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1.
Background
Recently some plasma biomarkers of inflammation have been recognized as important cardiovascular risk factors. There is little information about the effects of aerobic exercise training on these biomarkers and the risk of metabolic complications in obese type 2 diabetes patients.Objective
To compare the impact of moderate versus mild aerobic exercise training on the inflammatory cytokines in obese type 2 diabetic patients.Methods
Fifty obese type 2 diabetic patients of both sexes with body mass index (BMI) varying from 31 to 36 kg/m2, non smokers, free from respiratory, kidney, liver, metabolic and neurological disorders, participated in this study. Their age ranged from 40 to 55 years. The subjects were included into two equal groups; the first group (A) received moderate aerobic exercise training. The second group (B) received mild aerobic exercise training, three times / week for 3 months.Results
The mean values of leptin, TNF- alpha, IL2, IL4, IL6, HOMA-IR and HBA1c were significantly decreased in group (A) and group (B). Also, there were significant differences between both groups after treatment.Conclusion
Moderate aerobic exercise training modulates inflammatory cytokines more than mild aerobic exercise training in obese type 2 diabetic patients. 相似文献2.
Shehab M Abd El-Kader Osama H Al-Jiffri Fadwa M Al-Shreef 《African health sciences》2014,14(2):414-419
Background
Chronic hepatitis C (CHC) is a medical condition that has broad implications for a person''s physical and psychological health.Objective
The aim of this study was to detect changes in liver enzymes and psychological well-being in response to aerobic exercise training in patients with CHC.Material and Methods
Fifty CHC patients were included in two equal groups. The first group (A) received aerobic exercise training in addition to their regular medical treatment. The second group (B) received no training and only has their regular medical treatment. The program consisted of three sessions per week for three months.Results
There was a significant decrease in mean values of Alkaline Phosphatase (ALP), Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Gamma - Glutamyltransferase (GGT), Beck Depression Inventory (BDI ) & Profile of Mood States(POMS) and increase in Rosenberg Self-Esteem Scale (RSES) in group (A) after treatments, but the changes in group (B) were not significant. Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) at the end of the study.Conclusion
Aerobic exercise training improves hepatic enzymes and psychological well-being in patients with chronic hepatitis C. 相似文献3.
Barbalho-Moulim MC Miguel GP Forti EM Campos Fdo A Costa D 《Clinics (S?o Paulo, Brazil)》2011,66(10):1721-1727
OBJECTIVE:
To determine whether preoperative inspiratory muscle training is able to attenuate the impact of surgical trauma on the respiratory muscle strength, in the lung volumes, and diaphragmatic excursion in obese women undergoing open bariatric surgery.DESIGN:
Randomized controlled trial.SETTING:
Meridional Hospital, Cariacica/ES, Brazil.SUBJECTS:
Thirty-two obese women undergoing elective open bariatric surgery were randomly assigned to receive preoperative inspiratory muscle training (inspiratory muscle training group) or usual care (control group).MAIN MEASURES:
Respiratory muscle strength (maximal static respiratory pressure – maximal inspiratory pressure and maximal expiratory pressure), lung volumes, and diaphragmatic excursion.RESULTS:
After training, there was a significant increase only in the maximal inspiratory pressure in the inspiratory muscle training group. The maximal expiratory pressure, the lung volumes and the diaphragmatic excursion did not show any significant change with training. In the postoperative period there was a significant decrease in maximal inspiratory pressure in both the groups. However, there was a decrease of 28% in the inspiratory muscle training group, whereas it was 47% in the control group. The decrease in maximal expiratory pressure and in lung volumes in the postoperative period was similar between the groups. There was a significant reduction in the measures of diaphragmatic excursion in both the groups.CONCLUSION:
The preoperative inspiratory muscle training increased the inspiratory muscle strength (maximal inspiratory pressure) and attenuated the negative postoperative effects of open bariatric surgery in obese women for this variable, though not influencing the lung volumes and the diaphragmatic excursion. 相似文献4.
