益气养阴活血汤对2型糖尿病患者血糖、血脂及血液流变学的影响

选择2015年8月-2016年8月80例T_2DM患者,随机平分为对照组采用二甲双胍片治疗,观察组加用益气养阴活血汤治疗。结果观察组治疗后TC、HDL-C、LDL-C与血糖水平明显改善,(P0.05);治疗后,观察组患者纤维蛋白原、血浆黏度、全血低切粘度、全血高切粘度小于对照组,(P0.05);治疗期间两组均无明显不良反应发生。结论益气养阴活血汤可降低T_2DM患者血糖、血脂及血液流变学水平。     

益气养阴活血法对糖尿病合并冠心病患者的影响

目的探讨益气养阴活血法对糖尿病合并冠心病患者的影响。方法选取2014年2月—2017年4月西安市第九医院收治的糖尿病合并冠心病患者78例,采用随机数字表法分为对照组和观察组,每组39例。对照组患者予以常规西药治疗,观察组患者在对照组基础上给予益气养阴活血法治疗;两组患者均连续治疗6个月。比较两组患者临床疗效,治疗前后颈动脉内膜中层厚度(cIMT)、颈动脉斑块积分、血脂指标[包括总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、血糖指标[包括糖化血红蛋白(HbA_(1c))、空腹血糖(FPG)、餐后2 h血糖]及血清超敏C反应蛋白(hs-CRP)、高迁移率族蛋白B1(HMGB1)、网膜素1水平。结果观察组患者临床疗效优于对照组(P0.05)。治疗后观察组患者cIMT、颈动脉斑块积分、TC、TG、LDL-C、HbA_(1c)、FPG、餐后2 h血糖及血清hs-CRP、HMGB1水平低于对照组,HDL-C及血清网膜素1水平高于对照组(P0.05)。结论益气养阴活血法治疗糖尿病合并冠心病患者的临床疗效确切,可有效减轻颈动脉粥样硬化程度,改善血脂、血糖代谢,减轻炎性反应等。     

血糖血脂异常对肺结核合并2型糖尿病的影响分析

目的 探讨血糖血脂异常与肺结核(PTB)合并2型糖尿病(PTB-T2DM)的相关性,为降低PTB患病率提供新思路。方法 收集2020年9月至2021年8月于深圳市慢性病防治中心就诊的PTB病例90例(PTB组)、2型糖尿病(T2DM)病例90例(T2DM组)和PTB-T2DM病例90例(PTB-T2DM组),三组合并为试验组,本中心体检门诊就诊的健康人群60例为对照组。收集试验组和对照组全血和血清标本,采用HPLC法检测抗凝全血以测定HbA1c的百分含量,酶比色法检测血清空腹血糖(FBG)、总胆固醇(CHOL)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平,分析血糖血脂控制水平与PTB患病的关联。结果 T2DM组年龄最大,平均(57.34±9.52)岁,T2DM组和PTB-T2DM组HbA1c和FBG控制不理想的人数比例均显著高于对照组和PTB组(均P<0.05);PTB组、T2DM组和PTB-T2DM组的CHOL和LDL-C升高的人数比例均显著高于对照组(均P<0.05),T2DM组和PTB-T2DM组的TG升高的人数比例显著高...     

益气养阴活血法对2型糖尿病合并急性脑梗死患者血清VEGF表达的影响

目的 观察2型糖尿病合并急性脑梗死(ACI)患者血清血管内皮细胞生长因子(VEGF)在不同时间段变化及益气养阴活血法对其的影响.方法 将4例2型糖尿病合并ACI患者随机分为治疗组与对照组,各23例.对照组采用常规方法治疗,包括饮食疗法、降糖药物、脱水剂、脑细胞保护剂、改善脑灌注药物以及对症支持治疗.治疗组在常规治疗基础上口服加味补阳还五汤治疗.用双抗体夹心酶联免疫分析(ELISA)测定VEGF于第1天、第7天、第14天血清含量的变化.结果 两组于第1天血清VEGF水平比较无统计学意义(P＞0.05),治疗组于第7天达高峰(P＜0.01),第14天仍高于对照组(P＜0.01).结论 2型糖尿病合并ACI后血清VEGF开始升高,益气养阴活血法能够明显增加VEGF的血清含量,且能使其维持在一个较高的水平,以促进脑梗死损伤的修复.     

