糖尿病与牙周病关系研究

目的初步探讨糖尿病与牙周病之间的关系。方法选择44例已诊断为2型糖尿病的患者为糖尿病组,选择40例非糖尿病患者作为对照组。对糖尿病组和对照组进行相同的牙周疾病状况调查。对44例2型糖尿病患者中的18例进行牙周基础治疗,8周后再次进行牙周状况和血糖生化检查。结果糖尿病组的牙周病变程度大于对照组。牙周基础治疗后,伴糖尿病牙周病患者的牙周病变和糖尿病症状都得到一定程度缓解。结论糖尿病和牙周病之间相互影响。糖尿病患者患牙周病几率较高;通过对牙周病的治疗能在一定程度上缓解糖尿病症状。     

糖尿病与非糖尿病患者口腔疾病的对比

目的:分析糖尿病患者和非糖尿病患者在常见口腔疾病上的异同,指导糖尿病患者的口腔疾病诊治。方法:分别对糖尿病口腔疾病患者114例和非糖尿病口腔疾病患者120例的牙周炎、龋病、牙缺失和口腔黏膜炎等口腔疾病进行调查分析。结果:糖尿病患者牙周炎、龋病、牙缺失和口腔黏膜炎等的患病率显著高于非糖尿病患者。结论:糖尿病患者的口腔疾病患病率很高,为了降低其患病率,要加强糖尿病患者口腔卫生知识的宣教,养成良好口腔卫生习惯。     

不同健康教育模式对糖尿病合并高脂血症的疗效比较

1996年,国际糖尿病联盟提出糖尿病治疗的“五驾马车”理论,将糖尿病教育列为糖尿病5项基本治疗措施之一,凸显了糖尿病健康教育的重要性。糖尿病健康教育是糖尿病治疗的基石和关键,它对糖尿病的控制和管理具有明显的促进作用,可改善患者的血糖、血压、血脂水平,降低并发症的发生率、提高患者的生活质量。近年来糖尿病健康教育引起了世界卫生组织、国际糖尿病联盟和国内外糖尿病专家的高度重视,并已出现了多种教育模式。本文旨在探讨不同健康教育模式在糖尿病合并高血脂患者血糖、血脂控制中的作用。     

糖尿病预测模型用于筛选糖尿病高危人群的价值探讨

目的:探讨及时准确的糖尿病预测及生活干预对延缓糖尿病前期和糖尿病发病进程的应用效果。方法:研究分析T2DM和PDM的相关危险因素及本地区T2DM和IGR的流行情况,制定糖尿病危险评分量表开展糖尿病高危人群的筛查工作,并对高危人群予以为期2年的干预,对糖尿病前期人群进行相应的健康教育及生活方式干预,评估干预前后社区居民2型糖尿病高危人群知晓率以及相关健康指标。结果:糖尿病模型测试筛查和生活干预后糖尿病前期人群的血糖平均下降1.53mmmol/L,有效率为85.3%。结论:以社区为单位的对糖尿病高危人群进行糖尿病预测并实施干预,可以延缓糖尿病和糖尿病前期的发病进程,并提高高危人群生活质量,降低糖尿病并发症的风险。     

Ⅱ型糖尿病的用药原则分析

糖尿病是一种胰岛素相对或绝对不足引起的糖脂代谢紊乱综合征,主要临床症状为长期慢性高血糖。随着人类生活水平的提高,糖尿病的发病率逐渐升高。自1980—2010年,成人糖尿病患者人数从1．53亿上升至3．47亿[1],同时因糖尿病并发症如糖尿病肝病、糖尿病脑病和糖尿病肾病等引起的致死率也不断提高,糖尿病已成为威胁人类生命健康的第三大非传染性疾病。糖尿病一般分为3种类型,即I型糖尿病、Ⅱ型糖尿病和妊娠糖尿病,其中Ⅱ型糖尿病占全部糖尿病的90％以上,是糖尿病发病的主体,其治疗是目前临床关注的重点。     

