Intake of brown rice lees reduces waist circumference and improves metabolic parameters in type 2 diabetes

Intake of whole grains has been associated with lower risks of type 2 diabetes and cardiovascular disease. Brown rice is unrefined whole grain and is produced by removing the outermost layers containing the germ and bran, which are rich in nutrients including dietary fiber, vitamins, minerals, and other unmeasured dietary constituents. The lees of brown rice (LB) are by-products of its fermentation in the process of manufacturing takju, a Korean turbid rice wine. In this study, we hypothesized that intake of LB would reduce waist circumference, a strong risk factor for cardiovascular disease in type 2 diabetic patients. A randomized, double-blind, placebo-controlled study was scheduled for 12 weeks. Thirty subjects were randomly assigned to receive a supplement prepared from the LB or from a mixed-grain dietary product (MG). Body weight, waist circumference, body composition, lipid profiles, and other laboratory parameters were measured. The LB group showed greater reduction in waist circumference (LB: 87.9 ± 8.8 to 85.1 ± 9.0 cm; MG: 86.9 ± 8.8 to 86.0 ± 9.3 cm; P = .032). In addition, the consumption of LB resulted in a significantly greater decrease in the level of aspartate transaminase (LB: 25.4 ± 8.5 to 21.0 ± 5.1 IU/mL; MG: 22.5 ± 5.3 to 22.4 ± 5.7 IU/mL; P = .044) and alanine transaminase (LB: 28.6 ± 11.3 to 21.9 ± 8.2 IU/mL; MG: 24.4 ± 7.5 to 24.5 ± 9.9 IU/mL; P = .038). Consumption of the LB was associated with a decreased waist circumference in type 2 diabetic patients. Further study is required to evaluate the metabolic effect of the extract of the LB in type 2 diabetes.     

糖尿病肾病与糖尿病视网膜病变的临床相关性研究

目的 分析糖尿病视网膜病变(DR)和糖尿病肾病(DN)的临床特点及其相关性.方法 收集2004年1月至2009年6月住院的2型糖尿病患者9237例,统计DR和DN的患病率,分析其临床特点及二者的相关性.结果 住院2型糖尿病患者DR的总患病率为33.0%(3045/9237),在微量白蛋白尿、大量蛋白尿及大量蛋白尿合并肾功能损害患者中,DR患病分别为36.3%(588/1618)、53.7%(1113/2074)和70.7%(1206/1706);DN患病率为58.4%(5398/9237),与糖尿病未合并DR患者及轻度非增生性糖尿病视网膜病变(NPDR)比较,中度NPDR、重度NPDR及增生性糖尿病视网膜病变(PDR)患者尿微量白蛋白、总蛋白逐渐增加,肌酐清除率逐渐降低(P＜0.05);非条件Logistic回归分析发现与DR发病相关的危险因素包括糖尿病病程、蛋白尿、纤维蛋白原、C反应蛋白及周围神经病变,与DN发病相关的危险因素包括糖尿病病程、糖化血红蛋白、收缩压、蛋白尿、低密度脂蛋白和DR.结论 DR和DN是2型糖尿病患病率较高的慢性微血管并发症,二者具有较好的临床相关性.

Abstract：

Objective To investigate the clinical characteristics of diabetic retinopathy(DR)and diabetic nephropathy(DN)and their correlation. Methods All of 9237 hospitalized type 2 diabetes patients from January 2004 to June 2009 were collected. The prevalence and clinical of characteristics of DR and DN as well as their relationship were analyzed. Results The total prevalence of DR was 33.0%(3045/9237),and the prevalence of DR in the microalbuminuria, macroproteinuria and macroalbuminuria combined with renal dysfunction patients were 36.3%(588/1618),53.7%(1113/2074)and 70.7%(1206/1706)respectively.The prevalence of DN was 58.4%(5398/9237). Compared with that in the diabetes patients without DR, the levels of microalbumin and total protein in the urine were higher in the patients with moderate non-proliferative diabetic retinopathy(NPDR), serious NPDR and proliferative diabetic retinopathy(PDR), but the endogenous creatinine clearance rate was lower(P＜ 0.05). According to the non-conditional Logistic regression model,the risk factors of DR included diabetes duration,urinary protein,fibrinogen, C-reactive protein and peripheral neuropathy, and the risk factors of DN included diabetes duration, HbA1c, systolic blood pressure,urinary protein,low density lipoprotein and DR. Conclusions DR and DN are the chronic microvascular complications in the type 2 diabetes and have higher prevalence. There are good correlations between DR and DN.     

