A Study of Factors Related to the Incidence of Cataract in Patients with Non-Insulin Dependent Diabetes Mellitus

Purpose: To investigate the factors related to the development of cataract in patientswith non-insulin dependent diabetes mellitus(NIDDM).Methods: 792 NIDDM patients received ophthalmologic examinations including visualacuity, external status of the eyes, slit lamp microscopy and ophthalmoscopy. Glucose,urea nitrogen (BUN), creatinine (Cr), urine acid (UA), N-acetyl-β2-D-glucosaminidase(NAG), β2-microglobulin(β2-MG) and serum albumin in blood were quantitativelytested. Glucose, pH value, protein, cells, cast and ketobodies in urine were assayed.Diagnosis of cataract was based on lens opacities classification system Ⅱ. Any patientmeeting "NⅡ", "CⅡ" or "PⅡ" level was diagnosed as cataract.Results: The incidence of cataract in this group of NIDDM was 62.37 % (494/792),which significantly related to the duration of the disease course, but not to the sex of thepatient. The occurrence rate of cataract in patients suffering from NIDDM of less thanfive years duration, from five to ten years, and more than ten years was 49.67 % (228/459), 71.84 % (125/174), and 88.68 % (141/159), respectively. The occurrence ofcataract in patients diagnosed of the disease from five to ten years and more than tenyears was much higher than that of those with the course of the disease less than fiveyears( P ＜ 0.05 and P ＜ 0. 001, respectively) . Rising concentrations of blood ureanitrogen, creatinine, glycosylated hemoglobin HbA1c(G-HbA1c), N-acetyl-β2-D-glucosaminidase(NAG) and β2-microglobulin(β2-MG) indicated malfunction of thekidneys, and the rate of cataract occurrence in these patients was higher.Conclusion: This study indicates that prolongation of the duration of non-insulindependent diabetes mellitus, renal dysfunction, as well as poor blood glucose control,may accelerate the development of cataract.

The relationship between obese protein and noninsulin-dependent diabetes mellitus

To explore the role of obese protein (OP), the product of the obese gene, in the development of non-insulin-dependent diabetes mellitus (NIDDM). Metbods: Plasma obese protein level was measured by radioimmunoassay in 21 normal subjects, 24 adult obese patients and 20 patients with NIDDM. Results: The levels of the plasma obese protein in NIDDM patients (81. 0±17. 5 pg/ml) were very significantly lower than those in normal subjects (194. 3±17. 7 pg/ml) and obese patients (109.1±16. 4 pg/ml ) (P<0.01). The levels of the plasma obese protein in non-obese NIDDM patients were very significantly lower than those in non-obese normal subjects (P<0.01), and the levels of the plasma obese protein in obese NIDDM patients were very significantly lower than those in obese patients (P<0. 01). The leve1s of the plasma obese protein in NIDDM patients were significantly correlated with polyphagia (P<0.05), but not correlated with the body weight indexes after strict dieting, and the plasma levels of cholesterol, triglyceride, fasting glucose, hemoglobiti A, and the insulin levels during glucose tolerance test (P>0.05). Couclusion: Low plasma level of obese protein is one of the important factors contributing to obesity,and plasma obese protein may be closely related to the generation of NIDDM.

Association Studies of 3 Candidate Genes with Type 2 Diabetes Mellitus in a Chinese Population

