目的:评价丹蛭降糖胶囊对2型糖尿病患者FINS和IRI作用的有效性。方法:计算机检索中国生物医学文献数据库、中国期刊全文数据库、万方期刊数据库等相关资料,按照Cochrane系统评价的方法,客观评价纳入研究的质量,提取有效数据,采用Rev Man...目的:评价丹蛭降糖胶囊对2型糖尿病患者FINS和IRI作用的有效性。方法:计算机检索中国生物医学文献数据库、中国期刊全文数据库、万方期刊数据库等相关资料,按照Cochrane系统评价的方法,客观评价纳入研究的质量,提取有效数据,采用Rev Man 5.2软件进行Meta分析。结果:共纳入5个随机对照试验,包括294例患者。结果显示,丹蛭降糖胶囊能降低2型糖尿病患者FINS[MD=1.24,95%CI(0.90,1.59),P<0.01],降低IRI[MD=0.20,95%CI(0.14,0.27),P<0.01]。结论:丹蛭降糖胶囊对2型糖尿病患者FINS和IRI作用是有效的。展开更多
目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察...目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组给予硫辛酸治疗,观察组在对照组基础上加用益气化聚方治疗。比较2组患者在治疗后的临床疗效、血糖变化、代谢相关指标、周围神经病变及治疗期间不良反应发生情况。结果:治疗后,观察组患者治疗总有效率高于对照组,且高低密度脂蛋白胆固醇(HDL-C)水平、总神经运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)评分(正中神经和腓总神经)显著升高,差异有统计学意义(P<0.05),空腹血糖(FPG)、餐后2 h血糖(2 h PG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)与对照组比较显著降低(P<0.05)。观察组治疗期间出现血小板功能异常2例、脸色苍白1例,对照组治疗期间出现血小板功能异常2例、脸色苍白2例,2组治疗后不良反应发生情况差异无统计学意义。结论:采用益气化聚方联合硫辛酸治疗T2DM可更明显改善周围神经病变,降低血糖,控制血脂,且安全性良好。展开更多
目的分析老年糖尿病采用甘精胰岛素+二甲双胍治疗的临床疗效。方法回顾性选取2023年1—12月天水市秦州区人民医院内分泌科收治的60例老年糖尿病患者的临床资料,根据不同用药方法分为对照组(予以甘精胰岛素治疗)、观察组(予以甘精胰岛素...目的分析老年糖尿病采用甘精胰岛素+二甲双胍治疗的临床疗效。方法回顾性选取2023年1—12月天水市秦州区人民医院内分泌科收治的60例老年糖尿病患者的临床资料,根据不同用药方法分为对照组(予以甘精胰岛素治疗)、观察组(予以甘精胰岛素+二甲双胍治疗),各30例。比较两组糖代谢(空腹血糖、餐后2 h血糖、糖化血红蛋白、胰岛β细胞功能指数、胰岛素抵抗指数)、C肽水平、并发症、不良反应。结果治疗后,两组空腹血糖、餐后2 h血糖、糖化血红蛋白、胰岛素抵抗指数均低于治疗前,且观察组低于对照组,差异有统计学意义(P均<0.05);治疗后,两组胰岛β细胞功能指数高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组空腹C肽水平、餐后1 h C肽水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P均<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论在甘精胰岛素基础上应用二甲双胍,可显著改善老年糖尿病患者糖代谢状况,降低血糖水平,升高C肽水平,改善患者胰岛功能,有效延缓病情进展,预防并发症,且治疗安全性较高。展开更多
Preoperative fasting is mandatory before anesthesia to reduce the risk of aspiration.However,the prescribed 6-8 h of fasting is usually prolonged to 12-16 h for various reasons.Prolonged fasting triggers a metabolic r...Preoperative fasting is mandatory before anesthesia to reduce the risk of aspiration.However,the prescribed 6-8 h of fasting is usually prolonged to 12-16 h for various reasons.Prolonged fasting triggers a metabolic response that precipitates gluconeogenesis and increases the organic response to trauma.Various randomized trials and meta-analyses have consistently shown that is safe to reduce the preoperative fasting time with a carbohydrate-rich drink up to 2 h before surgery.Benefits related to this shorter preoperative fasting include the reduction of postoperative gastrointestinal discomfort and insulin resistance.New formulas containing amino acids such as glutamine and other peptides are being studied and are promising candidates to be used to reduce preoperative fasting time.展开更多
AIMTo determine the short-term biochemical effects and clinical tolerability of intermittent fasting (IF) in adults with type 2 diabetes mellitus (T2DM).METHODSWe describe a three-phase observational study (baseline 2...AIMTo determine the short-term biochemical effects and clinical tolerability of intermittent fasting (IF) in adults with type 2 diabetes mellitus (T2DM).METHODSWe describe a three-phase observational study (baseline 2 wk, intervention 2 wk, follow-up 2 wk) designed to determine the clinical, biochemical, and tolerability of IF in community-dwelling volunteer adults with T2DM. Biochemical, anthropometric, and physical activity measurements (using the Yale Physical Activity Survey) were taken at the end of each phase. Participants reported morning, afternoon and evening