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1.
Zhongguo Zhen Jiu ; 41(2): 155-60, 2021 Feb 12.
Artículo en Chino | MEDLINE | ID: mdl-33788462

RESUMEN

OBJECTIVE: To observe the effect of acupuncture on vascular endothelial function in patients of polycystic ovary syndrome (PCOS) with impaired glucose tolerance (IGT) and normal glucose tolerance (NGT). METHODS: A total of 140 patients with PCOS were divided into an IGT group (70 cases, 11 dropped off) and a NGT group (70 cases, 9 cases dropped off). The patients in the two groups were treated with full-cycle acupuncture at Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6), Tianshu (ST 25), etc. once every other day, 3 times a week, for 3 months. Before and after treatment, TCM symptom score, insulin resistance index [including fasting plasma glucose (FPG), 2-hour blood glucose (2hPG), fasting serum insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR)] and vascular endothelial related factors [including asymmetric dimethylarginine (ADMD), endothelin-1 (ET-1), malondialdehyde (MDA), nitric oxide (NO)] were compared between the two groups; in addition, the obese subgroup and non-obese subgroup of the two groups were further compared. RESULTS: Compared before treatment, the TCM symptom scores, ADMD, ET-1 and MDA after treatment were decreased (P<0.05), and NO was increased (P<0.05) in the two groups; FPG, 2hPG, FINS and HOMA-IR after treatment were decreased in the IGT group (P<0.05), the improvement of the above indexes in the IGT group was more significant than that in the NGT group (P<0.05). After treatment, the serum levels of ADMD, ET-1 and MDA were decreased (P<0.05), and NO was increased (P<0.05) in the obese subgroup. In the IGT group, the improvement of serum ADMD, ET-1, MDA and NO in the obese subgroup was more significant than that in the non-obese subgroup (P<0.05). In the NGT group, the improvement of ET-1, MDA and NO in the obese subgroup was more significant than that in the non-obese subgroup (P<0.05). CONCLUSION: Acupuncture could improve vascular endothelial function in PCOS patients, IGT patients have better efficacy than NGT patients, and obese patients have better efficacy than non-obese patients.


Asunto(s)
Terapia por Acupuntura , Intolerancia a la Glucosa , Resistencia a la Insulina , Síndrome del Ovario Poliquístico , Glucemia , Femenino , Glucosa , Intolerancia a la Glucosa/terapia , Humanos , Insulina , Síndrome del Ovario Poliquístico/terapia
2.
Medicine (Baltimore) ; 100(8): e24576, 2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33663065

RESUMEN

BACKGROUND: Diabetes is a chronic metabolic disease characterized by elevated blood glucose levels due to insulin resistance and ß-cell dysfunction. In China, Huangyusang decoction (HYS) has been widely used to treat Type 2 diabetes. However, there is no systematic review found. In order to evaluate the efficacy and safety of HYS in the treatment of Type 2 diabetes, we need to conduct a meta-analysis and systematic evaluation. METHODS: We will enroll the randomized controlled trials (RCTs) evaluating the effectiveness and safety of HYS in the treatment of Type 2 diabetes. Data come mainly from 4 Chinese databases (CNKI, Wanfang, CBM, and VIP Database) and 4 English databases (PubMed, Embase, Cochrane Library, and Web of science). The enrollment of RCTs is from the starting date of database establishment till January 30, 2021. Fasting blood glucose is considered as the main indicator of the dyslipidemia, while the body mass index, glycated hemoglobin, fasting insulin, triglycerides, and cholesterol are regarded as the secondary indicators. There are safety indicators including liver enzyme and kidney function. The work such as selection of literature, data collection, quality evaluation of included literature, and assessment of publication bias will be conducted by 2 independent researchers. Meta-analysis will be performed by RevMan 5.0 software. RESULTS: This study will provide high-quality evidence for the effectiveness and safety of HYS in the treatment of type 2 diabetes. CONCLUSION: The results of the study will help us determine whether HYS can effectively treat type 2 diabetes. ETHICS AND DISSEMINATION: This study does not require ethical approval. We will disseminate our findings by publishing results in a peer-reviewed journal. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/AXBRV.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Glucemia , Índice de Masa Corporal , Medicamentos Herbarios Chinos/administración & dosificación , Medicamentos Herbarios Chinos/efectos adversos , Hemoglobina A Glucada , Humanos , Pruebas de Función Renal , Lípidos/sangre , Pruebas de Función Hepática , Ensayos Clínicos Controlados Aleatorios como Asunto , Proyectos de Investigación
4.
Chemosphere ; 270: 128635, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33757275

