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.
Objective To investigate the correlation between cervical Modic change (MC) and blood lipid and glucose levels. Methods Patients hospitalized with neck and shoulder pain in the Affiliated Hospital of North Sichuan Medical College between January 2015 and January 2021 were selected and divided into MC group and non-MC group according to whether the signal changes of cervical vertebral endplate occurred on MRI. The general data (age, gender, smoking history, drinking history), blood lipid indicators (high-density lipoprotein, low-density lipoprotein, lipoprotein a, total cholesterol, triglyceride) and blood glucose indicators (glycosylated hemoglobin, fasting blood glucose) were compared between the two groups. Multivariate logistic regression analysis was used to explore the correlation between MC and various indicators. Results A total of 160 patients were included, including 48 patients in MC group and 112 patients in non-MC group. The age [(61.46±12.10) vs. (56.22±10.65) years], total cholesterol [(5.06±1.17) vs. (4.44±1.31) mmol/L], triglyceride [(1.61±0.64) vs. (1.38±0.58) mmol/L], glycosylated hemoglobin (6.78%±1.27% vs. 5.79%±0.85%), and fasting blood glucose [(7.84±1.51) vs. (6.93±1.47) mmol/L] of the patients in MC group were significantly higher than those in non-MC group (P<0.05). There was no significant difference in gender, smoking ratio, drinking ratio, high-density lipoprotein, low-density lipoprotein or lipoprotein a between the two groups (P>0.05). Logistic regression analysisshowed that age [odds ratio (OR)=1.064, 95% confidence interval (CI) (1.022, 1.109), P=0.003], total cholesterol [OR=1.788, 95%CI (1.187, 2.694), P=0.005], triglyceride [OR=2.624, 95%CI (1.257, 5.479), P=0.010] and glycosylated hemoglobin [OR=4.942, 95%CI (2.446, 9.987), P<0.001] were risk factors of cervical MC. Conclusions Age, total cholesterol, triglyceride and glycosylated hemoglobin are risk factors of cervical MC. Elderly patients with hyperlipidemia and hyperglycemia should be alert to the occurrence of cervical MC. Controlling the levels of blood lipid and glucose may reduce the risk of cervical MC.
摘要:目的:探討經尿道前列腺電切術中糖尿病患者血糖變化以及處理對策。方法:2006年7月~ 2009年1月共對80例患有前列腺增生合并糖尿病患者行TURP,同期對80例單純性前列腺增生患者進行相同手術,回顧分析其術前、術中30 min、60 min、90 min 指尖血糖變化及干預情況。結果:治療組80例患者,51例術中血糖值明顯低于術前,分別為1.8～3 mmol/L;對照組術前與術中血糖值基本一致,血糖波動于4.5～5.6 mmol/L。結論:糖尿病患者糖的儲備能力差,在行經尿道電切術中易發生低血糖綜合征,術中及時的血糖監測及干預對保證患者的安全有重要意義。Abstract: Objective: To study the changes and measures against the glucose in the operation of the Diabetes by TURP. Methods:Eighty patients with prostate combining diabetes operated from July 2006 to Jan. 2009 were reviewed, and 80 prostate treated at the same period with the same operation measure were selected as control. The preoperative glucose, intraoperative glucose (30′, 60′,90′) of fingertip, and countermeasures were studied and compared between the two groups. Results:Fiftyone cases of the experimental group of intraoperative blood glucose was significantly lower than preoperative values, respectively 1.83 mmol/ L; control group preoperative and intraoperative blood glucose values were basically the same, blood glucose fluctuations in the 4.55.6 mmol/L. Conclusion: The capacity in patients with diabetes is poor, easy to hypoglycemia syndrome in the act of TURP surgery, intraoperative blood glucose monitoring and timely intervention to ensure patient safety significance.
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.
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.