self-monitored blood glucose (SMBG) and fasting duration on a daily basis throughout all study stages, in addition to completing a remote food photography diary three times within each study phase. Fasting blood samples were collected on the final days of each study phase.RESULTSAt baseline, the ten participants had a confirmed diagnosis of T2DM and were all taking metformin, and on average were obese [mean body mass index (BMI) 36.90 kg/m<sup>2</sup>]. We report here that a short-term period of IF in a small group of individuals with T2DM led to significant group decreases in weight (-1.395 kg, P = 0.009), BMI (-0.517, P = 0.013), and at-target morning glucose (SMBG). Although not a study requirement, all participants preferentially chose eating hours starting in the midafternoon. There was a significant increase (P < 0.001) in daily hours fasted in the IF phase (+5.22 h), although few attained the 18-20 h fasting goal (mean 16.82 ± 1.18). The increased fasting duration improved at-goal (< 7.0 mmol/L) morning SMBG to 34.1%, from a baseline of 13.8%. Ordinal Logistic Regression models revealed a positive relationship between the increase in hours fasted and fasting glucose reaching target values (χ<sup>2</sup> likelihood ratio = 8.36, P = 0.004) but not for afternoon or evening SMBG (all P > 0.1). Postprandial SMBGs were also improved during the IF phase, with 60.5% readings below 9.05 mmol/L, compared to 52.6% at baseline, and with less glucose variation. Neither insulin resistance (HOMA-IR), nor inflammatory markers (C-reactive protein) normalized during the IF phase. IF led to an overall spontaneous decrease in caloric intake as measured by food photography (Remote Food Photography Method). The data demonstrated discernable trends during IF for lower energy, carbohydrate, and fat intake when compared to baseline. Physical activity, collected by a standardized measurement tool (Yale Physical Activity Survey), increased during the intervention phase and subsequently decreased in the follow-up phase. IF was well tolerated in the majority of individuals with 6/10 participants stating they would continue with the IF regimen after the completion of the study, in a full or modified capacity (i.e., every other day or reduced fasting hours).CONCLUSIONThe results from this pilot study indicate that short-term daily IF may be a safe, tolerable, dietary intervention in T2DM patients that may improve key outcomes including body weight, fasting glucose and postprandial variability. These findings should be viewed as exploratory, and a larger, longer study is necessary to corroborate these findings.展开更多
Backgrounds: Differences in serum lipids profiles in different type of glucose intolerance are unclear. Aims: To characterize lipid profiles in different type of glucose intolerance, and to assess relationships betwee...Backgrounds: Differences in serum lipids profiles in different type of glucose intolerance are unclear. Aims: To characterize lipid profiles in different type of glucose intolerance, and to assess relationships between serum lipids profile and disturbance of glucose metabolism in prediabetic subjects. Methods: Using the measurements in medical check-up with 75 goral glucose tolerance test (OGTT), total of 620 male subjects, who are not on medications for metabolic diseases or hypertension, were divided into normal fasting glucose and glucose tolerance (NFG/ NGT), isolated