BACKGROUND Bariatric and metabolic surgery have been routinely performed following the rapid increase in obesity and metabolic diseases worldwide.Of all evolving procedures,Roux-en-Y gastric bypass(RYGB)is considered ...BACKGROUND Bariatric and metabolic surgery have been routinely performed following the rapid increase in obesity and metabolic diseases worldwide.Of all evolving procedures,Roux-en-Y gastric bypass(RYGB)is considered the gold standard for surgical treatment of patients with type 2 diabetes mellitus(T2DM)and obesity.RYGB was introduced in China nearly 20 years ago,but the number of RYGB surgeries only accounts for 3.1%of the total number of weight loss and metabolic surgeries in China,it’s effect on Chinese people still needs further study.AIM To investigate the effect and safety of a modified gastric bypass performed in Chinese patients with T2DM.METHODS Patients with obesity and T2DM who underwent modified gastric bypass,with>5-year follow-up data,were analyzed.RESULTS All 37 patients underwent uneventful laparoscopic surgery,no patient was switched to laparotomy during the surgery,and no severe complications were reported.Average weight and body mass index of the patients reduced from 84.6±17.3(60.0–140.0)kg and 30.9±5.0(24.7–46.2)kg/m2 to 67.1±12.2(24.7–46.2)kg and 24.6±3.9(17.7–36.5)kg/m2,respectively,and fasting plasma glucose and glycated hemoglobin decreased from 7.4±3.4 mmol/L and 8.2%±1.7%preoperatively to 6.5±1.3 mmol/L and 6.5%±0.9%5-years postoperatively,respectively.Only 29.7%(11/37)of the patients used hypoglycemic drugs 5-years postoperatively,and the complete remission rate of T2DM was 29.7%(11/37).Triglyceride level reduced significantly but high-density lipoprotein increased significantly(both P<0.05)compared with those during the preoperative period.Liver and renal function improved significantly postoperatively,and binary logistic regression analysis revealed that the patients’preoperative history of T2DM and fasting C-peptide were significant prognostic factors influencing complete T2DM remission after RYGB(P=0.006 and 0.012,respectively).CONCLUSION The modified gastric bypass is a safe and feasible procedure for Chinese patients with obesity and T2DM,exhibiting satisfactory amelioration of weight problems,hyperglycemia,and combination disease.展开更多
BACKGROUND Quantitative studies on the changes in inflammation-related content in tears,especially the effect of diabetes,are lacking.In this study,we measured the preoperative and postoperative tear inflammatory medi...BACKGROUND Quantitative studies on the changes in inflammation-related content in tears,especially the effect of diabetes,are lacking.In this study,we measured the preoperative and postoperative tear inflammatory mediator levels in cataract patients,focusing on the expression of inflammatory factors in postoperative cataracts in the diabetic,and investigated the effect of drugs on the control of postoperative inflammation.AIM To study the expression of inflammatory factors in elderly people with type 2 diabetes after cataract surgery.METHODS Patients with a mean age of 70.3±6.3 years were divided into group A(composed of elderly patients with cataracts and type 2 diabetes,n=20 eyes)and group B(patients with age-related cataract,n=20 eyes).Their tears were collected before each operation and on days 1 and 3,and weeks 1,2,3,and 4 post-surgery.Saline(150μL)was dropped into the conjunctival sac of the surgical eye,followed by oculogyration in four directions.The fluid in the conjunctival sac was extracted using a sterile syringe and stored in Eppendorf tubes at-80°C until measurement.The expression levels of matrix metalloproteinase-2(MMP-2),MMP-9,tissue inhibitor of metalloproteinase-1(TIMP-1),TIMP-2,interleukin-6(IL-6),and IL-20 in tear fluid were measured using enzyme-linked immunosorbent assays.RESULTS The postoperative expression levels of MMP-2,MMP-9,TIMP-2,IL-6,and IL-20 in group A were significantly higher than those in group B,whereas the concentration of TIMP-1 in group A remained lower than that in group B.The levels of MMP-2 and IL-6 in both groups continuously increased until the peak in the first postoperative week,and then gradually decreased over the next three weeks.Ultimately,MMP-2 declined to a lower level than that preoperatively at week 4,but IL-6 decreased to the same level as that preoperatively.The level of MMP-9 peaked in the first two weeks postoperative and then returned to the same level as 1-day post-operation.The concentration of TIMP-1 post-operation remained constant at a lower level than before surgery,and TIMP-2 Levels remained stable in both groups.IL-20 content started to increase in the third week after surgery.CONCLUSION Inflammatory factor levels in tears fluctuated before and post-operation,which indicated more severe postoperative inflammation in the first two weeks.展开更多
BACKGROUND Diabetes is a chronic disease,which may cause various complications.Patients with diabetes are at high risk of bone and joint disorders,such as osteoporosis and bone fractures.In addition,it became widely a...BACKGROUND Diabetes is a chronic disease,which may cause various complications.Patients with diabetes are at high risk of bone and joint disorders,such as osteoporosis and bone fractures.In addition,it became widely accepted that diabetes has an important impact on bone metabolism.Metformin is a commonly used and effective first-line treatment for type 2 diabetes.Some glucose-lowering agents have been found to have an effect on bone metabolism.The present study explored if different doses of metformin have an effect on bone mineral density(BMD)and bone metabolism in type 2 diabetes.AIM To investigate the effects of different doses of metformin on BMD and bone metabolism in elderly male patients with type 2 diabetes mellitus.METHODS A total of 120 elderly male outpatients with type 2 diabetes mellitus who were admitted to our hospital were included in the study from July 2018 to June 2019.They were randomly assigned to an experimental group and a control group with 60 patients in each group.Patients in the experimental group were given high dose metformin four times a day 0.5 