BACKGROUND Glucose and lipid metabolic disorder in patients with type 2 diabetes mellitus(T2DM)is associated with the levels of serum tumor markers of the digestive tract,such as cancer antigen(CA)199.Therefore,tumor ...BACKGROUND Glucose and lipid metabolic disorder in patients with type 2 diabetes mellitus(T2DM)is associated with the levels of serum tumor markers of the digestive tract,such as cancer antigen(CA)199.Therefore,tumor markers in T2DM are important.AIM To evaluate the expression of serum tumor markers[CA199,CA242,and carcinoembryonic antigen(CEA)]and the clinical implications of the expression in T2DM.METHODS For this observational study conducted at Hefei BOE Hospital,China,we enrolled 82 patients with first-onset T2DM and 51 controls between April 2019 and December 2020.Levels of fasting blood glucose(FBG),tumor markers(CA199,CEA,and CA242),glycosylated hemoglobin(HbA1c),etc.were measured and group index levels were compared.Moreover,FBG and HbA1c levels were correlated with tumor marker levels.Tumor markers were tested for diagnostic accuracy in patients with>9%HbA1c using the receiver operating curve(ROC)curve.RESULTS The T2DM group had high serum FBG,HbA1c,CA199,and CEA levels(P<0.05).A comparative analysis of the two groups based on HbA1c levels(Group A:HbA1c≤9%;Group B:HbA1c>9%)revealed significant differences in CEA and CA199 levels(P<0.05).The areas under the ROC curve for CEA and CA199 were 0.853 and 0.809,respectively.CA199,CEA,and CA242 levels positively correlated with HbA1c(r=0.308,0.426,and 0.551,respectively)and FBG levels(r=0.236,0.231,and 0.298,respectively).CONCLUSION As compared to controls,serum CEA and CA199 levels were higher in patients with T2DM.HbA1c and FBG levels correlated with CA199,CEA,and CA242 levels.Patients with poorly controlled blood sugar must be screened for tumor markers.展开更多
BACKGROUND Cognitive dysfunction is the main manifestation of central neuropathy.Although cognitive impairments tend to be overlooked in patients with diabetes mellitus(DM),there is a growing body of evidence linking ...BACKGROUND Cognitive dysfunction is the main manifestation of central neuropathy.Although cognitive impairments tend to be overlooked in patients with diabetes mellitus(DM),there is a growing body of evidence linking DM to cognitive dysfunction.Hyperglycemia is closely related to neurological abnormalities,while often disregarded in clinical practice.Changes in cerebral neurotransmitter levels are associated with a variety of neurological abnormalities and may be closely related to blood glucose control in patients with type 2 DM(T2DM).AIM To evaluate the concentrations of cerebral neurotransmitters in T2DM patients exhibiting different hemoglobin A1c(HbA1c)levels.METHODS A total of 130 T2DM patients were enrolled at the Department of Endocrinology of Shanghai East Hospital.The participants were divided into four groups according to their HbA1c levels using the interquartile method,namely Q1(<7.875%),Q2(7.875%-9.050%),Q3(9.050%-11.200%)and Q4(≥11.200%).Clinical data were collected and measured,including age,height,weight,neck/waist/hip circumferences,blood pressure,comorbidities,duration of DM,and biochemical indicators.Meanwhile,neurotransmitters in the left hippocampus and left brainstem area were detected by proton magnetic resonance spectroscopy.RESULTS The HbA1c level was significantly associated with urinary microalbumin(mALB),triglyceride,low-density lipoprotein cholesterol(LDL-C),homeostasis model assessment of insulin resistance(HOMA-IR),and beta cell function(HOMA-β),N-acetylaspartate/creatine(NAA/Cr),and NAA/choline(NAA/Cho).Spearman correlation analysis showed that mALB,LDL-C,HOMA-IR and NAA/Cr in the left brainstem area were positively correlated with the level of HbA1c(P<0.05),whereas HOMA-βwas negatively correlated with the HbA1c level(P<0.05).Ordered multiple logistic regression analysis showed that NAA/Cho[Odds ratio(OR):1.608,95%confidence interval(95%CI):1.004-2.578,P<0.05],LDL-C(OR:1.627,95%CI:1.119-2.370,P<0.05),and HOMA-IR(OR:1.107,95%CI:1.031-1.188,P<0.01)were independent predictors of poor glycemic control.CONCLUSION The cerebral neurotransmitter concentrations in the left brainstem area in patients with T2DM are closely related to glycemic control,which may be the basis for the changes in cognitive function in diabetic patients.展开更多
Objectives The purpose of this study was to assess the association between triglycerides(TG),total cholesterol(TC)at baseline,and type 2 diabetes mellitus(T2DM)incidence in a general Chinese population.Further,it aime...Objectives The purpose of this study was to assess the association between triglycerides(TG),total cholesterol(TC)at baseline,and type 2 diabetes mellitus(T2DM)incidence in a general Chinese population.Further,it aimed to evaluate the ability of TG and TC to predict T2DM incidence.Methods Qingdao Diabetes Prevention Program participants recruited between 2006 and 2009 were followed up in 2012–2015.TG,TC,and T2DM status were measured.Cox proportional hazards models were used to estimate the association between TG,TC,and T2DM incidence.The receiver operating characteristic(ROC)curve was used to evaluate the ability of TG and TC to identify T2DM participants.Results The incidence of T2DM significantly increased with TG in women and TC in both men and women(Ptrend<0.05).Univariate Cox regression indicated that higher TG{borderline high TG[hazards ratio(HR):2.05;95%confidence interval(CI):1.40,3.00]and hypertriglyceridemia[HR:2.64;95%CI:1.68,4.15]}and TC[hypercholesterolemia(HR:2.05;95%CI:1.43,2.95)]were significantly associated with increased risk of T2DM incidence in women but not in men.Multivariate Cox regression showed that hypertriglyceridemia in women(HR:1.78,95%CI:1.07,2.97),borderline high TC in men(HR:1.61,95%CI:1.04,2.48),and hypercholesterolemia in women(HR:1.68,95%CI:1.81,2.61)had a higher significant risk of T2DM incidence.The optimal cutoff values of TG were>1.15 and>1.23 mmol/L in men and women,respectively.For TC,they were>5.17 and>5.77 mmol/L in men and women,respectively.The area under the ROCs of TG and TC were 0.54(0.51–0.57)and 0.55(0.52–0.58),respectively,in men,and 0.60(0.58–0.62)and 0.59(0.56–0.61),respectively,in women.Conclusion Elevated TG and TC were risk factors for T2DM incidence.However,no predictive capacity was found for both factors to identify T2DM incidence in Chinese men and women.Hence,TG and TC levels in both Chinese men and women might be used for decreasing the incidence of T2DM but no clinical predictive capacity for T2DM.展开更多
