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1.
目的研究社区人群糖尿病和糖耐量减低患者血糖与血脂的相关性.方法采用整群随机抽样流调1232人,隔夜禁食12小时以上,空腹采血5ml,测定血糖(BS)、甘油三脂(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL).结果1232人中,糖尿病(DM)161例,首诊DM病人66例;糖耐量减低(IGT)93例.首诊和IGT病人空腹以及餐后血糖为6.1±2.4mmol/L、7.9±6.1mmol/L;TG、TC、LDL-C为2.3±0.8mmol/L、5.7±0.7mmol/L、4.8±0.9mmol/L,均高于正常对照组,HDL-C1.1±0.3mmol/L,低于正常对照组;空腹和餐后血糖与TG、TC、LDL-C水平成正相关,P<0.01.结论糖尿病和糖耐量减低患者存在血脂异常,加强糖尿病患者血脂相关知识教育及普查意义重大.  相似文献   

2.
Treatment and control of blood pressure in patients with diabetes mellitus.   总被引:1,自引:0,他引:1  
PURPOSE: A study was conducted to characterize the prevalence of hypertension in patients with diabetes mellitus and the percentage of patients with diabetes and hypertension who achieved a targeted blood pressure goal (<135/80 mm Hg). METHODS: A retrospective, cross-sectional study was conducted in an ambulatory care clinic. Eligible patients were those individuals being managed for type 2 diabetes mellitus at least once each year for two consecutive years. Blood pressure measurements that were recorded in the medical chart or written diagnoses of hypertension were used to determine the presence of comorbid hypertension. Data were collected from the chart and electronic record using a standardized form. Clinic visits over the previous 12 months were reviewed to evaluate hypertension criteria. A blood pressure of > or = 135/80 mm Hg was used to define hypertension. RESULTS: A final sample of 362 patients with type 2 diabetes mellitus was included in the study. Of these, 79% had concomitant diabetes and hypertension. Blood pressure was controlled in 175 of 270 (65%) patients. Patients who met the blood pressure goal tended to be older and weigh less than those who did not. The adjusted odds of achieving the blood pressure goal were 1.9 times higher in those patients who also achieved their low-density-lipoprotein cholesterol goal. Most patients were on at least one antihypertensive agent; approximately 39% of the 89 patients treated with monotherapy were above the blood pressure goal. Combination therapy was used in 164 patients; approximately 32% of patients treated with combination therapy were above the blood pressure goal. CONCLUSION: Among ambulatory care patients with diabetes, 79% also had hypertension. Hypertension was controlled in 65% of patients with that disorder.  相似文献   

3.
A random blood sugar diabetes detection survey.   总被引:1,自引:0,他引:1  
In a co-operative study undertaken between various groups in the community, 3212 persons were screened at the Agricultural and Pastoral Summer Show in Christchurch. The mean glucose value was 88.4 mg/dl (4.9mmol/l) which roughly equates to 91 mg/dl (5.1mmol/l) plasma value. There was a standard deviation of 19.5mg/dl (1.08mmol/l) the 22.5 percentile was 63mg (3.5mmol/l), the 97.5 percentile was 125 (6.5mmol/l). One hundred and twenty persons of the total of 3212 were advised to contact their family doctors as a result of higher than normal blood sugar levels on the day. Twenty-five probable diabetics were diagnosed.  相似文献   

4.
目的探讨糖尿病患者围手术期血糖控制及其疗效影响因素.方法回顾分析8年间收治79例并发糖尿病的腹部外科手术患者的临床资料.结果79例糖尿病患者经积极有效的血糖控制,术前血糖为7.0~11.0mmol/L,术中血糖为8.3~13.9mmoL/L,术后血糖控制在7.8mmoL/L以下.术后切口感染2例,肺部感染3例,泌尿系统感染3例,所有病例未发生酮症酸中毒和死亡.结论糖尿病患者围手术期只要对血糖进行有效的控制和选择合理的麻醉方式,以防治感染,促进伤口愈合,完全可以达到理想的治疗效果.  相似文献   