g each time for 12 wk.Patients in the control group were given low dose metformin orally twice a day 0.5 g each time for 12 wk.The changes in bone mineral density and bone metabolism before and after treatment and the efficacy rate of the treatment were compared between the two groups.RESULTS There was no significant difference in the efficacy rate between the two groups(P>0.05).Before the treatment,there was no significant difference in BMD and bone metabolism between the two groups(P>0.05).However,after the treatment,BMD and bone metabolism were improved in the two groups.Moreover,BMD and 25-hydroxyvitamin D were significantly higher in the experimental group than in the control group,and N-terminal/midregion andβ-isomerized Cterminal telopeptides were significantly lower in the experimental group than in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION Both high and low dose metformin can effectively control the blood glucose levels in elderly male patients with type 2 diabetes mellitus.However,the benefits of high dose metformin in improving BMD and bone metabolism level was more obvious in patients with type 2 diabetes mellitus.展开更多
AIM To measure the incidence and determinants(predictors) of hypoglycemia among patients with type 2 diabetes mellitus(T2DM) who were on insulin treatment for at least one year. METHODS The present study is an out-pat...AIM To measure the incidence and determinants(predictors) of hypoglycemia among patients with type 2 diabetes mellitus(T2DM) who were on insulin treatment for at least one year. METHODS The present study is an out-patients based inquiry about the risk and predictors of hypoglycemia among patients with T2DM seeking care at the Al-Faiha Specialized Diabetes, Endocrine, and Metabolism Center, in Basrah over a period of 7 mo(from 15^(th) of April, 2013 to 15^(th) of October, 2013). The data used in the study were based on all detailed interview and selected laboratory investigations. A total of 336 patients could be included in the study.RESULTS The incidence of overall hypoglycemia among the studied patients was 75.3% within the last 3 mo preceding the interview. The incidence of hypoglycemia subtypes were 10.2% for severe hypoglycemia requiring medical assistance in the hospital, 44.36% for severe hypoglycemia treated at home by family; this includes both confirmed severe hypoglycemia with an incidence rate of 14.6% and unconfirmed severe hypoglycemia for which incidence rate was 29.76%. Regarding mild self-treated hypoglycemia, the incidence of confirmed mild hypoglycemia was 21.42%, for unconfirmed mildhypoglycemia the incidence rate was 50.0% and for total mild hypoglycemia, the incidence rate was 71.42%. The most important predictors of hypoglycemia were a peripheral residence, increasing knowledge of hypoglycemia symptoms, in availability and increasing frequency of self-monitoring blood glucose, the presence of peripheral neuropathy, higher diastolic blood pressure, and lower Hemoglobin A1c.CONCLUSION Hypoglycemia is very common among insulin-treated patients with T2DM in Basrah. It was possible to identify some important predictors of hypoglycemia.展开更多
BACKGROUND： At present, central cholinergic neuron system is regarded the most major structural basis of cognitive function. Changes in structure of cholinergic neuron system of brain and receptor expression after br...BACKGROUND： At present, central cholinergic neuron system is regarded the most major structural basis of cognitive function. Changes in structure of cholinergic neuron system of brain and receptor expression after brain injury can cause cognitive impairment. OBJECTIVE＂ To comparatively observe the intelligence quotient （IQ）, latent period and wave amplitude of P300 event-related potential and the difference of activity of acetylcholinesterase （ACHE） in blood and cerebrospinal fluid between patients with type 2 diabetes mellitus and with non-diabetes mellitus, and analyze the correlation of IQ of cognitive impairment patients with diabetes mellitus with AChE activity, latent period and wave amplitude of P300 event-related potential in cerebrospinal fluid. DESIGN： Correlation analysis of contrast observation SETTING： Department of Endocrinology, Affiliated Hospital of Binzhou Medical College PARTICIPANTS： Totally 32 patients with type 2 diabetes mellitus who received the treatment in the Department of Endocrinology, Affiliated Hospital of Binzhou Medical College between April 2004 and April 2005 were recruited, serving as diabetes mellitus group. They, including 19 male and 13 female, aged 49 to 73 years, with disease course of 4 to 11 years, all met the diagnostic criteria of diabetes mellitus revised by World Health Organization in 1999. Another 30 patients with non-diabetes mellitus who homeochronously underwent lumbar anesthesia in the Department of Surgery and Department of Gynecology were recruited, serving as non-diabetes mellitus group. The 30 patients included 18 male and 12 female, and their age ranged from 46 to 71 years. Informed consents of detected items were obtained from the involved patients. METHODS： ① Evaluation,on IQ： The IQ of involved subjects was evaluated with Chinese Version of the Wechsler Adult Intelligence Scale revised by Gong Yao-xian （WAIS-RC）. WAIS-RC included 6 verbal subscales and 5 performance subscales. The test scores of the 11 subscales integrated into the scores of the whole scale, and the scores on the WAIS-RC included verbal IQ （VlQ）, performance IQ （PIQ） and full scale IQ （FIQ）. FIQ ≤79 scores indicated low IQ and FIQ≤69 indicated intelligence impairment. ② Detection of P300 wave： P300 wave was detected with evoked potential instrument （MYTOPRO, Italian）, and data of latent period and amplitude of P300 event-related potential were automatically shown by computer. ③ Detection of AChE activity in blood and cerebrospinal fluid： Activity of AChE of blood and cerebrospinal fluid was measured with biochemical methods by using CORNING-560 autoanalyzer.