Lorenzo Gordon Dalip Ragoobirsingh Errol Morrison Donovan McGrowder Eric Choo-Kang E. Martorell 《Archives of Medical Science》2010,6(5):701-708
Introduction
Hypertension and obesity are common problems among diabetic patients accelerating progression of vascular diabetic complications.Materials and methods
A two-stage stratified random sampling design was used, and individuals aged 15 years and over were interviewed. This cross-sectional study evaluated lipid abnormalities of 117 obese type 2 diabetic patients (28 males and 89 females), and 56 hypertensive obese type 2 diabetic patients (22 males and 34 females). Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C) and high-density lipoprotein cholesterol (HDL-C) concentrations were assayed using standard biochemical methods.Results
Hypertensive obese type 2 diabetic females had significantly higher mean serum concentrations of TC (p = 0.043), TG (p = 0.046), LDL-C (p= 0.040), TC/HDL-C ratio (p = 0.001) and LDL-C/HDL-C ratio (p = 0.003) compared with hypertensive obese non-diabetic females. Similar results were found in hypertensive obese type 2 diabetic males compared with hypertensive obese non-diabetic males. Hypertensive obese type 2 diabetic females had significantly higher serum TC, TG and TC/HDL-C ratio (p < 0.05) than hypertensive obese type 2 diabetic males. Hypertensive obese type 2 diabetic females had significantly higher mean serum concentrations of TG (p = 0.03) and TC (p = 0.01) than obese type 2 diabetic females. There was a significant association between blood glucose and LDL-C concentrations in type 2 diabetic subjects (r = 0.36; p< 0.05).Conclusion
Obese hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidaemia compared with males. 相似文献5.
Hanne Verweij Ruth C Waumans Danique Smeijers Peter LBJ Lucassen A Rogier T Donders Henri?tte E van der Horst Anne EM Speckens 《The British journal of general practice》2016,66(643):e99-e105
Background
Burnout is highly prevalent in GPs and can have a negative influence on their wellbeing, performance, and patient care. Mindfulness-based stress reduction (MBSR) may be an effective intervention to decrease burnout symptoms and increase wellbeing.Aim
To gain insight into the feasibility and effectiveness of MBSR on burnout, empathy, and (work-related) wellbeing in GPs.Design and setting
A mixed methods pilot study, including a waiting list-controlled pre-/post-study and a qualitative study of the experiences of participating GPs in the Netherlands.Method
Participants were sent questionnaires assessing burnout, work engagement, empathy, and mindfulness skills, before and at the end of the MBSR training/waiting period. Qualitative data on how GPs experienced the training were collected during a plenary session and with evaluation forms at the end of the course.Results
Fifty Dutch GPs participated in this study. The MBSR group reported a greater decrease in depersonalisation than the control group (adjusted difference −1.42, 95% confidence interval [CI] = −2.72 to −0.21, P = 0.03). Dedication increased more significantly in the MBSR group than in the control group (adjusted difference 2.17, 95% CI = 0.51 to 3.83, P = 0.01). Mindfulness skills increased significantly in the MBSR group compared with the control group (adjusted difference 6.90, 95% CI = 1.42 to 12.37, P = 0.01). There was no significant change in empathy. The qualitative data indicated that the MBSR course increased their wellbeing and compassion towards themselves and others, including their patients.Conclusion
The study shows that MBSR for GPs is feasible and might result in fewer burnout symptoms and increased work engagement and wellbeing. However, an adequately powered randomised controlled trial is needed to confirm the study’s findings. 相似文献6.
Ahmad Movahedian Behzad Zolfaghari S. Ebrahim Sajjadi Reza Moknatjou 《Clinics (S?o Paulo, Brazil)》2010,65(6):629-633
INTRODUCTION:
Dyslipidemia is one of the most common complications of diabetes mellitus, significantly contributing to cardiovascular morbidity and mortality in diabetic patients. Peucedanum pastinacifolium Boiss. & Hausskn. is commonly used as an antihyperlipidemic vegetable in Iranian folk medicine.MATERIAL AND METHODS:
In this study, we examined a hydroalcoholic extract of the aerial parts of Peucedanum pastinacifolium to determine its lipid-lowering activity in normal and streptozotocin (STZ)-induced diabetic rats. Experimental diabetes mellitus was induced by a single intraperitoneal administration of streptozotocin. Normal and streptozotocin-induced diabetic rats were separated into four groups. The groups were fed with 0, 125, 250 or 500 mg/kg body weight of Peucedanum Pastinacifolium hydroalcoholic Extract (PPE) in aqueous solution for 30 days.RESULTS:
The results show that there were significant (P < 0.05) increases in total serum cholesterol, triglyceride and low-density lipoprotein cholesterol (LDL-C) and a decrease in high-density lipoprotein cholesterol (HDL-C) in streptozotocin-induced diabetic rats. Treatment of diabetic rats with PPE over a period of a month returned these levels close to control levels.CONCLUSION:
These results suggest that PPE has hypolipidemic effects in streptozotocin-induced diabetic rats. 相似文献7.
