非胰岛素类糖尿病治疗新药研究进展

糖尿病是一种以高血糖为特征的慢性代谢性疾病,随着生活水平的提高,其发病率逐年上升,已成为危害人类健康的重要因素之 一。对于糖尿病的治疗药物研究,也从对传统机制的药物研究过渡到对具有新靶点和新作用机制的药物研究。其中基于这些新靶点设计 的新型非胰岛素类糖尿病治疗药物已进入临床研究阶段或已上市,给糖尿病的治疗带来了新的思路。按作用靶点和机制分类对较有开发 前景的非胰岛素类糖尿病治疗新药的研究进展进行综述。     

线粒体基因突变与糖尿病的相关性研究进展

线粒体DNA(mtDNA)突变可引起多种遗传性疾病,其中包括糖尿病.与mtDNA突变相关的糖尿病中最常见的变异是tRNALeu(UUR)] 3243 A→G.文章描述了mtDNA线粒体突变与糖尿病的相关性,介绍了线粒体糖尿病的临床特点和发病机制,概括了线粒体糖尿病相关变异基因位点,重点介绍了m.3243A→G、3310C→T、16189T→C基因突变与线粒体糖尿病病理生理的联系.文章认为mtDNA突变位点的研究为糖尿病的发生机制提供新的视角,也为糖尿病的治疗提供了新方向.     

Basic study on biochemical mechanism of thoron and thermal therapy

Exposure to water in hot springs containing thoron is thought to exercise beneficial effects on hypertension and diabetes mellitus. To put to a test this hypothesis we examined the time dependent changes in the levels of lipid peroxide, vasoactive- and diabetes associated substances in human blood in order to throw further light on the possible beneficial influence of thoron and thermal therapy on the mechanism of hypertension and diabetes mellitus. Every 2 days, nasal inhalation of vapor containing thoron was performed for 40 min. Blood samples were collected after each treatment at 1, 2, and 3 weeks after the first treatment. Results show that the treatment decreased the lipid peroxide levels. The finding suggests that the treatment contributes to the prevention of peroxidation reaction related to hypertension and diabetes mellitus. Moreover, the changes in vasoactive-associated substances indicate an increase in tissue perfusion, suggesting that the treatment plays a role in alleviating hypertension. The treatment decreased the total ketone body levels and the finding suggests that the treatment contributes to the prevention of diabetes mellitus related to the insulin deficiency.     

The effect of agmatine on L-arginine metabolism in erythrocytes under streptozotocin-induced diabetes in rats

The effects of agmatine on oxidative and nonoxidative metabolic pathways of L-arginine were investigated both in plasma and erythrocytes under experimental diabetes mellitus. It was indicated, that agmatine prevents the development of oxidative-nitrosative stress in diabetic rats. After treatment of animals by agmatine NO-synthase methabolic pathway of L-arginine is depressed whereas arginase one increases in erythrocytes of rats with experimental diabetes mellitus.     

肛周脓肿合并糖尿病64例治疗体会

目的探讨肛周脓肿合并糖尿病的有效治疗方法。方法对64例肛周脓肿合并糖尿病患者给予胰岛素控制血糖,局部切开引流,抗生素治疗,中药坐浴,营养支持对症治疗。结果64例全部治愈,2例复发再次入院,治愈时间26～64d。结论综合降糖、手术、应用抗生素,是治疗肛周脓肿合并糖尿病的有效方法。     

Oral insulin preparation for regulation of the blood glucose level

Oral administration of diluted solutions of insulin to healthy volunteers and animals with diabetes mellitus results in the hypoglycemic effect. It is suggested that diluted insulin solutions may be used for the development of a novel strategy for treatment of diabetes mellitus.     

Current progress and perspectives in cell therapy for diabetes mellitus

Recent advances of cell transplantation and tissue engineering are remarkable. And also the diabetic treatment using pancreatic beta cells have performed great advances. Even clinical islet transplantation has been considered a common curative treatment for diabetes mellitus in the place of an experimental treatment. Still more the lack of donor's organ as a worst problem of transplantation will be overcome by using the beta cells produced in vitro culture. Therefore diabetes mellitus will be closed to cure in the near future.     