BACKGROUND Anaemia is common in patients with chronic kidney disease(CKD)and is a major risk factor that contributes to mortality in such patients.Type 2 diabetes mellitus(T2DM)is one of the leading causes of CKD.The ...BACKGROUND Anaemia is common in patients with chronic kidney disease(CKD)and is a major risk factor that contributes to mortality in such patients.Type 2 diabetes mellitus(T2DM)is one of the leading causes of CKD.The association between admission hemoglobin levels and renal damage in patients with T2DM remains unclear.AIM To evaluate the relationship between admission hemoglobin levels and prognosis in patients with T2DM.METHODS We performed a retrospective analysis of 265 consecutive patients presenting with T2DM between 2011 and 2015.The composite endpoint was end-stage renal disease or a 50%reduction in the estimated glomerular filtration rate.RESULTS In multivariable-adjusted Cox proportional hazards models(adjusting for demographic factors,traditional risk factors,lipids),the adjusted hazard ratios(HRs)for the highest and middle tertiles compared to the lowest tertile of hemoglobin were 0.82(95%CI:0.11-6.26,P=0.8457)and 0.28(95%CI:0.09-0.85,P=0.0246),respectively.However,after further adjustment for glycaemia control,hemoglobin was positively related to the risk of the composite endpoint(HR:1.05,95%CI:0.14-8.09,P=0.9602)when the highest tertile was compared to the lowest tertile of hemoglobin.We found a U-shaped relationship between hemoglobin levels and the composite endpoint.The curve tended to reach the lowest level at an optimal hemoglobin level.CONCLUSION Among patients with T2DM,a U-shaped relationship was observed between hemoglobin levels and renal damage.A lower admission hemoglobin level(hemoglobin<13.3 g/dL)is an independent predictor of renal damage.展开更多
This letter to editor discusses on the publication on admission hemoglobin level and prognosis of type 2 diabetes mellitus.A comment on published article is raised.The specific confounding conditions on the hemoglobin...This letter to editor discusses on the publication on admission hemoglobin level and prognosis of type 2 diabetes mellitus.A comment on published article is raised.The specific confounding conditions on the hemoglobin level are mentioned.Concerns on clinal application are raised and discussed.展开更多
Background: Diabetes mellitus is a common disease and it is a major cause of morbidity;several studies indicate that diabetes is a likely under reported cause of death. Chromium’s is important trace element to contro...Background: Diabetes mellitus is a common disease and it is a major cause of morbidity;several studies indicate that diabetes is a likely under reported cause of death. Chromium’s is important trace element to control diabetes mellitus and metabolism of carbohydrate, lipid and protein. Objective: The purpose of this study was to understand the relationship between serum chromium, with HbA1c, Total cholesterol and Triglycerides among type 2 diabetes patients among diabetic patients. Methodology: This is cross-sectional study done in Jabber Abu Ezz Centre for treatment and care of diabetics in Khartoum—Sudan. Four hundred subjects were enrolled in this study;one hundred subjects were normal healthy as control group, and three hundred subjects diabetic patient type 2 as test group;demographic and biochemical data were collected;serum chromium, Glycosylated Haemoglobin (HbA1c), Total cholesterol Triglycerides, were determined by using NYCOCARD READER II, spectrophotometer (Biosystem 310) and spectrophotometer 210-VGP. Result: In this study there is significant parameters level means of FBS HbA1c, Total Cholesterol, Triglycerides and Chromium of the test groups when compared with healthy control groups subjects (P = 0.001, 0.018, 0.01, 0.011, 0.004), respectively. Significant negative correlation is between FBS, HbA1c, Total Cholesterol, Triglycerides and Chromium (r = ?0.555, P value = 0.003), (r = ?0.668, P value = 0.002), (r = ?0.335, P value = 0.004) and (r = ?0.774, P value = 0.002) respectively. Conclusion: There was significant correlation between serum Chromium level with fasting blood sugaer, Glycosylated Haemoglobin (HbA1c), Total cholesterol and Triglycerides among type 2 diabetes patients.展开更多
AIM:To evaluate the safety and efficacy of human embryonic stem cells(h ESCs)for the management of type 2 diabetes mellitus(T2DM).METHODS:Patients with a previous history of diabetes and its associated complications w...AIM:To evaluate the safety and efficacy of human embryonic stem cells(h ESCs)for the management of type 2 diabetes mellitus(T2DM).METHODS:Patients with a previous history of diabetes and its associated complications were enrolled and injected with hE SC lines as per the defined protocol.The patients were assessed using Nutech functional score(NFS),a numeric scoring scale to evaluate the patients for 11 diagnostic parameters.Patients were evaluated at baseline and at the end of treatment period 1(T1).All the parameters were graded on the NFS scale from 1to 5.Highest possible grade(HPG)of 5 was considered as the grade of best improvement.RESULTS:Overall,94.8%of the patients showed improvement by at least one grade of NFS at the end of T1.For all the 11 parameters evaluated,54%of patients achieved HPG after treatment.The four essential parameters(improvement in glycated hemoglobin(HbA 1c)and insulin level,and fall in number of other oral hypoglycemic drugs with and without insulin)are presented in detail.For Hb A1c,72.6%of patients at the end of T1 met the World Health Organization cut off value,i.e.,6.5%of HbA 1c.For insulin level,65.9%of patients at the end of T1 were able to achieve HPG.After treatment,the improvement was seen in 16.3%of patients who required no more than two medications along with insulin.Similarly,21.5%of patients were improved as their dosage regimen for using oral drugs was reduced to 1-2 from 5.CONCLUSION:hE SC therapy is beneficial in patients with diabetes and helps in reducing their dependence on insulin and other medicines.展开更多
