Objective To investigate the effect of type 2 diabetes mellitus on the prognosis of coronary heart disease patients who had a complication of heart failure with preserved ejection fraction. Metohds A retrospective study was performed with 393 coronary heart disease patients who were complicated with heart failure with preserved ejection fraction. The diagnosis was based on the results of echocardiography and coronary angiography at the heart center of the First Affiliated Hospital of Xinjiang Medical University assessed from January 2017 to December 2017. The patients were divided into diabetic group and non-diabetic group. The incidence of major adverse cardiovascular events (MACE) was compared between the two groups. In addition, the incidence of MACE was compared between the complete revascularization group and the incomplete revascularization group. Multivariate Cox regression analysis was used to analyze the effect of the risk factors on prognosis. Results The prevalence of hypertension and the use of ACEi/ARB in the diabetic group were higher than those in the non-diabetic group (P<0.05), and the level of high-density lipoprotein in the diabetic group was lower than that in the non-diabetic group (P<0.05). The incidence of MACE in the diabetic group (35.8%) was higher than that in non-diabetic group (25%, P=0.027). Complete revascularization improved the prognosis and reduced the incidence of MACE in both the diabetic group and non-diabetic group (P<0.05). Multivariate Cox regression analysis showed that a history of myocardial infarction (HR=0.44, 95%CI 0.20 to 1.00, P=0.049), incomplete revascularization (HR=17.28, 95%CI 2.34 to 127.43, P=0.005), and ejection fraction (HR=0.90, 95%CI 0.82 to 1.00, P=0.046) were associated with the occurrence of MACE in patients with coronary heart disease complicated with heart failure with preserved ejection fraction. Conclusion Type 2 diabetes mellitus affects the prognosis of coronary heart disease patients who have complication of heart failure with preserved ejection fraction. Complete revascularization can improve the prognosis of type 2 diabetic patients with coronary heart disease who have complications of heart failure with preserved ejection fraction.
Objective To perform a meta-analysis and investigate the correlation between angiotensin-I converting enzyme gene insertion (I), deletion (D) polymorphism and type 2 diabetic nephropathy, assessing the bias of small sample size study and heterogeneity between studies. Methods MEDLINE, EBSCO, EMbase, PubMed, CHKD, CNKI, CBM, VIP and WanFang Data were searched (from January 1994 to March 18th 2011) for relevant case-control studies. Two reviewers independently identified the literature according to inclusion and exclusion criteria. Also references of the included literature were retrieved. Then data were extracted and assessed by the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using RevMan 5.0.0 software. Results A total of 61 studies comprising 9 979 cases and 7 252 control subjects were included. There was b evidence of heterogeneity (Plt;0.05, I2=60%) and a random effect model was employed to summarize the data. Results of meta-analysis showed that T2DM patients with II genotype had lower incidences of DN than those with DD+DI genotype (OR=0.65, 95%CI 0.57 to 0.74). The results of subgroup meta-analysis showed that Chinese, Japanese and Brazilians patients with II genotype had lower incidences of DN. However, there were no relation among Caucasus, Middle-East, Indian, Mexican, Korean, and Malaysian patients. Conclusion As for T2DM patients, their angiotensin-I converting enzyme gene insertion (I), deletion (D) polymorphism relates to DN. T2DM patients with II genotype have lower incidences of DN. But the difference of this relation varies with ethnicity.
Objective To evaluate the relationship between the single nucleotide polymorphisms (SNPs) of the adiponectin gene +45 in exon 2 and type 2 diabetes mellitus (T2DM) in Chinese population via meta-analysis. Methods Databases including PubMed, Ovid, CBM, VIP, CNKI, and WanFang Data were searched from inception to June 2012, and the references of articles were also retrieved to collect case-control studies about the correlation of SNPs of the adiponectin gene +45 in exon 2 and T2DM in Chinese population. According to the self-designed inclusion and exclusion criteria, two reviewers screened articles, extracted data, and assessed the quality of the included studies independently. Then meta-analysis was performed STATA 11.0, with stability evaluated by both stratified analysis and sensitivity analysis. Moreover, Begg’s funnel plot and Egger’s method were used to assess the published bias of articles. Results 21 articles involving 22 studies were included (3272 T2DM cases and 2597 controls). There were significant differences between the two groups in dominant, recessive and addictive genetic models, and the pooled ORs (95% CI) were 1.36 (1.04, 1.78), 2.07 (1.55, 2.75), and 2.44 (1.59, 3.75), respectively. Conclusion The genetic single nucleotide polymorphisms of the adiponectin +45 in exon 2 is associated with type 2 diabetes in Chinese population. G allele of APM1 is a risk factor for type 2 diabetes, no matter in dominant, recessive or addictive genetic models.