Objective To evaluate the feasibility of hyperinsulinemic normoglycemia strategy in critically ill patients. Methods Between January 2020 and October 2021, the critically ill patients with stress hyperglycemia in the Emergency Intensive Care Unit of the Fourth People’s Hospital of Langfang were randomly assigned into a trial group or a control group. The trial group adopted hyperinsulinemic normoglycemia therapy, while the control group adopted conventional glucose control therapy. The mean and variability (standard deviation) of blood glucose, incidences of severe hypoglycemia and abnormal hyperglycemia, as well as the percentage of blood glucose values within the target range were compared between the two groups, to evaluate the feasibility of hyperinsulinemic normoglycemia strategy in critically ill patients from the perspective of safety and effectiveness. The non-normally distributed measurement data were presented as median (lower quartile, upper quartile). Results A total of eighty patients were included, with forty cases in each group. The mean blood glucose level [6.00 (5.74, 6.70) vs. 9.51 (8.74, 10.01) mmol/L, P<0.001], the standard deviation of glucose level [1.58 (1.11, 2.15) vs. 2.20 (1.21, 2.76) mmol/L, P=0.028], and the glycemic lability index [175.52 (100.51, 346.69) vs. 408.51 (205.56, 651.91) mmol2/(L2·h·d), P<0.001] were all smaller in the trial group than those in the control group. The percentage of blood glucose values within the target range was 77.34% in the trial group and 5.33% in the control group, respectively, and the difference was statistically significant (P<0.001). No patients experienced severe hypoglycemia. There was a significant difference in the incidence of abnormal hyperglycemia between the two groups (5.08% vs. 36.16%, P<0.001). Conclusions Hyperinsulinemic normoglycemia strategy can effectively and safely provide normoglycemia, reduce glycemic variability, and achieve good glycemic control in critically ill patients. Hyperinsulinemic normoglycemia strategy may be a new approach to glycemic control in critically ill patients.
ObjectiveTo observe the lipid metabolism characteristics of type 2 diabetes mellitus (T2DM) patients with different levels of blood glucose control and preliminarily analyze their relationship with diabetic retinopathy (DR). MethodsA retrospective clinical study. From January 2019 to January 2024, 232 T2DM patients who underwent fundus examination in Department of Ophthalmology of Yichang Central People’s Hospital were included in the study. Based on the glycated hemoglobin A1c (HbA1c) test results, patients were divided into blood glucose standard group and blood glucose non standard group, with 100 and 132 cases respectively. Based on the results of fundus fluorescein angiography, patients were divided into non DR (NDR) group and DR group, with 89 and 143 cases, respectively. 100 healthy individuals who underwent physical examinations during the same period were selected as the control group. The thickness of peripapillary retinal nerve fiber layer (pRNFL) around the optic disc, the blood flow density of radial peripapillary capillaries (RPC) around the optic disc, and the thickness of ganglion cell complex (GCC) in the upper and lower parts of the optic disc and macular area were measured by optical coherence tomography angiography instrument. Fully automated biochemical analyzer was used to detect serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and HbA1c. After adjusting for confounding factors, multiple linear regression model was used to analyze the correlation between HbA1c and blood lipids. Multiple logistic regression analysis was conducted to investigate the correlation between TG, HDL-C, and the occurrence of DR. ResultsCompared with the control group, both the blood glucose standard group and the blood glucose non standard group had higher levels of HbA1c (F=8.115), TC (F=4.373), TG (F=20.220), and LDL-C (F=12.271), and lower levels of HDL-C (F=6.349), with statistically significant differences (P＜0.05). Compared with the blood glucose standard group, patients in the blood glucose non standard group had higher levels of serum HbA1c (t=3.531), TC (t=2.561), TG (t=6.418), LDL-C (t=7.880), and lower levels of HDL-C (t=5.152), with statistically significant differences (P＜0.05). Correlation analysis showed that HbA1c was positively correlated with TC, TG, and LDL-C (P＜0.05), and negatively correlated with HDL-C (P＜0.05). Multiple logistic regression analysis showed that TG, LDL-C, and HDL-C were independent risk factors for the occurrence of DR (Ptrend＜0.05). Compared with the NDR group, the DR group had thinner GCC and pRNFL thickness in the upper part of the optic disc, and lower overall and RPC blood flow density in the upper part of the optic disc, with statistically significant differences (t=4.964, 2.406, 2.685, 2.404; P＜0.05). Correlation analysis results showed that TG, LDL-C, HDL-C, HbA1c were correlated with GCC thickness, pRNFL thickness, and RPC blood flow density (P＜0.05). ConclusionsThe higher the blood glucose level in T2DM patients, the more likely they are to experience dyslipidemia. TG, LDL-C, and HDL-C are independent risk factors for the occurrence of DR. Abnormal blood lipids and blood glucose levels in T2DM patients can affect retinal nerves, blood vessels, and function.