Statut magnésique dans une population marocaine de patients diabétiques de type 2

Blood and urinary samples from 121 patients with type 2 diabetes mellitus and 51 healthy controls, were analysed for blood glucose, glycosylated Haemoglobin, total cholesterol and its fractions, triglycerides, serum creatinine, microalbuminuia, magnesium (plasma, erythrocyte and urinary).Diabetic patients had significantly lower plasma and erythrocyte magnesium comparatively to healthy control (P Mg: 0.83±0.09 mmol/L vs 0.90±0.06 mmol/L, P<0.001) (E Mg : 1.42±0.64 mmol/L vs 2.01±0.6 ; P<0.001). whereas the urinary magnesium excretion in diabetic patients and control group is not significantly different (U Mg : 6,47±3 mmol/24 heures vs 6,82±2,44 mmol/24 heures, P=0,48).Plasma and erythrocyte magnesium in diabetic patients was negatively correlated with glucose blood, and HbA1c (P Mg vs HbA1c: P=0,016, r =−0,22), (E Mg vs HbA1c : P=0,012, r =−0,23), whereas there is no correlation with lipids parameters.We also note that plasma magnesium concentrations are lower in diabetic patients with retinopathy compared to those without retinopathy (0,80±0,10 mmol/L vs 0.84±0,08; P=0.035).Conclusion: Magnesium depletion is most common in our population, particularly in uncontrolled diabetic patients, with a weakly significant relationship with diabetic retinopathy.     

Determination of free L-carnitine levels in type II diabetic women with and without complications

BACKGROUND: Studies on the determination of carnitine levels and nutritional status in patients of type II diabetes. OBJECTIVE: We designed this study to determine changes of serum-free L-carnitine in type II diabetic women. DESIGN: A cross-sectional study (case-control study). SETTING: Clinical of Endocrinology and Metabolism, Sina Hospital, Pharmacological Research Center, Tabriz Medical university, Iran. PATIENTS AND METHODS: Taking into account the importance of the control of diabetes, in the present case-control study, the levels of serum-free L-carnitine, blood glucose and lipids, systolic and diastolic blood pressure, body mass index (BMI) and nutritional status assessed in the case and control groups which were selected by the simple sampling method. The control group (n=18) included patients with no complications and the case group (n=33) was grouped into three subgroups including patients with retinopathy, hyperlipidemia and neuropathy. RESULTS: Study results indicated that the mean serum-free L-carnitine concentration in the case group was significantly lower than its mean concentration level in the control group, 39.63+/-8.99 vs 53.42+/-0.93 micromol/l, respectively (P<0.001). Serum-free L-carnitine in retinopathy, hyperlipidemia and neuropathy case subgroups were 39.03+/-9.89, 39.63+/-8.99 and 40.44+/-12.50 micromol/l, respectively (P>0.05). No significant difference was found between the serum-free carnitine levels of the case subgroups. The mean blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol levels and systolic and diastolic blood pressure were significantly higher in the case group than in the control group. CONCLUSION: In this study, the mean serum-free L-carnitine levels in diabetic patients with complications was almost 25% lower than in diabetic patients with no complications. On the basis of the study results, carnitine supplementation in diabetic patients, especially in patients with diabetes complications, might be useful.     

Glycaemic control and microvascular complications in a large cohort of Italian Type 1 diabetic out-patients

