Effect of needle-free injection on psychological insulin resistance and insulin dosage in patients with type 2 diabetes.

Background and objective: Psychological insulin resistance (PIR), which refers to the reluctance of diabetic patients to use insulin, is a frequently encountered clinical issue. Needle-free injection (NFI) offers advantages in terms of expediting insulin absorption and mitigating adverse reactions related to injection. To evaluate the effects of subcutaneous injection of insulin aspart 30 with NFI on PIR and insulin dosage in patients with type 2 diabetes mellitus (T2DM). Methods: Sixty-four patients with T2DM participated in this randomized, prospective, open, crossover study. Insulin aspart 30 was administered subcutaneously to each subject via QS-P NFI and Novo Pen 5 (NP) successively. The effects of NFI on PIR were analyzed. Differences in insulin dosage, glycemic variability, and injection safety were compared at similar levels of glycemic control. Results: After the administration of NFI, the insulin treatment attitude scale score decreased (53.7 ± 7.3 vs. 58.9 ± 10.7, p<0.001), the insulin treatment adherence questionnaire score increased (46.3 ± 4.9 vs. 43.8 ± 7.1, p<0.001), and the insulin treatment satisfaction questionnaire score increased (66.6 ± 10.5 vs. 62.4 ± 16.5, p<0.001). At the same blood glucose level, NFI required a smaller dosage of insulin aspart 30 compared with that of NP (30.42 ± 8.70 vs. 33.66 ± 9.13 U/d, p<0.001). There were no differences in glycemic variability indices (standard deviation, mean amplitude of glycemic excursion or coefficient of variation) between the two injection methods. Compared with NP, NFI did not increase the incidence of hypoglycemia (17.2% vs. 14.1%, p=0.774), and it decreased the incidence of induration (4.7% vs. 23.4%, p=0.002) and leakage (6.3% vs. 20.3%, p=0.022) while decreasing the pain visual analog scale score (2.30 ± 1.58 vs. 3.11 ± 1.40, p<0.001). Conclusion: NFI can improve PIR in patients with T2DM and be used with a smaller dose of insulin aspart 30 while maintaining the same hypoglycemic effect. Clinical trial registration: https://www.chictr.org.cn/, identifier ChiCTR2400083658.

Status of research on the resource utilization of stainless steel pickling sludge in China: a review.

The pickling sludge produced in the stainless steel pickling process is a hazardous waste and disposal in landfill poses a potential environmental risk. Stainless steel pickling sludge contains metal elements such as Fe, Cr, and Ni and substances such as SiO2 and CaO, which have good value for resource recycling. This paper briefly introduces the generation, nature, and hazards of stainless steel pickling sludge; and clustering analysis of relevant literature keywords in recent years; and detailed analysis and comparison of sludge obtained from different steel mills and resource utilization process. The current situation of pickling sludge resource utilization and the development of relevant policies in China in recent years are summarized, and new thoughts on the direction of its resource utilization are put forward.

Bimetal-organic framework-derived porous CoFe2O4 nanoparticles as biocompatible anode electrocatalysts for improving the power generation of microbial fuel cells.

HYPOTHESIS: The relatively lower power density of Microbial fuel cells (MFCs), primarily resulting from weak biofilm habitation and sluggish extracellular electron transfer (EET) at the anode interface, limits their practical implementation on a large scale. To address this challenge, porous CoFe2O4 nanoparticles could be used as anode electrocatalysts based on the following considerations: (i) the introduction of CoFe2O4 nanoparticles endows the anode with a rough surface that facilitates biofilm formation; (ii) the positively charged Co and Fe ions improve the interfacial affinity of anodes, enabling rapid immobilization and colonization of negatively bacteria; (iii) the multi-valent metal states of Co and Fe can function as electron shuttles, mediating EET process between biofilm and anode. EXPERIMENTS: CoFe2O4 nanoparticles prepared with a bimetal-organic framework (B-MOF) as precursor, were modified to the surface of carbon cloth as the anode of MFCs. FINDINGS: MFCs equipped with CoFe2O4 anode achieved a maximum power density of 1026.68 mW m-2, which was approximately 3.4 times higher than that of the pristine carbon cloth. Additionally, the biofilm density and viability on the anode were enhanced after CoFe2O4 modification. Considering the facile fabrication process and superior electrocatalytic performance, the CoFe2O4 nanoparticles are promising electrocatalysts for high performance and cost-effective MFCs.

