牙周基础治疗对2型糖尿病牙周炎患者的综合影响

目的:研究牙周基础治疗对伴2型糖尿病的慢性牙周炎患者近期牙周状态和糖脂代谢的影响.方法:对47例伴2型糖尿病的慢性牙周炎患者在牙周基础治疗前和牙周基础治疗后1、3、6个月时行牙周临床检查,并检测患者血糖、血脂等指标,分析比较治疗前、后的差异.结果:与治疗前相比较,探诊深度和探诊出血指数在治疗后1、3、6个月时均显著降低(P<0.05),附着丧失仅在治疗后6个月时有明显降低(P<0.05);从治疗后第3个月起,患者FPG、HbAlc以及TC水平开始明显降低(P<0.05),而TG水平无明显变化(P>0.05).结论:牙周基础治疗有助于改善伴2型糖尿病慢性牙周炎患者的近期牙周状态及糖代谢水平,并对血脂代谢有一定影响.     

牙周基础治疗对2型糖尿病患者血脂代谢的影响

正糖尿病是由于糖代谢障碍引起的,以多饮、多食、多尿、消瘦为特征的代谢性疾病,严重影响患者的身心健康,2型糖尿病是糖尿病的主要类型,发病占糖尿病患者90%以上[1]。牙周病是由于革兰阴性细菌引起的一种发生在牙周支持组织的慢性感染性疾病,是导致糖尿病患者失牙的主要原因之一[2]。糖尿病和牙周炎的双向关系一直受到不少学者关注,有研究认为糖尿病伴牙周炎患者同时存在两种慢性病状态,并且互相影响[3-5]。然而,牙周炎与糖尿病的相互作用机制尚不清楚,成为牙周     

番茄红素对2型糖尿病患者慢性炎症因子的影响

目的观察番茄红素(Lyc)对2型糖尿病(T2DM)患者血清炎症因子水平的作用。方法选取T2DM患者130例随机分为:A组(干预组)64例,给予Lyc胶囊30mg/d;B组(对照组)66例,不服用Lyc但给予安慰剂;另取年龄和性别匹配的62名健康志愿者入C组(健康组)。A、B两组患者均采集入组时和干预后3个月的空腹血清,C组采集一次空腹血清,于-80℃冰箱保存待测。监测餐前、餐后2 h末梢血糖,测定生化指标,用ELISA法测定血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)水平及外周血单核细胞胞核蛋白中NF-κB水平。结果两组患者相关炎症因子基线水平明显高于C组(P<0.05);干预治疗后,两组患者空腹血糖、餐后血糖均显著降低(P<0.05)。干预后3个月A组IL-6、TNF-α、hs-CRP、NF-κB水平均显著降低(P<0.05)。B组上述炎症因子水平变化差异无统计学意义(P>0.05)。结论 T2DM患者炎症因子水平明显高于健康人群,Lyc干预可显著降低其部分炎症因子水平。     

利拉鲁肽与胰岛素联合治疗对2型糖尿病患者血糖水平及炎症指标的影响

目的 探讨利拉鲁肽与胰岛素联合治疗对2型糖尿病患者血糖水平及炎症指标的影响.方法 选择2018年3月至2019年5月本院收治的2型糖尿病患者144例,随机分为研究组和对照组,每组72例.两组患者均在三餐前给予门冬胰岛素联合睡前地特胰岛素,研究组在此基础上皮下注射利拉鲁肽.分别于治疗前和治疗6个月后检测糖化血红蛋白和血清...     