The purpose of this cross-sectional study was to evaluate the degree of metabolic control, the prevalence of microvascular complications (nephropathy, retinopathy, and peripheral neuropathy) and their association with risk factors for cardiovascular diseases in all adult Type 1 diabetic out-patients attending 2 Diabetes Clinics of Northern Italy over 12 months. A total of 458 patients (mean age 37 +/- 12 yr, duration of diabetes 15.3 +/- 10.6 yr, BMI 23.2 +/- 3.1 kg/m2) were studied. Clinical characteristics and microvascular complications were evaluated. The proportion of patients with a good glycaemic control (HbA1c < 7%) was 14.7%. Nephropathy was observed in 24.4%, retinopathy in 41%, peripheral neuropathy in 23.7%. The prevalence of hypertension was 30.3%. Microvascular complications were associated with age, duration of diabetes, systolic blood pressure, creatinine, triglycerides and cholesterol plasma levels. Mean HbA1c was 8.5 +/- 1.6. Patients with HbA1c levels < 7% presented a lower prevalence of complications and lower levels of cholesterol, triglycerides, systolic blood pressure than patients with HbA1c > 9%. Our study indicates that an acceptable metabolic control is achieved in a too low proportion of Type 1 diabetic patients, even under multiple insulin injections. The association of poor metabolic control and microalbuminuria identifies a group of patients at higher risk of diabetic complications.     

上海市中心城区2型糖尿病患者视网膜病变现况调查

目的评价上海市中心城区成年人2型糖尿病患者糖尿病视网膜病变的患病率及相关因素。方法采用整群抽样方法选取上海市中心城区30岁以上已诊断为2型糖尿病的患者1039例，其中资料完整者767例纳入本研究。结果（1）767例患者完成1534张眼底摄片，其中不能分级者95例（12．4％），可以分级者672例（87．6％）；（2）非增殖期糖尿病视网膜病变145例，占可分级2型糖尿病患者的21．6％，其中轻度59例（8．8％）、中度75例（11．2％）、重度11例（1．6％），增殖期糖尿病视网膜病变9例（1．3％）；（3）糖尿病视网膜病变者较非病变者年龄更长，糖化血红蛋白、尿素氮和肌酐更高，逐步logistic回归分析显示糖尿病病程及空腹血糖水平为糖尿病视网膜病变的危险因素。结论上海市中心城区30岁以上已诊断2型糖尿病患者视网膜病变的现患率为22．9％，空腹血糖和糖尿病病程是影响因素。     

Assessment of vitamin B6 status in Korean patients with newly diagnosed type 2 diabetes

The purpose of this study was to assess vitamin B₆ intake and status in Korean patients with newly diagnosed type 2 diabetes. Sixty-four patients with newly diagnosed type 2 diabetes and 8-11% glycated hemoglobin (A1C), along with 28 age-matched non-diabetic subjects, participated. Dietary vitamin B₆ intake was estimated by the 24 hour recall method and plasma pyridoxal 5''-phosphate (PLP) was measured. There was a significant difference in daily total calorie intake between the diabetic and non-diabetic groups (1,917 ± 376 vs 2,093 ± 311 kcal). There were no differences in intake of total vitamin B₆ (2.51 ± 0.91 vs 2.53 ± 0.81 mg/d) or vitamin B₆/1,000 kcal (1.31 ± 0.42 vs 1.20 ± 0.32 mg) between the diabetic and non-diabetic groups, andI intakes of total vitamin B₆ were above the Korean RDA in both groups (180.0 ± 57.9 vs 179.0 ± 65.4). There was a higher percentage of diabetic subjects whose plasma PLP concentration was < 30 nmol/L compared to non-diabetic group. Plasma PLP levels tended to be lower in the diabetic subjects than in the non-diabetic subjects, although the difference was not statistically significant due to a large standard deviation (80.0 ± 61.2 nmol/L vs 68.2 ± 38.5 nmol/L). Nevertheless, plasma PLP levels should be monitored in pre-diabetic patients with diabetic risk factors as well as in newly diagnosed diabetic patients for long-term management of diabetes, even though this factor is not a major risk factor that contributes to the development of degenerative complications in certain patients.     

Asymptomatic bacteriuria in type 2 Iranian diabetic women: a cross sectional study

Background  

The risk of developing infection in diabetic patients is higher and urinary tract is the most common site for infection. Serious complications of urinary infection occur more commonly in diabetic patients. To study the prevalence and associates of asymptomatic bacteriuria (ASB) in women with type 2 diabetes mellitus in the Iranian population, this study was conducted.     

