Outpatient adjustment to insulin in patients with diabetes mellitus

Starting insulin treatment of patients with diabetes mellitus commonly takes place during hospital admission. Home blood glucose monitoring and specially trained nurses, however, enable the physician to start insulin treatment on an outpatient basis. Consistent application of this procedure starting 1-10-1986 resulted in a fall of hospital admissions from 98.3% to 13% in this category of patients. Severe hypo- or hyperglycaemic episodes did not occur. Starting insulin treatment as an outpatient is a safe and cost-saving procedure.     

Factors associated with insulin self-administration by diabetes mellitus patients in the Family Health Strategy

This cross-sectional study aimed to compare two groups of patients with diabetes mellitus treated under the Family Health Strategy, with insulin self-administration versus non-self-administration, in relation to socio-demographic variables, perceived difficulties, and the person responsible for the self-application. A total of 269 patients participated, included through simple random sampling, from 37 Family Health Strategy units in the urban area of a municipality in the State of Minas Gerais, Brazil. The self-administration group consisted of 169 individuals (62.8%), as compared to 100 (37.2%) in the non-self-administration group. Comparing the two groups, schooling was statistically significant; 45% of those who did not self-administer reported absence of physical or cognitive difficulties that might prevent them from conducting the procedure, demonstrating the potential for adherence; 90% reported needing assistance in the insulin administration process at home, and of these, 75% reported receiving assistance from family members. The Family Health Strategy favors the development of interventions centered on users' needs, encouraging them to adopt and develop self-care skills, and the results of the present study can contribute to the planning of such interventions.     

那格列奈联合甘精胰岛素治疗2型糖尿病患者的疗效观察

目的了解那格列奈联合甘精胰岛素治疗2型糖尿病患者的疗效。方法采取随机、对照的办法选取初发2型糖尿病患者50例,给予甘精胰岛素每天1次皮下注射,调整剂量使空腹血糖控制于5.0~8.0mmol/L,同时联合应用那格列奈,调整剂量使餐后2h血糖控制于8.0~10.0mmol/L,治疗2个月,观察疗效。结果 FPG,2hPG,HbA1c均明显下降(P﹤0.01),胰岛素1相分泌明显改善。结论那格列奈联合甘精胰岛素对初发2型糖尿病患者血糖有较好疗效,能明显改善胰岛素的I相分泌。     

胰岛素无针注射器在成年1型糖尿病患者中应用研究

目的 比较成年1型糖尿病(T1DM)患者采用无针注射器与胰岛素笔不同注射技术对患者的血糖控制效果、皮肤反应及安全性.方法 选取2019年1月 ～2021年6月在南京中医药大学常熟附属医院住院治疗的64例1型糖尿病患者.随机数表法均分为胰岛素笔组与无针注射器组每组各32例,入组患者均使用《中国1型糖尿病胰岛素治疗指南》中...     

妊娠期糖尿病血清脂联素水平与胰岛素抵抗的关系

目的探讨妊娠糖尿病(GDM)孕妇血清脂联素与胰岛素抵抗(IR)的关系。方法采用稳态模型评估法(HOMA)分别评估48例GDM孕妇和40例正常糖耐量(NGT)孕妇的胰岛素抵抗指数(HOMA-IR);利用放免法检测2组孕妇的血清脂联素水平。结果⑴GDM组HOMA-IR显著高于NGT组(P<0.01);⑵GDM组血清脂联素水平显著低于NGT组(P<0.01);⑶多元回归分析提示IR I、孕晚期体重指数(BM I)是影响血清脂联素水平的最显著因素(P<0.05)。结论GDM孕妇血清脂联素水平显著降低,其脂联素水平的改变与IR相关。     

Effect of chromium on the insulin resistance in patients with type II diabetes mellitus

