Systematic Review of Community Type 2 Diabetes Structured Health Education (CT2DSHE)

Aim: This paper aims to evaluate disparities of type 2 diabetes structured health education programmes that is utilised within the communities. Design: systematic review, (a type of secondary research design) aiming to summarize the results of prior primary research studies on available evidence Community type 2 diabetes structured education (CT2DSHE). Methods: Research question: Type 2 diabetic structured health education within a community how effective is it? Qualitative Systematic review, defined as a way to get reliable and objective picture of current available evidence on the specific topic—(CT2DSHE), (Denscombe, 2021) through reflexivity synthesis of available data as an example. This is valuable in time constraints such as project assignments that must be met within specific time and also to bring together available evidence together [1]. Results: This review has shown that CT2DSHE is effective with seven out of the eleven authors supporting, three authors against and one was neutral, further showed that knowledge and skills acquired can last longer with patient activation improved among T2DM patients ideal for sustaining their self-management of T2DM. Conclusion: This research provides suggestive answers to the research question: “Type 2 diabetic structured health education within a community how effective is it?”, This has demonstrated CT2DSHE effectiveness in knowledge acquisition and improving T2DM awareness among T2DM patients, whilst evidencing long effects beyond the study times of 3 - 9 months period in relation to patient activation. Also Identified diabetes education self-management on newly diagnosed (DESMOND) patient as CT2DSHE program for recommendation. Patient or Public Contribution: This work aspires to contribute to CT2DSHE in these areas;Influencing policy decision-making for community diabetes care within the UK and world at large., Contributing to already vast knowledge on diabetes self-management and reasons why?, Influencing educators on how CT2DSHEP are designed, delivered by putting the patient at the Centre and bringing different perspectives on CT2DSHEP in one place that is serving users time of having to consult several resources especially busy clinicians [2] [3].

Relationship between Serum Leptin and Adiponectin Levels in Obese Nigerians with Type 2 Diabetes Subjects

Background: Obesity is rising globally, independent of ethnicity, race and age, and is associated with increased risk of cardiovascular mortality and morbidity especially in persons living with diabetes. The effect of adipokines such as leptin, resistin and adiponectin which are secreted by adipose tissue factors has been linked to the increased risk of the cardiovascular mortality and morbidity. Aim: This study aims to assess the levels of serum leptin and serum adiponectin in obese type 2 diabetes subjects, and their relationship with cardio-metabolic component (using lipid profile). Method: This is a cross-sectional comparative hospital-based study in which one hundred and fifty participants grouped into 60 obese, 60 non-obese none diabetic and 30 non-obese non-diabetic adults with similar age from the Endocrinology outpatient’s clinic, General outpatient department (GOPD) and staff clinic of Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC). Anthropometric parameters and other relevant clinical details of all subjects were obtained. Fasting venous blood samples were taken from all subjects for the determination of fasting plasma glucose (FPG), fasting lipid profile, glycosylated haemoglobin levels (HbA1C), fasting serum insulin, leptin, and adiponectin. Data was analysed using the Statistical Package of Social Sciences (SPSS) version 23.0. Results: Twenty-eight (46.7%)) subjects were males while 32 subjects (53.3%) were females (in obese groups). There was no statistical difference between these two groups for both sexes (p = 1.000). The age range for all subjects was 34 to 64 years with their mean age being 52 ± 7.3 years, and for type 2 subjects and the obese non-diabetic 50.7 ± 7.3 years respectively. The mean body mass index of the non-obese and non-diabetic was 23.7 ± 4 Kg/m2 while the anthropometric measurements of the obese two groups were similar. The lipid profile, serum leptin and adiponectin in both the obese groups showed no difference. The relationship between components of obesity and serum leptin level in all subjects showed that serum leptin levels had significant positive correlation with BMI, WC, and serum insulin level. The correlation between adiponectin and lipid profile showed a positive correlation between serum adiponectin values and High-density lipoprotein (HDL) in obese diabetic (p = 0.02) but not in the non-diabetic group. Conclusion: In this study, there was no correlation in the serum leptin levels with the anthropometric parameters of obesity studied. For the components of the lipid profile, Triglycerides and low-density lipoprotein cholesterol (LDL) correlated with serum adiponectin and HDL showed a positive correlation with adiponectin. It is concluded that the effects of both serum adiponectin and serum leptin are driven by obesity rather than the glycaemic status of the obese subjects.

