老年糖尿病合并脑梗死急性期血糖水平与神经功能缺损相关性分析

本文对100例糖尿病急性脑梗死患者（DACI）的空腹血糖及病情转归的相关性进行回顾性分析,与同期住院患者非糖尿病急性脑梗死（NDACI）患者进行比较,探讨DACI患者入院时血糖水平与神经功能缺损及预后的关系.     

老年脑卒中患者血糖水平与病情变化的临床观察

老年脑卒中患者在急性发作期常发生高血糖症，但血糖水平与脑卒中的性质、神经功能缺损程度以及治疗康复效果之间的内在联系尚待研究。我们选择120例老年急性脑卒中患者为观察对象，探讨血糖水平与上述因素的临床关系。     

血糖水平与胰腺癌合并糖尿病患者术后恢复的相关性

目的 探讨血糖水平与胰腺癌合并糖尿病患者术后恢复的关系.方法 根据血糖控制水平,将68例胰腺癌合并糖尿病术后患者分为强化组（血糖控制在4.4～6.1 mmol/L）和对照组（血糖控制在6.1～11.1 mmol/L）,各34例.检测术后1、3、7d的空腹血糖（FBG）、空腹胰岛素定量（FINS）及C反应蛋白（CRP）水平,分析两组患者术后恢复情况及并发症发生情况.结果 强化组术后3d的FBG、FINS、CRP水平分别为（6.94±0.94） mmol/L、（17.38 ± 7.37） mmol/L、（108.33±37.25） mg/L,对照组分别为（7.81±1.36） mmol/L、（23.73±8.25） mmol/L、（131.51±42.34） mg/L,强化组较对照组显著降低,差异均有统计学意义（P值均＜0.05）.强化组患者术后发热时间、排气时间、抗生素使用时间分别为（1.4±0.8）、（3.1±0.7）、（2.5 ±0.5）d,显著少于对照组的（2.5±1.1）、（4.6±0.8）、（3.7 ±0.8）d,差异均有统计学意义（P值均＜0.05）.强化组切口感染率显著低于对照组（5.9％比23.5％,P＜0.05）,其他术后并发症发生率及病死率与对照组比较差异无统计学意义.结论 强化血糖控制可改善胰腺癌合并糖尿病患者术后胰岛素抵抗,减轻术后的炎性反应,促进患者恢复,且不增加术后并发症的发生率.     

298例急性脑卒中患者血糖水平与预后的相关性分析

近年来,我们共收治298例非糖尿病性脑卒中患者,现对其血糖水平与预后的关系进行相关性分析。     

老年糖尿病合并脑卒中患者应用下肢CPM训练联合综合血糖控制康复治疗的效果

目的 给予老年糖尿病合并脑卒中患者血糖控制康复治疗并应用下肢CPM(持续被动运动)训练,观察其中效果.方法 将2019年1月—2021年1月之间于该院进行治疗的老年糖尿病合并脑卒中患者作为该次研究对象,共110例,采用随机数表法分为研究组(n=55)和对照组(n=55),并分别应用血糖控制康复治疗+下肢CPM训练以及常...     

老年糖尿病患者血清糖化血红蛋白、血糖及血脂水平的相关性

正糖化血红蛋白(HbA1c)可间接反映血糖浓度的改变及机体糖代谢的状态,反映检测之前2～3个月血糖的平均水平,不受空腹及胰岛素治疗的影响。本文联合检测DM患者HbA1c、空腹血糖(FPG)、餐后2 h血糖(2 h BG)及血脂水平,探讨其在老年DM中的诊断价值,并分析各项检测指标之间的相关性。     