impaired fasting glucose (iIFG), isolated impaired glucose tolerance (iIGT) and combined IFG and IGT (IFG/IGT) based on results of the OGTT. Results: Age and body mass index (BMI) were similar in the four groups. Matsuda index (an index of whole body insulin sensitivity) was lower in iIFG, iIGT and IFG/IGT as compared with NFG/NGT. Plasma insulin excursion during the OGTT was significantly higher in IFG/IGT versus NFG/NGT. Serum triglyceride level (TG) and TG to HDL ratio (TG/HDL) were higher in IFG/IGT versus NFG/NGT. Matsuda index was positively correlated with HDL and was inversely correlated with TG, LDL, non-HDL, TG/ HDL and LDL to HDL ratio (LDL/HDL). Backward stepwise multiple regression analysis indicated that increases in BMI, plasma insulin level at 60 min (PI60) and plasma glucose level at 120 min in the OGTT were independently associated with increases in TG and TG/HDL. Increases in BMI and PI60 were related to an increase in non-HDL and LDL/HDL and a decrease in HDL. Conclusions: These results indicate that postprandial hyperglycemia and hyperinsulinemia based on advanced insulin resistance are closely related to lipid risk factors of atherosclerotic macrovascular disease in prediabetic subjects.展开更多
文摘目的:评价丹蛭降糖胶囊对2型糖尿病患者FINS和IRI作用的有效性。方法:计算机检索中国生物医学文献数据库、中国期刊全文数据库、万方期刊数据库等相关资料,按照Cochrane系统评价的方法,客观评价纳入研究的质量,提取有效数据,采用Rev Man 5.2软件进行Meta分析。结果:共纳入5个随机对照试验,包括294例患者。结果显示,丹蛭降糖胶囊能降低2型糖尿病患者FINS[MD=1.24,95%CI(0.90,1.59),P<0.01],降低IRI[MD=0.20,95%CI(0.14,0.27),P<0.01]。结论:丹蛭降糖胶囊对2型糖尿病患者FINS和IRI作用是有效的。
文摘目的:观察益气化聚方联合硫辛酸对2型糖尿病(T2DM)患者血糖、代谢指标及周围神经病变的影响。方法:选取2020年8月至2022年12月上海中医药大学附属岳阳中西医结合医院收治的T2DM患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组给予硫辛酸治疗,观察组在对照组基础上加用益气化聚方治疗。比较2组患者在治疗后的临床疗效、血糖变化、代谢相关指标、周围神经病变及治疗期间不良反应发生情况。结果:治疗后,观察组患者治疗总有效率高于对照组,且高低密度脂蛋白胆固醇(HDL-C)水平、总神经运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)评分(正中神经和腓总神经)显著升高,差异有统计学意义(P<0.05),空腹血糖(FPG)、餐后2 h血糖(2 h PG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)与对照组比较显著降低(P<0.05)。观察组治疗期间出现血小板功能异常2例、脸色苍白1例,对照组治疗期间出现血小板功能异常2例、脸色苍白2例,2组治疗后不良反应发生情况差异无统计学意义。结论:采用益气化聚方联合硫辛酸治疗T2DM可更明显改善周围神经病变,降低血糖,控制血脂,且安全性良好。
文摘目的分析老年糖尿病采用甘精胰岛素+二甲双胍治疗的临床疗效。方法回顾性选取2023年1—12月天水市秦州区人民医院内分泌科收治的60例老年糖尿病患者的临床资料,根据不同用药方法分为对照组(予以甘精胰岛素治疗)、观察组(予以甘精胰岛素+二甲双胍治疗),各30例。比较两组糖代谢(空腹血糖、餐后2 h血糖、糖化血红蛋白、胰岛β细胞功能指数、胰岛素抵抗指数)、C肽水平、并发症、不良反应。结果治疗后,两组空腹血糖、餐后2 h血糖、糖化血红蛋白、胰岛素抵抗指数均低于治疗前,且观察组低于对照组,差异有统计学意义(P均<0.05);治疗后,两组胰岛β细胞功能指数高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组空腹C肽水平、餐后1 h C肽水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P均<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论在甘精胰岛素基础上应用二甲双胍,可显著改善老年糖尿病患者糖代谢状况,降低血糖水平,升高C肽水平,改善患者胰岛功能,有效延缓病情进展,预防并发症,且治疗安全性较高。
文摘Preoperative fasting is mandatory before anesthesia to reduce the risk of aspiration.However,the prescribed 6-8 h of fasting is usually prolonged to 12-16 h for various reasons.Prolonged fasting triggers a metabolic response that precipitates gluconeogenesis and increases the organic response to trauma.Various randomized trials and meta-analyses have consistently shown that is safe to reduce the preoperative fasting time with a carbohydrate-rich drink up to 2 h before surgery.Benefits related to this shorter preoperative fasting include the reduction of postoperative gastrointestinal discomfort and insulin resistance.New formulas containing amino acids such as glutamine and other peptides are being studied and are promising candidates to be used to reduce preoperative fasting time.