Objectives To explore the relationship between the polymorphisms of the selected short tandem repeats (STRs) of the candidate genes and type 2 diabetes mellitus (DM) in a Chinese population,the role of genetic and environmental factors in the development of type 2 diabetes. Methods STRs including D11S916 of uncoupling protein 3 (UCP3) gene,binucleotide repeat (CA)n within intron 6 [HSLi6(CA)] of hormone-sensitive lipase(HSL)gene and D20S501 of protein tyrosine phosphatase-1B (PTP-1B)gene polymorphisms were detected, by poiymerase chain reaction(PCR) ,poly-acrylamide gel electrophoresis and silver staining in 106 patients with type 2 DM and 102 control subjects. Results The allele distribution of UCP3 and HSL gene differed significantly between patients with type 2 diabetes and control subjects (X2 = 26. 12,P<0. 005; X2 = 10. 33,P<0. 005,respectively). For UCP3 and HSL gene,the frequencies of alleles A6,A7,A8 and allele B9 were much higher in diabetic patients than in control subjects (0. 090 vs 0. 020,P<0. 005; 0. 109 vs 0. 015,P <0. 005; 0. 033 vs 0. 000,P<0. 05; 0. 033 vs 0. 005,P<0. 05,respectively),while the frequencies of allele A1 and allele B5 were lower in diabetic patients than in control subjects (0. 090 vs 0. 206,P<0. 005; 0. 057 vs 0. 118,P<0. 05,respectively). At D20S501 locus,The allele distribution of PTP-1B gene had no significant difference in two groups (X2 = 3. 77, P>0. 05). Multi-variate logistic regression analysis showed positive correlation between alleles A6,A7 of UCP3 gene,systolic blood pressure, apolipoprotein B, lipoprotein (a) and type 2 diabetes. Conclusion Our data show that D11S916 of UCP3 gene and HSLi6(CA) of HSL gene polymorphisms are associated with type 2 diabetes in Chinese suggesting that UCP3 and HSL might represent susceptibility genes for type 2 diabetes. D20S501 of PTP-IB gem polymorphism is not associated with type 2 diabetes in Chinese. Alleles A6, A7 of UCP3 gene, systolic blood pressure, apolipoprotein B,Upoprotein (a) may play some role in the development of type 2 diabetes.

Effects of Supplemented Taohe Chengqi Decoction (桃核承气汤) in Treating Insulin Resistance in Rats with Non-Insulin Dependent Diabetes Mellitus

Objective: To investigate the effect of supplemented Taohe Chengqi Decoction (桃核承气汤,STHCQD) in treating non-insulin dependent diabetes mellitus (NIDDM). Methods: The model of rats withNIDDM was formed with injection of streptozotocin and fed on high calorie diet to study the effects of STHCQDon the release of insulin sensitivity. Results: (l ) Fasting serum glucose, serum insulin, intake of food and waterwere significantly decreased (P < 0. 05 -- 0. 01 ) in STHCQD-treated diabetic rats as compared with untreated diabetic rats, while the insulin sensitivity was significantly increased (P < 0. 05 ). (2) The liver cell membranesfrom STHCQD-treated diabetic rats released the quantity of insulin receptor which inhibited adenylate cyclaseactivity, but this effect was blunted in untreated diabetic rats (P < 0. 05). (3) A significantly increased glucoseoxidation in adipocyte of STHCQD-treated diabetic rats was found as compared with those of untreated diabeticrats (P< 0. 05). Conclusions: STHCQD therapy Increased sensitivity and responsiveness of target cells to insulin, i. e. it might decrease insulin resistance at receptor sites and POst--receptor sites in rats with NIDDM, butcould not.reverse the insulin resistance.

Therapeutic Effect of Berberine on 60 Patients with Non－Insulin Dependent Diabetes Mellitus and Experimental Research

The effects of berberine on 60 cases with noninsulin dependent diabetes mellitus and ex-perimental research results were observed in this study. The results suggest berberine has significant ef-fects on noninsulin dependent diabetes mellitus patients and experimental diabetes in animals in the re-duction of blood glucose levels. The clinical symptoms basically disappeared and the level of serum insulinrose. The total effective rate was up to 90 percent and there were no signiticant side-effects. It was foundthat berberine has an effect on the recovery of pancreas islet cells, through pathological examination onthe animal subjects.

