A Study of Fluoxetine in Obese Elderly Patients with Type 2 Diabetes

In order to establish the safety and efficacy of fluoxetine in subjects over 60 years of age with Type 2 diabetes, a randomized, double-blind, parallel study of 30 obese subjects was undertaken, comparing the use of fluoxetine 60 mg daily with placebo. Subjects were diet controlled with an HbA₁ < 14% (reference range 6–9%) and BMI > 29 kg m². Those taking fluoxetine had a median weight loss of 2.6 kg at 3 months (p < 0.001) and 3.9 kg at 6 months (p < 0–02), compared with weight loss in the placebo group of 0.1 kg and 0.0 kg at 3 and 6 months, respectively. Improved glycaemic control was also demonstrated in the fluoxetine group compared with placebo, initial HbA₁ levels of 8.0% vs 8.7% (NS) falling at 4 months by 0.9% (p < 0.02) and at six months by 0.9% (p < 0.02). No sustained improvement in fasting blood glucose levels was demonstrated. Reporting of adverse events was similar in both groups. Fluoxetine in the short term aids weight loss and improves glycaemic control without a significant increase in adverse events in elderly Type 2 diabetic subjects.     

恩格列净和西格列汀治疗肥胖的2型糖尿病患者的临床效果比较

目的 比较恩格列净联合二甲双胍和西格列汀联合二甲双胍治疗合并肥胖的2型糖尿病患者的疗效和安全性.方法 选取2019年3月—2020年3月该院诊治的合并肥胖的2型糖尿病患者48例,按随机数字表将患者分为两组,A组24例,予恩格列净联合二甲双胍治疗,B组24例,予西格列汀联合二甲双胍治疗,疗程12周;对比两组患者治疗后的临...     

研究标准化饮食护理在2型糖尿病肥胖患者中的应用

目的 分析标准化饮食护理在2型标准化饮食护理在2型糖尿病肥胖患者中的应用.方法 选择该院2019年1月—2020年1月100例诊治的2型糖尿病肥胖患者,将其分为试验组与对照组,每组50例,试验组采用标准化饮食护理,对照组采用常规护理,观察并对比两组患者的护理效果.结果 试验组患者的在空腹血糖及餐后2h的血糖均优于对照组...     

标准化饮食护理在2型糖尿病肥胖患者中的应用分析

目的探讨标准化饮食护理在2型糖尿病肥胖患者中的应用分析。方法将2019年3—12月在该院内分泌科治疗的107例2型糖尿病肥胖患者随机分为两组,对照组45例使用常规护理,在此基础上,观察组62例使用标准化饮食护理,比较两组干预后的血糖及血脂指标、体重相关指标、自我管理能力。结果观察组干预后FPG、2 hPG、HbAlc、TC、TG水平均明显低于对照组,差异有统计学意义(P<0.05);观察组干预后体重、BMI、腰围均明显小于对照组,差异有统计学意义(P<0.05);观察组干预后饮食知识知晓、营养膳食执行、营养膳食态度、合理运动等自我管理能力指标均明显高于对照组,差异有统计学意义(P<0.05)。结论标准化饮食护理在2型糖尿病肥胖患者中的应用效果显著,能有效控制血糖、降低血脂、减轻体重、增强患者的自我管理能力,具有积极的临床意义。     

达格列净对超重及肥胖2型糖尿病患者的疗效

目的 探讨对超重及肥胖2型糖尿病患者采用达格列净进行治疗的临床疗效.方法 纳入对象为该院在2018年12月—2019年12月期间接收治疗的超重及肥胖2型糖尿病患者,共94例.对患者随机编号1～94号,其中单号为对照组(47例),采用利格列汀治疗,双号为观察组(47例),采用达格列净进行治疗.对比两组患者治疗的临床疗效,...     