RESUMEN

Epidemiological studies have indicated that polycyclic aromatic hydrocarbons were related to diabetes and insulin resistance. However, studies in mammals on the development of diabetes caused by polycyclic aromatic hydrocarbons are lacking. Pregnant mice were orally exposed to phenanthrene (0, 60 and 600 µg kg-1 body weight) once every 3 days during gestation. In adult mouse offspring, in-utero phenanthrene exposure caused glucose intolerance and decreased insulin levels in females, while caused elevated fasting blood glucose and insulin levels in males. Serum resistin and interleukin-6 levels were elevated in offspring of both sexes. Serum adiponectin levels were decreased in females but increased in males. The insulin receptor signals were upregulated in the liver and downregulated in the skeletal muscle of F1 females, while they were inhibited in both tissues of F1 males. The visceral fat weight and body weight of the treated mice were not increased, suggesting that phenanthrene is not an obesogen, which is supported by the nonsignificant alteration in pparγ transcription in visceral adipose tissue. The transcription of retn in visceral adipose tissue was upregulated in both sexes, and that of adipoq was downregulated in females but upregulated in males, which were matched with the promoter methylation levels of these genes. The results indicated that phenanthrene exposure during gestation could disturb adipocytokine levels via epigenetic modification in adult offspring, and further influence glucose metabolism. These results might be helpful for understanding nonobesogenic pollutant-induced insulin resistance and preventing against diabetes without obesity.


Asunto(s)
Intolerancia a la Glucosa , Resistencia a la Insulina , Fenantrenos , Efectos Tardíos de la Exposición Prenatal , Animales , Glucemia , Femenino , Glucosa , Intolerancia a la Glucosa/inducido químicamente , Homeostasis , Humanos , Insulina , Masculino , Exposición Materna/efectos adversos , Ratones , Fenantrenos/toxicidad , Embarazo , Efectos Tardíos de la Exposición Prenatal/inducido químicamente
5.
6.
Int J Mol Med ; 47(4): 1-8, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33649802

RESUMEN

The relationship between hemochromatosis and diabetes has been well established, as excessive iron deposition has been reported to result in impaired function of the endocrine and exocrine pancreas. Therefore, the objective of the present study was to analyze the effects of iron accumulation on the pancreata and glucose homeostasis in a bone morphogenetic protein 6­knockout (Bmp6­/­) mouse model of hemochromatosis. The sera and pancreatic tissues of wild­type (WT) and Bmp6­/­ mice (age, 3 and 10 months) were subjected to biochemical and histological analyses. In addition, 18F­fluorodeoxyglucose biodistribution was evaluated in the liver, muscle, heart, kidney and adipose tissue of both animal groups. The results demonstrated that 3­month­old Bmp6­/­ mice exhibited iron accumulation preferentially in the exocrine pancreas, with no signs of pancreatic injury or fibrosis. No changes were observed in the glucose metabolism, as pancreatic islet diameter, insulin and glucagon secretion, blood glucose levels and glucose uptake in the liver, muscle and adipose tissue remained comparable with those in the WT mice. Aging Bmp6­/­ mice presented with progressive iron deposits in the exocrine pancreas, leading to pancreatic degeneration and injury that was characterized by acinar atrophy, fibrosis and the infiltration of inflammatory cells. However, the aging mice exhibited unaltered blood glucose levels and islet structure, normal insulin secretion and moderately increased α­cell mass compared with those in the age­matched WT mice. Additionally, iron overload and pancreatic damage were not observed in the aging WT mice. These results supported a pathogenic role of iron overload in aging Bmp6­/­ mice leading to iron­induced exocrine pancreatic deficiency, whereas the endocrine pancreas retained normal function.


Asunto(s)
Células Acinares/patología , Proteína Morfogenética Ósea 6/genética , Diabetes Mellitus/patología , Hemocromatosis/patología , Sobrecarga de Hierro/patología , Animales , Glucemia/análisis , Modelos Animales de Enfermedad , Fibrosis/patología , Fluorodesoxiglucosa F18/farmacocinética , Glucosa/metabolismo , Hierro/metabolismo , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Páncreas/lesiones , Páncreas/patología , Tomografía de Emisión de Positrones
7.
PLoS One ; 16(3): e0246265, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33661932

RESUMEN

Medicinal uses and applications of metals and their complexes are of increasing clinical and commercial importance. The ligation behavior of quercetin (Q), which is a flavonoid, and its Zn (II) (Q/Zn) complex were studied and characterized based on elemental analysis, molar conductance, Fourier-transform infrared (FTIR) spectra, electronic spectra, proton nuclear magnetic resonance (1H-NMR), thermogravimetric analysis, and transmission electron microscopy (TEM). FTIR spectral data revealed that Q acts as a bidentate ligand (chelating ligand) through carbonyl C(4) = O oxygen and phenolic C(3)-OH oxygen in conjugation with Zn. Electronic, FTIR, and 1H-NMR spectral data revealed that the Q/Zn complex has a distorted octahedral geometry, with the following chemical formula: [Zn(Q)(NO3)(H2O)2].5H2O. Diabetes was induced by streptozotocin (STZ) injection. A total of 70 male albino rats were divided into seven groups: control, diabetic untreated group and diabetic groups treated with either MSCs and/or Q and/or Q/Zn or their combination. Serum insulin, glucose, C-peptide, glycosylated hemoglobin, lipid profile, and enzymatic and non-enzymatic antioxidant levels were determined. Pancreatic and lung histology and TEM for pancreatic tissues in addition to gene expression of both SOD and CAT in pulmonary tissues were evaluated. MSCs in combination with Q/Zn therapy exhibited potent protective effects against STZ induced hyperglycemia and suppressed oxidative stress, genotoxicity, glycometabolic disturbances, and structural alterations. Engrafted MSCs were found inside pancreatic tissue at the end of the experiment. In conclusion, Q/Zn with MSC therapy produced a synergistic effect against oxidative stress and genotoxicity and can be considered potential ameliorative therapy against diabetes with pulmonary dysfunction, which may benefit against COVID-19.