INTRODUCTION: Chromium deficiency in diabetic patients is a debatable problem. The prevailing opinion suggests the presence of low serum concentrations in such patients and therefore an early, long-term addition of chromium to the standard therapy is recommended. PURPOSE: The aim of the present study was to evaluate the effect of chromium on the insulin resistance in diabetic patients with type II diabetes mellitus. MATERIAL AND METHODS: We have studied a total of 34 overweight patients with type II diabetes mellitus, who were distributed in two study sub-groups--patients with very good metabolic control and patients with bad control. For sixty days the patients of both groups received 30 microg of chromium picolinate as food additive. We measured the serum concentration of chromium (using atom-absorption methods), immune-reactive insulin and the insulin resistance index at baseline and at the end of the two-month period. RESULTS: The serum concentrations of chromium was significantly lower in diabetic patients than in the healthy individuals used as controls (2.18 +/- 0.87 nmol/l versus 4.03 +/- 0.96 nmol/l; p < 0.001). We found a significant decrease of the immune-reactive insulin and the insulin resistance index after a two-month application of chromium 30 microg daily (1 tablet of chrome picolinate). The effects of this trace element are analysed in the light of an improved first phase of secretion of insulin or facilitated post-receptor insulin sensibility as a way of potentiating the insulin action. CONCLUSION: Chromium included early in the complex therapy of diabetes is beneficial in the reduction of the degree of insulin resistance.     

Treatment of patients with diabetes mellitus type 2 and coronary artery disease

Of all patients presenting with coronary, artery disease, 20-30% already have a diagnosis of diabetes mellitus type 2. Of the remaining patients, another 15-20% are found at presentation to have diabetes mellitus and 30% have glucose intolerance. Both conditions are major risk factors for the recurrence of coronary artery disease and mortality. The treatment of patients with diabetes mellitus type 2 always includes improvement in lifestyle, adequate blood-glucose control, cholesterol-lowering therapy and blood-pressure control. Furthermore, if one or more other traditional cardiovascular risk factors are present, or if the patient is over 40 years of age, acetylsalicylic acid must be added. Finally, with a prior history of coronary-artery disease, patients must be given an angiotensin converting enzyme (ACE) inhibitor. During percutaneous coronary interventions, patients with diabetes mellitus type 2 are preferably treated with a drug-eluting stent in combination with clopidogrel, and in case of an acute coronary syndrome, glycoprotein (GP) IIb/IIIa receptor antagonists are added to the standard treatment.     

Differential patterns of insulin secretion and sensitivity in patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease versus patients with type 2 diabetes mellitus alone

Aim

The aim of this study was to estimate the prevalence, awareness, treatment, and control of dyslipidemia in Xinjiang, China.

Method

Stratified sampling method was used to select a representative sample of the general population including Chinese Han, Uygur, and Kazak in this geographic area. Seven cities were chosen. Based on the government records of registered residences, one participant was randomly selected from each household. The eligibility criterion for the study was?≥?35 years of age.

Results

A total of 14,618 participants (5,757 Han, 4,767 Uygur, and 4,094 Kazak), were randomly selected from 26 villages in 7 cities. The prevalence of dyslipidemia was 52.72% in the all participants. The prevalence of dyslipidemia was higher in Han than that in the other two ethnic (58.58% in Han, 48.27% in Uygur, and 49.60% in Kazak, P?<?0.000). The prevalence of dyslipidemia was higher in men than that in women (56.4% vs. 49.3%, P?<?0.000). Among the participants with dyslipidemia, the proportion of those who aware, treat, control of dyslipidemia were 53.67%, 22.51%, 17.09% in Han, 42.19%, 27.78%, 16.20% in Uygur, 37.02%, 21.11%, 17.77% in Kazak.

Conclusion

Dyslipidemia is highly prevalent in Xinjiang. The proportion of participants with dyslipidemia who were aware, treated, and controlled is unacceptably low. These results underscore the urgent need to develop national strategies to improve the prevention, detection, and treatment of dyslipidemia in Xinjiang.     

速效胰岛素类似物和短效人胰岛素持续皮下输注治疗2型糖尿病高血糖状态的疗效分析

目的 比较速效胰岛素类似物门冬胰岛素和短效人胰岛素通过持续皮下输注方法治疗2型糖尿病高血糖状态的疗效.方法 将188例血糖控制差的2型糖尿病患者随机分为门冬胰岛素组和短效人胰岛素组,给予胰岛素泵治疗1周.观察两组患者血糖达标的时间、胰岛素用量、全天8个时间点的血糖水平以及低血糖发生率,并分析其相关因素.结果 门冬胰岛素组患者血糖达标时间[(4.2±1.8)d]短于短效人胰岛素组[(6.0±2.5)d],P<0.01;门冬胰岛素组三餐后2 h及睡前血糖均低于短效人胰岛素组(P<0.05).凌晨3时及三餐前血糖两组比较,差异均无统计学意义;两组患者胰岛素用量、低血糖发生情况比较,差异均无统计学意义.结论 门冬胰岛素能更快、更有效地控制血糖,且低血糖的风险无明显增加.     