④Correlation analysis： Correlation of FIQ with AChE of cerebrospinal fluid and P300 wave of patients with type 2 diabetes mellitus was analyzed, t test was used in intergroup comparison and linear correlation analysis for relevant treatment. MAIN OUTCOME MEASURES： ① Comparison of IQ, latent period and wave amplitude of P300 wave as well as the activity of AChE between two groups. ② Analysis on the correlation of FIQ of patients with type 2 diabetes mellitus with AChE of cerebrospinal fluid and P300 wave. RESULTS： Thirty-two patients with diabetes mellitus and 30 non-diabetes mellitus participated in the result analysis. ①Comparison of IQ, latent period and wave amplitude of P300 wave as well as the activity of AChE between two groups： The scores of VIP, PIQ and FIQ of patients with type 2 diabetes mellitus were （97.4±10.4）. （92.6±8.4） and （95.2±9.7） scores, respectively; and those of patients with non-diabetes mellitus were （104.7±9.6）, （102.5±8.5）and（102.7±8.9） scores, respectively, and P 〈 0.05-0.01 was set in intergroup comparison. The latent period of P300 wave at points Fz , Cz and Pz of patients with type 2 diabetes mellitus was （370.8±41.8）.（371.5±39.1）and （375.1±43.1） ms, respectively, and that of patients with non-diabetes mellitus was （ 332.1 ±28.3 ）, （335.7 ±29.4）and （339.7 ±27.3） ms, respectively, and P 〈 0.01 was set in intergroup comparison; Wave amplitude of P300 of patients with type 2 diabetes mellitus was （8.6±4.1）,（8.6±4.0） and （7.7±4.0） μV, respectively and that of patients with non-diabetes mellitus was （11.9±4.1）,（11.5±4.4） and （10.9±5.0） μV, respectively , and P 〈 0.05-0.01 was set in intergroup comparison; The level of AChE in blood and cerebrospinal fluid of patients with type 2 diabetes mellitus was （235.61 ±50.34）and （17.89±4.46） μkat/L, respectively, which was significantly higher than that of patients with non-diabetes mellitus [（205.03±44.15）and （14.63±0.48） μkat /L, respectively], and P 〈 0.05-0.01 was set in the intergroup comparison. ② Correlation of FIQ value of patients with type 2 diabetes mellitus with AChE of cerebrospinal fluid and P300 wave： The value of FIQ was significantly negatively correlated with the AChE activity of cerebrospinal fluid （r=-0.588 1, P 〈 0.01 ）, significantly negatively correlated with the latent period at points Fz. C and Pz of P300 wave （r= -0.700 5, -0.689 4, -0.688 5, P 〈 0.01 ）, and significantly positively correlated with the amplitude at points Fz . Cz and Pz of P300 wave（r= 0.607 4,0.616 1,0.592 0,P 〈 0.01 ）. CONCLUSION： ① Cognitive impairment of patients with type 2 diabetes mellitus might be related to the increase of activity of AChE in cerebrospinal fluid. ②Combined application of examination of P300 wave and evaluation of IQ is more useful in deciding the state of cognitive function of patients with type 2 diabetes mellitus.展开更多
Type 2 diabetes mellitus(T2DM)is a common clinical endocrine and metabolic disease characterized by elevated blood sugar and insulin resistance.The onset of T2DM will affect the metabolic balance of the body,and uric ...Type 2 diabetes mellitus(T2DM)is a common clinical endocrine and metabolic disease characterized by elevated blood sugar and insulin resistance.The onset of T2DM will affect the metabolic balance of the body,and uric acid metabolism is one of them.Hyperuricemia(HUA)is very common in type 2 diabetes.Based on HUA,gout is a crystal-related disease caused by urate deposition,and its clinical manifestations are complex and varied.Professor zhao quanlin has rich experience in clinical experience,and he has made good use of traditional Chinese medicine system to treat type 2 diabetes mellitus with gout in the acute phase of clinical effect.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
<strong>Background:</strong> Diabetes mellitus (DM) is one of the most common non-communicable diseases and among the leading causes of disability, morbidity and mortality globally. The study assessed adhe...<strong>Background:</strong> Diabetes mellitus (DM) is one of the most common non-communicable diseases and among the leading causes of disability, morbidity and mortality globally. The study assessed adherence to treatment by type 2 DM patients aged 20 years and above at Monze Mission Hospital in Monze district, Zambia. Research questions: 1) What is the level of adherence to treatment by type 2 DM patients receiving care from Monze Mission Hospital? 2) What factors influence adherence to treatment by type 2 DM patients? <strong>Methods:</strong> The study was conducted in 2017. It was a cross-sectional design. Simple random sampling method was used to select respondents and data was collected using a structured interview schedule. Data was entered and analyzed using the modified self-reported Morisky Medication Adherence Scale with six scores, modified self-care management questionnaire and IBM<span style="white-space:nowrap;"><sup><span style="white-space:nowrap;"><span style="white-space:nowrap;">©</span></span></sup> </span>Statistical Package for Social Sciences. Chi-Square was used to test associations between variables and binary logistic regression was used for multivariate analysis. The Morisky Medication Adherence scale was interpreted as follows: patients who scored between 4 - 6 points on knowledge had high knowledge while those who scored between 1 - 3 points had low knowledge about the disease. <strong>Results: </strong>The sample size of the study was 138 respondents. The study showed, only 44.2% of respondents had good adherence to treatment as they scored above 4 using the Morisky Medication Adherence Scale. Majority of the patients (55.6%) had knowledge about treatment despite 65.2% of respondents reported distance and financial challenges as hindrances to adherence. The study revealed a statistical association between adherence and knowledge of type 2 DM treatment. <strong>Conclusion:</strong> The study showed that poor adherence to treatment reduced as knowledge about DM increased. There is need to consider educational programs to strengthen adherence to dietary advice, regular exercise and follow up, to achieve normal glycemic levels.展开更多
