Variation of Mean Absolute Relative Differences of Continuous Glucose Monitoring Systems Throughout the Day

Background:There is an increasing use of continuous glucose monitoring (CGM) by people with diabetes. Measurement performance is often characterized by the mean absolute relative difference (MARD). However, MARD is influenced by a number of factors and little is known about whether MARD is stable throughout the day.Material and Methods:A total of 24 participants with type 1 diabetes were enrolled in the study. The study was performed for seven in-patient days. Participants wore two CGM systems in parallel and performed additional frequent blood glucose (BG) measurements. On two days, glucose excursions were induced.MARD was calculated between pairs of CGM and BG values, with BG values serving as reference values. ARD values calculated from CGM-BG pairs were grouped by hour of the day. Results were analyzed separately for glucose excursion days and for regular days.Results:Total MARDs for the complete study duration were 12.5% ± 3.6% and 13.2% ± 2.4% (n = 24). Throughout the day marked variability of MARD was observed (8.0% ± 1.3%-16.3% ± 2.9% (G5); 9.1% ± 1.4%-16.3% ± 5.3% (FL), up to n = 157 each). Low(est) MARD values were observed before breakfast and dinner, when subjects were in or near a fasting state. Especially after breakfast and lunch, MARD values were higher than average.Conclusions:Analytical performance of the two CGM systems, assessed by MARD, was found to vary markedly throughout the day. Activities of daily life likely triggered these variations. An increasing number of CGM users base therapeutic decisions on CGM values, and they should be aware of these variations of performance throughout the day.     

脂蛋白脂酶活化剂NO-1886抑制糖尿病兔动脉粥样硬化的形成

目的　合成化合物NO 1886 ,一种脂蛋白脂酶活化观察脂蛋白脂酶活化剂是否降低高脂 /高蔗糖饲料诱发的糖尿病新西兰兔的血浆葡萄糖并减轻其动脉粥样硬化。方法　给予高脂 /高蔗糖饲料升高新西兰兔血浆总胆固醇 ,甘油三酯和葡萄糖及降低高密度脂蛋白胆固醇而导致动脉粥样硬化。饲料中加入 1 0 %NO 1886进行治疗观察。分别在 0、4、8、12、16、2 0及 2 4wk从禁食过夜的兔耳静脉抽取血样测定葡萄糖和脂质水平。第 2 4周末 ,处死动物 ,分离主动脉 ,经苏丹Ⅳ染色固定脂质后 ,计算脂纹病变面积。结果　应用NO 1886后 ,实验动物血浆葡萄糖 ,总胆固醇和甘油三酯降低 ,高密度脂蛋白胆固醇增加。对动脉粥样硬化的发展具有抑制作用。结论　NO 1886不仅可改善脂质紊乱 ,而且可降低血浆葡萄糖 ,减轻糖尿病兔动脉粥样硬化     

基于伴刀豆球蛋白A的溶胶-凝胶互变糖敏感系统研究进展

伴刀球蛋白A(Con A)是一种由刀豆植物中提取的凝集素,其分子上存在与糖分子的特异性结合点,因此常应用于糖敏感给药系统中。文中首先介绍了基于Con A的溶胶-凝胶互变糖敏感系统的早期研究情况,提出早期研究普遍出现的难题,即系统中Con A流失产生的毒性以及系统糖敏感性的降低;而近年来的研究则采用将Con A固定在单体上或聚合物上试图解决此难题。文中还介绍了采用基于ConA的溶胶-凝胶互变糖敏感系统作为模拟性胰腺进行的基础性应用研究进展。     

盐酸二甲双胍治疗奥氮平导致的精神分裂症患者代谢综合征的疗效及其与慢性炎症状态的关系

目的：分析二甲双胍治疗奥氮平导致的精神分裂症患者代谢综合征（MS）的疗效,并进一步分析治疗过程中C-反应蛋白（CRP）和肿瘤坏死因子-α(TNF-α)的变化。方法：按照入组病历号随机选取满足入组标准和排除标准的精神分裂症患者100例,依据随机数字表分为研究组和对照组各50例,干预治疗前和24周后分别检测患者体质量指数（BMI）、稳态胰岛素评价指数（HOMA-IR）、空腹血浆葡萄糖（FPG）、糖化血红蛋白（Hb A1c）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、甘油三酯（TG）、CRP和TNF-α,并进行统计分析。结果：两组患者性别、受教育程度、婚姻、家族史、病程、年龄和奥氮平治疗剂量分布差异无统计学意义（P>0.05）。盐酸二甲双胍治疗后研究组BMI、HOMA-IR、FPG、HbA1c、HDL-C、LDL-C、TC、TG、CRP、TNF-α的差值明显高于对照组（P<0.05）。研究组CPR和TNF-α与BMI和HOMA-IR呈显著正相关,ΔCPR可以分别解释ΔBMI变异的13.4%,ΔHOMA-IR变异的11.4%;ΔTNF-α...     

重症监护患者胰岛素强化控制血糖的预后研究

无沦合并糖尿病与否,多种因素可导致重症患者出现高血糖,高血糖能够增加重症患者的病死率.近来,多项临床研究显示,胰岛素强化治疗可以使血糖严格的控制于正常水平,显著降低各种普通重症患者及诸如心血管、神经.外科等各科重症患者的病死率和医疗费用,并给患芹带来长期的生存获益.虽然强化治疗控制血糖增加了低血糖的发生,但低血糖并未增加患者的病死率.胰岛素强化控制血糖成为重症监护病房中不容忽视的一种重要治疗措施.     

恶性肿瘤糖代谢异常的再认识

恶性肿瘤和糖尿病已经成为严重威胁人类健康的两大常见疾病。研究表明有氧状态下的糖酵解是恶性肿瘤细胞显著的生化特征,恶性肿瘤与胰岛素抵抗和糖尿病的发生发展有一定的关系,本文就其相关性及作用机制综述如下。     

Hormonal contraception and HIV-positive women: metabolic concerns and management strategies

As HIV-positive women live longer lives, and as testing for HIV becomes more routine, clinicians can expect to see more HIV-positive women in their practices. The need to be aware of management issues particular to this population becomes increasingly important. Metabolic dysregulation is a common, long-term complication associated with HIV and is one of the most difficult to manage. Hormonal contraception also is associated with metabolic dysregulation. As more HIV-positive women choose long-term, reversible contraception, the potential for concomitant and additive side effects, and the need for careful, proactive management strategies to avoid these complications, will become more important. This article reviews research detailing the metabolic dysfunction associated with hormonal contraception and with HIV-seropositivity. It highlights reasons for concern regarding the potential, although as yet theoretical, increased risk for metabolic dysfunction when hormonal contraception is used in the presence of HIV. Suggestions for management strategies for women living with HIV who choose to use hormonal contraception are presented. These strategies should be viewed as suggestions for management until substantitive research becomes available.