Objectives To assess the effects of alpha-glucosidase inhibitors in patients with type 2 diabetes mellitus. Method We searched The Cochrane Library, MEDLINE, EMBASE, Current Contents, LILACS, databases of ongoing trials, reference lists of reviews on the topic of alpha-glucosidase inhibitors and we contacted experts and manufacturers for additional trials. Date of most recent search: December 2003 (Current Contents) and April 2003 (other databases). Randomised controlled trials of at least 12 weeks duration comparing alpha-glucosidase inhibitor monotherapy in patients with type 2 diabetes with any other intervention and that included at least one of the following outcomes: mortality, morbidity, quality of life, glycemic control, lipids, insulin levels, body weight, adverse events. Two reviewers read all abstracts, assessed quality and extracted data independently. Discrepancies were resolved by consensus or by the judgement of a third reviewer. A statistician checked all extracted data entrance in the database. We attempted to contact all authors for data clarification. Results We included 41 trials (8130 participants), 30 investigated acarbose, seven miglitol, one trial voglibose and three trials compared different alpha-glucosidase inhibitors. Study duration was 24 weeks in most cases and only two studies lasted amply longer than one year. We found only few data on mortality, morbidity and quality of life. Acarbose had a clear effect on glycemic control compared to placebo: glycated haemoglobin –0.77% (95% confidence interval –0.90 to –0.64), fasting blood glucose –1.1 mmol/L (95% confidence interval –1.4 to –0.9), post-load blood glucose –2.32 mmol/L (95% confidence interval –2.73 to –1.92). The effect on glycated haemoglobin by acarbose was not dose-dependent. We found a decreasing effect on post-load insulin and no clinically relevant effects on lipids or body weight. Adverse effects were mostly of gastro-intestinal origin and dose dependent. Compared to sulphonylurea, acarbose decreased fasting and post-load insulin levels by –24.8 pmol/L (95% confidence interval –43.3 to –6.3) and –133.2 pmol/L (95% confidence interval –184.5 to –81.8) respectively and acarbose caused more adverse effects. Conclusions It remains unclear whether alpha-glucosidase inhibitors influence mortality or morbidity in patients with type 2 diabetes. Conversely, they have a significant effect on glycemic control and insulin levels, but no statistically significant effect on lipids and body weight. These effects are less sure when alpha-glucosidase inhibitors are used for a longer duration. Acarbose dosages higher than 50 mg TID offer no additional effect on glycated haemoglobin but more adverse effects instead. Compared to sulphonylurea, alpha-glucosidase inhibitors lower fasting and post-load insulin levels and have an inferior profile regarding glycemic control and adverse effects.
摘要:目的:探討2型糖尿病合并糖尿病足患者與胰島素抵抗的關系。方法:205例2型糖尿病患伴糖尿病足患者作為觀察組,無足部病變的糖尿病患者作為對照組,觀察其體重指數、空腹血糖、胰島素、血脂等指標,兩組間進行比較并相關性分析、多元回歸分析。胰島素抵抗指數(HOMAIR)=FPG×FIns/22.5。結果:糖尿病足患者的HOMAIR顯著高于無糖尿病的患者(Plt;0.05)。多元回歸分析顯示糖尿病病程、LDL及BMI是影響2型糖尿病足患者胰島素抵抗的主要危險因素。結論:糖尿病足患者存在著更嚴重的胰島素抵抗。Abstract: Objective: To discuss the relationship between diabetes and pedopathy of type II diabetes and insulin resistance. Methods:The diabetes type II patients were divided into group A (combined with pedopathy) and group B (without pedopathy). The blood glucose and insulin of empty stomach, BMI,Alc and lipid were detected. The insulin resistance index (HOMAIR) was calculated and compared between two groups. Results:The HOMAIR was higher in group A than that in group B (Plt;0.05).The duration of disease,LDL and BMI was positive related with diabetes pedopathy. Conclusion:The insulin resistance was more worse in pedopathy of Type II diabetes.