不同肠内营养制剂用于2型糖尿病患者对血糖及血清UA、PA、ALB的影响

目的探究康全力、能全力与瑞能三种不同肠内营养制剂用于2型糖尿病(T2DM)患者对血糖及血清尿酸(UA)、前白蛋白(PA)、白蛋白(ALB)等的影响。方法选取2020年1月至2023年3月于涟水县人民医院重症医学科内分泌与代谢性疾病科治疗的99例T2DM患者为研究对象,按非随机临床同期对照研究及患者自愿原则分为康全力组、能全力组和瑞能组,每组各33例。三组患者分别给予康全力、能全力和瑞能三种不同肠内营养制剂治疗,均连续治疗2个月,比较糖代谢、营养指标、血脂、炎症因子水平和不良反应发生情况。结果治疗后三组糖代谢指标均显著降低,其中康全力组患者治疗后糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2hPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)与能全力组和瑞能组相比均显著降低(P<0.05);治疗后三组血清UA明显下降,PA和ALB水平明显升高(P<0.05),但组间差异无统计学意义(P>0.05);治疗后三组HDL-C均显著升高,康全力组LDL-C、TC和TG均显著降低(P<0.05),能全力组、瑞能组LDL-C、TC和TG未见显著改变(P>0.05),其中康全力组治疗后HDL-C与另外两组相比显著高,LDL-C与另外两组相比显著低,TC和TG与瑞能组相比显著低(P<0.05);治疗后三组IL-6、CRP水平与治疗前相比均显著降低(P<0.05),治疗后康全力组、能全力组IL-6和CRP水平与瑞能组相比显著低(P<0.05);治疗后康全力组、能全力组和瑞能组的不良反应发生总概率为12.12%、21.21%和15.15%,差异无统计学意义(P>0.05)。结论康全力在调节糖脂代谢、缓解炎症反应方面效果较其他肠内营养制剂更突出。

Surfactin alleviated hyperglycaemia in mice with type 2 diabetes induced by a high-fat diet and streptozotocin

Type 2 diabetes mellitus(T2DM)is associated with liver dysfunction and intestinal dysbiosis.Bioactive peptides(BAPs)have been reported to ameliorate T2DM by preventing oxidative damage to the liver.Bacillus amyloliquefaciens fmb50 produces the lipopeptide surfactin with a wide range of biological activities.The effects of surfactin on T2DM,on the other hand,have not been studied.In the present study,80 mg/kg body weight surfactin supplementation lowered fasting blood glucose(FBG)levels by 21.05%and insulin resistance(IR)by 18.18%compared with those in the T2DM group,reduced inflammation,and increased antioxidant activity in mice with T2DM induced by a high-fat diet(HFD)and streptozotocin(STZ).According to further research,surfactin administration reduced Firmicutes-to-Bacteroidetes ratios while increasing Bifi dobacterium abundance by 20 times and the level of the tight junction protein Occludin by 18.38%and ZO-1 by 66.60%.Furthermore,surfactin also improved hepatic glucose metabolism by activating the adenosine monophosphate-activated protein kinase(AMPK)signalling pathway,increasing glycogen synthesis and glucose transporter 2(GLUT2)protein expression while reducing glucose-6-phosphatase(G6Pase)protein expression.In addition,the increased Bifi dobacterium abundance indirectly reduced the liver burden of the metabolic products indole,cresol and amine produced by saprophytic bacteria.All of these findings revealed that surfactin not only ameliorated HFD/STZ-induced gut dysbiosis and preserved intestinal barrier integrity but also enhanced hepatic glucose metabolism and detoxifi cation function in T2DM mice.The gut microbiota appeared to be important in controlling glucose metabolism,IR,fat accumulation,inflammation and antioxidation,according to Spearman’s correlation coeffi cients.All data indicated that surfactin alleviated hyperglycaemia in mice with T2DM induced by HFD/STZ.

