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Objective To investigate the changes of blood lipid and glycosylated hemoglobin (HbA1c) levels in obese type 2 diabetes (T2DM) patients and their relationship with insulin resistance (Homa-IR). Methods A total of 120 cases of T2DM newly diagnosed in Motuo County, Tibet from February to October 2022 were selected as the observation group. According to BMI, the patients were divided into diabetes normal weight group (46 cases), overweight group (43 cases) and obesity group (31 cases); 145 healthy subjects were selected as the control group. The levels of HbA1c, fasting blood glucose (FPG), fasting insulin (FINS), serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL-C), and low-density lipoprotein (LDL-C) were detected in the study subjects, and Homa-IR and Homa-β indices were calculated. The height, weight, and abdominal circumference were measured. The differences in the levels of the above indicators between the observation group patients and the control group, as well as among various subgroups within the observation group were compared. The influencing factors of Homa-IR in obese T2DM patients were analyzed. Results Compared with the control group, a significant increase in BMI, abdominal circumference, blood pressure, HbA1c, FBG, FINS, TC, TG, LDL-C, UA, visceral fat area, and the levels of Home-IR and Home-β was found in the observation group (all P<0.05). There were significant differences in BMI, abdominal circumference, and the levels of FINS, Homa IR, Homa-β, and HbA1c in diabetes patients with different BMI (all P<0.05). Correlation analysis showed that TG levels in obese T2DM patients in the observation group were significantly correlated with HbA1c (r=0.396, P=0.027), Homa-IR (r=0.405, P=0.024), and Home-β (r=-0.401, P=0.025); LDL-C was significantly correlated with Homa-IR (r=0.411, P=0.022) and Homa-β (r=-0.412, P=0.021); HbA1c was significantly positively correlated with BMI (r=0.371, P=0.040). Conclusion Insulin resistance is closely related to TG, LDL-C, and BMI in obese T2DM patients from the Motuo ethnic minority of Tibet, suggesting that these factors may play a role in the occurrence of T2DM.
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Objective To investigate the nutritional status of elderly patients with diabetic foot ulcers and to explore its influencing factors and relationship.Methods Convenience sampling method was used to recruit 182 elderly patients with diabetic foot ulcers.The mini nutritional assessment (MNA) was adopted to assess nutritional status,and patients' clinical information,hemoglobin A1c,hemoglobin,serum albumin,C-reactive protein were also collected.Results The average score of MNA was 16.36±3.68 for 182 patients,and 121 patients suffered from malnutrition(66.48％),while 61 patients suffered from potential malnutrition(33.52％).The occurrence of malnutrition was positively correlated with age,course of diabetes,classification of foot ulcer,infection,C-reactive protein,hemoglobin A1c and food intake (P＜0.05);the incidence of malnutrition and C-reactive protein for patients with Wagner grade 3 and above were higher than those for patients with low Wagner grades,and hemoglobin A1c and hemoglobin were lower for patients with Wagner grade 3 and above(P＜0.05).Conclusion There was high incidence rate of malnutrition in elderly patients with diabetic foot ulcers,closely related to inflammatory state.Health care providers should provide targeted interventions in time,improve condition of malnutrition,and promote rehabilitation.