Clinical Study on Jiang Tang San（降糖散）in Treating Non－Insulin Dependent Diabetes Mellitus Patiente

The therapeutic effect of Jiang Tang San (JTS) on 30 cases with non-insulin dependent dia-betes mellitus (NIDDM) , was observed, whose fasting blood glucose ranged trom 11. 1 mmol/L to 13. 8mmol/L. The results suggested that JTS has significant effect on NIDDM patients in lowering blood glucose,blood lipid and blood pressure levels. Clinical symptoms and blood glucose improved rapidly. JTS promotedthe elevation of serum insulin level 1 hour after meal. The total effective rate of lowering blood glucosereached 86. 7% . The results showed JTS is better than berberine on lowering blood glucose ( P< 0. 01 ) andwhen patients failed to respond to other hypoglycemics or on recurrence JTS was still effective. There wereno marked side-effects during the course of treatment.

CHANGES OF NAILFOLD MICROCIRCULATION IN PATIENTS OF TYPE II DIABETES MELLITUS WITH DIABETIC RETINOPATHY

Objective. To study the changes of microcirculation in patients with diabetic retinopathy(DR). Methods. Examination were performed in 153 cases of type Ⅱ diabetes mellitus, among them, 72 cases were male, 81 cases were female, mean age 57.0±10.0 years, mean disease course 8.2±7.5 years. All cases were examined fundi by ophthalmologist, urinary albumin excretion rate (UAE) in 24 hours was measured by radioimmunoassay. Moreover, we examined the blood glucose, blood pressure, blood viscosity and observed the changes of naifold microcirculation. Results.It was found that there were more evident disturbance of microcirculation, markedly slowed velocity of blood flow(P<0.05), significantly increased aggregation of blood cells(P<0.05) and exudation around the loop(P<0.05) in the group with DR, compared with the group without DR. Conclusion. It was more evident disturbance of nailfold microcirculation in patients with diabetic retinopathy.

The Present Situation of TCM Treatment for Diabetes and its Researches

Diabetes is a frequently encountered disease. There are now approximately 40 million diabetes patients in China1, most of them with diabetes II.

Prevalences of Diabetes and Hypertension and Their Relationship in Community Population of Jiangsu Province

To determine the prevalences of non-insulin-dependent-diabetes mellitus (NIDDM),impaired glucose tolerance (IGT) and hypertension on urban and rural communities of Jiangsu province,8734 subjects sampled from six areas of Jiangsu were investigated. Blood glucose of 2 h after oral administration of 75 g glucose (2 h BG) was measured. WHO criteria were used for the diagnosis of NIDDMand IGT. Meanwhile epidemiological data were collected. Blood pressure, height, weight, waist and hip girths were measured. The crude prevalence was found to be 5. 82% (men 4.62%,woman 6. 69%) for NIDDM, 5. 87% (men 5. 30%, women 6. 29% ) for IGT and 14. 72% (men 16. 50%, women 13. 43 % ) for hypertension in the population obove 20 years of age. Age-adjusted prevalence was 4. 63% for NIDDM, 5. 07 % for IGT and 11. 19% for hypertension. Age increase (>40 years), obesity (BMI≥27) and central fat distribution (WHR≥0.88) were the risk factors for both diabetes and hypertension. The subjects≥40 years of age and obesity were the high risk population of NIDDM, IGT and hypertension. They were the target population for theprevention and treatment of diabetes and hypertension in the community level. High prevalences of NIDDM,IGT and hypertension were observed in the community population in Jiangsu province. To reinforce the prevention and treatment of these disorders in the province is imperative.