Expert Consensus on Clinical Management of T2DM Combined with Obesity Reversal Treatment in China(2023 Edition)

With lifestyle changes,the incidence of type 2 diabetes(T2DM)and obesity has significantly increased,becoming major chronic diseases that seriously threaten the health of China’s residents.Both domestic and international guidelines and consensus exist regarding the diagnosis and management of this disease.In recent years,T2DM treatment has focused more on new tactics that lean towards a patient-centered comprehensive management approach,replacing the traditional glucose-centered approach.Additionally,an increasing amount of evidence in medicine suggests that the reversal of diabetes is possible.However,there is currently no expert consensus on the clinical management of T2DM combined with obesity reversal treatment.Therefore,experts and scholars in China with extensive experience in T2DM combined with obesity reversal treatment have been invited to develop this consensus.The content includes early identification and diagnosis of T2DM combined with obesity,definition and mechanisms of diabetes reversal,disease assessment and grading,staging of diabetes and goals of reversal,the 2+N reversal strategy,inpatient system treatment combined with comprehensive outpatient management(including weight control,precise nutrition,scientific exercise,glucose-lowering medication,psychological intervention,rehabilitation therapy,and remote follow-up through online platforms),and evaluation of post-reversal efficacy.The aim is to further improve the level of T2DM combined with obesity reversal diagnosis,treatment,and management in China,and to implement the Healthy China strategy.

2型DM合并脑梗塞与载脂蛋白、脂蛋白(a)关系的研究

目的探讨载脂蛋白 (Apo)和脂蛋白 (a)〔L p(a)〕与 2型 DM合并脑梗塞的关系。方法运用配比的病例对照研究方法 ,使用 L ogistic回归模型进行分析。结果以其他病人作为对照 ,Apo和 L p(a)与 2型 DM合并脑梗塞有关 ;2型 DM病人作为对照仅发现 L p(a)与 2型 DM合并脑梗塞有关。经以 2型 DM为对照人群归因危险比(PARP)分析 ,L p(a)的 PARP高达 75 .6 7%。结论 L p(a)是 2型 DM合并脑梗塞的独立危险因素。为了降低 2型DM合并脑梗塞的危险性 ,应注意控制 L p(a)

Exercise as Component of Standard Diabetes Management, the Challenges to Improve Performance among Sudanese Type 2 Diabetes

Background: Exercise is important component of diabetes management. Regular exercise improves blood glucose, reduces hazard of cardiovascular diseases, decreases weight, increases insulin sensitivity and strengthens patients’ general health. Regular exercise can prevent or delay type 2 diabetes in those of high-risk populations. Although there are great benefits of regular exercise, unfortunately majority of people with type 2 diabetes are not active. Objectives: The main goal of this study was to assess patients adherence to regular exercise among type 2 diabetes Mellitus (T2DM) attending Ribat University Hospital Diabetic Clinic (RUHDC) Khartoum state, Sudan. Methods: Analytical cross sectional hospital based study was carried out among 351 patients from August 2012 to February 2013. Structured questionnaire and patients cards were used to collect data. Results: Out of 351 patients, female were 65.8% and male 34.2%. Patients older than 60 years 48.4%, illiterate 21.0%, only 44.2% had basic educational level, house wife 56.1% and retired 18.5%. Majority had irregular exercise program (80.1%), 12.1% specified lack of time whilst 87.9% did not specify any other reasons as barrier for regular exercise “no reason”. Daily activity was the main type of physical activity (59.8%). Although insignificant, irregular exercise was higher among female patients, their age above 60 years, patients had low education levels and those had financial problems. Conclusion: Regular exercise was low in this study. Lack of time, female, patients older than 60 years, had low education levels, and had financial problems, which were the main barriers of regular exercise. Family support, tailored patients’ education and reduction of patients’ use of technology and modern living can improve the patients’ activity.

