Observation of the effect of one-to-one education on high-risk cases of diabetic foot.

BACKGROUND: Diabetes is a common chronic disease, and its global incidence is on the rise. The disease is directly attributed to insufficient insulin efficacy/secretion, and patients are often accompanied by multiple complications. Diabetic foot is one of the most common complications of diabetes. Diabetic feet have ulcers and infections, which can eventually lead to amputation. Basic nursing care, such as lowering blood pressure and preventing foot skin infections in clinical nursing work, has positive significance for the prevention and control of diabetic feet. AIM: To explore the positive significance of one-to-one education in high-risk cases of diabetic foot. METHODS: This observation included 98 high-risk cases of diabetic foot in our hospital during the period from August 2017 to October 2019, and these patients were randomly divided into the basic nursing group and the one-to-one education group with 49 patients per group. The basic nursing group only received routine basic nursing, while the one-to-one education group gave patients one-to-one education on the basis of basic nursing. After nursing, the self-care ability and compliance behavior of the two groups were evaluated and compared between these two groups. The knowledge mastery of the patient and the satisfaction of nursing were accounted. RESULTS: The assessment results of patients (self-care responsibility, self-care skills, self-concept and self-care knowledge) were significantly higher in the one-to-one education group than in the basic nursing group. The scores of compliance behaviors (foot bathing, shoes and socks selection, sports health care) in the one-to-one education group were significantly higher than those in the basic nursing group. Patients in the one-to-one education group had a significantly higher level of knowledge mastery and satisfaction of nursing than the basic nursing group. CONCLUSION: One-to-one education for high-risk cases of diabetic foot is helpful to improve the cognition and self-care ability of patients with diabetic foot, to ensure that patients follow the doctor's advice of self-care and to improve their nursing satisfaction.

[Accuracy of a continuous glucose monitoring system in detection of blood glucose during oral glucose tolerance test].

OBJECTIVE: To evaluate the accuracy of continuous glucose monitoring system (CGMS) during oral glucose tolerance test (OGTT) in the detection of blood glucose changes in glucose stress condition. METHODS: Forty-nine out-patients with fasting plasma glucose of 3.9-11.0 mmol/L underwent continuous blood glucose monitoring using CGMS for 3 days, and OGTT was conducted on the third day. The venous blood glucose was measured at 0, 30, 60, 90, and 120 min after oral glucose intake, and the accuracy of CGMS during OGTT was evaluated. RESULTS: The correlation indices between CGMS values and the venous blood glucose values during the entire OGTT and in phases of stable, rapidly rising and falling glucose levels were 0.928, 0.901, 0.924 and 0.902, respectively (P<0.001). Clarke error-grid analysis showed that more than 95% of the measured results fell into the A and B zones. CONCLUSION: CGMS values show good consistency with venous blood glucose values measured during OGTT. CGMS is accurate in detection of rapidly changing blood glucose during OGTT.

[Effect of short-term intensive therapy with glimepiride and metformin in newly diagnosed type 2 diabetic patients].

OBJECTIVE: To evaluate the effect of short-term intensive therapy on blood glucose control, BETA-cell function, and blood lipid levels in newly diagnosed type 2 diabetic patients. METHODS: Out-patients with newly diagnosed type 2 diabetic patients were enrolled for intensive treatment with sulfonylureas and metformin for 12 weeks, and the therapeutic effect was evaluated. RESULTS: After the intensive treatment, FPG, 2 hPG, and HbA1c decreased significantly (P<0.01); HOMA-IR decreased and HOMA-B increased significantly (P<0.01), and TG, CHOL, LDL decreased significantly (P<0.01) after the treatment. CONCLUSION: Short-term intensive treatment with glimepiride combined with metformin is safe and effective in newly diagnosed type 2 diabetic patients with HbA1c>9%.

[Epidemiological investigation of diabetes and prediabetes in community residents in the suburbs of Guangzhou].

OBJECTIVE: To identify the prevalence and risk factors of diabetes and prediabetes in the community residents above 18 years old in the suburbs of Guangzhou. METHODS: Between April and May in 2008, the residents above 18 years living in 6 communities of Guangzhou for 5 or more years were sampled with multistage clustering sampling. The sampled residents were surveyed by questionnaires, and physical examination and glucose determination were carried out. RESULTS: A total of 1532 residents were sampled. The incidence of diabetes mellitus in these community residents was 8.46%, and that of impaired glucose regulation was 6.59%. Age, body mass index, family history of diabetes mellitus, case history of hypertension, hyperlipidemia, hypertension and smoking were all the independent risk factors for impaired glucose regulation and diabetes mellitus. CONCLUSION: Diabetes and prediabetes are prevalent in the community residents in Guangzhou. Controlling the risk factors such as obesity, hypertension, lipid metabolism disorder among the residents above 40 years with a family history of diabetes mellitus and hypertension is key to prevention of impaired glucose regulation and diabetes mellitus.

[Association of blood glucose fluctuation with the pain sensation in patients with painful diabetic neuropathy].

OBJECTIVE: To investigate the relationship between blood glucose fluctuation and the pain sensation in patients with painful diabetic neuropathy. METHODS: The severity of pain in 16 patients with painful diabetic neuropathy was assessed using visual analog scale (VAS), and according to the results, the patients were divided into mild to moderate pain group and severe pain group. The blood glucose of the patients were monitored continuously for 72 h using a continuous glucose monitoring system, and the MBG, SD, DMMG, MAGE, and AUCPG were obtained with the FBG and HbA1C tested. RESULTS: The SD, DMMG, and MAGE of the severe pain group were all significantly higher than those of the mild to moderate pain group (P<0.05), and no significant difference was found in MBG, FBG or HbA1c between the two groups. CONCLUSION: The blood glucose fluctuation is associated with the severity of the pain degree, and effective control of the blood glucose fluctuation helps prevent and treat painful diabetic neuropathy.

[Association of serum interleukin-6 and high-sensitivity C-reactive protein levels with insulin resistance in gestational diabetes mellitus].

OBJECTIVE: To investigate the association of serum concentration of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) with insulin resistance in women with gestational diabetes mellitus (GDM). METHODS: Forty normal pregnant women (NGT group) and 23 women with GDM (GDM group) were enrolled in this study with another 25 women of child-bearing age as the control group. Radio immunoassay (RIA) was used to measure the fasting serum IL-6 levels, and immunoturbidimetry performed to evaluate serum hs-CRP levels. The homeostasis model assessment-insulin resistance (HOMA-IR) and the homeostasis model assessment-B (HOMA-B) were calculated. RESULTS: Compared with NGT group and control group, GDM group had significantly elevated serum IL-6 and hs-CRP (P<0.01), but the levels were comparable between the former two groups (P>0.05). HOMA-IR was the highest in GDM group (P<0.001), and NGT group had significantly higher HOMA-IR than the control group (P<0.05), whereas the reverse was true for HOMA-B (P<0.01). Pearson correlation analysis showed that fasting blood glucose (FBG), fasting insulin (FINS), IL-6 and hs-CRP had significant association with HOMA-IR (P<0.01). Multiple regression analysis identified FINS, FBG, IL-6, and hs-CRP as the factors significantly affecting HOMA-IR (regression coefficient of 0.563, 0.992, 0.325, and 0.231, respectively, P<0.01). CONCLUSIONS: Serum levels of IL-6 and hs-CRP are elevated in women with GDM, which are the most significant factors affecting HOMA-IR. IL-6 and CRP may aggravate insulin resistance through various mechanisms and participate in the pathogenesis of GDM.