护理干预对2型糖尿病合并冠心病患者血糖血脂的影响

目的：探讨护理干预对2型糖尿病合并冠心病患者血糖、血脂水平的影响.方法：选择2013年9月～2014年1月我院收治的2型糖尿病并冠心病患者132例,随机分为常规护理组（66例）和加强护理组（66例,在常规护理基础上进一步加强护理）,观察半年后两组患者护理后的血糖、血脂水平的变化.结果：护理半年后,与常规护理组比较,加强护理组患者的空腹血糖[（6.73±1.39） mmol/L比（5.42±0.79） mmol/L]、餐后2h血糖[（12.07±1.43） mmol/L比（8.26±1.68） mmol/L]及总胆固醇[（194.32±21.07） mg/dl比（167.18±14.29）mg/dl]水平均显著降低（P均＜0.01）.结论：在常规护理基础上的加强护理,可显著改善2型糖尿病并冠心病患者的血糖及血脂水平,有利于病情的恢复.     

卡维地洛对稳定性冠心病合并2型糖尿病患者血糖血脂的影响

目的观察卡维地洛对稳定性冠心病合并2型糖尿病患者血糖血脂的影响。方法选择2010年1月—2013年12月该科治疗的稳定性冠心病合并2型糖尿病患者45例,全部患者根据病情给予治疗前即服用的抗血小板药物,血管紧张素转换酶抑制剂类药物、降糖药物等不变。加用卡维地洛3.125 mg bid,在1~2周内逐渐加量至25 mg/d的最大用量。服药6个月后进行疗效判定。随访:分别在患者开始服药前和服药后6个月检测空腹血糖、胰岛素水平和糖化血红水平测定及血脂(总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平)。在开始治疗后记录临床事件、患者依从性及导致患者退出试验的各种不良反应。结果加用卡维地洛6个月后患者血糖及胰岛素水平、糖化血红蛋白水平均比治疗前下降,高密度脂蛋白较前升高,总胆固醇、甘油三酯均比治疗前有下降。41例患者完成实验,其中2例发生心梗终止观察,2例患者因经济原因或用药依从性差退出试验。其余患者接受治疗后血压及心率均有下降,未见缓慢型心律失常发生,均未见诱发支气管哮喘、糖尿病并发症、低血糖及胃肠道不良反应。结论卡维地洛对稳定性冠心病合并2型糖尿病患者糖代谢及脂代谢的影响积极有益。     

湖北长盛川青砖茶对2型糖尿病合并血脂异常患者胰岛素抵抗、血脂的影响

目的观察湖北长盛川青砖茶对2型糖尿病(T2DM)患者胰岛素抵抗、血脂的影响。方法选择40例健康人为对照组。77例T2DM合并血脂异常患者随机分为饮用青砖茶组39例、基础治疗组38例。观察饮长盛川青砖茶前后稳态模型胰岛素抵抗指数(HOMA-IR)、空腹胰岛素(FIns)、白细胞介素(IL)-6、超氧化物歧化酶(SOD)、对氧磷酶(pon)3、鸢尾素(Irisin)、胰岛素用量(insulin dosage)的变化。结果青砖茶组、基础治疗组HOMA-IR、FIns、IL-6、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平显著高于对照组(P0.05,P0.01),pon3、Irisin、SOD、高密度脂蛋白胆固醇(HDL)-C显著低于对照组(P0.05,P0.01);血清pon3、Irisin、SOD水平与HOMA-IR呈负相关(P0.05,P0.01),空腹血糖(FPG)、糖化血红蛋白(HbA1c)、FIns、IL-6与HOMA-IR正相关(P0.05,P0.01);回归分析显示:pon3、Irisin、IL-6是HOMA-IR的独立影响因素。青砖茶组饮长盛川青砖茶后pon3、Irisin、SOD水平显著上升,insulin dosage、IL-6、HOMA-IR、TG显著下降(P0.05)。结论长盛川青砖茶改善了T2DM患者的胰岛素抵抗、脂代谢,减少了胰岛素用量。     

2型糖尿病合并冠心病患者行护理干预对血糖血脂的影响

目的分析2型糖尿病并冠心病患者行护理干预对血糖血脂的影响。方法回顾性分析2012年12月~2014年12月本院收治的2型糖尿病合并冠心病患者69例的临床资料,按不同护理方案分为对照组33例和研究组36例,对照组行常规护理,研究组在其基础上行护理干预,观察两组血糖血脂及并发症。结果对照组空腹、三餐后2 h的血糖水平均显著高于研究组,对照组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)的水平均显著高于研究组,高密度脂蛋白胆固醇(HDL-C)水平低于研究组,对照组并发症的发生率为39.4%,显著高于研究组的13.9%,差异均具统计学意义(P0.05)。结论 2型糖尿病合并冠心病患者行护理干预对血糖血脂的影响效果显著。     