5.
Utilisation of drugs for diabetes mellitus   总被引:2,自引:0,他引:2  
This article reviews the data from drug utilisation research on antidiabetic agents, oral hypoglycaemics and insulin. Study methods specific to this type of pharmacoepidemiological research are discussed and critiqued. A brief overview of the sources of drug utilisation data is presented, followed by a review of specific pharmacoepidemiological investigations. We evaluate the usefulness of these studies in assessing true drug consumption, in evaluating comorbidity in diabetic patients and in measuring the prevalence of diabetes. International comparisons of antidiabetic drug utilisation, also reviewed and analysed, demonstrate wide variations in the use of hypoglycaemic agents, which have arisen for reasons which are unclear. Drug utilisation research thus far has been limited by the paucity of studies relating these variations in antidiabetic drug use to specific clinical outcomes. There is a need to expand the applications of research on the use of antidiabetic agents, including assessment of patterns of morbidity across geographic boundaries and over time.  相似文献   

6.
BACKGROUND: Gastrointestinal symptoms are commonly reported as side-effects of oral hypoglycaemic drugs. It may be very difficult to distinguish between spontaneous and truly drug-related symptoms due to the high background incidence of gastrointestinal symptoms. Gastrointestinal symptoms in diabetic patients have also been linked to factors associated with long-standing disease and suboptimal control. AIM: To explore the association between gastrointestinal symptoms and treatment with oral hypoglycaemic drugs in a large cohort of subjects with type 2 diabetes. PATIENTS AND METHODS: 956 subjects with type 2 diabetes participated in the study. All subjects completed a validated, self-administered questionnaire on gastrointestinal symptoms, diabetes, drug use and various potential risk factors for gastrointestinal symptoms. The association between oral hypoglycaemics and nine gastrointestinal symptom groups was assessed based on logistic regression. RESULTS: 405 of the 956 patients used oral hypoglycaemic drugs. Metformin use was independently associated with chronic diarrhoea (odds ratio 3.08, 95% CI: 1.29-7.36, P < 0.02) and with faecal incontinence (odds ratio 1.95, 95% CI: 1.10-3.47, P < 0.05). Use of sulphonylureas was associated with less abdominal pain, but not with any other gastrointestinal symptom. CONCLUSIONS: Troublesome gastrointestinal symptoms do not appear to be caused by oral hypoglycaemics, except for diarrhoea and faecal incontinence, which are strongly and independently associated with metformin use.  相似文献   

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《Prescrire international》1999,8(43):147-152
(1) The UKPDS trial was a very large, complex, comparative study with methodological weaknesses such as the absence of blinding. It showed that lowering the blood glucose level in patients with type 2 diabetes reduces the risk of clinical complications, especially diabetic microangiopathy. (2) In contrast, glycaemic control had no statistically significant impact on mortality. (3) Contrary to findings in a previous trial, glucose-lowering sulphonylureas and insulin did not increase cardiovascular morbidity or mortality in the UKPDS study. (4) Glibenclamide was the only drug tested that yielded a statistically significant reduction in the risk of clinical complications linked to type 2 diabetes. (5) Strict glycaemic control with a glucose-lowering sulphonylurea or insulin was associated with hypoglycaemic episodes in approximately a quarter of patients each year. (6) Metformin gave conflicting results that are difficult to explain: metformin reduced mortality in overweight patients with type 2 diabetes; but in diabetic patients poorly controlled by glucose-lowering sulphonylureas, mortality was higher in the group treated with the sulphonylurea + metformin combination than in the group that continued treatment with a sulphonylurea alone. (7) Currently, the results of the UKPDS trial are the only available clinical data on which to base the choice of treatment for type 2 diabetic patients aged between 25 and 65 years. When a glucose-lowering drug is considered necessary and is not contraindicated, the first-line choice is glibenclamide for diabetics who are not overweight, and metformin for those who are.  相似文献   