老年糖尿病患者血糖水平与颈动脉斑块的相关性

目的分析老年糖尿病患者血糖水平与颈动脉斑块的相关性。方法选择老年糖尿病患者80例,根据有无颈动脉斑块分为无斑块组和有斑块组,有斑块组根据斑块等级分为斑块Ⅰ、Ⅱ级组和斑块Ⅲ级组,根据糖化血红蛋白(HbA1c)控制情况以6.5%为界限分为控制良好组(HbA1c≤6.5%)和控制不良组(HbA1c6.5%)。彩色多普勒超声测定颈动脉斑块,全自动生化分析仪测定血糖和血脂情况,多功能全定量特种蛋白金标检测仪测定HbA1c。分析老年糖尿病患者血糖水平与颈动脉斑块的相关性。结果 80例糖尿病患者中,无斑块组9例,斑块Ⅰ级组13例,斑块Ⅱ级组17例,斑块Ⅲ级组41例。各组糖尿病患者的年龄、总胆固醇(TC)和甘油三酯(TG)水平比较差异显著(P0.05)。糖尿病有斑块组的HbA1c、空腹血糖(FPG)和餐后2 h血糖均高于无斑块组(P0.05)。斑块Ⅰ级组、斑块Ⅱ级组和斑块Ⅲ级组之间HbA1c、FPG和餐后2 h血糖比较差异显著(P0.05)。斑块Ⅱ级组斑块Ⅲ级组各指标均高于斑块Ⅰ级(P0.05);斑块Ⅱ级组和斑块Ⅲ级组之间无差异(P0.05)。HbA1c控制良好组和控制不良组之间的颈动脉斑块等级之间有显著差异(P0.05),糖化血红蛋白控制良好组无斑块和斑块Ⅰ级患者比例高于控制不良组(P0.05),斑块Ⅱ级和Ⅲ级患者比例低于控制不良组(P0.05)。糖尿病患者的颈动脉斑块和患者的年龄呈正相关(r=0.351,P0.05),糖尿病患者的颈动脉斑块和患者的HbA1c水平、FPG水平和餐后2 h血糖水平均呈正相关(r=0.413,0.479,0.598,P0.05),结论老年性糖尿病患者的血糖和HbA1c水平与颈动脉斑块的发生正相关,HbA1c控制良好可以改善颈动脉斑块的严重程度。     

运动对老年糖尿病患者血糖血脂水平的影响

糖尿病是一种因胰岛素分泌绝对或相对不足,导致以血糖升高为特征的危害性较大的代谢障碍性疾病。随着人们生活水平的提高和平均寿命的延长,糖尿病发病率呈逐年上升趋势。糖尿病治疗目前仍以药物治疗、饮食控制为主,并大多以控制、改善症状为目的。本研究在患者用药治疗的同时,加用运动疗法进行干预,观察运动对其血脂、血糖的影响。     

脑卒中合并糖尿病老年患者的早期康复治疗效果探讨

目的 探讨老年脑卒中合并糖尿病患者积极进行早期康复治疗对疾病治疗效果的影响.方法 于2018年7月—2020年7月抽取该院收治的80例脑卒中合并糖尿病老年患者为临床研究对象,回顾分析80例老年患者的相关资料,严格遵循随机数表法分组原则将患者分为两组.对照组40例采用常规对症治疗,观察组40例采用早期康复治疗,获取两组患...     

Relationship between blood glucose level and mortality in Type 2 diabetes mellitus: a systematic review

Aim To review the relationship between blood glucose level and mortality in patients with Type 2 diabetes mellitus (DM) as reported in the literature. Methods Literature search using Medline Search: January 1966 – April 1998. Keywords: Diabetes, Non Insulin Dependent, Mortality. Inclusion criteria for papers were: Type 2 DM; follow-up for at least 3 years; glucose or glycated haemoglobin (HbA_1c) was used as parameter; published in the form of an article. Additionally all references in the selected articles that dealt with the relationship between blood glucose level and mortality in Type 2 DM were included in the search. Results Twenty-seven eligible articles were found. Twenty-three of them showed a positive association: measures of elevated blood glucose concentrations were associated with higher mortality; in 15 out of 23 studies the positive association was statistically significant, in two only for postprandial blood glucose. One study found a nonsignificant negative relationship in a very old population. Conclusion In the literature there is a positive, but rather weak, association between the measures of blood glucose control and the risk of dying of patients with Type 2 DM. In the six larger studies (more than 100 deceased patients) that used a continuous categorization of glycaemia, the Risk ratio per unit varies from 1.03 to 1.12. Diabet. Med. 16, 2–13 (1999)     

