Prevalence rates and cardiometabolic determinants of diabetes mellitus and pre-diabetes with projected coronary heart disease at bank site of Brazzaville

Background: Aim: Congolese Bank employees are often inactive without valid information on the burden of dysglycemia and cardiometabolic risk. This study aims to assess the prevalence rates of diabetes mellitus (DM) and pre-diabetes and to identify the environmental, genetic and cardiometabolic risk factors associated with Type 2 diabetes mellitus (T2DM) and pre-diabetes among Congolese bank employees. Methods: In representative 126 bank employees from Brazzaville, Congo, Central Africa, Abdominal obesity, dyslipidemia and metabolic syndrome (MetS) were defined by IDF for Europe, NCEP-ATPIII and IDF criteria modified for Central Africa. Projected high 10-year total risk of coronary heart disease (CHD) ≥20% was calculated using Framingham scores. Results: Out of the employees, 16% and 21.4% had DM and pre-diabetes, respectively. The rate of T2DM among diabetics was estimated 90%. Aging, high total cholesterol, high LDL-cholesterol, high conicity index and longer urban residence after migration were significantly associated with pre-diabetes. Physical inactivity, smoking, excessive alcohol intake, abdominal obesity, female gender, low HDL-C, hypertension, CHD, projected high 10-year total CHD risk, age ≥ 55 years, urban residence, Southern area residence, high socioeconomic status, non married status, MetS/NCEP, MetS/IDF for Europe and MetS/IDF for Africa were significantly associated with T2DM.MetS/IDF for Africa was the only independent determinant of T2DM. Conclusion: Urgent prevention and intervention programme are needed to curb the alarming increase in DM, T2DM, pre-diabetes.

Correlation of Liver Enzymes with Diabetes and Pre-diabetes in Middle-aged Rural Population in China

The survey aimed to explore the association of liver transaminases with the prevalence of type 2 diabetes mellitus（T2DM） and pre-diabetes（pre-DM） in the middle-aged rural population in China. A cross-sectional study was conducted in 10 800 middle-aged subjects who lived in rural area of central China. The 75-g oral glucose-tolerance test（OGTT） was performed. Participants were asked to complete physical examination and standard questionnaire. The serum liver transaminases（ALT and GGT）, Hb A1 C and serum lipids were measured. In middle-aged rural population, the prevalence of impaired fasting glucose（IFG）, impaired glucose tolerance（IGT）, impaired fasting glucose combined with impaired glucose tolerance（IFG＋IGT） and DM was 4.0%, 11.8%, 2.6% and 10.0%, respectively. Some measurements were higher in males than in females, such as waist hip ratio（WHR）, blood pressure, fasting blood glucose（FBG）, high density lipoprotein-cholesterol（HDL-C）, and liver enzymes（ALT and GGT）. Further, we found that elevated serum GGT and ALT levels were significantly positively correlated with the prevalence of DM, independent of central obesity, serum lipid and insulin resistance（IR） in both genders. However, the correlation of GGT and ALT with pre-DM was determined by genders and characteristics of liver enzymes. Higher serum GGT was indicative of IGT in both genders. The association of serum ALT with pre-DM was significant only in female IGT group. In conclusion, our present survey shows both serum GGT and ALT are positively associated with DM, independent of the cardiovascular risk factors in both genders.

NLRP3 Inflammasome in Relation to Glucose and Lipid Metabolism, and Insulin Resistance in Diabetes and Pre-Diabetes

Aims: To investigate the relationship among NLRP3 inflammasome, glucose and lipid metabolism, and insulin resistance (IR) in the serum of patients with diabetes and pre-diabetes. Methods: A total of 100 patients with abnormal blood glucose divided into the pre-diabetes mellitus (PDM) group (N = 46) and the type 2 diabetes mellitus (T2DM) group (N = 54). 20 normoglycemic subjects (NG, N = 20) were selected as a control group. The serum levels of glucose and lipid metabolism, IR, and the expression of NLRP3, ASC and Caspase-1 were measured. Besides, the correlations of NLRP3 inflammasome with glucose and lipid metabolism, and IR were analyzed. Results: Compared with the NG group, the levels of NLRP3, ASC, Caspase-1, FBG, HbA1C, TG, LDL-C, FINs, and HOMA-IR were higher (P β were lower (P P β were seen (P P β. Regression analysis further showed that blood glucose related indexes, FINs, and NLRP3 have made a decisive contribution to IR. Conclusions: Collectively, this evidence suggested that NLRP3 is closely related to glucose and lipid metabolism, and IR, and activated in PDM and T2DM.