Asunto(s)
Diabetes Mellitus Experimental/terapia , Hipoglucemiantes/uso terapéutico , Trasplante de Células Madre Mesenquimatosas , Quercetina/uso terapéutico , Zinc/uso terapéutico , Animales , Glucemia/análisis , Glucemia/metabolismo , Péptido C/sangre , Péptido C/metabolismo , Células Cultivadas , Complejos de Coordinación/química , Complejos de Coordinación/uso terapéutico , Diabetes Mellitus Experimental/sangre , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/patología , Hemoglobina A Glucada/análisis , Hemoglobina A Glucada/metabolismo , Hiperglucemia/sangre , Hiperglucemia/metabolismo , Hiperglucemia/patología , Hiperglucemia/terapia , Hipoglucemiantes/química , Insulina/sangre , Insulina/metabolismo , Pulmón/efectos de los fármacos , Pulmón/metabolismo , Pulmón/patología , Masculino , Estrés Oxidativo/efectos de los fármacos , Quercetina/análogos & derivados , Ratas , Zinc/química
8.
Sensors (Basel) ; 21(5)2021 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-33673415

RESUMEN

In type 1 diabetes management, the availability of algorithms capable of accurately forecasting future blood glucose (BG) concentrations and hypoglycemic episodes could enable proactive therapeutic actions, e.g., the consumption of carbohydrates to mitigate, or even avoid, an impending critical event. The only input of this kind of algorithm is often continuous glucose monitoring (CGM) sensor data, because other signals (such as injected insulin, ingested carbs, and physical activity) are frequently unavailable. Several predictive algorithms fed by CGM data only have been proposed in the literature, but they were assessed using datasets originated by different experimental protocols, making a comparison of their relative merits difficult. The aim of the present work was to perform a head-to-head comparison of thirty different linear and nonlinear predictive algorithms using the same dataset, given by 124 CGM traces collected over 10 days with the newest Dexcom G6 sensor available on the market and considering a 30-min prediction horizon. We considered the state-of-the art methods, investigating, in particular, linear black-box methods (autoregressive; autoregressive moving-average; and autoregressive integrated moving-average, ARIMA) and nonlinear machine-learning methods (support vector regression, SVR; regression random forest; feed-forward neural network, fNN; and long short-term memory neural network). For each method, the prediction accuracy and hypoglycemia detection capabilities were assessed using either population or individualized model parameters. As far as prediction accuracy is concerned, the results show that the best linear algorithm (individualized ARIMA) provides accuracy comparable to that of the best nonlinear algorithm (individualized fNN), with root mean square errors of 22.15 and 21.52 mg/dL, respectively. As far as hypoglycemia detection is concerned, the best linear algorithm (individualized ARIMA) provided precision = 64%, recall = 82%, and one false alarm/day, comparable to the best nonlinear technique (population SVR): precision = 63%, recall = 69%, and 0.5 false alarms/day. In general, the head-to-head comparison of the thirty algorithms fed by CGM data only made using a wide dataset shows that individualized linear models are more effective than population ones, while no significant advantages seem to emerge when employing nonlinear methodologies.


Asunto(s)
Automonitorización de la Glucosa Sanguínea , Glucemia/análisis , Hipoglucemia , Algoritmos , Humanos , Hipoglucemia/diagnóstico
9.
Zhongguo Zhong Yao Za Zhi ; 46(3): 552-559, 2021 Feb.
Artículo en Chino | MEDLINE | ID: mdl-33645019

RESUMEN

Polysaccharides are macromolecular compounds formed by more than 10 monosaccharide molecules linked by glycosidic bonds. Polysaccharides have a wide range of sources, high safety and low toxicity, with a variety of biological activities, such as anti-tumor, anti-virus, immune regulation, lowering blood glucose, and lowering blood lipids. Type 2 diabetes mellitus(T2 DM) is a chronic metabolic disorder characterized by hyperglycemia, insulin resistance and low inflammation. In recent years, the treatment of T2 DM with polysaccharide has become a research hotspot. Polysaccharides can not only make up for the side effects such as hypoglycemia, weight gain, gastrointestinal injury caused by long-term treatment of acarbose, biguanidine and sulfonylurea, but also play an effective role in reducing glucose by regulating glucose metabolism, oxidative stress, inflammatory response, intestinal flora, etc. In this paper, the research progress of polysaccharides in the treatment of T2 DM was reviewed. In addition, the hot spots such as the hypoglycemic activity of polysaccharides with structural modifications were summarized, providing theoretical guidance for the development of active polysaccharide hypoglycemic medicines and the further study of action mechanism.