Evidence based therapy with insulin in diabetic patients

A fast development in therapy with insulin was observed after its discovery. Besides the widely used human regular insulin preparations, nowadays ultrashort and long-acting insulin analogues are also available for the patients. At present, the results of large clinical trials enable an evidence based diabetes care. It is well documented, that near-normoglycemia should be achieved by intensive conservative insulin treatment or pump therapy in type 1 diabetic patients. The beneficial effects of the good metabolic control could also be observed years later concerning late specific complications of diabetes. Similarly, as good as possible metabolic control should be aimed with antidiabetic treatment including insulin, if necessary, in type 2 diabetic patients. It is documented that the risk of cardiovascular complications is not increased in type 2 diabetic patients treated with insulin. Hypoglycemia and weight gain are the most important side effects of the insulin treatment. Recently, evidence based recommendations for treatment with ultrashort (insulin lispro, insulin aspart) and long-acting insulin analogues (glargine) can also be determined.     

Mulberry leaf extract restores arterial pressure in streptozotocin-induced chronic diabetic rats

Free radical-induced vascular dysfunction plays a key role in the pathogenesis of vascular disease found in chronic diabetic patients. Morus alba (MA) leaf extract is promoted for good health especially in diabetic patients. Interestingly, antidiabetic and antioxidant activities of MA have been reported in experimental animals. Thus, the hypothesis of this study was that the long-term treatment with MA could improve vascular reactivity of chronic diabetic rats. To test this hypothesis, we examined the effect of long-term treatment with MA on the vascular responses to vasoactive agents in streptozotocin-induced chronic diabetic rats. The diabetic rats were either orally administered with distilled water, MA (0.25, 0.5 and 1 g/kg per day) or subcutaneously injected with insulin (4 U/kg per day) for 8 weeks. After each treatment, the fasting blood glucose, blood pressure, vascular responses to vasoactive agents and tissue malondialdehyde were examined. Morus alba at the doses of 0.5 and 1 g/kg, which significantly reduced blood glucose level, also significantly decreased the high blood pressure in diabetic rats. Vascular responses of the chronic diabetic rats to vasodilators, acetylcholine (3-30 nmol/kg) and sodium nitroprusside (1-10 nmol/kg) were significantly suppressed by 26% to 44% and 45% to 77% respectively, whereas those to vasoconstrictor, phenylephrine (0.01-0.1 μmol/kg) were significantly increased by 23% to 38% as compared to normal rats. Interestingly, the administration of 0.5 and 1 g/kg MA or 4 U/kg insulin significantly restored the vascular reactivities of diabetic rats. Moreover, 8 weeks of diabetes resulted in the elevation of malondialdehyde content in tissues (liver, kidney, heart, and aorta), and MA treatment significantly lessened this increase. These results provide the first evidence for the efficacy of MA in restoring the vascular reactivity of diabetic rats, the mechanism of which may associate with the alleviation of oxidative stress.     

2型糖尿病患者血8-OHdG水平与大血管并发症关系的初步探讨

目的初步探讨高血糖所致氧化应激在2型糖尿病患者大血管并发症中的作用。方法检测78例2型糖尿病患者的血糖化血红蛋白（HbAlC）及8．羟基脱氧鸟嘌呤（8-OHdG）水平。其中32例合并大血管并发症作为实验组,46例无并发症为对照组。8-OHdG检测采用酶联免疫吸附法（ELISA）。结果实验组血8-OHdG水平为（2．93±1．37）ng／mL,与对照组（2．67±1．30）ng／mL相比有上升趋势,但两者比较差异无统计学意义（P〉0．05）;分别将合并各种大血管并发症患者的血8-OHdG水平与对照组相比都有上升趋势,但差异均无统计学意义（P〉0．05）;实验组的病程、年龄与对照组相比亦明显升高,差异具有统计学意义（P〈0．05）;／6-者的糖化血红蛋白水平相比差异无统计学意义（P〉0．05）。患者的血8-OHdG水平与病程呈正相关（r=0．33,P〈0．05）,而与年龄及HbAlC水平无相关（P〉0．05）。结论2型糖尿病大血管并发症的发生可能与高血糖所致氧化应激并无密切关系．而与患者的病程、年龄更相关。     

