【摘要】 目的 研究不同壓力二氧化碳（CO2）氣腹對糖代謝的影響。 方法 18只雌性健康新西蘭大白兔按CO2氣腹壓力隨機均分為氣腹壓0 mm Hg （1 mm Hg=0.133 kPa）（Ⅰ組）、氣腹壓10 mm Hg（Ⅱ組）和氣腹壓15 mm Hg（Ⅲ組）。每組兔均在不同的壓力下接受氣腹1 h。在CO2氣腹前（T0）、氣腹后30 min （T1）、氣腹后60 min （T2） 測定動脈血氣分析值、血糖（Glu）、胰島素（Ins）和胰高糖素（Gln）。 結果 氣腹后30 min 、60 min，Ⅱ組與Ⅰ組比較，PaCO2、Glu 、Gln增加（Plt;0.05），pH值和Ins下降（Plt;0.05），Ⅲ組各參數變化更為顯著（Plt;0.01）。結論 CO2氣腹后機體可能處于較強烈的應激狀態，導致血糖升高。【Abstract】 Objective To study effects of different intraabdominal pressure of carbon dioxide (CO2) pneumoperitoneum on blood glucose level in rabbits. Methods Eighteen female healthy rabbits weighed 2.1-3.3 kg were randomly divided into three groups equally based on pneumoperitoneum pressure: 0 mm Hg (1 mm Hg=0.133 kPa) group (groupⅠ),10 mm Hg group (groupⅡ) and 15 mm Hg (groupⅢ). Each group received 1h pneumoperitoneum under diffent pressure. Blood samples were taken before CO2 pneumoperitoneum, at 30 and 60 minutes after pneumoperitoneum for the measure-ments of arterial blood gas, blood glucose (Glu), insulin (Ins) and glucone (Gln). Results After pneumoperitoneum at 30 and 60 minutes, compared with groupⅠ, PaCO2,Glu and Gln were significantly raised in groupⅡ(Plt;0.05), pH and Ins were markedly decreased (Plt;0.05). Even more significant changes were observed in group Ⅲ(Plt;0.01). Conclusion After CO2 pneumoperitoneum, body is in a relatively b stress, so blood glucose is decreased.
ObjectiveTo investigate the effect and mechanism of gastric bypass surgery (GBP) on fasting bloo-glucose (FBG) in type 2 diabetic rats. MethodsThe models of type 2 diabetic rats were induced by stretozotocin and 20 diabetic rats were randomly divided into two groups: diabetes-operation group (DO group, n=10) and diabetes-control group (DC group, n=10). Another twenty normal rats were randomly divided into two groups: normaloperation group (NO group, n=10) and normal-control group (NC group, n=10). The rats underwent GBP in DO group and NO group and sham operation in DC group and NC group. The FBG levels, serum dipeptidyl peptidase Ⅳ (DPPⅣ), and glucagon-like peptide-1 (GLP-1) concentrations of rats in each group were detected before operation and at 72 h, on 1 week, 4 weeks, and 8 weeks after operation. ResultsThe FBG levels of rats before operation were not significantly different between DO group and DC group or between NO group and NCgroup (Pgt;0.05). After operation, the FBG levels of rats in DO group gradually declined, reached the bottom on 4 weeks after operation and rose slightly on 8 weeks; The FBG levels of rats in DO group were lower after operation than before operation (Plt;0.05); After operation the FBG levels of rats in DO group were higher than that in NO group and NC group at the same time point (Plt;0.05); In DC group, the difference of FBG levels of rats at different time point was not statistically significant (Pgt;0.05); The inter-group and intra-group difference of FPG levels of rats for NO group and NC group was not statistically significant (Pgt;0.05). The concentrations of serum DPP-Ⅳ of rats before operation were not significantly different in each group (Pgt;0.05). After operation, the concentrations of serum DPP-Ⅳ of rats in DO group and NO group gradually decreased and markedly lower than that before operation, respectively (Plt;0.05). The concentrations of serum DPP-Ⅳ of rats after operation in DO group and NO group were significantly lower than that at the same time point in DC group and NC group, respectively (Plt;0.05); The intragroup difference of serum DPP-Ⅳ concentrations of rats for DC group and NC group was not statistically significant (Pgt;0.05). The concentrations of serum GLP-1 of rats before operation were not significantly different between DO group and DC group or between NO group and NC group (Pgt;0.05). After operation, the concentrations of serum GLP-1 of rats in DO group and NO group gradually increased, reached the top on 4 weeks after operation and declined slightly on 8 weeks; The concentrations of serum GLP-1 of rats in DO group and NO group were higher after operation than before operation (Plt;0.05);After operation, the concentrations of serum GLP-1 of rats in NO group were higher than that in NC group (Plt;0.05), but the concentrations of serum GLP-1 of rats at different time point in NO group were not different (Pgt;0.05). The intragroup difference of serum GLP-1 concentrations of rats for DC group and NC group was not statistically significant (Pgt;0.05). ConclusionsThere is obvious hypoglycemic effect of GBP on FBG levels of type 2 diabetic rats other than normal rats, in which high secretion of GLP-1 and low secretion of DPP-Ⅳ may be play an important role.