蚓激酶对2型糖尿病患者血糖、血脂、血液流变学的影响

研究证实,蚓激酶具有溶栓、抗凝、去纤等作用,对缺血性心脑血管病疗效确切[1,2]。我们应用蚓激酶治疗2型糖尿病患者40例,并观察其对血糖、血脂、血液流变学的影响,现报告如下。对象与方法按WHO分型标准确诊的2型糖尿病患者76例,随机分为两组。治疗组40例,男18例,女22例,平均年龄498±81岁,病程2～24年;对照组36例,男16例,女20例,平均年龄501±96岁,病程3～26年。研究采取双盲法。在基础治疗上用优降糖降血糖,治疗组加蚓激酶胶囊(青岛双龙制药有限公司生产)400mg,每日3次,餐前半小时服,疗程4周。治疗前后分别查空腹血糖、血脂、血液流变。…     

益气养阴活血法对2型糖尿病脑梗死患者糖代谢指标、血管内皮功能及预后的影响

目的探讨益气养阴活血法对2型糖尿病脑梗死患者糖代谢指标、血管内皮功能及预后的影响。方法选择2014年12月至2015年12月本院接诊的100例2型糖尿病合并脑梗死的患者,通过随机数表法分为观察组和对照组,各50例。给予对照组常规的治疗方式,观察组在对照组的基础上加用益气养阴活血法。观察两组治疗前后糖代谢指标、血管内皮功能、神经缺损评分、日常生活能力评分的变化,并对治疗后临床疗效比较。结果治疗后,观察组空腹血糖(FBG)、糖化血红蛋白(HbAlc)水平均低于对照组[(7.05±1.20)mmol/L比(8.43±1.56)mmol/L,(10.27±1.01)%比(11.68±2.54)%],血管内皮细胞生长因子(VEGF)水平高于对照组[(184.24±17.91)ng/L比(153.23±15.86)ng/L],神经功能缺损评分低于对照组,日常生活能力评分高于对照组[(8.34±1.42)比(15.76±3.18),(85.46±7.81)比(73.13±6.43)],治疗后总有效率比对照组高[82.0%(41/50)比98.0%(49/50)],差异均具有统计学意义(P0.05)。结论在2型糖尿病脑梗死患者中使用益气养阴活血法可有效改善患者血糖水平、血管内皮功能及日常生活能力,提高预后,效果显著,值得在临床上应用推广。     

阿卡波糖联合二甲双胍对2型糖尿病患者血糖及血脂的影响

目的探讨阿卡波糖联合二甲双胍对2型糖尿病患者血糖及血脂的影响。方法将82例2型糖尿病患者随机分成观察组和对照组,各41例。两组患者均给予常规治疗措施,另外,对照组患者给予二甲双胍治疗,观察组患者给予阿卡波糖联合二甲双胍治疗,对比两组患者的血糖水平、血脂水平及不良反应发生率。结果治疗后,观察组患者的空腹血糖水平、餐后2小时血糖水平及糖化血红蛋白水平均明显低于对照组(P0.05);观察组患者的甘油三酯水平、总胆固醇水平及低密度脂蛋白水平均显著低于对照组(P0.05);观察组患者的高密度脂蛋白水平明显高于对照组(P0.05);两组患者的不良反应发生率无显著差异(P0.05)。结论阿卡波糖联合二甲双胍可有效提高2型糖尿病患者血糖及血脂的控制效果,是安全而理想的治疗方式。     

细节护理对2型糖尿病患者治疗依从性及血糖的影响

目的探讨细节护理对2型糖尿病患者治疗依从性及血糖的影响。方法将94例2型糖尿病患者随机分成观察和对照组,每组47例。对照组患者实行常规护理,观察组患者实行细节护理。对比两组患者的治疗依从性及血糖水平。结果护理后,观察组患者的治疗依从性明显高于对照组(P0.05);观察组患者的空腹血糖水平、餐后2 h血糖水平及糖化血红蛋白水平均显著低于对照组(P0.05)。结论细节护理可有效提高2型糖尿病患者的治疗依从性及血糖控制效果,值得临床推广。     

The Association of Diurnal Blood Glucose Variability With Subclinical Cardiac Disease in Patients With Type 2 Diabetes Mellitus