Student nurses' perceptions and experiences in caring for people living with HIV/AIDS: a qualitative study.

BACKGROUND: Caring for people living with HIV/AIDS (PLWHA) requires clinical experience and quality care delivery skills. This study aimed to explore the perceptions and experiences of nursing students in caring for PLWHAs. METHODS: This qualitative descriptive study interviewed 18 student nurses who had cared for PLWHAs from 14 tertiary hospitals across 7 provinces in China through semi-structured telephone interviews. RESULTS: Two themes emerged from the narratives: student nurses' perceptions and attitudes toward PLWHAs and student nurses' practical experiences with PLWHAs. Five theme clusters were revealed, namely "negative attitudes held before the care-giving," "a series of psychological struggles in care-giving," "favorable attitudes increased after the care-giving," "consensus on care delivery for PLWHAs," and "considerations regarding contamination reduction." CONCLUSIONS: Findings shed light on the development and changes in student nurses' perspectives on PLWHAs throughout their clinical experiences. Student nurses' perceptions and attitudes toward PLWHAs progressed through three distinct stages, and positive changes were observed after care-giving. Participants' perceptions and practical experiences with patients with AIDS enable patients to receive fair and high-quality care and provide valuable insights for nursing educators better prepare HIV nurses.

Student nurses' spiritual care competence and attitude: An online survey.

AIMS: This study aimed to assess student nurses' competence and attitude toward spiritual care and analysed the associated factors. DESIGN: Cross-sectional study using an online survey. METHODS: From April 14 to June 14, 2018, a convenience sample of 938 student nurses were recruited from six schools of Nursing in Hunan Province, China. Data were collected by using the Chinese versions of the Spiritual Care Competence Scale (C-SCCS) and the Spiritual Care Attitude Scale (C-SCAS). RESULTS: The average total score on the C-SCCS was 21.42 (±4.27) out of 30 and the C-SCAS was 58.03 (±9.90) out of 75. Factors such as liking the nursing profession, attending a spiritual care course, participation in classroom learning or expert lecture, and supporting continuous and systematic training were the strongest predictors of higher spiritual care competence and attitude. A better attitude about spiritual care was a relatively moderate and significant predictor of higher spiritual care competence.

Selective recovery of nickel from stainless steel pickling sludge with NH3-(NH4)2CO3 leaching system.

The recovery of valuable metals from stainless steel pickling sludge(SSPS) has great economic and environmental benefits. In this study, a new method is proposed for selective recovery of nickel from SSPS by NH3-(NH4)2CO3 ammonia leaching system. The Eh-pH diagram was used to analyze Ni, Fe, Cr leaching behavior during the ammonia leaching process. Nickel can be leached as the complex [Ni(NH3)n]2+, whereas Fe and Cr remain as precipitates in the leaching slag. The effects of NH3·H2O concentration, liquid-solid ratio, reaction temperature, and reaction time on the leaching efficiency of nickel in the ammonia leaching system were analyzed and optimized by single-factor study and response surface analysis, and the kinetics were analyzed. The optimal conditions for Ni leaching were found to be 28.28 min, 54.07 °C, a liquid-solid ratio of 23.7:1, and NH3·H2O concentration of 5.10 mol/L. Each factor had a greater effect on the rate of Ni leaching in the following order: liquid-solid ratio > NH3·H2O concentration > leaching time > leaching temperature. The ammonia leaching recovery system was controlled by chemical reaction and the activation energy was 58.17 KJ/mol. The results of scanning electron microscopy-energy dispersion spectrum (SEM-EDS), x-ray diffraction (XRD), and X-ray photoelectron spectroscopy (XPS) show that the leaching slag was in granular form with agglomerated particles and particle size of approximately 2.8 µm The major components of the leaching slag were Fe(OH)3, Fe2O3, Fe(OH)2, Cr(OH)3, and Cr2O3. Therefore, this study provides a new and effective way of using the resources of SSPS.

Nurses' Intentions, Awareness and Barriers in Reporting Adverse Events: A Cross-Sectional Survey in Tertiary Hospitals in China.