2型糖尿病伴牙周炎患者的牙周治疗研究进展

2型糖尿病和牙周炎是临床中比较常见的两大类慢性疾病,目前牙周炎被认为是糖尿病的第六大并发症,两者之间存在一定的双向性。牙周炎与糖尿病关系密切,牙周炎会加快糖尿病患者疾病进程,目前临床上糖尿病对牙周炎的影响及机制尚未明确。引起牙周炎的主要因素是细菌感染,主要表现为牙龈肿痛、牙齿松动等。2型糖尿病主要的病因是因为患者胰岛素分泌缺陷或者胰岛素作用障碍。药物治疗能有效控制牙周炎症,改善牙周组织水平;激光治疗能够更好地控制患者牙周炎症状况,也更有利于患者短期内全身炎症以及糖代谢水平的控制;正畸治疗可以改善牙周炎患者牙齿伸长、移位等,加快牙周炎的恢复。本文从2型糖尿病与牙周炎的相互关系、牙周基础治疗、药物治疗、激光治疗、正畸治疗等5个方面进行综述,为2型糖尿病伴牙周炎患者的牙周基础治疗提供参考方案。     

南京市社区2型糖尿病患者不同代谢类型肥胖及血糖控制相关性分析

目的  探讨南京市社区不同肥胖和代谢类型的2型糖尿病患者分布及血糖控制情况。方法  2021年4―6月在南京市12个区,采取多阶段分层整群随机抽样方法招募2型糖尿病患者,进行问卷调查、体格检查和临床生化指标检测。根据代谢及肥胖状态,将研究对象分为体重正常代谢正常(metabolically healthy and normal weight, MHNW)、体重正常代谢异常(metabolically unhealthy but normal weight, MUHNW)、代谢正常性肥胖(metabolically healthy obese, MHO)和代谢异常性肥胖(metabolically abnormal obese, MAO)。采用logistic回归分析模型进行多因素分析。结果  共纳入研究对象1 389名,平均年龄为(65.14±7.71)岁,男性598名(43.05%)。其中MHNW者296名(21.31%),MUHNW者319名(22.97%),MHO者109名(7.85%),MAO者665名(47.87%)。年龄越大,发生MUHNW和MAO的比例越高;女性、糖尿病病程≥5年人群中MUHNW比例较高。调查对象空腹血糖(fasting blood glucose, FPG)、糖化血红蛋白(hemoglobinA1c, HbA1c)控制达标率分别为44.92%、48.88%。多因素分析结果显示,MAO者FPG控制未达标率是MHNW者的1.525倍(OR=1.525,95% CI：1.148~2.025,P=0.004);MAO者HbA1c控制未达标率是MHNW者的1.516倍(OR=1.516,95% CI：1.140~2.016,P=0.004)。结论  南京市社区2型糖尿病患者MUHNW和MAO较多,MAO的2型糖尿病患者血糖控制较差。应对不同肥胖亚群的2型糖尿病患者进行早期识别和分类干预,能够有效控制血糖,预防糖尿病并发症的发生。     

2型糖尿病患者自我管理对血糖控制情况的影响

目的探讨2型糖尿病患者自我管理对血糖控制情况的影响。方法选取2012年4月—2014年3月收治的2型糖尿病患者108例,随机分为观察组和对照组各54例。观察组采用综合干预,提高患者自我管理能力。对照组采用常规宣教。计数资料采用χ2检验,P0.05为差异有统计学意义。结果观察组血糖控制理想率为70.4%,对照组为40.7%,两组比较差异有统计学意义(χ2=9.600,P0.05)。结论提高2型糖尿病患者自我管理能力,可改善对血糖的控制。     

2型糖尿病血糖控制对血脂影响

目的 探讨2型糖尿病血糖控制对于血脂的影响。方法 对79例2型糖尿病患者在血糖控制前后进行血糖、血脂检测,并与58名体检健康人员的血糖、血脂进行对比分析。RT-PCR法检测载脂蛋白B(APOB)基因的表达。结果 2型糖尿病患者与正常对照组比较,糖化血红蛋白(HbA1c)、甘油三酯(TG)、血清总胆固醇(TC)和低密度脂蛋白(LDL-C)显著增高;2型糖尿病患者经胰岛素治疗后,HbA1c、TG、TC和LDL-C显著降低。患病组APOB基因的表达要高于正常组,在治疗后,APOB基因表达降低,但仍高于正常组。结论 控制2型糖尿病患者的血糖水平,可以部分改善血脂异常。     