老年高血压合并2型糖尿病患者餐后血糖与血压关系的研究

目的探讨老年高血压合并2型糖尿病患者,餐后血糖与炎症因子C-反应蛋白、脉压、昼夜血压的关系及临床意义。方法选择单纯高血压、高血压合并2型糖尿病餐后高血糖患者及健康体检者各30例,均测定空腹血糖（FPG）、餐后2h血糖（2hPG）、空腹血浆胰岛素（FINs）、糖化血红蛋白（HbAlC）、血清C-反应蛋白（CRP）,计算胰岛抵抗指数（IRI）,高血压患者行动态血压监测（ABPM）。对各组的CRP、糖代谢指标、动态血压参数等进行统计学分析,并比较高血压合并2型糖尿病餐后高血糖患者治疗前后各项指标。结果高血压合并糖尿病组FPG、2hPG、FINS、IRI、HbAlC及CRP各指标与单纯高血压组及正常对照组比较差异有统计学意义（P〈0．05）,单纯高血压组FINS、IRI及CRP高于正常对照组,差异有统计学意义（P〈0．05）;与单纯高血压患者相比,高血压合并糖尿病餐后高血糖组患者脉压（PP）增大,非杓型比率高,差异有统计学意义（P〈0．05）;高血压合并糖尿病餐后高血糖患者治疗后PP、非杓型比率下降,与治疗前比较差异有统计学意义（P〈0．05）。结论高血压与糖尿病同样存在胰岛素抵抗,高血压合并糖尿病患者,餐后血糖与CRP水平、PP、血压昼夜节律异常相关,餐后血糖的控制可能有助于夜间杓型血压的恢复,延缓动脉粥样硬化的进程。     

Gastrointestinal motor function in diabetes mellitus: Relationship to blood glucose concentrations

Abstract The application of novel investigative techniques has established that there is a high prevalence of disordered gastrointestinal motor function in patients with diabetes mellitus and has provided insights into its pathogenesis and clinical significance. Acute changes in the blood glucose concentration, even within the normal postprandial range, affect both gastrointestinal motor function and the perception of sensations arising from the gastrointestinal tract. Gastric emptying is slower during hyperglycaemia and accelerated during hypoglycaemia; the perception of gastric distension is greater during hyperglycaemia than euglycaemia. The pathways mediating the effects of the blood glucose concentration on gut motility and sensation are poorly defined. The rate of gastric emptying is an important determinant of postprandial blood glucose concentrations and there is increasing evidence that gastric emptying can be modulated therapeutically in order to optimize glycaemic control in patients with diabetes.     

2型糖尿病患者血浆Apelin-12水平与血糖的关系

目的探讨2型糖尿病患者血浆脂肪细胞因子Apelin-12水平变化及其与血糖的关系。方法选取2012年1月至2015年6月在民航总医院内分泌科住院的41例2型糖尿病患者作为研究对象,并招募44例健康对照者作为对照组。根据有无合并冠心病、脑血管病及高血压病将2型糖尿病患者再分为2型糖尿病合并心脑血管疾病组(21例)和单纯糖尿病组(20例)。酶联免疫吸附法测定Apelin-12的水平,测定其糖化血红蛋白、总胆固醇、甘油三酯、低密度脂蛋白以及空腹和餐后2 h血糖、C肽的水平,并对以上指标进行相关性分析。结果与对照组相比,2型糖尿病患者血浆Apelin-12水平显著降低(t=2.70,P=0.01); 2型糖尿病合并心脑血管疾病组血浆Apelin-12的水平与单纯糖尿病组差异无统计学意义(t=-0.44,P=0.67)。多元逐步回归分析显示,在2型糖尿病患者中,空腹血糖与Apelin-12相关(B=-0.12,β=-0.42,t=-2.03,P=0.04)。结论 2型糖尿病患者血浆Apelin-12水平显著降低且与空腹血糖呈负相关。     