Effects of Xianzhen Tablet（仙贞片）on Na^+-K^+-ATPase and Ca^(2+)-Mg^(2+)-ATPase in Erythrocytic Membranes and Viscosity of Whole Blood in Non-Insulin-Dependent Diabetes Patients with Qi-Yin Deficiency, Kidney Deficiency and Blood Stasis

Objective: To assess the effects of Xianzhen tablet (XZT) on Na+-K+ -ATPase and Ca2+ Mg2+-ATPase on erythrocytic membranes, viscosity of whole blood, plasma glucose and clinical manifestations.Methods: Seventy-two cases of non-insulin-dependent diabetes mellitus (NIDDM) patients with deficiency of both Qi and Yin, deficiency of the Kidney and blood stasis were selected, and the effects of treatment on Na+ K + -ATPase, Ca2+-Mg2+ -ATPase, whole blood viscosity, blood sugar and clinical Symptoms were observed.Results: In XZT group (test group), activities of Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase rose significantly(P< 0. 01, P< 0. 05) after treatment. Viscosity of whole blood and clinical manifestations also improved obviously. The total effective rate in lowering plasma glucose was 77. 8 % with fasting blood glucose (FBG) and 69.4 % with 2 hours postprandial plasma blood glucose (2°PBG). In the control group, viscosity of whole blood andclinical manifestations had no significant improvement. Its total effective rate in lowering plasma glucose was41. 7% with FBG and 38. 9% with 2°PBG. Conclusions: XZT played a certain role in increasing activities ofNa+ -K + -ATPase and Ca2+-Mg2+ -ATPase, decreasing viscosity of whole blood and plasma glucose and improving clinical manifestations. Therefore, XZT was experimentally manifested as an effective drug in treating NIDDM patients with Qi-Yin deficiency, renal deficiency and blood stasis.

Rejection of insulin therapy among patients with type 2 diabetes in China： reasons and recommendations

Background Insulin injection therapy is one of the most effective treatments for type 2 diabetes meUitus （T2DM）. Many people with T2DM in western countries resist starting insulin therapy; whether the same is true in China is unknown. This survey-based study assessed acceptance and rejection of insulin therapy among individuals with T2DM in China and self- reported reasons for these therapy choices. It also examined what methods may be useful for increasing the rate of insulin acceptance. Methods A multi-center, cross-sectional survey was conducted between April and July 2010 to a convenience sample of inpatients and outpatients at 50 medical centers across 29 administrative divisions in China. Data were collected on sociodemographic and T2DM characteristics, therapy regime, and attitudes toward insulin therapy. Results A total of 6 043 patients were surveyed, and 5 961 complete questionnaires （98.6%） were used in the analysis. Just over half the respondents （3 460, 58.0%） reported negative attitudes to insulin therapy, including 2 508 of the 4 469 patients （56.1%） whose physicians had recommended it to them. Of the patients counseled to use insulin, 800 （17.9%） were unwilling to start therapy and cited the following reasons： inconvenience （64.3%）; concerns over addiction （24.6%）; pain （14.3%）; side effects （14.1%）; and high cost （13.6%）. Logistic regression suggested that respondents would be more willing to undertake insulin therapy if they had received diabetes education, had positive attitudes to the treatment, had higher glycosylated hemoglobin level, or had suffered diabetes for a longer period or with more complications. Conclusions Patients with T2DM in China are often resistant to insulin therapy if they have been diagnosed with the disease for a relatively short time or if the disease has been relatively mild. Educating patients on the benefits of insulin therapy, not only at the initial diagnosis with T2DM but also when insulin therapy becomes necessary, will likely increase their willingness to undertake it.