西格列汀对2型糖尿病骨质疏松骨代谢及血糖的影响

目的 探讨西格列汀对2型糖尿病合并骨质疏松者骨代谢及血糖的影响。方法 选取2019年3月—2020年6月黄河三门峡医院确诊为2型糖尿病合并骨质疏松者80例。按照随机数字表法分为两组,每组各40例。对照组使用二甲双胍,观察组在对照组基础上联合应用西格列汀,比较两组治疗1疗程后血糖相关指标,如空腹血糖、餐后2 h血糖及糖化血红蛋白水平变化;比较两组治疗1疗程后骨代谢和骨转化指标,如碱性磷酸酶水平、骨降钙素水平及血清Ⅰ型胶原交联羧基末端肽水平变化;比较治疗前后骨密度水平变化;比较两组治疗过程中糖尿病相关并发症发生情况,如高血糖、低血糖、酮症酸中毒及高渗性昏迷的总比例。结果 治疗1疗程后观察组空腹血糖和餐后2 h血糖水平低于对照组,差异有统计学意义（P <0.05）,糖化血红蛋白水平恢复正常,且低于对照组,差异有统计学意义（P <0.05）。治疗1疗程后观察组碱性磷酸酶水平、骨降钙素水平高于对照组,差异有统计学意义（P <0.05）,血清Ⅰ型胶原交联羧基末端肽水平低于对照组,差异有统计学意义（P <0.05）。治疗后两组骨密度水平均高于治疗前,且治疗后观察组骨密度水平高...     

探讨2型糖尿病患者社区牙周的干预效果

目的评价定期牙周干预对2型糖尿病伴慢性牙周炎患者的治疗效果。方法采用完全随机方法选择参加慢性病管理的2型糖尿病患者60例,再随机分为观察组和对照组各30例,并于基线治疗或检查完成后6周、3、6个月分别进行复查和复治,比较两组牙周临床指标和空腹血糖水平的变化。计量资料用t检验及重复测量资料的方差分析,P0.05为差异有统计学意义。结果基线时两组空腹血糖(fasting blood-glucose,FBG)、探诊深度(probing depth,PD)、附着丧失(attachment loss,AL)、牙菌斑指数(plaque index,PLI)、牙龈指数(gingival index,GI)差异均无统计学意义(均P0.05)。观察组不同治疗时间PD、AL、PLI、GI差异均有统计学意义(均P0.05);治疗完成后6周、3、6个月时,观察组PD、AL、PLI、GI指标均明显优于对照组,差异均有统计学意义(均P0.05)。在治疗后6个月,两组FBG水平[(7.42±1.33)、(8.89±2.06)mmol/L]差异有统计学意义(t=3.28,P0.05)。结论对2型糖尿病患者进行社区牙周干预能显著改善牙周健康及空腹血糖水平,此治疗方法可用于社区糖尿病患者基本保健服务。     

Effect of basic periodontal treatment on glycemic control and inflammation in patients with diabetes mellitus type 1 and type 2: controlled clinical trial

Objective

Compare the response of basic periodontal therapy in diabetes patients with diabetes type 1 and type 2.

Materials and methods

We selected 70 patients with periodontitis; these were divided into three groups: the control group (n?=?11), systemically healthy patients; test group 1 (n?=?14), patients with type 1 diabetes mellitus; test group 2 (n?=?27), patients with type 2 diabetes mellitus. The groups received basic periodontal treatment after clinical examination. The analyses were performed at 0, 3 and 6 months; clinical parameters included the amount of periodontal and gingival crevicular fluid. Glycated hemoglobin (HbA1c) levels and prostaglandin E2 (PGE2) expression were measured.

Results

All clinical periodontal parameters evaluated improved in both groups, as did the amount of gingival crevicular fluid. A more significant decrease in HbA1c and PGE2 expression (p?<?0.05) occurred in test group 1 after 6 months.

Conclusion

The basic periodontal treatment was more effective for glycemic control in patients with type 1 diabetes mellitus.

