Development of diabetic complications and influencing factors among 32653 type 2 diabetes patients:retrospective cohort study using a multi-state Markov

Background:Patients with type 2 diabetes are at high risk for developing multiple chronic complications.However,there is a lack of studies of the cumulative number of diabetic complications in China.Methods:A retrospective cohort study was performed from 2009 to 2021.Type 2 diabetes patients who were first diagnosed after the age of 35 years between January 1,2009,and December 31,2017,were included.Five states were defined according to the number of chronic complications:no(S0),one(S1),two(S2),three(S3),and four or more complications(S4).A multi-state Markov model was constructed to estimate transition probability,transition intensity,mean sojourn time,and the possible factors for each state.Results:The study included 32653 type 2 diabetes patients(mean age,59.59 years;15929(48.8%)male),and mean follow-up time of 7.75 years.In all,4375 transitions were observed.The 12-year transition probability of from state S0 to S1 was the lowest at 16.4%,while that from S2 to S3 was the highest,at 45.6%.Higher fasting blood glucose,lower high-density lipoprotein cholesterol,higher total cholesterol,and an unhealthy diet were associated with higher risk of progression from S0 to S1.Being female,less than 60 years old,weekly physical activity,and vegetarian diet decreased this risk.Being female and less than 60 years old reduced the likelihood of transition from S1 to S2,whereas lower high-density lipoprotein cholesterol increased this likelihood.Conclusions:Following the occurrence of two complications in type 2 diabetes patients,the risk for accumulating a third complication within a short time is significantly increased.It is important to take advantage of the stable window period when patients have fewer than two complications,strengthen the monitoring of blood glucose and blood lipids,and encourage patients to maintain good living habits to prevent further deterioration.

Sitagliptin in treatment of diabetes complicated by chronic hepatitis C

To the Editor: A high prevalence of glucose intolerance in patients with chronic hepatitis C has been reported, [1] and there is a significant association of chronic hepatitis C with diabetes mellitus (DM). [2] But DM has been suggested to be associated with the onset of hepatocellular carcinoma

Effects of Lipoprotein(a) on Elderly Diabetes Mellitus

In order to explore clinical relationship between Lipoprotein(a) and elderly diabetes, the level of plasma Lp(a) in 78 elderly patients with diabetes mellitus and 60 healthy controls was assayed. The results showed that there was significant difference in the percentage of high Lp(a) level between diabetis and healthy subjects (P<0.01); that the percentages of high Lp(a) level with fasting Lp(a)200 mg/L, 300 mg/L in complication group were all significantly higher than those in noncomplication group (P<0.02); that there was significant difference in the percentage of high Lp(a) level with fasting and postprandial 2 hours Lp(a)200 mg/L in 30 patients without complication, the former was also significantly higher as compared with controls. These suggested that fasting blood sample was better for measurement of plasma Lp(a) level, and that fasting plasma Lp(a)200 mg/L might be useful for diabetes epidemiological investigation; that there was high plasma Lp(a) level in diabetics, especially in diabet

ORIGINAL ARTl CLESSilybin Decreases Erythrocytic Sorbitol Level and ImprovesPeripheral Nerve Conduction Velocity in Patients with Non-lnsulin Dependent Diabetes Mellitus

The effects of silybin on erythrocytic sorbitol level and peripheral nerve conduction veloci-ty were studied in 14 cases of noninsulin dependent diabetes mellitus (NIDDM) . Atter oral administrationof silybin 231 mglday for 4 weeks, no blood glucose change was observed in patients with NIDDM, whilethe erythrocytic sorbitol level was significantly decreased from 72. 55 21. 61 to 39. 53 14. 94 nmol/g .Hb (P<0. 01) . At the same time, peripheral nerve conduction vefocity was also improved. These resultsindicate that silybin is an effective aldose reductase inhibitor which can improve the disorder of polyolpathway in NIDDM patients and prevent chronic complications of diabetes.