Brugmann评分预测妊娠期糖尿病孕妇产前胰岛素治疗需求的应用价值

目的 探讨Brugmann评分预测妊娠期糖尿病(GDM)孕妇产前胰岛素治疗需求的应用价值。方法 选择2021年1月—2023年1月丽水市人民医院妇产科的GDM孕妇206例,根据产前是否应用胰岛素治疗分为产前胰岛素治疗组(35例)和非产前胰岛素治疗组(171例)。获取孕妇临床资料以及孕期血糖相关指标,应用Brugmann-口服葡萄糖耐量试验(OGTT)评分和Brugmann-空腹血糖(FBG)评分两个独立评分进行评估。结果 产前胰岛素治疗组孕前体质量指数(BMI),三酰甘油、FBG、1 h OGTT、2 h OGTT、血红蛋白(HbA1c)水平,Brugmann-OGTT评分及Brugmann-FBG评分分别为(24.53±2.81)kg/m^(2)、(3.70±0.71)mmol/L、(6.75±1.83)mmol/L、(11.46±2.10)mmol/L、(10.09±2.11)mmol/L、(5.61±0.70)%、(6.75±2.55)分、(4.86±2.08)分;非产前胰岛素治疗组孕前BMI、三酰甘油、FBG、1 h OGTT、2 h OGTT、HbA1c水平,Brugmann-OGTT评分及Brugmann-FBG评分分别为(23.10±2.17)kg/m^(2)、(2.93±0.66)mmol/L、(6.01±1.76)mmol/L、(9.18±1.83)mmol/L、(8.16±1.16)mmol/L、(5.18±0.35)%、(3.84±1.26)分、(3.18±1.55)分。两组上述指标比较差异均有统计学意义(均P<0.05)。多因素logistic回归分析结果显示:三酰甘油(OR=2.796)、Brugmann-OGTT评分(OR=4.163)、Brugmann-FBG评分(OR=2.538)是GDM孕妇产前胰岛素治疗需求的独立影响因素(均P<0.05)。受试者工作特征(ROC)曲线显示:Brugmann-OGTT评分、Brugmann-FBG评分以及两评分联合预测GDM孕妇产前胰岛素治疗需求的曲线下面积分别为0.873、0.802、0.889。结论 Brugmann-OGTT评分和Brugmann-FBG评分可较好地预测GDM孕妇产前胰岛素治疗需求,适宜在临床推广,用于优化GDM孕妇血糖控制方案和患者管理。

糖尿病大鼠肾脏病变及其SnoN蛋白表达的变化

目的:复制2型糖尿病动物模型,并观察其肾脏病变及SnoN蛋白表达的变化。方法:SD大鼠随机分为正常对照组(NC)、高脂高糖组(HG)。高脂、高糖饮食12周后又随机分为高脂高糖对照组(HC)、糖尿病组(DM)。采用高脂、高糖饮食12周加小剂量链脲佐菌素注射(30 mg/kg)的方法复制2型糖尿病动物模型,成模大鼠随机分别于糖尿病8周(DM8)、12周(DM12)和16周(DM16)处死;Western印迹法检测肾皮质SnoN蛋白的水平;生物化学方法测血糖、血清胰岛素水平、甘油三酯、总胆固醇、血肌酐及24 h尿蛋白;光镜检查肾组织形态学改变。结果:DM组大鼠出现高血糖、高血脂、肾功能和肾组织形态学改变;HG组血清胰岛素水平、甘油三酯和总胆固醇明显升高,血糖与NC组相比差异无统计学意义;Western印迹检测发现DM8组肾组织中SnoN蛋白的表达明显低于NC组,且随病程进展逐渐减少,至DM16时减至NC组的64.20%。结论:成功复制了2型糖尿病动物模型;SnoN蛋白的表达变化可能参与了2型糖尿病肾脏病变的发生、发展过程。

Gene Expression of Adiponectin and Adiponectin Receptor 1 in Type 2 Diabetic Rats and the Relationship with the Parameters of Glucose and Lipid Metabolism

