糖尿病合并皮肤病36例临床分析

据报道 ,30 %的糖尿病患者可有皮肤损害 ,糖尿病患者确诊前 ,常因皮肤症状就诊皮肤科。1998～ 2 0 0 2年 ,我院确诊糖尿病合并皮肤病 36例 ,现报告如下。临床资料 :本组男 14例 ,女 2 2例 ;平均年龄 6 5 .8( 4 1～90 )岁 ,平均病程 15 .8( 4个月至 8年 )个月。8例表现为全身皮肤干燥、粗糙、阵发性瘙痒 ,瘙痒以夜间为重 ,无原发性皮损 ,仅见患处皮肤抓痕、表皮剥脱、血痂及色素沉着 ,病程较长者局部呈苔藓样变 ;11例表现为外阴部反复发作性剧痒 ,局部粘膜皮肤肥厚、浸润、苔藓样变或色素改变 ,14例念珠菌性阴道炎、龟头炎 ,表现为女性阴道粘…     

糖尿病并发皮肤病

糖尿病的并发症很多种,其中糖尿病并发的皮肤病较容易被人们所忽视。本期来谈谈糖尿病并发的皮肤病。     

认清皮肤病变

糖友常见的皮肤病1．糖尿病性皮肤病。是糖尿病最常见的皮肤病变,约占糖尿病患者的50％,男性多于女性,一般无临床症状。本病的特征为下肢远端伸侧皮肤多发性色素沉着。起初病损为圆形或卵圆形暗红色丘疹,继之成为黑褐色下蹈的萎缩斑。在治疗上主要是积极治疗糖尿病。     

糖尿病慢性病变

糖尿病慢性并发症可遍及全身各重要器官 ,不论是Ⅰ型或Ⅱ型糖尿病 ,由于胰岛素、性激素、生长激素、儿茶酚胺等内分泌激素均有异常 ,就会导致高血糖、脂肪代谢紊乱、血管内皮功能紊乱等一系列改变 ,并促进动脉粥样硬化的发生和发展。一、糖尿病与脑血管病脑梗塞、脑出血等脑血管病 ,常是糖尿病人死亡的重要原因。北京医科大学戴氏统计其发病率占同期住院糖尿病患者的 18 6% ,男性略多于女性。平均年龄 62岁左右 ,其中以颈内动脉系统脑血栓形成占绝大多数 ,部分为椎基底动脉血栓形成 ,少数为一过性缺血或蛛网膜下腔出血 ,梗塞和出血的比例约…     

糖尿病特征性皮肤病变

除了皮肤感染,糖尿病患者容易伴发与血糖代谢相关的皮肤病变还有很多。这些病变具有特征性表现,有的为糖尿病患者所独有。     

当糖尿病“遇见”皮肤病

对很多人来讲,糖尿病不是什么可怕的疾病,但是糖尿病一旦出现并发症的话就相对的严重了。它的出现给很多的糖友们和家属都造成了一定的危害,严重的可能会引起残疾或是生命危险,可见并发症的厉害,那么在生活中它的发病原因是什么呢？     

糖尿病皮肤病变92例临床分析

对92例糖尿病皮肤病变患者的临床特点进行回顾研究。结论细菌及真菌所致的皮肤感染在糖尿病患者中最为常见,单一的治疗方法无法取得满意的治疗效果,需通过降糖治疗结合皮肤科等综合治疗,方能取得良好的疗效。     

糖尿病皮肤病变及其机制的研究进展

糖尿病皮肤在未遭遇外源性损伤的情况下即已存在组织学和细胞功能学的异常改变.由于糖尿病皮肤存在含糖量增高以及晚期糖基化终末产物蓄积、基质金属蛋白酶及其抑制剂的比例失平衡、生长因子异常、炎性反应等异常改变,导致糖尿病皮肤厚度变薄,皮肤层次减少,结缔组织变性,细胞形态变异,黏附力及增殖能力F降,胶原合成紊乱.这种有别于皮肤组织完整性破坏的隐匿性损害可能是糖尿病皮肤易损或创面形成后难以愈合的重要原因之一.     