Blood glucose response to aerobic exercise training programme among patients with type 2 diabetes mellitus at the University of Nigeria Teaching Hospital, Enugu South-East, Nigeria

The following article has been retracted due to the conflicts between the authors. The scientific community takes a very strong view on this matter, and HEALTH treats all unethical behavior seriously. This paper published in Vol.5 No.11, 1796-1802 (2013) has been removed from this site. Title: Blood glucose response to aerobic exercise training programme among patients with type 2 diabetes mellitus at the University of Nigeria Teaching Hospital, Enugu South-East, Nigeria Authors: Charles Ikechukwu Ezema, Amarachi Akuegbu Onwunali, Sikiru Lamina, Uche Anthonia Ezugwu, Augustine Amaeze Amaeze, Maduabuchukwu Joseph Nwankwo, Florence Ngozi

Literature review of type 2 diabetes mellitus among minority Muslim populations in Israel

This review surveys the literature published on the characteristics and implications of pre-diabetes and type 2 diabetes mellitus(T2DM) for the Arab andBedouin populations of Israel. T2 DM is a global health problem. The rapid rise in its prevalence in the Arab and Bedouin populations in Israel is responsible for their lower life expectancy compared to Israeli Jews. The increased prevalence of T2 DM corresponds to increased rates of obesity in these populations. A major risk group is adult Arab women aged 55-64 years. In this group obesity reaches 70%. There are several genetic and nutritional explanations for this increase. We found high hospitalization rates for micro and macrovascular complications among diabetic patients of Arab and Bedouin origin. Despite the high prevalence of diabetes and its negative health implications, there is evidence that care and counseling relating to nutrition, physical activity and self-examination of the feet are unsatisfactory. Economic difficulties are frequently cited as the reason for inadequate medical care. Other proposed reasons include faith in traditional therapy and misconceptions about drugs and their side effects. In Israel, the quality indicators program is based on one of the world's leading information systems and deals with the management of chronic diseases such as diabetes. The program's baseline data pointed to health inequality between minority populations and the general population in several areas, including monitoring and control of diabetes. Based on these data, a pilot intervention program was planned, aimed at minority populations. This program led to a decrease in inequality and served as the basis for a broader, more comprehensive intervention that has entered the implementation stage. Interventions that were shown to be effective in other Arabic countries may serve as models for diabetes management in the Arab and Bedouin populations in Israel.

Toll-like receptor expression and signaling in human diabetic wounds

AIM: To examine the contribution of toll-like receptors(TLRs) expression and activation to the prolonged inflammation often seen in human diabetic wounds.METHODS: Debridement wound tissue was collected from diabetic patients with informed consent. Total RNA and protein were isolated and subjected to real-time polymerase chain reaction and Western blot analyses. RESULTS: TLR1, 2, 4, and 6 mRNA expressions were increased significantly in wounds of diabetic patients compared with non-diabetic wounds(P 【 0.05). MyD88 protein expression was significantly increased in diabetic wounds compared to non-diabetic wounds. Interleukin-1beta, tumor necrosis factor-alpha concentration nuclear factor-kappa B activation, and thiobarbituric acid reactive substances were increased in diabetic wounds compared to non-diabetic wounds(P 【 0.01). CONCLUSION: Collectively, our novel findings show that increased TLR expression, signaling, and activation may contribute to the hyper inflammation in the human diabetic wounds.