9.
胡杉林 《安徽医药》2017,21(2):297-300
目的 探讨血糖水平、肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)和前列腺素-2(PGE-2)炎性因子水平与糖尿病伴慢性牙周炎病人牙周病变程度的相关性.方法 选择2型糖尿病伴慢性牙周炎病人102例.检测血清TNF-α、IL-1、IL-6和PGE-2.检测血浆糖化血红蛋白(HbA1C)水平,以HbA1C和胰岛素抵抗指数评估糖尿病病变程度,以牙龈指数评估牙周炎病变程度.分析血糖水平、TNF-α、IL-1、IL-6和PGE-2炎性因子水平与糖尿病伴慢性牙周炎病人疾病严重程度的相关性.结果 轻、中、重度HbA1C组牙龈指数等级分布差异有统计学意义(P<0.05),Person相关性检验结果显示血糖水平与牙龈指数等级存在显著正相关(P<0.05).任意两组牙龈指数等级比较,胰岛素抵抗指数均差异有统计学意义,两者呈显著正相关(r=0.468,P=0.009).任意两组牙龈指数等级比较,血清TNF-α、IL-1、IL-6和PGE-2水平均差异有统计意义(P<0.05),血清各炎性因子与牙龈指数等级差异有统计学意义(r=0.211,P=0.044;r=0.354,P=0.023;r=0.396,P=0.017;r=0.538,P=0.011).结论 2型糖尿病伴慢性牙周炎病人的血糖水平和血清TNF-α、IL-1、IL-6和PGE-2炎性因子水平与牙周病变程度呈显著正相关,治疗此类病人应该兼顾控制血糖和消除炎症.  相似文献   

10.
目的研究胰岛素控制妊娠期糖尿病血糖对妊娠结局的影响。方法 78例娠期糖尿病患者,分为实验组(给予胰岛素)和对照组(口服降糖药),比较两组血糖控制水平、达标时间以及妊娠并发症等情况。结果两组血糖控制水平、达标时间差异均有统计学意义(P<0.05)。两组妊娠并发症如妊娠期高血压疾病、羊水过多、产褥感染、产后出血发生率相比差异均有统计学意义(P<0.05)。结论胰岛素控制妊娠期糖尿病血糖水平效果优于口服降糖药,能明显改善妊娠期糖尿病的妊娠结局。  相似文献   

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目的探讨动态血糖检测系统和胰岛素泵皮下持续输注系统组成的“双C”方案在难治性糖尿病患者血糖控制中的治疗效果。方法对24例血糖波动大、难治性、脆性糖尿病患者先进行24h动态血糖监测,再使用胰岛素泵皮下持续输注控制血糖,同时使用动态血糖检测系统评估胰岛素泵治疗前后的血糖情况。结果接受胰岛素泵治疗3d后患者的空腹血糖、三餐后、晚23:00明显低于治疗前(P〈0.05);患者的平均血糖值(MBG)、平均血糖波动幅度(MAGE)显著低于治疗前(P〈0.05),均有统计学意义,血糖漂移(血糖〉11.1mmol/L)所占的时间百分比低于治疗前(44%(19%~79%)和17%(0~34%),P〈0.05),出现低血糖事件(34.1±2.47)次,也显著低于治疗前(59.3±3.22)次(P〈0.05)。结论动态血糖检测系统与胰岛素皮下持续输注联合应用的“双C”方案更能有效控制血糖。  相似文献   

13.
张文香 《中国当代医药》2014,21(15):44-45,48
目的 分析血糖控制与妊娠期糖尿病(GDM)产妇围生期结局之间的关系.方法 选取本院2012年1月~2013年6月收治的60例妊娠期糖尿病孕妇为研究对象,依照入院顺序随机分为观察组和对照组,对照组早晚餐前混合胰岛素皮下注射,观察组三餐前及睡前分别皮下注射短效和长效胰岛素,参照30例健康孕妇的相关资料,对比两组血糖控制效果及围生结局.结果 观察组血糖控制效果更佳、新生儿体重优于对照组(P<0.05),巨大儿比率与对照组差异无统计学意义(P>0.05);观察组均顺利分娩,围生结局优于对照组(P<0.05).结论 三餐前及睡前分别皮下注射短效和长效胰岛素血糖控制效果更佳,同时产妇围生结局更理想,此种治疗方案可作为妊娠期糖尿病的首选血糖控制途径.  相似文献   

