Diabetes mellitus and hearing loss

A prospective hearing survey was performed in a sample of 102 diabetic patients. The hearing data were compared with the hearing thresholds of three control population groups. A significant difference was found in the average hearing thresholds between the diabetic patients and all of the three control populations. Diabetic patients have worse hearing threshold levels especially at low and mid frequencies (P < 0.001). There was also a correlation between the duration of diabetes and hearing loss. No significant correlation was found between the different stages of diabetic retinopathy and the degree of hearing loss.     

Hypoglycaemic activity of Anthocleista vogelii (Planch) aqueous extract in rodents

The hypoglycaemic effect of Anthocleista vogelii was studied in mice, rats and rabbits. Aqueous extract of the plant obtained by infusion from finely pulverized root was used. The extract (100, 400 and 800 mg/kg) induced significant hypoglycaemic activity in a dose-related fashion at 2 h after oral administration in mice and rats with ED₂₅ of 250 mg/kg and 350 mg/kg respectively. The extract (800 mg/kg, orally) similarly induced statistically significant lowering of blood glucose levels at 8 h in normoglycaemic rabbits. The extract (400 mg/kg and 800 mg/kg, orally) also caused reduction of blood glucose levels in alloxan-induced diabetic animals. The results of this study indicate that the aqueous extract of the roots of Anthocleista vogelii possess favourable hypoglycaemic activity both in normo and hyperglycaemic animals compared to chlorpropamide as a standard.     

A randomized, blinded trial of uncooked cornstarch to diminish nocturnal hypoglycemia at Diabetes Camp

Objective: To determine if uncooked cornstarch, as part of the evening snack, can avert nocturnal hypoglycemia in type 1 diabetes. Research Design and Methods: Fifty-one campers and counselors at the American Diabetes Association Camp in San Bernardino, CA were randomly assigned to receive 5 g of uncooked cornstarch as part of the 21:00 evening snack vs. a standard snack of equivalent carbohydrate content. Each snack was given for five nights and the participants and medical personnel were blinded as to assignment. Midnight and 07:00 finger stick blood glucose levels were compared with values <60 mg/dl defined as hypoglycemia and values >250 mg/dl defined as hyperglycemia. Results: There were 218 midnight and 222 07:00 values for comparison. There were six episodes of hypoglycemia at midnight and nine episodes of hypoglycemia at 07:00 for the cornstarch snack nights vs. 30 hypoglycemia episodes at midnight and 21 at 07:00 for the standard snack nights (P < 0.001 and < 0.05, respectively). There was no difference in the number of hyperglycemic events at midnight or 07:00 for the cornstarch vs. standard snack nights. At midnight, 12% of campers had hypoglycemia after the cornstarch snack vs. 46% after the standard snack (P < 0.001), and at 07:00, 16% had hypoglycemia after cornstarch vs. 26% after the standard snack (P = 0.327). Conclusions: These data suggest that uncooked cornstarch, as part of the evening snack, can diminish the nighttime and morning hypoglycemia associated with type 1 diabetes, without causing hyperglycemia.     

Urinary protein excretion and renal function in young people with diabetes mellitus.

To detect early renal involvement in young diabetic patients (IDDM), urinary protein excretion and renal function were examined in 110 patients aged 5.9-25.0 years. Clearances of inulin and PAH were determined as well as albumin (Alb), IgG, N-acetyl-beta-D-glucosaminidase (NAG) and creatinine (Cr) excretion rates (UV). The patients were grouped according to IDDM duration (2- less than 5, 5-10 and greater than 10 years) and albumin excretion rate (non-albuminuria less than 20, microalbuminuria 20-200, and albuminuria greater than 200 micrograms/min per 1.73 m2). Four patients had overt albuminuria, 17 microalbuminuria (equally distributed among the duration groups). Grouped according to albumin excretion rate, the mean GFR was increased in those without albuminuria but 'normalized' in patients with microalbuminuria/albuminuria. Grouped according to albumin excretion rate and the duration of the disease, the non-albuminuric patients with IDDM for greater than 10 years had a lower GFR than those with a shorter duration of IDDM. The patients with microalbuminuria/albuminuria and IDDM for less than 5 years had a reduced GFR. Patients with increased NAG excretion rate had lower Na excretion rate, lower fractional Na excretion and greater creatinine excretion than those with normal NAG excretion. Albumin excretion correlated with IgG excretion, but also with NAG excretion. Our results suggest that early albuminuria in IDDM is of both glomerular and tubular origin. The hyperfiltration declines with increasing albumin excretion but also with the duration of the disease.     

