糖耐康颗粒干预糖尿病患者前期糖耐量异常临床观察

目的：糖调节受损阶段是糖尿病发生过程的必经阶段,在不经干预的前提下,有近四分之一到患者在4-7年内发展为糖尿病。因此,对糖尿病前期的干预治疗在糖尿病预防与控制方面具有重要意义。本研究主要考察糖耐康颗粒对2 型糖尿病前期的疗效。方法：记录入组糖尿病前期患者年龄、病程、性别、中医症状积分等,检测病人血脂、血糖、肝肾功能、心电图等,在低糖低盐饮食及合理运动的健康宣教的情况下,以随机数字表法分为对照组31例与治疗组43例,以双盲给药,分别以模拟糖耐康安慰剂颗粒与糖耐康颗粒治疗气阴两虚型2 型糖尿病前期患者74例,疗程为3 个月。3 个月后检测空腹及餐后血糖,糖化血红蛋白,糖耐量,胰岛素耐量等指标考察二者疗效。结果：糖耐康颗粒无论在患者治疗有效率、中医症状积分及血糖复常率方面均优于安慰剂,且服用糖耐康颗粒物无肝肾功能等损伤。结论：糖耐康对糖尿病前期患者治疗安全有效。     

Screening for type 2 diabetes and prediabetes in obese youth: evaluating alternate markers of glycemia – 1,5‐anhydroglucitol,fructosamine, and glycated albumin

Hemoglobin A1c (HbA1c) is increasingly performed over the oral glucose tolerance test (OGTT) as the initial screening test for type 2 diabetes in youth. However, the optimal strategy for identifying type 2 diabetes in youth remains controversial. Alternate glycemic markers have been proposed as potentially useful tools for diabetes screening. We examined the relationships among fructosamine (FA), glycated albumin (GA), and 1,5‐anhydroglucitol (1,5‐AG) with traditional screening tests, HbA1c and OGTT. Youth 10–18 yrs, BMI ≥85th‰, and HbA1c <7.5% had a single visit with measurement of HbA1c, 1,5‐AG, FA, GA, and a standard OGTT. Distributions of FA, GA, and 1,5‐AG by HbA1c and 2‐hour glucose (2hG) categories were compared. Receiver operating characteristic (ROC)‐curves were generated to determine the cut points at which alternate markers maximized sensitivity and specificity for predicting prediabetes and diabetes. One hundred and seventeen, 62% female, 59% Hispanic, 22% White, 17% black, median 14.1 yr, and body mass index (BMI) z‐score 2.3 participated. Median values of each alternate marker differed significantly between prediabetes and diabetes HbA1c and 2hG categories (p < 0.017). Only GA medians differed (p = 0.006) between normal and prediabetes HbA1c. Area under the receiver operating characteristic curves (ROC‐AUCs) for alternate markers as predictors of prediabetes (0.5–0.66) were low; however, alternate marker ROC‐AUCs for identifying diabetes (0.82–0.98) were excellent. Although the alternate markers were poor predictors of prediabetes, they all performed well predicting diabetes by 2hG and HbA1c. Whereas the usefulness of these markers for identifying prediabetes is limited, they may be useful in certain scenarios as second line screening tools for diabetes in overweight/obese youth.     

486例糖尿病前期人群的中医证素特点研究

[目的]了解糖尿病前期人群的中医证素特点,明确糖尿病前期的易患因素。[方法]选取2016年1—12月期间在天津市第一中心医院进行体检的20～79岁天津市常住居民,经化验检查后确诊为糖尿病前期的患者共500例,填写中医证素调查问卷,得出研究对象的病位、病性证素,所有数据进行统计学处理。[结果]最终纳入486例糖尿病前期患者,体质量以超重最多见（41.15%）,其次为肥胖病例（33.95%）。脾（35.80%）为最主要的病位证素,其次为肾（33.74%）、肝（25.93%）、胃（20.58%）等;主要的病性证素包括：湿（37.86%）、痰（36.79%）、气虚（52.06%）、阴虚（42.39%）。脾病位证素组的体重指数（BMI）、腹围大于非脾组,差异具有统计学意义（P<0.01）。[结论]糖尿病前期主要与脾、肾、肝等脏腑功能失调密切相关,发病主要与湿、痰、气滞、热等病理因素相关,肥胖与糖尿病前期的发生发展是相互关联的,痰湿困脾是糖尿病前期的核心病机。     

