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.
Objective
To identify related factors of anxiety and depression in spinal cord injury (SCI) patients based on patient-environment-occupation (PEO) model, and provide evidences for clinical practice.
Methods
A total of 241 patients with SCI treated between April 2014 and April 2015 were collected as the study subjects. All the patients were confirmed with SCI through CT or MRI, and had physical dysfunction. Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were applied in all the 241 SCI patients to measure their psychological state. Meanwhile, PEO factors such as demographic information as well as ability of activities of daily living (ADL) and relatives’ stress were assessed by self-made questionnaire, Modified Barthel Index (MBI) and Relatives’ Stress Scale (RSS). Then, multiple stepwise regression was applied to identify significant covariance with SAS/SDS as dependent variables and other 14 factors as independent variables.
Results
The regression equation showed that only SDS, MBI, living environment and disease course were significantly associated with SAS. Only SAS, MBI and RSS were significantly associated with SDS.
Conclusions
The ability of ADL and environment are significantly correlated with psychological state of SCI patients. Early intervention of ADL and decreasing environmental barriers are needed to improve patients’ psychological state.
【摘要】 目的 探討胰島素強化治療對2型糖尿病（type 2 diabetes mellitus，T2DM）患者血清脂聯素（adiponectin，APN）的影響。 方法 2007年7—12月，研究納入連續使用胰島素治療至少3個月但血糖控制欠佳[6.5%≤糖化血紅蛋白（hemoglobin A1c， HbA1c）≤11.0%]的T2DM患者40例，其中男18例，女22例；年齡29~〖JP2〗69歲；平均診斷T2DM病史11年。治療方案為進行16周的胰島素強化治療，血糖控制目標為空腹血糖≤7 mmol/L，〖JP〗餐后2 h血糖≤8 mmol/L。分別于強化治療前、強化治療4周后及強化治療16周后測定HbA1c以及血清APN水平。 結果 與強化治療前相比，胰島素治療4周后空腹及三餐后2 h血糖明顯下降（Plt;0.05），但HbA1c和血清APN水平差異無統計學意義（Pgt;0.05）；強化16周后，HbA1c水平明顯低于治療前和治療4周后且差異具有統計學意義（Plt;0.05），APN水平高于治療前和治療4周后且差異有統計學意義（Plt;0.05）。體質量指數在強化治療16周后明顯增加且與強化治療前和強化治療后4周相比差異具有統計學意義（Plt;0.05）。APN與空腹血糖（b=-0.225，P=0.013）、早餐后2 h血糖（b=-0.229，P=0.012）呈負相關。 結論 胰島素強化治療可以提高T2DM患者血清APN水平。【Abstract】 Objective To investigate the effect of intensive insulin therapy on serum adiponectin (APN) level in patients with type 2 diabetes mellitus (T2DM). Methods Forty patients with T2DM who had undergone insulin therapy for at least three months but with their blood glucose poorly controlled [glycosylated hemoglobin Alc (HbA1c) level ranged from 6.5% to 10.0%] from July to December 2007 were enrolled in this study. There were 18 males and 22 females with their age ranged from 29 to 69 years. They had an average time of T2DM history of 11 years. Intensive insulin therapy was carried out for 16 weeks with a target of less than 7 mmol/L for fasting blood glucose and 8 mmol/L for postprandial blood glucose. HbA1c and serum adiponectin concentrations were detected at baseline, at week 4 after intensive therapy and at the end of the study. Results After 4 weeks of intensive blood glucose control, fasting and postprandial blood glucose levels decreased significantly (Plt;0.05), but the HbA1c and serum APN concentrations did not reduce remarkably (Pgt;0.05). After 16 weeks of treatment, the level of HbA1c was significantly lower than those at baseline and 4 weeks after treatment (Plt;0.05), and serum APN concentration increased significantly (Plt;0.05), compared with those two time points. However, an evident increase of body mass index (BMI) was found while compared with BMI at baseline and 4 weeks after treatment (Plt;0.05). The linear regression analysis indicated that APN was negatively associated with fasting blood glucose (b=-0.225,P=0.013) and blood glucose level 2 hours after breakfast (b=-0.229,P=0.012). Conclusion Intensive insulin therapy can improve serum adiponectin level in type-2 diabetic patients.
