BACKGROUND Gastric cancer is one of the most common malignant tumors worldwide,and surgical resection is one of the main ways to treat gastric cancer.However,the immune status of postoperative patients is crucial for ...BACKGROUND Gastric cancer is one of the most common malignant tumors worldwide,and surgical resection is one of the main ways to treat gastric cancer.However,the immune status of postoperative patients is crucial for prognosis and survival,and immune cells play an important role in this process.Therefore,it is helpful to understand the immune status of postoperative patients by evaluating the levels of peripheral blood immune cells,especially total T cells(CD3+),helper T cells(CD3+CD4+),and suppressor T cells(CD3+CD8+),and its relationship to sur-vival.AIM To analyzed the immune cells in peripheral blood of patients with gastric cancer after surgery,detect the levels of total T cells,helper T cells and suppressor T cells.METHODS A total of 58 patients with gastric cancer who received surgical treatment were included in the retrospective study.Flow cytometry was used to detect the level of peripheral blood immune cells and analyze the correlation between total T cells,helper T cells and inhibitory T cells.To explore the relationship between these immune markers and patient survival.RESULTS The results showed that the levels of total T cells,helper T cells,and suppressor T cells changed in patients after gastric cancer surgery.There was a significant positive correlation between total T cells,helper T cells and suppressor T cells(r=0.35,P<0.01;r=0.56,P<0.01).However,there was a negative correlation between helper T cells and suppressor T cells(r=-0.63,P<0.01).Follow-up showed that the survival rate of patients in the high-level total T cell group was significantly higher than that in the low-level group(28.87±24.98 months vs 18.42±16.21 months).The survival curve shows that the curve of patients in the high-level group is shifted to the upper right,and that of the low-level group is shifted downward.There was no significant difference between the levels of helper T cells and suppressor T cells and patient survival time.CONCLUSION By detecting peripheral blood immune cells with flow cytometry,we can initially evaluate the immune status of patients after gastric cancer surgery and initially explore its relationship with patient survival.展开更多
To establish the parsimonious model for blood glucose monitoring in patients with type 2 diabetes receiving oral hypoglycemic agent treatment. One hundred and fifty-nine adult Chinese type 2 diabetes patients were ran...To establish the parsimonious model for blood glucose monitoring in patients with type 2 diabetes receiving oral hypoglycemic agent treatment. One hundred and fifty-nine adult Chinese type 2 diabetes patients were randomized to receive rapid-acting or sustained-release gliclazide therapy for 12 weeks.展开更多
Severe deterioration of liver function in patients can be characterized by coagulation disorders, jaundice, hepatic encephalopathy, ascites, and other symptoms. Severe liver injury can develop as acute liver failure, ...Severe deterioration of liver function in patients can be characterized by coagulation disorders, jaundice, hepatic encephalopathy, ascites, and other symptoms. Severe liver injury can develop as acute liver failure, subacute liver failure, acute-on-chronic liver failure, or further worsening of end-stage liver disease [1].展开更多
<strong>Background:</strong> In participating in the medical support work in the Nyingchi area of Tibet, the author found that the medical education resources in this area are scarce, and the clinical nurs...<strong>Background:</strong> In participating in the medical support work in the Nyingchi area of Tibet, the author found that the medical education resources in this area are scarce, and the clinical nurses in this area have relatively insufficient knowledge about blood glucose monitoring and management. Accurately understanding the knowledge-attitude/belief-practice (KAP) level of nurses in Nyingchi area on blood glucose management is of great significance to the development of blood glucose monitoring management guidance for nurses in this area. Therefore, this study investigated the current status of the management of blood glucose monitoring management standards for clinical nurses in Nyingchi, Tibet. Objective: To investigate and analyze the current situation of clinical nurses in Nyingchi region of Tibet to grasp the regulation of blood glucose monitoring and guide the implementation of the norm of blood glucose monitoring for clinical nurses. <strong>Methods: </strong>The research survey was carried out from March to April 2020. Random sampling method was used to select 134 clinical in-service nurses in Nyingchii, Tibet. The self-designed knowledge-attitude/belief-practice survey questionnaire for clinical nurses’ blood glucose monitoring and management in Tibet was used. Nurses’ blood glucose monitoring management “KAP” scores and related influencing factors are analyzed. <strong>Results: </strong>Blood sugar monitoring and management knowledge score is (36.78 ± 6.80), attitude dimension is (42.48 ± 6.42), practice dimension is (61.87 ± 10.24) and total score is (304.73 ± 36.24). The nurse’s department and whether to participate in diabetes training are the main influencing factors of the blood glucose monitoring management norms, knowledge and behavior (both P < 0.05). <strong>Conclusion: </strong>The standard knowledge of blood glucose monitoring and management of clinical nurses in Nyingchi region of Tibet is at the middle level, positive attitude and unsatisfactory behavior. Nursing managers should conduct standardized training for clinical nurses in blood glucose monitoring, develop the training mode of diabetes specialty nursing talents in Nyingchi area, and construct a complete management system of diabetes specialty nursing.展开更多
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. OB...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.展开更多
Semi-invasive blood sampling devices mimic the way female mosquitoes extract blood from a host. They generally consist of a microneedle, a microactuator for needle insertion, a blood extraction mechanism and a blood g...Semi-invasive blood sampling devices mimic the way female mosquitoes extract blood from a host. They generally consist of a microneedle, a microactuator for needle insertion, a blood extraction mechanism and a blood glucose sensor. These devices have great potential to overcome the major disadvantages of several current blood glucose monitoring methods. Over last two decades, extensive research has been made in all of these related fields. More recently, several wearable devices for semi-invasive blood sampling have been developed. This review aims at summarizing the current state-of-the-art development and utilization of such wearable devices for continuous monitoring of blood glucose levels, with a special attention on design considerations, fabrication technologies and testing methods.展开更多
