A（GluN2A） and GluN2B in the hippocampus. Enzyme-linked immunosorbent assay was used to determine levels of interleukin-1β, tumor necrosis factor α, and interleukin-6 in the hippocampus and cerebral cortex, as well as hippocampal amyloid beta（Aβ）1-40 and Aβ_（1-42） levels. Our results showed that in the rat model of type 2 diabetes mellitus caused by monosodium glutamate exposure during the neonatal period, latency was prolonged and the number of errors increased in the Barnes maze. Further, latency was increased and time in the escape platform quadrant shortened. Number of times crossing the platform was also reduced in the Morris water maze. After high frequency stimulation of the hippocampus, synaptic transmission was inhibited, expression of GluN2A and GluN2B were decreased in the hippocampus, expression of interleukin 1β, interleukin 6, and tumor necrosis factor α was increased in the hippocampus and cortex, and levels of Aβ_（1-40） and Aβ_（1-42） were increased in the hippocampus. These findings confirm that type 2 diabetes mellitus induced by neonatal monosodium glutamate exposure results in Alzheimer-like neuropathological changes and further causes cognitive deficits and neurodegeneration in young adulthood.

Factors Associated with Peripheral Neuropathy in Type 2 Diabetes： Subclinical versus Confirmed Neuropathy

This study determined the prevalence of diabetic peripheral neuropathy(DPN) and subclinical DPN(s DPN) in patients with type 2 diabetes mellitus(T2DM) using nerve conduction study(NCS) as a diagnostic tool. We also investigated the factors associated with the development of s DPN and compared factors between the sD PN and confirmed DPN(cDPN). This cross-sectional study involved 240 T2DM patients who were successively admitted to the endocrinology wards of Wuhan Union Hospital over the period of January to December 2014. Data on the medical history, physical and laboratory examinations were collected. DPN was diagnosed using NCS. One-way ANOVA with least significant difference(LSD) analysis or chi-square tests was used to compare parameters among DNP-free, s DPN and c DPN patients. Independent factors associated with s DPN were determined using logistic regression. The results showed that 50.8% of the participants had DPN, and among them, 17.1% had sDPN. sDPN showed significant independent associations with age, height, HbA1c, presence of atherosclerosis and diabetic retinopathy. Patients with DPN differed significantly from those without DPN with respect to age, duration of disease(DOD), HbA1c, presence of atherosclerosis, diabetic retinopathy, nephropathy and hypertension. Patients with cDPN, relative to those with sDPN, had significantly longer DOD and higher prevalence of peripheral artery disease(PAD) and coronary artery disease(CAD). Our study suggests that a significant number of T2DM patients are affected by s DPN, and the development of this condition is associated with advanced age, tall stature, poor glycaemic control, presence of diabetic retinopathy and atherosclerosis. On the other hand, patients with cDPN tend to have a longer DOD and are more likely to suffer from PAD and CAD.

Ankle-brachial index and brachial-ankle pulse wave velocity are risk factors for ischemic stroke in patients with type 2 diabetes

The incidence of ischemic stroke in patients with diabetes is increasing. While brachial-ankle pulse wave velocity （BaPWV） and ankle-bra- chial index （ABI） are known to be associated with ischemic cardiovascular and cerebrovascular diseases, whether these measures predict the risk of ischemic cerebrovascular disease in diabetic patients remains unclear. 117 patients with type 2 diabetes were enrolled in this study. According to the results of head magnetic resonance imaging, the patients were divided into a diabetes-only group （n = 55） and a diabetes and ischemic stroke group （n = 62）. We then performed ABI and BaPWV examinations for all patients. Compared with the diabe- tes-only group, we found decreased ABI and increased BaPWV in the diabetes and ischemic stroke group. Multivariate logistic regression analyses revealed that BaPWV and ABI were risk factors for ischemic stroke in patients with type 2 diabetes. Our findings indicate that decreased ABI and increased BaPWV are objective indicators of increased risk of ischemic stroke in patients with type 2 diabetes.