Purpose: This study explored nurses' intentions, awareness and barriers in reporting adverse events in tertiary hospitals in China. We also analyzed its associated factors to increase the chance to evaluate preventable errors, enhance care delivery, and improve patient outcomes. Patients and Methods: A cluster sampling method was used to recruit 1382 nurses from two tertiary hospitals in Chenzhou and Handan City. An online structured questionnaire was used to collect data, which included general information questionnaire (eight questions), reporting awareness questionnaire (eight items with scores ranging from 0 to 8), reporting intention questionnaire (15 items with scores ranging from 0 to 15), and reporting barriers questionnaire (22 items with scores ranging from 22 to 110). Results: We received 1565 completed questionnaires from 1734 potential participants (a response rate of 90.25%), with 1382 valid questionnaires, yielding an effective rate of 88.31%. The scores of reporting awareness, reporting intention, and reporting barriers in adverse events for nurses in tertiary hospitals were 8 (1), 15 (0), and 83.04 (±12.21) out of 110, respectively. Reporting awareness and barriers to adverse events were positively correlated with nurses' intention to report adverse events (rs = 0.237 and 0.361, respectively; P < 0.001). Regression analyses showed that reporting awareness and barriers in adverse events and professional title influenced nurses' intention to report adverse events (P < 0.05) in tertiary hospitals. Conclusion: Nurses in tertiary hospitals have a strong intention to report adverse events. The higher the reporting awareness of adverse events or the fewer perceived reporting barriers, the stronger the nurses' intention to report. Hospital managers should deliver patient safety education and training for nurses, to increase their reporting awareness and decrease their perceived reporting barriers, improve their intention to report adverse events.

Professional commitment and willingness to care for people living with HIV among undergraduate nursing students: The mediating role of empathy.

BACKGROUND: As future registered nurses, undergraduate students play a vital role in integrated care for acquired immunodeficiency syndrome; hence, there is a need to examine factors that can increase their willingness to care for persons with such conditions. OBJECTIVE: This study examined the relationship among nursing professional commitment, empathy, and willingness to care for people living with human immunodeficiency virus and acquired immunodeficiency syndrome among undergraduate student nurses, and the mediating role of empathy in this relationship. DESIGN: Quantitative, cross-sectional design. SETTINGS: Nursing schools from five provinces of China, including Hunan, Jiangxi, Guangxi, Henan, and Hebei. PARTICIPANTS: A total of 747 undergraduate student nurses were recruited via cluster sampling. METHODS: Online survey was used to collect data. Nursing Willingness Questionnaire, Professional Commitment Scale, and Jefferson Scale of Empathy were the scales used to measure the variables. Structural equation modeling was used to determine significant relationships. RESULTS: Respondents' professional commitment and empathy demonstrated moderate positive associations with willingness to care. Empathy demonstrated a 21 % mediating effect on the effect of professional commitment and willingness to care (p < 0.05). CONCLUSIONS: Findings highlight the enabling role of professional commitment and empathy in improving undergraduate student nurses' willingness to care for persons living with human deficiency virus. Nurse educators can help improve the impact of students' professional commitment on their willingness by using educational strategies that enhance their empathy.

Adverse Events and Risk Management in Residential Aged Care Facilities: A Cross-Sectional Study in Hunan, China.

Purpose: Adverse events threaten residents' safety. Risk management is important to provide proper care and maintain quality in residential aged care facilities (RACFs). However, there is little data on adverse events, risk management, and risk early warning in RACFs in the Chinese mainland. This study aimed to fill this gap by investigating the prevalence of the aforementioned aspects and related factors in China. Participants and Methods: Using a cross-sectional design, a field survey of 272 RACFs in Hunan Province was conducted from January 25 to June 1, 2020. Data were collected using four main tools on prevalence of nursing adverse events, risk management, risk early warning, and general information. Descriptive statistics were described by frequency (percentage) and median (interquartile range). Mann-Whitney U-test and Kruskal-Wallis H-test, and Spearman coefficient were used for statistical analysis. Results: RACFs experienced an average of five (15) adverse events in 2019, with falls and pressure ulcers being the most common. The total average score of risk management in RACFs was 4.72 (0.98) out of 5, with the environment and personnel management dimensions scoring the highest with 4.75 (1) and the service management dimension scoring the lowest with 4.60 (1). Only 72.79% had trained their staff on ethical and legal knowledge and 84.56% had utilized pre-hospital first aid. Further, 30% to 40% were unprepared for contingency plans of suicide, electric shock, gas poisoning, and drowning. There were significant risk management differences among the following variables: facilities' locations, accreditation with the Practice Certificate of Social Welfare Facilities, bed-size, nursing hours per resident day, requirement for nursing staff with certificates, and payment for nursing staff (p < 0.05). Conclusion: RACFs are facing safety challenges with a high prevalence of nursing adverse events. These facilities need to improve risk early warning and management to ensure residents' safety.