We assayed the levels of free radical and scavenger in the blood and lens of streptozotocin-in-duced diabetic SD rats, and found that the levels of lipoperoxide(LPO),MDA were higher than that of normal SD rats, and the total superoxygen dismutase (T-SOD), Cu-Zn-SOD) were lower that that of normal rats ( P lt;0.01 ). Simultaneous injection of streptozotocin and large dose of SOD could no avoid the occurence of diabetes mllitus, but did improve the metabolism of free radical in blood and lens. Hence, we think that large dose of SOD might be effective in preventing to development of diabetic cataract which is related to deterioration of free radical metabolism. （Chin J Ocul Fundus Dis,1994,10:25-27）
Patients with type 2 diabetes mellitus often face significant treatment burden, which substantially impacts their quality of life and health outcomes. Reducing treatment burden represents a critical component for improving patient prognosis and enhancing treatment adherence. Based on the cumulative complexity model, this article systematically examines the conceptual connotation and multidimensional characteristics of treatment burden in type 2 diabetes mellitus patients, explores the theoretical extension and application value of cumulative complexity model in the type 2 diabetes mellitus field, elucidates its specific applications and recent advances in treatment burden research, evaluates the limitations of existing assessment tools while proposing a multidimensional assessment framework, and ultimately develops cumulative complexity model based intervention strategies. The findings provide theoretical references for optimizing patient-centered diabetes management approaches and offer novel perspectives for treatment burden intervention.
ObjectiveTo systematically review the efficacy of interactive message management on patients with type 2 diabetes mellitus (T2DM).MethodsCNKI, VIP, WanFang Data, Web of Science, PubMed and The Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) of T2DM with interactive message intervention from inception to May 2021. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using Revman5.3 software.ResultsA total of 17 RCTs involving 1 827 patients were included. Results of meta-analyses showed that compared with routine management, interactive message combined with routine management was associated with improvement of glycosylated hemoglobin, fasting blood glucose, body mass index, systolic blood pressure, and total cholesterol in T2DM patients. However, diastolic blood pressure, triglyceride, low-density lipoprotein, or high-density lipoprotein were not improved. ConclusionsThe current evidence shows that interactive message combined with routine management can significantly reduce blood glucose level, body mass index, systolic blood pressure and total cholesterol in T2DM patients. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
Hypertension is a strong risk factor for atherosclerotic cardiovascular disease (ASCVD), heart failure, and microvascular complications. Hypertension is common among patients with diabetes. Recently, the American Diabetes Association (ADA) published a new position statement which updated the assessment and treatment for hypertensive patients with diabetes. This interpretation is intended to help Chinese clinicians to understand the new ADA position statement.
Objective To assess the influence of different digestive tract reconstruction on the blood glucose of gastric antral cancer patients with type 2 diabetes. Methods The clinical data of 51 cases of gastric antral cancer with type 2 diabetes treated radical surgery in this hospital from January 2006 to January 2012 were analyzed retrospectively. The patients were divided into three groups according to the different digestive tract reconstruction methods：BillrothⅠ anastomosis group （n=14）， BillrothⅡ anastomosis group （n=28）， and Roux-en-Y anastomosis group （n=9）. The indexes were analyzed and compared among three groups：① The levels of fast blood glucose （FBG） and 2h postprandial blood glucose （PG2h） were detected before operation and on 1 month and 6 months after the operation；② The level of glycated hemoglobin （HbA1c） was detected before operation and 6 months after the operation；③ The diabetes control was observed. Results The FBG and PG2h levels in the BillrothⅠ anastomosis group detected on 1 month and 6 months after the operation were not statistically different from those detected before the operation （P＞0.05）. The FBG and PG2h levels in the BillrothⅡanastomosis group and Roux-en-Y anastomosis group detected on 1 month and 6 months after the operation were significantly lower than those before the operation respectively （P＜0.05）. The FBG and PG2h levels in the BillrothⅡ anastomosis group detected on 1 month and 6 months after the operation were not statistically different from those in the Roux-en-Y anastomosis group respectively （P＞0.05）， but which were markedly lower than those in the BillrothⅠ anastomosis group， the differences were statistically significant （P＜0.05）. The HbA1c levels in the BillrothⅠ anastomosis group detected before the operation and on 6 months after the operation were not statistically different from each other （P＞0.05）. The HbA1c levels in the BillrothⅡ anastomosis group and Roux-en-Y anastomosis group detected on 6 months after the operation were markedly lower than those before the operation and the difference was statistically significant （P＜0.05）. On 6 months after the operation， the HbA1c levels in the BillrothⅡanastomosis group and Roux-en-Y anastomosis group were markedly lower than those in the BillrothⅠ anastomosis group and the differences were statistically significant （P＜0.05）；the HbA1c level was not statistically different between the BillrothⅡ anastomosis group and the Roux-en-Y anastomosis group （P＞0.05）. The total curative effects in the BillrothⅡ anastomosis and Roux-en-Y anastomosis groups were significantly better than those in the BillrothⅠ anastomosis group （P＜0.05）. Conclusion According to our limited clinical data， BillrothⅡ anastomosis and Roux-en-Y anastomosis for gastric antral cancer patients with type 2 diabetes may be the best surgical approach.