AIM:To determine the effect of different Roux-en-Y gastric bypass procedures in gastric carcinoma patients with type 2 diabetes mellitus.METHODS:A retrospective analysis of the clinical data of 54 patients with gastri...AIM:To determine the effect of different Roux-en-Y gastric bypass procedures in gastric carcinoma patients with type 2 diabetes mellitus.METHODS:A retrospective analysis of the clinical data of 54 patients with gastric cancer and type 2 diabetes mellitus treated in the Department of General Surgery from January 2006 to June 2013 was conducted.The patients underwent gastrectomy using different Rouxen-Y gastric bypass procedures(traditional,n=26;modified,n=28).Fasting plasma glucose(FPG),two hour postprandial blood glucose(2 h PBG)and hemoglobin A1c(Hb A1c)were analyzed before surgery(0 mo)and 1,3 and 6 mo after surgery.RESULTS:FPG and 2 h PBG levels were significantlydecreased 1 mo after surgery in the traditional Rouxen-Y gastric bypass group(FPG 7.5±1.3 vs 10.7±1.2,P<0.05)(2 h PBG 10.2±1.8 vs 13.8±3.2,P<0.05).FPG and 2 h PBG levels were significantly decreased after surgery in the modified Roux-en-Y gastric bypass group(FPG 6.9±1.2 vs 10.5±1.1,6.5±1.3 vs 10.5±1.1,6.4±1.2 vs 10.5±1.1,P<0.05)(2 h PBG9.9±2.2 vs 14.1±2.9,9.2±2.4 vs 14.1±2.9,8.9±2.6 vs 14.1±2.9,P<0.05).Compared with the levels before surgery,Hb A1c levels were significantly decreased 3 and 6 mo after surgery(7.2±1.1 vs 10.5±1.1,5.5±1.1 vs 10.5±1.1,P<0.05).Significant differences between the two groups regarding FPG,2 h PBG and Hb A1c concentration were observed 3 and 6mo after surgery(FPG 10.1±1.5 vs 6.5±1.3,10.3±1.4 vs 6.4±1.2,P<0.05)(2 h PBG 13.1±2.8 vs 9.2±2.4,13.6±3.1 vs 8.9±2.6,P<0.05)(Hb A1c 10.1±1.4 vs 7.2±1.1,10.5±1.3 vs 5.5±1.1,P<0.05).CONCLUSION:Modified Roux-en-Y gastric bypass can improve glucose metabolism in type 2 diabetic patients with gastric cancer.展开更多
BACKGROUND Type 2 diabetes mellitus(T2DM)is a risk factor for nonalcoholic fatty liver disease(NAFLD).AIM To determine the prevalence and clinical correlates of NAFLD in a large cohort of patients with T2DM.METHODS Fo...BACKGROUND Type 2 diabetes mellitus(T2DM)is a risk factor for nonalcoholic fatty liver disease(NAFLD).AIM To determine the prevalence and clinical correlates of NAFLD in a large cohort of patients with T2DM.METHODS Four hundred thirty-seven participants with T2DM who consulted at Meijo Hospital from April 2019 to September 2020 and underwent computed tomography(CT)were assessed.The mean age was 74±13 years,and 269 were men.Hepatic attenuation minus splenic attenuation(CTL−S)less than 1 Hounsfield unit was considered fatty liver.NAFLD was defined as fatty liver in the absence of significant alcohol consumption and hepatitis virus infection.A multiple logistic regression was used to assess the independent factors associated with NAFLD.RESULTS NAFLD was identified in 25.2%of the participants.Young age(odds ratio[OR]=−0.945;95%confidence interval[CI]:0.922–0.969),higher hemoglobin levels(OR=1.501,95%CI:1.278–1.764),lower high-density lipoprotein(HDL)cholesterol levels(OR=0.971,95%CI:0.953–0.989),and the absence of dialysis(OR=0.109,95%CI:0.014–0.856)were independent predictors of NAFLD.CONCLUSION NAFLD was detected with CT in 25.2%of the participants.NAFLD was associated with younger age,higher hemoglobin levels,lower HDL cholesterol levels,and an absence of dialysis.展开更多
Type 2 diabetes mellitus and its complications are associated with oxidative stress and the depletion of antioxidant defenses. The influence of acetylsalicylic acid on reversing the decrease in antioxidants, insulin r...Type 2 diabetes mellitus and its complications are associated with oxidative stress and the depletion of antioxidant defenses. The influence of acetylsalicylic acid on reversing the decrease in antioxidants, insulin resistance, glucose homeostasis, and inflammatory cascade can help prevent diabetes complications. Purpose: The aim of the study was to evaluate the effect of acetylsalicylic acid on the antioxidant enzymatic system in patients with diabetes. Methods: A randomized, double-blind, placebo-controlled clinical trial was carried out in 21 patients of both sexes with Type 2 diabetes for less than five years at the time of diagnosis, without pharmacological treatment, and randomly selected. Acetylsalicylic acid (300 mg) was administered orally for three months to the study group (n = 11) compared to the placebo control group (n = 10). Before and after the intervention, anthropometric and metabolic measurements were taken, fasting plasma glucose, glycated hemoglobin A1c, lipid profile panel, glutathione peroxidase, superoxide dismutase, catalase, and antioxidant capacity/activity were determined;values are presented as mean ± standard deviation. Intra- and intergroup differences were tested by Wilcoxon signed rank and Mann-Whitney U test, respectively;p-value ≤ 0.05 was considered statistically significant. Results: The acetylsalicylic acid group showed a decrease in weight (85.6 ± 19.3 vs. 84.1 ± 19.0 kg p = 0.01), cholesterol (205.9 ± 16.6 vs. 186.0 ± 23.2 mg/dL p = 0.02), and glycated hemoglobin A1c (7.8% ± 0.9% vs. 7.0% ± 0.7% p = 0.02). The placebo group exhibited reduction in weight (76.1 ± 14.9 vs. 74.9 ± 15.0 kg p = 0.04), glycated hemoglobin A1c (6.9% ± 0.6% vs. 6.2% ± 0.4% p = 0.004), and total antioxidant capacity (4.1 ± 0.5 vs. 4.8 ± 0.3 mmol/L p = 0.002). Conclusion: The administration of acetylsalicylic acid did not modify the antioxidant enzyme system.展开更多
<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong><em>Background:</em></strong> Very limited data are available regarding the associat...<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong><em>Background:</em></strong> Very limited data are available regarding the association of vitamin D with glycemic status among adults with newly detected type 2 diabetes mellitus (T2DM) in Bangladesh. <strong><em>Objectives:</em></strong> To determine vitamin D status and its association with glycemic status in Bangladeshi adults with newly detected T2DM. <strong><em>Materials and Methods:</em></strong> This cross-sectional study was carried out in 102 newly detected T2DM diagnosed on the basis of the American Diabetes Association 2017 criteria (age: 42.95 ± 10.68 yrs.;m/f: 44/58) and equal number of age and sex matched controls (age: 40.43 ± 11.04 years) recruited consecutively from the Department of Endocrinology, BSMMU to measure serum vitamin D by high performance liquid chromatography method. <strong><em>Results:</em></strong> Both vitamin D deficiency (<20 ng/ml) (87.3% vs. 74.5%, <em>p </em>< 0.03) and severe vitamin D deficiency (<10 ng/ml) (56.2% vs. 26.3%, <em>p</em> < 0.001) were significantly higher in people with T2DM than control population. The mean level of 25(OH)D was significantly lower in adults with T2DM than control population (12.41 ± 6.85 ng/ml vs. 15.74 ± 6.25 ng/ml, <em>p</em> < 0.001). A significant inverse correlation was observed between vitamin D & HbA<span style="white-space:nowrap;"><sub>1</sub></span>c (r = <span style="white-space:nowrap;">-</span>0.249, <em>p</em> = 0.011) in patients with T2DM. HbA<span style="white-space:nowrap;"><sub>1</sub></span>c was linearly associated with vitamin D (<em>β </em>= <span style="white-space:nowrap;">-</span>0.26, <em>p</em> = 0.009) and severe vitamin D deficiency by binary (OR = 1.37, <em>p</em> = 0.003) and multinomial logistic regression (HbA<span style="white-space:nowrap;"><sub>1</sub></span>c ≥ 10%: OR = 4.25, <em>p </em>= 0.04) in people with T2DM after adjustment for age and BMI. <strong>Conclusions:</strong> Severe vitamin D deficiency was positively associated with T2DM and inversely associated with HbA<span style="white-space:nowrap;"><sub>1</sub></span>c in patients with newly detected T2DM.</span> </div>展开更多