PRE-084通过调节神经元MAM改善1型糖尿病小鼠的学习记忆障碍

目的糖尿病小鼠可表现出学习记忆功能障碍,探究Sigma-1受体激动剂PRE-084对1型糖尿病小鼠海马区神经元及认知损伤的影响。方法将20只8~10周龄链脲佐菌素诱导的1型糖尿病小鼠和20只对照小鼠随机分为4组(CON+Vehicle、CON+PRE-084、T1DM+Vehicle和T1DM+PRE-084组);分别用添加PRE-084及对照溶剂的高糖培养基培养小鼠原代神经元。监测并记录各组小鼠的体质量、饮食饮水量及空腹血糖水平,利用新物体识别实验检测小鼠的学习记忆能力,透射电镜检测小鼠海马CA1区神经元MAM结构的变化,生化试剂盒检测小鼠海马区ATP、活性氧(ROS)的表达水平;利用CCK8和细胞ROS试剂盒检测原代神经元的细胞活力和ROS水平。结果PRE-084可降低糖尿病小鼠体质量、饮食饮水量和血糖。PRE-084明显缓解1型糖尿病小鼠的学习记忆障碍,改善糖尿病小鼠海马CA1区神经元MAM结构的变化,升高糖尿病小鼠海马区ATP的水平,降低糖尿病小鼠海马区及高糖条件下神经元中ROS表达水平。结论Sigma-1受体激动剂PRE-084改善1型糖尿病小鼠学习记忆障碍可能与海马区神经元MAM结构变化、ATP产量增加及ROS生成减少相关。

糖尿病前期及2型糖尿病皮层萎缩与认知功能的相关性研究

目的探讨糖尿病前期(pre-diabetes mellitus,PDM)和2型糖尿病(type 2 diabetes mellitus,T2DM)大脑皮层的改变模式及其与认知功能的关系,以期探寻血糖代谢异常被试早期脑损害的影像标志物。材料与方法本研究纳入96例T2DM患者、30例PDM被试以及48名正常对照(normal control,NC),对被试进行了认知功能测试、临床生化检查及高分辨率3D-T1WI磁共振扫描。使用CAT12软件进行基于体素的形态学分析和基于表面的形态学分析得到全脑灰质体积和皮层厚度、局部回指数等皮层结构参数,并比较3组间的差异,结果均使用P<0.05的阈值和FWE校正进行多重比较校正。进一步提取组间具有差异的参数,与生化指标及认知量表得分进行相关分析。结果与NC相比,PDM被试右侧额下回眶部及左侧中央后回灰质萎缩(P<0.05,FWE校正),T2DM患者出现更多灰质萎缩,特别是右侧颞上回、右侧额下回眶部、右侧颞中回及左侧中央后回,右侧前额叶皮层厚度减小(P<0.05,FWE校正)。在血糖代谢异常被试中全脑灰质体积与胰岛素抵抗指数(r=−0.227,P=0.012,未校正)及连线测试A得分(r=−0.250,P=0.001,FDR校正)呈负相关,与数字广度-倒背得分呈正相关(r=0.267,P=0.003,FDR校正);皮层厚度与糖化血红蛋白(r=−0.181,P=0.040,未校正)及餐后2 h血糖(r=−0.272,P=0.020,未校正)呈负相关,与餐后2 h胰岛素(r=0.236,P=0.010,未校正)及胰岛β细胞功能指数(r=0.207,P=0.022,未校正)呈正相关。结论本研究发现PDM人群已存在脑区灰质萎缩,T2DM患者出现更多的灰质萎缩,且与注意和工作记忆功能相关,因此皮层萎缩有可能是糖尿病相关脑损伤早期的影像标志物。