Self-monitoring of blood glucose(SMBG)is critical for gestational diabetes mellitus(GDM)care.However,there are several hurdles to its practice during the coronavirus disease 2019(COVID-19)pandemic in GDM patients in l...Self-monitoring of blood glucose(SMBG)is critical for gestational diabetes mellitus(GDM)care.However,there are several hurdles to its practice during the coronavirus disease 2019(COVID-19)pandemic in GDM patients in low-and middle-income countries when GDM care recommendations emphasize telemedicine-based care.Based on available knowledge,this letter proposes the following barriers to SMBG in these GDM patients during the ongoing COVID-19 pandemic:Poor internet connectivity,affordability of SMBG and digital applications to connect with healthcare providers,government-imposed social mobility restriction,psychological stress,and mental health conditions.Nevertheless,definitive evidence will only be acquired from rigorous research.展开更多
Diabetes mellitus is a huge and significantly grow ing problem. Continuous and real-time monitoring of blood glucose plays a key role for the people with diabetes,which can help them to control glucose concentration m...Diabetes mellitus is a huge and significantly grow ing problem. Continuous and real-time monitoring of blood glucose plays a key role for the people with diabetes,which can help them to control glucose concentration more effectively. However,current blood glucose monitoring methods require blood by needle-pricking,which limit the detection frequency. It is necessary to develop non-invasive blood glucose monitoring methods to achieve the ideal therapeutic and management of diabetes. In this paper,the developments and challenges of non-invasive blood glucose monitoring technologies in recent years are reviewed. And the bottleneck and the developing trends are also analyzed.展开更多
AIM: Hyperglycemia commonly seen in liver transplantation (LT) has often been attributed to the dextrose in the storage solution of blood transfusion products. The purpose of the study is to compare the changes of the...AIM: Hyperglycemia commonly seen in liver transplantation (LT) has often been attributed to the dextrose in the storage solution of blood transfusion products. The purpose of the study is to compare the changes of the blood glucose levels in transfused and non-transfused patients during LT. METHODS: A retrospective study on 60 biliary pediatric patients and 16 adult patients undergoing LT was carried out. Transfused pediatric patients were included in Group Ⅰ (GⅠ), those not transfused in Group Ⅱ (GⅡ). Twelve adult patients were not given transfusion and assigned to Group Ⅲ(GⅢ); whereas, four adult patients who received massive transfusion were assigned to Group Ⅳ (GⅣ). The blood glucose levels, volume of blood transfused, and the volume of crystalloid infused were recorded, compared and analyzed. RESULTS: Results showed that the changes in blood glucose levels during LT for both non-transfused and minimally transfused pediatric groups and non-transfused and massively-transfused adult groups were almost the same. CONCLUSION: We conclude that blood transfusion does not cause significant changes in the blood glucose levels in this study.展开更多
Critically ill patients are prone to high glycemic variations irrespective of their diabetes status.This mandates frequent blood glucose(BG)monitoring and regulation of insulin therapy.Even though the most commonly em...Critically ill patients are prone to high glycemic variations irrespective of their diabetes status.This mandates frequent blood glucose(BG)monitoring and regulation of insulin therapy.Even though the most commonly employed capillary BG monitoring is convenient and rapid,it is inaccurate and prone to high bias,overestimating BG levels in critically ill patients.The targets for BG levels have also varied in the past few years ranging from tight glucose control to a more liberal approach.Each of these has its own fallacies,while tight control increases risk of hypoglycemia,liberal BG targets make the patients prone to hyperglycemia.Moreover,the recent evidence suggests that BG indices,such as glycemic variability and time in target range,may also affect patient outcomes.In this review,we highlight the nuances associated with BG monitoring,including the various indices required to be monitored,BG targets and recent advances in BG monitoring in critically ill patients.展开更多
Diabetes mellitus is a common chronic disease.With the improvement of living standards,the prevalence of diabetes mellitus in China is increasing.There are now more people with diabetes in China(>100 million)than i...Diabetes mellitus is a common chronic disease.With the improvement of living standards,the prevalence of diabetes mellitus in China is increasing.There are now more people with diabetes in China(>100 million)than in any other country.About half of these people with diabetes need to undergo at least one procedure in their lifetime.Diabetic patients have a much higher probability of perioperative dysglycemia than the normal population,which has a great impact on their prognosis.In addition,non-diabetic patients may also have abnormal blood glucose levels due to various reasons during the perioperative period,which will also lead to a series of adverse consequences.This ar ticle reviews the perioperative blood glucose management of patients to provide a reference for improving their health status.展开更多
