AIM To compare the safety and efficacy or 3 basal-bolus regimens of neutral protamine hagedorn(NPH)/regular insulin in the management of inpatient hyperglycemia.METHODS We randomized 105 patients with blood glucose le...AIM To compare the safety and efficacy or 3 basal-bolus regimens of neutral protamine hagedorn(NPH)/regular insulin in the management of inpatient hyperglycemia.METHODS We randomized 105 patients with blood glucose levelsbetween 140 and 400 mg/dL to a basal-bolus regimen of NPH insulin given once(n = 30), twice(n = 40) or three times(n = 35) daily, in addition to pre-meal regular insulin. Major outcomes included were differences in glycemic control, frequency of hypoglycemia and total insulin dose.RESULTS NPH insulin given in a once-daily regimen was associated with better glycemic control(58.3%) compared to twice daily(42.4%) and three times daily(48.9) regimens(P = 0.031). The frequency of hypoglycemia was similar between the three groups(2.0%, 0.7% and 1.2%, P = 0.21). The mean insulin dose at discharge was 0.48 ± 0.14 U/kg in the once-daily group compared to 0.69 ± 0.28 in the twice-daily, and 0.65 ± 0.20 in the three times daily regimens(P < 0.001).CONCLUSION NPH insulin administered in a once-daily regimen resulted in improvement in glycemic control with similar rates of hypoglycemia compared to a twice-daily and a three times-daily regimen. Further studies are needed to evaluate whether this regimen could be implemented in all hospitalized patients with hyperglycemia.展开更多
The Hagedorn wavepacket method is an important numerical method for solving the semiclassical time-dependent Schrödinger equation.In this paper,a new semi-discretization in space is obtained by wavepacket operato...The Hagedorn wavepacket method is an important numerical method for solving the semiclassical time-dependent Schrödinger equation.In this paper,a new semi-discretization in space is obtained by wavepacket operator.In a sense,such semi-discretization is equivalent to the Hagedorn wavepacket method,but this discretization is more intuitive to show the advantages of wavepacket methods.Moreover,we apply the multi-time-step method and the Magnus-expansion to obtain the improved algorithms in time-stepping computation.The improved algorithms are of the Gauss–Hermite spec-tral accuracy to approximate the analytical solution of the semiclassical Schrödinger equation.And for the given accuracy,the larger time stepsize can be used for the higher oscillation in the semiclassical Schrödinger equation.The superiority is shown by the error estimation and numerical experiments.展开更多
目的:甘精胰岛素是一种新型长效人胰岛素类似物,格列美脲是具有胰外降血糖作用的降糖药。文中比较甘精胰岛素联合格列美脲治疗老年糖尿病血糖控制情况与发生低血糖的风险。方法:40例应用口服降糖药控制血糖效果不佳的老年糖尿病患者[空...目的:甘精胰岛素是一种新型长效人胰岛素类似物,格列美脲是具有胰外降血糖作用的降糖药。文中比较甘精胰岛素联合格列美脲治疗老年糖尿病血糖控制情况与发生低血糖的风险。方法:40例应用口服降糖药控制血糖效果不佳的老年糖尿病患者[空腹血糖(FBG)≥10 mmol/L)],按治疗方法分为中效鱼精蛋白锌人胰岛素(NPH)联合格列美脲组19例,甘精胰岛素联合格列美脲治疗组21例。依照空腹血糖(FBG)水平调整胰岛素用量,治疗目标值FBG<7.0 mmol/L,治疗时间12周。观察治疗后空腹及餐后2 h血糖(2 h PBG)水平、低血糖、糖化血红蛋白(HbA1c)及体质量指数(BMI)等指标的变化情况。结果:治疗后2组患者FBG、2 h PBG及HbA1c均明显低于治疗前水平(P<0.05),甘精胰岛素联合格列美脲组低血糖发生率明显低于NPH联合格列美脲(P<0.05),甘精胰岛素联合格列美脲组治疗前后BMI无明显差异(P>0.05),而NPH联合格列美脲组治疗前后BMI有明显差异(P<0.05)。结论:甘精胰岛素联合格列美脲可较好地控制老年糖尿病患者的血糖,低血糖发生率低,对患者体质量影响小,具有安全、方便的特点,是老年糖尿病患者理想的治疗方案。展开更多
