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31.
目的 比较门冬胰岛素(IAsp)和可溶性人胰岛素(HI)分别联合中性鱼精蛋白胰岛素(NPH)在糖尿病治疗中的有效性和安全性.方法 220例来自全国5家医院的1型(T1DM)或2型糖尿病(T2DM)患者按1:1的比例随机分为两组,分别接受IAsp或HI联合NPH治疗.以空腹血糖(FPG)、餐后2 h血糖(2h PPG)、糖化血红蛋白(HbA1c)及低血糖事件作为评价指标.结果 IAsp/NPH组[(14.6±5.3)mmol/L比(8.4±4.1)nunol/L]较HI/NPH组治疗后2 h PPG改善更为显著[(14.9±3.9)mmol/L比(10.6±3.5)mmoL/L,P<0.05],且达标率分别为50.0%、25.5%(P<0.01).治疗后IAsp/NPH组[(9.3±1.4)%比(7.7±1.3)%]和HI/NPH组[(9.2±1.2)%比(7.7±1.2)%]HbA1c明显下降,但两组比较差异无统计学意义(P=0.437).达标率分别为24.5%和14.5%(P<0.05).在Imp/NPH组未见严重低血糖事件和其他不良事件,且夜间低血糖发生率更低(IAsp/NPH:3%,HI/NPH:4%).IAap/NPH组与HI/NPH组患者胰岛素日均剂量分别是0.60/0.23 IU/kg和0.65/0.24 IU/kg.结论 IAsp联合NPH能更好地控制餐后血糖,提高患者血糖达标率且不增加夜间低血糖和不良事件的风险. 相似文献
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<正>1重症糖尿病患者高血糖的危害重症糖尿病患者处于严重应激状态,不论既往是否合并有糖尿病,都容易发生应激性高血糖,这是与炎症和神经内分泌紊乱导致的肝糖输出增多和胰岛素抵抗相关的[1]。不同血糖水平与感染性并发症的荟萃分析显示:血糖从8.0mmol/L增加 相似文献
34.
目的 观察不同浓度棕榈酸培养INS-1细胞时过氧化物酶体增殖物激活受体γ辅助激活因子-1α(PGC-1α)的表达变化及其与细胞增殖、凋亡和胰岛素分泌能力的关系. 方法 INS-1细胞在50、100、400 μmol/L棕榈酸培养4、8、12、24、48 h检测PGC-1α mRNA和蛋白表达、细胞增殖活力、Bcl-2蛋白、基础及葡萄糖刺激的胰岛素分泌. 结果 50 μmol/L棕榈酸培养时,INS-1细胞PGC-1α mRNA48 h有增多趋势,但差异无统计学意义;8、12 h细胞增殖活力降低,24、48 h与对照组比较差异无统计学意义;Bcl-2蛋白表达无变化;48 h基础及葡萄糖刺激胰岛素分泌量增加.100μmol/L棕榈酸培养时,INS-1细胞PGC-1α mRNA 24 h表达增加,48 h蛋白表达增加;8、12、24 h细胞增殖活力降低,48 h与对照组比较差异无统计学意义;Bcl-2蛋白表达无变化;基础及葡萄糖刺激胰岛素分泌量增加.400 μmol/L棕榈酸培养时,INS-1细胞PGC-1α mRNA 12 h表达增加,24 h后PGC-1α蛋白表达进行性增加;8h起细胞增殖活力降低;24 h起Bcl-2蛋白表达减少;48 h基础胰岛素分泌及葡萄糖刺激的胰岛素分泌降低. 结论 轻、中度高脂培养条件下INS-1细胞PGC-1α表达轻度增加,与细胞增殖活力改变和胰岛素分泌能力增加相关,重度高脂培养条件下INS-1细胞PGC-1α表达增加,与细胞增殖活力减低、抗凋亡减少和胰岛素分泌能力受损相关,提示PGC-1α可能参与棕榈酸对INS-1细胞增殖、凋亡及功能改变的影响. 相似文献
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不同糖耐量人群胰岛素抵抗和胰岛β细胞功能减退的差异 总被引:1,自引:0,他引:1
目的探讨不同糖耐量人群胰岛素抵抗(IR)和胰岛B细胞功能状态。方法分析5523例患者行OGTT和胰岛素释放试验的结果,根据WHO标准将研究对象分为糖代谢正常(NGT)组、单纯空腹血糖升高(IFG)组、单纯糖耐量减低(IGT)组、空腹血糖升高合并糖耐量受损(IFG+IGT)组和2型糖尿病(T2DM)组。结果(1)HOMA-IR:IFG、IGT、IFG+IGT和T2DM组比NGT组分别增加41%、19%、47%和69%(P〈0.01)。(2)校正IR影响后,IFG、IGT、IFG+IGT和T2DM组比NGT组HOMA-β分别下降54%、19%、55%和68%,△I30/△G30分别下降47%、40%、63%和82%(P〈0.001);IFG、IFG+IGT和T2DM组AUCI比NGT组分别下降27%、26%和30%(P〈0.01)。结论(1)从IGT、IFG、IFG+IGT到T2DM发展过程中IR程度逐渐加重,胰岛β细胞早时相分泌和基础分泌功能逐渐衰竭,晚时相分泌代偿能力功能减弱,总体分泌功能逐渐减退。(2)从NGT、IGT、IFG、IFG+IGT到T2DM的糖代谢异常发生发展过程反映了胰岛β细胞早时相、基础和整体分泌功能逐渐衰退变化规律。 相似文献
