社区糖尿病患者的健康教育

目的 评价社区健康教育在糖尿病(DM)防治中的作用.方法 对已经在社区卫生服务站建立健康档案的85例DM患者进行DM相关知识的健康教育,通过患者不良生活方式和自我管理能力的改变及监测血糖、血脂等指标的变化情况,观察健康教育结果.结果 实施健康教育后,患者不良生活方式明显得到改变,自我管理能力得到显著提高,血糖、血脂控制理想.结论 对DM患者实施社区健康教育,有利于控制血糖、血脂,延缓并发症发生,提高患者生活质量.     

糖化血红蛋白及糖化血清蛋白与糖尿病肾功能衰竭患者的血糖监测

糖化血红蛋白(Hb)A1c是血糖监测的苇要指标,反映检测前2～3个月的平均血糖水平.慢性肾功能衰竭(CRF)患者存在贫血、酸中毒、氧化应激、胰岛素抵抗、血液透析及促红细胞生成素(EPO)的应用等因素,对HbA1c的测定会造成影响.糖化血清蛋白(GSP)反映检测前2～3周的平均血糖水平,仅受血浆蛋白的影响,几乎不受血红蛋白和EPO治疗等以上因素的影响,且对短时间内的血糖变化更为敏感.将GSP作为糖尿病肾功能衰竭患者血糖监测指标可能比HbA1c更理想.     

过氧钒烟酸对糖尿病鼠苯丙氨酸羟化酶活性的影响

目的　探讨过氧钒烟酸（ Ｐ Ｏ Ｖ） 的降血糖作用的分子生物学机制。方法　选用 Ｓ Ｄ 大鼠用链脲佐菌素诱导产生糖尿病鼠动物模型，观察用 Ｐ Ｏ Ｖ 和美迪康（ Ｍｅｔ） 治疗后各组大鼠血、尿糖水平及血肝细胞质中苯丙氨酸羟化酶（ Ｐ Ａ Ｈ） 活性改变情况，并进行比较。结果　糖尿病鼠 Ｐ Ａ Ｈ 活性明显增高，用 Ｐ Ｏ Ｖ治疗４ 周后活性受到抑制，血糖水平明显下降，临床症状得以改善。结论　 Ｐ Ｏ Ｖ 的降糖作用优于美迪康，且未见明显毒副作用。     

Impact of type 2 diabetes mellitus on diffuse inflammatory activation of de novo atheromatous lesions: Implications for systemic inflammation

AimsLocal coronary and systemic inflammation is pronounced in patients with diabetes mellitus (DM). Intracoronary thermography detects local inflammation and C-reactive protein (CRP) is a marker of systemic inflammation. We investigated whether or not, in patients with DM, thermal heterogeneity of culprit lesions (CLs) correlates with that of non-culprit lesions (NCLs) and with systemic inflammation.MethodsWe included DM patients who had two angiographically significant lesions and were undergoing percutaneous coronary intervention. We measured the temperature difference (ΔT) between the lesion and proximal vessel wall.ResultsWe included 104 (n = 208 lesions) patients: 32 (n = 64 lesions) had DM and 72 (n = 144 lesions) were non-DM (control group). ΔT was increased in DM in both CLs and NCLs (CLs: DM = 0.12 ± 0.06 °C; no DM = 0.06 ± 0.04 °C; P < 0.01 versus NCLs: DM = 0.13 ± 0.08 °C versus no DM = 0.06 ± 0.05 °C; P < 0.01). Patients with DM had similar ΔT in CLs and NCLs (P = 0.49). A linear correlation was detected between heat production in all lesions and CRP (R = 0.45; P < 0.01), which was attributed to the correlation of ΔT in lesions of patients with DM and CRP (R = 0.32; P < 0.01). In lesions of patients with low CRP, a greater rate of discrepancy was found, as 100% of lesions in patients with DM versus 66.1% of lesions of patients without DM had a high ΔT in one or both lesions (P < 0.01).ConclusionIn patients with DM, local inflammatory activation is diffuse and correlates with systemic inflammation. However, low systemic inflammatory activation does not always predict an increase in local thermal heterogeneity.     