择期剖宫产术中应用ERAS对GDM孕妇及其新生儿的疗效及安全性探讨

【目的】探讨对择期剖宫产的妊娠期糖尿病(GDM)孕妇实施加速康复外科(ERAS)是否会导致孕妇围术期血糖异常以及增加新生儿低血糖的风险。【方法】回顾性分析2022年5月1日至2023年10月31日期间在中山大学附属第三医院行择期剖宫产并接受ERAS处理的单胎妊娠孕妇。其中血糖控制良好GDM孕妇纳入GDM组,以产妇年龄(18~30岁;30~35岁;35~40岁,>40岁),BMI(<18.5 kg/m^(2);18.5~24.9 kg/m^(2);25~30 kg/m^(2);>30 kg/m^(2))及胎龄(7 d内)为标准,1:1匹配非GDM产妇为对照组。观察术前口服碳水化合物后孕产妇血糖变化趋势、任何时段的高血糖、低血糖,以及新生儿低血糖、低Apgar评分、血气分析中异常PH值的发生率,分娩后即刻转儿科率。【结果】本研究共收集孕妇150例,其中GDM组(n=75),非GDM组(n=75),两组孕妇手术当日空腹血糖无明显差异[(4.4±0.5)mmol/L vs.(4.3±0.5)mmol/L;t=1.395,P=0.165],在饮用300 mL(含低剂量碳水化合物42.6 g)的清亮饮品后30 min达到血糖峰值[(7.2±0.9)mmol/L vs.(6.4±0.8)mmol/L;t=5.773,P<0.001],后快速下降,在口服碳水化合物后120 min时血糖基本回到口服碳水化合物前水平,GDM组血糖均显著高于非GDM组(P<0.005)。虽然在口服碳水化合物后30 min的血糖峰值中,GDM组孕妇的高血糖发生率显著高于非GDM组,差异有统计学意义(17.3%vs.1.3%,χ^(2)=11.354,P<0.001),但并未发生严重高血糖(≥10 mmol/L)。GDM组新生儿低血糖发生率与非GDM组相比差异无统计学意义(22.7%vs.28%,χ^(2)=0.564,P=0.453)。与非GDM组相比,在调整了年龄+BMI(Model 1);初产+分娩孕周(Model 2);妊娠期高血压疾病(Model 3);剖宫产指征+剖宫产时间+术中出血(Model 4);新生儿体质量(Model 5)后,ERAS并没有显著增加GDM组新生儿低血糖发生率。【结论】对血糖控制良好的GDM孕妇择期剖宫产前实施口服低剂量碳水化合物的ERAS方案不增加孕妇术前严重高血糖及新生儿低血糖的风险。

老年2型糖尿病患者衰弱前期现状及其影响因素分析

目的调查分析某三甲医院老年2型糖尿病(T2DM)患者衰弱前期现状及其影响因素,为制定精准护理干预方案以减少该病发生提供理论依据。方法选取2018年1月至2021年12月在某三甲医院老年病内分泌科收治的170例老年T2DM患者作为研究对象,利用Fried衰弱表型定义量表将患者分为无衰弱组、衰弱前期组和衰弱组。剔除已经发展到衰弱的患者,保留无衰弱和衰弱前期的患者。收集无衰弱组、衰弱前期组患者的资料,探讨老年T2DM患者发生衰弱前期的影响因素。结果170例老年T2DM患者中,剔除已经发展到衰弱的40例患者,其余58例无衰弱,72例为衰弱前期。无衰弱组和衰弱前期组的性别、婚姻状况、T2DM病程、合并其他疾病及老年抑郁量表-15(GDS-15)、匹兹堡睡眠质量指数量表(PSQI)、老年人运动功能量表(GLFS)评分比较,差异具有统计学意义(P<0.05)。性别、婚姻状况、T2DM病程及GDS-15、GLFS评分是老年T2DM患者发生衰弱前期的影响因素(P<0.05)。结论老年T2DM患者衰弱前期发生率较高,医护人员应特别关注女性、离婚/丧偶、T2DM病程长、有抑郁症状和运动障碍综合征的患者,针对此类人群制定精准护理干预方案,以延缓其发展到衰弱前期的进程。