心脏搭桥术对糖尿病人降糖治疗方案的影响

目的 :通过观察 型糖尿病 (DM- )行心脏冠脉搭桥术 (CABG)术后血糖水平的升高到恢复至术前状态的过程 ,从而判断 CABG对 DM- 降糖治疗的影响。方法 :选择 36例 DM- 合并冠心病病人 ,均于体外循环 (CPB)下行心脏搭桥术 ,从术前监测血糖 ,直至术后第七天 ,于术中及术后根据血糖水平适当应用胰岛素 ,观察其对降糖治疗效果及血糖趋于稳定的过程 ,从而判断 CABG对 DM- 血糖的影响。结果 :术中及术后 1～ 3d血糖会较术前明显升高 ,需加用胰岛素助降糖 ,术后 3d血糖渐降 ,第六天趋于稳定 ,第七天恢复至接近术前水平。结论 :DM- ,病人行 CABG术 ,只要围术期有效控制血糖 ,术后血糖基本会逐渐恢复至术前状态 ,对其今后的降糖治疗不会造成严重影响     

对AF系统整复压缩爆裂骨折椎体高度及椎管横截面的观测

目的 :量化评价AF系统恢复胸腰段压缩爆裂椎体高度椎管截面积的效果。方法 :测量AF系统治疗的 72例胸腰段压缩爆裂骨折术前后影像。统计椎体前后缘高度、Cobb角、椎管截面积资料。结果 :术后伤椎前缘高度恢复至 ( 96.5± 2 .3 ) %后缘高度恢复至 ( 98.2± 0 .9) % ,Cobb角恢复至 ( 5 .4± 1.5 )° ,椎管截面积恢复至 ( 97.2± 2 .1% ) ,各项指标与术前比较有非常显著性差异 (P <0 .0 0 1)。术后随访 0 .5～ 3 .5年 ,神经功能按Frankel评定 :60例提高 1～ 3级。结论 :AF系统能恢复或基本恢复胸腰段压缩爆裂骨折椎体的前后缘高度、Cobb角、椎管容积 ,为脊髓神经功能的恢复提供一个良好的环境。是治疗脊柱胸腰段压缩爆裂骨折较好的内固定器。     

老年2型糖尿病患者胰岛素抵抗相关指标的检测和意义

目的:探讨老年2型糖尿病胰岛素抵抗(IR)及其相关性,为老年2型糖尿病的合理防治提供临床依据。方法:选择120例老年2型糖尿病患者,按胰岛素敏感指数(HOMA)胰岛素抵抗(HOMA-IR)50百分位点将患者分为两组:胰岛素相对敏感组(HOMA-IR<3.56)和胰岛素相对抵抗组(HOMA-IR≥3.56),比较体重指数(BMI)、腰/臀比(WHR)、血压、血生化学检查等指标。用年龄>40岁,<60岁的2型糖尿病患者做对照组。结果:两组老年患者在年龄、性别、舒张压、空腹血糖、胆固醇、高密度脂蛋白、糖化血红蛋白、HOMA胰岛β细胞功能方面无差异;但BMI、WHR、收缩压、甘油三脂、空腹胰岛素、HOMA-IR差异具有显著性。多线性回归分析后,只有腰/臀比、收缩压、甘油三脂、HOMA-IR存在统计学差异。老年患者与对照组相比,IR发生率明显增加,且两者腰/臀比、收缩压、甘油三脂方面也差异显著。结论:IR与老年2型糖尿病密切相关,是临床防治糖尿病的重要靶点。