目的:比較羅格列酮鈉片與二甲雙胍片分別聯合胰島素治療2型糖尿病的療效和安全性。方法:40例單用胰島素控制血糖不理想的2型糖尿病患者,隨機分為A組,太羅組(羅格列酮鈉片)(21例);B組,二甲雙胍組(19例),進行為期16周的對照觀察。結果:兩組治療后空腹及餐后2小時血糖及糖化血紅蛋白(HbA1c)均呈有意義的下降(Plt;0.05),從下降幅度的百分率統計,太羅組下降幅度明顯高于二甲雙胍組。結論:太羅聯合胰島素治療對于血糖的控制明顯優于二甲雙胍聯合胰島素治療。
【摘要】 目的 對比分析胰島素類似物賴脯胰島素75/25和人胰島素優泌林70/30治療2型糖尿病對血糖的控制作用和安全性。 方法 選取2007年6月-2008年7月107例2型糖尿病患者，隨機分為兩組:賴脯胰島素75/25組54例，每日早、晚餐前10 min皮下注射賴脯胰島素75/25，劑量0.5～0.7 U/（kg?d）；優泌林70/30組53例，每日早、晚餐前30 min注射優泌林70/30，劑量0.7～1.0 U /（kg?d），治療2周后觀察患者日胰島素總量、血糖控制情況、體質量及低血糖發生率。 結果 治療2周后，賴脯胰島素75/25組FBG由（15.4±3.1） mmol/L降為（6.5±1.4） mmol/L（Plt;0.05）、PBG-2h由（22.2±6.5） mmol/L降至（9.23±2.51） mmol/L（Plt;0.05）；優泌林70/30組FBG由（14.9±3.0） mmol/L降為（6.7±1.7） mmol/L（Plt;0.05），PBG-2h由（21.7±7.3） mmol/L降至（11.10±2.73） mmol/L（Plt;0.05）。治療3個月后賴脯胰島素75/25組HbA1c水平明顯下降，與優泌林70/30組比較差異有統計學意義（Plt;0.05）；日胰島素用量賴脯胰島素75/25組較優泌林70/30組低（Plt;0.05），體質量變化及低血糖發生率兩組比較無統計差異性（Pgt;0.05）。 結論 賴脯胰島素75/25治療2型糖尿病，HbA1c水平更低，達標患者的比例更高，具有良好的安全性及依從性。【Abstract】 Objective To compare the clinical safety and effect of insulin analogues insulin lispro 75/25 and human insulin humulin 70/30 on type 2 diabetes mellitus. Methods A total of 107 patients with type 2 diabetes mellitus from June 2007 to July 2008 were randomly divided into two groups: 54 patients in group A were injected with insulin lispro 75/25 [0.5-0.7 U/(kg?d)], twice per day, 10 minutes before each breakfast and dinner, and another 53 patients in group B were injected with human insulin humulin 70/30 [0.7-1.0 U/(kg?d)], twice per day, 30 minutes before each breakfast and dinner. The daily insulin dosage, level of blood glucose, body mass and the incidence of low blood sugar in the two groups were observed. Results Two weeks after the treatment, the level of FBG decreased from (15.4±3.1) mmol/L to (6.5±1.4) mmol/L (Plt;0.05), and the level of PBG-2h decreased from (22.2±6.5) mmol/L to (9.23±2.51) mmol/L (Plt;0.05) in group A; the level of FBG decreased from (14.9±3.0) mmol/L to (6.7±1.7) mmol/L (Plt;0.05), and the level of PBG-2h decreased from (21.7±7.3) mmol/L to (11.10±2.73) mmol/L (Plt;0.05) in group B. Three months after the treatment, the level of HbA1c in group A decreased apparently, which differed much from that in group B (Plt;0.05). The daily dosage of insulin in group A was lower than that in group B (Plt;0.05); the differences in changes of body mass and the incidence of hypoglycemia between the two groups were not significant (Pgt;0.05). Conclusion The treatment with insulin lispro 75/25 for type 2 diabetes mellitus shows a good effect on HbA1c level control with safety and compliance.
【摘要】 目的 探討糖尿病管理的有效模式，提高糖尿病患者的治療達標率，減少低血糖發生。 方法 研究對象為2008年5月-2009年5月就診的2型糖尿病患者356例。測量所有研究對象的空腹血糖、餐后2 h血糖、糖化血紅蛋白。觀察糖尿病管理后及常規治療后血糖的變化。 結果 應用糖尿病達標管理軟件管理糖尿病患者，血糖達標率明顯升高，差異有統計學意義（Plt;0.05）；低血糖的發生率下降，差異有統計學意義（Plt;0.05）。 結論 大多數糖尿病患者的病情控制未達到理想的目標，應用科學的糖尿病達標管理軟件進行管理是改善現狀的有效方法。【Abstract】 Objective To study the effective management model for diabetes mellitus, promote the treatment results of patients with disease, and reduce the occurrence of hypoglycemia. Methods A total of 356 patients with type 2 diabetes mellitus (T2DM) treated from May 2008 to May 2009 were chosen in this study. Fasting bloods glucose, 2-hour postprandial blood glucose and hemoglobin A1c were detected in all the subjects. Then, the change of glucose level for the management group and the common treatment group was observed. Results The glucose-target-rate of patients managed by diabetes management software was significantly higher than patients in the common treatment group (Plt;0.05), and the occurrence rate of hypoglycemia was also significantly lower (Plt;0.05). Conclusions The control of T2DM for most patients is far from satisfaction. The application of scientific disease care software is effective for improving disease control.
