Nutraceuticals use and type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) is a complicated metabolic disease and has become one of the significant medical problems worldwide. Researchers aim to provide fine-tuned treatment for T2DM with minimal exposed side effects. Nutraceuticals are compounds or materials and emerging evidence suggests that the use of nutraceuticals has recently been recognized as a promising option for the prevention and management of T2DM, such as probiotics and prebiotics, Vitamin D, n-3 long-chain polyunsaturated fatty acids, and Plant-derived nutraceuticals. This review attempts to show the most popular nutraceuticals and review their effects and possible mechanisms in the prevention or glycemic control of T2DM.     

Single and combined effect of bisphenol A with high sucrose diet on the diabetic and renal tubular dysfunction phenotypes in Drosophila melanogaster

In the present study, effect of exposure of bisphenol A (BPA) and combined exposure of BPA + HSD has been investigated on the glucose homeostasis and associated renal complications in Drosophila. Exposure of 1.0 mM BPA alone induced type 2 diabetes like condition (T2D) in adult male D. melanogaster via oxidative stress. Elevated TGF-β signaling was evident by increased expression of baboon (babo) in BPA exposed organism that stimulated the modulation of extracellular matrix (ECM) component collagen IV resulting in the fibrosis of the Malpighian tubules (MTs). Combined exposure of BPA + HSD (high sucrose diet) resulted in the increased magnitude of T2D and MTs dysfunction parameters. Taken together, the study illustrates that BPA has diabetogenic potential in exposed Drosophila that caused adverse effects on their MTs and combined exposure with BPA and HSD could aggravate the renal tubular dysfunction. The study further suggests the use of Drosophila model to study the environmental chemicals induced diabetes mediated renal dysfunction.     

Correlation analysis of intestinal flora and pathological process of type 2 diabetes mellitus

ObjectiveTo observe the relationship between the different stages of type 2 diabetes mellitus (T2DM) and the intestinal flora and verify its underlying mechanism.MethodsT2DM rats were generated by high-fat diet (HFD) combined with intraperitoneal streptozotocin (STZ) injection. The rats were divided into four groups: the control group (fed with normal feed for 1 month), the HFD group (fed with HFD for 1 month), the T2DM group (HFD combined with STZ and blood glucose ≥11.1 mM), and the unformed T2DM model (Un-mod) group (HFD combined with STZ and blood glucose <11.1 mM). Feces were collected, and bacterial communities in the fecal samples were analyzed by 16S rRNA gene sequencing. The content of short-chain fatty acids (SCFAs) in feces was measured by gas chromatography. Western blot and quantitative real-time polymerase chain reaction were used to detect the expression of G protein-coupled receptor 41 (GPR41) and GPR43.ResultsAt different stages of T2DM, the intestinal flora and SCFAs content of rats were significantly decreased (all P < .05). Our results indicated that g__Prevotella had a significant negative correlation, and g__Ruminococcus_torques_group and g__lachnoclastic had a significant positive correlation with blood glucose. The content of SCFAs, in particular acetate and butyrate, in rat feces of different stages of T2DM were significantly reduced, as well as GPR41 and GPR43 expression. The results in the Un-mod group were similar to the T2DM group, and the expression of GPR41 and GPR43 proteins were significantly higher than those in the T2DM group (both P < .001).ConclusionThe intestinal flora–SCFAs–GPR41/GPR43 network may be important in the development of T2DM. Decreasing blood glucose levels by regulating the intestinal flora may become a new therapeutic strategy for T2DM, which has very important clinical and social values.     