Trace glucose fluxes in individuals with prediabetes using stable isotopes

Background The glucose fluxes of individuals with prediabetes in Chinese population are not clear.This study was to determine whether the endogenous glucose production （EGP）,oral glucose rate of appearance （Ra） and glucose rate of disappearance （Rd） were different in Chinese individuals with prediabetes under fasting conditions and following an oral glucose challenge.Methods Five subjects with type 2 diabetes,5 subjects with prediabetes and 5 non-diabetic subjects matched for age,weight,fat free mass and body mass index underwent a 180 minute stable glucose isotope tracing （[6,6-2H2] glucose,[1-13C] glucose,and [U-13C] glucose） study under fasting and after ingestion of a 75 g oral glucose load.Isotope glucose enrichment was measured by gas chromatography-mass spectrometry.Insulin sensitivity was estimated using the oral glucose tolerance test （OGTT）-derived insulin sensitivity index,β cell function was determined by the insulinogenic index （△I30/△G30）.Results The insulin sensitivity index （P=0.043） and insulinogenic index （P=0.021） were decreased in subjects with prediabetes compared with non-diabetes.Fasting EGP was slightly higher （P=0.29） and postprandial EGP was comparable in subjects with prediabetes and non-diabetes during 120 minutes after glucose ingestion,but nadir EGP occurred later in prediabetic than non-diabetic subjects.Ra did not differ among the three groups.Rd was substantially lower in subjects with prediabetes than non-diabetes after glucose intake （P=0.013）.Conclusion The mild hyperglycemia observed among individuals with prediabetes may result from decreased Rd during the postprandial state.     

Identification of risk factors affecting impaired glucose metabolism among the adult population of district Srinagar

BackgroundThe World has seen an emerging trend of diabetes among adolescents and moderately aged people over the last decade. The aim of the study was to identify the risk factors associated with impaired glucose metabolism and the prevalence of impaired glucose metabolism among the adult population of district Srinagar.MethodsMulti-stage cluster random sampling design was used and from each household, participants were selected using a Kish grid method. Socio-demographic and clinical data were collected. The participants were then subjected to fasting venous blood glucose estimation.ResultsAge, waist circumference, hip circumference, weight, and body mass index were all statistically significant between normoglycemic participants and those with impaired glucose metabolism (p < 0.018). On logistic regression, subjects who had a higher BMI were more likely to develop Impaired glucose metabolism (OR = 3.52, OR 95% CI = 1.25–9.87); Moreover, consumption of carbonated drinks, (3–6 times/week OR = 4.40, OR 95% CI = 2.06–9.40; >6 times/week OR = 11.04, OR 95% CI = 0.86–140.66) was found to be a potential risk factor. Participants with a family history of diabetes were more susceptible to develop impaired glucose metabolism (OR = 6.41, OR 95% CI = 3.22–12.78). The risk effect of these factors was even stronger before adjusting for age, sex, family history of diabetes, and BMI in participants.ConclusionRisk factors for impaired glucose metabolism include increasing age, obesity, and higher consumption of carbonated drinks, hypertension, smoking behavior, high-calorie diet intake and positive family history of diabetes.     

Prediabetes diagnosis criteria,type 2 diabetes risk and dietary modulation: The CORDIOPREV study

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Technology and Human Connection to Prevent Diabetes in Rural United States

This quality improvement pilot project implemented a diabetes prevention program using physical activity trackers and human connection to increase physical activity (PA) and reduce the risk of diabetes among adults with prediabetes from a rural primary care clinic. The outcomes included PA steps, PA minutes, the achievement of self-established PA goals, hemoglobin A1C level, weight, and body mass index. During the 3 months of the project, PA steps significantly increased, and most participants reached self-established PA goals. Overall, the program outcomes were positive. Participants and health care team members reported additional benefits and drawbacks to the project, confirming the study’s feasibility.     

Dietary Patterns and the Risk of Prediabetes in Taiwan: A Cross-Sectional Study

Background: prediabetes prevention and management are the main methods used to combat the prevalence of diabetes. Exploratory factor analysis is an upcoming method that is successful in identifying dietary patterns that correlate with healthy or unhealthy outcomes. Aim: this study aims to identify dietary patterns in Taiwan that are associated with the risk of prediabetes. Methods: anthropometric, blood glucose, 3 d/24 h dietary records, and food frequency questionnaire data were collected from subjects recruited at Taipei Tzu-Chi Hospital. The following five dietary patterns were identified using factor analysis: Western, prudent, convenience, Asian traditional, and continental. This cross-sectional study compares tertiles of dietary patterns and analyzes the significance of the characteristics. Results: the Western and the prudent patterns are the major dietary patterns found in other studies. A higher factor loading in the Western pattern is significantly related to a higher risk of prediabetes. A higher factor loading in the continental pattern is significantly related to a lower risk of prediabetes. Conclusion: decreasing meat and seafood consumption while increasing egg, coffee, and milk consumption may be associated with a decreased risk for prediabetes.