     

Effects of surgical periodontal therapy on serum levels of TNF-alpha in patients with chronic periodontitis

AIM: To find if serum levels of tumor necrosis factor-alpha (TNF-alpha) can change after a surgical periodontal treatment. PATIENTS AND METHODS: Moderate to severe periodontitis subjects who received basic periodontal treatment were included in the study and randomly divided into two groups. In group A, periodontal surgery was performed. In group B, supportive periodontal therapy was administered. Clinical parameters including probing pocket depth, plaque index and circulating serum TNF-alpha levels were assessed at baseline and 16 weeks following treatment. RESULTS: There was a significant improvement in periodontal health of the surgery group compared with the control subjects, with reduction in plaque index and pocket probing depths. The circulating levels of TNF-alpha decreased statistically significantly in the group A (P < 0.05). CONCLUSION: Surgical periodontal therapy can reduce the circulating serum levels of TNF-t.     

Effect of cerivastatin on serum cholesterol levels in patients with type 2 diabetes mellitus

The incidence of coronary heart disease (CHD) is greatly increased in overweight diabetic patients. Modification of dietary intake and weight loss improve hypercholesterolaemia. However, cholesterol goal levels are not achieved in several patients under this treatment. The aim of our study was to evaluate the effect of Cerivastatin, an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, in patients with type 2 diabetes mellitus. A population of 40 diabetic type 2 outpatients were analyzed in a prospective way. The mean+/-SD age was 60.7+/-11.6 years, with a diabetes duration of 8.5+/-6.6 years. All patients were treated with cerivastatin (0.2 mg once a day) for 6 months. Weight HbAlc fasting blood glucose, urine microalbuminuria, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were measured at the beginning of the study and again after 3 and 6 months of treatment with cerivastatin. An improvement in lipid levels was achieved, with a significant decrease in LDL-cholesterol (27.7%), total cholesterol (21.4%), triglycerides levels (10.4%) and a significant increase in HDL-cholesterol levels (8.3%) (P<0.05). Cardiovascular risk ratios such as; total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol improved during treatment, decreasing 11.3% and 30%, respectively (P<0.05). Low incidence of side effects was demonstrated. In summary, cerivastatin improved lipid control in patients with type 2 diabetes, with a low incidence of side effects.     

Effect of non-surgical periodontal therapy on patients with type 2 diabetes mellitus

The AIM of this study was to evaluate the effect of non-surgical therapy on clinical variables and glycemic control on type 2 diabetics with chronic periodontitis. PATIENTS AND METHODS: Forty six type 2 diabetics with chronic periodontitis were randomized into two groups (group A and group B). Treatment included scaling and root planning for group A plus systematic use of doxycycline in both groups. Assessment was made prior to and 16 weeks following the therapy. RESULTS: Analysis of data showed that both groups had clinical and glycated hemoglobin (HbAlc) improvement after the treatment. Group A had a statistically significant reduction of plaque index and bleeding on probing scores compared with controls (P < 0.05) at 16 weeks. CONCLUSION: These results suggest that non-surgical therapy is of value in maintaining periodontal health and may be beneficial in reducing blood glucose level in type 2 diabetics with chronic periodontitis.     

缓释糖类系统对高龄2型糖尿病管饲病人糖脂代谢的影响

目的:探讨缓释糖类系统对高龄2型糖尿病管饲病人糖脂代谢的影响. 方法:选择确诊为2型糖尿病的住院高龄老年管饲病人11例.在等能量的情况下,用含有缓释糖类系统的肠内营养制剂(益力佳)替代或部分替代原有的肠内营养支持液,1～3个月,观察病人血红蛋白、淋巴细胞计数、血清清蛋白、总蛋白、血糖、餐后2 h血糖、糖化血红蛋白、血脂、肾功能、电解质及胃肠道的变化. 结果:应用含缓释糖类系统的肠内营养制剂后病人的肾功能和电解质均无影响,总蛋白有所上升,使用前、后有显著性差异(P＜0.05).空腹血糖、餐后2 h血糖均有下降,差异有显著性意义(P＜0.05,＜0.001).血清三酰甘油、低密度脂蛋白、胆固醇、糖化血红蛋白均有下降,但差异无显著性意义(P＞0.05).高密度脂蛋白未出现明显的变化.肠内营养支持后,胃肠道不适症状均有不同程度的改善. 结论:含缓释糖类系统的肠内营养制剂,不仅能改善老年2型糖尿病管饲病人的糖代谢和脂代谢,还能帮助改善病人应用肠内营养后出现的胃肠道不适症状.     