妊娠期糖尿病孕妇孕前正常体重指数与妊娠结局的相关性

目的:探讨正常孕前体重指数(body mass index,BMI)的妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇不同BMI范围对妊娠结局的影响。方法:回顾性收集南京市妇幼保健院2022年5月—2023年5月孕前正常BMI的GDM孕妇2319例,按照孕前BMI分为A组(18.5 kg/m^(2)≤BMI<20.0 kg/m^(2),581例)、B组(20.0 kg/m^(2)≤BMI<22.0 kg/m^(2),922例)与C组(22.0 kg/m^(2)≤BMI<24.0 kg/m^(2),816例)。拟合Logistic回归模型,对不同孕前BMI与妊娠结局的相关性进行分析评价。结果:3组GDM患者发生GDM A2级、子痫前期、巨大儿和新生儿高胆红素血症的风险随孕前BMI的升高而增加;发生胎盘早剥、新生儿低血糖症的风险随孕前BMI的升高而降低。在正常BMI人群中,GDM女性孕前较高或较低的BMI水平是发生GDM A2级、子痫前期、巨大儿、新生儿高胆红素血症、胎盘早剥和新生儿低血糖症的独立危险因素。结论:早期体重管理可能是预防GDM孕妇不良妊娠结局发生的不容忽视的关键措施之一。

血清miR-503、miR-520h对妊娠期糖尿病患者并发子痫前期的诊断价值

目的探讨血清微小核糖核酸-503(miR-503)和微小核糖核酸-520h(miR-520h)对妊娠期糖尿病(GDM)患者并发子痫前期(PE)的诊断价值。方法选取2019年12月至2021年12月于唐山中心医院产科定期产检并建档的GDM患者102例作为研究对象,根据疾病类型分为GDM+PE组(53例)、GDM组(49例)。另选取同期于唐山中心医院进行定期产检并分娩的57例健康孕妇作为正常妊娠组。比较3组糖脂代谢相关指标[甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、游离脂肪酸(FFA)、空腹胰岛素(FINS)、空腹血糖(FBG)、餐后2 h血糖(2 h PG)]水平及血清miR-503、miR-520h表达水平、血清胱抑素C(CysC)、同型半胱氨酸(Hcy)水平;比较3组不良妊娠结局。采用多因素Logistic回归分析GDM患者并发PE的危险因素;绘制受试者工作特征(ROC)曲线分析miR-503、miR-520h单独及2项指标联合检测对GDM并发PE的诊断价值。结果3组孕周、年龄、孕前体质量指数、LDL-C水平比较,差异均无统计学意义(P>0.05)。GDM+PE组TC、TG、FFA水平均明显高于GDM组和正常妊娠组,HDL-C水平明显低于GDM组和正常妊娠组,差异均有统计学意义(P<0.05)。GDM组TC、FFA水平均明显高于正常妊娠组,差异均有统计学意义(P<0.05)。GDM+PE组和GDM组FINS、FBG、2 h PG、HbA1c水平均明显高于正常妊娠组,差异均有统计学意义(P<0.05)。GDM+PE组血清miR-503、miR-520h表达水平、CysC和Hcy水平均明显高于GDM组和正常妊娠组,差异均有统计学意义(P<0.05),GDM组血清miR-503、miR-520h表达水平及CysC和Hcy水平均明显高于正常妊娠组,差异均有统计学意义(P<0.05)。GDM+PE组不良妊娠结局总发生率为62.26%(33/53),GDM组为40.82%(20/49),正常妊娠组为10.53%(6/57),GDM+PE组不良妊娠结局总发生率明显高于GDM组和正常妊娠组,差异均有统计学意义(χ^(2)=4.692、32.125,P<0.05),GDM组不良妊娠结局总发生率明显高于正常妊娠组,差异有统计学意义(χ^(2)=13.059,P<0.05)。3组孕妇不良妊娠结局中产后出血、早产或过期产、胎盘早剥、新生儿窒息、宫内生长受限的发生率比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,CysC水平升高、Hcy水平升高、miR-503表达水平升高和miR-520h表达水平升高均为GDM并发PE的危险因素(P<0.05)。ROC曲线分析结果显示,血清miR-503、miR-520h单独及2项指标联合检测诊断GDM并发PE的曲线下面积(AUC)分别为0.755、0.847、0.935,2项指标联合检测的AUC大于miR-503、miR-520h单独检测(Z_(2项联合-miR-503)=4.210、Z_(2项联合-miR-520h)=2.708,P<0.001、0.007)。结论GDM并发PE患者血清miR-503、miR-520h表达水平升高,与妊娠不良结局呈正相关,二者联合检测对诊断GDM并发PE具有重要意义。