妊娠期糖尿病人保健指导体会

妊娠期间的糖尿病包括两种情况：一种是妊娠前已有糖尿病的患者妊娠,称为妊娠合并糖尿病;另一种为妊娠后首次发现或发病的糖尿病,又称为妊娠期糖尿病（gestational diabetes mellitus,GDM）。妊娠期糖尿病是糖尿病的一种特殊类型,糖尿病孕妇中80%以上为妊娠期糖尿病。它严重危害母儿的健康。妊娠期糖尿病控制不良可以导致母体和胎儿近期和远期严重并发症和合并症。所以在孕期进行严格管理十分必要。     

常见糖尿病慢性并发症的药物研发进展

糖尿病慢性并发症是由糖尿病病变转化而来的一系列慢性疾病,常见的主要包括糖尿病肾病、糖尿病视网膜病变和糖尿病神经病变等,严重影响着人们的生活。目前直接治疗糖尿病慢性并发症的药物很少,为了研发出治疗这些病的药物,各国的科研人员正在做不懈的努力。将对糖尿病肾病、糖尿病视网膜病变和糖尿病神经病变三大慢性并发症的药物研发进展进行综述。     

浅谈糖尿病患者心电图改变与临床关系的分析

长期患糖尿病可引起多个系统器官的慢性并发症,其中心血管系统疾病,尤其是心脏疾病的危害最大。糖尿病专家将糖尿病患者所并发的心脏疾患统称为糖尿病性心脏病,这类病变包括糖尿病心肌病、与糖尿病有关的冠心病和高血压性心脏病,以及微血管病变和自律神经功能紊乱所致的心率、心律和心功能失常。据世界卫生组织统计,糖尿病患者死亡率最高的为心血管病变约占42%,其次是肾病和糖尿病。     

冠心病合并糖尿病与下肢血管动脉硬化关系的研究

目的:探讨下肢血管动脉硬化病变与冠心病和(或)糖尿病发生的关系及预测价值。方法:因心律失常、胸痛等症状入院的患者353例,根据有无冠心病和有无糖尿病分为糖尿病不合并冠心病组、糖尿病合并冠心病组、无糖尿病不合并冠心病组和无糖尿病合并冠心病组。于冠脉造影前进行下肢血管超声检查,观察斑块形成和血管内径(D)。结果:糖尿病患者较非糖尿病患者股动脉粥样硬化检出率增高,无糖尿病亦无冠心病患者股动脉斑块发生率极低,糖尿病不合并冠心病患者与冠心病不合并糖尿病患者下肢血管情况相似(P>0.05),斑块发生均明显高于无糖尿病亦无冠心病的患者(P<0.01),但明显低于糖尿病合并冠心病的患者(P<0.01或P<0.05),糖尿病合并冠心病患者其冠状动脉狭窄程度重,多为多支血管病变。结论:检测下肢血管动脉硬化斑块,对糖尿病和(或)冠心病患者冠状动脉硬化程度的预测具有重要意义。     

浅谈2型糖尿病的基因检测

<正>糖尿病是一种慢性病、常见病、多发病,根据世界卫生组织估计,全球糖尿病患者到2025年将达3亿[1]。我国已经成为全球第一糖尿病大国。2010版中国糖尿病指南指出20岁以上糖尿病患病率9.7%,大约10人有1人是糖尿病,这是令人震惊的事实!糖尿病分为1型糖尿病、2型糖尿病、妊娠期糖尿病、其他特殊类型糖尿病四种。其中2型糖尿病占95%。2型糖尿病发病原因不明,但公认的是遗传和外界因     