HLA class Ⅱ alleles and risk for peripheral neuropathy in type 2 diabetes patients

The potential impact of human leukocyte antigen （HLA） genotype variations on development of diabetic peripheral neuropathy （DPN） is not well determined. This study aimed to identify the association of HLA class II alleles with DPN in type 2 diabetes （T2D） patients. Totally 106 T2D patients, 49 with DPN and 57 without DPN, and 100 ethnic-matched healthy controls were analyzed. Both groups of the patients were matched based on sex, age, body mass index （BMI） and duration of T2D. Polyneuropathy was diagnosed using electrodiagnostic methods. HLA-DRB1 and DQB1 genotyping was performed in all subjects by the polymerase chain reaction with sequence-specific primers （PCR-SSP） method. T2D patients with DPN showed higher frequencies of HLA-DRB1＊10 and DRB1＊12 alleles compared to control group （P = 0.04）. HLA-DQB1＊02 allele and HLA-DRB1＊07-DQB1＊02 haplotype were associated with a decreased risk for developing DPN in T2D patients （P = 0.02 and P = 0.05 respectively）. Also, patients with severe neuropathy showed higher frequencies of DRB1＊07 （P = 0.003） and DQB1＊02 （P = 0.02） alleles than those with mild-to-moderate form of neuropathy. The distribution of DRB 1 and DQB 1 alleles and haplotypes were not statistically different between all patients and healthy controls. Our findings implicate a possible protective role of HLA-DQB1＊02 allele and HLA-DRB1＊07-DQB1＊02 haplotype against development of peripheral neuropathy in T2D patients. Therefore, variations in HLA genotypes might be used as genetic markers for prediction and potentially management of neuropathy in T2D patients.

Sodium ozagrel and atorvastatin for type 2 diabetes patients with lacunar cerebral infarction

BACKGROUND The main pathological factor of cerebral infarction is atherosclerosis,which is the pathological process of chronic inflammatory diseases such as vascular smooth muscle hyperplasia,inflammatory cell infiltration,extracellular matrix increase,and thrombosis.At present,the focus of clinical treatment is anti-platelet aggregation and improving blood status,and current research is limited to improving symptoms only.AIM To observe the effect of sodium ozagrel and atorvastatin on type 2 diabetes patients with lacunar cerebral infarction.METHODS Eighty-two patients with type 2 diabetes and lacunar cerebral infarction admitted to our hospital from January 2018 to February 2020 were equally categorized into two groups according to their treatment method.The control group was administered atorvastatin,and the observation group was administered sodium ozagrel combined with atorvastatin.The National Institutes of Health stroke scale(NIHSS)score,activities of daily living(ADL)score,blood glucose,lipid levels,inflammatory factors,high-mobility group box 1(HMGB1)levels,paraoxonase-1(PON-1)levels,erythrocyte sedimentation rate(ESR),and macrophage migration inhibitory factor(MIF)levels were recorded before and after treatment.The total effective rate and adverse reaction rate of the two groups were analyzed.RESULTS The total effective rate of the observation group(94.00%)was significantly higher than that of the control group(80.00%)(χ2=3.998;P=0.046).The blood glucose indexes,total cholesterol levels,triglyceride levels,low-density lipoprotein cholesterol levels,high-sensitivity C-reactive protein levels,interleukin-1βlevels,tumor necrosis factor-αlevels,HMGB1 Levels,ESR,MIF levels,platelet aggregation rates,and plasma viscosity of the two groups decreased after treatment;however,high-density lipoprotein cholesterol and PON-1 Levels increased after treatment.After treatment,the blood glucose indexes;blood lipid indexes;inflammatory factors;HMGB1,PON-1,and MIF levels;ESR;platelet aggregation rate;and plasma viscosity of the observation group were better than those of the control group(P<0.05).After treatment,all patients in the observation group had higher ADL scores and lower NIHSS scores than those in the control group(P<0.05).CONCLUSION Sodium ozagrel with atorvastatin can reduce inflammatory reactions;regulate ESR and HMGB1,PON-1,and MIF levels;control blood glucose and lipid indexes;and alleviate nerve injury without increasing adverse effects of atorvastatin alone.