越鞠丸联合八段锦治疗糖尿病前期患者的临床研究

目的探讨越鞠丸联合八段锦治疗糖尿病前期(PDM)患者的临床效果。方法选取2021年8月至2023年8月赣南医科大学第一附属医院收治的60例PDM患者作为研究对象,按照随机数字表法分为对照组(n=30)和观察组(n=30)。对照组采用盐酸二甲双胍治疗,观察组在对照组基础上加用越鞠丸联合八段锦治疗,两组均连续治疗3个月。比较两组患者的治疗效果及安全性。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);两组患者治疗后血糖、血脂水平及中医证候积分、体重低于本组治疗前,且观察组血糖、血脂水平及中医证候积分、体重低于对照组,差异有统计学意义(P<0.05);两组患者均未见明显不良反应。结论PDM患者应用越鞠丸联合八段锦治疗具有良好的临床效果,有利于改善血糖、血脂水平,减轻体重,缓解临床症状,值得推广。

疗养军事飞行人员糖代谢现状调查分析

目的 调查疗养军事飞行人员的血糖代谢现状,分析其糖代谢异常的发病特点,为飞行人员的糖尿病(diabetes mellitus,DM)航卫保障提供科学依据。方法 随机抽取2021-01/2023-09月于某中心疗养的军事飞行人员共2591例,行口服葡萄糖耐量试验,测定其空腹血糖(fasting plasma glucose,FPG)、餐后2 h血葡萄糖(2 h postprandial blood glucose,2 hPG)和糖化血红蛋白(glycosylated hemoglobin,HbA_(1)c),统计DM、糖尿病前期(pre-diabetes mellitus,PDM)的患病率,比较不同年龄段(年龄<30岁、30岁≤年龄<40岁、40岁≤年龄<50岁、年龄≥50岁)、不同飞行时间(飞行时间<1000 h、1000 h≤飞行时间<3000 h、3000≤飞行时间<5000 h、飞行时间≥5000 h)、不同勤务类别(空勤、战勤)、不同机种(歼击机、轰炸机、直升机、运输机、其他)飞行人员血糖代谢情况。结果 2591例军事飞行人员中,诊断为PDM 286例(11.04%),诊断为DM 49例(1.89%),血糖正常2256例(87.07%)。在286例PDM患者中,空腹血糖受损(impaired fasting glucose,IFG)、糖耐量减低(impaired glucose tolerance,IGT)、IFG合并IGT及单纯5.7%≤HbA_(1C)≤6.4%者的检出率分别为1.93%、2.82%、2.01%、4.28%。军事飞行人员DM或PDM患病率及FPG、2 hPG、HbA_(1C)水平随年龄增大而增加(P均<0.01),随飞行时间增长而增加(P均<0.01),不同勤务类别、不同机种DM或PDM患病率及FPG、2 hPG、HbA_(1C)水平差异均无统计学意义(P均>0.05)。结论 军事飞行人员血糖代谢问题突出,潜在DM患病风险高,飞行人员DM或PDM患病率及FPG、2hPG、HbA_(1C)水平随年龄及飞行时间增加而增加,而与勤务类别和机种关系不大,应加强飞行人员DM防控措施。

从糖尿病前期谈“治未病”

未病是指不具有诊断某种疾病的特征性症状的前病状态,即"无典型症状,有客观证候"。所谓"不治已病,治未病"是指在发现异常苗头时,采取积极的预防措施,逆转其发展方向,恢复其正常状态。防病于未然,治病于潜伏阶段,是中医"治未病"的精髓。糖尿病是一种生活习惯病,其未病状态是指糖尿病前期,主要表现为糖耐量低减。古代治未病尚包括"已病防变",现代医疗对象的主体是已病人群,缺少的恰恰是开展大规模的未病医疗。糖尿病"治未病"的核心思想实为早期预警、早期防治,借助现代医学的微观检测手段,结合中医学辨证论治及养生保健方法,将糖尿病治疗重心大大提前。