BackgroundThe relationship between glycemic control and the risk of cardiac disease in patients with Type 2 Diabetes Mellitus (T2DM) is controversial. 1,5-Anhydroglucitol (1,5-AG) is a biomarker of Glucose Variability (GV) and has been associated with clinical cardiovascular disease. However, its association with Subclinical Cardiac Disease (SCD) is unknown.Aim of the workStudy the association between GV and SCD.Subjects and methodsA cross-sectional study was conducted on 46 asymptomatic patients with T2DM as T2DM individuals group. Another 46 non-diabetic age and sex matched subjects were included as the healthy group. 1,5-AG was measured for all subjects. M-mode echocardiography in parasternal long axis view was used to measure Left Ventricular (LV) end diastolic dimension, LV end systolic dimension, ejection fraction, interventricular septum, LV posterior wall thickness, LV fractional shortening, left atrial dimension and aortic root dimension. Global Longitudinal Strain (GLS) was assessed by speckled tracking echocardiography.ResultsThere were no significant differences between both groups as regarding age, sex, BMI, AST, ALT, and serum creatinine. 1,5-AG was lower in T2DM individuals group. As regarding the echo parameters no significant difference found between both groups regarding left ventricular, left atrial and aortic root dimensions. T2DM individuals group showed a statistically significant higher mitral valve area, apical 2 chambers, apical 4 chambers, apical longitudinal axis and GLS. No correlation found between HbA1c and any echo parameters while 1,5-AG showed a significantly negative correlation with apical 2 chambers, apical 4 chambers, apical longitudinal axis and GLS. ROC curve analysis detected 1,5-AG less than 7.51 ng/ml as the best cut off value with sensitivity of 85.7%, specificity 75% to diagnose patients with T2DM and SCD.Conclusion1,5-AG might be used as an additional surrogate marker to identify patients with T2DM and SCD.     

Interactive Exposure With a Blood Glucose Monitor With a Novel Glucose Color Range Indicator Is Associated With Improved Glucose Range Interpretation and Awareness in Patients With Type 2 Diabetes

Aims:

The ability of patients to achieve glycemic control depends in part on their ability to interpret and act on blood glucose (BG) results. This clinical study was conducted to determine if a simple on-meter color range indicator (CRI) could improve the ability of patients to categorize BG values into low, in-range, and high glycemic ranges.

Methods:

The clinical study was conducted in 59 subjects with type 2 diabetes (T2DM). Subjects classified 50 general, 15 before- and 15 after-meal BG values as low, in-range, or high based on their current knowledge. Subjects then interactively experienced the on-meter CRI, which showed whether alternate BG values were low, in-range, or high. After CRI interaction, subjects repeated the original scoring assessment followed by a survey exploring their awareness of glucose ranges.

Results:

Following interaction with the CRI, subjects improved their ability to categorize general, before-meal and after-meal BG results by 23.4% ± 3.0% (SEM), 14.2% ± 2.4%, and 16.1% ± 2.9%, respectively (all P < .001), into low, in-range, and high glycemic ranges. Improvement was not accompanied by an increase in time spent categorizing results. There was no correlation between subject HbA1c, test frequency, or duration of diabetes and ability to correctly classify results. Subjects agreed the CRI feature helped them easily interpret glucose values and improved their awareness of glucose ranges.

Conclusion:

A short interactive session with a meter including a CRI feature improved the ability of T2DM subjects to interpret and categorize BG values into recommended ranges.     

硬膜外麻醉和全身麻醉对2型糖尿病患者围手术期血糖的影响

目的总结分析硬膜外麻醉和全身麻醉对2型糖尿病患者围手术期血糖的影响。方法随机选取该院2014年2月1日—2015年1月1日期间的2型糖尿病患者围手术期患者,其中,30例接受全身麻醉的患者被设为对照组,30例接受硬膜外麻醉的患者被设为试验组,观察、比较两组患者的血糖情况。结果试验组手术切皮充CO2气腹时、手术结束时的血糖(8.5±1.5)mmol/L、(8.2±2.2)mmol/L均优于对照组(12.4±2.5)mmol/L、(11.5±2.3)mmol/L,差异具有统计学意义(P0.05);试验组手术后3 h、23 h血糖(13.3±2.3)mmol/L、(12.5±2.5)mmol/L均优于对照组(15.4±5.4)mmol/L、(16.3±2.9)mmol/L,试验组胰岛素用量(20.2±4.2)U优于对照组(27.1±6.3)U,差异均具有统计学意义(P0.05)。结论 2型糖尿病经硬膜外麻醉的围手术期血糖情况显著优于全身麻醉,减少胰岛素用量,可考虑于临床中合理推广。     