Objective:To probe glycemic excursions in type 2 diabetic patients whose hemoglobin A1c(HbA1c) was kept ≤6.0%.Methods:Totally 36 cases with type 2 diabetes(T2DM) with HbA1c≤6.0% and 30 cases with normal glucose tole...Objective:To probe glycemic excursions in type 2 diabetic patients whose hemoglobin A1c(HbA1c) was kept ≤6.0%.Methods:Totally 36 cases with type 2 diabetes(T2DM) with HbA1c≤6.0% and 30 cases with normal glucose tolerance(NGT) from December 2005 to December 2007 in our department were subjected prospectively.Continuous glucose monitoring system(CGMS) was employed to record their continuous blood glucose level for 3 d.The blood glucose profiles including the mean blood glucose(MBG),standard differentiation(SD),mean amplitude of glycemic excursions(MAGE) and absolute means of daily differences(MODD) were analyzed.Results:T2DM group had obviously postprandial hyperglycemia,in about 2 h after meal,especially after breakfast.Fifty-two hypoglycemic episodes occurred during the monitoring period in T2DM groups,of which 73.1%(38 episodes) were absence of symptomatic hypoglycemia with the lowest value of blood glucose only 2.0 mmol/L.And 20 episodes took place during the day hours,while 32 episodes observed during the night hours.Compared with NGT groups,SD,MAGE and MODD were all significantly higher in T2DM groups.MBG was significantly correlated with HbA1c in T2DM groups,but SD,MAGE,NGE and MODD were all independent of HbA1c.MAGE was independent of MODD.Conclusion:The amplitude of glycemic excursions is higher in normol-controlled T2DM groups than the NGT groups.Thus ideally glycemic control is not only to make HbA1c reach standard,but also to lessen glycemic excursions and reduce hypoglycemia episodes.展开更多
Objective:To compare the therapeutic effects of acupuncture with sham acupuncture on levels of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) among patients with type-2 diabetes mellitus (T2DM) under tre...Objective:To compare the therapeutic effects of acupuncture with sham acupuncture on levels of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) among patients with type-2 diabetes mellitus (T2DM) under treatment with metformin.Method:Eighty participants with T2DM were allocated randomly to treatment (n =40) and control (n =40) groups.In addition to metformin therapy,patients in the acupuncture group received acupoint stimulation with even manipulation at 15 acupoints,and needles were retained for 20 minutes.The sham-acupuncture group was treated with very small needles inserted at a very shallow depth (3-5 mm) without manipulation at non-acupoints 1 cm around the actual acupuncture points.Both groups were treated for 14 sessions during 10 weeks of treatment.The FPG level was measured before treatment as well as after 1,2,4,6 and 12 weeks of treatment.The HbA1c percentage was assessed once before treatment and once 12 weeks after treatment initiation.Results:Levels of FPG and HbA1c in both groups were reduced significantly in comparison with baseline measurements (both P <.01).However,acupuncture treatment led to a significant reduction in the FPG level as compared with sham acupuncture after 4 weeks or 10 sessions of treatment [mean difference (MD) =10.18,95% confidence interval (CI) =1.74 to 18.6,P =.019],after 6 weeks or 12 sessions of treatment (MD =10.53,95% CI =2.22 to 18.83,P =.014) and after 12-week follow-up (MD =8.8,95% Cl =0.66 to 16.94,P =.034).Acupuncture treatment reduced the HbA1c level significantly in comparison with that in the shamacupuncture group (MD =0.27,95%Cl =0.08 to 0.47,P =.007).Conclusion:Our study revealed that acupuncture (as a type of Chinese therapy) combined with metformin (as a conventional hypoglycemic medication) had a greater effect on glycemic control than that elicited in the placebo control group.Consequently,acupuncture could be used as adjuvant therapy among patients with T2DM.展开更多
BACKGROUND Diabetic nephropathy(DN)is a common complication of type 1 and type 2 diabetes that can lead to kidney damage and high blood pressure.Increasing evidence support the important roles of microproteins and cyt...BACKGROUND Diabetic nephropathy(DN)is a common complication of type 1 and type 2 diabetes that can lead to kidney damage and high blood pressure.Increasing evidence support the important roles of microproteins and cytokines,such asβ2-microglobulin(β2-MG),glycosylated hemoglobin(HbA1c),and vascular endothelial growth factor(VEGF),in the pathogenesis of this disease.In this study,we identified novel therapeutic options for this disease.AIM To analyze the guiding significance ofβ2-MG,HbA1c,and VEGF levels in patients with DN.METHODS A total of 107 patients with type 2 diabetes mellitus complicated with nephropathy and treated in our hospital from May 2018 to February 2021 were included in the study.Additionally,107 healthy individuals and 107 patients with simple diabetes mellitus were selected as the control groups.Changes inβ2-MG,HbA1c,and VEGF levels in the three groups as well as the different proteinuria exhibited by the three groups were examined.RESULTS Changes inβ2-MG,HbA1c,and VEGF levels in the disease,healthy,and simple diabetes groups were significantly different(P<0.05).The expression of these factors from high to low were evaluated in different groups by pairwise comparison.In the disease group,high to low changes inβ2-MG,HbA1c,and VEGF levels were noted in the massive proteinuria,microproteinuria,and normal urinary protein groups,respectively.Changes in these factors were positively correlated with disease progression.CONCLUSION The expression of serumβ2-MG,HbA1c,and VEGF was closely correlated with DN progression,and disease progression could be evaluated by these factors.展开更多