妊娠合并糖代谢异常并发先兆子痫对母儿结局影响的分析

目的 :探讨妊娠合并糖代谢异常并发先兆子痫母、儿的结局。方法 :收集1981至 2 0 0 3年糖代谢异常孕妇 12 0 2例的临床资料 ,其中 15 1例孕妇并发先兆子痫 ,按照有无先兆子痫的发生将孕妇分为先兆子痫组 (Ⅰ组 )和非先兆子痫组 (Ⅱ组 )。回顾分析比较两组孕妇、新生儿的结局。结果 :(1)I组孕妇早产、羊水过多、酮症、手术产的发生率明显高于II组 ,发生率分别为 2 1.2 %vs 6 .0 %、13.9%vs 6 .2 %、15 .2 %vs 7.4 %、71.5 %vs6 0 .7% (P <0 .0 1) ;两组孕妇胎死宫内、胎儿窘迫、宫内感染、产后出血的发生率比较 ,差异无统计学意义 (P >0 .0 5 ) ;(2 )I组与II组的新生儿结局比较 :两组新生儿患病率有明显差异 (P <0 .0 5 ) ,新生儿窒息、畸形、红细胞增多症、低血糖和高胆红素血症发生率分别为12 .0 %vs 3.9%、7.3%vs 3.1%、8.7%vs 2 .2 %、15 .3vs 5 .7%和 18.0 %vs 12 .3% ;两组大于胎龄儿和小于胎龄儿发生率分别为 17.2 %vs 11.3%、10 .6 %vs 1.9% ;新生儿转科(41.0 %vs 19.6 % ) ,差异有显著性 (P <0 .0 5 ) ;新生儿呼吸窘迫综合征 (NRDS)及围产儿死亡的发生率两组无统计学差异 (P >0 .0 5 )。结论 :妊娠合并糖代谢异常的孕妇一旦并发先兆子痫将增加糖代谢异常孕妇的并发症及新生儿的患病率。

八段锦养生法对糖尿病前期的干预作用分析

【目的】研究八段锦养生法对糖尿病前期的总体健康及血糖的干预作用。【方法】将175例糖尿病前期者按年龄分为Ⅰ层(35～55岁)、Ⅱ层(56～75岁)2个年龄层,每层再按随机卡片法分为空白对照组(简称对照组)、健康教育组、八段锦组3组,3组分别采取不同的干预措施,分别于实验开始、3个月、6个月采用SF-36量表进行调查及进行相关指标的检测。【结果】随访6个月,健康教育组和八段锦组均无人发展为真正的糖尿病,对照组有11例发展为糖尿病,糖尿病总发生率为6.29%。健康教育组、八段锦组试验者的总体健康水平得到显著提高(与对照组比较,P<0.05);对照组、健康教育组、八段锦组的空腹血糖恢复正常率分别为11.86%、65.00%,69.64%,八段锦组、健康教育组的空腹血糖恢复正常率显著高于对照组(P<0.01);口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)餐后2 h血糖正常转化率分别为6.78%、15.00%、48.21%,且八段锦组效果优于健康教育组(P<0.01)。【结论】八段锦养生法可预防或延缓糖调节受损发展为糖尿病。