Asunto(s)
Diabetes Mellitus Tipo 2 , Resistencia a la Insulina , Glucemia , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Humanos , Hipoglucemiantes/farmacología , Polisacáridos
10.
Medicine (Baltimore) ; 100(9): e25025, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655974

RESUMEN

ABSTRACT: This study aimed to investigate the correlation between triglyceride glucose (TyG) index and coronary artery disease (CAD) with type 2 diabetes mellitus (T2DM) and identify the risk associated TyG index in different subgroups.A total of 1665 eligible inpatients (CAD with T2DM group [n = 680], non-coronary artery disease without T2DM [n = 985]) were consecutively enrolled in this study. They were assigned into 4 subgroups: middle-aged, elderly, male, and female subgroups. Receiver operating characteristic curve diagnostic test and a logistic regression model was established to analyze the risk factors for CAD with T2DM.TyG index is an independent risk factor for patients with CAD with T2DM. The risk of increased TyG index is greater in the middle-aged and male subgroups than in the elderly and female subgroups, respectively (all P < .05). The specificity and the positive predictive value of the TyG index is greater than the sensitivity and the negative predictive value, respectively (all P < .05).Increased TyG index is a new independent risk factor for CAD with T2DM, and its risk is higher in the middle-aged and male subgroups than in the elderly and female subgroups, respectively. TyG index may be used as a clinical predictor of CAD with T2DM.


Asunto(s)
Glucemia/metabolismo , Enfermedad de la Arteria Coronaria/sangre , Diabetes Mellitus Tipo 2/sangre , Medición de Riesgo/métodos , Triglicéridos/sangre , Anciano , Biomarcadores/sangre , China/epidemiología , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/epidemiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Pronóstico , Curva ROC , Estudios Retrospectivos , Factores de Riesgo
11.
BMC Med ; 19(1): 72, 2021 03 24.
Artículo en Inglés | MEDLINE | ID: mdl-33757497

RESUMEN

BACKGROUND: Observational studies suggest poorer glycemic traits and type 2 diabetes associated with coronavirus disease 2019 (COVID-19) risk although these findings could be confounded by socioeconomic position. We conducted a two-sample Mendelian randomization to clarify their role in COVID-19 risk and specific COVID-19 phenotypes (hospitalized and severe cases). METHOD: We identified genetic instruments for fasting glucose (n = 133,010), 2 h glucose (n = 42,854), glycated hemoglobin (n = 123,665), and type 2 diabetes (74,124 cases and 824,006 controls) from genome wide association studies and applied them to COVID-19 Host Genetics Initiative summary statistics (17,965 COVID-19 cases and 1,370,547 population controls). We used inverse variance weighting to obtain the causal estimates of glycemic traits and genetic predisposition to type 2 diabetes in COVID-19 risk. Sensitivity analyses included MR-Egger and weighted median method. RESULTS: We found genetic predisposition to type 2 diabetes was not associated with any COVID-19 phenotype (OR: 1.00 per unit increase in log odds of having diabetes, 95%CI 0.97 to 1.04 for overall COVID-19; OR: 1.02, 95%CI 0.95 to 1.09 for hospitalized COVID-19; and OR: 1.00, 95%CI 0.93 to 1.08 for severe COVID-19). There were no strong evidence for an association of glycemic traits in COVID-19 phenotypes, apart from a potential inverse association for fasting glucose albeit with wide confidence interval. CONCLUSION: We provide some genetic evidence that poorer glycemic traits and predisposition to type 2 diabetes unlikely increase the risk of COVID-19. Although our study did not indicate glycemic traits increase severity of COVID-19, additional studies are needed to verify our findings.


Asunto(s)
Glucemia/genética , Diabetes Mellitus Tipo 2/genética , Hemoglobina A Glucada/genética , Análisis de la Aleatorización Mendeliana , Adulto , Glucemia/metabolismo , /epidemiología , Estudios de Casos y Controles , Enfermedad Crítica/epidemiología , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Ayuno/sangre , Femenino , Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Hemoglobina A Glucada/metabolismo , Humanos , Masculino , Fenotipo , Polimorfismo de Nucleótido Simple , Factores de Riesgo , Índice de Severidad de la Enfermedad
12.
Medicine (Baltimore) ; 100(10): e24600, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33725823