【摘要】 目的 探討心理干預對糖尿病患者血糖控制及情緒的影響。 方法 2001年3月-2009年7月將120例2型糖尿病患者隨機分成干預組和對照組，每組各60例。兩組均給予正規藥物治療，干預組同時予心理干預。8周后用焦慮自評量表（self-rating anxiety scale，SAS）、抑郁自評量表（self-rating depression scale，SDS）評定兩組患者情緒變化，同時測定空腹血糖、餐后2 h血糖。 結果 干預前后干預組空腹血糖及餐后2 h 血糖下降值多于對照組，差異有統計學意義（Plt;0.05）；通過干預，干預組患者SAS、SDS評分均有明顯改善，干預前后評分差異有統計學意義（Plt;0.05），對照組干預前后差異無統計學意義（Pgt;0.05）；患者血糖與SAS、SDS評分等因子呈現中等程度的相關性（|r|為0.4~0.6，Plt;0.05）。 結論 糖尿病患者血糖與SAS、SDS等情緒指標相關，心理干預能顯著改善血糖和患者情緒。【Abstract】 Objective To study the effect of psychological intervention on blood-glucose control and emotions of diabetic patients. Methods A total of 120 patients with type 2 diabetes treated between March 2001 and July 2009 were randomly divided into the intervention group and the control group with 60 patients in each. Medicine treatment was carried out for patients in both groups, and psychological intervention was applied only to the intervention group. Eight weeks later, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate emotion changes of the patients. Fasting blood glucose, post-meal blood glucose (P2hBG) examination were conducted at the same time. Results The result showed a significantly larger decrease of both fasting blood glucose and post-meal blood glucose in the intervention group than the control group (Plt;0.05). Through these methods, the SAS and SDS evaluation of patients in the intervention group improved significantly (Plt;0.05); However, the change of these two scores was not statistically significant in the control group (Pgt;0.05). There was a mid-level correlation between the blood sugar level of diabetic patients and SAS, SDS evaluation scores (0.4lt;|r|lt;0.6, Plt;0.05). Conclusion The blood sugar level of patients with diabetes is closely related to SAS and SDS scores, and psychological intervention can significantly improve the control of blood glucose and emotions of the patients.
目的:研究羅格列酮(ROS)治療2型糖尿病,對患者組織胰島素敏感性與血清炎癥介質改變的關系。方法:選取符合1999年WHO標準確診的2型糖尿病患者30例。試驗采用前后自身配對方法。口服ROS 4mg每天一次,總療程8周。測定指標包括常規臨床檢查項目、血糖,同時檢測血漿胰島素水平,糖化血紅蛋白(HbA1c)水平、C反應蛋白(CRP)、白細胞介素6(IL-6)、腫瘤壞死因子-α(TNF-α)水平,以 HOMA模型和胰島素鉗夾試驗評價組織胰島素敏感性。結果:應用ROS治療的2型糖尿病患者組織胰島素敏感性顯著改善(Plt;0.05),并降低血漿CRP、IL-6、TNF-α水平,這些炎癥介質的改變與組織胰島素敏感性的改變相關。結論:應用ROS治療2型糖尿病能降低患者血漿炎癥介質水平,減輕胰島素抵抗,延緩或減輕糖尿病大血管并發癥的發生發展。
Objective To study the therapeutic effect of Roux-en-Y gastric bypass （RYGB） on type 2 diabetes mellitus （T2DM） rats and explore the possible mechanism of vaspin in RYGB on T2DM. Methods Twenty SD rats with T2DM and 20 age- and sex-matched normal SD rats were randomly divided into 4 groups according to the random digits table：T2DM-RYGB group， T2DM-sham operation （SO） group，RYGB group，and SO group，10 rats in each group. Fasting plasma glucose （FPG） level，serum insulin （INS） level，vaspin level，and homeostasis model of insulin resistance （HOMA-IR） were determined before operation and on week 4，8 after operation，respectively．At the same time，the correlation between vaspin and the indicators （FPG，INS，or HOMA-IR） was analyzed．Results Compared the indicators after operation with before operation，the FPG level，INS level，vaspin level，and HOMA-IR were not significantly different between the T2DM-RYGB group and T2DM-SO group （P＞0.05） or between the RYGB group and SO group （P＞0.05），but the FPG level，INS level，vaspin level，and HOMA-IR in the T2DM-RYGB group and T2DM-SO group were significantly higher than those in the RYGB group （P＜0.05） and SO group （P＜0.05），respectively. On week 4 after operation，the FPG level，INS level，vaspin level，and HOMA-IR decreased in the T2DM-RYGB group，except for the FPG level，the other indexes had no significant differences as compared with the values before operation. On week 8 after operation，the FPG level，INS level，vaspin level，and HOMA-IR further decreased in the T2DM-RYGB group，there were significant differences of these indicators between before operation and on week 8 after operation. Compared the indicators after operation with before operation，the FPG level，INS level，vaspin level，and HOMA-IR were not statistically significant （P＞0.05） in the T2DM-SO group，RYGB group，or SO group. The changes in serum vaspin level correlated positively with those in INS and HOMA-IR before operaion and on week 4，8 after operaion in the T2DM-RYGB group and T2DM SO group rats （P＜0.05），respectively. Conclusions RYGB surgery has a therapeutic effect on T2DM rats，and serum vaspin level decreases and insulin resistance is improved after RYGB surgery，which may be one of the mechanisms of the treatment for T2DM.