Objective:This study aimed to evaluate the system accuracy of four types of blood glucose monitoring systems(BGMSs)and explore the differences in the system accuracy acceptability of each BGMS against five different s...Objective:This study aimed to evaluate the system accuracy of four types of blood glucose monitoring systems(BGMSs)and explore the differences in the system accuracy acceptability of each BGMS against five different standards.Methods:The glucose measurement values obtained from four types of BGMSs(Roche Accu-Chek® Performa,Bayer Contour™ TS,Sinomedisite Glupad® H1 Plus,and Sinocare® Gold-Accu)were evaluated against the reference values obtained from the biochemical analyzer of the central laboratory.The system accuracy acceptability of each BGMS was determined using the criteria specified in five standards,namely the International Organization for Standardization(ISO)15197:2003,Clinical Laboratory Standards Institute(CLSI)POCT12-A3,ISO 15197:2013,Chinese Society of Laboratory Medicine(CSLM)consensus,and US Food and Drug Administration(FDA)guidelines.Results:From 2018 to 2022,10,980 pairs of measurement values were obtained from 366 glucose meters of four types of BGMSs.Significant correlations were observed between the glucose measurement values from the BGMSs and the reference values from the biochemical analyzer of the central laboratory.The correlation coefficient r was 0.995 for Roche Accu-Chek® Performa,0.994 for Bayer Contour™ TS,0.983 for Sinomedisite Glupad® H1 Plus,and 0.997 for SinocareR Gold-Accu.The acceptability criteria specified in ISO 15197:2003 were met by 100.00%(135/135)of the glucose meters of Roche Accu-Chek® Performa,100.00%(109/109)of Bayer Contour™ TS,81.61%(71/87)of Sinomedisite Glupad® H1 Plus,and 100.00%(35/35)of SinocareR Gold-Accu.Whereas,the acceptability criteria specified in ISO 15197:2013 were met by 99.26%(134/135)of the glucose meters of Roche Accu-Chek® Performa,88.07%(96/109)of Bayer Contour™ TS,58.62%(51/87)of Sinomedisite Glupad R H1 Plus,and 91.43%(32/35)of SinocareR Gold-Accu.Conclusions:Among the four types of BGMSs evaluated,the glucose meters of Roche Accu-Chek® Performa exhibited superior system accuracy.The system accuracy acceptability of each BGMS varied significantly against the acceptability criteria specified in the five different standards.展开更多
Continuous blood glucose monitoring is important for the diagnosis,treatment,and study of diabetes. many organizations have been working on this subject in recent two decades. Glucose concentration in interstitial flu...Continuous blood glucose monitoring is important for the diagnosis,treatment,and study of diabetes. many organizations have been working on this subject in recent two decades. Glucose concentration in interstitial fluid is closely related to the blood glucose levels. Minimally invasive continuous blood glucose monitoring technology based on the glucose detection in interstitial fluid develops rapidly and gets more and more attentions from the patients and the doctors,due to its instantaneous real-time display of glucose level,"24/7"coverage,and the ability to characterize glycemic variability. According to the different detection methods,most of the continuous glucose monitoring technology could be divided into two kinds: subcutaneous implantation method and transdermal extraction method. This paper review s the recent development of minimally invasive blood glucose monitoring technology and instruments. The mainly remained challenges and related research directions are presented as well.展开更多
Objective:To evaluate the accuracy of Roche Accu-Chek Performa glucose meters at a low glucose concentration of<5.55 mmol/L(100 mg/dL)over a 9-year period.Methods:The accuracy of the Roche Accu-Chek Performa glucos...Objective:To evaluate the accuracy of Roche Accu-Chek Performa glucose meters at a low glucose concentration of<5.55 mmol/L(100 mg/dL)over a 9-year period.Methods:The accuracy of the Roche Accu-Chek Performa glucose meters at low glucose concentrations was evaluated using annual comparison data for 9 consecutive years from 2015 to 2023,according to the acceptability criteria specified in International Organization for Standardization(ISO)15197:2013.Blood samples with low glucose concentrations of<5.55 mmol/L were prepared by incubation and glycolysis.The glucose concentration was detected using Roche Accu-Chek Performa glucose meters and a biochemical analyzer in the central laboratory.Results:A total of 2978 pairs of comparison results from 211 glucose meters at a low glucose concentration of<5.55 mmol/L were retrospectively analyzed from 2015 to 2023.The clinical use duration spanned from 1 to 9 years and 40.76%(86 out of 211 glucose meters)had been used for more than 2 years.The correlation coefficient r between glucose meter measurements and laboratory reference values was 0.98(p<0.001).The mean according to Roche Accu-Chek Performa glucose meters was 0.05 mmol/L(0.9 mg/dL)higher than that of the biochemical analyzer(Z=-13.82,p<0.0001).The results showed that 100.00%(211 out of 211)of the Roche Accu-Chek Performa glucose meters met the acceptability criteria specified in ISO 15197:2013.At a low glucose concentration of<5.55 mmol/L,99.90%(2975 out of 2978)of the comparative data pairs in the error distribution fell within the range of±0.83 mmol/L(15 mg/dL).Parkes consensus error grid analysis showed that 100.00%(2978 out of 2978)of comparative data pairs fell within region A.Conclusions:This study demonstrated that Roche Accu-Chek Performa glucose meters successfully met the accuracy standards of ISO 15197:2013 for measuring blood glucose within the hypoglycemic range.Greater attention should be given to the performance of blood glucose monitoring systems in the low glycemic range,especially for patients with diabetes who are prone to hypoglycemia and require precise measurements.展开更多
Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To d...Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To determine the frequency of self-monitoring of blood glucose and to describe the errors found during self-monitoring in diabetic patients followed at the Endocrinology Department of Donka University Hospital in Guinea. Materials and methods: Descriptive cross-sectional study carried out between August and September 2020 involving diabetic patients followed up at the Endocrinology and Diabetology Department of the Donka National Hospital, CHU Conakry. Results: A total of 301 patients were enrolled, with an average age of 44.24 ± 21.01 years. 64.12% were female. Type 2 diabetes predominated in 64% of cases. The mean duration of diabetes was 6.14 ± 4.67 years, and 75.08% of patients lived in urban areas. Patients were on insulin in 36.21% of cases, insulin and biguanides (26.25%), hypoglycemic sulfonamide and biguanides (19.27%) and biguanides in 18.27% of cases. The frequency of self-monitoring of blood glucose was 43%, and 38% of patients made errors, notably reusing lancets (60%), not checking the expiration date (55.65%) and not washing their hands (48%). Conclusion: This study shows that self-monitoring of blood glucose is not performed by the majority of patients. Numerous errors were identified during blood glucose testing. Continued therapeutic education on the use of blood glucose meters will help empower patients and improve their quality of life.展开更多