BACKGROUND Carpal tunnel syndrome(CTS)has been associated with gout and type 2 diabetes mellitus(T2DM).However,due to insufficient clinical understanding of goutrelated CTS and reliance on the diagnostic importance of...BACKGROUND Carpal tunnel syndrome(CTS)has been associated with gout and type 2 diabetes mellitus(T2DM).However,due to insufficient clinical understanding of goutrelated CTS and reliance on the diagnostic importance of elevated serum uric acid levels,such cases are prone to missed diagnosis,misdiagnosis,and delayed treatment.In addition,the effect of T2DM on gout-induced carpal tunnel syndrome has not been reported.CASE SUMMARY Herein,we present an unusual case of CTS and motor dysfunction caused by miliary tophaceous gout and T2DM.The patient presented to the hand and foot clinic with paresthesia of the fingers of both hands,especially at night.The patient was diagnosed with type 2 diabetes a month ago.Ultrasonography revealed bilateral transverse carpal ligament thickening with median nerve compression during hospitalization.The patient was successfully treated with carpal tunnel decompression and tendon release.The postoperative pathological examination revealed typical gout nodules.This case suggests that the presence of T2DM could accelerate tophi formation and worsen CTS symptoms,although no definitive proof in this regard has been described previously.CONCLUSION Tophi formation may most likely cause the co-occurrence of CTS and flexor dysfunction in gout and incipient diabetes patients.展开更多
Objective Modified upper abdominal cluster transplantation ( MCT) ,which was inspired by classical cluster transplant technique,has been proven more effective and feasible in the treatment of patients with end stage l...Objective Modified upper abdominal cluster transplantation ( MCT) ,which was inspired by classical cluster transplant technique,has been proven more effective and feasible in the treatment of patients with end stage liver diseases associated with insulin - dependent展开更多
Diabetes has become a growing concern in Japan, both medically and financially. The medical cost of diabetes was estimated at 1215 billion yen for fiscal year 2011. We analyzed the length of stay (LOS) in a hospital f...Diabetes has become a growing concern in Japan, both medically and financially. The medical cost of diabetes was estimated at 1215 billion yen for fiscal year 2011. We analyzed the length of stay (LOS) in a hospital for type 2 diabetes mellitus patients who participated in educational programs to determine factors affecting LOS. Data on 991 patients obtained from 28 Red Cross hospitals in 2008 were used. For the analysis, we used the Box-Cox transformation model and Hausman test. The results revealed that patients aged 75 years and above and those with comorbidities and complications were prone to longer LOS. The analysis also revealed significant differences in LOS across the hospitals, even after controlling for patient characteristics. Finally, we applied the least squares method to determine the effects of hospital and regional factors and revealed that patients’ LOS was affected by the region’s average LOS. Regional corporations and networks appeared to be important in improving educational programs.展开更多
Objective: To evaluate patient satisfaction with insulin glargine. Design: Multicentre observational registry. Data were collected at baseline/inclusion visit, and 12 and 24 weeks. Setting: Physicians in Hong Kong, wh...Objective: To evaluate patient satisfaction with insulin glargine. Design: Multicentre observational registry. Data were collected at baseline/inclusion visit, and 12 and 24 weeks. Setting: Physicians in Hong Kong, who managed type 2 diabetes patients and had >5 years’ experience in using insulin glargine. Patients: People with type 2 diabetes, new to insulin, aged 18 - 75 years, who were previously being treated with ≤3 oral antidiabetes drugs (OAD) and had HbA1c > 7%, and in whom the?physicians had chosen to prescribe glargine for the first time. Main outcome measures: Treatment satisfaction assessed by Diabetes Treatment Satisfaction Questionnaire (DTSQs), glycaemic control (fasting blood glucose and HbA1c) and adverse events. Results: Between April 2010-October 2011, 41 patients completed the study. Average duration of diabetes and OAD therapy was 7.8 ± 8.0 years and 6.7 ± 7.4 years, respectively. The global DTSQs treatment satisfaction scores improved from 20.9 at baseline to 28.4 (p < 0.05) at the end of 24 weeks insulin glargine treatment. Analysis of DTSQs scores showed a decrease in perceived frequency of hyperglycaemia (4.1 to 1.9, p < 0.001) and hypoglycemia (2.2 to 1.5, p = 0.079). Perceived convenience (0.60, p < 0.025) and flexibility (0.9, p < 0.009) were also improved from baseline. Reduction in mean HbA1c (10.2% ± 2.2% to 7.0% ± 1.0%) and fasting blood glucose (10.9 ± 4.0 mmol/L to 6.4 ± 1.8 mmol/L) from baseline to study termination was significant (p < 0.05). Almost half (48.7%) of patients achieved HbA1c ≤ 7.0%, while 26.0% patients had FBG < 5.6 mmol/L. In total, 9 (22.0%) patients experienced at least one hypoglycemia event;there were no reports of severe hypoglycaemia. Conclusions: Despite a small number of subjects completed in this study, the study demonstrated clearly that the addition of insulin glargine to OAD therapy in diabetes management improved treatment satisfaction and perceived frequency of hyper-and hypoglycaemia together with glycaemic control close to recommended target without severe side-effects in this cohort of patients in Hong Kong.展开更多