Background
Weight loss studies were conducted in children without asthma have demonstrated a reduction in systemic inflammation. However, the impact of weight loss in the obese paediatric population with asthma has not been investigated.Objective
To measure the effects of weight loss on markers of systemic inflammation in obese children with bronchial asthma.Methods
Eighty obese children with bronchial asthma (42 boys, and 38 girls) with mean age 13.86± 3.21 years were divided into two equal groups. The training group received diet regimen, exercise training in addition to the medical treatment for two months, where the control group received the medical treatment only.Results
There was a 17.5%, 15.5%, 22.4%, 14.1% and 15.9% reduction in mean values of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), interleukin-8 (IL-8), Leptin and body mass index (BMI) respectively and 38.7 % increase in mean values of adiponectin in the training group. While, there was a 0.7%, 9.0%, 2.8%, 1.6% and 1.2% increase in mean values of TNF-alpha, IL-6, IL-8, Leptin and BMI respectively and 3.9% decrease in mean values of adiponectin in the control group. The mean values of TNF-alpha, IL-6, IL-8, Leptin and BMI was decreased and adiponectin was increased significantly in the training group, however the results of the control group were not significant. Also, there were significant differences between both groups at the end of the study.Conclusion
Weight loss improves markers of systemic inflammation in obese Saudi children with bronchial asthma. 相似文献8.
Guler Tosunbayraktar Murat Bas Altug Kut Aylin Hasbay Buyukkaragoz 《African health sciences》2015,15(4):1161-1169
Background
The aim of this study was to investigate the association of 25(OH)D levels with biochemical, anthropometric, and metabolic data obtained from normal and obese people.Methods
This study was carried out on 90 individuals between the ages of 18 to 63 that had various body mass indexes. Blood samples and anthropometric measurements were taken.Results
Waist circumferences, fat mass, LDL cholesterol levels, HDL cholesterol levels, 25(OH)D levels, and triglyceride levels were significantly different according to the body mass index groups of the participants (p<0.05). When compared to the normal body mass index group, both other groups (overweight and obese) had higher waist circumferences, triglyceride levels, LDL cholesterol levels, fasting insulin levels, HOMA-IR ratios, parathyroid hormone levels, and fat mass, and had lower 25(OH)D levels (p<0.05). The overweight group participants had higher 25(OH)D levels than the obese group, and had lower waist circumferences, fat mass, fasting insulin level, HOMA-IR ratios, and HbA1C and PTH levels than those in the obese group (p<0.05).Conclusion
In conclusion, the mean level of 25(OH)D is very low in overweight and obese individuals and low serum 25(OH)D levels appear to be associated with obesity, visceral obesity, hypertriglyceridemia, insulin resistance, and metabolic syndrome in obese patients. 相似文献9.
Vicki Tsianakas Michael Calnan Karl Atkin Elizabeth Dormandy Theresa M Marteau 《The British journal of general practice》2010,60(580):822-828
Background
Timely antenatal sickle cell and thalassaemia (SC&T) screening for all women in primary care facilitates informed decision making, but little is known about its implementation.Aim
To assess the feasibility of offering antenatal SC&T screening in primary care at the time of pregnancy confirmation.Design of study
Cross-sectional investigation of GPs'' beliefs and perceived practices.Method
Informal face-to-face interviews with 34 GPs.Setting
Seventeen inner-city general practices that offered antenatal SC&T screening as part of a trial.Results
GPs identified both barriers and facilitators. Organisational barriers included inflexible appointment systems and lack of interpreters for women whose first language was not English. Professional barriers included concerns about raising possible adverse outcomes in the first antenatal visit. Perceived patient barriers included women''s lack of awareness of SC&T. Hence, GPs presented the test to women as routine, rather than as a choice. Organisational facilitators included simple and flexible systems for offering screening in primary care, practice cohesion, and training. Professional facilitators included positive attitudes to screening for SC&T. Perceived patient facilitators included women''s desire for healthy children.Conclusion
GPs reported barriers, as well as facilitators, to successful implementation but the extent to which screening could be regarded as offering ‘informed choice’ remained fundamental when making sense of these barriers and facilitators. 相似文献10.