Retinopathy in Maltese Type 2 Diabetic Patients

Since diabetes is a major health problem in Malta a study was conducted to gain a better insight into one of its most common complications, that of retinopathy. A random sample of 200 cases of adult onset diabetes with retinopathy who attended the main hospital's diabetes clinic was assessed by an experienced ophthalmologist. Non-proliferative retinopathy was subdivided into three degrees of severity according to the number of microaneurysms, haemorrhages, exudates, and intraretinal microvascular abnormalities present while proliferative retinopathy included also advanced eye disease. Data on medical and family histories was gathered from personal interrogation and counterchecked from hospital files. A medical examination searched for other concomitant disease. The 124 females and 73 males were similarly aged with a mean of 59.5 ± 11.5 years. The mean age at onset of diabetes was 44.4 ± 7.9 years: no significant differences were seen between the grades of retinopathy or the sexes. Onset of eye disease was first detected at a mean age of 56.9 ± 7.0 years. The great majority (82%) of retinopathy cases occurred after 10 years of diabetes. Males appeared to develop eye disease (especially non-proliferative) at a younger age (53.4 ± 7.6 vs 58.9 ± 6.6 years, p < 0.01) and after a shorter duration of diabetes (10.1 ± 6.6 vs 14.0 ± 7.8 years, p < 0.001) than females. Severity of retinopathy was strongly associated (p < 0.001), in females rather more than in males, with poor glycaemic control, use of insulin, presence of proteinuria and decreasing vision; and less markedly (p < 0.01) with duration of diabetes of more than 10 years, neuropathy and glaucoma. No important relation was observed between the degree of eye disease and body weight (expressed as BMI), hypertension, macroangiopathy (cardiac or peripheral), cataract, smoking or family history of diabetes or of retinopathy. These findings characterize those Maltese Type 2 diabetes patients that require closer attention to ophthalmic complications, and support the need to improve diabetes health care to reduce the burden of visual impairment.     

2型糖尿病患者使用胰岛素治疗期间的药师指导

目的 探讨药师参与2型糖尿病患者在使用胰岛素治疗过程中对患者治疗效果的影响.方法 选择该院在2019年5月—2020年5月门诊收治的200例2型糖尿病患者为研究对象,随机分为实验组和观察组,每组100例,实验组患者在治疗期间药师参与患者治疗全过程;观察组按照常规治疗方案进行治疗;观察患者各项指标变化情况.结果 实验组在...     

Energy Expenditure in Lean and Obese Diabetic Patients Using the Doubly Labelled Water Method

Obesity is a common problem among Type 2 diabetic patients. To investigate the role of energy expenditure in the maintenance of obesity in diabetic subjects, total energy output was measured during weight stability in 23 diabetic patients: 8 lean, 5 overweight, and 10 obese. Free living total energy expenditure was measured over 14 days using doubly labelled water method, resting metabolic rate by indirect calorimetry, and urinary energy losses were assessed. Total energy output was higher in the obese (13.66 ± SD 3.18 MJ 24 h^?1) than normal weight patients (10.84 ± 2.02 MJ 24 h^?1; p < 0.05); 11.96 ± 2.51 MJ 24 h^?1 in the overweight. None of the lean but four of the obese had total energy output > 16 MJ 24 h^?1. Urinary energy losses accounted for only 0.6% of total energy output in lean, 2.8% in overweight, and 3.1% in obese. Resting metabolic rate was significantly higher in obese (7.47 ± 1.69 MJ 24 h^?1) compared to lean (5.87 ± 1.07; p < 0.05) and resting metabolic rate correlated with lean body mass (r = 0.8, p < 0.001). Thermogenesis plus physical activity was substantial and not lower in the obese (5.77 versus lean 4.97 MJ 24 h^?1). The mean ratio of total energy expenditure to resting metabolic rate was in the moderate exercise category and similar in lean (1.87) and obese (1.80). Resting metabolic rate, total energy expenditure, and thermogenesis and physical activity were similar in all three groups when corrected for differences in lean body mass. In conclusion, high energy intake and not reduced energy expenditure is the major cause of the maintenance of obesity in diabetic patients. Overall there was no evidence of an energy deficit in the obese. This work emphasized the need for increased patient nutritional education to control energy intake.     

西格列汀联合二甲双胍治疗肥胖型2型糖尿病的疗效及对体脂含量情况分析

目的 研究肥胖型2型糖尿病患者联合采用西格列汀、二甲双胍治疗的临床效果.方法 选择2018年10月—2020年4月该院100例肥胖型2型糖尿病患者为研究对象,采用随机数表法分成常规组和治疗组,每组50例.常规组予二甲双胍治疗,治疗组予二甲双胍+西格列汀治疗.比较两组治疗效果、血糖指标、体脂含量、胰岛功能指标及不良反应....     