Background Self-monitoring of blood glucose (SMBG) by individuals with type 2 diabetes (T2D) is crucial for long-term health,yet numerous cultural,economic and health factors can reduce SMBG.Most studies on SMBG a...Background Self-monitoring of blood glucose (SMBG) by individuals with type 2 diabetes (T2D) is crucial for long-term health,yet numerous cultural,economic and health factors can reduce SMBG.Most studies on SMBG adherence have come out of the US and Europe,and their relevance to Asia is unclear.The aims of the present study were to assess the current state of SMBG in China and analyze demographic and diabetes-related characteristics that may influence it.Methods In this multi-center,cross-sectional study,5 953 individuals with T2D from 50 medical centers in 29 provinces across China filled out a standardized questionnaire that requested information on demographic characteristics,education level,occupation,income,lifestyle risk factors,duration of diabetes,chronic complications,and frequency of SMBG.Respondents were also asked whether their glycosylated hemoglobin (HbA1c) had been checked in the past 6 months.The most recent values for fasting plasma glucose,2-hour postprandial blood glucose and HbA1c were recovered from medical records.Results Only 1 130 respondents (18.98%) performed SMBG with the recommended frequency,while 4 823 (81.02%) did not.In fact,nearly 2 105 (35.36%) reported never performing SMBG.In the subset of 3 661 individuals on insulin therapy,only 266 (7.27%) performed SMBG at least once a day,while 1 210 (33.05%) never performed it.In contrast,895 of 2 292 individuals (39.05%) on diet/exercise therapy or oral hypoglycemic therapy never performed it.Multivariate Logistic regression identified several factors associated with SMBG adherence:female gender,higher education level,higher income,longer T2D duration and education about SMBG.Conclusions SMBG adherence in our Chinese population with T2D was less frequent than that in developed countries.Several factors influence SMBG adherence:gender,education level,income,T2D duration,therapy regimen and exposure to education about SMBG.展开更多
Background: The information-motivation-behavioral skills (IMB) model of health behavior is an effective tool to evaluate the behavior of diabetes self-management. The purpose of this study was to explore behavioral...Background: The information-motivation-behavioral skills (IMB) model of health behavior is an effective tool to evaluate the behavior of diabetes self-management. The purpose of this study was to explore behavioral factors affecting the practice of self-monitoring of blood glucose (SMBG) within the frame of IMB model of health behavioral among adult patients with type 1 diabetes in a single diabetes clinic in China. Methods: A questionnaire with three subscales on SMBG information, motivation, and behavioral skills based on IMB model was developed. Validity and reliability of the measures were examined and guaranteed. Adult patients with type 1 diabetes visiting our diabetes clinic from January to March 2012 (n = 55) were consecutively interviewed. The self-completion questionnaires were administered and finished at face-to-face interviews among these patients. Both descriptive and correlational analyses were made. Results: Fifty-five patients finished the questionnaires, with the median duration of diabetes 4.5 years and the median of SMBG frequency 2.00. Specific SMBG information deficits, motivation obstacles, and behavioral skill limitations were identified in a substantial proportion of participants. Scores of SMBG motivation (r - 0.299, P = 0.026) and behavioral skills (r = 0.425, P = 0.001) were significantly correlated with SMBG frequency. The multiple correlation of SMBG information, SMBG motivation, and SMBG behavioral skills with SMBG frequency was R - 0.411 (R2 = 0.169, P = 0.023). Conclusions: Adult patients with type 1 diabetes in our clinic had substantial SMBG information deficits, motivation obstacles, and skill limitations. This information provided potential-focused education targets for diabetes health-care providers.展开更多
The authors would like to apologize for some mistakes in the letter on Chinese Optics Letters vol. 12, no. 11, page 111701 and wish to make the corrections described below:
OBJECTIVE:This meta-analysis was performed to systematically assess the efficacy and safety of the Chinese herbal medicine Huangqi Guizhi Wuwu Decoction(HGWWD) for treating diabetic peripheral neuropathy.DATA SOUR...OBJECTIVE:This meta-analysis was performed to systematically assess the efficacy and safety of the Chinese herbal medicine Huangqi Guizhi Wuwu Decoction(HGWWD) for treating diabetic peripheral neuropathy.DATA SOURCES:Six electronic databases,including the Cochrane Library,MEDLINE database,Chinese Biomedical Database,Chinese National Knowledge Infrastructure Database,Chinese Science and Technique Journals Database,and the Wanfang Database,were search ed on the internet for randomized controlled trials published up until 1 December 2015.The search terms included "Chinese herbal medicine","diabetic peripheral neuropathy" and "randomized controlled trials" in Chinese and in English.DATA SELECTION:We included randomized controlled trials using HGWWD/modified HGWWD for the treatment group,without restriction for the control group.We assessed literature quality in accordance with the Cochrane Review Handbook.A random or a fixed effects model was used to analyze outcomes using Rev Man 5.2 software.OUTCOME MEASURES:The primary outcomes were changes in symptoms and nerve conduction velocities.The secondary outcomeswere fasting blood glucose and hemorheological indexes.RESULTS:Sixteen randomized controlled trials,with a total of 1,173 patients,were included.Meta-analysis revealed that the efficacy of HGWWD for diabetic peripheral neuropathy was significantly superior compared with the control treatment(i.e.,control group)(risk ratio = 0.36,95% confidence interval(CI):0.29–0.46,Z =8.33,P 〈 0.00001) Compared with the control group,there was an increase in median motor nerve conduction velocity(mean difference(MD) = 3.46,95%CI:1.88–5.04,Z = 4.30,P 〈 0.01) and median sensory nerve conduction velocity(MD = 3.30,95%CI:2.04–4.56,Z = 5.14,P 〈 0.01).There was also an increase in peroneal motor nerve conduction velocity(MD = 3.22,95%CI:2.45–3.98,Z = 8.21,P 〈 0.01) and peroneal sensory nerve conduction velocity(MD = 3.05,95%CI:2.01–4.09,Z = 5.75,P 〈 0.01) in the treatment groups.No significant difference in fasting blood glucose was found between the treatment groups and the control groups(MD =-0.12,95%CI:-0.42–0.19,Z = 0.76,P = 0.45).Plasma viscosity was significantly decreased after treatment(MD =-0.11,95%CI:-0.21 to-0.02,Z = 2.30,P = 0.02).No significant difference in fibrinogen was detectable(MD =-0.53,95%CI:-1.28–0.22,Z = 1.38,P = 0.17).Four trials reported that treatment groups experienced no adverse reactions.Adverse events were not mentioned in the other 12 trials.No trial reported the incidence of complications,quality of life outcomes,or health economics.CONCLUSION:HGWWD treatment improves diabetic neurologic symptoms and ameliorates nerve conduction velocities.Our study suggests that HGWWD may have significant therapeutic efficacy for the treatment of diabetic peripheral neuropathy.However,the methodological quality of the randomized controlled trials was generally low.Larger and better-designed randomized controlled trials are required to more reliably assess the clinical effectiveness of HGWWD.展开更多
