强化教育干预对初诊2型糖尿病患者治疗效果及费用的影响

目的 研究初诊2型糖尿病患者强化健康教育干预的效果及医疗费用.方法 收集初诊2型糖尿病患者324例,随机分为两组,干预组(健康教育强化治疗组)159例,子糖尿病健康教育强化治疗,每周安排两次健康教育讲座,每次1～2 h,8次为1个周期.对照组(健康教育传统治疗组)165例,予一般性糖尿病健康教育,以自学为主,宣传资料内...     

452例2型糖尿病患者并发症的临床分析

目的通过对452例2型糖尿病患者并发症的回顾性分析,了解糖尿病并发症发病情况及相关因素,为针对性防治措施提供科学依据.方法收取我院2002年至2003年住院病人中按WHO标准确诊为2型糖尿病的病例452例,按神经病变、糖尿病肾病、眼病、脑血管意外、心脏病及其它进行分类,再进行分析.结果单一并发症发病率最高.并发症中神经病变为最多,占43%;病程越长,平均血糖水平愈高,并发症愈多.结论糖尿病并发症与其病程,平均血糖水平相关.     

糖化血红蛋白对2型糖尿病患者脂代谢及其并发症影响的研究

目的 探讨T2DM患者HbA1c的控制情况对代谢指标及并发症的影响. 方法 276例T2DM患者根据HbA1c水平分为3组:A组HbA1c≤7％;B组7％＜HbA1c＜10％.C组HbA1c＞10％,测定血糖、血脂水平,同时进行相关并发症的筛查. 结果 (1)3组间年龄、病程、血压、TC和HDL-C差异无统计学意义(P＞0.05).随着HbA1c上升,FPG、TG和LDL-C逐渐升高,组间比较差异有统计学意义(P＜0.05);(2)随着HbA1c上升,DR、DN和冠心病(CHD)的发病率升高(P＜0.05).糖尿病周围神经病变(DNP)、糖尿病足(DF)和脑梗死的发病率组间差异无统计学意义(P＞0.05);(3)相关分析表明,HbA1c与FPG、TG呈正相关,与HDL-C呈负相关. 结论 T2DM患者HbA1c控制率低,HbA1c水平与其慢性并发症相关,控制HbA1c可更好地防治糖尿病并发症.     

2型糖尿病患者实施瑞格列奈治疗对并发症发生率及血糖指标的影响

目的 分析2型糖尿病患者采用瑞格列奈治疗对患者血糖指标及并发生发生率的影响.方法 选取该院2020年6月—2021年5月收治的84例2型糖尿病患者为研究对象,根据治疗方法的不同划分为观察组、对照组.对照组采用常规治疗治疗,观察组在此基础上使用瑞格列奈治疗,观察比较两组患者的治疗效果.结果 治疗前两组患者各项血糖指标水平...     

2型糖尿病患者的血糖控制和医疗费用的多因素分析

目的　了解中国大城市 2型糖尿病 (T2DM )患者的血糖 (PG)和糖化血红蛋白 (HbA1c)及其控制情况 ,以及影响患者医疗费用的因素。　方法　对国内 11个大城市的T2DM患者抽样调查 ,收集其疾病控制和治疗费用数据 ,以及相关的影响因素。调查的 1111例T2DM患者中 ,门诊 6 5 8例 ,住院 4 5 3例 ,采用描述统计的方法分析患者的HbA1c和PG控制情况 ,用多因素模型分析医疗费用的主要影响因素。　结果　 6 8%患者的空腹血糖 (FPG)没有得到很好控制 ( >7.0mmol/L) ,4 2 %的HbA1c控制效果不佳 ( >7.5 % )。门诊医疗费用的多因素分析中医院级别 (P <0 .0 0 1)、并发症 (P<0 .0 0 1)和末次空腹静脉血糖控制水平 (P <0 .0 5 )是影响患者就诊费用的主要因素。住院医疗费用多因素分析结果显示 ,住院天数 (P <0 .0 0 1)、医院级别、并发症 (P <0 .0 0 1)、家庭人均收入是影响患者住院费用的主要因素。　结论　中国大城市中 5 0 %左右T2DM患者按照 ( 2 0 0 2年的治疗情况 )PG和HbA1c控制效果不佳 ,并发症和PG控制效果不好是T2DM患者医疗费增多的显著因素     