Wine for Type 2 Diabetic Patients?

To ensure an acceptable quality of life for Type 2 diabetic patients, the food recommendations have to be as liberal and individualized as possible. Unfortunately, disagreements exists about the consumption of different types of wine. Diabetic patients are advised by some to restrain their wine intake and to use dry wine containing little carbohydrate, while others are more liberal. The purpose of this study was to evaluate the effects of dry and sweet wine on the glycaemic control in Type 2 diabetes. Twelve diabetic patients consumed a light meal with either 300 ml tap water 300 ml dry white wine, 300 ml sweet white wine with ethanol added or 300 ml dry white wine with glucose added. Similar glucose, insulin, and triglyceride responses were obtained in all four situations. There was a greater suppression of the free fatty acid levels in the three situations with wine as compared with water (p < 0.001). This effect may be caused by an attenuation of the free fatty acid mobilization and esterification of free fatty acids to triglycerides induced by alcohol. Our results indicate that patients with well-controlled Type 2 diabetes can drink moderate amounts of wine with meals without risking acute deterioration of glycaemic control. Whether the wine is dry or sweet has no impact on the glycaemic control.     

唑来膦酸与利拉鲁肽联合治疗2型糖尿病合并骨质疏松患者的临床应用效果

目的探讨唑来膦酸与利拉鲁肽联合治疗2型糖尿病合并骨质疏松患者的临床应用效果。方法选取2019年4月—2020年4月该院收治的50例2型糖尿病合并骨质疏松患者,根据蒙特卡罗随机将患者分为对照组(n=25)和观察组(n=25),两组均进行胰岛素联合唑来膦酸治疗,对照组采取常规方案治疗,观察组在对照组基础上增加利拉鲁肽,持续3个月治疗后进行BMD的检测。比较两组治疗效果。结果治疗后观察组Ca、ALP和BMD较对照组升高对比差异有统计学意义(P<0.05);FBG、HbA1c、2 hPBG与治疗前相比全部有降低,差异有统计学意义(P<0.05)。结论对有骨质疏松的2型糖尿病患者,临床可采用唑来膦酸联合利拉鲁肽治疗,疗效较为理想,可明显提高骨密度,降低骨质疏松性骨折的风险,同时降低血糖,可在临床应用。     

No Important Differences in Glycaemic Responses to Common Fruits in Type 2 Diabetic Patients

The aim of this study was to determine the glycaemic indices (GIs), peak incremental indices (PI), and time of peak increment (TPI) of eight kinds of fruits and their relationship with the type and amount of simple sugars directly assayed in the fruits. Sixty-one type 2 diabetic patients randomized into eight groups—one for each category of fruit—participated in the study. GIs consisted of the following: pears = 60 ± 4.9; apples = 63 ± 8.3; oranges = 68 ± 6.5; grapes = 70 ± 7.5; plums = 75 ± 8.4; peaches = 80 ± 7.4; apricots = 82 ± 9.1; bananas = 83 ± 8.5. The PI values (mmol l^?1) were the following: grapes = 2.52 ± 0.26; apples = 3.13 ± 0.75; pears = 3.48 ± 0.55; oranges = 4.02 ± 0.42; peaches = 4.07 ± 0.38; apricots = 4.08 ± 0.47; plums = 4.2 ± 0.45; bananas = 4.45 ± 0.39. There was no statistical differences in GI, and PI, within the different fruits. TPI of grapes (43.3 ± 5.2 min), oranges (45 ± 5.6 min), and peaches (45 ± 5.6 min) were statistical different (p < 0.01) in respect to apricots (81.4 ± 5.5 min). GIs were positively correlated with total glucose contained in the fruits (p < 0.05) and with PI (p < 0.0002); negatively with fructose both free (p < 0.02) and total (sum of free and present in sucrose (p < 0.05). On the basis of these findings, there is unlikely to be a difference of biological importance related to GI and PI of fruits, whereas the significance of TPI remains still to be evaluated.     