Gene Expression Profile of Human Skeletal Muscle and Adipose Tissue of Chinese Han Patients with Type 2 Diabetes Mellitus

Objective To study the differential patterns of gene expression in skeletal muscle and adipose tissue between type 2 diabetes mellitus （T2DM） patients and healthy subjects using DNA microarray analysis, Methods T2DM patiens were divided into female group, young male group and old male group. DNA microarray analysis and quantitative real-time PCR were carried out to anaIyze the relation between gene expressions and T2DM. Results The mRNA expression of 298, 578, and 350 genes was changed in the skeletal muscle of diabetes mellitus patients compared with control subjects. The 1320, 1143, and 2847 genes were modified in adipose tissue of the three groups. Among the genes surveyed, the change of 25 and 39 gene transcripts in skeletal muscle and adipose tissue was ≥2 folds, These differentially expressed genes were classified into 15 categories according to their functions. Conclusion New genes are found and T2DM can be prevented or cured.

Correlation between the Polymorphism of PPARγ-2 gene and the Susceptibility of Type 2 Diabetes Mellitus in Guangxi Bama Mini-pigs

[ Objective] The research aimed to discuss the relationship between the polymorphism of PPARy.2 gene and the susceptibility of type 2 diabetes mellitus （T2DM） in Guangxi Bama mini-pigs. [ Method] 24 Guangxi Bama mini-pigs were fed with high-fat and high-sucrose diet, and partial sequences of exon 2 of PPARy-2 gene were amplified by using PCR method. In addition, the contents of fasting blood glucose and insulin （INS） in Guangxi Bama mini-pigs were determined, and the glucose tolerance test （GTT） was also carried out. [ Result] There was one SNP site （19813A/G） Jn partial sequence of exon 2 of the cloned PPAFly-2 gene, and AA （7 pigs） and AG （17 pigs） genotype were detected. The contents of fasting insulin and 60-min blood glucose in GTT in AG-genotype Guangxi Bama mini-pigs were significantly higher than those of AA genotype （ P 〈0.05）, while the incidence of T2DM in AG-genotype Guangxi Bama mini-pigs （71.4%） was obviously higher than that of AA gen- otype （5.9%）. [ Conclusion] The polymorphism of 19813A/G in exon 2 of PPARy-2 gene was related with the susceptibility of T2DM in Guangxi Bama mini-pigs.

Initiation of Basal Insulin in Patients with Uncontrolled Type 2 Diabetes Mellitus

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-naïve type 2 diabetic patients resulted in significant improvement of glycemic control, with improved HbA1c level, without adverse effects.

Silkworm Extract Ameliorates Type 2 Diabetes Mellitus and Protects Pancreaticβ-cell Functions in Rats

Objective The aim of the present study was to investigate the hypoglycemic effects of silkworm extract(SE)on experimental type 2 diabetes mellitus(T2DM)rats.Methods SE was prepared by dissolving freeze-dried silkworm powder in 70%(v/v)aqueous ethanol.T2DM rats were induced by feeding them a high fat diet and an intraperitoneal injection of streptozotocin(STZ).The blood glucose,free fatty acid(FFA),malondialdehyde(MDA),tumor necrosis factor alpha(TNF-α)and superoxide dismutase(SOD)levels were detected by enzyme-linked immunosorbent assay(ELISA).The quality of SE was controlled by high performance liquid chromatography(HPLC;Agilent 1260,Agilent,USA).Hematoxylin-eosin(HE)staining was performed for histological evaluation.Antibody expression was assessed via immunohistochemistry(IHC)staining.Results SE could improve insulin resistance and islet cell function by reducing FFA,MDA and TNF-αlevels and increasing SOD level.In addition,pancreatic HE staining analysis revealed that SE has a protective effect on isletβ-cells.Conclusions The present study indicates that SE has hypoglycemic as well as pancreatic protective effects in T2DM model rats.