文摘BACKGROUND Gastric cancer is one of the most common malignant tumors worldwide,and surgical resection is one of the main ways to treat gastric cancer.However,the immune status of postoperative patients is crucial for prognosis and survival,and immune cells play an important role in this process.Therefore,it is helpful to understand the immune status of postoperative patients by evaluating the levels of peripheral blood immune cells,especially total T cells(CD3+),helper T cells(CD3+CD4+),and suppressor T cells(CD3+CD8+),and its relationship to sur-vival.AIM To analyzed the immune cells in peripheral blood of patients with gastric cancer after surgery,detect the levels of total T cells,helper T cells and suppressor T cells.METHODS A total of 58 patients with gastric cancer who received surgical treatment were included in the retrospective study.Flow cytometry was used to detect the level of peripheral blood immune cells and analyze the correlation between total T cells,helper T cells and inhibitory T cells.To explore the relationship between these immune markers and patient survival.RESULTS The results showed that the levels of total T cells,helper T cells,and suppressor T cells changed in patients after gastric cancer surgery.There was a significant positive correlation between total T cells,helper T cells and suppressor T cells(r=0.35,P<0.01;r=0.56,P<0.01).However,there was a negative correlation between helper T cells and suppressor T cells(r=-0.63,P<0.01).Follow-up showed that the survival rate of patients in the high-level total T cell group was significantly higher than that in the low-level group(28.87±24.98 months vs 18.42±16.21 months).The survival curve shows that the curve of patients in the high-level group is shifted to the upper right,and that of the low-level group is shifted downward.There was no significant difference between the levels of helper T cells and suppressor T cells and patient survival time.CONCLUSION By detecting peripheral blood immune cells with flow cytometry,we can initially evaluate the immune status of patients after gastric cancer surgery and initially explore its relationship with patient survival.
文摘To establish the parsimonious model for blood glucose monitoring in patients with type 2 diabetes receiving oral hypoglycemic agent treatment. One hundred and fifty-nine adult Chinese type 2 diabetes patients were randomized to receive rapid-acting or sustained-release gliclazide therapy for 12 weeks.
基金supported by grants from Key Research and Development Project of Department of Science and Technology of Zhejiang Province(2017C03051)Science Fund for Creative Research Groups of the National Natural Science Foundation of China(81721091)
文摘Severe deterioration of liver function in patients can be characterized by coagulation disorders, jaundice, hepatic encephalopathy, ascites, and other symptoms. Severe liver injury can develop as acute liver failure, subacute liver failure, acute-on-chronic liver failure, or further worsening of end-stage liver disease [1].
文摘<strong>Background:</strong> In participating in the medical support work in the Nyingchi area of Tibet, the author found that the medical education resources in this area are scarce, and the clinical nurses in this area have relatively insufficient knowledge about blood glucose monitoring and management. Accurately understanding the knowledge-attitude/belief-practice (KAP) level of nurses in Nyingchi area on blood glucose management is of great significance to the development of blood glucose monitoring management guidance for nurses in this area. Therefore, this study investigated the current status of the management of blood glucose monitoring management standards for clinical nurses in Nyingchi, Tibet. Objective: To investigate and analyze the current situation of clinical nurses in Nyingchi region of Tibet to grasp the regulation of blood glucose monitoring and guide the implementation of the norm of blood glucose monitoring for clinical nurses. <strong>Methods: </strong>The research survey was carried out from March to April 2020. Random sampling method was used to select 134 clinical in-service nurses in Nyingchii, Tibet. The self-designed knowledge-attitude/belief-practice survey questionnaire for clinical nurses’ blood glucose monitoring and management in Tibet was used. Nurses’ blood glucose monitoring management “KAP” scores and related influencing factors are analyzed. <strong>Results: </strong>Blood sugar monitoring and management knowledge score is (36.78 ± 6.80), attitude dimension is (42.48 ± 6.42), practice dimension is (61.87 ± 10.24) and total score is (304.73 ± 36.24). The nurse’s department and whether to participate in diabetes training are the main influencing factors of the blood glucose monitoring management norms, knowledge and behavior (both P < 0.05). <strong>Conclusion: </strong>The standard knowledge of blood glucose monitoring and management of clinical nurses in Nyingchi region of Tibet is at the middle level, positive attitude and unsatisfactory behavior. Nursing managers should conduct standardized training for clinical nurses in blood glucose monitoring, develop the training mode of diabetes specialty nursing talents in Nyingchi area, and construct a complete management system of diabetes specialty nursing.
文摘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.
文摘Semi-invasive blood sampling devices mimic the way female mosquitoes extract blood from a host. They generally consist of a microneedle, a microactuator for needle insertion, a blood extraction mechanism and a blood glucose sensor. These devices have great potential to overcome the major disadvantages of several current blood glucose monitoring methods. Over last two decades, extensive research has been made in all of these related fields. More recently, several wearable devices for semi-invasive blood sampling have been developed. This review aims at summarizing the current state-of-the-art development and utilization of such wearable devices for continuous monitoring of blood glucose levels, with a special attention on design considerations, fabrication technologies and testing methods.