Ameliorating effects of L-carnitine on diabetic podocyte injury

High glucose levels can change podocyte gene expression and subsequently induce podocyte damage through altered glucose metabolism. l-Carnitine is known to play a beneficial role in diabetes; however, there are no studies on the effects of l-carnitine on podocyte alteration under high glucose conditions. This study investigated whether l-carnitine can attenuate diabetic podocyte injury through the prevention of loss of slit diaphragm proteins. The l-carnitine treatment group showed increased glucose uptakes compared to the control group, suggesting that glucose utilization in the podocytes was increased by l-carnitine. l-Carnitine treatment also prevented decreased mRNA expressions of nephrin and podocin in the high glucose-stimulated podocytes. However, mRNA expressions of CD2AP and α-actinin-4 were not significantly changed by the high glucose conditions. When these data are taken together, l-carnitine can increase glucose uptake in podocytes under high glucose conditions, and its mechanism may be at least partly related to the up-regulation of nephrin and podocin. Our results help clarify the beneficial effects of l-carnitine in diabetic nephropathy.     

Vitamin E Levels in Ethnic Communities in Malaysia and Its Relation to Glucose Tolerance,Insulin Resistance and Advanced Glycation End Products: A Cross-Sectional Study

Malaysian national morbidity surveys on diabetic prevalence have shown ethnical variation among prediabetic and diabetic populations. In our attempt to understand this variation, we studied the α-tocopherol, insulin resistance, β-cell function and receptor of advanced glycation end-products (RAGE) levels, as risk factors of type 2 diabetes, among the different ethnicities. In total, 299 subjects of Malay, Chinese, Indian and aboriginal Orang Asli (OA) heritage were recruited from urban and rural areas of Malaysia by stratified random sampling. Serum α-tocopherol concentrations were measured using high performance liquid chromatography (HPLC) and insulin concentrations were measured using enzyme-linked immunosorbent assay (ELISA). In subjects with pre-diabetes, OAs had the highest α-tocopherol level, followed by Chinese and Malays (0.8938, 0.8564 and 0.6948 respectively; p < 0.05). In diabetic subjects, Malays had significantly higher RAGE levels compared to Chinese and Indians (5579.31, 3473.40 and 3279.52 pg/mL respectively, p = 0.001). Low α-tocopherol level (OR = 3.021, p < 0.05) and high insulin resistance (OR = 2.423, p < 0.05) were linked strongly to the development of pre-diabetes. Low β-cell function (OR = 5.657, p < 0.001) and high RAGE level (OR = 3.244, p < 0.05) were linked strongly to the development of diabetes from pre-diabetes. These factors might be involved in the development of diabetes, along with genetic and environmental factors.     

血清成纤维细胞生长因子-21水平与2型糖尿病患者下肢动脉粥样硬化关系

目的 探讨血清成纤维细胞生长因子-21（FGF-21）水平与2型糖尿病患者下肢动脉粥样硬化的关系。方法 以2017年11月至2018年9月在重庆大足区人民医院临床确诊的2型糖尿病患者为研究对象,对患者体格项目及血生化指标进行检测,并测定患者的下肢动脉内-中膜厚度（IMT）。比较粥样硬化2型糖尿病患者和非粥样硬化糖尿病患者指标差异,并采用多元线性回归方法分析IMT与血清FGF-21的相关性。结果 共纳入2型糖尿病患者121例,无粥样硬化组69例,粥样硬化组52例,粥样硬化发生比例为43.0%。2组病例男性分别为42、31例,女性分别为27、21例,性别构成差异无统计学意义（P>0.05）。粥样硬化组病程和腰臀比均大于无粥样硬化组（均P<0.01）,平均年龄、BMI、收缩压、舒张压差异无统计学意义（均P>0.05）。粥样硬化2型糖尿病患者空腹血糖（FBG）、甘油三酯、糖化血红蛋白（HbA1c）、胰岛素抵抗指数（HOMA-IR）、IMT、FGF-21均高于非粥样硬化患者（均P<0.01）。相关分析结果显示IMT与腰臀比、FBG、HbA1c、HOMA-IR、FGF-21呈正相关关系（r=0.271、0.319、0.322、0.372、0.265,P<0.05）。多元线性回归分析显示腰臀比、FBG、FGF-21是IMT的影响因素（标准偏回归系数=0.194、0.341、0.657）。结论 2型糖尿病患者IMT与腰臀比、FBG、FGF-21有关。血清FGF-21水平升高,可能对2型糖尿病患者下肢动脉粥样硬化的形成产生了作用。     

