ObjectiveTo compare effectiveness of single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) and single anastomosis sleeve ileal (SASI) bypass on weight loss and glucose regulating as well as difference in micronutrient deficiency in obese rats with type 2 diabetes mellitus. MethodsThirty-six Spraque-Dawley rats fed with high fat diet combined with intraperitoneal injection of low-dose streptozotocin (35 mg/kg) for 1 month were used to induce obese rats with type 2 diabetes mellitus, then were randomly averagely divided into 3 groups: SADI-S group, SASI group, and sham operation (SO) group. Eight rats from numbered rats of each group were randomly selected to carry out experimental observation. The rats’ body weight, food intake, and fasting blood glucose (FBG) were measured from before operation to postoperative 1–6 months. Meanwhile blood was collected before surgery, as well as at month 1 and 6 after surgery for oral glucose tolerance testing (OGTT) and insulin resistance testing (ITT). Serum glucagon-like peptide (GLP-1), hemoglobin, and albumin levels, as well as vitamin B12, calcium, and ferrum concentrations were measured before surgery as well as at month 1 and 6 after surgery. Results① The body weight, food intake (except 5–6 months), and FBG level in the SADI-S group and SASI group were lower than the SO group (P<0.05) from 1- to6-month after operation, and all obviously decreased at month 1 after operation (P<0.05), but there was no statistical differences between the SADI-S group and SASI group (P>0.05). ② The postoperative OGTT and ITT blood glucose levels in the SADI-S group and SASI group were lower than those in the SO group (P<0.05) and were lower than those in the preoperative levels (P<0.05), and the SADI-S group had a lower OGTT blood glucose level than the SASI group at month 6 after operation (P<0.05). ③ The GLP-1 levels of the SADI-S group and SASI group were higher than that of the SO group (P<0.05), and higher than before operation at month 6 after operation (P<0.05) , but there was no statistical difference was found between the SADI-S group and SASI group after operation (P>0.05). ④ The postoperative albumin levels of the SADI-S group and SASI groups= were lower than of the SO group (P<0.05) and were lower than before operation, and albumin level of the SADI-S group was lower than of the SASI group at postoperative month 6 (P<0.05); while the hemoglobin had no statistical differences among the 3 groups (P>0.05). ⑤ The ferrum concentration of the SADI-S group was lower than that of the SASI group and SO group at 1 month after operation (all P<0.05), while it increased slightly at month 6 after operation and had no statistical difference between the SADI-S group and SASI group (P>0.05); the calcium concentrations of the SADI-S group and SASI group only at 6 month after operation were lower than those of the SO group (P<0.05), and were lower as compared with before operation (P<0.05) , but no statistical difference was found between the SADI-S group and SASI group (P>0.05); the vitamin B12 had no statistical differences among the 3 groups (P>0.05). ConclusionsFor obese rats with type 2 diabetes mellitus, SADI-S and SASI have similar weight loss effect. Long-term glucose reduction of SADI-S shows a advantage than SASI, but influence of postoperative micronutrients of SASI is inferior to SASI.
摘要:目的：探討低血糖指數膳食干預對2 型糖尿病病人營養治療效果的影響。方法：選擇住院2 型糖尿病病人109例,隨機分為營養組56例和對照組53例。營養組由營養師根據患者情況提供低血糖指數營養治療飲食,對照組則自行控制飲食。分別于住院第1天與3個月復查時對兩組患者進行膳食調查及相關生化指標測定, 以觀察營養治療的效果。結果:采用干預措施后, 兩組空腹血糖、餐后2 h血糖、糖化血紅蛋白、血清膽固醇、甘油三酯等生化指標均降低, 但營養組與對照組相比效果更為明顯(P＜005)；營養組的飲食結構更為合理。結論：低血糖指數膳食可有效控制2 型糖尿病病人的血糖、血脂水平,對促進患者康復有積極意義。Abstract: Objective: To observed the effect of nutrition therapy of low glycemic index foods on type 2 diabetic patients. Methods: A total of 109 subjects with the hospitalized diabetes were randomly allocated into two groups: The nutrition group(56 cases) were provided with weighed individual low glycemic index foods and the control group(53 cases) went on diet dominated by themselves. patients in both groups were investigated on meals, diabetic nutrition knowledge and were detected for correlative biochemical indices. Results：After the nutrition treatment, patients biochemical indices of fasting bloodglucose, blood sugar 2 hours after meal, hemoglobin of glycosylation, cholesterol and triglyceride in serum in both groups were significantly lower. Compared with the control group, the effect of the nutrition group was even better. The acknowledgement rate of nutrition knowledge on diabetes of the nutrition group improved significantly, and their meals were more scientifically arranged. Conclusion: The nutrition therapy of low glycemic index foods would be very helpful for type 2 diabetic patients to control their bloodsugar level and improve the nutritional state and outcome.