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<p><b>OBJECTIVE</b>To compare the efficacy differences between moxibustion at Geshu (BL 17) and oral administration of cilostazol on diabetic limb arterial obliteration (DLAO) at early stage as well as the impacts on hemorheology and arterial inner dimension of lower extremity.</p><p><b>METHODS</b>Seventy patients of DLAO at early stage were randomly divided into an observation group and a control group, 35 cases in each one. The two groups were treated with regular treatment of blood glucose and blood lipid. The patients in the control group was treated with oral administration of cilostazol, 50 mg, twice a day; the patients in the observation group were treated with moxibustion at Geshu (BL 17), once a day. The consecution treatment of two weeks constituted one session, and totally 4 sessions were given. The total syndrome score, hemorheology index (including low and high shear viscosity of blood, plasma viscosity, hematocrit and erythrocyte aggregation index) and arterial inner dimension of lower extremity (including popliteal artery, posterior tibial artery and dorsalis pedis artery) were compared before and after treatment.</p><p><b>RESULTS</b>Compared with those before treatment, the total syndrome score, hemorheology index and arterial inner dimension of lower extremity were significantly improved after treatment in the two groups (all<0.05). The total syndrome score, hemorheology index in the observation group were superior to those in the control group (all<0.05), but the improvement of arterial inner dimension of lower extremity was not significantly different between the two groups (>0.05). After treatment, the total effective rate was 91.4% (32/35) in the observation group, which was significantly superior to 85.7% (30/35) in the control group (<0.05).</p><p><b>CONCLUSION</b>Moxibustion at Geshu (BL 17) is superior to oral administration of cilostazol for DLAO at early stage, which could effectively improve the clinical symptoms, blood flow and blood vessel and increase the blood flow of lower limb.</p>
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<p><b>OBJECTIVE</b>To compare the efficacy between acupuncture at stellate ganglion combined with intravenous administration of alprostadil and simple intravenous administration of alprostadil on lower limb atherosclerosis of early diabetes mellitus.</p><p><b>METHODS</b>Sixty patients of lower limb atherosclerosis of early diabetes mellitus were randomly divided into an observation group and a control group, 30 cases in each one. Patients in the two groups were treated with basic treatment to control blood glucose and lipid. In addition, patients in the control group were treated with intravenous administration of alprostadil (10 µg) and sodium chloride solution (100 mL); based on this, patients in the observation group were treated with acupuncture at stellate ganglion. The treatment was given once a day; the consecutive treatment of two weeks constituted one session, and totally 4 sessions were given. The total syndrome score, glycosylated hemoglobin (HbA1c), blood flow of posterior tibial artery and dorsal artery of foot were observed before and after treatment; the clinical efficacy was compared between the two groups.</p><p><b>RESULTS</b>Compared before treatment, the total syndrome score, HbA1c, blood flow of posterior tibial artery and dorsal artery of foot were significantly improved after treatment (all P < 0.05), which were more obvious in the observation group (all P < 0.05). After treatment, the total effective rate was 93.3% (28/30) in the observation group, which was significantly superior to 86.7% (26/30) in the control group (P < 0.05). CONCLUSION Acupuncture at stellate ganglion combined with intravenous administration of alprostadil achieve better effect than simple intravenous administration of alprostadil for lower limb atherosclerosis of early diabetes mellitus, which improve the clinical symptoms, regulate blood sugar and increase the blood flow of lower limb.</p>
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Aged , Female , Humans , Male , Middle Aged , Acupuncture Points , Acupuncture Therapy , Atherosclerosis , Therapeutics , Diabetes Mellitus, Type 2 , Lower Extremity , Stellate Ganglion , Treatment OutcomeABSTRACT
Objective To investigate the mixed protamine zinc recombinant human insulin lispro injection on glucose metabolism, immune function in patients with type 2 diabetes and its inflammatory mechanisms.Methods 125 patients enrolled were randomly divided into two groups according to the random number table: control group (n =61) and observation group (n =64).The control group were received conventional treatment, observation group were received mixed protamine zinc recombinant human insulin lispro injection on the basis of control group, with a course of three months of both groups.The fasting blood glucose (FBG), 2h post prandial blood glucose (2hPG), glycated hemoglobin (HbA1c), fasting insulin, insulin resistance index ( IRI) , CD4 +, CD8 +, CD4 +/CD8 +changes and inflammatory cytokines levels were compared before and after treatment between two groups. Results The level of FBG, 2hPG, HbA1c after treatment was respectively lower than that before treatment in both groups (P<0.05), and the above indexes of observation group after treatment was respectively lower than that of control group (P<0.05).The level of fasting insulin, IRI after treatment was respectively lower than that before treatment in both groups (P<0.05), and the above indexes of observation group after treatment was respectively lower than that of control group (P<0.05).The level of CD8 +was lower, CD4 +, CD4 +/CD8 +was higher after treatment than that before treatment in both groups, respectively (P<0.05), and the CD8 +level of observation group after treatment was lower, CD4 +, CD4 +/CD8 +was higher than that of control group, respectively (P<0.05).The level of TNF-α, IL-6, CRP after treatment was respectively lower than that before treatment in both groups (P<0.05), and the above indexes of observation group after treatment was respectively lower than that of control group (P<0.05).Conclusion The mixed protamine zinc recombinant human insulin lispro injection can significantly improve glucose metabolism in patients with type 2 diabetes, and enhance immune function, reduce inflammation, thereby reducing the incidence of cardiovascular events.