Simone Alves Dantas Elisabeth Salvatori Ficker Carmen G. C. Vinagre Barbara Maria Ianni Raul Cavalcante Maranh?o Charles Mady 《Clinics (S?o Paulo, Brazil)》2010,65(1):23-27
INTRODUCTION:
Obesity increases triglyceride levels and decreases high-density lipoprotein concentrations in plasma. Artificial emulsions resembling lipidic plasma lipoprotein structures have been used to evaluate low-density lipoprotein metabolism. In grade III obesity, low density lipoprotein metabolism is poorly understood.OBJECTIVE:
To evaluate the kinetics with which a cholesterol-rich emulsion (called a low-density emulsion) binds to low-density lipoprotein receptors in a group of patients with grade III obesity by the fractional clearance rate.METHODS:
A low-density emulsion was labeled with [14C]-cholesterol ester and [3H]-triglycerides and injected intravenously into ten normolipidemic non-diabetic patients with grade III obesity [body mass index higher than 40 kg/m2] and into ten non-obese healthy controls. Blood samples were collected over 24 hours to determine the plasma decay curve and to calculate the fractional clearance rate.RESULTS:
There was no difference regarding plasma levels of total cholesterol or low-density lipoprotein cholesterol between the two groups. The fractional clearance rate of triglycerides was 0.086 ± 0.044 in the obese group and 0.122 ± 0.026 in the controls (p = 0.040), and the fractional clearance rate of cholesterol ester (h−1) was 0.052 ± 0.021 in the obese subjects and 0.058 ± 0.015 (p = 0.971) in the controls.CONCLUSION:
Grade III obese subjects exhibited normal low-density lipoprotein removal from plasma as tested by the nanoemulsion method, but triglyceride removal was slower. 相似文献11.
Background
The findings form studies on the relationship between vitamin D and type 2 diabetes were inconsistent.Objectives
To elucidate the association between vitamin D consumption and type 2 diabetes risk by conducting a meta-analysis.Methods
We conducted a systematic literature search to identify prospective cohort studies of vitamin D intake and type 2 diabetes risk prior to November 2012. Eligible studies were retrieved via both computer searches and manual review of references. The summary risk estimates were calculated based on the highest versus the lowest categories.Results
Meta-analysis of 4 prospective cohort studies involving 187, 592 participants and 9, 456 incident cases showed an absence of significant association between total vitamin D intake and type 2 diabetes risk. The combined RR was 0.93 (95% CI: 0.85–1.01). The associations were similar for subgroup analyses, a combined RR respectively was 0.94 (95% CI: 0.77–1.08), 0.91 (95% CI: 0.77–1.08), 0.93 (95% CI: 0.84–1.02), and 0.92 (95% CI: 0.84–1.01) for the intake of dietary vitamin D, supplemental vitamin D, total vitamin D in USA and total vitamin D for women only.Conclusions
Our results support that there was no association between vitamin D intake and type 2 diabetes. 相似文献12.
13.
Hilal Y Acar TN Koksal E Gezmen KM Akbulut G Bilici S Sanlier N 《African health sciences》2011,11(3):407-413
Background
Few studies have associated anthropometric measurements and lipid profile with hypertension in adult populations and to the best of our knowledge none has been done in TurkeyObjectives
To relate anthropometric derivatives of overweight/obesity with hyperlipidemia status in a group of Turkish hypertensive adults.Methods
Six hundred forty nine (307 male, 342 female) hypertensive adults aged between 20 and 64 yearswere included in the study.Results
The mean systolic and diastolic blood pressure (BP) of participants were measured as 147.6±17.2 and 91.4±10.4 mmHg for males and 149.9±16.3 and 91.1±9.4 mmHg for females, respectively. With respect to BMI classification systolic BP was significantly higher in obese males and females, and diastolic BP was only higher in obese females (p<0.05). According to BMIs for lipid profile, high-density lipoprotein-cholesterol (HDL-C), total cholesterol (TC) levels were found to be lower in normal females than other BMI groups. Age and waist circumference (WC) in particular was the most related factor for systolic and diastolic BP in both genders (p<0.05).Conclusions
This study indicates most hypertensive adults surveyed were overweight and obese. Furthermore, age and WC were the important factors that affects the systolic and diastolic BP in both genders. 相似文献14.