Changes in Glucose Disposal and Cellular Insulin Binding in Obese Black Southern African Patients with Type 2 Diabetes Mellitus Before and After Sulphonylurea Therapy

Peripheral insulin action and cellular insulin binding were studied in 10 newly detected, obese, black, Southern African women with Type 2 diabetes mellitus before and after midterm oral sulphonylurea therapy and in five obese, non-diabetic controls. Glucose disposal (assessed by the euglycaemic insulin clamp technique) was significantly reduced in diabetic patients compared to control subjects (4.4 ± 0.5 vs 6.4 ± 0.5 mg kg^-1 min^-1, p < 0.05), and increased after 1 and 3 months of sulphonylurea therapy to 6.8 ± 0.6 mg kg^-1 min^-1 (p = 0.01) and 6.3 ± 0.7 mg kg^-1 min^-1 (p = 0.04), respectively. The major change in the binding kinetics of insulin to peripheral monocytes was an increase in the mean receptor concentration in the diabetic patients which was significant after 3 months of therapy (0.2 ± 0.08 to 0.6 ± 0.01 nM, p = 0.05). The basal plasma C-peptide concentration was significantly lower in the diabetic patients than in the controls and remained so following sulphonylurea therapy, despite significant reductions in fasting glucose and HbA_-1 concentrations. We conclude that newly diagnosed, obese, black Southern Africans with Type 2 diabetes showed diminished peripheral glucose disposal which increased following sulphonylurea therapy. This was accompanied by an increase in insulin receptor concentration but not with changes in basal insulin secretion.     

达格列净、利拉鲁肽对超重或肥胖2型糖尿病合并冠心病患者的糖脂代谢的影响

目的 探讨达格列净、利拉鲁肽对超重或肥胖2型糖尿病合并冠心病患者的糖脂代谢的影响.方法 随机纳入2018年6月—2020年1月该院就诊的160例超重或肥胖2型糖尿病合并冠心病患者为研究对象,分两组,每组80例.所有患者均口服盐酸二甲双胍片(格华止)≥1500 mg/d,达格列净组启始予5 mg,根据血糖情况调整药物剂量...     

Plasma Lipid Levels at Diagnosis in Type 2 Diabetic Patients

Plasma lipid measurements were obtained at the time that 545 subjects were screened for diabetes mellitus. Both the women and men diagnosed with diabetes had significantly higher triglyceride levels (p < 0.05) and lower high-density-lipoprotein cholesterol (HDL-cholesterol) levels (p < 0.05) than those with normal glucose tolerance. Low-density-lipoprotein cholesterol (LDL-cholesterol) levels were only higher in the diabetic women (p < 0.001). Differences in lipid values were diminished somewhat with allowances for the waist-hip ratio. HDL-cholesterol values were inversely related to fasting insulin levels in the normoglycaemic men and women (p < 0.01), but not in the diabetic individuals. Triglyceride levels were strongly positively related to insulin values in the normoglycaemic men and women (p < 0.001 for both), while associations tended to be smaller in the diabetic subjects. In 13 of the diabetic individuals who were not medicated for diabetes over a period of 17.5 ± 4.6 months, changes in HDL-cholesterol levels were positively related (p = 0.80, < 0.001) and changes in tryglyceride levels inversely related (r = –0.70, p < 0.01) to changes in insulin values. These data indicate that at diagnosis Type 2 diabetic patients have an atherogenic lipid pattern that may be related in part to differences in adipose distribution. In addition, the data suggest that HDL-cholesterol is positively related and triglyceride inversely related to insulin action.     

2型糖尿病性干眼患者眼表改变的研究进展

现今,伴随着2型糖尿病患病率日益增高的同时,以糖尿病性干眼为代表的眼表并发症亦引起了社会各界的重视。糖尿病性干眼因其病情容易反复发作,而不易根治,故而可对患者的身体健康和生活质量造成各种不利影响。因此,积极展开关于糖尿病性干眼方面的研究,具有重大意义。该文从近10年来,关于2型糖尿病性干眼的眼表结构及功能改变的研究现状,进行部分归纳与探讨,旨在日后更好的服务于临床。     