ObjectiveTo systematically review the correlation between type 2 diabetes mellitus (T2DM) and the risk of kidney cancer. MethodsPubMed, EMbase, Web of Science, CBM, VIP and CNKI databases were electronically searched to collect cohort studies on the association between T2DM and kidney cancer from inception to August 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis then performed by using Stata 15.0 software. ResultsA total of 17 cohort studies involving 2 003 165 T2DM patients were included. The results of meta-analysis showed that patients with T2DM had a higher kidney cancer risk than controls (RR=1.51, 95%CI 1.39 to 1.64, P<0.001). Subgroup analysis showed that the incidence of kidney cancer in T2DM patients was higher in different gender, region, population, follow-up time, diabetes assessment method and other subgroups. ConclusionsCurrent evidence shows that T2DM is a risk factor for kidney cancer.
Objective To assess the effectiveness and safety of biphasic insulin aspart 30 given three times a day in the management of type 2 diabetes. Methods Such databases as CENTRAL, MEDLINE, PubMed and CNKI were searched on computer; additionally, the relevant conference proceedings from associations like American Diabetes Association, and the references of all selected literatures were also hand-searched. The randomized controlled trials (RCTs) on biphasic insulin aspart 30 given three times a day in treating type 2 diabetes were screened according to inclusive and exclusive criteria, without concerning the limitation of languages and blind methods. After data extraction and quality evaluation, Meta-analysis was performed by using RevMan 4.2 software. Results Ten trials involving 1 415 patients were included. The sub-group analysis showed that compared with the group of given biphasic insulin aspart 30 twice a day (the bid group), the group of given biphasic insulin aspart 30 three times a day (the tid group) was superior in decreasing HbAlc (Plt;0.000 01). Compared with the group of thrice preprandial injection of Novolin R plus one injection of Novolin N at bedtime (the qid group), Meta-analysis showed that, a) As to the average fasting glucose levels: the tid group was not superior to the qid group (P=0.65); b) As to the average 2-hour postprandial glucose levels: the tid group was superior to the qid group (P=0.0003); c) As to the therapeutic time: the tid group was not superior to the qid group (P=0.38); d) As to the insulin doses: the tid group was superior to the qid group (P=0.000 1); e) As to the insulin costs: the tid group was inferior to the qid group (P=0.02); and e) As to the incidence of hypoglycaemia: the tid group was superior to the qid group (P=0.000 2). Compared with the oral antidiabetic drugs, the results of Meta-analyses showed: the tid group was superior in decreasing HbAlc (P=0.001). Conclusion The limited current evidence shows that biphasic insulin aspart 30 given three times a day, as a simple insulin intensified scheme, is safe and effective for type 2 diabetes, and is worth recommending in clinic. However, all these findings should be further confirmed with more large sample and well-designed RCTs.
ObjectiveTo observe and evaluate the predictive value of serum cystatin C (Cys-C) on the risk of sight-threatening diabetic retinopathy (STDR). MethodsA non-randomized controlled cross-sectional clinical study. Ninety-two patients with type 2 diabetes mellitus (T2DM) who were admitted to Department of Ophthalmology of Beijing Tsinghua Changgung Hospital from January 2022 to October 2022 were included in the study. Among them, 50 were male, 42 cases were female, with the mean age of (58.24±12.49) years. The mean duration of T2DM was (13.18±8.35) years, of which 38 cases had a duration of ≥10 years. Twenty-nine cases complicated with hypertension, of which 16 cases had a duration of ≥10 years. Seventeen cases complicated with chronic kidney disease stage 2 and 23 cases were treated with lipid-lowering drugs. Hemoglobin Alc, serum Cys-C, serum lipids and renal function were tested, and urinary microalbumin/creatinine ratio (ACR) was calculated. According to the 2003 American Academy of Ophthalmology "Clinical Guidelines for Diabetic Retinopathy (DR)" and international clinical DR severity grading standards, the patients were divided into STDR and non-STDR groups, with 44 and 48 cases in each group, respectively. STDR was defined as severe non-proliferative DR, proliferative DR, and macular edema. Logistic regression was used to analyze the independent risk factors of STDR in T2DM patients. Receiver operating characteristic curve (ROC curve) was used to calculate and analyze the area under ROC curve (AUC) and the predictive value of serum Cys-C and ACR in predicting STDR in T2DM patients. ResultsSerum Cys-C levels in STDR and non-STDR groups were 1.10 (0.94, 1.28) and 0.91 (0.83, 1.02) mg/L, respectively, with ACR of 4.29 (1.05, 21.89) and 1.39 (0.77, 3.80) mg/mmol, respectively. Compared with non-STDR group, serum Cys-C and ACR in STDR group were higher, and the difference was statistically significant (Z=－3.984, －3.280; P＜0.05). Multivariate logistic regression analysis showed that serum Cys-C was an independent risk factor for STDR (odds ratio=1.337, 95% confidence interval 1.145-2.090, P=0.033), and the risk of STDR increased by 33.7% for every 0.1 mg/L increase in serum Cys-C. ROC analysis results showed that serum Cys-C＞1.065 mg/L combined with ACR＞5.84 mg/mmol predicted the AUC of STDR in T2DM patients was 0.661, with the specificity of 95.8%. ConclusionsThe high serum Cys-C level is an independent risk factor for STDR in T2DM patients. Serum Cys-C has high predictive value for the occurrence of STDR.