The Effect of Liraglutide on Epicardial Adipose Tissue in Type 2 Diabetes.

OBJECTIVE: To study the effect of liraglutide on the thickness of epicardial adipose tissue (EAT) in type 2 diabetes mellitus (T2DM) patients with abdominal obesity. METHODS: Abdominal obesity T2DM patients with poor glycemic control were collected and treated with liraglutide. The changes of blood glucose, blood lipid, waist circumference, body mass index (BMI), and EAT thickness were compared after 3 months of treatment with liraglutide. Cardiac magnetic resonance imaging (MRI) was used to measure EAT thickness. RESULTS: After 3 months of treatment with liraglutide, glycosylated hemoglobin (HbA1c) decreased from 9.81 ± 1.46% to 6.94 ± 1.29% (95%CI = 2.14-3.59, p < 0.001). The weight decreased from 91.67 ± 16.29 kg to 87.29 ± 16.43 kg (95%CI = 2.97-5.79, p < 0.001). Waist circumference before treatment was 103.69 ± 9.14 cm, and after treatment was 96.42 ± 8.42 cm (95%CI = 5.04-9.50, p < 0.001). Total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) were significantly lower than those before treatment. TC decreased from 5.34 ± 1.05 mmol/L to 4.86 ± 0.97 mmol/L (95%CI = 0.15-0.82, p < 0.001). TG was 1.89 (1.48-3.17) and then to 1.92 ± 0.69 (p = 0.03). LDL-C decreased from 3.39 ± 0.84 mmol/L to 3.01 ± 0.74 mmol/L (95%CI = 0.17-0.59, p = 0.001). HDL-C increased by 1.7% after treatment, with no significant difference (p = 0.062). More importantly, the thickness of EAT decreased from 5.0 (5.0-7.0) mm to 3.95 ± 1.43 mm (p < 0.001) after liraglutide administered for 3 months. CONCLUSION: Liraglutide significantly reduces EAT thickness in T2DM with abdominal obesity, which provides theoretical support for the cardiovascular benefits of liraglutide.

Perceptions and experiences of risk management by managers of residential aged care facilities: a qualitative study from Hunan Province, China.

BACKGROUND: With adverse events and injuries recurring in residential aged care facilities (RACFs), older adults' safety in residential age care settings has attracted extensive attention from governments, researchers, and healthcare providers. Risk management is of utmost importance in reducing risks and improving the quality of care for older adults in long-term care. Although previous studies have made great efforts to explore risk management methods and technologies in RACFs, little is known about how managers identify and respond to risks in practice. PURPOSE: This qualitative study aimed to elucidate the perceptions and experiences of managers involved in risk management in RACFs in China. PARTICIPANTS AND METHODS: This study used a phenomenological research design. We conducted semi-structured interviews with 13 managers across 11 RACFs in Changsha City, Hunan Province, China. Data were analysed using Colaizzi's seven steps and NVivo 12 plus software. RESULTS: "Facilitation of an error-free culture" emerged as a central theme of managers' perceptions of risk management. Four sub-themes were revealed, namely "creating an age-friendly physical environment," "paying close attention to frail older adults," "improving the competence of nursing staff," and "building effective management programs." CONCLUSION: Facilitation of an error-free culture was of prime importance in risk management. Managers' experiences can help RACFs to better manage risks, as well as provide new perspectives and approaches for RACFs to improve the quality and outcomes of care. This study developed initiatives for improving resident safety in RACFs and may foster interest in the developing these initiatives.

Catalytic Asymmetric Amino Acid and Its Derivatives by Chiral Aldehyde Catalysis.