The correlation between liver enzymes and lipid profile in T2D patients in the Yemeni population has been evaluated. This is a case-control study comprising 142 T2D patients and 142 healthy control subjects were carri...The correlation between liver enzymes and lipid profile in T2D patients in the Yemeni population has been evaluated. This is a case-control study comprising 142 T2D patients and 142 healthy control subjects were carried out at the outpatient clinics of Ibn-Sina hospital, Mukalla, during the period from January to May 2020. Serum fasting blood glucose (FBG), total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT) were analyzed using the Cobas Integra Plus 400 autoanalyzer. Also, anthropometric and blood pressure measurements were taken from each participant. Independent sample T-test and Pearson correlation coefficient were used. T2D patients had significantly higher FBG (P ≤ 0.0001), total cholesterol (P ≤ 0.0001), LDL-C (P ≤ 0.0001), and GGT (P ≤ 0.0001) while HDL-C was significantly lower in T2D patients (P = 0.021). In correlation analysis, serum GGT was positively associated with FBG (r = 0.216;P ≤ 0.0001), total cholesterol (r = 0.196;P = 0.0001), triglyceride (r = 0.123;P = 0.038), and LDL-C (r = 0.209;P ≤ 0.0001). Also, serum ALT was positively associated with FBG (r = 0.145, P = 0.014) and triglyceride (r = 0.172, P = 0.004). In conclusion, higher levels of ALT and GGT are used as the predictive biomarkers for NAFLD in T2D patients with hyperlipidemia. Thus, routine screening of liver enzymes and lipid profile in T2D patients is recommended for the early detection of liver abnormalities and diminish diabetes complications.展开更多
目的分析老年2型糖尿病(T2DM)患者发生抑郁的影响因素,为制定精准干预方案以减少抑郁发生提供理论依据。方法采用便利抽样法选取2018年1月至2021年12月在某三甲医院老年病内分泌科接受治疗的242例老年T2DM患者作为研究对象,利用老年抑...目的分析老年2型糖尿病(T2DM)患者发生抑郁的影响因素,为制定精准干预方案以减少抑郁发生提供理论依据。方法采用便利抽样法选取2018年1月至2021年12月在某三甲医院老年病内分泌科接受治疗的242例老年T2DM患者作为研究对象,利用老年抑郁量表-15(GDS-15)评估患者发生抑郁的情况,根据纳入及排除标准最终纳入170例。收集患者的临床资料,用Fried衰弱表型定义量表、匹兹堡睡眠质量指数量表(PSQI)、老年人运动功能量表(GLFS)分别评定患者的衰弱、睡眠质量及运动功能。采用二分类Logistic回归分析探讨影响老年T2DM患者发生抑郁的因素。结果170例老年T2DM患者中有51例发生抑郁(抑郁组),119例未发生抑郁(非抑郁组)。两组的居住方式、低血糖次数、合并其他疾病及衰弱分类占比比较,差异具有统计学意义(P<0.05);抑郁组的病程长于非抑郁组,甘油三酯(TG)、空腹血浆葡萄糖(FPG)、餐后2小时血糖(2 h PBG)水平、糖化血红蛋白(HbA1c)及Fried衰弱评分、PSQI、GLFS评分高于非抑郁组(P<0.05)。多因素Logistic回归分析结果显示,运动相关指标、PSQI评分及居住方式是影响老年T2DM患者发生抑郁的因素(P<0.05)。结论老年T2DM患者抑郁发生率较高,需重点关注睡眠质量差、几乎不锻炼和独居的患者,并针对上述因素制定干预措施。展开更多
文摘BACKGROUND Bariatric and metabolic surgery have been routinely performed following the rapid increase in obesity and metabolic diseases worldwide.Of all evolving procedures,Roux-en-Y gastric bypass(RYGB)is considered the gold standard for surgical treatment of patients with type 2 diabetes mellitus(T2DM)and obesity.RYGB was introduced in China nearly 20 years ago,but the number of RYGB surgeries only accounts for 3.1%of the total number of weight loss and metabolic surgeries in China,it’s effect on Chinese people still needs further study.AIM To investigate the effect and safety of a modified gastric bypass performed in Chinese patients with T2DM.METHODS Patients with obesity and T2DM who underwent modified gastric bypass,with>5-year follow-up data,were analyzed.RESULTS All 37 patients underwent uneventful laparoscopic surgery,no patient was switched to laparotomy during the surgery,and no severe complications were reported.Average weight and body mass index of the patients reduced from 84.6±17.3(60.0–140.0)kg and 30.9±5.0(24.7–46.2)kg/m2 to 67.1±12.2(24.7–46.2)kg and 24.6±3.9(17.7–36.5)kg/m2,respectively,and fasting plasma glucose and glycated hemoglobin decreased from 7.4±3.4 mmol/L and 8.2%±1.7%preoperatively to 6.5±1.3 mmol/L and 6.5%±0.9%5-years postoperatively,respectively.Only 29.7%(11/37)of the patients used hypoglycemic drugs 5-years postoperatively,and the complete remission rate of T2DM was 29.7%(11/37).Triglyceride level reduced significantly but high-density lipoprotein increased significantly(both P<0.05)compared with those during the preoperative period.Liver and renal function improved significantly postoperatively,and binary logistic regression analysis revealed that the patients’preoperative history of T2DM and fasting C-peptide were significant prognostic factors influencing complete T2DM remission after RYGB(P=0.006 and 0.012,respectively).CONCLUSION The modified gastric bypass is a safe and feasible procedure for Chinese patients with obesity and T2DM,exhibiting satisfactory amelioration of weight problems,hyperglycemia,and combination disease.
基金Supported by Cataract Prevention and Control Appropriate Technology Base of Sichuan Provincial Health Commission(Regional Demonstration),No.2022JDXM012。
文摘BACKGROUND Quantitative studies on the changes in inflammation-related content in tears,especially the effect of diabetes,are lacking.In this study,we measured the preoperative and postoperative tear inflammatory mediator levels in cataract patients,focusing on the expression of inflammatory factors in postoperative cataracts in the diabetic,and investigated the effect of drugs on the control of postoperative inflammation.AIM To study the expression of inflammatory factors in elderly people with type 2 diabetes after cataract surgery.METHODS Patients with a mean age of 70.3±6.3 years were divided into group A(composed of elderly patients with cataracts and type 2 diabetes,n=20 eyes)and group B(patients with age-related cataract,n=20 eyes).Their tears were collected before each operation and on days 1 and 3,and weeks 1,2,3,and 4 post-surgery.Saline(150μL)was dropped into the conjunctival sac of the surgical eye,followed by oculogyration in four directions.The fluid in the conjunctival sac was extracted using a sterile syringe and stored in Eppendorf tubes at-80°C until measurement.The expression levels of matrix metalloproteinase-2(MMP-2),MMP-9,tissue inhibitor of metalloproteinase-1(TIMP-1),TIMP-2,interleukin-6(IL-6),and IL-20 in tear fluid were measured using enzyme-linked immunosorbent assays.RESULTS The postoperative expression levels of MMP-2,MMP-9,TIMP-2,IL-6,and IL-20 in group A were significantly higher than those in group B,whereas the concentration of TIMP-1 in group A remained lower than that in group B.The levels of MMP-2 and IL-6 in both groups continuously increased until the peak in the first postoperative week,and then gradually decreased over the next three weeks.Ultimately,MMP-2 declined to a lower level than that preoperatively at week 4,but IL-6 decreased to the same level as that preoperatively.The level of MMP-9 peaked in the first two weeks postoperative and then returned to the same level as 1-day post-operation.The concentration of TIMP-1 post-operation remained constant at a lower level than before surgery,and TIMP-2 Levels remained stable in both groups.IL-20 content started to increase in the third week after surgery.CONCLUSION Inflammatory factor levels in tears fluctuated before and post-operation,which indicated more severe postoperative inflammation in the first two weeks.