Dietary treatment of diabetes mellitus in the pre-insulin era (1914-1922)

Before the discovery of insulin, one of the most common dietary treatments of diabetes mellitus was a high-fat, low-carbohydrate diet. A review of Frederick M. Allen's case histories shows that a 70% fat, 8% carbohydrate diet could eliminate glycosuria among hospitalized patients. A reconsideration of the role of the high-fat, low-carbohydrate diet for the treatment of diabetes mellitus is in order.     

综合护理干预对老年住院糖尿病患者影响的临床观察

目的：观察综合护理干预对老年住院糖尿病患者的临床影响,探讨改善老年住院糖尿病患者临床表现及预后的护理方式。方法：选择老年住院糖尿病患者160例,随机均分为对照组和观察组,对照组采取常规专科护理,观察组加行综合护理干预,治疗2周后比较两组患者焦虑自评量表（SAS）和抑郁自评量表（SDS）评分;出院3个月后比较两组患者自我管理和生活质量（GQOL-100）评分结果：治疗2周和出院3个月后,两组患者在上述方面比较,差异具有统计学意义（P〈0.01,P〈0.05）,观察组优于对照组。结论：对老年住院DM患者施行综合护理干预措施,具有积极的临床意义。     

Awareness,Treatment, Control of Diabetes Mellitus and the Risk Factors: Survey Results from Northeast China

Background

The awareness, treatment and control of diabetes mellitus (DM) can effectively reflect on the social status of diabetes conditions. Although several researchers have investigated the awareness, treatment and control rates of diabetes mellitus in China, little is known about their association with risk factors. This study aims to examine the relationship between risk factors and awareness, treatment and control of diabetes mellitus in northeast China.

Methods

A cross-sectional survey was conducted in 2012. Multistage stratified random cluster sampling design was used to select participants aged 18 to 79 years old. The analysis was based on a representative sample of 1,854 adult subjects. Multivariable logistic regression analysis was used to examine socio-demographic factors associated with the levels of awareness, treatment and control of diabetes mellitus.

Results

The awareness, treatment, and control rates of diabetes mellitus were 64.1%, 52.9% and 44.2%, respectively. In the multivariable logistic regression analysis, family history of diabetes was significantly positively associated with awareness (OR, 2.145; 95% CI, 1.600–2.875) and treatment (OR, 2.021; 95% CI, 1.559–2.619) of diabetes mellitus, while negatively associated with control (OR, 0.671; 95% CI, 0.529–0.951). Cigarette smokers and alcohol drinkers were less likely than non-smokers and non-drinkers to be aware of their blood glucose levels (OR, 0.895, 0.614; 95% CI, 0.659–1.216, 0.446–0.844, respectively). Participants who frequently exercise were more likely to be aware of their diabetic conditions than people who never or rarely exercise (OR, 2.003; 95% CI, 1.513–2.651).

Conclusions

We found that the awareness and treatment of diabetes mellitus were positively associated with age and were high in participants with a family history of diabetes and those who exercise frequently, but low for cigarette smokers and alcohol drinkers. Participants with a family history of diabetes had their diabetic condition poorly controlled.     

Management of diabetes mellitus in children.

In many respects the management of diabetes mellitus in children differs from the management in adults. Guidelines for the short- and long-term management of the child with diabetes mellitus, particularly as it relates to clinical presentation, treatment of ketoacidosis, long-term therapy and psychological counseling, are presented. The specific aspects of diabetes management that are unique to the child are best met by an increased understanding of the problems by the child and the family and an integrated approach by the physician and allied health personnel.     