胰岛素泵治疗2型糖尿病合并妊娠患者的疗效分析

目的分析胰岛素泵治疗2型糖尿病合并妊娠患者的疗效。方法选择2018年2月—2019年1月在该院接受治疗的56例2型糖尿病合并妊娠患者,随机分为观察组和对照组,其中观察组患者选择胰岛素泵治疗,对照组患者采取传统的多次皮下注射方式进行治疗。经过治疗干预后比较两组患者的血糖情况、体质量指数、并发症情况及妊娠结局。结果经过治疗干预,观察组患者的空腹血糖含量为(5.17±0.68)mmol/L,并发症发生率为17.85%,体质量指数为(21.22±2.03)kg/m2,对照组患者的空腹血糖含量为(5.62±0.98)mmol/L,并发症发生率为32.14%,体质量指数为(24.78±2.04)kg/m2。且统计结果显示,观察组患者的妊娠结局要在一定程度上优于对照组。结论采取胰岛素泵治疗2型糖尿病合并妊娠可以取得较好的治疗效果,且有助于降低患者并发症的发生率,改善患者妊娠结局。     

Coagulation Activation in Type 2 Diabetes Mellitus: the Higher Coronary Risk of Female Diabetic Patients

Thrombophilia in diabetic patients is a well-recognized phenomenon which constitutes an additional risk of coronary heart disease. This study included 1980 ethnic Chinese people (835 male, 1145 female); age range: 45 to 69 years, including 280 Type 2 diabetic patients (male 125, female 155). Haemostatic parameters measured were fibrinogen, prothrombin time, activated partial thromboplastin time (APTT), factor VIIc, factor VIIIc, antithrombin III, and plasminogen. Compared with a control group, male diabetic patients showed significantly shorter APTT (25.6 ± 3.7 vs 27.5 ± 3.6 s, p<0.001), and elevated factor VIIIc (171.1 ± 77.48 vs 131.16 ± 52.23%, p<0.0001), whereas female diabetic patients showed significantly shorter APTT (24.9 ± 4.2 vs 26.5 ± 3.9 s, p<0.001) and elevated fibrinogen (10.6 ± 3.3 vs 9.8 ± 2.6 μmol 1^?1, p<0.05), factor VIIc (150.4 ± 68.7 vs 135.3 ± 32.3%, p<0.001), factor VIIIc (190.1 ± 92.6 vs 141.1 ± 62.4%, p<0.0001), and plasminogen (140.3 ± 41.9 vs 128.4 ± 38.7%, p<0.01). This study showed that Chinese diabetic patients had coagulation activation, and that female diabetic patients seemed to constitute a higher risk group for coronary heart disease than males.     

Haemostatic Measures in Type 2 Diabetic Patients with Microalbuminuria

The major cause of disability and early mortality in Type 2 diabetes is cardiovascular disease. An enhanced urinary albumin excretion is strongly predictive of increased mortality, but the causal relationship behind this association is unclear. Abnormalities in the haemostatic system may be involved in the vascular pathology. We therefore studied the level of von Willebrand factor (vWf:Ag), factor VIII (VIII:Ag), fibrinogen, and fibronectin in male diabetic patients 50–70 years of age, with normal albumin excretion (n = 14), microalbuminuria (n = 14), and frank albuminuria (n = 7). Fourteen healthy age-matched males served as a reference group. There were no significant differences between normo-and micro-albuminuric patients but vWf:Ag (p < 0.01), VIII:Ag (p < 0.01), and fibrinogen (p < 0.05) were increased in those with frank albuminuria. Urinary albumin excretion rate was significantly correlated to vWf:Ag (r = 0.46, p = 0.005), VIII:Ag (r = 0.45, p = 0.007), and fibrinogen (r = 0.49, p = 0.003). The known duration of diabetes was correlated to vWf and F VIII. The increased level of vWf:Ag in Type 2 diabetes and the significant association to the urinary albumin excretion rate may suggest a linkage between albuminuria and cardiovascular disease. However, the present study demonstrated no increase in haemostatic variables in patients with microalbuminuria as compared with those with normal albumin excretion.     

Physical Activity in Obese Type 2 Diabetes After Gastric Bypass or Medical Management

Background

The purpose of this study was to compare effects of Roux-en-Y gastric bypass versus a multidisciplinary, group-based medical diabetes and weight management program on physical fitness and behaviors.