卒中后首次随机血糖水平与卒中严重程度和预后的相关性研究

目的 探讨卒中患者急性期血糖水平与卒中严重程度和预后的关系.方法:根据随机血糖水平足否>7.8 mmol/L,将连续173例急性卒中患者分为随机血糖升高组(72例)和止常组(101例).平均发病至入院时间为(6.5±5.1)h,接诊20 min内对其进行美国国立卫生院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评定和格拉斯哥昏迷量表(Glasgow Coma Stroke,GCS)评分,40 min完成血浆血糖测定和头颅CT扫描,对脑梗死患者进行OCSP分型,并且在3个月后对存活患者进行改良Rankin量表(modified Rankin Stroke,mRS)评定.结果:两组在年龄、性别、血管危险因素以及卒中性质和治疗原则方面无统计学差异,首次就诊时的NHISS、GCS和3个月时的mRS评分差异显著(P<0.01).随机血糖升高组有糖尿病史的比例显著高于正常血糖组(P<0.01).在两组有糖尿病史的患者之间,随机血糖水平与卒中严重程度尤关;在无糖尿病史的患者之间,随机血糖升高与卒中严重程度和预后存在显著相关性(P<0.01).结论:无糖尿病史的卒中患者急性期血糖升高是病情严重程度和预后的独立危险因素.卒中患者急性期随机血糖升高可提示有糖尿病史.     

血糖波动与老年人糖尿病血管并发症的研究进展

对于早期2型糖尿病患者,强化降糖治疗可以降低糖尿病微血管和大血管慢性并发症的发生风险。但老年糖尿病患者多伴有重要脏器功能减退、多种疾病共存、用药复杂、血糖波动幅度大及易发低血糖等特点,而过大的血糖波动和严重的低血糖被认为与糖尿病血管并发症密切相关。因此新的治疗理念认为,对于病程较长的老年2型糖尿病患者,在控制血糖的基础上,应减少血糖波动和严重低血糖的发生,从而减少糖尿病慢性并发症的发生发展。     

Association of admission blood glucose level and clinical outcomes in elderly community‐acquired pneumonia patients with or without diabetes

IntroductionCommunity‐acquired pneumonia (CAP) is the major cause of infection‐related mortality worldwide. Patients with CAP frequently present with admission hyperglycemia.ObjectivesThe aim of this study was to evaluate the association between admission blood glucose (ABG) level and clinical outcomes in elderly CAP patients (≥80 years of age) with or without diabetes.MethodsIn this single center retrospective study, 290 elderly patients diagnosed with CAP were included. Demographic and clinical information were collected and compared. The associations between admission blood glucose level and the 30‐day mortality as well as intensive care unit (ICU) admission and invasive mechanical ventilation (IMV) in elderly CAP patients with or without diabetes were assessed.ResultsOf the 290 eligible patients with CAP, 159 (66.5%) patients were male, and 64 (22.1%) had a known history of diabetes at hospital admission. After adjusting for age and sex, the logistic regression analysis had identified several risk factors that might be associated with clinical outcomes in elderly patients with CAP. Multivariable logistic regression analysis revealed that admission glucose level > 11.1 mmol/L was significant associated with ICU admission, IMV, and 30‐day mortality both in non‐diabetic and diabetic patients. Furthermore, Kaplan–Meier analysis indicated that patients with higher admission glucose level were correlated statistically significantly with 30‐day mortality in patients with CAP (P < 0.001).ConclusionAdmission blood glucose is correlated with 30‐day hospital mortality, ICU admission, and IMV of CAP in elderly patients with and without diabetes. Specially, admission glucose > 11.1 mmol/L was a significant risk factor for 30‐day hospital mortality.     