Association of UCP3,APN,and TNF-α Gene Polymorphisms with Type 2 Diabetes in a Population of Northern Chinese Han Patients

We observed the polymorphism distribution and coaction of uncoupling protein 3（UCP3）-55C/T,adiponectin（APN）＋45T/G and tumor necrosis factor（TNF）-α-308G/A on the onset and development of T2DM in a Northern Chinese Han population of 213[100 type 2 diabete（T2DM） patients and 113 health control subjects] by polymerase chain reaction-restriction fragment length polymorphisum（PCR-RFLP） method.Results demonstrate the polymorphism of UCP3-55C/T,APN＋45T/G,and TNF-α-308G/A related to T2DM onset and developement.And the individuals carrying UCP3-55T,APN＋45G and TNF-α-308A allele had higher T2DM risk.Those results are the first report to evaluate the association of the coaction of UCP3,APN,TNF-α genes polymorphism on T2DM risk and the susceptibility of T2DM in the Northern Chinese Han population.

Study of hsCRP, adiponectin, NF-κB in low bodyweight, standard bodyweight and obese subjects with type 2 diabetes mellitus in India

Introduction: Low bodyweight type 2 DM is a distinct clinical entity having many inherent peculiarities seen in India and developing countries, constituting 11% to 25% of type 2 diabetic subjects. Our study aimed at assessing the prevalence of inflammatory markers like hsCRP, adiponectin and NF-κB expression in peripheral blood mononuclear cells in subjects with type 2 DM in relation to BMI. Materials and Methods: 57 consecutive type 2 diabetics were recruited for study, classified as Low Bodyweight (A = BMI < 18.5), Standard weight (B = BMI 18.5 - 24.99) and Obese (C = BMI ≥ 25). Group D comprised 14 healthy controls. They were evaluated for clinical parameters, FBG, 2hrPPBG, HbA1c, lipid profile and above mentioned inflammatory markers. Results: Serum hsCRP was significantly higher in all group of diabetics as compared to Group D but was lowest in Group A. Adiponectin levels were highest in Group D, similar in Groups B and C but lowest in Group A. NF-κB expression, though higher in diabetic subjects than controls (OD = 0.041 ± 0.006), was least in Group A (OD = 0.045 ± 0.005). Discussion and Conclusion: Our study revealed that Indians with type 2DM are in a pro-inflamematory state. Low bodyweight type 2 diabetics had the least pro-inflammatory load. This further supported the earlier observation of lesser macrovascular disease load and testifying that Low Bodyweight type2DM constitutes a distinct entity.

Evaluation of Type of Nephropathy in Patients of Type-2 Diabetes Mellitus

Background of the Study, Aims and Objectives: There are very few studies on histological patterns of diabetic nephropathy in our part of country. The aim of this study was to evaluate the renal involvement in patients with Type-2 diabetes mellitus (T2DM), assess the histopathological changes and establish a clinico-pathological correlation. Subjects, Method and Materials: Thirty two Type 2 DM patients with nephropathy, after screening consecutive hundred(100) Type 2 Diabetics admitted to the Medicine Department were evaluated for renal involvement by kidney biopsy and histopathological study. Statistical analysis was done by student’s t-test, chi-square and linear regression analysis. Results: Thirty two patients (32) with diabetic nephropathy (20 males and 12 females) formed the study group out of hundred (100) consecutive Type-2 diabetes mellitus patients (58 males and 42 females) admitted to Medicine Department of SCB Medical College Hospital, Cuttack. The frequency of occurrence of clinical diabetic nephropathy was 32%. Most of the patients were having duration of DM of 6-10 years (87.5%). Pedal edema was found in 96.87%, hypertension in 87.5% patients respectively. Regression analysis showed that durations of DM and HbA1c were the two significant risk factors (P Histopathologically, diffuse glomerulosclerosis was the most common form of renal abnormality found in 93.75% followed by nodular glomerulosclerosis in 62.50% with overlap in many patients, membranous nephropathy in 12.5% and focal necrotising glomerulonephritis in 6.25% respectively. There was no statistically significant clinicopathological correlation observed between clinical and biochemical parameters in patients harbouring the two predominant histological types of nephropathy i.e. diffuse and nodular glomerulosclerosis with respect to age, sex, duration of diabetes, body mass index, systolic blood pressure, HbA1c, 24 hour urinary protein, creatinine clearance, serum urea, serum creatinine or lipid profile. Conclusion: Durations of diabetes and HbA1c were found to be strongly associated with development of diabetic nephropathy. Diffuse glomerulosclerosis was the most common form of renal abnormality found in 93.75% followed by nodular glomerulosclerosis in 62.50% of patients.