2型糖尿病患者初诊时血管并发症患病率的调查分析

按ＷＨＯ多国家血管研究方案，对１９９３年患病率调查所筛选出来的２型糖尿病患者的血管病变进行了前瞻性的调查分析。ＤＭ９６６例和正常糖耐量２９９６０例（均经７５ｇＯＧＴＴ诊断）。并发症判定标准：①高血压（ＨＴ）：收缩压（ＳＢＰ）≥２１．３ｋＰａ（１６０ｍｍＨｇ）或舒张压（ＤＢＰ）≥１２ｋＰａ（９０ｍｍＨｇ）；②冠心病（ＣＨＤ）：临床症状及明尼苏达编码的心电图诊断；③微量白蛋白尿（ＭＡＵ）：尿白蛋白排出量（ＵＡＥ）２０～２００μｇ／ｍｉｎ；④脑血管病（ＣＶＤ）：采用问卷和查体调查，有阳性征象者行ＣＴ证实；⑤糖尿病视网膜病变（ＤＲ）为散瞳检查或眼底荧光造影确定。结果显示：初诊２型糖尿病患者ＨＴ、ＣＨＤ、ＣＩ和ＭＡＵ的患病率分别为３７．３７％，９．３２％，５．５３％和２１．０５％均显著地高于对照组的相应患病率（１４．４％，２．４６％，１．１９％和４．３２％）。ＤＲ的患病率为１６．６％，对照组未进行荧光造影。经多元逐步回归分析，ＦＢＳ、ＭＢＰ和ＢＭＩ升高以及血脂紊乱为其血管并发症的独立危险因素。上述并发症的患病率显著高于对照组。控制血糖和血压、保持理想体重、纠正脂质代谢紊乱等，对防止糖尿病血管并发症将起积极作用     

452例2型糖尿病患者并发症的临床分析

目的通过对452例2型糖尿病患者并发症的回顾性分析，了解糖尿病并发症发病情况及相关因素，为针对性防治措施提供科学依据。方法：收取我院2002年至2003年住院病人中按WHO标准确诊为2型糖尿病的病例452例，按神经病变、糖尿病肾病、眼病、脑血管意外、心脏病及其它进行分类，再进行分析。结果：单一并发症发病率最高。并发症中神经病变为最多，占43％；病程越长，平均血糖水平愈高，并发症愈多。结论：糖尿病并发症与其病程，平均血糖水平相关。     

2型糖尿病患者心脑血管并发症的临床分析

目的探讨2型糖尿病患者心脑血管并发症的实验室指标及高危因素。方法选择该院自2012年1月—2013年12月收治的75例2型糖尿病患者的临床资料,分析其高危因素。结果两组患者实验室检查指标对比均具有显著性差异(P<0.05),患者年龄、DBP、SBP、UALB/Cr是2型糖尿病血管并发症的重要危险因素。结论 2型糖尿病伴血管并发症患者存在更高的血糖水平,更严重的胰岛素抵抗及脂代谢紊乱问题,而年龄、血压及微量白蛋白尿是其高危因素。     

神经酰胺与2型糖尿病及其并发症的关系

神经酰胺是脂质第二信使,可在多个水平上阻断胰岛素信号转导的胰岛素受体底物-1／磷脂酰肌醇3激酶／蛋白激酶B途径并参与了肿瘤坏死因子α、游离脂肪酸所致的胰岛素抵抗。此外, 神经酰胺及其代谢产物可通过对细胞增殖、生长、凋亡的调控在2型糖尿病并发症,如动脉粥样硬化、糖尿病心肌病、糖尿病视网膜病变和糖尿病肾病的发生、发展中起重要作用。对神经酰胺作用及机制的进一步阐明将对2型糖尿病及其并发症的防治具有重要意义。     

Prevalence of Type 2 diabetes in urban and rural Chinese populations in Qingdao, China.

AIMS: To determine the prevalence of diabetes in the Chinese adult population in rural and urban areas of Qingdao city. METHODS: A population-based cross-sectional study of diabetes was performed in 12 436 (5346 men) Chinese adults (20-74 years old) from 2001 to 2002. Fasting capillary whole blood glucose test (FCG) was performed in all participants and a 2-h 75-g oral glucose tolerance test in those with FCG > or = 6.1 mmol/l following initial screening. The 1999 World Health Organization diagnostic criteria for diabetes were used. RESULTS: The age-standardized prevalence of diabetes was 6.1% (4.1% for undiagnosed and 2.1% for previously known diabetes) in adults aged 20-74 years. Diabetes prevalence increased with age up to the oldest age group (70-74); in subjects over 50 years of age, the prevalence reached 10%. Men tended to have a higher prevalence of known diabetes than women, whereas the prevalence of undiagnosed diabetes was lower in men than in women (4.6% vs. 3.3%, d.f. = 1, P = 0.001). Diabetes was more prevalent in the urban than in the rural population (6.9% vs. 5.6%, d.f. = 1, P < 0.001). However, the proportion of undiagnosed diabetes was higher in the rural than in the urban areas (70.5% vs. 58.0%, d.f. = 1, P < 0.001). CONCLUSIONS: The prevalence of Type 2 diabetes in Qingdao city is moderately high, but much higher than reported in 1996. The large proportion of undiagnosed cases of diabetes indicates the lack of public awareness of diabetes and shortage of medical facilities. In view of the huge population in China, the results of this study emphasize the need to improve the early detection and prevention of diabetes in China to prevent the emerging diabetes epidemic.     