2型糖尿病患者应用胰岛素泵控制高血糖状态的疗效观察

目的比较在初诊和口服降糖药效果差的2型糖尿病(T2DM)患者中应用胰岛素泵控制高血糖状态的疗效。方法选择32例初诊的T2DM患者(NDM组)和64例口服降糖药效果差的T2DM患者(ODM组),两组血糖水平、体重指数(BMI)、年龄、性别构成等均匹配,均给予胰岛素泵强化治疗。结果(1)NDM组的血糖达标时间(GT)、胰岛素最大剂量均低于ODM组,P均<0.05。(2)多元回归分析显示,在NDM组中影响GT的主要因素为空腹血糖(FBG)、糖化血红蛋白,影响胰岛素最大剂量的因素是糖化血红蛋白、BMI;而在ODM组中影响GT的主要因素为年龄、FBG、病程,影响胰岛素最大剂量的因素是治疗前FBG和餐后2h血糖、病程。结论初诊的T2DM患者可能较口服降糖药效果差的T2DM患者对胰岛素泵降糖效果更满意。影响两组患者GT及胰岛素用量的因素不完全相同。     

妊娠期糖尿病患者血清Chemerin的变化及与胰岛素抵抗的关系

目的探讨血清趋化素(Chemerin)在妊娠期糖尿病(GDM)患者中的变化及其与胰岛素抵抗的关系。方法选择深圳市龙岗中心医院妇产科于2018年1月至2018年12月期间收治的50例妊娠期糖尿病患者为观察组,随机选择同期50例血糖筛查或OGTT正常孕妇纳入对照组;比较两组甘油三酯(TG)及总胆固醇(TC)、空腹血糖(FPG)、Chemerin水平,以及胰岛素抵抗指数(HOMA-IR)水平。分析GDM患者血清Chemerin水平与HOMA-IR之间的关系。结果观察组患者TG、TC、FPG、HOMA-IR及Chemerin水平均显著高于对照组,差异有统计学意义(t值分别为12.875、6.705、4.073、3.621、3.066,均P <0.05)。相关性统计分析显示GDM患者血清Chemerin水平与HOMA-IR呈显著正相关(r=0.454,P <0.05)。结论血清Chemerin在妊娠期糖尿病患者明显增高,且与胰岛素抵抗具有相关性,可能是妊娠期糖尿病发病的重要机制。     

妊娠糖尿病患者子代脂联素水平与胰岛素抵抗的关系

目的:探讨妊娠糖尿病(GDM)患者子代血清脂联素(APN)水平与胰岛素抵抗(IR)之间的关系。方法:检测28例GDM患者新生儿脐静脉血清、1岁儿童空腹静脉血清和20例正常糖耐量妊娠(NGT)者新生儿脐静脉血清、1岁儿童空腹静脉血清APN、胰岛素、血糖、血脂水平和体重、体重指数(BMI)。结果:①GDM组新生儿脐血清APN、胰岛素水平、体重、BMI比NGT组新生儿显著增高(P0.05),血糖比NGT组新生儿低(P0.05);直线相关分析GDM组新生儿APN与IRI、体重、体重指数呈正相关(P0.05)。②GDM组1岁儿童血清APN水平显著低于NGT组(P0.05),GDM组1岁儿童血清胰岛素、体重、BMI较NGT组高(P0.05);TG、LDL-c水平较NGT组高,HDL-c水平较NGT组低,但组间比较差异无统计学意义(P0.05);直线相关分析GDM组APN与IRI、体重、BMI呈负相关(P0.05),与血糖无关,与血脂无显著相关;回归分析结果,进入回归方程的因素有脂联素(t=2.749,P0.05)、BMI(t=3.624,P0.05)。结论:GDM患者子代血清脂联素水平与IR、体重、BMI有密切关系,GDM患者子代可能是代谢紊乱的高危人群,应受关注。