文摘BACKGROUND Glucose and lipid metabolic disorder in patients with type 2 diabetes mellitus(T2DM)is associated with the levels of serum tumor markers of the digestive tract,such as cancer antigen(CA)199.Therefore,tumor markers in T2DM are important.AIM To evaluate the expression of serum tumor markers[CA199,CA242,and carcinoembryonic antigen(CEA)]and the clinical implications of the expression in T2DM.METHODS For this observational study conducted at Hefei BOE Hospital,China,we enrolled 82 patients with first-onset T2DM and 51 controls between April 2019 and December 2020.Levels of fasting blood glucose(FBG),tumor markers(CA199,CEA,and CA242),glycosylated hemoglobin(HbA1c),etc.were measured and group index levels were compared.Moreover,FBG and HbA1c levels were correlated with tumor marker levels.Tumor markers were tested for diagnostic accuracy in patients with>9%HbA1c using the receiver operating curve(ROC)curve.RESULTS The T2DM group had high serum FBG,HbA1c,CA199,and CEA levels(P<0.05).A comparative analysis of the two groups based on HbA1c levels(Group A:HbA1c≤9%;Group B:HbA1c>9%)revealed significant differences in CEA and CA199 levels(P<0.05).The areas under the ROC curve for CEA and CA199 were 0.853 and 0.809,respectively.CA199,CEA,and CA242 levels positively correlated with HbA1c(r=0.308,0.426,and 0.551,respectively)and FBG levels(r=0.236,0.231,and 0.298,respectively).CONCLUSION As compared to controls,serum CEA and CA199 levels were higher in patients with T2DM.HbA1c and FBG levels correlated with CA199,CEA,and CA242 levels.Patients with poorly controlled blood sugar must be screened for tumor markers.
基金Supported by the Academic Leaders Training Program of Pudong Health Bureau of Shanghai,No.PWRd2023-03Clinical Research Fund of Shanghai Municipal Commission of Health,No.202040136+1 种基金National Natural Science Foundation of China,No.82070842Jiangxi Health Commission Science and Technology Plan Project,No.202212838 and No.202212852.
文摘BACKGROUND Cognitive dysfunction is the main manifestation of central neuropathy.Although cognitive impairments tend to be overlooked in patients with diabetes mellitus(DM),there is a growing body of evidence linking DM to cognitive dysfunction.Hyperglycemia is closely related to neurological abnormalities,while often disregarded in clinical practice.Changes in cerebral neurotransmitter levels are associated with a variety of neurological abnormalities and may be closely related to blood glucose control in patients with type 2 DM(T2DM).AIM To evaluate the concentrations of cerebral neurotransmitters in T2DM patients exhibiting different hemoglobin A1c(HbA1c)levels.METHODS A total of 130 T2DM patients were enrolled at the Department of Endocrinology of Shanghai East Hospital.The participants were divided into four groups according to their HbA1c levels using the interquartile method,namely Q1(<7.875%),Q2(7.875%-9.050%),Q3(9.050%-11.200%)and Q4(≥11.200%).Clinical data were collected and measured,including age,height,weight,neck/waist/hip circumferences,blood pressure,comorbidities,duration of DM,and biochemical indicators.Meanwhile,neurotransmitters in the left hippocampus and left brainstem area were detected by proton magnetic resonance spectroscopy.RESULTS The HbA1c level was significantly associated with urinary microalbumin(mALB),triglyceride,low-density lipoprotein cholesterol(LDL-C),homeostasis model assessment of insulin resistance(HOMA-IR),and beta cell function(HOMA-β),N-acetylaspartate/creatine(NAA/Cr),and NAA/choline(NAA/Cho).Spearman correlation analysis showed that mALB,LDL-C,HOMA-IR and NAA/Cr in the left brainstem area were positively correlated with the level of HbA1c(P<0.05),whereas HOMA-βwas negatively correlated with the HbA1c level(P<0.05).Ordered multiple logistic regression analysis showed that NAA/Cho[Odds ratio(OR):1.608,95%confidence interval(95%CI):1.004-2.578,P<0.05],LDL-C(OR:1.627,95%CI:1.119-2.370,P<0.05),and HOMA-IR(OR:1.107,95%CI:1.031-1.188,P<0.01)were independent predictors of poor glycemic control.CONCLUSION The cerebral neurotransmitter concentrations in the left brainstem area in patients with T2DM are closely related to glycemic control,which may be the basis for the changes in cognitive function in diabetic patients.
基金supported by grants from Qingdao Diabetes Prevention Program and World Diabetes Foundation[WDF05–108 and WDF07–308]Qingdao Science & Technology department program [19-6-1-5-nsh]+1 种基金Qingdao Outstanding Health Professional Development FundQingdao Medical Research Guidance Program in 2017 [2017-WJZD129 and 2017-WJZD134]
文摘Objectives The purpose of this study was to assess the association between triglycerides(TG),total cholesterol(TC)at baseline,and type 2 diabetes mellitus(T2DM)incidence in a general Chinese population.Further,it aimed to evaluate the ability of TG and TC to predict T2DM incidence.Methods Qingdao Diabetes Prevention Program participants recruited between 2006 and 2009 were followed up in 2012–2015.TG,TC,and T2DM status were measured.Cox proportional hazards models were used to estimate the association between TG,TC,and T2DM incidence.The receiver operating characteristic(ROC)curve was used to evaluate the ability of TG and TC to identify T2DM participants.Results The incidence of T2DM significantly increased with TG in women and TC in both men and women(Ptrend<0.05).Univariate Cox regression indicated that higher TG{borderline high TG[hazards ratio(HR):2.05;95%confidence interval(CI):1.40,3.00]and hypertriglyceridemia[HR:2.64;95%CI:1.68,4.15]}and TC[hypercholesterolemia(HR:2.05;95%CI:1.43,2.95)]were significantly associated with increased risk of T2DM incidence in women but not in men.Multivariate Cox regression showed that hypertriglyceridemia in women(HR:1.78,95%CI:1.07,2.97),borderline high TC in men(HR:1.61,95%CI:1.04,2.48),and hypercholesterolemia in women(HR:1.68,95%CI:1.81,2.61)had a higher significant risk of T2DM incidence.The optimal cutoff values of TG were>1.15 and>1.23 mmol/L in men and women,respectively.For TC,they were>5.17 and>5.77 mmol/L in men and women,respectively.The area under the ROCs of TG and TC were 0.54(0.51–0.57)and 0.55(0.52–0.58),respectively,in men,and 0.60(0.58–0.62)and 0.59(0.56–0.61),respectively,in women.Conclusion Elevated TG and TC were risk factors for T2DM incidence.However,no predictive capacity was found for both factors to identify T2DM incidence in Chinese men and women.Hence,TG and TC levels in both Chinese men and women might be used for decreasing the incidence of T2DM but no clinical predictive capacity for T2DM.