Assessing the impact of complications on the costs of Type II diabetes

AIMS/HYPOTHESIS: 'The Cost of Diabetes in Europe - Type II (CODE-2) study' provides the first coordinated attempt to assess the total costs of managing people with Type II (non-insulin-dependent) diabetes mellitus in Europe. Type II diabetes is associated with a number of serious long-term complications, which are a major cause of morbidity, hospitalisation and mortality in diabetic patients. METHODS: Patients were divided into four broad categories defining their complication status in terms of no complications, one or more microvascular complications, one or more macrovascular complications or one or more of each microvascular and macrovascular complication. The prevalence of complications and associated costs were assessed retrospectively for 6 months. RESULTS: In total, 72% of patients in the CODE-2 study had at least one complication, with 19% having microvascular only, 10% having macrovascular only and 24% of the total having both microvascular and macrovascular complications. Of patients with microvascular complications, 28% had neuropathy, 20% renal damage, 20% retinopathy and 6.5% required treatment for eye complications. Among the patients with macrovascular complications, 18% had peripheral vascular disease, 17% angina, 12% heart failure and 9% had myocardial infarction. Percutaneous transluminal coronary angioplasty, coronary artery bypass graft or stroke occurred in 3%, 4% and 5% of the patients, respectively. In patients with both microvascular and macrovascular complications, the total cost of management was increased by up to 250% compared to those without complications. CONCLUSION/INTERPRETATION: Complications have a substantial impact on the costs of managing Type II diabetes. This study has confirmed that the prevention of diabetic complications will not only benefit patients, but potentially reduce overall healthcare expenditure.     

2型糖尿病患者下肢血管功能与胰岛素抵抗的关系

目的　研究 2型糖尿病患者下肢血管功能与胰岛素抵抗的关系　方法　 80例 (男 4 8例 ,女 32例 )无明显下肢缺血和水肿 ,皮色正常 ,足背动脉搏动存在的 2型糖尿病患者纳入研究。血管功能测定采用肢体阻抗血流图仪。胰岛素敏感指数 (ISI) =1 / FPG× FIns。胰岛素抵抗指数 (H- IR) =FPG× FIns/ 2 2 .5。观察踝趾段和膝踝段血管功能与 ISI、H- IR的相关性。　结果　 (1 )血管弹性随着ISI减低和 H- IR增高而从正常变差劣。 (2 )随着 ISI下降和 H- IR增加 ,血管阻力逐渐增加。 (3)下肢血流量与 ISI和 H- IR有关 ,ISI降低和 H- IR增加导致下肢血流量降低。　结论　在无明显的下肢缺血的临床迹象的 2型糖尿病患者中 ,下肢血管功能和胰岛素抵抗有密切的关系。胰岛素抵抗的增大可能是 2型糖尿病早期周围血管病的独立危险因素     

白脂素与2型糖尿病及其血管并发症的研究进展

白脂素(asprosin)是一种新型葡萄糖调控蛋白激素,其主要由白色脂肪细胞合成分泌。Asprosin可通过增强胰岛素抵抗、调节胰岛素分泌、影响食欲参与糖脂代谢,从而调节血糖稳态。此外,研究发现Asprosin与糖尿病大血管并发症及糖尿病微血管并发症存在较多联系,但具体机制尚不清楚。深入探讨Asprosin与糖尿病及其...     

Nonalcoholic fatty liver disease and microvascular complications in type 2 diabetes

