目的:比较罗格列酮钠片与二甲双胍片分别联合胰岛素治疗2型糖尿病的疗效和安全性。方法:40例单用胰岛素控制血糖不理想的2型糖尿病患者,随机分为A组,太罗组(罗格列酮钠片)(21例);B组,二甲双胍组(19例),进行为期16周的对照观察。结果:两组治疗后空腹及餐后2小时血糖及糖化血红蛋白(HbA1c)均呈有意义的下降(Plt;0.05),从下降幅度的百分率统计,太罗组下降幅度明显高于二甲双胍组。结论:太罗联合胰岛素治疗对于血糖的控制明显优于二甲双胍联合胰岛素治疗。
ObjectiveTo evaluate the efficacy and safety of piolitazone combined with metformin for type 2 diabetes mellitus. MethodsThe Cochrane Library (Issue 9, 2015), PubMed, EMbase, CNKI, WanFang Data and VIP databases were searched up to September 2015 for randomized controlled trials (RCTs) about pioglitazone combined with metformin versus sulfonylurea combined with metformin for type 2 diabetes mellitus. Two reviewers independently screened literature, extracted date, and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 7 RCTs involving 3 005 patients were included. The results of metaanalysis showed that when the course of treatment was ≤24 weeks, no significant difference was found in the level of HbA1c between the piolitazone plus metformin group and the sulphonylurea plus metformin group (MD=-0.04, 95%CI -0.26 to 0.19, P=0.74), but the piolitazone plus metformin group had lower risk of hypoglycemia (RR=0.39, 95%CI 0.15 to 1.01, P=0.05); when the course of treatment >24 weeks, only one RCT was included, we didn't conduct pool analysis. ConclusionPiolitazone combined with metformin has similar effect to sulphonylurea combined with metformin in controlling blood sugar, but piolitazone combined with metformin has lower incidence of hypoglycemia. Due to limited quality and quantity of the included studies, the above conclusion need to be verified by more high quality studies.
ObjectiveTo systematically review the effect of intermittent fasting on type 2 diabetes mellitus. MethodsThe CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, The Cochrane Library and EMbase databases were electronically searched to collect randomized controlled trials (RCTs) on intermittent fasting intervention in the treatment of type 2 diabetes mellitus from inception to April 2022. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included studies. The RevMan 5.4 software and Stata 17.0 software were used for meta-analysis. ResultsA total of 17 RCTs comprising 1 428 patients with type 2 diabetes mellitus were included. The results of meta-analysis showed that intermittent fasting improved body weight (WMD=−2.84, 95%CI −3.79 to −1.88, P<0.05), body mass index (BMI) (WMD=−1.07, 95%CI −1.52 to −0.61, P<0.05), glycosylated hemoglobin levels (SMD=−0.78, 95%CI −1.19 to −0.38, P<0.05), and fasting glucose levels (SMD=−0.65, 95%CI −1.01 to −0.3, P<0.05). ConclusionThe current evidence suggests that intermittent fasting improves body weight, BMI, glycated hemoglobin, and fasting blood glucose levels in patients with type 2 diabetes. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
【摘要】 目的 探讨糖尿病管理的有效模式，提高糖尿病患者的治疗达标率，减少低血糖发生。 方法 研究对象为2008年5月-2009年5月就诊的2型糖尿病患者356例。测量所有研究对象的空腹血糖、餐后2 h血糖、糖化血红蛋白。观察糖尿病管理后及常规治疗后血糖的变化。 结果 应用糖尿病达标管理软件管理糖尿病患者，血糖达标率明显升高，差异有统计学意义（Plt;0.05）；低血糖的发生率下降，差异有统计学意义（Plt;0.05）。 结论 大多数糖尿病患者的病情控制未达到理想的目标，应用科学的糖尿病达标管理软件进行管理是改善现状的有效方法。【Abstract】 Objective To study the effective management model for diabetes mellitus, promote the treatment results of patients with disease, and reduce the occurrence of hypoglycemia. Methods A total of 356 patients with type 2 diabetes mellitus (T2DM) treated from May 2008 to May 2009 were chosen in this study. Fasting bloods glucose, 2-hour postprandial blood glucose and hemoglobin A1c were detected in all the subjects. Then, the change of glucose level for the management group and the common treatment group was observed. Results The glucose-target-rate of patients managed by diabetes management software was significantly higher than patients in the common treatment group (Plt;0.05), and the occurrence rate of hypoglycemia was also significantly lower (Plt;0.05). Conclusions The control of T2DM for most patients is far from satisfaction. The application of scientific disease care software is effective for improving disease control.
