Experimental hypoglycemia is a human model of stress-induced hyperalgesia

Hypoglycemia is a physiological stress that leads to the release of stress hormones, such as catecholamines and glucocorticoids, and proinflammatory cytokines. These factors, in euglycemic animal models, are associated with stress-induced hyperalgesia. The primary aim of this study was to determine whether experimental hypoglycemia in humans would lead to a hyperalgesic state. In 2 separate 3-day admissions separated by 1 to 3 months, healthy study participants were exposed to two 2-hour euglycemic hyperinsulinemic clamps or two 2-hour hypoglycemic hyperinsulinemic clamps. Thermal quantitative sensory testing and thermal pain assessments were measured the day before and the day after euglycemia or hypoglycemia. In contrast to prior euglycemia exposure, prior hypoglycemia exposure resulted in enhanced pain sensitivity to hot and cold stimuli as well as enhanced temporal summation to repeated heat-pain stimuli. These findings suggest that prior exposure to hypoglycemia causes a state of enhanced pain sensitivity that is consistent with stress-induced hyperalgesia. This human model may provide a framework for hypothesis testing and targeted, mechanism-based pharmacological interventions to delineate the molecular basis of hyperalgesia and pain susceptibility.     

Mismatch between ADA and AGS recommendations for glycated hemoglobin targets for older adults

In recent years, modified glycemic targets have been defined for older adults with diabetes mellitus. In a sample of elderly patients, we have identified several inconsistencies between the real life applicability of glycated hemoglobin goals recommended by the American Diabetes Association and the American Geriatrics Society.     

急诊室晕厥的护理

目的：探讨急诊室晕厥患者的临床特点以及护理措施,以期能够提高护理人员对该病的认识。方法：对不同类型的晕厥患者行不同的护理措施,并观察其效果。结果：67例患者中52例经积极治疗和护理后完全康复离开,15例转入病房进行治疗。结论：护理人员应熟练掌握各种晕厥类型的临床特点与抢救措施,以期减少晕厥对患者的伤害。     

Hypoglycemia incidence and risk factors assessment in hospitalized neonates

Objective: To assess the incidence and risk factors of hypoglycemia in hospitalized neonates in China.

Methods: Blood glucose level in hospitalized neonates was monitored routinely. Also, in high-risk newborns and neonates with abnormal blood glucose levels in initial detection, the blood sugar level was monitored daily until it was back to normal and stable.

Results: Hypoglycemia was detected in 113 out of 668 hospitalized neonates, and the incidence of hypoglycemia was 16.9%. The statistical analysis also showed that hypoglycemia always occurred within one week after birth, especially within three days after birth.

Conclusion: Neonates with premature birth, low birth weight and perinatal asphyxia were susceptible to hypoglycemia. Active and continuous monitoring of blood glucose level should be performed in the early newborns, especially in high-risk children, and attention should be paid to timely feeding for the early diagnosis and treatment of neonatal hypoglycemia to reduce its impact on the newborns.     

德谷胰岛素—治疗糖尿病的新选择

糖尿病需要长期的药物治疗和患者自我饮食运动调节。无论1型还是2型糖尿病,随着病程的发展,注射外源性胰岛素都是必须的治疗手段。胰岛素有低血糖风险,理想的胰岛素治疗应该在改善血糖控制的同时,降低低血糖的危险。德谷胰岛素是一种新型超长效基础胰岛素,皮下注射后,半衰期接近25 h,只需1次/d给药,且其在到达稳态时没有胰岛素累积现象,峰谷比较其他基础胰岛素低,因此,低血糖风险更低。本文对德谷胰岛素的研究现状进行综述。