老年2型糖尿病视网膜病变与尿白蛋白排泄率等关系探讨

目的探讨老年2型糖尿病视网膜病变的危险因素。方法55例老年2型糖尿病视网膜病变增殖期（C组）与55例老年2型糖尿病视网膜病变单纯期（B组）及55例老年2型糖尿病无视网膜病变（A组）进行临床和生化等指标的检测。结果C组与A组相比,SBP、UAER、病程、BMI、UA高于A组（P〈0.05）,Fc-p、HDL-ch、ApoA低于A组（P〈0.05）;C组与B组相比,CR、UAER、年龄、病程,UA高于B组（P〈0.05）;B组与A组相比,UAER高于A组（P〈0.05）,年龄、病程,ApoA低于A组（P〈0.05）。logistic回归分析发现尿白蛋白排泄率升高是糖尿病患者视网膜病变的危险因素。影响力度依次为尿白蛋白排泄率〉BUN〉年龄〉病程。结论为预防糖尿病视网膜病变的发生,必须严格控制血压、血糖、血脂、降低尿白蛋白排泄率。     

The Effect of a Low-Glycemic Diet vs a Standard Diet on Blood Glucose Levels and Macronutrient Intake in Children with Type 1 Diabetes

A low-glycemic index (GI) diet may lower postprandial hyperglycemia and decrease the risk for postabsorptive hypoglycemia in people with type 1 diabetes. However, insufficient evidence exists on the efficacy of a low-GI diet to support practice recommendations. The goal of this study was to examine the blood glucose response to and the macronutrient composition of low-GI meals vs usual meals consumed ad libitum at home in children with type 1 diabetes. A within-subject, crossover design was employed. Twenty-three participants were recruited between June and August 2006. Participants wore a continuous blood glucose monitoring system and completed diet diaries on 2 days. On 1 day, participants consumed their usual meal; on another day, participants consumed low-GI meals ad libidum. Order of the 2 days was counterbalanced. The mean GI was 34±6 for the low-GI day and 57±6 for the usual meal day (P<0.0001). During the low-GI day, mean daytime blood glucose values (125±28 mg/dL [6.9±1.5 nmol/L] vs 185±58 mg/dL [10.3±3.2 nmol/L], P<0.001), blood glucose area above 180 mg/dL (4,486±6,138 vs 26,707±25,038, P<0.006), and high blood glucose index (5.1±5.1 vs 13.6±7.6, P<0.001) were lower compared to the usual mean day. During the low-GI day, subjects consumed more fiber (24.5±12.3 g vs 14.5±6.1 g, P<0.007) and less fat (45.7±12.2 g vs 76.8±32.4 g, P<0.005); however, there were no differences in energy, carbohydrate, or protein intake. In this pilot study, a low-GI diet was associated with improved diet quality and a reduction in hyperglycemia.     

超敏C-反应蛋白与2型糖尿病肾病的关系

目的　探讨C -反应蛋白(CRP)与不同时期糖尿病肾病的关系。方法　采用颗粒增强免疫法测定超敏CRP(usCRP)。根据尿白蛋白排泄率(UAER)将1 0 4例2型糖尿病患者分为正常蛋白尿组(48例)、微量白蛋白尿组(30例)、临床蛋白尿组(2 6例)。另选30例作为正常对照组。观察各组血清usCRP水平。结果　2型糖尿病各组血清usCRP水平较正常对照组明显升高,且usCRP水平随白蛋白尿的增加而升高;在2型糖尿病病人中,Person相关分析显示usCRP与UAER(r =0 .6 0 7,P =0 .0 0 0 )、甘油三酯(r =0 .4 2 3,P =0 .0 0 2 )及血肌酐(r =0 .32 2 ,P =0 .0 1 9)呈正相关,逐步线性回归结果表明,UAER、甘油三酯是影响usCRP的主要因素。结论　CRP与糖尿病肾病有关,且其水平与糖尿病肾病的程度呈一致性。     

Patterns of diabetic complications at jimma university specialized hospital, southwest ethiopia

Background

Diabetes Mellitus is common metabolic disease worldwide. Its complications in the Ethiopian care setup has not been well documented. The objective of this study was to assess the pattern and distribution of diabetic complications among patients having follow-up at Jimma University specialized Hospital diabetic clinic.