以皮肤病为首发症状的2型糖尿病2例报告

例 1:男 ,6 8岁。患者 12年前无明显诱因出现全身瘙痒 ,皮肤粗糙 ,并出现红色米粒大斑丘疹 ,当地医院诊为皮炎、瘙痒症 ,口服抗过敏及糖皮质激素类药物及外用治疗无效 ,后转入省级医院 ,查血糖 12 .1mmol/ L,尿糖 (++++) ,诊断为 2型糖尿病 (DM) ,口服磺脲类及双胍类降糖药后血糖降至正常 ,瘙痒及皮疹消失。以后每逢血糖升高便出现皮肤瘙痒、皮疹 ,血糖降至正常后 ,皮疹及瘙痒减轻 ,消失。例 2 :女 ,6 1岁。因皮肤瘙痒、皮疹 7年入院。患者 7年前曾到多家皮肤病医院就诊 ,治疗无效。偶查血糖 18.1m mol/ L,尿糖(++++) ,遂口服消渴丸及二甲…     

色素性紫癜性皮肤病

色素性紫癜性皮肤病是一组以紫癜样皮疹及含铁血黄素沉着为主要表现的慢性毛细血管炎性皮肤病 ,包括进行性色素性紫癜皮肤病、色素性紫癜性苔藓样皮肤病和毛细血管扩张性环状紫癜 ,上述三病的发病机制、临床表现及组织病理均相似。1　病因及发病机制本病病因尚不清楚。有人认为可能与体内感染性或中毒性因素有关。重力和静脉压升高、下肢静脉血回流不畅是重要的局部诱发因素。病变处可见淋巴细胞围管性浸润 ,毛细血管扩张、管壁通透性增高、红细胞外溢和崩溃、含铁血黄素沉着 ,常缓慢进行 ,且时轻时重。2　临床表现2 .1　进行性色素性紫癜性…     

Diabetes mellitus and vasopressin sensitive diabetes insipidus

Summary The rare association of diabetes mellitus and vasopressin sensitive diabetes insipiclus found in 5 patients attending the Institute of Endocrinology and Metabolic Diseases in a ten-year period is reported. Suspicious signs and criteria for diagnosis were discussed and a brief review made on the pathogenesis and treatment of this association.     

糖尿病与勃起功能障碍

勃起功能障碍（ED）是一种年龄相关性疾病，糖尿病患者的ED患病率更高。本文从生理学机制、致病原因、诊断和治疗等几方面对糖尿病ED进行了讨论。     

Carotenemia,skin colour and diabetes mellitus

Summary Carotenemia with its yellowish-red tint is found in diabetes. The frequency of this phenomenon is unknown and the relationship between skin colour and blood carotenoid level is controversial. Frequently the suspicion of diabetes arising from inspection of the skin colour is in fact confirmed by the usual laboratory tests. We decided to examine skin colour, blood carotenoids, cholesterol and total blood lipid levels in 51 overt diabetics, 42 latent diabetics and 25 healthy subjects as well as 14 patients who had recently suffered an acute myocardial infarction. The healthy subjects showed blood carotenoid levels slightly higher than the patients. As is known, in cases of increased intake of carotenoid-rich fruit and vegetables the yellowish-red skin colour is marked. Diabetic patients however show this phenomenon even though they may not follow such a diet. This finding, although diagnostically useful, does not usually parallel a high carotenoid blood level. From this point of view overt and latent diabetes are similar. ProfessorFritz Dreyfuss died in March 1974.     