ObjectiveTo investigate the effect and mechanism of sleeve gastrectomy (SG) on reducing blood glucose level. MethodsThirty GK rats were randomly divided into SG group, sham operation (SO) group, pair-fed (PF) group, and blank control (BC) group. The changes of weight, fasting blood glucose, glucose tolerance (oral glucose tolerance test, OGTT), insulin tolerance (insulin tolerance test, ITT), plasma insulin, ghrelin, and glucagon like peptide-1 (GLP-1) were monitored before and 24 weeks after operation respectively. ResultsFrom the 4th week after operation, weight gain in SG group and PF group began to decrease significantly compared with SO group (Plt;0.01). From the 2nd week after operation, fasting blood glucose level in SG group was lower than that in SO, PF, and BC groups (Plt;005), and the glucose tolerance in SG group obviously improved compared with preoperation and the other 3 groups (Plt;0.01). On the 6th week after operation, the insulin sensitivity in SG group obviously improved compared with SO group (Plt;0.05, Plt;0.01). There was no significant difference of insulin level between SG group and SO group (Pgt;0.05), ghrelin level significantly decreased (Plt;0.01) while GLP-1 level significantly increased (Plt;0.01) in SG group compared with SO group during 2-24 weeks after operation. ConclusionsThe effect of SG on reducing blood glucose is definite. SG can directly lower blood glucose independent with weight loss. Postoperative decreased ghrelin level and increased GLP-1 level may be its primary mechanism.
【摘要】 目的 觀察單用二甲雙胍與二甲雙胍聯合阿卡波糖對2型糖尿病（type 2 diabetes mellitus，T2DM）降糖作用的臨床療效。 方法 對2010年1—10月就診有典型易饑多食的T2DM患者45例，隨機分為二甲雙胍組20例和二甲雙胍聯合阿卡波糖25例，療程12周。 結果 二甲雙胍組與二甲雙胍聯合阿卡波糖組治療后對患者的饑餓感和食量改善差異有統計學意義（Plt;0.05），空腹及餐后血糖差異（Plt;0.01）、空腹血糖達標比例差異（Plt;0.01）、餐后血糖達標比例差異（Plt;0.05）均有統計學意義。 結論 二甲雙胍聯合阿卡波糖能顯著改善T2DM患者的食欲及食量，從而明顯降低空腹及餐后血糖。【Abstract】 Objective To observe and compare the clinical affects and curative effects between using metformin and metformin plus acarbose in the treatment of type 2 diabetes mellitus (T2DM). Methods From January to October 2010, 45 T2DM patients with common symptoms of easy-starving and overeating were randomized into two groups and treated for 12 weeks with either metformin (n=20) or metformin plus acarbose (n=25). Results After the treatment, significant differences were found between the two groups in the improvement on patients’ sense of starving and quantity of eating (Plt;0.05), fasting and postprandial blood glucose (Plt;0.01), up-to-standard rate of fasting blood glucose (Plt;0.01), and up-to-standard rate of postprandial blood glucose (Plt;0.05). Conclusion The combination of metformin and acarbose can substantially improve the appetite and quantity of eating for patients with T2DM, hence significant reductions of fasting and postprandial blood glucose level can be feasibly achieved.