The costs of nephropathy in type II diabetes

Diabetic nephropathy was first described in patients with non-insulin-dependent diabetes mellitus (NIDDM, type II diabetes) by Kimmelstiel and Wilson in 1936. It is a classical, late diabetic complication, diagnosed by measurement of the urinary albumin or total protein excretion, and typically develops after more than 15 years of diabetes. As most studies of patients with type II diabetes have been performed in White, European or North American populations in which the highest incidence of this disease is recorded in individuals aged over 70 years, a low prevalence has generally been found in these patients. Nephropathy has been considered a rare complication in type II diabetes patients. Other ethnic groups such as Pima Indians in the USA or Pacific Islanders have totally different incidence patterns of type II diabetes, with a high incidence in the 20- to 50-year age group. These patients live long enough to develop nephropathy, and they do so at the same rate as insulin-dependent diabetes mellitus (IDDM, type I diabetes) patients. Since the prevalence of type II diabetes is increasing worldwide, particularly in the developing world, diabetic nephropathy will be a growing problem in patients with this disease. From our experience in the treatment of type I diabetes patients, we know that prevention of end-stage renal failure is possible in most patients, but that treatment of end-stage renal disease is very expensive. In this paper, some of the major risk factors for the development of nephropathy are discussed together with the potential for treatment. It is shown that, in type I diabetes patients, early detection by screening for microalbuminuria and immediate recourse to antihypertensive treatment are likely to increase life-expectancy significantly while at the same time reducing the total costs to healthcare. Whether this is also the case in patients with type II diabetes is less clear, as most of the controlled clinical trials of the effect of strict metabolic control or antihypertensive treatment have been performed in patients with type I diabetes. Thus, clinical trials in patients with type II diabetes should be performed, and further epidemiological data relating to these patients are needed.     

An overview of salsalate as a potential antidiabetic therapy

The incidence of type 2 diabetes is increasing at an alarming rate throughout the world. This is in large part due to the increase in obesity and the aging of the population. Therefore, new medications to combat type 2 diabetes are needed. Salicylates have been used as analgesics and antiinflammatory agents for several decades. Incidentally, in some studies it was noted that high-dose salicylate treatment reduced blood glucose concentrations. Recently, inflammation has been strongly associated with insulin resistance and diabetes. Some studies show that salsalate, which is a nonacetylated form of salicylate, reduces blood glucose concentrations in patients with type 2 diabetes, as well as in insulin-resistant patients without diabetes. Postulated mechanisms include the inhibition of nuclear factor NF-kappa-B. Discussed in this review are the efficacy, safety and mechanisms of salsalate relevant to the treatment of type 2 diabetes.     

社区中西医结合糖尿病防治管理探索

社区糖尿病管理可有效改善患者自我管理行为,本文以糖尿病的中西医结合防治为切入点,综合分析中西医结合的手段防治糖尿病的优势,社区中西医结合糖尿病管理团队的建立,加强健康教育,提高患者的治疗依从性;以八纲辨证为纲、脏腑辨证为目,系统地辨证探讨社区中西医结合糖尿病防治管理体系的实践和进展,为更全面、系统、有效地开展中西医结合社区糖尿病防治工作奠定基础。     

临床药师参与糖尿病患者分级诊疗模式探讨

摘 要分级诊疗是按照疾病进行分级,不同级别医疗机构承担不同的疾病,实现基层首诊和双向转诊。糖尿病作为常见的慢性病之一,严重地威胁着人类健康,分级诊疗模式有利于控制血糖,推动慢性疾病的综合管理。临床药师作为兼具医学和药学的专业人员,在糖尿病分级诊疗中可以提供药学服务,促进合理用药。本文对目前国内外分级诊疗模式（结合糖尿病）及临床药师参与糖尿病分级诊疗的方式进行总结与概述,以期为糖尿病综合管理提供新的思路。     

糖尿病的理论分析与临床研究

糖尿病是终身性疾病,并发症可导致全身多个脏器功能损害;严重困扰着广大疾病患者的生存质量,人们的遗传易感性与糖尿病家族史紧密相关,加以高度重视,及早预防、早诊断、早治疗,为糖尿患者创造一个温馨舒适,健康优美的生存环境,提高他们的生存质量,注重全民健康教育。健康教育是公认的治疗成败的关键,充分调动患者的主观能动性,积极配合治疗,有利于疾病控制达标。严防各种并发症的发生和发展。随着医学的飞速发展,在药物治疗,胰岛素治疗的基础上,相继研发并临床应用胰岛素泵的科研工作已被广泛应用到部分病患者的治疗上。更待进一步的推广使用,造福于民。     