文摘Self-monitoring of blood glucose(SMBG)is critical for gestational diabetes mellitus(GDM)care.However,there are several hurdles to its practice during the coronavirus disease 2019(COVID-19)pandemic in GDM patients in low-and middle-income countries when GDM care recommendations emphasize telemedicine-based care.Based on available knowledge,this letter proposes the following barriers to SMBG in these GDM patients during the ongoing COVID-19 pandemic:Poor internet connectivity,affordability of SMBG and digital applications to connect with healthcare providers,government-imposed social mobility restriction,psychological stress,and mental health conditions.Nevertheless,definitive evidence will only be acquired from rigorous research.
基金supported by the National Natural Science Foundation of China (No.81471698 and 81401454)the National High Technology Research and Development Program of China (‘863’ Program,No.2012AA022602)
文摘Diabetes mellitus is a huge and significantly grow ing problem. Continuous and real-time monitoring of blood glucose plays a key role for the people with diabetes,which can help them to control glucose concentration more effectively. However,current blood glucose monitoring methods require blood by needle-pricking,which limit the detection frequency. It is necessary to develop non-invasive blood glucose monitoring methods to achieve the ideal therapeutic and management of diabetes. In this paper,the developments and challenges of non-invasive blood glucose monitoring technologies in recent years are reviewed. And the bottleneck and the developing trends are also analyzed.
文摘AIM: Hyperglycemia commonly seen in liver transplantation (LT) has often been attributed to the dextrose in the storage solution of blood transfusion products. The purpose of the study is to compare the changes of the blood glucose levels in transfused and non-transfused patients during LT. METHODS: A retrospective study on 60 biliary pediatric patients and 16 adult patients undergoing LT was carried out. Transfused pediatric patients were included in Group Ⅰ (GⅠ), those not transfused in Group Ⅱ (GⅡ). Twelve adult patients were not given transfusion and assigned to Group Ⅲ(GⅢ); whereas, four adult patients who received massive transfusion were assigned to Group Ⅳ (GⅣ). The blood glucose levels, volume of blood transfused, and the volume of crystalloid infused were recorded, compared and analyzed. RESULTS: Results showed that the changes in blood glucose levels during LT for both non-transfused and minimally transfused pediatric groups and non-transfused and massively-transfused adult groups were almost the same. CONCLUSION: We conclude that blood transfusion does not cause significant changes in the blood glucose levels in this study.
文摘Critically ill patients are prone to high glycemic variations irrespective of their diabetes status.This mandates frequent blood glucose(BG)monitoring and regulation of insulin therapy.Even though the most commonly employed capillary BG monitoring is convenient and rapid,it is inaccurate and prone to high bias,overestimating BG levels in critically ill patients.The targets for BG levels have also varied in the past few years ranging from tight glucose control to a more liberal approach.Each of these has its own fallacies,while tight control increases risk of hypoglycemia,liberal BG targets make the patients prone to hyperglycemia.Moreover,the recent evidence suggests that BG indices,such as glycemic variability and time in target range,may also affect patient outcomes.In this review,we highlight the nuances associated with BG monitoring,including the various indices required to be monitored,BG targets and recent advances in BG monitoring in critically ill patients.
基金supported by Emerging Industry Leading Talent Project of Shanxi Province (No.2020587)。
文摘Diabetes mellitus is a common chronic disease.With the improvement of living standards,the prevalence of diabetes mellitus in China is increasing.There are now more people with diabetes in China(>100 million)than in any other country.About half of these people with diabetes need to undergo at least one procedure in their lifetime.Diabetic patients have a much higher probability of perioperative dysglycemia than the normal population,which has a great impact on their prognosis.In addition,non-diabetic patients may also have abnormal blood glucose levels due to various reasons during the perioperative period,which will also lead to a series of adverse consequences.This ar ticle reviews the perioperative blood glucose management of patients to provide a reference for improving their health status.
文摘Objective:This study aimed to evaluate the system accuracy of four types of blood glucose monitoring systems(BGMSs)and explore the differences in the system accuracy acceptability of each BGMS against five different standards.Methods:The glucose measurement values obtained from four types of BGMSs(Roche Accu-Chek® Performa,Bayer Contour™ TS,Sinomedisite Glupad® H1 Plus,and Sinocare® Gold-Accu)were evaluated against the reference values obtained from the biochemical analyzer of the central laboratory.The system accuracy acceptability of each BGMS was determined using the criteria specified in five standards,namely the International Organization for Standardization(ISO)15197:2003,Clinical Laboratory Standards Institute(CLSI)POCT12-A3,ISO 15197:2013,Chinese Society of Laboratory Medicine(CSLM)consensus,and US Food and Drug Administration(FDA)guidelines.Results:From 2018 to 2022,10,980 pairs of measurement values were obtained from 366 glucose meters of four types of BGMSs.Significant correlations were observed between the glucose measurement values from the BGMSs and the reference values from the biochemical analyzer of the central laboratory.The correlation coefficient r was 0.995 for Roche Accu-Chek® Performa,0.994 for Bayer Contour™ TS,0.983 for Sinomedisite Glupad® H1 Plus,and 0.997 for SinocareR Gold-Accu.The acceptability criteria specified in ISO 15197:2003 were met by 100.00%(135/135)of the glucose meters of Roche Accu-Chek® Performa,100.00%(109/109)of Bayer Contour™ TS,81.61%(71/87)of Sinomedisite Glupad® H1 Plus,and 100.00%(35/35)of SinocareR Gold-Accu.Whereas,the acceptability criteria specified in ISO 15197:2013 were met by 99.26%(134/135)of the glucose meters of Roche Accu-Chek® Performa,88.07%(96/109)of Bayer Contour™ TS,58.62%(51/87)of Sinomedisite Glupad R H1 Plus,and 91.43%(32/35)of SinocareR Gold-Accu.Conclusions:Among the four types of BGMSs evaluated,the glucose meters of Roche Accu-Chek® Performa exhibited superior system accuracy.The system accuracy acceptability of each BGMS varied significantly against the acceptability criteria specified in the five different standards.