Comparison on Efficacy and Safety of Three Inpatient Insulin Regimens for Management of Non-Critical Patients with Type 2 Diabetes

Background: Hyperglycemia in hospitalized patients is associated with poor clinical outcomes. Scheduled Subcutaneous Insulin therapy has been recommended for better glycemic control. Aims: To compare efficacy and safety of traditional sliding scale insulin (SSI) versus modified 70/30 insulin versus basal plus supplemental scale (SS) insulin regimens for glycemic control of inpatients with diabetes. Methods: In a prospective trial, 62 patients with diabetes were randomized to receive either hospital SSI (N = 22), or twice daily 70/30 insulin plus supplemental lunchtime insulin for BG ≥ 150 mg/dL (N = 21) or once every night glargine plus prandial glulisine for BG ≥ 150 mg/dL (N = 19). 70/30 insulin and glargine were started respectively at 0.4 and 0.2 U/kg/day for BG ≤ 200 mg/dL or 0.5 and 0.3 U/kg/day for BG above 200 mg/dL. Results: Starting at BG level of 204 ± 68, 200 ± 50 and 241 ± 94 mg/dL in SSI, 70/30 insulin and glargine/glulisine groups respectively, (F(2,35.47) = 1.467, p = 0.244, Welch test), mean daily BG after first day of hospitalization was statistically significant (F(2,35.58) = 7.043, p = 0.003, Welch test) lower in 70/30 insulin group (171 ± 38 mg/dL) compared to (218 ± 71 mg/dL) in SSI group (p = 0.026) and (225 ± 65 mg/dL) in glargine/glulisine group (p = 0.01). Conclusions: With poorly educated nursing staff, basal plus SS insulin failed to provide adequate glycemic control. However, tailored 70/30 insulin regimen resulted in statistically significant glycemic control compared to traditional SSI.

Association between the SUMO4 M55V Polymorphism and Susceptibility to Type 2 Diabetes Mellitus:A Meta-analysis

Objective The aim of this study is to determine whether the SUMO4 M55V polymorphism is associated with susceptibility to type 2 diabetes mellitus （T2DM）. Methods A meta-analysis was performed to detect the potential association of the SUMO4 M55V polymorphism and susceptibility to T2DM under dominant, recessive, co-dominant （homogeneous and heterogeneous）, and additive models. Results A total of eight articles including 10 case-control studies, with a total of 2932 cases and 2679 controls, were included in this meta-analysis. The significant association between the SUMO4 M55V polymorphism and susceptibility to T2DM was observed in the dominant model （GG ＋ GA versus AA： OR = 1.21, 95% CI = 1.05-1.40, P = 0.009）, recessive model （GG versus GA ＋ AA： OR = 1.29, 95% CI = 1.07-1.356, P = 0.010）, homozygous model （GG versus AA： OR = 1.41, 95% CI = 1.06-1.56, P = 0.001）, and additive model （G versus A： OR = 1.18, 95% CI = 1.08-1.29, P = 0.001）, and marginally significant in the heterozygous model （GA versus AA： OR = 1.16, 95% CI = 0.98-1.36, P = 0.080）. In subgroup analyses, significant associations were observed in the Chinese population under four genetic models excluding the heterozygous model, whereas no statistically significant associations were observed in the Japanese population under each of the five genetic models. Conclusion The meta-analysis demonstrated that the G allele of the SUMO4 M55V polymorphism could be a susceptible risk locus to T2DM, mainly in the Chinese population, while the association in other ethnic population needs to be further validated in studies with relatively large samples.