目的 探讨视网膜微血管直径与2型糖尿病(DM2)并发症糖尿病视网膜病变(DR)的关系。 方法 选取2009年1月-11月住院确诊DM2患者200例，根据眼底彩色照相结果将患者分为DR组和NDR组，测量视网膜血管直径、测定生化指标及血压，用非条件Logistic回归分析糖尿病视网膜病变发生的危险因素。 结果 V1扩张10 μm时，DM2患者并发DR危险性增加(OR 1.75，95% CI 1.14～3.04，Plt;0.05)；空腹血糖水平增加1 mmol/L，DM2患者并发DR的危险性增加(OR 1.87，95% CI 1.43～2.81，Plt;0.05)； 糖化血红蛋白增加1个单位，DM2患者并发DR的危险性增加(OR 1.08，95% CI 1.02～1.13，Plt;0.05)；DM病程增加1年，DM2患者并发DR的危险性增加(OR 1.41，95% CI 1.18～1.70，Plt;0.05)。 结论 在DM2患者中，视网膜静脉直径大小、空腹血糖水平、糖化血红蛋白水平、糖尿病病程是DR发生的危险因素。
ObjectiveTo investigate the effects of single anastomosis sleeve ileal (SASI) bypass on weight loss, metabolic improvements, and postoperative safety in patients with obesity and its metabolic comorbidities (such as type 2 diabetes and hyperlipidemia). MethodsA retrospective analysis was conducted. The clinical data of patients with obesity [body mass index (BMI) ≥32.5 kg/m² or BMI ≥27.5 kg/m² with metabolic diseases] who underwent SASI bypass in the Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School from January 2023 to December 2023. Weight loss outcomes, including the percentage of total weight loss (%TWL), percentage of excess weight loss (%EWL), and percentage of excess BMI loss (%EBMIL), were recorded at 6 and 12 months postoperatively. Metabolic disease remission and complications at 12 months postoperatively were also documented. ResultsA total of 82 patients were included in the study. At 12 months postoperatively, the reductions in %TWL, %EWL, and %EBMIL were significantly greater than those observed at 6 months postoperatively [%TWL: (27.1±4.6)% vs. (23.6±3.8)%, t=2.379, P=0.026; %EWL: (72.1±5.8)% vs. (56.6±7.3)%, t=2.593, P<0.001; %EBMIL: (71.6±6.7)% vs. (58.3±4.9)%, t=2.607, P<0.001], remission was observed in 40 out of 48 patients (83.3%) with comorbid hypertension, 49 out of 51 patients (96.1%) with comorbid type 2 diabetes mellitus, and all patients with comorbid hyperlipidemia (33 cases) and obstructive sleep apnea syndrome (29 cases) achieved complete remission. Within 12 months after SASI bypass, 3 patients (3.7%) experienced melena, 2 patients (2.4%) developed incomplete intestinal obstruction, and 10 patients (12.1%) showed malnutrition. ConclusionThe findings of this study indicate that SASI bypass demonstrates significant weight loss and metabolic improvement effects in patients with obesity and metabolic diseases, with a controllable safety profile.
ObjectiveTo systematically review the efficacy of Roux-en-Y gastric bypass for obesity and its comorbidities. MethodsSuch databases as PubMed, EMbase, The Cochrane Library (Issue 11, 2013), CBM, CNKI, VIP and WanFang Data, etc. were electronically searched from inception to November 2013, for including all studies on Roux-en-Y gastric bypass for obesity and its comorbidities. According to inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and evaluated methodological quality of included studies. And then meta-analysis was performed using RevMan 5.3 software. ResultsA total of 25 before and after self-control studies involving 2 966 cases with overweight or obesity were included. The results of meta-analysis showed that:after Roux-en-Y gastric bypass operation, the patients had significant reduction in BMI (MD=-16.40, 95%CI-17.42 to-15.38, P < 0.000 01), type 2 diabetes mellitus prevalence (RR=0.23, 95%CI 0.17 to 0.31, P < 0.000 01), and hypertension prevalence (RR=0.34, 95%CI 0.26 to 0.43, P < 0.000 01); besides, fasting glucose, blood pressure and serum lipid levels obviously decreased (P < 0.000 01). ConclusionRoux-en-Y gastric bypass for obesity patients is effective in reducing weight loss, type 2 diabetes mellitus incidence and cardiovascular disease incidence. Due to the limitation of the design of the included studies, the conclusion needs to be verified by further conducting high quality randomized controlled trials with large sample-size.
目的 了解接受胰岛素治疗的糖化血红蛋白＞7.5%的2型糖尿病患者自我血糖监测现状及存在的问题，为帮助患者建立健康行为提供理论依据。 方法 对2008年12月－2011年2月住院治疗的128例符合纳入标准的患者进行问卷调查。调查内容包括患者一般资料、血糖控制情况、自我监测相关知识及技能等内容。 结果 共发放问卷128份，收回128份，其中有效问卷122份。糖尿病患者血糖自我监测知识获取渠道单一，且相关知识匮乏；不能制定正确血糖自我监测方案，不能对检测结果进行正确记录和汇报；血糖检测操作不正确，检测频率达不到标准要求。 结论 接受胰岛素治疗的2型糖尿病患者自我监测现状并不容乐观，患者自我监测行为缺乏。为此，提高糖尿病患者健康教育水平，帮助其建立并维持健康行为，是糖尿病教育工作的重点和挑战。
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 Methods of evidence-based medicine were used to make an individulized treatment plan concerning newly diagnosed type 2 diabetes mellitus in elderly patients. Method After clinical problems were put forward, evidence was collected from third issue, 2003, Cochrane Library, Medline (PubMed 1990.1-2003.2) and http:// sumsearch.uthscsa.edu/ searchform4.htm according to the search strategy. Subject words were: diabetes mellitus non-insulin-dependent; self-monitor of blood glucose; micro-and macro-vascular complications; sulphonylureas; insulin ; aspirin; metformin; acarbose; self-monitor of blood glucose; older patient; hypertension management; Lipid management; RCT; human; meta-analysis；systmatic review. Results A total of 112 RCTs, and 24 systematic reviews were identified. A rational treatment plan was made upon a serious evaluation of the data. After one year follow-up, the plan was proved optimal. Conclusions The treatment efficacy in newly diagnosed type 2 diabetes mellitus in the elderly has been improved by determining an individulized treatment plan according to evidence-based methods.