In order to confirm whether the mRNA levels of adiponectin in adipose tissue and mRNA levels of AdipoR1 in the skeletal muscles were correlated with the serum parameters of glucose and lipid metabolism and to clarify the regulation of adiponectin receptor gene expression in diabetic states, serum adiponectin, mRNA levels of adiponectin in adipose tissue and mRNA levels of AdipoR1 in the skeletal muscles were examined in type 2 diabetic rats. The model of type 2 diabetes was prepared by feeding high fat diet and injecting low dosage of streptozotocin (STZ). The diabetic rats were screened out by oral glucose tolerance test. One group of type 2 diabetic rats received rosiglitazone. The serum adiponectin concentration was detected by using ELISA and mRNA levels were examined by RT-PCR. The serum adiponectin levels and mRNA levels of adiponectin in adipose tissue of type 2 diabetic rats were significantly decreased as compared with the normal control rats (P<0.05, P<0.01 respectively). No siglificant changes were observed in the expression of adiponectin receptor 1 in the skeletal muscle of type 2 diabetic rats. The mRNA levels of adiponectin in adipose tissue were reversely correlated with serum insulin (r=-0.66, P<0.05), triglyceride (r=-0.58, P<0.05), cholesterol (r=-0.49, P<0.05), interleukin-6 (r=-0.49, P<0.05) and tumor necrosis factor (r=-0.43, P<0.05). The expression of adiponectin receptors was not altered in the skeletal muscle of Type 2 diabetic rats. The decreased serum adiponectin was caused by the decreased expression of adiponectin mRNA in adipose tissue rather than the adiponectin receptors in the skeletal muscle, which could be improved by rosiglitazone.

Advances in TCM Research of Insulin Resistance

Insulin resistance (IR) refers to subnormal response to a certain amount of insulin and is the most characteristic phenomenon in non-insulin dependent diabetes mellitus (NIDDM). It is also an element of the pathogenic mechanism shared with obesity, systemic hypertension, abnormal lipid metabolism and atherosclerosis. In recent years, studies on its treatment with traditional Chinese medicine (TCM) have gradually been carried out and the following is a report of them.Mechanisms of Diabetic IR in TCM TermsAction of insulin antagonizing hormones in peripheral tissues is one of the causes of diabetic IR. Cyclic nucleosides cAMP and cGMP, important intracellular messengers, are considered to be the second messenger of insulin, and cAMP is related to the amount of insulin receptors. Early in 1980s, some authors investigated the relationship among the symptoms of diabetes and such hormones and cAMP/cGMP ratio. Although they did not give due attention to IR, their studies provided evidences for differentiation of symptoms and signs in IR typing.

Emblica officinalis improves glycemic status and oxidative stress in STZ induced type 2 diabetic model rats

Objective:To evaluate the antidiabetic and antioxidant potential of Emblica officinalis(E.officinalis)fruit on normal and type 2 diabetic rats.Methods:Type 2 diabetes was induced into the male Long-Evans rats.The rats were divided into nine groups including control groups receiving water,type 2 diabetic controls,type 2 diabetic rats treated with glibenclamide(T2GT)and type 2diabetic rats treated with aqueous extract of fruit pulp of E.officinalis.They were fed orally for8 weeks with a single feeding.Blood was collected by cutting the tail tip on 0 and 28 days and by decapitation on 56 day.Packed red blood cells and serum were used for evaluating different biochemical parameters.Results:Four weeks administration of aqueous extract of E.officinalis improved oral glucose tolerance in type 2 rats and after 8 weeks it caused significant(P<0.007)reduction in fasting serum glucose level compared to 0 day.Triglycerides decreased by 14%but there was no significant change in serum ALT,creatinine,cholesterol and insulin level in any group.Furthermore,reduced erythrocyte malondialdehyde level showed no significant change(P<0.07)but reduced glutathione content was found to be increased significantly(P<0.05).Conclusions:The aqueous extract of E.officinalis has a promising antidiabetic and antioxidant properties and may be considered for further clinical studies in drug development.

非胰岛素依赖型糖尿病患者对低血糖认知现状调查及影响因素分析

目的通过调查非胰岛素依赖型糖尿病患者对于低血糖认知情况,为医务人员给本型糖尿病患者精准制订健康教育计划及落实健康教育措施提供科学依据。方法采用自行设计的“非胰岛素依赖型糖尿病患者低血糖认知情况问卷”,对2020年6—8月于某中医药大学第一附属医院内分泌科住院的84例非胰岛素依赖型糖尿病患者进行面对面的问卷调查,其中80例问卷应答有效。结果80例患者对低血糖相关知识,认知相对不足。性别、文化程度、低血糖病史是2型糖尿病患者低血糖认知的影响因素(P<0.05)。结论临床上应为糖尿病患者制订全面、个性化的健康教育计划,进行低血糖的预防、临床表现、治疗护理、应急处理等多方面的健康知识宣教,以避免或降低低血糖发生率。并做到发生低血糖后,能及时识别并采取有效措施,降低低血糖对患者造成的伤害,提高患者的生活质量。