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To compare the effect of insulin glargine combined with nateglinide and continuous subcutaneous insulin infusion(CSII) during intraoperative period in type 2 diabetic patients with fracture. Both of the managements made blood glucose under control [fasting blood glucose(6.89±1.96)vs(6.75±2.33)mmol/L] in similar period [(3.6±1.6)vs(2.9±1.2) d,both P>0.05]. The mean blood glucose was lower in patients treated by CSII than that of the other group.
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Objective To investigate the therapeutic and adverse effects of short-term continuous subcutaneous insulin infusion (CSII) in patients with newly-diagnosed type 2 diabetes mellitus. Methods By way of follow-up and retrospective study, 256 patients with newly-diagnosed type 2 diabetes mellitus receiving two weeks of CSII therapy were analyzed in our diabetes center. The parameters, such as blood glucose level after two-week CSII therapy, time needed to control hyperglycemia, insulin dosage and the rate of hypoglycemic episodes were observed and recorded. Results The optimal glycemic control rates after 3 days, 7 days, 2 weeks were 46.7%, 78.4%, 92.2% respectively. The remission rates of patients who maintained optimal glycemic control at the third, sixth, twelfth, twenty-fourth and thirty-sixth months and more than 48 months after withdrawal of insulin were 75%, 64.8%, 53.5%, 30.9%, 10.2% and 0%, respectively. In patients with a period of remission over 3 months,the daily total insulin requirement on the day of withdrawal of CSII was less than that in patients with remission less than 3 months (P＜0.01). The duration of remission was negatively correlated to daily insulin requirement on the day of CSII withdrawal(r=-0.63, P＜0.01). Conclusion Patients with newly-diagnosed type 2 diabetes mellitus can quickly achieve optimal glycemic control by CSII. CSII may decrease glucotoxicity to pancreatic β cells and delay the deterioration of β-cell function .
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<p><b>OBJECTIVE</b>To observe the effect of Yiqi Yangyin Huoxue Tongfu (YYHT) principle in treating diabetes mellitus type 2 of secondary failure to sulfonylurea agents.</p><p><b>METHODS</b>Forty patients were randomly divided into two groups, based on the unchanged previous treatment of sulfonylurea agents, Chinese decoction prescribed according to YYHT principle was given to the treated group and rosiglitazone was given to the control group. Changes of insulin sensitivity (SI), insulin response to glucose (IRG), insulin sensitive index (ISI), tumor necrosis factor-alpha (TNF-alpha), endothelin-1 (ET-1), 6-keto-prostaglandin F1alpha(6-keto-PGF1alpha) and thromboxane B2 (TXB2) were observed.</p><p><b>RESULTS</b>The total effective rate in the treated group was 71.4%, that on improving peripheral insulin resistance was 76.2%, the two parameters were similar to those in the control group. In the treated group, SI, ISI were significantly improved, and TNF-alpha, ET-1 and TXB2 significantly lowered, but no change of IRR was found.</p><p><b>CONCLUSION</b>Application of YYHT principle in treating patients with diabetes mellitus type 2 of secondary failure to sulfonylurea agents could alleviate the peripheral resistance to insulin, inhibit TNF-alpha, and protect the vascular endothelial cells.</p>