Association between “diabetic thick skin syndrome” and neurological disorders in diabetes mellitus

Skin thickness on the extremities of patients with diabetes mellitus has been described controversially. Using high resolution ultrasonography, we were able to show a significant increase in skin thickness at the forearm (P<0.05), thigh (P<0.001) and lower limb (P<0.05) of diabetic patients, most prominent at the thigh. No difference in skin thickness was found at the dorsum of the foot. In addition, skin thickness was not related to the duration of diabetes, age or HbA₁. A close association was found between diabetic neuropathy and increasing skin thickness. Diabetic patients with neurological disorders had a significant increase in skin thickness versus diabetic patients without neuropathy. The present findings suggest that diabetic neuropathy and abnormalities of connective tissue have a common etiological link in their development or that both are time-dependent processes. Whether changes in capillary blood flow, increase of nonenzymatic glycosylation, polyol accumulation or other metabolic disorders are responsible for these findings remains still to be established.     

WHO与美国糖尿病学会糖尿病诊断标准异同的探讨

目的　探讨WHO与美国糖尿病学会 (ADA)糖尿病 (DM )诊断标准的异同及可能的原因。方法　对大庆地区 9832人糖尿病普查中做口服葡萄糖耐量试验 (OGTT)的 10 6 9人 ,分别以WHO与ADA诊断标准划分不同的血糖水平人群。分析人群分布的异同 ,并以Pearson相关分析探讨两种诊断标准的血糖异常人群不相符的原因。结果　WHO与ADA标准检出糖尿病患者分别为2 0 2例及 2 5 3例 ,与WHO标准比较 ,ADA标准诊断的DM符合率为 78.7% ,血糖正常人群符合率为 72 .3 % ,WHO检出的糖耐量低减 (IGT)人群中仅有 41.6 %被ADA判定为空腹血糖升高 (IFG) ,在空腹血浆葡萄糖 (FPG) <5 .83mmol/L的IGT及DM人群中 ,FPG均与 2小时血糖 (PG2h)不相关 ;在FPG≥ 5 .83mmol/L的人群中 ,FPG与PG2h相关。结论　ADA糖尿病诊断标准并非WHO诊断标准的替代物。WHO之IGT与ADA之IFG人群差异很大 ,以空腹血糖为标准找出与IGT完全相同的人群是不可能的     

Diabetes mellitus and oral mucosa alterations: prevalence and risk factors

Aims

To investigate the prevalence of oral mucosa alterations in patients with type 2 diabetes and to identify possible risk factors related to oral mucosa alterations.

Methods

146 patients with type 2 diabetes and 111 age- and gender-matched healthy controls subjects were consecutively recruited from Araraquara School of Dentistry to answer a structured questionnaire designed to collect demographic data as well as current and former history of diabetes. Clinical examination of the oral mucosa was carried out by a stomatologist.

Results

A higher prevalence of oral mucosa alterations was found in patients with diabetes than in patients without diabetes (p < 0.001), with significant difference to development conditions (p < 0.0001), potentially malignant disorders (p < 0.0001) and fungal infections (p < 0.05). In the multiple logistic regression, diabetes (odds ratio 9.9 IC 5.11-19.16) and smoking habit (odds ratio 3.17 IC 1.42-7.12) increased the odds of oral mucosa alterations significantly.

Conclusions

Patients with diabetes mellitus not only showed an increased prevalence of oral mucosa alterations but also a significant percentage of potentially malignant disorders. These findings elucidate the necessity of regular clinical examination to ensure early diagnosis and prompt management of oral mucosa lesions in patients with diabetes.     