AIM:To evaluate the correlation between nonalcoholic fatty liver disease(NAFLD) and microvascular complications in type 2 diabetes mellitus(T2DM).METHODS:Data were obtained from 1217 inpatients with T2DM(757 females,460 males;aged 63.39 ± 12.28 years).NAFLD was diagnosed by hepatic ultrasonography.Diabetic nephropathy(DN),diabetic peripheral neuropathy(DPN),and diabetic retinopathy(DR) were diagnosed according to their respective criteria.The prevalence of NAFLD and the independent correlations of clinical characteristics with NAFLD were determined by cross-tabulation and logistic regression,respectively.RESULTS:Approximately 61% of inpatients with T2DM in Qingdao,China had NAFLD,which decreased significantly with increase in age and prolonged course of diabetes.The prevalence of NAFLD in patients presenting with DN,DPN and DR was 49.4%,57.2% and 54.9%,respectively.These rates were significantly lower than those of patients without DN,DPN and DR(65.9%,65.6% and 66.1%,respectively,P < 0.05).Participants with NAFLD had greater body weight,waist circumference(WC),body mass index(BMI),fasting blood glucose(FBG),hemoglobin A1c,alanine aminotransferase,aspartate aminotransferase,γ-glutamyltransferase,blood pressure,as well as triglyceride(TG) levels and lower high-density lipoprotein(HDL) concentration than those without NAFLD(P < 0.05).NAFLD was positively correlated with BMI,WC,TG,FBG,diastolic blood pressure,and systolic blood pressure but negatively correlated with the duration of diabetes,DR,DPN,DN,and HDL.CONCLUSION:Despite the benign nature of NAFLD,efforts should be directed toward early diagnosis,intensive blood glucose and blood pressure control,and effective dyslipidemia correction.     

Knowledge of ocular complications of diabetes in community-based people with type 2 diabetes: The Fremantle Diabetes Study II

AimsTo assess knowledge of diabetes-related eye disease in Australians with type 2 diabetes and its associations with diabetic retinopathy (DR), other ocular complications and vision-related quality of life.MethodsA random sample from the Fremantle Diabetes Study Phase II cohort (n = 360) was invited to participate. Knowledge was assessed using 10 multiple-choice questions covering how diabetes affects the eyes, frequency of ophthalmic screening, risk factors, prevention, available treatments, and prognosis. DR was assessed from fundus photographs. Multiple linear regression was used to identify independent associates of the knowledge score (KS).ResultsWe included 264 participants (mean ± SD age 72.1 ± 9.2 years, 56.8% male, median [IQR] diabetes duration 15.4 [11.1–22.3] years). The mean ± SD KS out of 10 was 5.3 ± 1.8. Most (67%) participants knew diabetes can affect the eye and lead to blindness. Only 13.6% knew that DR screening intervals depend on risk factors. Those with moderate non-proliferative DR (NPDR) or worse had a better knowledge score (B = 1.37,P = 0.008) after adjusting for age (B = ?0.03, P = 0.004) and education beyond primary school (B = 1.75, P < 0.001).ConclusionsOverall knowledge of diabetes-related ocular complications was suboptimal. Education targeting eye disease may benefit people with type 2 diabetes who are older, less well educated and/or who have no DR/mild NPDR.     

sVCAM-1与2型糖尿病血管并发症关系的临床探讨

目的　探讨血清中可溶性血管细胞黏附分子 1(sVCAM 1)与 2型糖尿病 (T2DM)血管并发症的关系。　 方法 　应用酶联免疫吸附法 (ELISA)测定 86例T2DM患者和 40例健康对照者血清中sVCAM 1的水平。　 结果　所有T2DM患者血清中sVCAM 1水平显著高于健康对照组 (P <0 0 1) ;T2DM患者微血管病变组sVCAM 1水平明显高于无血管病变组 (P <0 0 5 ) ;T2DM患者大血管病变组sVCAM 1水平明显高于微血管病变组 (P <0 0 5 )。　 结论　sVCAM 1参与了T2DM血管并发症的发生发展。     

2型糖尿病及其大血管病变患者血清脂联素水平的研究

目的 探讨血清脂联素(ADP)水平及相关代谢指标与2型糖尿病(T2DM)及其大血管病变的相关性.方法 将80例2型糖尿病患者根据有无大血管病变分为无大血管病变组(30例)和伴大血管病变组(50例),并选取50例健康体检者作为对照组.检测空腹血糖(FPG)、血脂、C反应蛋白(CLRP)及血清脂联素等生化指标.酶联免疫法测定血清脂联素浓度,放射免疫法测定空腹胰岛素(FINS)浓度.计算稳态模式胰岛素抵抗指数(HOMA-IR).结果 T2DM组脂联素水平与对照组比较降低(P＜0.01);T2DM伴大血管病变组脂联素水平显著低于单纯T2DM组(P＜0.01).相关分析显示,脂联素与FPG、FINS、HOMA-IR及收缩压(SBP)呈负相关.多元逐步回归分析显示,脂联素与三酰甘油(TG)、FPG、CRP及HOMA-IR密切相关.结论 2型糖尿病及其伴大血管病变患者血清脂联素水平降低,脂联素可能延缓糖尿病及其大血管并发症的发生、发展,动态检测ADP水平对及早发现糖尿病大血管病变有临床意义.