Methods

A cross sectional study based on record review of 305 patients, selected using systematic sampling with replacement was carried out in October 2008. The data were analyzed using SPSS for Windows version 13.0.

Results

Larger proportion, 189 (62.0%), of patients had type II diabetes and 163 (53.4%) of them were diabetic for less than 5 years. Seventy three of the 76 (96.1%) patients with type II diabetes mellitus had hypertension. Acute complications were observed in 93 (30.5%) of the patients of which Diabetic Ketoacidosis was documented in 66(71.0%).Forty eight (45.7%) of patients had proteinuria, 90 (29.5%) had peripheral neuropathy, 13(6.8%) had impotence. Diabetic foot ulcer, skin and/or subcutaneous tissue infection, dental problems and tuberculosis were documented in 14(4.5%), 31(10.0%), 31(10.0%), and 17(5.6%) patients, respectively. Any of the chronic complications were not different by sex of the patient but age had statistically significant association with hypertension, visual disturbance and neuropathy (p< 0.05). Type of diabetes had statistically significant association with all the tested complications except infection (P<0.05) where most of the complications occurred in type II diabetics. Statistically significant association was observed between the duration of the diabetes and impotence and visual disturbances (p < 0.05).

Conclusion

The majority of patients were type II diabetics. Acute complications were observed more commonly among type I diabetics and DKA was the commonest acute complication. The frequency of chronic complications was high. Increased occurrence of retinopathy, peripheral neuropathy, hypertension and nephropathy was observed with longer duration of illness. Impotence and diabetic nephropathy were more common in type II diabetics. The study showed that age, sex, type of diabetes mellitus and duration of diabetes were significantly associated with the development of diabetic complications.     

2型糖尿病下肢血管病变发生率及危险因素分析

目的了解2型糖尿病下肢血管病变(PVD)发生率,分析PVD的相关危险因素。方法收集住院的2型糖尿病患者145例进行回顾性分析。结果多普勒超声检查提示有下肢血管病变者占72.41%。2型糖尿病PVD组年龄(66.68±9.87)岁与无PVD组(50.83±12.29)岁相比,差别有统计学意义(P<0.01),PVD组病程(8.63±6.48)a、总胆固醇(4.82±1.18)mmol/L]、低密度脂蛋白胆固醇(2.79±1.01)mmol/L,患高血压比例(74/105)也明显高于无PVD组(P<0.05)。Logistic回归分析结果表明,年龄、性别、病程、总胆固醇是PVD的独立危险因素(OR=1.151,0.098,1.142,2.021)。结论2型糖尿病下肢血管病变发生率高,年龄、性别、病程、血脂是2型糖尿病患者下肢血管病变的危险因素。     

Skin lesions in diabetic patients

OBJECTIVE: It is yet unknown the relationship between diabetes and determinants or triggering factors of skin lesions in diabetic patients. The purpose of the present study was to investigate the presence of unreported skin lesions in diabetic patients and their relationship with metabolic control of diabetes. METHODS: A total of 403 diabetic patients, 31% type 1 and 69% type 2, underwent dermatological examination in an outpatient clinic of a university hospital. The endocrine-metabolic evaluation was carried out by an endocrinologist followed by the dermatological evaluation by a dermatologist. The metabolic control of 136 patients was evaluated using glycated hemoglobin. RESULTS: High number of dermophytosis (82.6%) followed by different types of skin lesions such as acne and actinic degeneration (66.7%), pyoderma (5%), cutaneous tumors (3%) and necrobiosis lipoidic (1%) were found. Among the most common skin lesions in diabetic patients, confirmed by histopathology, there were seen necrobiosis lipoidic (2 cases, 0.4%), diabetic dermopathy (5 cases, 1.2%) and foot ulcerations (3 cases, 0.7%). Glycated hemoglobin was 7.2% in both type 1 and 2 patients with adequate metabolic control and 11.9% and 12.7% in type 1 and 2 diabetic patients, respectively, with inadequate metabolic controls. A higher prevalence of dermatophytoses was seen in the both groups with inadequate metabolic control. CONCLUSIONS: The results showed a high prevalence of skin lesions in diabetic patients, especially dermatophytoses. Thus, poor metabolic control of diabetes increases patient's susceptibility to skin infections.