基金the Research Project of Health and Family Planning Commission of Shenzhen Municipality,No.SZFZ2018063Shenzhen Key Medical Discipline Construction Fund,No.SZXK009+1 种基金Sanming Project of Medicine in Shenzhen,No.SZSM201512004and Shenzhen Second People’s Hospital Clinical Research Fund of Guangdong Province High-level Hospital Construction Project,No.20203357003 and No.20213357018.
文摘BACKGROUND Anaemia is common in patients with chronic kidney disease(CKD)and is a major risk factor that contributes to mortality in such patients.Type 2 diabetes mellitus(T2DM)is one of the leading causes of CKD.The association between admission hemoglobin levels and renal damage in patients with T2DM remains unclear.AIM To evaluate the relationship between admission hemoglobin levels and prognosis in patients with T2DM.METHODS We performed a retrospective analysis of 265 consecutive patients presenting with T2DM between 2011 and 2015.The composite endpoint was end-stage renal disease or a 50%reduction in the estimated glomerular filtration rate.RESULTS In multivariable-adjusted Cox proportional hazards models(adjusting for demographic factors,traditional risk factors,lipids),the adjusted hazard ratios(HRs)for the highest and middle tertiles compared to the lowest tertile of hemoglobin were 0.82(95%CI:0.11-6.26,P=0.8457)and 0.28(95%CI:0.09-0.85,P=0.0246),respectively.However,after further adjustment for glycaemia control,hemoglobin was positively related to the risk of the composite endpoint(HR:1.05,95%CI:0.14-8.09,P=0.9602)when the highest tertile was compared to the lowest tertile of hemoglobin.We found a U-shaped relationship between hemoglobin levels and the composite endpoint.The curve tended to reach the lowest level at an optimal hemoglobin level.CONCLUSION Among patients with T2DM,a U-shaped relationship was observed between hemoglobin levels and renal damage.A lower admission hemoglobin level(hemoglobin<13.3 g/dL)is an independent predictor of renal damage.
文摘This letter to editor discusses on the publication on admission hemoglobin level and prognosis of type 2 diabetes mellitus.A comment on published article is raised.The specific confounding conditions on the hemoglobin level are mentioned.Concerns on clinal application are raised and discussed.
文摘Background: Diabetes mellitus is a common disease and it is a major cause of morbidity;several studies indicate that diabetes is a likely under reported cause of death. Chromium’s is important trace element to control diabetes mellitus and metabolism of carbohydrate, lipid and protein. Objective: The purpose of this study was to understand the relationship between serum chromium, with HbA1c, Total cholesterol and Triglycerides among type 2 diabetes patients among diabetic patients. Methodology: This is cross-sectional study done in Jabber Abu Ezz Centre for treatment and care of diabetics in Khartoum—Sudan. Four hundred subjects were enrolled in this study;one hundred subjects were normal healthy as control group, and three hundred subjects diabetic patient type 2 as test group;demographic and biochemical data were collected;serum chromium, Glycosylated Haemoglobin (HbA1c), Total cholesterol Triglycerides, were determined by using NYCOCARD READER II, spectrophotometer (Biosystem 310) and spectrophotometer 210-VGP. Result: In this study there is significant parameters level means of FBS HbA1c, Total Cholesterol, Triglycerides and Chromium of the test groups when compared with healthy control groups subjects (P = 0.001, 0.018, 0.01, 0.011, 0.004), respectively. Significant negative correlation is between FBS, HbA1c, Total Cholesterol, Triglycerides and Chromium (r = ?0.555, P value = 0.003), (r = ?0.668, P value = 0.002), (r = ?0.335, P value = 0.004) and (r = ?0.774, P value = 0.002) respectively. Conclusion: There was significant correlation between serum Chromium level with fasting blood sugaer, Glycosylated Haemoglobin (HbA1c), Total cholesterol and Triglycerides among type 2 diabetes patients.
文摘AIM:To evaluate the safety and efficacy of human embryonic stem cells(h ESCs)for the management of type 2 diabetes mellitus(T2DM).METHODS:Patients with a previous history of diabetes and its associated complications were enrolled and injected with hE SC lines as per the defined protocol.The patients were assessed using Nutech functional score(NFS),a numeric scoring scale to evaluate the patients for 11 diagnostic parameters.Patients were evaluated at baseline and at the end of treatment period 1(T1).All the parameters were graded on the NFS scale from 1to 5.Highest possible grade(HPG)of 5 was considered as the grade of best improvement.RESULTS:Overall,94.8%of the patients showed improvement by at least one grade of NFS at the end of T1.For all the 11 parameters evaluated,54%of patients achieved HPG after treatment.The four essential parameters(improvement in glycated hemoglobin(HbA 1c)and insulin level,and fall in number of other oral hypoglycemic drugs with and without insulin)are presented in detail.For Hb A1c,72.6%of patients at the end of T1 met the World Health Organization cut off value,i.e.,6.5%of HbA 1c.For insulin level,65.9%of patients at the end of T1 were able to achieve HPG.After treatment,the improvement was seen in 16.3%of patients who required no more than two medications along with insulin.Similarly,21.5%of patients were improved as their dosage regimen for using oral drugs was reduced to 1-2 from 5.CONCLUSION:hE SC therapy is beneficial in patients with diabetes and helps in reducing their dependence on insulin and other medicines.