Stanford A型主动脉夹层术后肾脏功能损伤的危险因素

目的调查分析Stanford A型主动脉夹层术后肾脏功能损伤(AKI)的危险因素,为临床降低肾脏功能损伤并发率对策提供支持。方法收集2017年1月—2019年12月医院心血管外科确诊且顺利行A型主动脉夹层手术的179例患者为研究对象,均由同组外科医师和麻醉医师实施手术,术后进入ICU监测治疗。根据术后早期是否存在AKI,将发生AKI 60例设为病例组,未发生AKI 119例设为对照组。分析发生AKI高危因素。结果经过多因素Logistics回归分析显示,年龄(OR=2.396)、双侧肾脏灌注欠佳(OR=8.725)、BMI值(OR=3.454)、监测膀胱温度(OR=4.180)、CPB时长(OR=2.165)、术中红细胞输注(OR=2.291)均为此类手术患者发生AKI独立危险因素(P<0.05)。结论年龄、BMI值、双侧肾脏灌注欠佳、CPB、监测膀胱温度、术中红细胞输注均为影响A型主动脉夹层术后AKI的独立相关因素,临床护士应针对上述分析制定个体化针对方案以降低术后AKI发生风险。     

Self-care activities,glycaemic control and health-related quality of life of patients with type 2 diabetes in a tertiary hospital in Nigeria

Background and aimsDiabetes is one of the global health emergencies of the 21st century. This study sought to assess self-care behaviours, glycaemic control and health-related quality of life (HRQoL) of type 2 diabetes patients at a Nigerian hospital, determine factors associated with HRQoL, and assess the inter-relationship among these outcomes.MethodsThe Summary of Diabetes Self-Care Activities (SDSCA) measure was used to assess self-care behaviours; HRQoL was assessed with the Appraisal of Diabetes Scale (ADS) and SF-12v2 Health Survey. Glycaemic control was assessed with fasting blood sugar (FBS). The questionnaires were distributed to 250 eligible patients attending Endocrinology clinic at the University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria.ResultsMean scores (±SD) of self-care behaviours were 4.0 ± 1.3, 3.9 ± 1.0, 2.4 ± 1.2, 1.0 ± 1.1, and 2.5 ± 2.1 for general diet, specific diet, exercise, blood glucose monitoring, and foot care respectively. Mean FBS was 7.1 ± 2.1 mmol/L. Mean ADS score was 18.1 ± 4.2. The physical and mental component summary scores were 47.84 ± 8.21 and 45.66 ± 8.74 respectively. HRQoL was significantly associated with patient socio-demographic (except gender) and clinical variables (p < 0.05). Self-care activities, FBS and HRQoL were significantly inter-correlated (r_s ?0.31 to 0.68; p < 0.01, p < 0.001).ConclusionsPatients were more adherent to diet recommendations than to other aspects of self-care. Though most patients had adequate glucose control, the presence of diabetes had a negative impact on the mental component of health. HRQoL was affected by most of the patient-related variables. Interventions to improve adherence to self-care are recommended to achieve good glycaemic control and improve HRQoL.     

A型肉毒素在皮肤科的应用

A型肉毒素是由肉毒梭状芽胞杆菌在其繁殖过程中产生的细菌外毒素,可抑制神经末梢乙酰胆碱的释放,使肌肉松弛,在整形外科、神经内科、眼科等多个科室均有应用。随着医学实践及科研实验的不断深入,发现A型肉毒素还具有抑制纤维细胞增生、阻止支配汗腺的神经末梢释放乙酰胆碱、阻断相关疼痛介质的释放或传导及抑制炎性神经递质等作用,在防疤、止汗、止痛、抗瘙痒、减少皮脂腺分泌等方面均有一定的疗效。基于此,文章从美容医疗及疾病治疗两方面分析A型肉毒素在皮肤科的应用。     

2型糖尿病患者使用胰岛素治疗期间的药师指导

目的探讨药师参与2型糖尿病患者在使用胰岛素治疗过程中对患者治疗效果的影响。方法选择该院在2019年5月—2020年5月门诊收治的200例2型糖尿病患者为研究对象,随机分为实验组和观察组,每组100例,实验组患者在治疗期间药师参与患者治疗全过程;观察组按照常规治疗方案进行治疗;观察患者各项指标变化情况。结果实验组在经过药师指导后,糖化血红蛋白、空腹血糖、患者用药依从性明显优于观察组,差异有统计学意义(P<0.05)。结论药师参与2型糖尿病患者使用胰岛素治疗期间,能够明显提高患者的治疗效果和生活质量,实现了医药护理共同协作,值得被医护人员在临床中广泛应用,并进行大力推广及宣传。     