<div style="text-align:justify;"> <span style="font-family:Verdana;">Type 2 diabetes mellitus is a growing health problem, characterized by insulin resistance progressing to beta cell d...<div style="text-align:justify;"> <span style="font-family:Verdana;">Type 2 diabetes mellitus is a growing health problem, characterized by insulin resistance progressing to beta cell dysfunction and insulin deficiency, most of these patients will need intensification of treatment and initiation of insulin to delay or prevent diabetic complications. Glycemic control is the most important aspect of management, and in reducing morbidity and mortality of the diseases. Control of plasma glucose in patients with diabetes can be assessed by HbA1c, FPG, PPG, but still HbA1c% remains the gold standard for assessment of glycemic control and follow up of diabetic patients. The aim of this study is to assess HbA1c% in patients on oral anti-diabetic drugs, with poor glycemic control before and after adding basal insulin, with titration of the dose of insulin depending on fasting blood sugar. 82 patients with uncontrolled type 2 diabetes (43.9% male, 56.1% female), with HbA1c more than 9%, on two types of oral diabetic medication or more, were started on basal insulin (glargine, lantus) and followed for three to six months. Overall 82 patients with type 2 diabetes mellitus were included in the study. The mean age of the study population was 58.4 years, the mean duration of the disease range was 13.4 years. All patients with HbA1c more than 9%, without organ failure, were included in the study. The mean HbA1c overall had decreased from mean of 11.15% before starting basal insulin to the mean of 8.43% within 3 to 6 month, after initiating basal insulin, this difference was significant at p < 0.001. There was no adverse effect on this medication in any of the study group. The addition of basal insulin to oral anti-diabetic medication in uncontrolled insulin-na<span style="color:#4F4F4F;font-family:"font-size:14px;white-space:normal;background-color:#F7F7F7;">ï</span>ve type 2 diabetic patients resulted in significant improvement of glycemic control, with improved HbA1c level, without adverse effects.</span> </div>展开更多
目的比较住院患者使用甘精胰岛素(glargine)和中性鱼精蛋白锌胰岛素(NPH)控制血糖达标的成本。方法92例新诊断的2型糖尿病患者,70例用口服降糖药治疗的2型糖尿病患者以及16例1型糖尿病患者进入本研究,每组等分为两亚组,分别予glargine和...目的比较住院患者使用甘精胰岛素(glargine)和中性鱼精蛋白锌胰岛素(NPH)控制血糖达标的成本。方法92例新诊断的2型糖尿病患者,70例用口服降糖药治疗的2型糖尿病患者以及16例1型糖尿病患者进入本研究,每组等分为两亚组,分别予glargine和NPH,运用药物经济学最小成本分析法比较两种药物的治疗成本。结果3组研究人群均显示,与NPH比较,glargine单药成本(人民币元)高(116．30±18．80 vs 38．68±6．57,190．84±30．37vs53．43±7．15,120．06±10．90 vs 29．51±2．17),每日成本(人民币元)高(431．62±62．18vs 370．16±49．80,356．48±55．46 vs 335．77±41．69,294．12±55．99vs 245．17±29．57),总成本(人民币元)低(2 679．40±92．49 vs 3016．50±174．72,3 629．23±105．55vs 3 821．62±140．25,1 576．55±114．69vs 1 715．85±126．32)。结论使用glargine控制血糖较NPH节约住院成本。展开更多
文摘AIM To compare the safety and efficacy or 3 basal-bolus regimens of neutral protamine hagedorn(NPH)/regular insulin in the management of inpatient hyperglycemia.METHODS We randomized 105 patients with blood glucose levelsbetween 140 and 400 mg/dL to a basal-bolus regimen of NPH insulin given once(n = 30), twice(n = 40) or three times(n = 35) daily, in addition to pre-meal regular insulin. Major outcomes included were differences in glycemic control, frequency of hypoglycemia and total insulin dose.RESULTS NPH insulin given in a once-daily regimen was associated with better glycemic control(58.3%) compared to twice daily(42.4%) and three times daily(48.9) regimens(P = 0.031). The frequency of hypoglycemia was similar between the three groups(2.0%, 0.7% and 1.2%, P = 0.21). The mean insulin dose at discharge was 0.48 ± 0.14 U/kg in the once-daily group compared to 0.69 ± 0.28 in the twice-daily, and 0.65 ± 0.20 in the three times daily regimens(P < 0.001).CONCLUSION NPH insulin administered in a once-daily regimen resulted in improvement in glycemic control with similar rates of hypoglycemia compared to a twice-daily and a three times-daily regimen. Further studies are needed to evaluate whether this regimen could be implemented in all hospitalized patients with hyperglycemia.
基金supported by projects NSF of China(11271311)Program for Changjiang Scholars and Innovative Research Team in University of China(IRT1179)Hunan Province Innovation Foundation for Postgraduate(CX2011B245).