Background
Being a leading cause of death worldwide, epidemiological studies about diabetes mellitus have encouraged governments to initiate or improve local diabetes monitoring and prevention strategies.Objective
The main objective of this study was to examine the profile of diabetic patients in the city of Misurata, the third largest city in Libya.Methods
260 diabetic cases of both gender randomly selected from the total number of patients admitted to the centre of diabetes and endocrine disorders, Misurata -Libya for the period between January to March 2008. Data collected from patients'' files and by directly questioning the patients. SPSS software version 13 was used for the statistical analysis and presentation of the data.Results
87% of all patients were type 2 diabetics, while only 9.9% were type 1. 73% of all patients had family history of diabetes. 52% of all diabetic patients were obese, with more obesity in females (70% of females) than males (33.8% of males). Obesity was more pronounced in type 2 patients (56.8%) than in type 1 patients (11.5%). 38% of all patients were treated with insulin while 35.4% were treated with oral hypoglycemics. Meanwhile 32.6% of type 2 diabetic patients were treated with insulin. Only 9.2% of all patients had fasting blood sugar below 140 mg/dl, whereas 55% had levels in the range of 140–180 mg/dl, while 35.8% had levels above 180 mg/dl. Microvascular complications included retinopathy (16.2% of all patients), neuropathy (11.2%), nephropathy (1.5%) and combination of neuropathy and retinopathy (6.5%).Conclusion
High percentage of risk factors including obesity, family history of diabetes, hypertension and microvascular complications requires a Libyan national policy for the surveillance, prevention and control of diabetes and its complications. 相似文献15.
Geoffrey K Mitchell Afaf Girgis Moyez Jiwa David Sibbritt Letitia H Burridge Hugh E Senior 《The British journal of general practice》2013,63(615):e683-e690
Background
Carers of patients with advanced cancer often have health and psychosocial needs, which are frequently overlooked.Aim
To meet the needs of carers through a GP consultation directed by a self-completed carer needs checklist.Design and setting
Randomised controlled trial in general practice with recruitment through specialist oncology clinics, in Brisbane, Australia.Method
Intervention was (a) carer–GP consultations directed by a self-completed checklist of needs at baseline and 3 months; and (b) a GP-Toolkit to assist GPs to address carer-identified needs. Control group received usual care. Outcome measures were intensity of needs, anxiety and depression, and quality of life.Results
Total recruitment 392. Overall, no significant differences were detected in the number or intensity of need between groups. Compared to controls, intervention participants with baseline clinical anxiety showed improvements in mental wellbeing (P = 0.027), and those with baseline clinical depression had slower development of anxiety (P = 0.044) at 6 months. For those not anxious, physical wellbeing improved at 1 month (P = 0.040). Carers looking after patients with poor functional status had more physical needs (P = 0.037) at 1 month and more psychological and emotional needs at 3 months (P = 0.034). Those caring for less unwell patients showed improved mental wellbeing at 3 months (P = 0.022).Conclusion
The intervention did not influence the number or intensity of needs reported by carers of people with advanced cancer. There was limited impact in people with pre-existing clinical anxiety and depression. For the carer of those most severely affected by advanced cancer, it drew attention to the needs arising from the caregiving role. 相似文献16.
Background
Pulse pressure (PP), might be a stronger determinants of cardiovascular risk.Objective
To investigate the effect of interval training program on PP in subjects with hypertension.Methods
Two hundred and forty five male patients with mild to moderate (Systolic Blood Pressure [SBP] between 140–179 & Diastolic Blood Pressure [DBP] between 90–109 mmHg) essential hypertension were age-matched and grouped into exercise and control groups. The exercise (work: rest ratio of 1:1) groups involved in an 8-weeks interval training programs of between 45–60 minutes, at intensities of 60–79% of HR max (maximum heart rate), while the control group remained sedentary during this period. SBP, DBP, VO2max and PP were assessed.Results
Findings of the study revealed significant correlation between PP and blood pressure; correlation of PP with SBP was much stronger (95% variance). Also, there was significant effect of the exercise training program on SBP, DBP and PP. Changes in VO2max also negatively correlated with changes in PP (r= −.285) at p<0.05.Conclusion
Moderate intensity interval training programs is effective in the non-pharmacological management of hypertension and may prevent cardiovascular event through the down regulation of PP in hypertension. 相似文献17.