雾化吸入布地奈德治疗AECOPD合并2型糖尿病患者疗效及对肺通气功能和糖代谢的影响

目的分析雾化吸入布地奈德治疗慢性阻塞性肺疾病急性加重(AECOPD)合并2型糖尿病(T2DM)患者疗效及对肺通气功能和糖代谢指标的影响。 方法选择四川大学华西医院2019年1月至2020年5月诊治的120例AECOPD合并T2DM患者作为对象，根据非随机临床同期对照研究及患者自愿原则分为对照组58例和观察组62例，其中对照组给予低剂量布地奈德治疗，观察组给予高剂量布地奈德治疗。比较两组患者治疗前后肺通气功能、糖代谢指标和炎性因子水平变化，并评估疗效和安全性。 结果两组患者治疗有效率比较无显著差异(P>0.05)；与治疗前比，两组患者治疗后肺通气功能指标均显著升高，但观察组较对照组升高更为显著(P<0.05)；两组患者之间及其治疗前后糖代谢指标均无显著差异(P>0.05)；与治疗前比，两组患者治疗后炎症因子水平均显著降低，但观察组较对照组降低更为显著(P<0.05)；两组不良反应发生率比较无统计学意义(P>0.05)。 结论布地奈德雾化吸入治疗AECOPD合并T2DM安全有效，对糖代谢指标无明显影响，但高剂量的布地奈德对于患者肺通气功能和炎症水平改善效果更好。     

2型糖尿病患者病耻感调查及其影响因素分析

目的探讨2型糖尿病患者病耻感现状,并分析病耻感的影响因素。方法2018年8月—2020年3月期间,采用便利抽样法,对该院就诊的135例2型糖尿病患者进行问卷调查。调查工具为一般情况调查表、2型糖尿病病耻感评估表。对病耻感的影响因素进行单因素分析和多因素分析。结果所有患者平均病耻感得分为(54.22±10.65)分。不同年龄、文化水平、是否接受胰岛素治疗、是否合并并发症等4个因素的单因素亚组分析显示,组间病耻感得分差异有统计学意义(P<0.05);采用逐步多元线性回归分析显示,只有年龄、是否合并并发症、文化水平是影响病耻感的独立因素。结论该次调查显示2型糖尿病患者普遍存在病耻感,年龄低、具有糖尿病并发症和文化水平较高的患者具有更明显的病耻感,应引起医务人员的重视,并及时给予治疗干预。     

Evaluation of the metformin initiation rate in veterans with newly identified type 2 diabetes

BackgroundAn estimated 35 million individuals in the United States have diabetes. The American Diabetes Association recommends metformin as first-line pharmacologic treatment. The primary objective of this study was to evaluate the metformin initiation rate in veterans with recently identified type 2 diabetes.MethodsVeterans with new onset type 2 diabetes were identified using National Veterans Health Administration Data. Retrospective information was obtained from those with a first A1C ≥ 6.5% (48 mmol/mol) between 2013 and 2018. Veterans with at least one additional A1C < 6.5% (48 mmol/mol) documented in the three years prior to the A1C diagnostic for diabetes were included in the analysis.ResultsA total of 144,180 veterans were included. Of those, 45,776 (31.7%) were started on metformin within one year of diabetes diagnosis. The median time to metformin initiation was 12 days and median time to initiation of any anti-hyperglycemic was 11 days. Approximately 16,000 veterans were referred for lifestyle interventions within 90 days.ConclusionMetformin initiation occurred in fewer patients than expected given metformin is a generic, well-tolerated medication recommended as first-line pharmacologic treatment option regardless of A1C. Further studies are needed to assess the barriers of initiating metformin at time of diabetes diagnosis.