Fat Versus Carbohydrate-Based Energy-Restricted Diets for Weight Loss in Patients With Type 2 Diabetes

Purpose of Review

The prevalence of combined obesity and diabetes has increased dramatically in the last few decades. Although medical and surgical weight management are variably effective in addressing this epidemic, it is essential to parallel these strategies with a hypocaloric diet comprising the appropriate macronutrient composition to induce weight loss, enhance glycemic control, and improve cardiovascular risk factors. This review reports the current evidence of the role of carbohydrates and fat-based diets for weight management in patients with combined type 2 diabetes (T2D) and obesity.

Recent Findings

Low-carbohydrate diets were shown to decrease postprandial glucose levels whereas high-carbohydrate, low-fat diets are considered cardio-protective.

Summary

A diet with an optimal macronutrient composition remains uncertain for patients with combined T2D and obesity. Further research is still needed to define the best dietary composition that achieves the maximum benefits on weight management, glycemic control, and cardiovascular risk factors.

     

二甲双胍治疗2型糖尿病人对血压影响的研究

目的观察胰岛素增敏剂二甲双胍治疗2型糖尿病,降低血浆胰岛素水平、改善胰岛素敏感性后对血压的影响.方法 71例2型糖尿病人口服二甲双胍(格华止)850 mg,qd～bid.治疗前后测定BMI、血压、FBG、PBG、FINS、PINS,并按HOMA模型计算胰岛素抵抗指数和胰岛素分泌指数.结果 (1) 二甲双胍治疗8周后,BMI治疗前后比较无显著性差异;血压治疗后明显下降,降压幅度达 13.1±4.9/4.2±9.9 mmHg, 血压治疗前后比较有显著性差异;(2)治疗后FBG、PBG、FINS均明显下降,治疗前后比较有显著性差异;(3)治疗后HOMA-IR下降,IAI升高,治疗前后比较有显著性差异,但HOMA-IS、FINS/FBG无显著性差异.结论二甲双胍治疗2型糖尿病,在降低血浆胰岛素水平、改善IR的同时,伴有血压的明显下降.     

Effects of Pistachio Nut Supplementation on Blood Glucose in Patients with Type 2 Diabetes: A Randomized Crossover Trial

BACKGROUND: Diabetes is a chronic, potentially debilitating, and often fatal disease. Dietary strategies to reduce postprandial glycemia are important in the prevention and treatment of diabetes. Nuts are rich in mono- and polyunsaturated fatty acids, which may reduce hyperglycemia and improve metabolism. OBJECTIVES: To evaluate the effectiveness of pistachio nut supplementation on glycemic and inflammatory measures in patients with type 2 diabetes. METHODS: In this double-blind, randomized, placebo-controlled, crossover trial, 48 diabetic patients were equally assigned to groups A and B. Patients in group A received a snack of 25 g pistachio nuts twice a day for 12 weeks and group B received a control meal without nuts. After 12 weeks of intervention, the patients had an 8-week washout. Then the groups were displaced, and group B received the same amount of pistachios for 12 weeks. RESULTS: With respect to the total change in variables over both phases, there was a marked decrease in HbA1c (-0.4%) and fasting blood glucose (FBG) concentrations (-16 mg/dl) in the pistachio group compared with the control group (p ≤ 0.001 for both). There was no overall significant change in BMI, blood pressure, HOMA-IR, and C-reactive protein (CRP) concentrations. Analysis of the two phases separately showed a decrease in FBG by 14 mg/dl and in HbA1c by 0.45% in the treatment group (A) after 12 weeks, while no significant differences were seen in group B (control group). In the second phase, FBG decreased from 151.36 ± 39.22 to 137.28 ± 28.65 mg/dl (-14 mg/dl) and HbA1c decreased from 7.42 ± 0.97 to 7.15 ± 0.68 mg/dl (-0.28%, p = 0.013 and p = 0.033, respectively) in the pistachio group (B). Pistachio consumption reduced systolic blood pressure (p = 0.007), BMI (p = 0.011), and CRP (p = 0.002) in patients from the treatment groups, but not insulin resistance. CONCLUSIONS: Dietary consumption of pistachio nuts as a snack has beneficial effects on glycemic control, blood pressure, obesity, and inflammation markers in diabetic patients.