基金Supported by The Basic Research Projects of Shenzhen R&D Funding in Science and Technology,No.JCYJ20130402113802233 and No.JC201005260209A
文摘AIM:To determine the effect of different Roux-en-Y gastric bypass procedures in gastric carcinoma patients with type 2 diabetes mellitus.METHODS:A retrospective analysis of the clinical data of 54 patients with gastric cancer and type 2 diabetes mellitus treated in the Department of General Surgery from January 2006 to June 2013 was conducted.The patients underwent gastrectomy using different Rouxen-Y gastric bypass procedures(traditional,n=26;modified,n=28).Fasting plasma glucose(FPG),two hour postprandial blood glucose(2 h PBG)and hemoglobin A1c(Hb A1c)were analyzed before surgery(0 mo)and 1,3 and 6 mo after surgery.RESULTS:FPG and 2 h PBG levels were significantlydecreased 1 mo after surgery in the traditional Rouxen-Y gastric bypass group(FPG 7.5±1.3 vs 10.7±1.2,P<0.05)(2 h PBG 10.2±1.8 vs 13.8±3.2,P<0.05).FPG and 2 h PBG levels were significantly decreased after surgery in the modified Roux-en-Y gastric bypass group(FPG 6.9±1.2 vs 10.5±1.1,6.5±1.3 vs 10.5±1.1,6.4±1.2 vs 10.5±1.1,P<0.05)(2 h PBG9.9±2.2 vs 14.1±2.9,9.2±2.4 vs 14.1±2.9,8.9±2.6 vs 14.1±2.9,P<0.05).Compared with the levels before surgery,Hb A1c levels were significantly decreased 3 and 6 mo after surgery(7.2±1.1 vs 10.5±1.1,5.5±1.1 vs 10.5±1.1,P<0.05).Significant differences between the two groups regarding FPG,2 h PBG and Hb A1c concentration were observed 3 and 6mo after surgery(FPG 10.1±1.5 vs 6.5±1.3,10.3±1.4 vs 6.4±1.2,P<0.05)(2 h PBG 13.1±2.8 vs 9.2±2.4,13.6±3.1 vs 8.9±2.6,P<0.05)(Hb A1c 10.1±1.4 vs 7.2±1.1,10.5±1.3 vs 5.5±1.1,P<0.05).CONCLUSION:Modified Roux-en-Y gastric bypass can improve glucose metabolism in type 2 diabetic patients with gastric cancer.
文摘BACKGROUND Type 2 diabetes mellitus(T2DM)is a risk factor for nonalcoholic fatty liver disease(NAFLD).AIM To determine the prevalence and clinical correlates of NAFLD in a large cohort of patients with T2DM.METHODS Four hundred thirty-seven participants with T2DM who consulted at Meijo Hospital from April 2019 to September 2020 and underwent computed tomography(CT)were assessed.The mean age was 74±13 years,and 269 were men.Hepatic attenuation minus splenic attenuation(CTL−S)less than 1 Hounsfield unit was considered fatty liver.NAFLD was defined as fatty liver in the absence of significant alcohol consumption and hepatitis virus infection.A multiple logistic regression was used to assess the independent factors associated with NAFLD.RESULTS NAFLD was identified in 25.2%of the participants.Young age(odds ratio[OR]=−0.945;95%confidence interval[CI]:0.922–0.969),higher hemoglobin levels(OR=1.501,95%CI:1.278–1.764),lower high-density lipoprotein(HDL)cholesterol levels(OR=0.971,95%CI:0.953–0.989),and the absence of dialysis(OR=0.109,95%CI:0.014–0.856)were independent predictors of NAFLD.CONCLUSION NAFLD was detected with CT in 25.2%of the participants.NAFLD was associated with younger age,higher hemoglobin levels,lower HDL cholesterol levels,and an absence of dialysis.
文摘Type 2 diabetes mellitus and its complications are associated with oxidative stress and the depletion of antioxidant defenses. The influence of acetylsalicylic acid on reversing the decrease in antioxidants, insulin resistance, glucose homeostasis, and inflammatory cascade can help prevent diabetes complications. Purpose: The aim of the study was to evaluate the effect of acetylsalicylic acid on the antioxidant enzymatic system in patients with diabetes. Methods: A randomized, double-blind, placebo-controlled clinical trial was carried out in 21 patients of both sexes with Type 2 diabetes for less than five years at the time of diagnosis, without pharmacological treatment, and randomly selected. Acetylsalicylic acid (300 mg) was administered orally for three months to the study group (n = 11) compared to the placebo control group (n = 10). Before and after the intervention, anthropometric and metabolic measurements were taken, fasting plasma glucose, glycated hemoglobin A1c, lipid profile panel, glutathione peroxidase, superoxide dismutase, catalase, and antioxidant capacity/activity were determined;values are presented as mean ± standard deviation. Intra- and intergroup differences were tested by Wilcoxon signed rank and Mann-Whitney U test, respectively;p-value ≤ 0.05 was considered statistically significant. Results: The acetylsalicylic acid group showed a decrease in weight (85.6 ± 19.3 vs. 84.1 ± 19.0 kg p = 0.01), cholesterol (205.9 ± 16.6 vs. 186.0 ± 23.2 mg/dL p = 0.02), and glycated hemoglobin A1c (7.8% ± 0.9% vs. 7.0% ± 0.7% p = 0.02). The placebo group exhibited reduction in weight (76.1 ± 14.9 vs. 74.9 ± 15.0 kg p = 0.04), glycated hemoglobin A1c (6.9% ± 0.6% vs. 6.2% ± 0.4% p = 0.004), and total antioxidant capacity (4.1 ± 0.5 vs. 4.8 ± 0.3 mmol/L p = 0.002). Conclusion: The administration of acetylsalicylic acid did not modify the antioxidant enzyme system.