经皮耳穴-迷走神经刺激对2型糖尿病大鼠学习记忆能力和认知功能的影响

目的探讨经皮耳穴迷走神经刺激对2型糖尿病大鼠学习能力和认知功能的影响及可能作用机制。方法将32只SD大鼠随机分为空白组、模型组、耳缘非迷走神经刺激组、耳穴迷走神经刺激组,每组8只。除空白组外,其余组大鼠均采用链脲佐菌素+高脂法制备2型糖尿病模型。造模成功后,耳穴迷走神经刺激组在大鼠双侧耳甲腔进行电刺激,耳缘非迷走神经刺激组在大鼠双侧耳缘处进行电刺激,刺激强度均为2 mA,每次30 min,1次/d,持续3周。采用Morris水迷宫实验评价大鼠学习和记忆能力,HE染色观察海马组织形态,ELISA法检测海马组织中肿瘤坏死因子-α(TNF-α)含量,Western blot法检测海马组织中磷脂酰肌醇3-激酶(PI3K)、蛋白激酶B(Akt)表达情况。结果与空白组比较,模型组和耳缘非迷走神经刺激组大鼠逃避潜伏期均明显延长(P均<0.05),穿越平台次数均明显减少(P均<0.05);与模型组和耳缘非迷走神经刺激组比较,耳穴迷走神经刺激组大鼠水迷宫逃避潜伏期明显缩短(P均<0.05),穿越平台次数明显增多(P均<0.05)。与空白组比较,模型组大鼠海马组织中TNF-α含量明显升高(P<0.05),PI3K、Akt蛋白相对表达量均明显降低(P均<0.05);与模型组比较,耳穴迷走神经刺激组大鼠海马组织中TNF-α含量明显降低(P<0.05),PI3K、Akt蛋白相对表达量均明显升高(P均<0.05)。结论经皮耳穴迷走神经刺激可以改善2型糖尿病大鼠的学习能力和认知功能,机制可能与抑制炎症反应、激活PI3K/Akt信号通路有关。

成人高血压合并2型糖尿病和血脂异常基层防治中国专家共识(2024年版)

高血压、2型糖尿病、血脂异常被统称为“三高”,常同时存在于同一个体中,显著增加了患者的住院和死亡风险,以及相关疾病负担。因此,有必要对三者进行共同风险管理和规范治疗。基层医疗卫生机构是慢性病防治的“主战场”,现有临床证据对“三高”人群的基层预防、治疗及管理具有重要启示,但目前国内外尚无适用于基层的“三高”共管规范、共识和指南。北京高血压防治协会等4家学/协会组织基层医务人员,并邀请心血管、内分泌、药学及公共卫生等诸多领域专家/学者共同参与,广泛征询基层医务人员临床实践需求,在整合与评价“三高”基层防治相关证据的基础上,经过多轮讨论、修订与投票表决,形成了包含21条推荐意见的“三高”基层防治专家共识。本共识的推荐意见旨在提高基层医务人员的“三高”防治意识和能力,为基层医疗卫生机构开展“三高”防治提供科学的策略支持,为实施具有基层特色的“三高”共管奠定坚实基础。

神经营养因子联合他达拉非治疗2型糖尿病勃起功能障碍疗效及对血清神经生长因子脑源性神经营养因子血管内皮生长因子表达水平的影响

目的探讨神经营养因子联合他达拉非治疗2型糖尿病勃起功能障碍疗效及对血清神经生长因子(NGF)、脑源性神经营养因子(BDNF)、血管内皮生长因子(VEGF)表达水平的影响。方法回顾性选取2020年5月至2023年6月浙江省慈溪市龙山医院收治80例2型糖尿病勃起功能障碍患者为研究对象,按照治疗方法不同分为对照组(他达拉非治疗)40例;观察组(神经营养因子+他达拉非治疗)40例。比较2组临床疗效、血管内皮功能、血清神经营养因子、射精功能和精子质量、勃起功能障碍指数和勃起硬度以及性生活质量。结果治疗后观察组临床总有效高于对照组(χ^(2)=4.581、P=0.032);治疗8周后观察组血清内皮素(ET-1)低于对照组,6酮前列腺素F1a(6-keto-PGF1a)、前列环素(PGI2)、VEGF高于对照组(t=8.057、P<0.01,t=4.688、P<0.01,t=2.538、P=0.013,t=3.969、P<0.01);观察组NGF、BDNF、胶质源性神经营养因子(GDNF)水平高于对照组(t=2.094、P=0.039,t=2.124、P=0.037,t=2.876、P=0.005);观察组射精功能量表(CI-PE)评分高于对照组,精子数量、精子密度、精子活力大于对照组(t=2.459、P=0.016,t=2.821、P=0.006,t=3.370、P=0.001,t=4.181、P<0.01);观察组勃起功能指数(IIEF-5)、勃起硬度分级(EHGS)、性生活质量量表评分高于对照组(t=6.242、P<0.01,t=2.658、P=0.009,t=2.340、P=0.022)。结论神经营养因子联合他达拉非治疗2型糖尿病勃起功能障碍临床疗效显著,可有效提高血管内皮功能和血清神经营养因子水平,提高射精和勃起功能,以及提升性生活质量,安全性良好。