RESUMEN

ABSTRACT: To understand the adverse association of short sleep duration and insufficient fruit and vegetable intake (FVI) with and their combined effect on metabolic syndrome (MetS) in Chinese adults.This cross-sectional study analyzed 7052 adults aged 18∼64 years old in 2009, with fasting blood samples collected. Participants were divided into short/normal/long sleep duration groups and sufficient/insufficient FVI groups in accordance with self-reported information. Metabolic syndrome was defined by National Cholesterol Education Program's Adult Treatment Panel III criteria.The prevalence of MetS among the study subjects was 21.74%. Participants were classified into short (<7 h/d), normal (7∼9 h/d), and long (>9 h/d) groups according to their daily sleep duration. Participants with less than 500 g of FVI per day was considered as insufficient FVI. After adjusting for confounders, the negative effect of short sleep duration on MetS was statistically significant, with an OR of 1.29 (95%CI = 1.06∼1.56); and high fasting glucose levels were significantly associated with insufficient FVI. Compared with subjects with normal sleep duration and sufficient FVI, participants with short sleep time and insufficient FVI had the highest risk of MetS (OR = 1.37, 95% CI: 1.04-1.66).This study revealed that insufficient FVI and short sleep duration were significantly associated with an increased risk of MetS among Chinese adults. Increasing FVI and normal sleep duration during Chinese adults could be significant targets for reducing the prevalence of MetS.


Asunto(s)
Conducta Alimentaria/fisiología , Frutas , Síndrome Metabólico/epidemiología , Sueño/fisiología , Verduras , Adolescente , Adulto , Glucemia/análisis , China/epidemiología , Estudios Transversales , Ayuno/sangre , Femenino , Humanos , Masculino , Síndrome Metabólico/sangre , Síndrome Metabólico/fisiopatología , Síndrome Metabólico/prevención & control , Persona de Mediana Edad , Prevalencia , Medición de Riesgo , Factores de Riesgo , Autoinforme/estadística & datos numéricos , Factores de Tiempo , Adulto Joven
13.
Medicine (Baltimore) ; 100(10): e25100, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33725905

RESUMEN

BACKGROUND: Mitochondrial diabetes mellitus (MDM) is characterized by maternal inheritance, progressive neurosensory deafness, insulin secretory disorder, and progressive microvascular complications. Mitochondria are critical organelles that provide energy in the form of adenosine triphosphate (ATP). An impairment of ATP production in pancreatic ß cells is regarded as the main cause of the insulin secretory disorder in patients with MDM, and these patients require insulin replacement therapy early after the diagnosis. The amino acid 5-aminolevulinic acid (5-ALA), a precursor of heme metabolites, is a non-proteinogenic δ amino acid synthesized in mitochondria. An addition of ferrous iron to 5-ALA enhances heme biosynthesis and increases ATP production through an upregulation of the respiratory complex. Several studies have reported that the administration of 5-ALA and ferrous iron to existing treatment improved the glycemic control in both patients with prediabetes and those with type 2 diabetes mellitus. The additional administration of 5-ALA and ferrous iron to MDM patients on insulin therapy may improve their insulin secretory capacity and glycemic control by improving their mitochondrial function. The findings of this study are expected to provide new treatment options for MDM and improve the patients' glycemic control and prognosis. METHODS/DESIGN: This study is a single-arm, open-label pilot intervention study using clinical endpoints to investigate the effects of treatment with 5-ALA plus sodium ferrous citrate (SFC) to patients with MDM on their glucose tolerance. A total of 5 patients with MDM will be administered 5-ALA/SFC (200 mg/d) for 24 weeks. We will perform a 75-g oral glucose tolerance test before and at 24 weeks after the start of this 5-ALA/SFC treatment to evaluate glucose-dependent insulin responses. DISCUSSION: To the best of our knowledge, this study will be the first assessment of the effects of 5-ALA/SFC in patients with MDM. This study will obtain an evidence regarding the effectiveness and safety of 5-ALA/SFC for patients with MDM. TRIAL REGISTRATION: This study was registered with the University Hospital Medical Information Network (UMIN000040581) on July 1, 2020 and with the Japan Registry of Clinical Trials (jRCTs071200025) on August 3, 2020.


Asunto(s)
Sordera/tratamiento farmacológico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Compuestos Ferrosos/administración & dosificación , Intolerancia a la Glucosa/tratamiento farmacológico , Insulina/administración & dosificación , Ácidos Levulínicos/administración & dosificación , Enfermedades Mitocondriales/tratamiento farmacológico , Adenosina Trifosfato/metabolismo , Adulto , Glucemia/análisis , Sordera/sangre , Sordera/diagnóstico , Sordera/patología , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/patología , Quimioterapia Combinada/efectos adversos , Quimioterapia Combinada/métodos , Femenino , Compuestos Ferrosos/efectos adversos , Intolerancia a la Glucosa/sangre , Intolerancia a la Glucosa/diagnóstico , Intolerancia a la Glucosa/patología , Prueba de Tolerancia a la Glucosa , Humanos , Japón , Ácidos Levulínicos/efectos adversos , Masculino , Mitocondrias/efectos de los fármacos , Mitocondrias/patología , Enfermedades Mitocondriales/sangre , Enfermedades Mitocondriales/diagnóstico , Enfermedades Mitocondriales/patología , Proyectos Piloto , Resultado del Tratamiento
14.
Clin Appl Thromb Hemost ; 27: 1076029621996445, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33760664