ObjectiveTo systematically review the effect of intermittent fasting on type 2 diabetes mellitus. MethodsThe CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, The Cochrane Library and EMbase databases were electronically searched to collect randomized controlled trials (RCTs) on intermittent fasting intervention in the treatment of type 2 diabetes mellitus from inception to April 2022. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included studies. The RevMan 5.4 software and Stata 17.0 software were used for meta-analysis. ResultsA total of 17 RCTs comprising 1 428 patients with type 2 diabetes mellitus were included. The results of meta-analysis showed that intermittent fasting improved body weight (WMD=?2.84, 95%CI ?3.79 to ?1.88, P<0.05), body mass index (BMI) (WMD=?1.07, 95%CI ?1.52 to ?0.61, P<0.05), glycosylated hemoglobin levels (SMD=?0.78, 95%CI ?1.19 to ?0.38, P<0.05), and fasting glucose levels (SMD=?0.65, 95%CI ?1.01 to ?0.3, P<0.05). ConclusionThe current evidence suggests that intermittent fasting improves body weight, BMI, glycated hemoglobin, and fasting blood glucose levels in patients with type 2 diabetes. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
【摘要】 目的 探討預混門冬胰島素對2型糖尿病（type 2 diabetes mellitus，T2DM）患者血漿成纖維細胞生長因子-21（fibroblast growth factor-21，FGF-21）水平的影響。 方法 2008年2—12月采用酶聯免疫吸附試驗測定44例正常人及37例采用預混門冬胰島素治療前后的T2DM患者的血漿FGF-21水平，分析血漿FGF-21水平與體質量指數（body mass index，BMI）、體內脂肪百分比（FAT%）、腰臀比、血脂、血糖、糖化血紅蛋白（hemoglobin A1c， HbA1c）、游離脂肪酸（free fatty acid，FFA）等的關系。 結果 治療前T2DM組患者血漿FGF-21[（1.79±0.04） μg/L]水平明顯高于正常對照組[（1.35± 0.21） μg/L]，差異有統計學意義（Plt;0.01）。T2DM組經16周預混人胰島素類似物（BIAsp 50和BIAsp 30）治療后FFA、HbA1c、空腹血糖、餐后2 h血糖均降低（Plt;0.01），空腹血漿FGF-21水平降低至（1.33±0.39） μg/L，與治療前比較差異有統計學意義（Plt;0.01）。相關分析發現T2DM組患者血漿FGF-21水平與BMI呈正相關（r=0.53，Plt;0.01），BMI是影響T2DM患者血漿FGF-21水平的獨立相關因素。 結論 預混人胰島素類似物能有效改善T2DM患者代謝紊亂，同時能顯著降低FGF-21水平。【Abstract】 Objective To investigate the effects of treatment with aspart insulin on plasma fibroblast growth factor-21 (FGF-21) levels in patients with type 2 diabetes mellitus (T2DM). Methods From February to December 2008, plasma FGF-21 levels were measured by enzyme-linked immunosorbent assay in 37 patients with T2DM treated with aspart insulin and 44 normal controls. The relationship between plasma FGF-21 levels and body mass index (BMI), percentage of body fat (FAT%), waist-hip ratio (WHR), blood lipid, blood glucose, hemoglobin A1c (HbA1c), and free fatty acid (FFA) was analyzed. Results Before treatment, plasma FGF-21 level was significantly higher in T2DM patients [(1.79±0.04) μg/L] than that in the normal controls [(1.35±0.21) μg/L] (Plt;0.01). After 16 weeks of treatment with premixed human insulin analogues (BIAsp 50 and BIAsp 30), FFA, HbA1c, fasting plasma glucose and 2-hour postprandial blood glucose decreased significantly (Plt;0.01), and fasting plasma FGF-21 level decreased to (1.33±0.39) μg/L which was significantly different from that before treatment (Plt;0.01). Correlation analysis showed that plasma FGF-21 level was positively correlated with BMI (r=0.53,Plt;0.01), which was an independent factor in influencing the FGF-21 level in the patients. Conclusion Aspart insulin treatment can remarkably improve glucose metabolism and significantly decrease the fasting plasma FGF-21 level.