团体认知行为干预对2型糖尿病患者血糖和自我管理水平的影响研究

目的 探讨团体认知行为干预对2型糖尿病患者的自我管理行为及血糖的影响。方法 944例患者以社区为单位随机分配到研究组和对照组。对照组开展常规随访,研究组在常规随访的基础上开展团体认知行为干预。比较3个月后研究组和对照组自我管理能力、糖化血红蛋白的差异。用密西根糖尿病自我管理评定量表(DCP)评估干预前后糖尿病患者的自我管理水平。干预前后2组自身情况比较采用重复测量方差分析;干预后的组间比较采用混合效应线性模型。结果 干预后,研究组HbAlc值较干预前下降,差异有统计学意义[(7.97±1.92)% vs (7.25±1.39)%;F=45.673,P＜0.001],而对照组干预前后HbAlc值差异无统计学意义[(7.92±1.77)% vs (7.68±1.93) % ;F=3.691,P=0.055]。干预前后2组自身比较,研究组除患者自我管理的坚持性因子得分差异无统计学意义之外(P=0.618),其他9个自我管理水平因子均较干预前有所提高(P值均＜0.05),对照组患者仅药物治疗问题、运动锻炼、病情控制、糖尿病知识理解自评和对疾病的态度5个因子得分较干预前有所提高(P均＜0.001);干预后,研究组的自我管理能力、饮食的依从性、病情控制问题和糖尿病知识的掌握程度均优于对照组(P＜0.05)。结论 团体认知行为干预可以提高患者的自我管理能力,改善患者的血糖水平。     

One-stage full-mouth disinfection and basic periodontal treatment in patients with diabetes mellitus

Aim

The objective of this study was to evaluate the effectiveness of two modalities of treatment through clinical periodontal parameters in glycemic control of patients with diabetes mellitus and periodontal disease.

Subjects and methods

40 patients, who had not been submitted to conventional periodontal scaling and root planning, were selected and divided into two groups: (1) conventional periodontal treatment with scaling and root planning plus mechanical control, and (2) periodontal treatment (one-stage full-mouth disinfection) plus mechanical control. The analysis was carried at 0, 3 and 6 months, including probing depth, level of clinical attachment and bleeding on probing with evaluation of glycated hemoglobin.

Results

Only group 1 showed a significant reduction in bleeding on probing, while only group 2 showed a significant reduction in probing depth. The level of clinical attachment showed improvement in both the groups after 6 months. In the glycated hemoglobin test, only group 1 significantly reduced after 6 months, while for group 2 there was a reduction after 3 months and a significant increase after 6 months.

Conclusion

We suggest that after a period of 6 months, the basic periodontal treatment is more efficient for glycemic control in patients with type 2 diabetes with periodontal disease.     

血脂康对2型糖尿病伴高脂血症患者血脂及血糖代谢的影响

目的探讨血脂康对2型糖尿病伴高脂血症患者血脂及血糖代谢的影响。方法将60例2型糖尿病伴高脂血症患者随机分为两组,在维持原糖尿病治疗方案的同时治疗组30例加服血脂康0.6g/次,2次/d;对照组30例加服复合维生素B,2片/次,2次/d。治疗前及治疗后3个月、6个月测血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白-胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、空腹血糖(FBG)及肝肾功能指标。结果治疗组与对照组比较血脂六项、FBG的变化差异均有统计学意义(P均<0.05)。结论血脂康治疗伴有高脂血症的糖尿病患者不仅能使TC、TG、LDL-C、ApoB下降,ApoA1、HDL-C升高,改善脂质代谢,还能改善糖代谢,使FBG下降。