Objective
To evaluate the influence of diabetes on coronary artery bypass graft (CABG) surgery using bilateral internal mammary artery (BIMA).
Methods
From December 2015 to August 2017, 182 patients (153 males, 29 females, age of 56.5±6.8 years) underwent CABG using BIMA. The propensity score was used to create matched diabetes (n=66) and non-diabetes (n=66) cohorts. The operative data, post-operative outcomes and coronary computed tomographic angiography (CTA) of the diabetes group (53 males, 13 females, age of 57.8±7.2 years) and the non-diabetes group (56 males, 10 females, age of 56.3±6.0 years) were analyzed retrospectively.
Results
There was no peri-operative mortality. There was no difference in operative sternal wound complication (P=0.466), or graft patency (P=0.730 for internal mammary arteries and 0.684 for saphenous vein grafts) between the matched diabetes and the non-diabetes groups. However, patients with elevated glycated hemoglobin (HbA1c) (n=54) had more sternal wound complications (P=0.006). The level of Hb1Ac of the patients with sternal wound complication was significantly higher than that of the patients without sternal wound complication.
Conclusion
BIMA grafting may be performed routinely even in diabetic patients, without increased complications. However, elevated HbA1c level should be avoided to reduce sternal wound complication.
摘要:目的:比較不同人群踝肱指數（ABI）的測量值,探討糖尿病大血管病變的多發性及相關性 。方法: 對2007年2月至2009年5月間在本院住院的49名經冠狀動脈造影和/或心肌損傷三項及心電圖臨床證實心肌梗死的糖尿病患者,及50名經冠狀動脈造影和/或心肌損傷三項及心電圖臨床證實無冠脈病變的糖尿病患者,并另選取50名無糖尿病及冠心病的對照50人共149例行下肢檢查,分析各組ABI的特點。結果: 三組間ABI比較均有差異,兩兩比較有統計學差異(Plt;0.05),且糖尿病并冠心病患者的ABI值較對照組明顯下降,兩組ABI值比較有統計學差異(Plt;0.01)。 結論: 糖尿病合并冠心病與糖尿病足的發病有相關一致性,ABI降低最明顯。Abstract: Objective: To explore the multiplicity and correlation of macroangiopathy in type 2 diabetes,we compared the ankle brachial index(ABI) in different populations. Methods: We analyzed the ankle brachial index(ABI) of lower extremity of 149 people in our hospital from February,2007 to May, 2009:A group,49 diabetes with myocardial infarction diagnosed by coronary angiography and / or myocardial damage check and ECG.B group,50 diabetes without myocardial infarction diagnosed by the same methods. Control group, 50 people without diabetes or coronary heart disease. Results: There were significant differences among three groups, respectively (Plt;0.05). And there was decreased ankle brachial index(ABI)in diabetes with coronary heart disease compared with the control group, with significant difference(Plt;0.01). Conclusion: There was a relation between diabetes with coronary heart disease and the incidence of diabetic foot, with obvious reduction of ankle brachial index(ABI)
The medical literature contains a wealth of valuable medical knowledge. At present, the research on extraction of entity relationship in medical literature has made great progress, but with the exponential increase in the number of medical literature, the annotation of medical text has become a big problem. In order to solve the problem of manual annotation time such as consuming and heavy workload, a remote monitoring annotation method is proposed, but this method will introduce a lot of noise. In this paper, a novel neural network structure based on convolutional neural network is proposed, which can solve a large number of noise problems. The model can use the multi-window convolutional neural network to automatically extract sentence features. After the sentence vectors are obtained, the sentences that are effective to the real relationship are selected through the attention mechanism. In particular, an entity type (ET) embedding method is proposed for relationship classification by adding entity type characteristics. The attention mechanism at sentence level is proposed for relation extraction in allusion to the unavoidable labeling errors in training texts. We conducted an experiment using 968 medical references on diabetes, and the results showed that compared with the baseline model, the present model achieved good results in the medical literature, and F1-score reached 93.15%. Finally, the extracted 11 types of relationships were stored as triples, and these triples were used to create a medical map of complex relationships with 33 347 nodes and 43 686 relationship edges. Experimental results show that the algorithm used in this paper is superior to the optimal reference system for relationship extraction.