文摘<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong><em>Background:</em></strong> Very limited data are available regarding the association of vitamin D with glycemic status among adults with newly detected type 2 diabetes mellitus (T2DM) in Bangladesh. <strong><em>Objectives:</em></strong> To determine vitamin D status and its association with glycemic status in Bangladeshi adults with newly detected T2DM. <strong><em>Materials and Methods:</em></strong> This cross-sectional study was carried out in 102 newly detected T2DM diagnosed on the basis of the American Diabetes Association 2017 criteria (age: 42.95 ± 10.68 yrs.;m/f: 44/58) and equal number of age and sex matched controls (age: 40.43 ± 11.04 years) recruited consecutively from the Department of Endocrinology, BSMMU to measure serum vitamin D by high performance liquid chromatography method. <strong><em>Results:</em></strong> Both vitamin D deficiency (<20 ng/ml) (87.3% vs. 74.5%, <em>p </em>< 0.03) and severe vitamin D deficiency (<10 ng/ml) (56.2% vs. 26.3%, <em>p</em> < 0.001) were significantly higher in people with T2DM than control population. The mean level of 25(OH)D was significantly lower in adults with T2DM than control population (12.41 ± 6.85 ng/ml vs. 15.74 ± 6.25 ng/ml, <em>p</em> < 0.001). A significant inverse correlation was observed between vitamin D & HbA<span style="white-space:nowrap;"><sub>1</sub></span>c (r = <span style="white-space:nowrap;">-</span>0.249, <em>p</em> = 0.011) in patients with T2DM. HbA<span style="white-space:nowrap;"><sub>1</sub></span>c was linearly associated with vitamin D (<em>β </em>= <span style="white-space:nowrap;">-</span>0.26, <em>p</em> = 0.009) and severe vitamin D deficiency by binary (OR = 1.37, <em>p</em> = 0.003) and multinomial logistic regression (HbA<span style="white-space:nowrap;"><sub>1</sub></span>c ≥ 10%: OR = 4.25, <em>p </em>= 0.04) in people with T2DM after adjustment for age and BMI. <strong>Conclusions:</strong> Severe vitamin D deficiency was positively associated with T2DM and inversely associated with HbA<span style="white-space:nowrap;"><sub>1</sub></span>c in patients with newly detected T2DM.</span> </div>
基金Supported by the National "Eleventh Five-year Plan" for Major Scientific and Technological Research (2006BAI02B08)
文摘Objective:To probe glycemic excursions in type 2 diabetic patients whose hemoglobin A1c(HbA1c) was kept ≤6.0%.Methods:Totally 36 cases with type 2 diabetes(T2DM) with HbA1c≤6.0% and 30 cases with normal glucose tolerance(NGT) from December 2005 to December 2007 in our department were subjected prospectively.Continuous glucose monitoring system(CGMS) was employed to record their continuous blood glucose level for 3 d.The blood glucose profiles including the mean blood glucose(MBG),standard differentiation(SD),mean amplitude of glycemic excursions(MAGE) and absolute means of daily differences(MODD) were analyzed.Results:T2DM group had obviously postprandial hyperglycemia,in about 2 h after meal,especially after breakfast.Fifty-two hypoglycemic episodes occurred during the monitoring period in T2DM groups,of which 73.1%(38 episodes) were absence of symptomatic hypoglycemia with the lowest value of blood glucose only 2.0 mmol/L.And 20 episodes took place during the day hours,while 32 episodes observed during the night hours.Compared with NGT groups,SD,MAGE and MODD were all significantly higher in T2DM groups.MBG was significantly correlated with HbA1c in T2DM groups,but SD,MAGE,NGE and MODD were all independent of HbA1c.MAGE was independent of MODD.Conclusion:The amplitude of glycemic excursions is higher in normol-controlled T2DM groups than the NGT groups.Thus ideally glycemic control is not only to make HbA1c reach standard,but also to lessen glycemic excursions and reduce hypoglycemia episodes.
文摘Objective:To compare the therapeutic effects of acupuncture with sham acupuncture on levels of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) among patients with type-2 diabetes mellitus (T2DM) under treatment with metformin.Method:Eighty participants with T2DM were allocated randomly to treatment (n =40) and control (n =40) groups.In addition to metformin therapy,patients in the acupuncture group received acupoint stimulation with even manipulation at 15 acupoints,and needles were retained for 20 minutes.The sham-acupuncture group was treated with very small needles inserted at a very shallow depth (3-5 mm) without manipulation at non-acupoints 1 cm around the actual acupuncture points.Both groups were treated for 14 sessions during 10 weeks of treatment.The FPG level was measured before treatment as well as after 1,2,4,6 and 12 weeks of treatment.The HbA1c percentage was assessed once before treatment and once 12 weeks after treatment initiation.Results:Levels of FPG and HbA1c in both groups were reduced significantly in comparison with baseline measurements (both P <.01).However,acupuncture treatment led to a significant reduction in the FPG level as compared with sham acupuncture after 4 weeks or 10 sessions of treatment [mean difference (MD) =10.18,95% confidence interval (CI) =1.74 to 18.6,P =.019],after 6 weeks or 12 sessions of treatment (MD =10.53,95% CI =2.22 to 18.83,P =.014) and after 12-week follow-up (MD =8.8,95% Cl =0.66 to 16.94,P =.034).Acupuncture treatment reduced the HbA1c level significantly in comparison with that in the shamacupuncture group (MD =0.27,95%Cl =0.08 to 0.47,P =.007).Conclusion:Our study revealed that acupuncture (as a type of Chinese therapy) combined with metformin (as a conventional hypoglycemic medication) had a greater effect on glycemic control than that elicited in the placebo control group.Consequently,acupuncture could be used as adjuvant therapy among patients with T2DM.
文摘BACKGROUND Diabetic nephropathy(DN)is a common complication of type 1 and type 2 diabetes that can lead to kidney damage and high blood pressure.Increasing evidence support the important roles of microproteins and cytokines,such asβ2-microglobulin(β2-MG),glycosylated hemoglobin(HbA1c),and vascular endothelial growth factor(VEGF),in the pathogenesis of this disease.In this study,we identified novel therapeutic options for this disease.AIM To analyze the guiding significance ofβ2-MG,HbA1c,and VEGF levels in patients with DN.METHODS A total of 107 patients with type 2 diabetes mellitus complicated with nephropathy and treated in our hospital from May 2018 to February 2021 were included in the study.Additionally,107 healthy individuals and 107 patients with simple diabetes mellitus were selected as the control groups.Changes inβ2-MG,HbA1c,and VEGF levels in the three groups as well as the different proteinuria exhibited by the three groups were examined.RESULTS Changes inβ2-MG,HbA1c,and VEGF levels in the disease,healthy,and simple diabetes groups were significantly different(P<0.05).The expression of these factors from high to low were evaluated in different groups by pairwise comparison.In the disease group,high to low changes inβ2-MG,HbA1c,and VEGF levels were noted in the massive proteinuria,microproteinuria,and normal urinary protein groups,respectively.Changes in these factors were positively correlated with disease progression.CONCLUSION The expression of serumβ2-MG,HbA1c,and VEGF was closely correlated with DN progression,and disease progression could be evaluated by these factors.