Diabetes Mellitus Associated with Epidemic of Infectious Hepatitis in Nigeria

This report concerns nine cases of diabetes mellitus associated with infectious hepatitis, an epidemic of which swept through eastern Nigeria between 1970 and 1972. All the patients showed the classical symptoms and signs of diabetes. They quickly responded to treatment, and after a few months the diabetes completely disappeared. Corticosteroid-glucose tolerance tests in four patients 12 to 30 months after the remission of their diabetes were normal. Contact with the remaining five patients had been lost a few months after clinical remission of their diabetes. The infectious hepatitis virus may have damaged pancreatic islet cells to cause an acute remittant form of diabetes mellitus.     

阿加曲班与葛根素联合治疗糖尿病下肢动脉硬化闭塞症的临床研究

目的:研究阿加曲班与葛根素联合治疗糖尿病动脉硬化闭塞症的临床效果。方法:选择糖尿病动脉硬化闭塞症患者124例。随机分为观察组与对照组,各62例。观察组给予阿加曲班与葛根素联合治疗,对照组单用阿加曲班治疗。治疗前使用降糖和降压药物使血糖和血压保持稳定。观察治疗前后临床症状改善的情况,检测治疗前后足背动脉血流量及踝/肱动脉压比值。结果:单用阿加曲班组及联合葛根素组在改善糖尿病动脉硬化闭塞症的临床症状方面均有良好的效果,但联合葛根素组比单用阿加曲班组的治疗效果更佳(P<0.01)。在足背动脉血流量,踝/肱动脉压比值治疗前后各项指标的改善方面,联合葛根素组比单用阿加曲班组的治疗效果更佳,差异亦有统计学意义(均为P<0.05)。两组治疗期间和治疗后均无明显不良反应,耐受性好。结论:糖尿病动脉硬化闭塞症患者经使用阿加曲班与葛根素联合治疗,效果良好,二者具有协同作用。     

Assessment of the Magnitude of Contextual and Individual Demographic Effects on Diabetes Mellitus and Glucose Intolerance in Rural Southwest China: A Multilevel Analysis

Objective

This study aimed to determine the contribution of individual and contextual socioeconomic status (SES) to the prevalence of diabetes mellitus and glucose intolerance in the adult population in rural southwest China.

Methods

A population-based cross-sectional study of diabetes was performed in 4801(2152 men) Chinese adults (≥25 years old). Multilevel logistic regression model was used to examine the association between individuals’ and townships’ variables and the prevalence of diabetes mellitus and glucose intolerance.

Results

The age-and gender-standardized prevalence of diabetes mellitus and glucose intolerance were 7.1% (3.6% for undiagnosed) and 8.8% in adults aged ≥25 years, respectively, and increasing with age. Females were more likely to develop diabetes than males. The probability of developing diabetes increased with BMI. Both contextual and individual educational level and yearly household income were found to be negatively associated with the prevalence of diabetes. Residence in communities with a higher percentage of ethnic minorities was associated with higher prevalence of diabetes. Smoking had a protective effect for diabetes, drinking had a positive association with diabetes mellitus and glucose intolerance.

Conclusions

Diabetes mellitus and glucose intolerance are common in rural adults of southwest China by international standards. These results indicate that diabetes mellitus has become a major public health problem in rural areas in southwest China, and strategies aimed at the prevention and treatment of diabetes mellitus and glucose intolerance are needed.     

Effects of Ballota nigra on glucose and insulin in alloxan-diabetic albino rats

The hypoglycemic effect of Ballota nigra extract on albino rats was investigated. Alloxan-induced diabetes mellitus was accompanied by several fold increases in plasma glucose. Administration of aqueous extract of B. nigra extract significantly reduced glucose in both healthy and diabetic rats. These results suggest that B. nigra possess hypoglycemic effects in rats and therefore, can be useful for the treatment of diabetes mellitus.     