糖尿病患者尿层粘连蛋白的测定

目的 探讨尿层粘连蛋白（ＬＮ）与糖尿病肾病的关系。方法 将ＰＥＧ－４０００和γ球蛋白浓缩的尿标本,用放射免疫法检测了８３例糖尿病患者的尿ＬＮ含量,同时测定了尿微量白蛋白（Ｍ－Ａｌｂ）,肌酐清除率（Ｃｃｒ）,血糖（Ｇｌｕ）和糖化血红蛋白（ＨｂＡｌｃ）。结果 选用１５０ｇ／Ｌ的ＰＥＧ－４０００和０．５％的γ－球蛋白,二者具有良好的浓缩功能,糖尿病患者尿ＬＮ均较正常对照组高。结论 尿ＬＮ可作为诊断早期糖     

WHO及美国糖尿病学会糖尿病诊断标准在老年人群中应用的分析和评估

目的　探讨 1985年WHO与 1997年美国糖尿病学会 (ADA)糖尿病 (DM)诊断标准在老年人群应用中的敏感性及特异性 ,确定在老年人群中诊断DM的理想空腹血糖 (FPG)切点。方法对在北京地区居住 5年以上的老年人群体检时进行口服葡萄糖耐量试验 (OGTT)的 12 0 4人 ,分别根据WHO标准与ADA标准划分不同血糖水平的人群 ,分析其分布的异同 ,并以OGTT 2h血糖 (2hPG)≥ 11.1mmol/L为DM诊断标准 ,分析ADA(FPG)≥ 7.0mmol/L的标准诊断DM的敏感性及特异性变化情况 ,并确定在老年人群中应用FPG诊断DM的理想切点。结果　按WHO标准 (2hPG)诊断DM的患病率为 16 .2 8% ,按ADA标准 (FPG)诊断DM的患病率为 3.16 %。ADA标准制定的FPG 7.0mmol/L所得出的诊断DM的敏感度为 15 .3% ,特异度为 99.2 %。WHO与ADA两项标准均诊断DM的符合率仅为 15 .3% ,糖耐量低减 (IGT)与空腹血糖异常 (IFG)的一致性仅为 4 .5 %。老年人群诊断DM的理想FPG切点为 5 .5mmol/L ,其受性别、年龄、BMI和有否高血压的影响。结论　WHO标准和ADA标准在本人群中缺乏一致性 ,以ADA(FPG)标准诊断老年人群DM时 ,在很大程度上不能替代WHO(2hPG)诊断标准。对 5 .5mmol/L≤FPG <7.0mmol/L老年人群应建议行OGTT检查。     

Diabetes mellitus and medicinal plants-a review

Diabetes mellitus is a group of metabolic disorders sharing the common underlying feature of hyperglycemia. Along with hyperglycemia, diabetes is associated with micro and macro-vascular complications, which are the major causes of morbidity and death in diabetic subjects. The currently available antidiabetic agents include sulfonylureas, biguanides, thiazolidinediones and alpha glucosidase inhibitors and are widely used to control the hyperglycemia. These drugs fail significantly to alter the course of diabetic complications. They have limited use because of undesirable pathological conditions and high rates of secondary failure. Thus, it is essential to look for more effective antidiabetic agents with fewer side effects. Traditional medicinal plants having antidiabetic properties can be a useful source for the development of safer and effective oral hypoglycemic agents. More than 350 traditional plants are used in the treatment of diabetes mellitus, which have been recorded. Only a small number of these have received scientific and medical evaluation to assess their efficacy. However, plant remedies are the mainstream of treatment in underdeveloped regions. This review focuses on diabetes mellitus and the role of plants in the treatment of diabetes mellitus.     

中国老年2型糖尿病防治临床指南(2022年版)

中国第七次人口普查数据显示,2020年我国老年人口(≥60岁)占总人口的18.7%(2.604亿),其中约30%的老年人是糖尿病患者(7813万,95%以上是2型糖尿病)。糖尿病控制欠佳所致并发症是老年人健康生存的主要危险因素,糖尿病防治已是健康中国(2019—2030年)的重点行动之一。延续“中国老年2型糖尿病诊疗措施专家共识(2018年版)”的主旨,制订“中国老年2型糖尿病防治临床指南(2022年版)”,汇总国内外老年糖尿病相关指南和研究信息,旨在进一步优化老年糖尿病防治理念,促进规范化预防、诊疗临床措施的实施,不断提高老年糖尿病总体管理水平。