ObjectiveTo explore the relationship between hand grip strength and depression and the moderating role of monthly household income level between grip strength and depression of community-dwelling female patients with type 2 diabetes.MethodsFrom March to June 2021, 3 communities in Chengdu were selected by convenience sampling method, and elderly female patients with type 2 diabetes were randomly selected from these communities. The patients were investigated through a self-made demographic and disease-related questionnaire and the Geriatric Depression Scale-15, and their grip strength was measured by a grip meter. The Process V3.3 plugin in SPSS 25.0 software was used to test the moderation effect.ResultsA total of 389 elderly female patients with type 2 diabetes were enrolled in this study. Spearman correlation analyses indicated that the grip strength was negatively correlated with the depression score (rs=?0.125, P=0.014), and positively correlated with the monthly household income level (rs=0.157, P=0.002); the depression score was negatively correlated with the monthly household income level (rs=?0.147, P=0.004). The results of the moderating effect showed that grip strength and monthly household income level could independently affect the patients’ depression scores [unstandardized partial regression coefficient (b)=?0.254, P=0.002; b=?1.552, P=0.009], and the interaction item of grip strength and monthly household income level was statistically significant for depression scores (b=0.065, P=0.031).ConclusionThe hand grip strength of community-dwelling elderly female patients with type 2 diabetes can negatively predict the level of depression, and the monthly household income level has a moderating effect between grip strength and depression.
Objective To evaluate the effectiveness of diabetic patient education on glycemic control for diabeties. Methods Fifty cases of type 2 diabetic patients with educational interventions from the Diabetic Educational Center of West China Hospital and 50 type 2 diabetic patients without educational intervention were selected randomly. All the patients completed the same questionnaire. The data were analyzed by SPSS 10.0. Results The age of patients in educational group was older and the duration of sickness was longer than those in the control group, but their blood glucoses were better controlled. Conclusions Diabetic patient education is important to improve their glycemic control and decrease the risks and deterioration of diabetic chronic complications.
ObjectiveTo systematically review the intervention efficacy of resistance exercise on prediabetes and type 2 diabetes. MethodsPubMed, The Cochrane Library, EMbase, Web of Science, EBSCO, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of resistance exercise applied to pre-diabetic and type 2 diabetic population from 2010 to April, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using Revman 5.1 and Stata 12.0 software. ResultsA total of 26 RCTs involving 2 078 patients were included. The results of meta-analysis showed that resistance exercise could improve fasting blood glucose (MD=?0.57, 95%CI ?0.69 to ?0.45, P<0.000 01), glycosylated hemoglobin (MD=?0.28, 95%CI ?0.33 to ?0.22, P<0.000 01), high density lipoprotein (MD=0.06, 95%CI 0.01 to 0.11, P=0.01), low density lipoprotein (MD=?0.35, 95%CI ?0.47 to ?0.24 , P<0.000 01), total cholesterol (MD=?0.25, 95%CI ?0.39 to ?0.12, P=0.000 3), steady-state model-insulin resistance index (MD=?0.74, 95%CI ?0.80 to ?0.68, P<0.000 01), and body mass index (MD=?0.54, 95%CI ?1.03 to ?0.05, P=0.03) compared with control group. ConclusionsResistance exercise can improve the blood glucose, blood lipid, and insulin resistance levels of individuals with abnormal glucose and lipid metabolism. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
【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.