The blood glucose lowering effects of exercise and glibenclamide in patients with Type 2 diabetes mellitus

Physical exercise is associated with a fall in serum insulin levels, whereas sulphonylurea administration increases insulin release. To date, the opposing effects of exercise and sulphonylurea administration have not been systematically studied in Type 2 diabetic patients, who are not infrequently treated with sulphonylureas. In this study nine patients with Type 2 diabetes mellitus were subjected to four treatments in random order on separate days: (A) endurance exercise after the administration of 3.5 mg glibenclamide; (B) as A but given only 1.75 mg glibenclamide; (C) as A but with placebo; (D) rest and administration of 1.75 mg glibenclamide. Exercise and placebo resulted in only a small decrease in glycaemia. Rest and administration of 1.75 mg glibenclamide led to a moderate but steady fall in blood glucose concentrations. If glibenclamide administration and exercise were combined, blood glucose concentrations declined more markedly. Serum insulin concentrations showed a physiological decrease during exercise and placebo administration. If patients rested after administration of glibenclamide serum insulin levels rose and remained elevated. When exercise and glibenclamide were combined the rise in serum insulin levels was blunted and insulin levels fell once exercise was begun. Thus, exercise attenuates the glibenclamide induced increase in serum insulin in moderately hyperglycaemic Type 2 diabetic patients. Nevertheless, exercise has a substantial hypoglycaemic effect in glibenclamide treated Type 2 diabetic patients. © 1998 John Wiley & Sons, Ltd.     

Effect of nebulized albuterol on blood glucose in patients with diabetes mellitus with and without cystic fibrosis

Over 90% of cystic fibrosis (CF) patients are treated with bronchodilators, and 6% have diabetes. Some with asthma also have diabetes, and most are treated with bronchodilators. Systemic administration of adrenergic agents can cause increases in blood glucose, but the effect of inhaled agents is unclear. A double-blind study was performed on 10 patients with type 1 diabetes mellitus (DM) without CF (3 male, 7 female, mean age 25.5 years) and 9 patients with insulin-dependent CF-related diabetes (CFRD) (8 male, 1 female, mean age 21.9 years). On 2 separate days before 9 AM fasting and the morning dose of insulin, 2.5 mg of albuterol or nebulized placebo were given. Blood glucose was measured by finger stick with a glucose reflectance meter before and 15, 30, 45, and 60 min after treatment. No significant changes from baseline or differences between placebo and albuterol occurred in either group. The mean maximum increase from baseline in DM was 20 mg/dl on placebo, and 38 mg/dl on albuterol; in the CFRD, the respective changes were 7 and 7 mg/dl. Two DM patients had a > 50 mg/dl increase on albuterol vs. placebo; no CFRD patients had differences of such magnitude. DM patients had greater increases from baseline than CFRD patients on placebo and albuterol. Differences reached statistical significance at 30 and 45 min on placebo, and 45 min on albuterol. Albuterol 2.5 mg by nebulizer causes no clinically significant increases in blood glucose in DM or CFRD patients. Diabetes patients without CF have a significantly greater increase of glucose with time (placebo or albuterol) than CFRD patients.     

高血压合并糖尿病与老年人认知功能的关系

目的探讨高血压合并糖尿病(DM)对老年人认知功能的影响。方法选取2015年6月至2016年6月期间在武警后勤学院附属医院心血管内科诊治的60~80岁患者129例。根据合并高血压和糖尿病情况分为3组:单纯高血压组(n=59)、单纯DM组(n=30)和高血压+DM组(n=40)。收集患者的一般资料,并进行简易精神状况检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)评估。结果与单纯高血压组和单纯DM组相比,高血压+DM组患者的MMSE和MoCA评分显著降低,且轻度认知障碍(MCI)发生率显著增高,差异均具有统计学意义(P0.05)。logistic回归分析结果显示,年龄、糖化血红蛋白、高血压病程、独居、痴呆家族史是认知功能减退的危险因素(P0.05),受教育年限是认知功能减退的保护因素(P0.05)。结论与单纯高血压和单纯DM患者相比,高血压合并DM会加重认知功能的减退。