早期胰岛素强化治疗改善2型糖尿病患者的疗效及对胰岛功能的影响

目的:探讨2型糖尿病(T2DM)采取早期胰岛素强化治疗对改善疗效及胰岛功能的影响。方法:选择2021年1月—2022年12月我院收治的T2DM患者150例研究,双色球法分为两组,对照组采用口服降糖药物治疗,观察组采用早期胰岛素强化治疗,对比效果。结果:观察组总有效率高于对照组(P<0.05);治疗前两组血糖、血脂、胰岛功能指标无明显差异(P>0.05),治疗后观察组空腹血糖、餐后2h血糖、糖化血红蛋白、甘油三酯、总胆固醇、HOMA-IR低于对照组,而HOMA-β高于对照组,差异显著(P<0.05);两组用药期间低血糖发生率无明显差异(P>0.05)。结论:T2DM患者采取早期胰岛素强化治疗,与口服降糖药物比较,可提高疗效,而且更好地改善患者的血糖与血脂指标,且能促进胰岛功能改善,而低血糖发生率低,值得应用。

国内42年文献源抗糖尿病药物的不良反应分析

目的 :探讨我国抗糖尿病药物不良反应(ADR)发生的一般规律及有关特点 ,为临床用药提供资料。方法 :对个人呈报的ADR报告 ,参照国家卫生部ADR监测中心指定的原则列入分析文献源 ,ADR按世界卫生组织 (WHO)国际药品监测合作中心的药物ADR分类方法分类 ,我们收集了国内 4 2a文献源抗糖尿病药物的ADR资料 ,并进行文献计量学分析。结果 :抗糖尿病药物ADR的发生男性、女性数量相当 ;从年龄结构来看 ,ADR发生集中于 4 5～ 74a年龄段。抗糖尿病药物的ADR是以代谢和营养障碍、神经系统损害、精神紊乱、胃肠系统损害为主 ,其中除胃肠系统损害主要由阿卡波糖引起外 ,其余以磺酰脲类抗糖尿病药物占绝大多数 ;抗糖尿病药物的ADR绝大多数预后良好 ,但亦有相当数量的ADR留有后遗症甚至死亡 ,其中以格列本脲和苯乙双胍引起的ADR预后较差。结论 :抗糖尿病药物ADR涉及系统广泛 ,有些后果严重 。

加味桃核承气汤对Ⅱ型糖尿病大鼠胰岛素抵抗的影响

目的：观察加味桃核承气汤对Ⅱ型糖尿病（ＮＩＤＤＭ）的影响。方法：采用链脲佐菌素和高热量饲料的方法模拟ＮＩＤＤＭ大鼠模型，研究加味桃核承气汤对ＮＩＤＤＭ大鼠肝细胞膜胰岛素介体释放、脂肪细胞葡萄糖氧化和胰岛素敏感性指数的影响。结果：加味桃核承气汤可明显降低空腹血糖、胰岛素、摄食量和饮水量（Ｐ＜０．０５～０．０１），提高胰岛素敏感性（Ｐ＜０．０５），增加肝细胞膜释放的抑制腺苷酸环化酶活力的胰岛素介体量（Ｐ＜０．０５），提高基础的和胰岛素刺激的大鼠脂肪细胞葡萄糖氧化能力（Ｐ＜０．０５）。结论：加味桃核承气汤治疗可提高ＮＩＤＤＭ大鼠靶细胞对胰岛素的敏感性和反应性，即可使受体和受体后胰岛素抵抗减轻，但不能使之完全逆转。