37.
Ghrelin是一个由 2 8个氨基酸组成的多肽 ,3位丝氨酸上有酰化基团。它是第一个被发现的生长激素促分泌剂受体 (GHS R)的内源性配体。Ghrelin主要由胃分泌 ,下丘脑、肾脏、胎盘均有分泌。GHS R分布在多种组织 ,而且有不同的亚型 ,它有很强的促生长激素 (GH)释放的作用 ,可使循环中GH迅速、显著而持久地增加 ,甚至比生长激素释放激素的作用还强。Ghrelin是促进食欲的脑肠肽 ,参与下丘脑、垂体和胃肠道共同对能量平衡的调节 相似文献
38.
Objective To evaluate the current state of glycemie control in Chinese patients with type 2 diabetes mellitus who have received oral antidiabetic agents in the out-patient clinic,and the efficacy and safety of optimized regiments of gliclazide modified-release tablets (Diamicron MR, SERVIER, Tianjin) in patients with failed glycemic control (HbA1c 6.5%). Methods The patients with type 2 diabetes were enrolled from 54 hospitals in more than 20 cities and received long-term (more than 3 months) oral antidiabetic agents. HbA1c was measured and the success rate of HbA1c reduction was evaluated. The patients who failed to achieve glycemic control (HbA1c 6. 5%) and received daily multiple-dosing insulin secretagogues were provided with the optimized treatment regimen, consisting of replacing daily multiple-dosing insulin secretagogues with single-dosing gliclazide sustained-release tablets. Clinical efficacy and safety were evaluated after three months treatment. Results The survey of glycemic control revealed that the mean HbA1c of 5 586 patients with diabetes mellitus was (7.97±2.89)% ,and the success rate (HbA1c≤6.5%) was 14. 1%. Further more, HbA1c decreased from (8.23±4.00)% before optimization to (6.86±2.24)% after optimization with the average decrement of 1.37% (P<0. 001) and the success rate was raised to 34. 1%. The gliclazide modified-release tablets were well tolerated by most patients, only 2.6% of whom were reported to experience unconfirmed hypoglycemia. Conclusion The success rate of glycemic control was low in Chinese out-patients with type 2 diabetes mellitus receiving oral antidiabetic agents in the clinic. The optimized regimen of gliclazide modified-release tablets taken once daily can down-regulate glycemic levels and increase the success rate of HbA1c reduction,and thus plays efficiently and safely a key role in the optimized management of type 2 diabetes mellitus. 相似文献
39.