基金Supported by Department of Medicine,University of Saskat-chewan,and the College of Pharmacy and Nutrition,University of Saskatchewan
文摘AIMTo determine the short-term biochemical effects and clinical tolerability of intermittent fasting (IF) in adults with type 2 diabetes mellitus (T2DM).METHODSWe describe a three-phase observational study (baseline 2 wk, intervention 2 wk, follow-up 2 wk) designed to determine the clinical, biochemical, and tolerability of IF in community-dwelling volunteer adults with T2DM. Biochemical, anthropometric, and physical activity measurements (using the Yale Physical Activity Survey) were taken at the end of each phase. Participants reported morning, afternoon and evening self-monitored blood glucose (SMBG) and fasting duration on a daily basis throughout all study stages, in addition to completing a remote food photography diary three times within each study phase. Fasting blood samples were collected on the final days of each study phase.RESULTSAt baseline, the ten participants had a confirmed diagnosis of T2DM and were all taking metformin, and on average were obese [mean body mass index (BMI) 36.90 kg/m<sup>2</sup>]. We report here that a short-term period of IF in a small group of individuals with T2DM led to significant group decreases in weight (-1.395 kg, P = 0.009), BMI (-0.517, P = 0.013), and at-target morning glucose (SMBG). Although not a study requirement, all participants preferentially chose eating hours starting in the midafternoon. There was a significant increase (P < 0.001) in daily hours fasted in the IF phase (+5.22 h), although few attained the 18-20 h fasting goal (mean 16.82 ± 1.18). The increased fasting duration improved at-goal (< 7.0 mmol/L) morning SMBG to 34.1%, from a baseline of 13.8%. Ordinal Logistic Regression models revealed a positive relationship between the increase in hours fasted and fasting glucose reaching target values (χ<sup>2</sup> likelihood ratio = 8.36, P = 0.004) but not for afternoon or evening SMBG (all P > 0.1). Postprandial SMBGs were also improved during the IF phase, with 60.5% readings below 9.05 mmol/L, compared to 52.6% at baseline, and with less glucose variation. Neither insulin resistance (HOMA-IR), nor inflammatory markers (C-reactive protein) normalized during the IF phase. IF led to an overall spontaneous decrease in caloric intake as measured by food photography (Remote Food Photography Method). The data demonstrated discernable trends during IF for lower energy, carbohydrate, and fat intake when compared to baseline. Physical activity, collected by a standardized measurement tool (Yale Physical Activity Survey), increased during the intervention phase and subsequently decreased in the follow-up phase. IF was well tolerated in the majority of individuals with 6/10 participants stating they would continue with the IF regimen after the completion of the study, in a full or modified capacity (i.e., every other day or reduced fasting hours).CONCLUSIONThe results from this pilot study indicate that short-term daily IF may be a safe, tolerable, dietary intervention in T2DM patients that may improve key outcomes including body weight, fasting glucose and postprandial variability. These findings should be viewed as exploratory, and a larger, longer study is necessary to corroborate these findings.
文摘Backgrounds: Differences in serum lipids profiles in different type of glucose intolerance are unclear. Aims: To characterize lipid profiles in different type of glucose intolerance, and to assess relationships between serum lipids profile and disturbance of glucose metabolism in prediabetic subjects. Methods: Using the measurements in medical check-up with 75 goral glucose tolerance test (OGTT), total of 620 male subjects, who are not on medications for metabolic diseases or hypertension, were divided into normal fasting glucose and glucose tolerance (NFG/ NGT), isolated impaired fasting glucose (iIFG), isolated impaired glucose tolerance (iIGT) and combined IFG and IGT (IFG/IGT) based on results of the OGTT. Results: Age and body mass index (BMI) were similar in the four groups. Matsuda index (an index of whole body insulin sensitivity) was lower in iIFG, iIGT and IFG/IGT as compared with NFG/NGT. Plasma insulin excursion during the OGTT was significantly higher in IFG/IGT versus NFG/NGT. Serum triglyceride level (TG) and TG to HDL ratio (TG/HDL) were higher in IFG/IGT versus NFG/NGT. Matsuda index was positively correlated with HDL and was inversely correlated with TG, LDL, non-HDL, TG/ HDL and LDL to HDL ratio (LDL/HDL). Backward stepwise multiple regression analysis indicated that increases in BMI, plasma insulin level at 60 min (PI60) and plasma glucose level at 120 min in the OGTT were independently associated with increases in TG and TG/HDL. Increases in BMI and PI60 were related to an increase in non-HDL and LDL/HDL and a decrease in HDL. Conclusions: These results indicate that postprandial hyperglycemia and hyperinsulinemia based on advanced insulin resistance are closely related to lipid risk factors of atherosclerotic macrovascular disease in prediabetic subjects.