不同人群对糖尿病相关知识的认知现状及影响因素分析

目的了解新发2型糖尿病、糖尿病前期和血糖正常人群的糖尿病相关知识的认知状况。方法 2016年3—6月,采用多阶段分层整群抽样方法对江苏省6个地级市的7804名18～65周岁城乡居民进行问卷调查和体格检查。采用χ~2检验、单因素方差分析进行组间比较,多元线性回归分析糖尿病防治知识得分的相关影响因素。结果共收到有效问卷7689份,"糖尿病是一种常见慢性病"知晓率较高,为82.14%;"糖尿病可以治愈"知晓率较低,为43.48%。糖尿病典型症状中"常常口渴"的知晓率较高,为61.56%;"糖尿病引起酮症酸中毒"的知晓率较低,为30.99%。糖尿病高危人群中"有糖尿病家族史"的认知率较高,为65.26%;"巨大儿生产史"的知晓率较低,为22.67%。糖尿病预防措施知晓率均高于80.00%,全部回答正确率为1.74%。合计知识得分为(15.91±7.95)分,不同人群在糖尿病基本认识、典型症状和预防措施的得分差异有统计学意义(P均<0.05)。多因素分析显示,影响糖尿病认知水平的因素有性别、年龄、文化程度、家庭收入和糖尿病家族史(P均<0.05)。结论不同血糖水平居民糖尿病防治知识认知水平不同,且影响因素较多,应对不同特征人群开展针对性的糖尿病健康教育和行为指导。

金芪益气降糖汤用于糖尿病前期患者“治未病”的临床研究

目的:对比研究金芪益气降糖汤用于糖尿病前期患者"治未病"的临床疗效。方法:符合标准的234例糖尿病前期患者按照1∶1原则随机分入观察组和对照组。所有患者进行糖尿病健康教育。对照组仅予生活方式干预,观察组则予生活方式和药物同时干预,即自拟金芪益气降糖汤,餐前30 min服用,2次/d,持续12个月。观察两组患者治疗后临床症状评分及血糖、血脂各项指标的变化,计算糖尿病发病率及血糖回复率。结果:治疗12个月后,观察组糖尿病发病率显著低于对照组(2.7%)优于对照组(9.3%),而血糖回复率(33.6%)却远远高于对照组(16.8%),差异均有统计学意义(χ2=5.883,P=0.015;χ2=8.104,P=0.004)。观察组治疗后2hPG及HbA1c的降低程度明显优于对照组,差异有统计学意义(t=2.042、2.297;P<0.05);另外,在血脂指标上,观察组TG、LDL-C的水平亦降低,与对照组相比差异显著(t=2.071、2.055;P<0.05)。治疗期间无严重的不良事件发生。结论:以"治未病"的思想为指导,对糖尿病前期患者联合益气金芪降糖汤与生活方式干预的综合防治措施,可有效的阻止向糖尿病的进展,疗效显著,值得临床推广应用。

妊娠期糖代谢异常患者脂代谢与妊娠结局的关系

目的了解妊娠期糖代谢异常孕妇的血脂情况及其与妊娠结局的关系。方法选样于2003—2005年在上海交通大学附属第一人民医院门诊行产前检查的孕24～28周、常规50g葡萄糖筛查血糖≥7.8mmol/L的妊娠妇女406例,行75g口服葡萄糖耐量试验(OGTT)同时,测定总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)和载脂蛋白B(ApoB)。根据OGTT结果,分为妊娠期糖尿病(GDM)+妊娠期糖耐量减低(GIGT)组(GIGT+GDM组,175例)及糖筛查阳性组[GCT(+)组,231例]。记录孕妇年龄、孕产次、分娩孕周及并发症等。结果GIGT+GDM组的TG、LDL-C显著高于GCT(+)组(P值分别<0.01、0.05),HDL-C、ApoB显著低于GCT(+)组(P值均<0.05)。GIGT+GDM组的早产儿(18.3%)和子痫前期发生率(12.6%)均显著高于GCT(+)组(分别为9.5%、6.1%,P值均<0.05),GCT(+)组中,高TG(≥3.5mmol/L)孕妇的巨大儿(25.0%)和子痫前期发生率(20.5%)均显著高于TG正常(<3.5mmol/L)孕妇(分别为11.2%、2.7%,P值均<0.05),GIGT+GDM组中,高TG孕妇的早产儿(26.2%)和子痫前期发生率(30.8%)均显著高于TG正常孕妇(分别为13.6%和1.8%,P值<0.05)。Logistic回归分析显示,TG水平的升高是子痫前期的独立危险因素是(OR=1.91,95%CI为1.53～2.40,P<0.001)。结论妊娠期糖代谢患者中存在异常的脂代谢,异常有效脂代谢与不良妊娠预后有关。