Objective To demonstrate the efficacy, tolerability, and safety of domestic Acarbose tablet compared with Glucobay (Acarbose tablet produced by Bayer company) in patients with type 2 diabetic patients. Method A multicenter randomized controlled parallel-group comparison study was conducted. 177 Chinese type 2 diabetic patients were recruited from 4 clinical centers. The patients were divided randomly into domestic Acarbose tablet (A group) or Glucoby (B group) treatment group. The trial consisted of a 2-4 weeks equilibrated period followed by an 8 week course of treatment. Results 165 patients have finished the trial (81 in A group and 84 in B group). After 4 weeks of treatment, the mean of fasting blood glucose (FBG) in A and B group were reduced 1.61 and 2.08 mmol/L respectively, and mean of postprandial blood glucose (PBG) lowered 5.06 and 5.09mmol/L respectively. After 8 weeks of treatment, the mean of FBG were reduced 1.95 and 2.62mmol/L respectively, and mean of PBG lowered 4.88 and 5.98 mmol/L, respectively, and mean of HbA1c were lowered 1.13% and 1.20% respectively in A and B group. The differences in reduction of FBG, PBG, and HbA1c between A and B group were no statistic significance. The serum triglyceride levels and BMI were decreased significantly in both A, B groups. 3 patients who drinking wine during trial on A group had asymptomatic elevations in serum transaminases that normalized in 2 weeks after stopped drinking and Acarbose withdrawal. Flatulence was the most common side effect. Conclusions In this multicenter study, domestic Acarbose tablet 50 mg t.i.d. was an effective, safe, and generally well-tolerated therapy as similar as Glucobay in type 2 diabetic patients.
【摘要】 目的 調查成都地區2型糖尿病患者糖耐量正常一級親屬的代謝狀態及與胰島素抵抗、胰島β細胞功能的相關性。 方法 2007年7-9月共納入糖耐量正常的一級親屬312例（NGT-FDR組），無家族史的正常對照1 348例（NGT-C組）。測量兩組血壓、體重、腰圍；檢測口服葡萄糖耐量試驗（OGTT）中0、0.5、2 h血糖、胰島素水平；測定空腹血脂；計算體重指數、HOMA-胰島素抵抗指數（HOMA-IR）、胰島β細胞功能指數（HOMA-β），β細胞早相分泌功能指數（△I30/△G30），并比較兩組間上述指標的差異和代謝綜合征（MS）及其各組分的發病情況。 結果 ①NGT-FDR組MS發生率高于NGT-C組，發生MS的風險是后者的1.737倍。NGT-FDR組高甘油三酯血癥（hypertriglyceridemia，HTG）、空腹血糖偏高（5.6~6.0 mmol/L）的發生率高于NGT-C組，合并4種及以上代謝異常的幾率亦高于NGT-C組（Plt;0.05）；②年齡lt;40歲的NGT-FDR中心性肥胖、HTG、空腹血糖偏高和MS均高于同年齡對照；男性NGT-FDR空腹血糖偏高和MS發病率高于男性對照（Plt;0.05）；③腰圍、收縮壓（SBP）、空腹血糖（FBG）、甘油三酯（TG）及糖尿病家族史同HOMA-IR呈正相關。腰圍、SBP、TG及糖尿病家族史同HOMA-β呈正相關，FBG則同HOMA-β呈負相關。 結論 2型糖尿病糖耐量正常一級親屬比無家族史的對照表現出更多的代謝異常，尤其是在年齡lt;40歲及男性中。各種代謝異常可加重胰島素抵抗，影響胰島基礎分泌功能。故有必要對糖耐量正常的一級親屬進行各項代謝指標的監測和早期預防性干預。【Abstract】 Objective To investigate the metabolic status of the normal glucose-tolerant first-degree relatives (NGT-FDR) of type-2 diabetic patients and its relationship with insulin resistance (IR) and β-cell function in Chengdu area. Methods From July to September 2007, a total of 312 NGT-FDR of type-2 diabetic patients and 1 348 normal glucose tolerant controls without positive family history of diabetes (NGT-C) were enrolled in this study. Blood pressure, weight, waists, plasma glucose at hour 0, 1/2 and 2 in oral glucose tolerance test (OGTT), insulin levels and fasting blood lipids were measured. Body mass index (BMI), HOMA-IR, HOMA-β and the early insulin secreting index (△I30/△G30) were calculated. Then, we compared the above-mentioned data and the incidence of metabolic syndrome (MS) between the two groups. Results ①The incidence of MS, hypertriglyceridemia (HTG), higher fasting blood glucose (FBG) (5.6-6.0 mmol/L) in the NGT-FDR group were all significantly higher than those in the NGT-C group. The risk of developing MS in the NGT-FDR group was 1.737 times as high as that in the NGT-C