基金supported by the National Natural Science Foundation of China (No.61176107,No.11204210,No.61428402,and No.61201039)the Key Program of Tianjin Natural Science Foundation (No.15JCZDJC36100)+1 种基金the National High Technology Research and Development Program of China (No.2012AA022602)the 111 Project of China (No.B07014)
文摘Continuous blood glucose monitoring is important for the diagnosis,treatment,and study of diabetes. many organizations have been working on this subject in recent two decades. Glucose concentration in interstitial fluid is closely related to the blood glucose levels. Minimally invasive continuous blood glucose monitoring technology based on the glucose detection in interstitial fluid develops rapidly and gets more and more attentions from the patients and the doctors,due to its instantaneous real-time display of glucose level,"24/7"coverage,and the ability to characterize glycemic variability. According to the different detection methods,most of the continuous glucose monitoring technology could be divided into two kinds: subcutaneous implantation method and transdermal extraction method. This paper review s the recent development of minimally invasive blood glucose monitoring technology and instruments. The mainly remained challenges and related research directions are presented as well.
基金The Incubation Program Project of Beijing Municipal Administration of Hospitals of China,Grant/Award Number:PG2018013Education Reform Project of Tsinghua University,Grant/Award Number:ZY01_02Beijing High-level Public Health Technical Personnel Project,Grant/Award Number:2023‐03‐03。
文摘Objective:To evaluate the accuracy of Roche Accu-Chek Performa glucose meters at a low glucose concentration of<5.55 mmol/L(100 mg/dL)over a 9-year period.Methods:The accuracy of the Roche Accu-Chek Performa glucose meters at low glucose concentrations was evaluated using annual comparison data for 9 consecutive years from 2015 to 2023,according to the acceptability criteria specified in International Organization for Standardization(ISO)15197:2013.Blood samples with low glucose concentrations of<5.55 mmol/L were prepared by incubation and glycolysis.The glucose concentration was detected using Roche Accu-Chek Performa glucose meters and a biochemical analyzer in the central laboratory.Results:A total of 2978 pairs of comparison results from 211 glucose meters at a low glucose concentration of<5.55 mmol/L were retrospectively analyzed from 2015 to 2023.The clinical use duration spanned from 1 to 9 years and 40.76%(86 out of 211 glucose meters)had been used for more than 2 years.The correlation coefficient r between glucose meter measurements and laboratory reference values was 0.98(p<0.001).The mean according to Roche Accu-Chek Performa glucose meters was 0.05 mmol/L(0.9 mg/dL)higher than that of the biochemical analyzer(Z=-13.82,p<0.0001).The results showed that 100.00%(211 out of 211)of the Roche Accu-Chek Performa glucose meters met the acceptability criteria specified in ISO 15197:2013.At a low glucose concentration of<5.55 mmol/L,99.90%(2975 out of 2978)of the comparative data pairs in the error distribution fell within the range of±0.83 mmol/L(15 mg/dL).Parkes consensus error grid analysis showed that 100.00%(2978 out of 2978)of comparative data pairs fell within region A.Conclusions:This study demonstrated that Roche Accu-Chek Performa glucose meters successfully met the accuracy standards of ISO 15197:2013 for measuring blood glucose within the hypoglycemic range.Greater attention should be given to the performance of blood glucose monitoring systems in the low glycemic range,especially for patients with diabetes who are prone to hypoglycemia and require precise measurements.
文摘Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To determine the frequency of self-monitoring of blood glucose and to describe the errors found during self-monitoring in diabetic patients followed at the Endocrinology Department of Donka University Hospital in Guinea. Materials and methods: Descriptive cross-sectional study carried out between August and September 2020 involving diabetic patients followed up at the Endocrinology and Diabetology Department of the Donka National Hospital, CHU Conakry. Results: A total of 301 patients were enrolled, with an average age of 44.24 ± 21.01 years. 64.12% were female. Type 2 diabetes predominated in 64% of cases. The mean duration of diabetes was 6.14 ± 4.67 years, and 75.08% of patients lived in urban areas. Patients were on insulin in 36.21% of cases, insulin and biguanides (26.25%), hypoglycemic sulfonamide and biguanides (19.27%) and biguanides in 18.27% of cases. The frequency of self-monitoring of blood glucose was 43%, and 38% of patients made errors, notably reusing lancets (60%), not checking the expiration date (55.65%) and not washing their hands (48%). Conclusion: This study shows that self-monitoring of blood glucose is not performed by the majority of patients. Numerous errors were identified during blood glucose testing. Continued therapeutic education on the use of blood glucose meters will help empower patients and improve their quality of life.
文摘Background Self-monitoring of blood glucose (SMBG) by individuals with type 2 diabetes (T2D) is crucial for long-term health,yet numerous cultural,economic and health factors can reduce SMBG.Most studies on SMBG adherence have come out of the US and Europe,and their relevance to Asia is unclear.The aims of the present study were to assess the current state of SMBG in China and analyze demographic and diabetes-related characteristics that may influence it.Methods In this multi-center,cross-sectional study,5 953 individuals with T2D from 50 medical centers in 29 provinces across China filled out a standardized questionnaire that requested information on demographic characteristics,education level,occupation,income,lifestyle risk factors,duration of diabetes,chronic complications,and frequency of SMBG.Respondents were also asked whether their glycosylated hemoglobin (HbA1c) had been checked in the past 6 months.The most recent values for fasting plasma glucose,2-hour postprandial blood glucose and HbA1c were recovered from medical records.Results Only 1 130 respondents (18.98%) performed SMBG with the recommended frequency,while 4 823 (81.02%) did not.In fact,nearly 2 105 (35.36%) reported never performing SMBG.In the subset of 3 661 individuals on insulin therapy,only 266 (7.27%) performed SMBG at least once a day,while 1 210 (33.05%) never performed it.In contrast,895 of 2 292 individuals (39.05%) on diet/exercise therapy or oral hypoglycemic therapy never performed it.Multivariate Logistic regression identified several factors associated with SMBG adherence:female gender,higher education level,higher income,longer T2D duration and education about SMBG.Conclusions SMBG adherence in our Chinese population with T2D was less frequent than that in developed countries.Several factors influence SMBG adherence:gender,education level,income,T2D duration,therapy regimen and exposure to education about SMBG.