Amine acid transformation is an important chemical process in biological systems. As a well-developed and acknowledged tool, chiral aldehyde catalysis provides good catalytic activation and stereoselective control abilities in the asymmetric reaction of N-unprotected amino acid esters and amino acid esters analogs, in which the key to success is the design of the catalysts derived from chiral BINOL aldehyde, which is based on the face control of enolate intermediates. In this review, one of the co-catalytic systems that combined with a transition metal to form a multiplex catalytic system and the well-established multiplex stereocenters of chiral aldehyde catalysis have been reviewed. Finally, a novel organocatalysis is prospected.

Anxiety and Adaptation of Behavior in Pregnant Zhuang Women During the COVID-19 Pandemic: A Mixed-Mode Survey.

PURPOSE: This study explored the impact of COVID-19 on the mental health and adaptation of behavior of Zhuang women in China to provide more specific guidance for the social and medical practice of pregnant women during public health emergencies. PARTICIPANTS AND METHODS: This cross-sectional study recruited 446 pregnant Zhuang women from obstetric outpatient clinics in four tertiary hospitals and online maternity schools in Nanning, Guangxi, between February 24 and March 1, 2020. Self-designed questionnaires and the Self-Rating Anxiety Scale were used. RESULTS: During the COVID-19 pandemic, the prevalence rate of anxiety among women was 36.77%, and some adaptation of behavior was observed. Logistic regression analysis showed that pregnant women who had an annual household income of less than $7,000, were primiparous, went out for prenatal examination, wanted to self-monitor during pregnancy but did not know how to do it, believed that they should be strictly isolated at home and cancel prenatal examinations, and expected to receive pregnancy healthcare through teleconsultation services showed a higher risk of anxiety. Nevertheless, pregnant Zhuang women who were 22-35 years old, undergraduate-educated, and in their second trimester were less likely to suffer from anxiety. CONCLUSION: The COVID-19 pandemic has a significant psychological impact on pregnant women from ethnic minorities. Factors related to quarantine and social isolation policies appear to drive changes in behaviors and anxiety disorders. Multidisciplinary mental health services and culturally sensitive interventions are necessary for minority pregnant women, especially for low-income primiparous women in the first or third trimester.

Psychological Impact of COVID-19 Cases on Medical Staff of Beijing Xiaotangshan Hospital.

PURPOSE: To investigate the psychological impact of cases of coronavirus disease 19 (COVID-19) on medical staff of Beijing Xiaotangshan Hospital. METHODS: The 287 online questionnaires were distributed to medical staff working at Beijing Xiaotangshan Hospital, comprising three main sections and 17 questions: basic information, current departmental position, and the 12-item General Health Questionnaire (GHQ-12). The threshold for emotional distress was defined to be a total score of 4 on the GHQ-12 and above. RESULTS: A total of 255 members of medical staff participating in this study presented an emotional distress rate of 17%. Members who were male, aged 50-59, married with children, positioned as doctors, and in administration were the population with the highest rate of emotional distress. Furthermore, the severity of emotional distress among those under 30 was significantly lower than those aged 30-39 and 50-59. Doctors and other occupations shared a lower level of satisfaction on routine activities compared with nurses, so did staff in the administration compared with those who were working in screening or logistic departments. Besides, males and staff of the confirmation department had more difficulty in concentrating than females and those of the screening department, respectively. CONCLUSION: Medical staff working at Xiaotangshan Hospital underwent relatively low levels of emotional distress thanks to sufficient medical and psychological preparations. However, special attention should be paid to those who were male, married with children, senior, doctors, in administration, and in the confirmation department.

Barriers to Self-Management of Type 2 Diabetes During COVID-19 Medical Isolation: A Qualitative Study.

PURPOSE: Diabetes self-management behaviors are necessary to obtain optimum glycemic control, reduce the risk of complications, and improve health outcomes. The COVID-19 pandemic imposes an additional struggle for self-management by diabetes patients. Although previous studies have reported socio-demographic, behavioral, psychological, and cultural barriers to diabetes self-management, little is known about perceived barriers to diabetes self-management among patients during isolation following their recovery from COVID-19. The purpose of this study was to explore perceived barriers among type 2 diabetes patients during isolation following their recovery from COVID-19. PATIENTS AND METHODS: A qualitative, exploratory, and descriptive research design was utilized. Semi-structured telephonic interviews were conducted with 12 patients with diabetes who had been discharged from one COVID-19 designated hospital and underwent isolation in the designated facilities in Wuhan City, Hubei Province, China. Data were analyzed using Colaizzi's seven steps. RESULTS: Barriers to diabetes self-management identified by patients with diabetes during isolation were categorized into five major themes: inadequate knowledge and behavioral beliefs, shortage of resources, suffering from health problems, negative emotions, and lack of support. CONCLUSION: Perceived barriers to diabetes self-management described by diabetes patients indicated a lack of environmental resources and support strategies to meet their needs. Efforts to remove barriers are important in assisting patients with diabetes to improve their quality of life and health outcomes.