硫辛酸注射液联合甲钴胺治疗2型糖尿病周围神经病变患者的疗效及对神经传导速度的影响

目的:探讨硫辛酸注射液联合甲钴胺治疗2型糖尿病周围神经病变的效果。方法:选取2021年6月—2022年9月醴陵远恒医院糖尿病专科收治的2型糖尿病周围神经病变患者148例,按照信封法随机分为观察组(n=74)和对照组(n=74),两组均给予常规降糖措施。对照组给予甲钴胺治疗,观察组在对照组基础上给予硫辛酸注射液治疗。比较两组治疗前后血糖水平、神经病变主觉症状问卷(TSS)评分、神经传导速度和炎性因子水平等,比较两组不良反应。结果:治疗后两组空腹血糖、餐后2 h血糖、糖化血红蛋白水平和TSS评分以及C反应蛋白(CRP)和降钙素原(PCT)水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后两组腓神经和腓总神经运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率(9.46%)低于对照组(24.32%),差异有统计学意义(P<0.05)。结论:2型糖尿病周围神经病变患者采用硫辛酸注射液联合甲钴胺治疗效果好,可改善血糖水平,提高神经传导速度,降低炎症反应,减少不良反应,安全性较高。

Effects of a Community-Based Intervention on the Lifestyle and Health of People at Risk of Type 2 Diabetes in Benin

Introduction: Worldwide, the prevalence of type 2 diabetes (T2D) is increasing at an epidemic rate. The objective of this study was to measure the effects on lifestyle intervention in subjects at risk of T2D in a West African country. Methods: This study involved Beninese adults at risk of T2D randomly selected from 2 groups of villages: control villages and villages exposed to nutrition education, cooking demonstrations and physical activity sessions. Anthropometric, clinical, and biological measurements were taken in both groups at the beginning and end of the intervention, which lasted 12 months. The paired sample t-test was used to assess the effect of the intervention on the lifestyle of people at risk of T2D. Results: After 12 months of exposure to nutrition education, cooking demonstrations and physical activity sessions in the intervention villages, the mean body mass index, waist circumference, body fat percentage, blood glucose, triglycerides, total cholesterol and amount of alcohol consumed per week had significantly decreased. Conversely, the mean intensity of physical activity and food consumption score had significantly increased. In the control group, 5.6% of the people at risk developed to diabetes. The relative risk was RR = 0.20 [0.14 - 0.56]. Conclusion: The intervention significantly improved metabolic indicators, intensity of leisure activity and dietary score. We suggest larger studies to better assess the effect of community-based interventions on the lifestyle and health of people at risk of T2D in Africa.

硫辛酸联合维生素D_(2)应用于老年2型糖尿病伴糖尿病周围神经病患者的临床效果

目的:探讨硫辛酸联合维生素D_(2)应用于老年2型糖尿病伴糖尿病周围神经病患者的临床效果。方法:选择2021年3月—2023年9月于山东大学齐鲁医院(青岛)接受治疗的105例老年2型糖尿病伴糖尿病周围神经病患者作为研究对象,按照乱数表法将其分为观察组(n=53)和对照组(n=52)。对照组给予硫辛酸治疗,观察组给予硫辛酸联合维生素D_(2)治疗,比较两组临床疗效、血清学指标[血清同型半胱氨酸(Hcy)、空腹C肽(FCP)]、糖尿病神经病变症状评分、神经传导速度[右腓总神经运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)]及不良反应。结果:治疗后,观察组总有效率为96.23%,高于对照组的75.00%,差异有统计学意义(P<0.05)。治疗前,两组Hcy、FCP水平、MNCV、SNCV及灼烧感、疼痛、麻木、感觉异常评分比较,差异无统计学意义(P>0.05);治疗后,两组Hcy水平及灼烧感、疼痛、麻木、感觉异常评分低于治疗前,FCP水平及MNCV、SNCV高于治疗前,且观察组Hcy水平及灼烧感、疼痛、麻木、感觉异常评分均低于对照组,FCP水平及MNCV、SNCV均高于对照组,差异有统计学意义(P<0.05)。治疗期间,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:硫辛酸联合维生素D_(2)应用于老年2型糖尿病伴糖尿病周围神经病患者的疗效与安全性良好,能有效改善血清学指标和临床症状,并加快神经传导速度。