基金This work was supported by grants from the Sun Yat-sen University Clinical Research 5010 Program (No. 2007030), the Science and Technology Planning Project of Guangdong Province (No. 2014A020212065, No. 2015A030401034), and the Chinese National Natural Science Foundation (No. 81100556).
文摘Background: The information-motivation-behavioral skills (IMB) model of health behavior is an effective tool to evaluate the behavior of diabetes self-management. The purpose of this study was to explore behavioral factors affecting the practice of self-monitoring of blood glucose (SMBG) within the frame of IMB model of health behavioral among adult patients with type 1 diabetes in a single diabetes clinic in China. Methods: A questionnaire with three subscales on SMBG information, motivation, and behavioral skills based on IMB model was developed. Validity and reliability of the measures were examined and guaranteed. Adult patients with type 1 diabetes visiting our diabetes clinic from January to March 2012 (n = 55) were consecutively interviewed. The self-completion questionnaires were administered and finished at face-to-face interviews among these patients. Both descriptive and correlational analyses were made. Results: Fifty-five patients finished the questionnaires, with the median duration of diabetes 4.5 years and the median of SMBG frequency 2.00. Specific SMBG information deficits, motivation obstacles, and behavioral skill limitations were identified in a substantial proportion of participants. Scores of SMBG motivation (r - 0.299, P = 0.026) and behavioral skills (r = 0.425, P = 0.001) were significantly correlated with SMBG frequency. The multiple correlation of SMBG information, SMBG motivation, and SMBG behavioral skills with SMBG frequency was R - 0.411 (R2 = 0.169, P = 0.023). Conclusions: Adult patients with type 1 diabetes in our clinic had substantial SMBG information deficits, motivation obstacles, and skill limitations. This information provided potential-focused education targets for diabetes health-care providers.
文摘The authors would like to apologize for some mistakes in the letter on Chinese Optics Letters vol. 12, no. 11, page 111701 and wish to make the corrections described below:
基金supported by a grant from the National Basic Research Program of China(973 Program),No.2010CB530600Institutes Project from Guang’anmen Hospital of China Academy of Chinese Medical Sciences,No.2011261
文摘OBJECTIVE:This meta-analysis was performed to systematically assess the efficacy and safety of the Chinese herbal medicine Huangqi Guizhi Wuwu Decoction(HGWWD) for treating diabetic peripheral neuropathy.DATA SOURCES:Six electronic databases,including the Cochrane Library,MEDLINE database,Chinese Biomedical Database,Chinese National Knowledge Infrastructure Database,Chinese Science and Technique Journals Database,and the Wanfang Database,were search ed on the internet for randomized controlled trials published up until 1 December 2015.The search terms included "Chinese herbal medicine","diabetic peripheral neuropathy" and "randomized controlled trials" in Chinese and in English.DATA SELECTION:We included randomized controlled trials using HGWWD/modified HGWWD for the treatment group,without restriction for the control group.We assessed literature quality in accordance with the Cochrane Review Handbook.A random or a fixed effects model was used to analyze outcomes using Rev Man 5.2 software.OUTCOME MEASURES:The primary outcomes were changes in symptoms and nerve conduction velocities.The secondary outcomeswere fasting blood glucose and hemorheological indexes.RESULTS:Sixteen randomized controlled trials,with a total of 1,173 patients,were included.Meta-analysis revealed that the efficacy of HGWWD for diabetic peripheral neuropathy was significantly superior compared with the control treatment(i.e.,control group)(risk ratio = 0.36,95% confidence interval(CI):0.29–0.46,Z =8.33,P 〈 0.00001) Compared with the control group,there was an increase in median motor nerve conduction velocity(mean difference(MD) = 3.46,95%CI:1.88–5.04,Z = 4.30,P 〈 0.01) and median sensory nerve conduction velocity(MD = 3.30,95%CI:2.04–4.56,Z = 5.14,P 〈 0.01).There was also an increase in peroneal motor nerve conduction velocity(MD = 3.22,95%CI:2.45–3.98,Z = 8.21,P 〈 0.01) and peroneal sensory nerve conduction velocity(MD = 3.05,95%CI:2.01–4.09,Z = 5.75,P 〈 0.01) in the treatment groups.No significant difference in fasting blood glucose was found between the treatment groups and the control groups(MD =-0.12,95%CI:-0.42–0.19,Z = 0.76,P = 0.45).Plasma viscosity was significantly decreased after treatment(MD =-0.11,95%CI:-0.21 to-0.02,Z = 2.30,P = 0.02).No significant difference in fibrinogen was detectable(MD =-0.53,95%CI:-1.28–0.22,Z = 1.38,P = 0.17).Four trials reported that treatment groups experienced no adverse reactions.Adverse events were not mentioned in the other 12 trials.No trial reported the incidence of complications,quality of life outcomes,or health economics.CONCLUSION:HGWWD treatment improves diabetic neurologic symptoms and ameliorates nerve conduction velocities.Our study suggests that HGWWD may have significant therapeutic efficacy for the treatment of diabetic peripheral neuropathy.However,the methodological quality of the randomized controlled trials was generally low.Larger and better-designed randomized controlled trials are required to more reliably assess the clinical effectiveness of HGWWD.