Existing near-infrared non-invasive blood glucose detection modelings mostly detect multi-spectral signals with different wavelength, which is not conducive to the popularization of non-invasive glucose meter at home and does not consider the physiological glucose dynamics of individuals. In order to solve these problems, this study presented a non-invasive blood glucose detection model combining particle swarm optimization (PSO) and artificial neural network (ANN) by using the 1 550 nm near-infrared absorbance as the independent variable and the concentration of blood glucose as the dependent variable, named as PSO-2ANN. The PSO-2ANN model was based on two sub-modules of neural networks with certain structures and arguments, and was built up after optimizing the weight coefficients of the two networks by particle swarm optimization. The results of 10 volunteers were predicted by PSO-2ANN. It was indicated that the relative error of 9 volunteers was less than 20%; 98.28% of the predictions of blood glucose by PSO-2ANN were distributed in the regions A and B of Clarke error grid, which confirmed that PSO-2ANN could offer higher prediction accuracy and better robustness by comparison with ANN. Additionally, even the physiological glucose dynamics of individuals may be different due to the influence of environment, temper, mental state and so on, PSO-2ANN can correct this difference only by adjusting one argument. The PSO-2ANN model provided us a new prospect to overcome individual differences in blood glucose prediction.
Both bariatric surgery and pharmacotherapy, particularly glucagon-like peptide-1 receptor agonist (GLP-1RA), are effective interventions for obesity, yet each has its own advantages and limitations. Drawing on the “bridging” concept from cancer therapy, this commentary explores an innovative obesity management strategy that involves the combined application of GLP-1RA and bariatric surgery during the perioperative period, with the aim of optimizing treatment outcomes. The present analysis focuses specifically on the potential value of this approach: preoperatively, GLP-1RAs serve as a “bridging therapy” to promote weight loss and reduce surgical risks in severely obese patients; postoperatively, they might be used to manage weight rebound or insufficient weight loss. This multimodal integrated strategy is designed to overcome the inherent limitations of single therapies and offer patients more comprehensive treatment options. Emphasizing that future research must urgently focus on optimizing treatment parameters (e.g., timing, dosage), evaluating long-term safety and efficacy, and establishing patient selection criteria for combination therapy. Integrating surgical and pharmacological treatments, this comprehensive strategy based on the oncological “bridging” concept represents a highly promising paradigm shift in obesity management.
Objective
To explore the correlation between blood glucose and self-management behaviors in patients with type 2 diabetic mellitus before initial basal insulin therapy.
Methods
A convenient sample of 200 patients with type 2 diabetic mellitus who were hospitalized in a tertiary hospital from February to August 2016 were enrolled in the study on a voluntary basis. Patients’ demographic information, fast blood glucose, glycosylated hemoglobin, and scores of diabetes self-care activities were gathered through questionnaires.
Results
A total of 193 valid questionnaires were recovered. Before starting basal insulin therapy, the mean blood glucose and the mean glycosylated hemoglobin of the 193 patients were (12.22±3.95) mmol/L and (10.01±2.38)%, respectively, with 12 patients (6.22%) meeting the goal of fasting blood glucose ≤7 mmol/L and 18 patients (9.33%) meeting the goal of glycosylated hemoglobin <7%, respectively. The total score of self-care activities was 26.76±14.77, in which 3 patients (1.55%) performed well. Spearman analysis demonstrated that the total score of self-care activities was negatively correlated with fast blood glucose ( r=–0.401, P<0.001) and glycosylated hemoglobin (r=–0.227, P=0.028).
Conclusions
The blood glucose levels and self-management behaviors in diabetic patients at the beginning of initial basal insulin therapy are not optimistic. Enhanced management of type 2 diabetic patients with initial basal insulin therapy is the prerequisite to promote diabetes self-care activities.