文摘BACKGROUND Diabetes is a chronic disease,which may cause various complications.Patients with diabetes are at high risk of bone and joint disorders,such as osteoporosis and bone fractures.In addition,it became widely accepted that diabetes has an important impact on bone metabolism.Metformin is a commonly used and effective first-line treatment for type 2 diabetes.Some glucose-lowering agents have been found to have an effect on bone metabolism.The present study explored if different doses of metformin have an effect on bone mineral density(BMD)and bone metabolism in type 2 diabetes.AIM To investigate the effects of different doses of metformin on BMD and bone metabolism in elderly male patients with type 2 diabetes mellitus.METHODS A total of 120 elderly male outpatients with type 2 diabetes mellitus who were admitted to our hospital were included in the study from July 2018 to June 2019.They were randomly assigned to an experimental group and a control group with 60 patients in each group.Patients in the experimental group were given high dose metformin four times a day 0.5 g each time for 12 wk.Patients in the control group were given low dose metformin orally twice a day 0.5 g each time for 12 wk.The changes in bone mineral density and bone metabolism before and after treatment and the efficacy rate of the treatment were compared between the two groups.RESULTS There was no significant difference in the efficacy rate between the two groups(P>0.05).Before the treatment,there was no significant difference in BMD and bone metabolism between the two groups(P>0.05).However,after the treatment,BMD and bone metabolism were improved in the two groups.Moreover,BMD and 25-hydroxyvitamin D were significantly higher in the experimental group than in the control group,and N-terminal/midregion andβ-isomerized Cterminal telopeptides were significantly lower in the experimental group than in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION Both high and low dose metformin can effectively control the blood glucose levels in elderly male patients with type 2 diabetes mellitus.However,the benefits of high dose metformin in improving BMD and bone metabolism level was more obvious in patients with type 2 diabetes mellitus.
文摘AIM To measure the incidence and determinants(predictors) of hypoglycemia among patients with type 2 diabetes mellitus(T2DM) who were on insulin treatment for at least one year. METHODS The present study is an out-patients based inquiry about the risk and predictors of hypoglycemia among patients with T2DM seeking care at the Al-Faiha Specialized Diabetes, Endocrine, and Metabolism Center, in Basrah over a period of 7 mo(from 15^(th) of April, 2013 to 15^(th) of October, 2013). The data used in the study were based on all detailed interview and selected laboratory investigations. A total of 336 patients could be included in the study.RESULTS The incidence of overall hypoglycemia among the studied patients was 75.3% within the last 3 mo preceding the interview. The incidence of hypoglycemia subtypes were 10.2% for severe hypoglycemia requiring medical assistance in the hospital, 44.36% for severe hypoglycemia treated at home by family; this includes both confirmed severe hypoglycemia with an incidence rate of 14.6% and unconfirmed severe hypoglycemia for which incidence rate was 29.76%. Regarding mild self-treated hypoglycemia, the incidence of confirmed mild hypoglycemia was 21.42%, for unconfirmed mildhypoglycemia the incidence rate was 50.0% and for total mild hypoglycemia, the incidence rate was 71.42%. The most important predictors of hypoglycemia were a peripheral residence, increasing knowledge of hypoglycemia symptoms, in availability and increasing frequency of self-monitoring blood glucose, the presence of peripheral neuropathy, higher diastolic blood pressure, and lower Hemoglobin A1c.CONCLUSION Hypoglycemia is very common among insulin-treated patients with T2DM in Basrah. It was possible to identify some important predictors of hypoglycemia.
基金the Grants from Department of Education of Shandong Province, No.J02K11
文摘BACKGROUND： At present, central cholinergic neuron system is regarded the most major structural basis of cognitive function. Changes in structure of cholinergic neuron system of brain and receptor expression after brain injury can cause cognitive impairment. OBJECTIVE＂ To comparatively observe the intelligence quotient （IQ）, latent period and wave amplitude of P300 event-related potential and the difference of activity of acetylcholinesterase （ACHE） in blood and cerebrospinal fluid between patients with type 2 diabetes mellitus and with non-diabetes mellitus, and analyze the correlation of IQ of cognitive impairment patients with diabetes mellitus with AChE activity, latent period and wave amplitude of P300 event-related potential in cerebrospinal fluid. DESIGN： Correlation analysis of contrast observation SETTING： Department of Endocrinology, Affiliated Hospital of Binzhou Medical College PARTICIPANTS： Totally 32 patients with type 2 diabetes mellitus who received the treatment in the Department of Endocrinology, Affiliated Hospital of Binzhou Medical College between April 2004 and April 2005 were recruited, serving as diabetes mellitus group. They, including 19 male and 13 female, aged 49 to 73 years, with disease course of 4 to 11 years, all met the diagnostic criteria of diabetes mellitus revised by World Health Organization in 1999. Another 30 patients with non-diabetes mellitus who homeochronously underwent lumbar anesthesia in the Department of Surgery and Department of Gynecology were recruited, serving as non-diabetes mellitus group. The 30 patients included 18 male and 12 female, and their age ranged from 46 to 71 years. Informed consents of detected items were obtained from the involved patients. METHODS： ① Evaluation,on IQ： The IQ of involved subjects was evaluated with Chinese Version of the Wechsler Adult Intelligence Scale revised by Gong Yao-xian （WAIS-RC）. WAIS-RC included 6 verbal subscales and 5 performance subscales. The test scores of the 11 subscales integrated into the scores of the whole scale, and the scores on the WAIS-RC included verbal IQ （VlQ）, performance IQ （PIQ） and full scale IQ （FIQ）. FIQ ≤79 scores indicated low IQ and FIQ≤69 indicated intelligence impairment. ② Detection of P300 wave： P300 wave was detected with evoked potential instrument （MYTOPRO, Italian）, and data of latent period and amplitude of P300 event-related potential were automatically shown by computer. ③ Detection of AChE activity in blood and cerebrospinal fluid： Activity of AChE of blood and cerebrospinal fluid was measured with biochemical methods by using CORNING-560 autoanalyzer.