group. Furthermore, the incidence of 4 or more than 4 co-existent metabolic disorders in the NGT-FDR group was also significantly higher than that in the NGT-C group (Plt;0.05); ②For subjects less than 40 years old, the incidence of central obesity, HTG, higher FBG and MS in the NGT-FDR group were all higher than those in the NGT-C group. In male subjects, the rates of higher FBG and MS were all significantly higher in the NGT-FDR group than those in the NGT-C group. (Plt;0.05); ③Waists, FBG, systolic blood pressure (SBP), triglycerides (TG) and diabetic family history were positively correlated with HOMA-IR. Waists, SBP, TG and diabetic family history were positively correlated with HOMA-β. Conclusion NGT-FDR present significantly increased metabolic disorders than NGT controls, especially in the less than 40-year-old and the male subjects. The metabolic disorders can aggravate insulin resistance and influence islet β-cell secretion function, so it is necessary to monitor the metabolic status of the NGT-FDR of type-2 diabetic patients and provide early preventive interventions.
Objective To evaluate efficacy and safety of domestic Nateglinide tablet in comparison with domestic Repaglinide in Type 2 diabeties. Methods A multi-centre, double-blind, dummy trial was conducted.Two hundred and thirty type 2 diabetic patients recuited from 5 clinical centers were randomly allocated into Group A (domestic Repaglinide, 1.0 mg tid, n =115) and Group B (domestic Nateglinide, 90 mg tid, n =115).The trial consisted of a 4 weeksequilibrated period followed by 12 weeks treatment course. Results Ninety seven percent of patients(223) completed the trial (110 in Group A and 113 in Group B). The mean of fasting blood glucose (FBG) in both Group A and B was decreased statistically (P＜ 0.000 1) after 2, 6 and 12 weeks duration. At week 12, the mean FBG in Group A and B was reduced by 1.68±1.81 mmol/L (17.27%) and 1.17±1.67 mmol/L (12.53%) respectively with statistically significant difference between the two groups (P=0.017 7). The mean of 120 minutes postprandial blood glucose (PBG) also lowered markedly in 2, 6, and 12 weeks in both groups. At the end of therapy, PBG of 30, 60, 120 minutes were reduced significantly, mean of 120 minutes PBG was reduced 3.95±3.25 mmol/L (26.12%), and 3.81±3.05 mmol/L (26.22%) respectively in Group A and B , the differences in reduction between Group A and B had no statistical significance (P =0.726 9). In Group A and B, the mean of Alc was reduced significantly after 12 weeks duration. At week 12, the mean of Alc in Group A and B was lowered by 1.21% and 0.68% respectively, with statistical difference between the two groups (P =0.002 3). Though fasting insulin level in both groups had no change after 12 weeks duration, the insulin level at 30, 60 and 120 min increased significantly in both groups (P＜0.000 1). It suggested that both Nateglinide and Repaglinide promoted insulin secretion in early phase with maximal value at 60 min in Repaglinide group and 30 min in Nateglinide group, respectively. The adverse reaction rate in Group A including hypoglycemic reaction, thrombocytopenia and recrudescence of HBV was 4.5% when compared to only one case of thrombocytopenia in Group B (0.87%). Conclusions Both domestic Nateglinide and Repaglinide have similar effect on reducing postprandial blood glucose, but Repaglinide has ber effect on reducing FBG and A1c than Nateglinide. The results suggest that both domestic Nateglinide and Repaglinide are safe and generally well-tolerated in type 2 diabetic patients.