RESUMEN

BACKGROUND: To investigate the factors associated with elevated fibrinogen (Fbg) levels in COVID-19 patients with and without diabetes (DM) and impaired fasting glucose (IFG). METHODS: According to whether or not their glucose metabolism was impaired, COVID-19 patients were subdivided into 2 groups: 1) with DM and IFG, 2) control group. Their demographic data, medical history, signs and symptoms, laboratory results, and final clinical results were analyzed retrospectively. RESULTS: 28 patients (16.3%) died during hospitalization, including 21 (29.2%) in group 1 and 7 (7.0%) in group 2 (P < 0.001). Fbg levels in groups 1 and 2 were higher than the normal range, at 5.6 g/L (IQR 4.5-7.2 g/L) and 5.0 g/L (IQR 4.0-6.1 g/L), respectively (P = 0.009). Serum ferritin levels, C-reactive protein (CRP), interleukin-6 (IL-6), IL-8, tumor necrosis factor-α (TNF-α), triglycerides (TG) were significantly increased in group 1 compared to those in the control. TG levels were 1.3 mmol/L in the control, while that in group 1 was 1.8 mmol/L. Multiple linear regression showed that the predicting factors of Fbg in the control group were serum ferritin and CRP, R2 = 0.295; in group 1, serum ferritin, CRP, and TG, R2 = 0.473. CONCLUSIONS: Fbg in all COVID-19 patients is related to serum ferritin and CRP involved in inflammation. Furthermore, in COVID-19 patients with insulin resistance, Fbg is linearly positively correlated with TG. This suggests that regulation of TG, insulin resistance, and inflammation may reduce hypercoagulability in COVID-19 patients, especially those with insulin resistance.


Asunto(s)
Glucemia/análisis , Diabetes Mellitus/sangre , Ayuno/sangre , Fibrinógeno/análisis , Resistencia a la Insulina , Trombofilia/sangre , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Coagulación Sanguínea , Proteína C-Reactiva/análisis , /virología , Diabetes Mellitus/diagnóstico , Femenino , Ferritinas/sangre , Humanos , Mediadores de Inflamación/sangre , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Trombofilia/diagnóstico , Trombofilia/virología , Triglicéridos/sangre , Regulación hacia Arriba , Adulto Joven
15.
Medicine (Baltimore) ; 100(12): e24574, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33761635

RESUMEN

BACKGROUND: Metabolic syndrome (MS) is a common chronic disease in modern society, and the etiology and pathogenesis of it is still unknown. For its main symptoms: disorder of glucose and lipid metabolism, the usual treatment is applying statin and hypoglycemic drugs. Comparing to the long-term application of these drugs which may cost great side effects, Dendrobium Nobile Lindl (DN) has been proved for its hypoglycemic and lipid-lowering effects without obvious side effects. So this trial is aim to evaluate the efficacy and safety of DN-powder in intervention of MS, and to explore the mechanism of action of DN through multi-group correlation analysis. METHODS: This clinical trial is a single-arm, non-randomized, open, exploratory trial. A total of 30 participants who are suffering from MS will be assigned into therapy group (n = 30). The treatment course will last for 8 weeks, and a follow-up period for 4 weeks. The participants will receive DN-powder for 6 g, twice a day during the study period. The primary outcome will be the change of lipid and glucose metabolism. Other outcomes will be the body weight and body mass index (BMI) which will be assessments record in every 2 weeks. Participants who quit the trial due to untolerable reactions or uncontrollable conditions will enter into a follow-up period after the last treatment. All participants will enter into a follow-up period for 4 weeks after the last treatment. Adverse events will be recorded during the whole study. DISCUSSION: The results of the trial are aim to provide evidence of the safety and efficacy of DN-powder in intervention of MS which may be potential to become an important alternative therapy for certain patients. TRIAL REGISTRATION: It has been registered at http://www.chictr.org.cn/showprojen.aspx?proj=55914. (Identifier: ChiCTR2000034550), Registered 9 July 2020.


Asunto(s)
Dendrobium/química , Medicamentos Herbarios Chinos/efectos adversos , Hipoglucemiantes/efectos adversos , Hipolipemiantes/efectos adversos , Síndrome Metabólico/tratamiento farmacológico , Adolescente , Adulto , Anciano , Glucemia/análisis , Glucemia/efectos de los fármacos , Glucemia/metabolismo , Índice de Masa Corporal , Peso Corporal/efectos de los fármacos , Medicamentos Herbarios Chinos/administración & dosificación , Femenino , Estudios de Seguimiento , Humanos , Hipoglucemiantes/administración & dosificación , Hipolipemiantes/administración & dosificación , Metabolismo de los Lípidos/efectos de los fármacos , Lípidos/sangre , Masculino , Síndrome Metabólico/sangre , Síndrome Metabólico/diagnóstico , Persona de Mediana Edad , Adulto Joven
16.
Circ Heart Fail ; 14(3): e007048, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33663235