Using the Delphi Method to Identify Risk Factors Contributing to Adverse Events in Residential Aged Care Facilities.

PURPOSE: This study aimed to identify risk factors associated with adverse events in residential aged care facilities in China. PATIENTS AND METHODS: After compiling a list of risk factors for adverse events generated from in-depth interviews with managers of residential aged care facilities, a three-round Delphi method was used to reach consensus. The synthesized risk factors were presented on a Likert scale to the expert panelists three times to validate their responses. RESULTS: The list identified 67 items as risk factors for adverse events, attached to four first-level indexes (ie, environmental facility, nursing staff, older adults' characteristics, and management factors). The experts' authority coefficient was 0.87. The positive coefficients were 82.76%, 91.67%, and 100%, and the coordination coefficients were 0.154, 0.297, and 0.313 in the first, second, and third rounds, respectively. CONCLUSION: Using a Delphi method, this study established a consensus on risk factors contributing to adverse events and developed a risk assessment grade for use in future aged care practice and research. The resulting list is useful in prioritizing risk-reduction activities and assessing intervention or education strategies for preventing adverse events in residential aged care facilities. IMPACT: This study fills the gap in risk identification in the Chinese residential aged care system to ensure provision of best-practice care to this vulnerable population. Nursing staff and management factors at the top of the list are not only the most common causes of adverse events but also the core elements in creating a secure and error-free environment. This list was intended to support predictive and prevention-oriented decision-making by managers and nursing supervisors to reduce preventable adverse events.

The Psychological Impact and Associated Factors of COVID-19 on the General Public in Hunan, China.

PURPOSE: This study aimed to assess the psychological impact of the COVID-19 pandemic among the general public in Hunan Province, China, which could help develop psychological interventions and mental health programs. PARTICIPANTS AND METHODS: This online cross-sectional study recruited 571 participants through snowball sampling between February 2 and February 5, 2020. Data were collected through a general information questionnaire, the Public Emergency Psychological State Questionnaire, the Simple Coping Style Questionnaire, and the Public Disease Awareness on COVID-19 Scale. RESULTS: The total mean score of the public emergency psychological state of the sample was 0.27 (0.31) points, with only 5.78% of participants (n = 33) developing psychological distress. Avoidant coping style and disease awareness were weakly positively correlated (rs = 0.257, p < 0.01) and weakly negatively correlated (rs = -0.124, p <0.01) with psychological responses, respectively. There were significant psychological differences among the following variables: occupation, symptoms of fever or fatigue, discernment of the authenticity of COVID-19 information, and level of concern regarding COVID-19 (p < 0.05). CONCLUSION: The COVID-19 pandemic appears to have had a minor psychological impact on the general population in Hunan Province. However, psychological health promotion in the general public is still required, especially for employees (such as company employees, migrant workers, and businessmen), individuals with COVID-19-like symptoms, limited discernment competence and unconcerned attitudes. IMPLICATIONS: The initiatives for improving psychological health among the general public could focus on delivering COVID-19 knowledge and alleviating avoidant coping styles. Our findings could provide important insight for the development of psychological support strategies in China, as well as in other places affected by the epidemic.

Intensive multifactorial intervention improved renal impairment in short-duration type 2 diabetes: A randomized, controlled, 7-year follow-up trial.