文摘The Hagedorn wavepacket method is an important numerical method for solving the semiclassical time-dependent Schrödinger equation.In this paper,a new semi-discretization in space is obtained by wavepacket operator.In a sense,such semi-discretization is equivalent to the Hagedorn wavepacket method,but this discretization is more intuitive to show the advantages of wavepacket methods.Moreover,we apply the multi-time-step method and the Magnus-expansion to obtain the improved algorithms in time-stepping computation.The improved algorithms are of the Gauss–Hermite spec-tral accuracy to approximate the analytical solution of the semiclassical Schrödinger equation.And for the given accuracy,the larger time stepsize can be used for the higher oscillation in the semiclassical Schrödinger equation.The superiority is shown by the error estimation and numerical experiments.
文摘目的:甘精胰岛素是一种新型长效人胰岛素类似物,格列美脲是具有胰外降血糖作用的降糖药。文中比较甘精胰岛素联合格列美脲治疗老年糖尿病血糖控制情况与发生低血糖的风险。方法:40例应用口服降糖药控制血糖效果不佳的老年糖尿病患者[空腹血糖(FBG)≥10 mmol/L)],按治疗方法分为中效鱼精蛋白锌人胰岛素(NPH)联合格列美脲组19例,甘精胰岛素联合格列美脲治疗组21例。依照空腹血糖(FBG)水平调整胰岛素用量,治疗目标值FBG<7.0 mmol/L,治疗时间12周。观察治疗后空腹及餐后2 h血糖(2 h PBG)水平、低血糖、糖化血红蛋白(HbA1c)及体质量指数(BMI)等指标的变化情况。结果:治疗后2组患者FBG、2 h PBG及HbA1c均明显低于治疗前水平(P<0.05),甘精胰岛素联合格列美脲组低血糖发生率明显低于NPH联合格列美脲(P<0.05),甘精胰岛素联合格列美脲组治疗前后BMI无明显差异(P>0.05),而NPH联合格列美脲组治疗前后BMI有明显差异(P<0.05)。结论:甘精胰岛素联合格列美脲可较好地控制老年糖尿病患者的血糖,低血糖发生率低,对患者体质量影响小,具有安全、方便的特点,是老年糖尿病患者理想的治疗方案。
文摘<div style="text-align:justify;"> <span style="font-family:Verdana;">Type 2 diabetes mellitus is a growing health problem, characterized by insulin resistance progressing to beta cell dysfunction and insulin deficiency, most of these patients will need intensification of treatment and initiation of insulin to delay or prevent diabetic complications. Glycemic control is the most important aspect of management, and in reducing morbidity and mortality of the diseases. Control of plasma glucose in patients with diabetes can be assessed by HbA1c, FPG, PPG, but still HbA1c% remains the gold standard for assessment of glycemic control and follow up of diabetic patients. The aim of this study is to assess HbA1c% in patients on oral anti-diabetic drugs, with poor glycemic control before and after adding basal insulin, with titration of the dose of insulin depending on fasting blood sugar. 82 patients with uncontrolled type 2 diabetes (43.9% male, 56.1% female), with HbA1c more than 9%, on two types of oral diabetic medication or more, were started on basal insulin (glargine, lantus) and followed for three to six months. Overall 82 patients with type 2 diabetes mellitus were included in the study. The mean age of the study population was 58.4 years, the mean duration of the disease range was 13.4 years. All patients with HbA1c more than 9%, without organ failure, were included in the study. The mean HbA1c overall had decreased from mean of 11.15% before starting basal insulin to the mean of 8.43% within 3 to 6 month, after initiating basal insulin, this difference was significant at p < 0.001. There was no adverse effect on this medication in any of the study group. The addition of basal insulin to oral anti-diabetic medication in uncontrolled insulin-na<span style="color:#4F4F4F;font-family:"font-size:14px;white-space:normal;background-color:#F7F7F7;">ï</span>ve type 2 diabetic patients resulted in significant improvement of glycemic control, with improved HbA1c level, without adverse effects.</span> </div>
文摘目的比较住院患者使用甘精胰岛素(glargine)和中性鱼精蛋白锌胰岛素(NPH)控制血糖达标的成本。方法92例新诊断的2型糖尿病患者,70例用口服降糖药治疗的2型糖尿病患者以及16例1型糖尿病患者进入本研究,每组等分为两亚组,分别予glargine和NPH,运用药物经济学最小成本分析法比较两种药物的治疗成本。结果3组研究人群均显示,与NPH比较,glargine单药成本(人民币元)高(116．30±18．80 vs 38．68±6．57,190．84±30．37vs53．43±7．15,120．06±10．90 vs 29．51±2．17),每日成本(人民币元)高(431．62±62．18vs 370．16±49．80,356．48±55．46 vs 335．77±41．69,294．12±55．99vs 245．17±29．57),总成本(人民币元)低(2 679．40±92．49 vs 3016．50±174．72,3 629．23±105．55vs 3 821．62±140．25,1 576．55±114．69vs 1 715．85±126．32)。结论使用glargine控制血糖较NPH节约住院成本。