Objective To evaluate the current state of glycemie control in Chinese patients with type 2 diabetes mellitus who have received oral antidiabetic agents in the out-patient clinic,and the efficacy and safety of optimized regiments of gliclazide modified-release tablets (Diamicron MR, SERVIER, Tianjin) in patients with failed glycemic control (HbA1c 6.5%). Methods The patients with type 2 diabetes were enrolled from 54 hospitals in more than 20 cities and received long-term (more than 3 months) oral antidiabetic agents. HbA1c was measured and the success rate of HbA1c reduction was evaluated. The patients who failed to achieve glycemic control (HbA1c 6. 5%) and received daily multiple-dosing insulin secretagogues were provided with the optimized treatment regimen, consisting of replacing daily multiple-dosing insulin secretagogues with single-dosing gliclazide sustained-release tablets. Clinical efficacy and safety were evaluated after three months treatment. Results The survey of glycemic control revealed that the mean HbA1c of 5 586 patients with diabetes mellitus was (7.97±2.89)% ,and the success rate (HbA1c≤6.5%) was 14. 1%. Further more, HbA1c decreased from (8.23±4.00)% before optimization to (6.86±2.24)% after optimization with the average decrement of 1.37% (P<0. 001) and the success rate was raised to 34. 1%. The gliclazide modified-release tablets were well tolerated by most patients, only 2.6% of whom were reported to experience unconfirmed hypoglycemia. Conclusion The success rate of glycemic control was low in Chinese out-patients with type 2 diabetes mellitus receiving oral antidiabetic agents in the clinic. The optimized regimen of gliclazide modified-release tablets taken once daily can down-regulate glycemic levels and increase the success rate of HbA1c reduction,and thus plays efficiently and safely a key role in the optimized management of type 2 diabetes mellitus. 相似文献
40.
Objective To evaluate the current state of glycemie control in Chinese patients with type 2 diabetes mellitus who have received oral antidiabetic agents in the out-patient clinic,and the efficacy and safety of optimized regiments of gliclazide modified-release tablets (Diamicron MR, SERVIER, Tianjin) in patients with failed glycemic control (HbA1c 6.5%). Methods The patients with type 2 diabetes were enrolled from 54 hospitals in more than 20 cities and received long-term (more than 3 months) oral antidiabetic agents. HbA1c was measured and the success rate of HbA1c reduction was evaluated. The patients who failed to achieve glycemic control (HbA1c 6. 5%) and received daily multiple-dosing insulin secretagogues were provided with the optimized treatment regimen, consisting of replacing daily multiple-dosing insulin secretagogues with single-dosing gliclazide sustained-release tablets. Clinical efficacy and safety were evaluated after three months treatment. Results The survey of glycemic control revealed that the mean HbA1c of 5 586 patients with diabetes mellitus was (7.97±2.89)% ,and the success rate (HbA1c≤6.5%) was 14. 1%. Further more, HbA1c decreased from (8.23±4.00)% before optimization to (6.86±2.24)% after optimization with the average decrement of 1.37% (P<0. 001) and the success rate was raised to 34. 1%. The gliclazide modified-release tablets were well tolerated by most patients, only 2.6% of whom were reported to experience unconfirmed hypoglycemia. Conclusion The success rate of glycemic control was low in Chinese out-patients with type 2 diabetes mellitus receiving oral antidiabetic agents in the clinic. The optimized regimen of gliclazide modified-release tablets taken once daily can down-regulate glycemic levels and increase the success rate of HbA1c reduction,and thus plays efficiently and safely a key role in the optimized management of type 2 diabetes mellitus. 相似文献