松叶消渴方治疗2型糖尿病的临床观察

目的探讨松叶消渴方在预防和治疗2型糖尿病及其并发症方面的临床意义,发挥中医的治疗优势。方法将196例符合标准的2型糖尿病患者进行随机分为两组(对照组和治疗组),对照组按常规西药治疗,治疗组在对照组的基础上再给予松叶消渴方加减治疗。每3个月为1个疗程。两组患者均每隔1周复查血糖和糖化血红蛋白,每3个月排查或监控并发症情况。按照血糖和糖化血红蛋白控制情况以及并发症发生率或控制效果评判疗效,总结评判松叶消渴方的临床疗效。结果治疗组患者总有效率为92.86%,明显优于对照组的82.65%,差异有统计学意义(P<0.05)。结论松叶消渴方治疗、预防2型糖尿病及其并发症具有良好效果。     

Muraglitazar: an agent for the treatment of type 2 diabetes and associated dyslipidemia

Many studies indicate that postprandial metabolic abnormalities, such as hyperglycemia and dyslipidemia, which are exaggerated and prolonged in type 2 diabetes, are important risk factors for cardiovascular disease. Different pharmacotherapies have been developed to specifically target these risk factors associated with type 2 diabetes. The peroxisome proliferator-activated receptor (PPAR) agonists, which are potent insulin sensitizers, have been the focus of much research during the past decade. Since their development, PPAR agonists have emerged as an important target for the treatment of insulin resistance and dyslipidemia. The more recent development of agonists that selectively target both the alpha and gamma PPARs has provided a potential treatment of global risk in patients with the metabolic syndrome or type 2 diabetes. Muraglitazar is a non-thiazolidinedione, oxybenzylglycine dual PPARalpha/gamma agonist that is in advanced clinical development for the treatment of type 2 diabetes and its associated dyslipidemia. This article summarizes the available clinical data on the efficacy and safety of muraglitazar in patients with type 2 diabetes.     

Stavudine extended release (once-daily,Bristol-Myers Squibb) for the treatment of HIV/AIDS

Exenatide is a glucagon-like peptide 1 receptor agonist, which has recently received FDA approval in the US for the treatment of Type 2 diabetes. Exenatide is an incretin mimetic that improves glycaemic control in patients with diabetes through acute mechanisms, such as glucose-dependent stimulation of insulin secretion, suppression of inappropriate glucagon secretion and slowing of gastric emptying, as well as chronic mechanisms that include enhancement of β-cell mass in rodent studies and weight loss and inhibition of food intake in humans. This article reviews the mechanisms of exenatide action, as well as its efficacy in the treatment of Type 2 diabetes.     

中医院住院糖尿病患者药学监护模式的构建与实施

目的：探讨住院糖尿病患者药学监护模式。方法：通过临床药师对糖尿病患者的药学监护为例,依据三甲中医医院糖尿病专科实际情况,制订了住院糖尿病患者的药学服务路径及服务内容,按照服务路径监护并实施。结果：依据药学服务路径进行监护,糖尿病患者得到更好的药学服务,不合理用药、药品不良事件得到及时发现并干预,患者综合治疗效果得到提高。结论：建立医院糖尿病专科的临床药学服务工作模式,为临床药师全面参与临床药物治疗工作提供参考,有利于对糖尿病患者进行有效的用药管理,保障患者用药安全有效。     

Exenatide: a GLP-1 receptor agonist as novel therapy for Type 2 diabetes mellitus

Exenatide is a glucagon-like peptide 1 receptor agonist, which has recently received FDA approval in the US for the treatment of Type 2 diabetes. Exenatide is an incretin mimetic that improves glycaemic control in patients with diabetes through acute mechanisms, such as glucose-dependent stimulation of insulin secretion, suppression of inappropriate glucagon secretion and slowing of gastric emptying, as well as chronic mechanisms that include enhancement of beta-cell mass in rodent studies and weight loss and inhibition of food intake in humans. This article reviews the mechanisms of exenatide action, as well as its efficacy in the treatment of Type 2 diabetes.