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目的观察营养治疗对妊娠期糖尿病患者血糖控制及妊娠结局的影响。方法选取2018年1-12月海安市人民医院收治的妊娠期糖尿病患者80例,根据入院单双日分为观察组和对照组各40例,对照组采用常规治疗,观察组在常规治疗基础上联合营养治疗,比较2组临床效果。结果治疗后2组空腹血糖、餐后2 h血糖水平均低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。观察组难产率低于对照组,差异有统计学意义(χ~2=6.991,P<0.05)。观察组胎膜早破、巨大儿、早产儿、黄疸发生率均低于对照组,差异均有统计学意义(P<0.05)。结论针对妊娠期糖尿病患者在常规治疗的基础上联合营养治疗可控制血糖,改善妊娠结局,值得临床应用与推广。  相似文献   

17.
Summary Of 23 patients with non-insulin-dependent diabetes mellitus (NIDDM), whose fasting blood glucose had not reached 6.0 mmol·l–1 after 10 weeks of dietary regulation, 15, who had had a weight reduction of –2.8 kg by dietary control, did achieve a fasting blood glucose 6.0 mmol·l–1 after addition of 20 mg glipizide daily. They had a sustained (2 years) increase in meal-induced insulin secretion (32% increase in postprandial C-peptide AUC), and a sustained reduction in postprandial hyperglycaemia (34% reduction in AUC). Ten of the patients took a mean daily dose <5mg (4.8 mg) and had a sustained increase in insulin secretion rate (increased C-peptide slope). The 15 patients had no elevation of basal insulin secretion and no impairment of weight reduction. The remaining 8 subjects, who showed little or no weight reduction on dietary control, had little or no reduction in fasting blood glucose despite long-term treatment with 20 mg glipizide daily, a less sustained increase in meal-induced insulin secretion, a smaller reduction of postprandial hyperglycaemia, and an increase in body weight. On diagnosis the 8 subjects did not differ from the other 15 subjects in age, body weight, blood glucose, HbA1c, C-peptide or insulin, nor in their glucose and insulin responses to a test dose of glipizide; the main reason for the apparent drug failure appeared to be deficient compliance with dietary regulation rather than a primary inability to respond to sulphonylurea treatment. The findings indicate that glipizide is able to promote and maintain increased meal-induced insulin secretion and near-normal fasting and non-fasting blood glucose levels without continuous B cell stimulation. However, these improvements prevail mainly in subjects who persist with hypocaloric dietary regulation.  相似文献   

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目的分析心理护理干预对2型糖尿病患者血糖控制的影响。方法纳入实验病例来自我院2013年7月~2015年3月收治的2型糖尿病患者者74例,将其随机分为两组,每组37例,A组患者开展一般性常规护理,B组患者强化心理护理的应用。评估两组患者SCL-90量表评分、干预前后血糖水平的变化、护理满意率和低血糖反应发生率、血糖达标率。结果 B组患者干预后SCL-90量表评分、血糖水平改善更显著(P0.05)。B组护理满意率、血糖达标率明显高于A组,低血糖反应发生率明显少于A组(P0.05)。结论心理护理干预对2型糖尿病患者血糖控制的影响大,可有效改善患者负性情绪和控制血糖,提高血糖达标率,减少低血糖反应发生率,提升患者满意度,值得推广。  相似文献   

20.
2型糖尿病是我国主要慢性疾病之一,而其控制状况不容乐观。降糖药物的使用是控制血糖的重要利器之一,糖尿病的药物治疗按作用机制和结构主要分为胰岛素促泌剂、双胍类、噻唑烷二酮类药物、糖苷酶抑制剂、DPP-Ⅳ抑制剂、GLP-1、胰岛素及其类似物等。本文概述临床常用降糖药物的药理机制、作用特点及其特性,并提出适时启用胰岛素、简单化原则、合理联用、个体化原则及兼顾安全性、性价比的合理使用降糖药物策略。  相似文献   

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