Objective To assess the efficacy and safety of glimepiride for type 2 diabetes mellitus (T2DM). Methods We searched the literature from PubMed, Ovid (All EBM Reviews), CNKI, Wanfang, VIP, CBM and other databases. Evaluating the quality of the study according to Cochrane systematic reviews, Meta-analysis was performed for the results of homogeneous studies by The Cochrane Collaboration’s software RevMan 5.0, and the heterogeneous data conducted a descriptive qualitative analysis. Results Six RCTs included in the analysis and Meta-analysis was not performed due to the insufficient data (for the median or standard deviation). Six RCTs are multi-center, randomized, double-blind, placebo-controlled trials. The results showed that glimepiride groups to reduce glycosylated hemoglobin, lower fasting and postprandial blood glucose, postprandial plasma insulin enhance the efficacy were statistically significant differences (Plt;0.05) compared to placebo groups. Four studies informed the impact of fasting plasma insulin (FI) and 3 studies showed that the glimepiride groups improving the fasting plasma insulin (FI) were statistically significant differences (Plt;0.05), but 1 study showed the two groups had no significant difference (Pgt;0.05). All studies showed minor adverse reactions of glimepiride. Conclusion Glimepiride can reduce the glycosylated hemoglobin, lower the fasting and postprandial blood glucose, improve fasting and postprandial plasma insulin for type 2 diabetes patients, and have minor adverse reactions. In a word, glimepiride is an effective and security sulfonylureas drug.
Objective To analyze the risk factors of type 2 diabetes mellitus and establish BP neural network model for screening of type 2 diabetes mellitus based on particle swarm optimization (PSO) algorithm. Methods Inpatients with type 2 diabetes mellitus in the Department of Endocrinology of the Affiliated Hospital of Guangdong Medical University and the Second Affiliated Hospital of Guangdong Medical University between July 2021 and August 2022 were selected as the case group and healthy people in the Health Management Center of the Affiliated Hospital of Guangdong Medical University as the control group. Basic information and physical and laboratory examination indicators were collected for comparative analysis. PSO-BP neural network model, BP neural network model and logistic regression models were established using MATLAB R2021b software and the optimal screening model of type 2 diabetes mellitus was selected. Based on the optimal model, the mean impact value algorithm was used to screen the risk factors of type 2 diabetes mellitus. Results A total of 1 053 patients were included in the case group and 914 healthy peoples in the control group. Except for type of salt, family history of comorbidities, body mass index, total cholesterol, low density lipoprotein cholesterol and staple food intake (P>0.05), the other indexes showed significant differences between the two groups. The performance of the PSO-BP neural network model outperformed the BP neural network model and the logistic regression model. Based on PSO-BP neural network model, the mean impact value algorithm showed that the risk factors for type 2 diabetes mellitus were fasting blood glucose , heart rate, age , waist-arm ratio and marital status , and the protective factors for type 2 diabetes mellitus were high density lipoprotein cholestero, vegetable intake, residence, education level, fruit intake and meat intake. Conclusions There are many influencing factors of type 2 diabetes mellitus. Focus should be placed on high-risk groups and regular disease screening should be carried out to reduce the risk of type 2 diabetes. The screening model of PSO-BP neural network performs the best, and it can be extended to the early screening and diagnosis of other diseases in the future.
ObjectiveTo systematically evaluate effect of metformin on prognosis of colorectal cancer patients with type 2 diabetes mellitus (T2DM).MethodsThe PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP, Wangfang, etc. databases for cohort studies over the past 10 years were systematically searched. The relationship between the metformin and the prognosis in the colorectal cancer patients with T2DM was assessed with RevMan 5.3 software.ResultsA total of 12 articles with 13 694 patients were included in this study, of which 9 069 patients treated by the metformin (metformin group) and 4 625 patients treated by the other antidiabetic agent (control group). The results of meta-analysis showed that the metformin group had higher over survival [HR=0.74, 95%CI (0.66, 0.82), P<0.000 01] and cancer-specific survival [HR=0.77, 95%CI (0.69, 0.86), P<0.000 01] as compared with the control group. The sensitivity analysis of the heterogeneity showed that the research results did not be changed when the study which might cause heterogeneity was excluded. ConclusionMetformin treatment could improve prognosis of colorectal cancer patients with T2DM and improve overall survival and cancer-specific survival.
ObjectiveTo investigate the impact of thoracic duct ligation (TDL) on metabolism and postoperative complications during esophagectomy in patients with type-2 diabetes mellitus (T2DM).MethodsWe conducted a retrospective clinical data analysis of 230 esophageal carcinoma patients with T2DM who underwent esophagectomy in our hospital from January 2003 to December 2018. Patients were divided into a TDL+ group (n=112), including 78 males and 34 females aged 63.47±7.23 years, and a TDL– group (n=118), including 84 males and 34 females aged 64.38±7.57 years. We compared the blood glucose, liver function parameters and lipid metabolic parameters at different time points before and after surgery. In addition, we compared the postoperative major complications between the two groups. Propensity score-matched (PSM) was used to control the observed confounders.ResultsCompared with the TDL– group, patients in TDL+ group had higher blood glucose level (P<0.05, except the fourth postoperative day). The total protein and albumin levels on the first and fourth postoperative days in the TDL+ group were lower than those in the TDL– group (P<0.05). The alanine transaminase (P=0.027) and aspartate transaminase (P=0.007) levels on the fourth postoperative day in the TDL+ group were higher than those in the TDL– group. More pulmonary complications (P=0.014) and anastomotic leaks (P=0.047) were found in the TDL+ group.ConclusionGiven that TDL may aggravate metabolic disorders, increase anastomotic leaks and the pulmonary complications, it is cautious to perform TDL, and prophylactic TDL should not be performed routinely for patients with T2DM.