Insulin Glargine 300 Units/mL Effectiveness in Patients with T2DM Uncontrolled by Basal Insulin in Real-Life Settings in the Czech Republic

Introduction: To evaluate the clinical effectiveness of Gla-300 units/mL (Gla-300) in the treatment of patients with type 2 diabetes (T2DM) uncontrolled by basal insulin in real-life clinical settings in the Czech Republic (TOPAZ study). Methods: TOPAZ was a prospective, multi-center, non-interventional, 6-month study. Of the 312 patients screened, 289 were evaluated at month 6. The primary objective was the change of HbA1c after 6 months. The proportion of patients with HbA1c < 7.0% DCCT (< 53 mmol/mol), and those with a decrease of at least 0.5% of HbA1c at month 6, change in FPG, body weight and insulin dose at month 3 and 6 were analysed as secondary objectives. Incidence of hypoglycemia, adverse events and patient treatment satisfaction were also assessed. Results: HbA1c decreased significantly after 6 months (mean change 0.9% ± 1.1% DCCT [−9.9 ± 11.6 mmol/mol], p < 0.0001). HbA1c target < 7.0% DCCT was achieved in 17.6% of patients, 66.1% of patients showed mean HbA1c decrease of 0.5% ± 0.8%. At month 6, FPG decreased (mean change from baseline −1.8 ± 3.1 mmol/L) as well as the incidence of hypoglycemia decreased by 49% (p < 0.0001) while no weight gain was observed. No significant safety signals were identified. Conclusion: In a real-life setting, switching to Gla-300 in T2DM patients uncontrolled with other basal insulin was associated with improved glycemic control and reduced risk of hypoglycemia without weight gain, while patients’ satisfaction with treatment increased.

2型糖尿病皮肤微循环改变与其微血管并发症的关系

目的研究糖尿病皮肤微循环改变与其它微血管并发症的关系。方法应用激光多普勒血流仪对81例2型糖尿病患者及26名正常对照进行了皮肤微循环的测定。结果糖尿病患者四肢皮肤最大血流在不同病程、不同视网膜病变、不同尿微量白蛋白排泄率（UAER）各组均低于正常组（P均＜O．01），并随病程延长、视网膜病变加重、UAER增高而逐渐降低（分别P＜0．05和P＜0．01），以双下肢表现更明显。单因素相关性分析显示，皮肤微循环病变与病程、视网膜病变、UAER、内皮素及糖化血红蛋白呈负相关，多元回归分析显示与病程和视网膜病变关系最密切。结论2型糖尿病皮肤微血管病变与视网膜病变、肾脏病变共存。

2型糖尿病合并冠心病危险因素分析

目的分析2型糖尿病合并冠心病危险因素。方法应用多因素Logistic回归，分析了405例2型糖尿病患者有关冠心病的危险因素。结果①2型糖尿病病人冠心病发生率为26．2％；②年龄、糖尿病病程、高血压、体重指数、空腹血清C肽、甘油三酯、血清尿酸7个因素与Ⅱ型糖尿病病人冠心病发病有关。结论除了常见的冠心病危险因素外，为了防止2型糖尿病病人冠心病的发生，亦应注重控制高胰岛素血症、高甘油三酯血症和高尿酸血症。

2型糖尿病合并骨质疏松患者IGF-Ⅱ水平的变化

目的研究2型糖尿病合并骨质疏松患者血IGF-Ⅱ水平的变化,及其与骨质疏松发生的关系。方法受试者101例,均测量身高、体重、腰围、血糖、糖化血红蛋白、尿蛋白、IGF-Ⅱ和骨密度。按糖尿病病程将糖尿病患者分为病程<10年组、病程≥10年组;根据糖尿病肾病病程将糖尿病患者分为正常组、肾病病程<10年组、肾病病程≥10年组;根据骨密度结果将所有受试者分为骨密度正常组、骨量减低组、骨质疏松组。结果与非糖尿病组相比,糖尿病病程<10年组及糖尿病病程≥10年组患者骨质疏松的发生率差异无统计学意义。随着糖尿病病程延长,IGF-Ⅱ水平下降;随着骨密度的降低,IGF-Ⅱ水平下降;糖尿病患者中随着骨密度的降低,IGF-Ⅱ水平无明显变化。结论骨质疏松的发生与2型糖尿病无关系,与血糖控制好坏无关。IGF-Ⅱ可能参与了2型糖尿病的发病过程。IGF-Ⅱ的下降参与了骨质疏松的发生。