Peter J Neibert 《Journal of Athletic Training》2009,44(4):378-390
Objective:
To discover the theoretic constructs that confirm, disconfirm, or extend the principles and their applications appropriate for National Athletic Trainers'' Association (NATA)–accredited postprofessional athletic training education programs.Design:
Interviews at the 2003 NATA Annual Meeting & Clinical Symposia.Setting:
Qualitative study using grounded theory procedures.Patients and Other Participants:
Thirteen interviews were conducted with postprofessional graduates. Participants were purposefully selected based on theoretic sampling and availability.Data Collection and Analysis:
The transcribed interviews were analyzed using open coding, axial coding, and selective coding procedures. Member checks, reflective journaling, and triangulation were used to ensure trustworthiness.Results:
The participants'' comments confirmed and extended the current principles of postprofessional athletic training education programs and offered additional suggestions for more effective practical applications.Conclusions:
The emergence of this central category of novice to expert practice is a paramount finding. The tightly woven fabric of the 10 processes, when interlaced with one another, provides a strong tapestry supporting novice to expert practice via postprofessional athletic training education. The emergence of this theoretic position pushes postprofessional graduate athletic training education forward to the future for further investigation into the theoretic constructs of novice to expert practice. 相似文献18.
Yu Na Cho Kee Ook Lee Julie Jeong Hyung Jun Park Seung-Min Kim Ha Young Shin Ji-Man Hong Chul Woo Ahn Young-Chul Choi 《Yonsei medical journal》2014,55(3):700-708
Purpose
We previously reported that insulin resistance, low high-density lipoprotein (HDL) cholesterol, and glycaemic exposure Index are independently associated with peripheral neuropathy in Korean patients with type 2 diabetes mellitus. We followed the patients who participated in that study in 2006 for another 6 years to determine the relationship between insulin resistance and neuropathy.Materials and Methods
This study involved 48 of the original 86 Korean patients with type 2 diabetes mellitus who were referred to the Neurology clinic for the assessment of diabetic neuropathy from January 2006 to December 2006. These 48 patients received management for glycaemic control and prevention of diabetic complications in the outpatient clinic up to 2012. We reviewed blood test results and the nerve conduction study findings of these patients, taken over a 6-year period.Results
Low HDL cholesterol and high triglycerides significantly influenced the development of diabetic neuropathy. Kitt value (1/insulin resistance) in the previous study affected the occurrence of neuropathy, despite adequate glycaemic control with HbA1c <7%. Insulin resistance affected the development of diabetic neuropathy after 6 years: insulin resistance in 2006 showed a positive correlation with a change in sural sensory nerve action potential in 2012.Conclusion
Diabetic neuropathy can be affected by previous insulin resistance despite regular glycaemic control. Dyslipidaemia should be controlled in patients who show high insulin resistance because HDL cholesterol and triglycerides are strongly correlated with later development of diabetic neuropathy. 相似文献19.
Welcome Mkululi Wami Frank Buntinx Stefaan Bartholomeeusen Geert Goderis Chantal Mathieu Marc Aerts 《The British journal of general practice》2013,63(609):e267-e273
Background
Evidence on the influence of comorbidity and comedication on clinical outcomes in patients with type 2 diabetes mellitus is scarce.Aim
To ascertain the effect of five chronic diseases (joint disorder, respiratory disease, anaemia, malignancy, depression) and three chronically used drugs (non-steroid anti-inflammatory drugs [NSAIDs], corticosteroids, antidepressants) on treatment for hypoglycaemia in patients with type 2 diabetes.Design and setting
Retrospective cohort study in a variety of practices across Flanders, Belgium.Method
A retrospective cohort study was conducted, based on data from Intego, a general practice-based continuous morbidity registry. Multiple logistic regression analysis was used to predict the change in glycosylated haemoglobin (HbA1c) levels related to comorbidity, comedication, and a combination of both in 3416 patients with type 2 diabetes. Adjustments were made for age, sex, and diabetes-treatment group (diet, oral antidiabetic drugs, combination treatment, insulin).Results
Concomitant joint and respiratory disorders, as well as the chronic use of NSAIDs and corticosteroids, either separately or in combination, were significantly associated with the worsening of HbA1c levels. Anaemia, depression, malignancy, and antidepressants had no statistically significant influence on the efficacy of treatment for hypoglycaemia.Conclusion
The presence of some comorbid diseases or drug use can impede the efficacy of treatment for type 2 diabetes. This finding supports the need to develop treatment recommendations, taking into account the presence of both chronic comorbidity and comedication. Further research must be undertaken to ascertain the effect other combinations of chronic diseases have on the efficacy of treatment of this and other diseases. 相似文献20.
So Yun Park Yeon Jean Cho Sa Ra Lee Hyewon Chung Kyungah Jeong 《Yonsei medical journal》2015,56(3):785-792