RESUMEN

BACKGROUND: Empagliflozin reduces the risk of hospitalization for heart failure in patients with type 2 diabetes and cardiovascular disease. We sought to elucidate the effect of empagliflozin as an add-on therapy on decongestion and renal function in patients with type 2 diabetes admitted for acute decompensated heart failure. METHODS: The study was terminated early due to COVID-19 pandemic. We enrolled 59 consecutive patients with type 2 diabetes admitted for acute decompensated heart failure. Patients were randomly assigned to receive either empagliflozin add-on (n=30) or conventional glucose-lowering therapy (n=29). We performed laboratory tests at baseline and 1, 2, 3, and 7 days after randomization. Percent change in plasma volume between admission and subsequent time points was calculated using the Strauss formula. RESULTS: There were no significant baseline differences in left ventricular ejection fraction and serum NT-proBNP (N-terminal pro-B-type natriuretic peptide), hematocrit, or serum creatinine levels between the 2 groups. Seven days after randomization, NT-proBNP level was significantly lower in the empagliflozin group than in the conventional group (P=0.040), and hemoconcentration (≥3% absolute increase in hematocrit) was more frequently observed in the empagliflozin group than in the conventional group (P=0.020). The decrease in percent change in plasma volume between baseline and subsequent time points was significantly larger in the empagliflozin group than in the conventional group 7 days after randomization (P=0.017). The incidence of worsening renal function (an increase in serum creatinine ≥0.3 mg/dL) did not significantly differ between the 2 groups. CONCLUSIONS: In this exploratory analysis, empagliflozin achieved effective decongestion without an increased risk of worsening renal function as an add-on therapy in patients with type 2 diabetes with acute decompensated heart failure. Registration: URL: https://www.umin.ac.jp/ctr/index.htm; Unique identifier: UMIN000026315.


Asunto(s)
Compuestos de Bencidrilo/uso terapéutico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Glucósidos/uso terapéutico , Insuficiencia Cardíaca/tratamiento farmacológico , Hospitalización , Riñón/efectos de los fármacos , Inhibidores del Cotransportador de Sodio-Glucosa 2/uso terapéutico , Volumen Sistólico/efectos de los fármacos , Función Ventricular Izquierda/efectos de los fármacos , Anciano , Anciano de 80 o más Años , Compuestos de Bencidrilo/efectos adversos , Biomarcadores/sangre , Glucemia/efectos de los fármacos , Glucemia/metabolismo , Creatinina/sangre , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/fisiopatología , Terminación Anticipada de los Ensayos Clínicos , Femenino , Glucósidos/efectos adversos , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/fisiopatología , Humanos , Japón , Riñón/fisiopatología , Masculino , Péptido Natriurético Encefálico/sangre , Fragmentos de Péptidos/sangre , Estudios Prospectivos , Inhibidores del Cotransportador de Sodio-Glucosa 2/efectos adversos , Factores de Tiempo , Resultado del Tratamiento
17.
N Engl J Med ; 384(10): 895-904, 2021 03 11.
Artículo en Inglés | MEDLINE | ID: mdl-33704936

RESUMEN

BACKGROUND: Gestational diabetes mellitus is common and is associated with an increased risk of adverse maternal and perinatal outcomes. Although experts recommend universal screening for gestational diabetes, consensus is lacking about which of two recommended screening approaches should be used. METHODS: We performed a pragmatic, randomized trial comparing one-step screening (i.e., a glucose-tolerance test in which the blood glucose level was obtained after the oral administration of a 75-g glucose load in the fasting state) with two-step screening (a glucose challenge test in which the blood glucose level was obtained after the oral administration of a 50-g glucose load in the nonfasting state, followed, if positive, by an oral glucose-tolerance test with a 100-g glucose load in the fasting state) in all pregnant women who received care in two health systems. Guidelines for the treatment of gestational diabetes were consistent with the two screening approaches. The primary outcomes were a diagnosis of gestational diabetes, large-for-gestational-age infants, a perinatal composite outcome (stillbirth, neonatal death, shoulder dystocia, bone fracture, or any arm or hand nerve palsy related to birth injury), gestational hypertension or preeclampsia, and primary cesarean section. RESULTS: A total of 23,792 women underwent randomization; women with more than one pregnancy during the trial could have been assigned to more than one type of screening. A total of 66% of the women in the one-step group and 92% of those in the two-step group adhered to the assigned screening. Gestational diabetes was diagnosed in 16.5% of the women assigned to the one-step approach and in 8.5% of those assigned to the two-step approach (unadjusted relative risk, 1.94; 97.5% confidence interval [CI], 1.79 to 2.11). In intention-to-treat analyses, the respective incidences of the other primary outcomes were as follows: large-for-gestational-age infants, 8.9% and 9.2% (relative risk, 0.95; 97.5% CI, 0.87 to 1.05); perinatal composite outcome, 3.1% and 3.0% (relative risk, 1.04; 97.5% CI, 0.88 to 1.23); gestational hypertension or preeclampsia, 13.6% and 13.5% (relative risk, 1.00; 97.5% CI, 0.93 to 1.08); and primary cesarean section, 24.0% and 24.6% (relative risk, 0.98; 97.5% CI, 0.93 to 1.02). The results were materially unchanged in intention-to-treat analyses with inverse probability weighting to account for differential adherence to the screening approaches. CONCLUSIONS: Despite more diagnoses of gestational diabetes with the one-step approach than with the two-step approach, there were no significant between-group differences in the risks of the primary outcomes relating to perinatal and maternal complications. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development; ScreenR2GDM ClinicalTrials.gov number, NCT02266758.).