Aspart与正规人胰岛素应用胰岛素泵控制血糖的疗效比较

选择21例应用预混人胰岛素Novolin 30R治疗血糖控制欠佳的1型和2型糖尿病患者，用胰岛素泵交叉应用相同剂量的速效人胰岛素类似物Aspart与正规人胰岛素NovolinR控制高血糖，比较两种药物应用期间全天毛细血管血糖谱，发现Aspart在控制空腹血糖、餐后血糖及全天平均血糖均较后者疗效为佳。     

胰岛素强化治疗在2型糖尿病骨折患者围手术期的应用

Objective To investigate the best way to control the blood sugar level during the perioperation of bone fracture patients with type 2 diabetes(T2DM).Methods Bone fracture patients with T2DM were randomly divided into three groups:continuous subcutaneous insulin infusion group(insulin aspart,group CSII,n=20),glargine treatment group(insulin aspart+insulin glargine,group GA,n=20),and NPH treatment(insulin aspart+rh-insulin,group NA,n=20).The levels of fasting plasma glucose(FPG)and the 2 hours postprandial glucose(2h PG),blood glucose fluctuation(BGF),insulin dosage(ID),good effective time(GET),incidence of hypoglycemia,dawn phenomenon and infection,average time of stitches removal(ATSR),average hospitalized length(AHL)of three groups were compared.Results FPG and 2hPG,ID in group CSII[(6.32±1.18)mmol/L,(7.72±1.53)mmol/L,(35.40±1.60)IU]and group GA [(6.25±0.88)mmol/L,(7.32±1.17)mmol/L,(36.20±0.80)IU]were significantly lower than those of group NA [(7.44±1.36)mmol/L,(8.52±0.76)mmol/L,(40.50±2.40)IU,all P<0.05],simulaneously,BGF,GET incidence of complications,ATSR,AHL of group CSII and GA were significantly lower than those of group NA(all P<0.05).There were not significant difference between group CSII and group GA.Compared with group CSII,group GA had less costs in-hospital and better practicability.Conclusion Both CSII and insulin glargine combined with insulin aspart can effectively,safely,rapidly and stablely control hyperglycemia.and might be the first choice to control blood sugar for bone fracture patients with T2DM in perioperation.     

Haemoglobin A1 and congenital malformation

Two hundred and thirty pregnancies were studied in 196 diabetic women. Seven women with babies found to have major malformations had a higher median first trimester haemoglobin A1 (12.9%) than the median HbA1 (10.8%) in those with normal babies (p = 0.06). No relationship was found between the occurrence of minor malformations and first trimester maternal haemoglobin A1. Two of the seven congenital malformations were diagnosed antenatally at a time when therapeutic abortion could be offered. Expert antenatal ultrasound scanning should be offered to all pregnant diabetic women as poor glycaemic control at the time of conception and organogenesis, as evidenced by raised first trimester HbA1, predisposes to congenital malformation.     

降糖灵1号降血糖的实验研究

目的　验证降糖灵 1号的降血糖作用。方法　以大、小白鼠为实验动物 ,分别与空白对照、高血糖对照及降糖甲片组和消渴丸组进行对照。研究降糖灵 1号对肾上腺素性和四氧嘧啶性高血糖的药理作用。结果　降糖灵 1号组除与消渴丸组对糖尿病差异无显著性意义 (P >0 0 5 )外 ,与其他各组差异均有显著性意义 (P <0 0 5 ,P <0 0 1)。结论　降糖灵 1号具有明显的降血糖作用     

瑞格列奈与迪沙片治疗新诊断2型糖尿病的疗效对比观察

比较对新诊断2型糖尿病患者应用瑞格列奈（11例）和迪沙片（10例）治疗4周后空腹血糖（FPG）、餐后2h血糖（2hPG）、晨3点血糖（3aPG）,空腹胰岛素（FIns）、餐后2h胰岛素（2hIns）,糖化白蛋白的值。结果显示,与迪沙片组相比,瑞格列奈组治疗后空腹血糖、餐后2h血糖的下降幅度更为明显,但低血糖的发生次数反而减少。