④Correlation analysis： Correlation of FIQ with AChE of cerebrospinal fluid and P300 wave of patients with type 2 diabetes mellitus was analyzed, t test was used in intergroup comparison and linear correlation analysis for relevant treatment. MAIN OUTCOME MEASURES： ① Comparison of IQ, latent period and wave amplitude of P300 wave as well as the activity of AChE between two groups. ② Analysis on the correlation of FIQ of patients with type 2 diabetes mellitus with AChE of cerebrospinal fluid and P300 wave. RESULTS： Thirty-two patients with diabetes mellitus and 30 non-diabetes mellitus participated in the result analysis. ①Comparison of IQ, latent period and wave amplitude of P300 wave as well as the activity of AChE between two groups： The scores of VIP, PIQ and FIQ of patients with type 2 diabetes mellitus were （97.4±10.4）. （92.6±8.4） and （95.2±9.7） scores, respectively; and those of patients with non-diabetes mellitus were （104.7±9.6）, （102.5±8.5）and（102.7±8.9） scores, respectively, and P 〈 0.05-0.01 was set in intergroup comparison. The latent period of P300 wave at points Fz , Cz and Pz of patients with type 2 diabetes mellitus was （370.8±41.8）.（371.5±39.1）and （375.1±43.1） ms, respectively, and that of patients with non-diabetes mellitus was （ 332.1 ±28.3 ）, （335.7 ±29.4）and （339.7 ±27.3） ms, respectively, and P 〈 0.01 was set in intergroup comparison; Wave amplitude of P300 of patients with type 2 diabetes mellitus was （8.6±4.1）,（8.6±4.0） and （7.7±4.0） μV, respectively and that of patients with non-diabetes mellitus was （11.9±4.1）,（11.5±4.4） and （10.9±5.0） μV, respectively , and P 〈 0.05-0.01 was set in intergroup comparison; The level of AChE in blood and cerebrospinal fluid of patients with type 2 diabetes mellitus was （235.61 ±50.34）and （17.89±4.46） μkat/L, respectively, which was significantly higher than that of patients with non-diabetes mellitus [（205.03±44.15）and （14.63±0.48） μkat /L, respectively], and P 〈 0.05-0.01 was set in the intergroup comparison. ② Correlation of FIQ value of patients with type 2 diabetes mellitus with AChE of cerebrospinal fluid and P300 wave： The value of FIQ was significantly negatively correlated with the AChE activity of cerebrospinal fluid （r=-0.588 1, P 〈 0.01 ）, significantly negatively correlated with the latent period at points Fz. C and Pz of P300 wave （r= -0.700 5, -0.689 4, -0.688 5, P 〈 0.01 ）, and significantly positively correlated with the amplitude at points Fz . Cz and Pz of P300 wave（r= 0.607 4,0.616 1,0.592 0,P 〈 0.01 ）. CONCLUSION： ① Cognitive impairment of patients with type 2 diabetes mellitus might be related to the increase of activity of AChE in cerebrospinal fluid. ②Combined application of examination of P300 wave and evaluation of IQ is more useful in deciding the state of cognitive function of patients with type 2 diabetes mellitus.
基金National natural science foundation of China(No.81774254)。
文摘Type 2 diabetes mellitus(T2DM)is a common clinical endocrine and metabolic disease characterized by elevated blood sugar and insulin resistance.The onset of T2DM will affect the metabolic balance of the body,and uric acid metabolism is one of them.Hyperuricemia(HUA)is very common in type 2 diabetes.Based on HUA,gout is a crystal-related disease caused by urate deposition,and its clinical manifestations are complex and varied.Professor zhao quanlin has rich experience in clinical experience,and he has made good use of traditional Chinese medicine system to treat type 2 diabetes mellitus with gout in the acute phase of clinical effect.
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<strong>Background:</strong> Diabetes mellitus (DM) is one of the most common non-communicable diseases and among the leading causes of disability, morbidity and mortality globally. The study assessed adherence to treatment by type 2 DM patients aged 20 years and above at Monze Mission Hospital in Monze district, Zambia. Research questions: 1) What is the level of adherence to treatment by type 2 DM patients receiving care from Monze Mission Hospital? 2) What factors influence adherence to treatment by type 2 DM patients? <strong>Methods:</strong> The study was conducted in 2017. It was a cross-sectional design. Simple random sampling method was used to select respondents and data was collected using a structured interview schedule. Data was entered and analyzed using the modified self-reported Morisky Medication Adherence Scale with six scores, modified self-care management questionnaire and IBM<span style="white-space:nowrap;"><sup><span style="white-space:nowrap;"><span style="white-space:nowrap;">©</span></span></sup> </span>Statistical Package for Social Sciences. Chi-Square was used to test associations between variables and binary logistic regression was used for multivariate analysis. The Morisky Medication Adherence scale was interpreted as follows: patients who scored between 4 - 6 points on knowledge had high knowledge while those who scored between 1 - 3 points had low knowledge about the disease. <strong>Results: </strong>The sample size of the study was 138 respondents. The study showed, only 44.2% of respondents had good adherence to treatment as they scored above 4 using the Morisky Medication Adherence Scale. Majority of the patients (55.6%) had knowledge about treatment despite 65.2% of respondents reported distance and financial challenges as hindrances to adherence. The study revealed a statistical association between adherence and knowledge of type 2 DM treatment. <strong>Conclusion:</strong> The study showed that poor adherence to treatment reduced as knowledge about DM increased. There is need to consider educational programs to strengthen adherence to dietary advice, regular exercise and follow up, to achieve normal glycemic levels.
基金Supported by Science and Technology Bureau of Jining,No.2021YXNS115.
文摘BACKGROUND Carpal tunnel syndrome(CTS)has been associated with gout and type 2 diabetes mellitus(T2DM).However,due to insufficient clinical understanding of goutrelated CTS and reliance on the diagnostic importance of elevated serum uric acid levels,such cases are prone to missed diagnosis,misdiagnosis,and delayed treatment.In addition,the effect of T2DM on gout-induced carpal tunnel syndrome has not been reported.CASE SUMMARY Herein,we present an unusual case of CTS and motor dysfunction caused by miliary tophaceous gout and T2DM.The patient presented to the hand and foot clinic with paresthesia of the fingers of both hands,especially at night.The patient was diagnosed with type 2 diabetes a month ago.Ultrasonography revealed bilateral transverse carpal ligament thickening with median nerve compression during hospitalization.The patient was successfully treated with carpal tunnel decompression and tendon release.The postoperative pathological examination revealed typical gout nodules.This case suggests that the presence of T2DM could accelerate tophi formation and worsen CTS symptoms,although no definitive proof in this regard has been described previously.CONCLUSION Tophi formation may most likely cause the co-occurrence of CTS and flexor dysfunction in gout and incipient diabetes patients.