Asunto(s)
Diabetes Gestacional/diagnóstico , Prueba de Tolerancia a la Glucosa/métodos , Hiperglucemia/diagnóstico , Adulto , Glucemia/análisis , Diabetes Gestacional/sangre , Diabetes Gestacional/epidemiología , Femenino , Macrosomía Fetal/epidemiología , Humanos , Hiperglucemia/sangre , Incidencia , Tamizaje Masivo , Embarazo , Resultado del Embarazo
18.
Medicine (Baltimore) ; 100(8): e24937, 2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33663132

RESUMEN

BACKGROUND: No studies were located which used a web-based educational intervention to improve the knowledge about newly diagnosed type 2 diabetes mellitus (T2DM). Therefore, the primary objective of the present study was to evaluate the efficacy of web-based educational intervention on psychological outcomes and glycemic control in newly diagnosed T2DM in rural China. METHODS: This work is a part of a comprehensive research project to assess and provide educational intervention that potentially improve psychological status and blood glucose among patients with T2DM. Eligibility criteria for the study includes newly diagnosed with T2DM, adult patients (age ≥30 years) regardless of gender; speak and understand Chinese languages; having no significant comorbidity; being not involved in any trial/study related to diabetes during last 3 months and able to attend regular visits. Eligible participants were divided into 2 groups according to completely randomized design: education group and control group. The outcomes included fasting blood glucose level, EQ-5D-3L questionnaire, Self-rating Anxiety Scale, and Self-rating Depression Scale. RESULTS: This protocol will provide a reliable theoretical basis for the following research. CONCLUSION: The sample came from a single health centre. Therefore, the results can not be generalized for the entire population. TRIAL REGISTRATION: This study protocol was registered in Research Registry (researchregistry6511).


Asunto(s)
Glucemia/metabolismo , Diabetes Mellitus Tipo 2/psicología , Intervención basada en la Internet , Adulto , China , Diabetes Mellitus Tipo 2/sangre , Femenino , Humanos , Masculino , Ensayos Clínicos Controlados Aleatorios como Asunto , Población Rural , Automanejo/educación , Encuestas y Cuestionarios
19.
J Infect Dev Ctries ; 15(2): 209-213, 2021 03 07.
Artículo en Inglés | MEDLINE | ID: mdl-33690202

RESUMEN

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is declared as pandemic by the World Health Orgnazation (WHO) on March 2020. One of the heavily utilized measures during this pandemic is vitamin C (aka ascorbic acid). Unfortunately, vitamin C has been associated with glucose measurement interference and thus this study highlights the elevated levels of blood glucose correlated with the presence of vitamin C interference. METHODOLOGY: Thirty samples were selected randomly and the blood glucose were measured prior and post the addition of spiked standard concentrations of vitamin C. The interference of vitamin C with glucose readings in COVID-19 pandemic were evaluated and observed employing the Auto Chemistry Analyzer machine. RESULTS: The addition of ascorbic acid (vitamin C) standards (spikes) into the isolated samples shows a correlated increment in the reading measures. Thereafter, the increments of Random Blood Sugar (RBS) readings after being spiked with the vitamin C standards shows a logarithmic correlation with good interesting R-squared (R2 = 0.9921). CONCLUSIONS: The authors find that the presence of vitamin C in blood actively and significantly alters the glucose level readings especially with the highly consumption of vitamin C during the COVID-19 pandemic.


Asunto(s)
Ácido Ascórbico/sangre , Glucemia/análisis , Ácido Ascórbico/administración & dosificación , Humanos
20.
Ann Intern Med ; 174(3): JC34, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33646841

RESUMEN

SOURCE CITATION: Rosenstock J, Bajaj HS, Janez A, et al. Once-weekly insulin for type 2 diabetes without previous insulin treatment. N Engl J Med. 2020:383:2107-16. 32960514.


Asunto(s)
Diabetes Mellitus Tipo 2 , Hipoglucemia , Glucemia , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hemoglobina A Glucada/análisis , Humanos , Hipoglucemia/inducido químicamente , Hipoglucemia/prevención & control , Hipoglucemiantes/efectos adversos , Insulina , Insulina Glargina/efectos adversos
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