Insulin binding to circulating erythrocytes in nonobese diabetic mice

Insulin binding to circulating erythrocytes was studied in nonobese diabetic (NOD) mice which develop insulinopenic diabetes mellitus spontaneously. NOD mice with a short duration of diabetes mellitus and mild insulinopenia did not show any change in insulin binding, while those with a long duration of diabetes mellitus and severe insulinopenia showed an increase in insulin binding compared with nondiabetic NOD mice (6.85 +/- 0.38% bound vs. 4.19 +/- 0.24% bound, p less than 0.01). This increase in insulin binding was due to an increase in the number of receptors. Insulin treatment of diabetic NOD mice significantly reduced the insulin binding by 64%, which resulted from a decrease in the number of the receptors. These results indicate that insulin binding to erythrocytes in NOD mice is controlled mostly by up-and-down regulation.     

Cellular immunity in insulin-dependent diabetes mellitus (type 1)

Cell-mediated immunity was investigated with T-cell blastic transformation stimulated by phytohaemagglutinin and/or insulin in patients with diabetes mellitus type 1. T-cell blastic transformation was determined in the whole blood by the intake of labelled thymidine intake by the lymphocytic DNA. Healthy individuals and patients with diabetes mellitus type 2 served as control groups. It was found that T-cell blastic transformation stimulated with phytohaemagglutinin is markedly diminished in patients with diabetes mellitus type 1 and to a lesser degree in patients with diabetes mellitus type 2. Insulin increased T-cell blastic transformation in insulin-dependent diabetic patients but has no effect in diabetes mellitus type 2. The obtained results suggest that induction and central phases of the cell-mediated immunological response are diminished in diabetes mellitus independently on its type. Such disorders may have different etiology depending on the type of diabetes mellitus.     

Effect of chloroquine on insulin and glucose homoeostasis in normal subjects and patients with non-insulin-dependent diabetes mellitus.

Plasma glucose, insulin, and C peptide concentrations were determined after an oral glucose load in normal subjects and in a group of patients with non-insulin-dependent diabetes mellitus before and during a short course of treatment with chloroquine. In the control group there was a small but significant reduction in fasting blood glucose concentration but overall glucose tolerance and hormone concentrations were unaffected. In contrast, the patients with non-insulin-dependent diabetes mellitus showed a significant improvement in their glucose tolerance, which paralleled the severity of their diabetes. This response seems to reflect decreased degradation of insulin rather than increased pancreatic output. These observations suggest that treatment with chloroquine or suitable analogues may be a new approach to the management of diabetes.     

黄绿卷毛菇水提物对糖尿病大鼠机体抗氧化及抗炎作用初探

氧化应激被认为是糖尿病、肿瘤、肝病等多种疾病发生的一个关键危险因素。通过抗氧化剂阻断或延缓氧化反应和炎症过程,有望成为预防或治疗糖尿病的一种有效的干预手段。黄绿卷毛菇Floccularia luteovirens又名黄绿蜜环菌,是青藏高原特有的一种稀有珍贵的食药用菌,其子实体具有抗肿瘤、抗炎、抗氧化等诸多药理作用。在本研究中,我们初步探究了黄绿卷毛菇水提物（water extract of Floccularia luteoviren,FLW）对Ⅱ型糖尿病大鼠机体抗氧化和抗炎作用。二甲双胍及FLW连续灌胃给药8周,结果表明,FLW可以促进外源性葡萄糖的消耗,明显改善糖尿病大鼠的口服糖耐量;显著提高血清中SOD水平,显著降低血清中MDA及炎症因子IL-1β、TNF-α、IL-6的释放。综上所述,FLW表现出较强的抗氧化和抗炎活性,对Ⅱ型糖尿病大鼠机体氧化应激和炎症具有良好的改善作用。     

胰升血糖素样肽-1及其受体与 2 型糖尿病的治疗

胰岛素对治疗 2 型糖尿病有一定效果,但长期使用会引起低血糖反应;双胍类药物降糖疗效显著,但会引起消化道不良反应 . 因此,寻找一种安全有效的药物是 2 型糖尿病治疗的当务之急 . 胰升血糖素样肽-1 作为一种胰岛素分泌促进剂和胰岛素增敏剂越来越受人们的关注,将它用于治疗糖尿病不会产生低血糖,对 1 型和 2 型糖尿病都有疗效 . 讨论胰升血糖素样肽-1及其受体的最新研究状况 .