文摘Objective Modified upper abdominal cluster transplantation ( MCT) ,which was inspired by classical cluster transplant technique,has been proven more effective and feasible in the treatment of patients with end stage liver diseases associated with insulin - dependent
文摘Diabetes has become a growing concern in Japan, both medically and financially. The medical cost of diabetes was estimated at 1215 billion yen for fiscal year 2011. We analyzed the length of stay (LOS) in a hospital for type 2 diabetes mellitus patients who participated in educational programs to determine factors affecting LOS. Data on 991 patients obtained from 28 Red Cross hospitals in 2008 were used. For the analysis, we used the Box-Cox transformation model and Hausman test. The results revealed that patients aged 75 years and above and those with comorbidities and complications were prone to longer LOS. The analysis also revealed significant differences in LOS across the hospitals, even after controlling for patient characteristics. Finally, we applied the least squares method to determine the effects of hospital and regional factors and revealed that patients’ LOS was affected by the region’s average LOS. Regional corporations and networks appeared to be important in improving educational programs.
文摘Objective: To evaluate patient satisfaction with insulin glargine. Design: Multicentre observational registry. Data were collected at baseline/inclusion visit, and 12 and 24 weeks. Setting: Physicians in Hong Kong, who managed type 2 diabetes patients and had >5 years’ experience in using insulin glargine. Patients: People with type 2 diabetes, new to insulin, aged 18 - 75 years, who were previously being treated with ≤3 oral antidiabetes drugs (OAD) and had HbA1c > 7%, and in whom the?physicians had chosen to prescribe glargine for the first time. Main outcome measures: Treatment satisfaction assessed by Diabetes Treatment Satisfaction Questionnaire (DTSQs), glycaemic control (fasting blood glucose and HbA1c) and adverse events. Results: Between April 2010-October 2011, 41 patients completed the study. Average duration of diabetes and OAD therapy was 7.8 ± 8.0 years and 6.7 ± 7.4 years, respectively. The global DTSQs treatment satisfaction scores improved from 20.9 at baseline to 28.4 (p < 0.05) at the end of 24 weeks insulin glargine treatment. Analysis of DTSQs scores showed a decrease in perceived frequency of hyperglycaemia (4.1 to 1.9, p < 0.001) and hypoglycemia (2.2 to 1.5, p = 0.079). Perceived convenience (0.60, p < 0.025) and flexibility (0.9, p < 0.009) were also improved from baseline. Reduction in mean HbA1c (10.2% ± 2.2% to 7.0% ± 1.0%) and fasting blood glucose (10.9 ± 4.0 mmol/L to 6.4 ± 1.8 mmol/L) from baseline to study termination was significant (p < 0.05). Almost half (48.7%) of patients achieved HbA1c ≤ 7.0%, while 26.0% patients had FBG < 5.6 mmol/L. In total, 9 (22.0%) patients experienced at least one hypoglycemia event;there were no reports of severe hypoglycaemia. Conclusions: Despite a small number of subjects completed in this study, the study demonstrated clearly that the addition of insulin glargine to OAD therapy in diabetes management improved treatment satisfaction and perceived frequency of hyper-and hypoglycaemia together with glycaemic control close to recommended target without severe side-effects in this cohort of patients in Hong Kong.
文摘The correlation between liver enzymes and lipid profile in T2D patients in the Yemeni population has been evaluated. This is a case-control study comprising 142 T2D patients and 142 healthy control subjects were carried out at the outpatient clinics of Ibn-Sina hospital, Mukalla, during the period from January to May 2020. Serum fasting blood glucose (FBG), total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT) were analyzed using the Cobas Integra Plus 400 autoanalyzer. Also, anthropometric and blood pressure measurements were taken from each participant. Independent sample T-test and Pearson correlation coefficient were used. T2D patients had significantly higher FBG (P ≤ 0.0001), total cholesterol (P ≤ 0.0001), LDL-C (P ≤ 0.0001), and GGT (P ≤ 0.0001) while HDL-C was significantly lower in T2D patients (P = 0.021). In correlation analysis, serum GGT was positively associated with FBG (r = 0.216;P ≤ 0.0001), total cholesterol (r = 0.196;P = 0.0001), triglyceride (r = 0.123;P = 0.038), and LDL-C (r = 0.209;P ≤ 0.0001). Also, serum ALT was positively associated with FBG (r = 0.145, P = 0.014) and triglyceride (r = 0.172, P = 0.004). In conclusion, higher levels of ALT and GGT are used as the predictive biomarkers for NAFLD in T2D patients with hyperlipidemia. Thus, routine screening of liver enzymes and lipid profile in T2D patients is recommended for the early detection of liver abnormalities and diminish diabetes complications.
文摘目的分析老年2型糖尿病(T2DM)患者发生抑郁的影响因素,为制定精准干预方案以减少抑郁发生提供理论依据。方法采用便利抽样法选取2018年1月至2021年12月在某三甲医院老年病内分泌科接受治疗的242例老年T2DM患者作为研究对象,利用老年抑郁量表-15(GDS-15)评估患者发生抑郁的情况,根据纳入及排除标准最终纳入170例。收集患者的临床资料,用Fried衰弱表型定义量表、匹兹堡睡眠质量指数量表(PSQI)、老年人运动功能量表(GLFS)分别评定患者的衰弱、睡眠质量及运动功能。采用二分类Logistic回归分析探讨影响老年T2DM患者发生抑郁的因素。结果170例老年T2DM患者中有51例发生抑郁(抑郁组),119例未发生抑郁(非抑郁组)。两组的居住方式、低血糖次数、合并其他疾病及衰弱分类占比比较,差异具有统计学意义(P<0.05);抑郁组的病程长于非抑郁组,甘油三酯(TG)、空腹血浆葡萄糖(FPG)、餐后2小时血糖(2 h PBG)水平、糖化血红蛋白(HbA1c)及Fried衰弱评分、PSQI、GLFS评分高于非抑郁组(P<0.05)。多因素Logistic回归分析结果显示,运动相关指标、PSQI评分及居住方式是影响老年T2DM患者发生抑郁的因素(P<0.05)。结论老年T2DM患者抑郁发生率较高,需重点关注睡眠质量差、几乎不锻炼和独居的患者,并针对上述因素制定干预措施。