AIMS: To investigate the effect of multifactorial intervention on the urinary albumin to creatinine ratio (UACR) and the estimated glomerular filtration rate (eGFR) in short-duration type 2 diabetes. METHODS: A total of 150 type 2 diabetes patients, with disease duration <1 year and with no evidence of atherosclerosis were randomized to either the intensive intervention group (IG, n = 75), or the conventional group (CG, n = 75) for 7 years. The predefined endpoint of microvascular complications was the progression of renal impairments (the development of albuminuria and the change of eGFR). RESULTS: The incidence of progression to albuminuria (UACR ≥30 mg/g) was 12% in IG and 28% in CG (HR 0.37, 95% CI: 0.19-0.70, P = .0025). eGFR was significantly lower in IG than that in CG in the year 2 (P = .043) and 3 (P = .032) follow-up. Sex, fasting plasma glucose (FPG), HbA1c, and systolic blood pressure (SBP) were independently associated with the UACR (ß = -5.112, P = .015; ß = 0.908, P = .045; ß = 2.087, P = .038; and ß = 2.787, P = .002, respectively); aging was independently associated with eGFR (ß = -0.447, P = .000). CONCLUSIONS: Intensive multifactorial intervention delayed the progression to albuminuria, and reduced eGFR rapidly in early stage of intervention in short-duration type 2 diabetes. FPG, HbA1c, and SBP were risk factors for UACR increase; aging was a risk factor for eGFR decline.

The Association Between the rs2975760 and rs3792267 Single Nucleotide Polymorphisms of Calpain 10 (CAPN10) and Gestational Diabetes Mellitus.

BACKGROUND This study aimed to investigate the association between the rs2975760 and rs3792267 single nucleotide polymorphisms (SNPs) of the calpain 10 (CAPN10) gene and gestational diabetes mellitus. MATERIAL AND METHODS The study included 138 patients with gestational diabetes mellitus and 152 healthy pregnant women. Venous blood was separated, and the DNA was extracted. The rs2975760 and rs3792267SNP polymorphisms of CAPN10 were detected using polymerase chain reaction (PCR). The frequencies of different genotypes in patients with gestational diabetes mellitus and healthy pregnant women were determined, and the relationship between different SNP genotypes and the risk of gestational diabetes mellitus was analyzed. RESULTS There were no significant differences in the frequencies of the TT, CT and CC genotypes of rs2975760 and the frequencies of the GG, AG and AA genotypes of rs3792267 between the women with gestational diabetes and the controls. Expression of rs2975760 and rs3792267 were not associated with the risk of gestational diabetes in the dominant model, recessive model, and additive model. However, grade B and grade D diabetes in the CC and TC genotypes of rs2975760 were significantly different from those in the TT genotype (P<0.05). Grade B and grade D diabetes in the AA and AG genotypes of rs3792267 were significantly different compared with those in the GG genotype (P<0.05), and allele A was significantly increased compared with allele G (P<0.05). CONCLUSIONS The rs2975760 and rs3792267 SNP polymorphisms of CAPN10 showed no significant association with the incidence of gestational diabetes mellitus and only a mild association with the severity.

Efficacy and safety of sitagliptin added to metformin and insulin compared with voglibose in patients with newly diagnosed type 2 diabetes.

OBJECTIVE: To assess the efficacy and safety of sitagliptin compared with voglibose added to combined metformin and insulin in patients with newly diagnosed type 2 diabetes (T2DM). METHODS: In this 12-week prospective, randomized, parallel trial, 70 newly diagnosed T2DM patients with glycosylated hemoglobin (HbA1c) ≥9% and/or fasting plasma glucose (FPG) ≥11.1 mmol/L were randomized (1:1) to receive sitagliptin 100 mg per day + metformin + insulin glargine or voglibose 0.2 mg three times daily + metformin + insulin glargine. Change in HbA1c at week 12 was the primary endpoint. RESULTS: The mean baseline HbA1c was 11.0% in the patients. The changes in HbA1c from baseline were -6.00% in the sitagliptin group and -3.58% in the voglibose group, and the between-group difference was -2.42% (95% CI -1.91 to -2.93, p=0.02). The differences in FPG and homeostatic model assessment of ß-cell function (HOMA-ß) and the change in body weight between groups from baseline were -2.95 mmol/L (p=0.04), 43.91 (p=0.01) and -2.23 kg (p=0.01), respectively. One patient (2.9%) in the sitagliptin group and three patients (8.6%) in the voglibose group exhibited hypoglycemia. CONCLUSIONS: Sitagliptin added to combined metformin and insulin therapy showed greater efficacy and good safety regarding hypoglycemia in patients with newly diagnosed T2DM compared with voglibose.