1533例2型糖尿病患者合并症与并发症的调查分析

目的:了解上海地区门诊糖尿病患者的各种慢性合并症与并发症及其相关危险因素.方法:调查我院门诊糖尿病患者1533例,记录慢性合并症、并发症及各种相关危险因素并进行相关的统计分析.结果:上海地区糖尿病患者的各种慢性合并症与并发症的发生率由高到低依次为周围血管病变67.0%,高血压63.2%,血脂紊乱45.1%,家族糖尿病34.8%,高尿酸血症29.O%,视网膜病变28.0%,脂肪肝27.1%,糖尿病肾病21.1%.女性患者高尿酸血症、脂肪肝、家族糖尿病史发生率高于男性,各种慢性合并症与并发症多随年龄与病程的增加而升高.结论:上海地区门诊糖尿病患者各种慢性合并症与并发症的发病率较高,定期监测并联合控制血糖、血压、血脂水平是防治各种慢性合并症与并发症的关键.     

IL-6与2型糖尿病关系的研究进展

2型糖尿病(T2DM)已成为全世界危害人类健康的主要疾病,且患病率逐年增加.虽然T2DM确切的发病机制尚未完全阐明,但越来越多的证据提示T2DM的发生同炎症密切相关.IL-6是参与炎症反应的重要的细胞因子,研究发现IL-6在T2DM及其并发症的发生发展中起重要的作用.通过阻断炎症因子及其受体的抗炎治疗明显降低糖尿病的发生率或延迟其发展.这将有望给T2DM的防治提供新途径,为临床早发现及治疗提供更多的科学依据.     

维吾尔族2型糖尿病患者糖尿病肾病相关因素分析

目的：探讨维吾尔族2型糖尿病肾病（DN）发病的相关临来因素。方法：分析292例维吾尔族2型糖尿病患者的临床资科。结果：维吾尔族2型糖尿病患者糖尿病肾病（DN）发病率为43,49％（127／292）。DN患者的病程、SBP、TC、TG、FBG、HbAIC、LDL—C、BUN和Cr均显著高于NDN患者（P〈0．05）;但DBP、HDL．C、BMI之间无统计学差异（P〉0．05）。Logistic归分析结果显示,DM病程、患病年龄、SBP、FBP、TC、TG、LDL—C、HbAlc、BUN、Cr是DN的危险因素（OR值〉1）。结论：维吾尔族2型糖尿病患者的Did病程、患病年龄、SBP、FBP、TC、TG、LDL—C、HbAlc、BUN、Cr等参数与糖尿病肾病并发率之间有相关性。     

维吾尔族2 型糖尿病患者糖尿病肾病相关因素分析

目的:探讨维吾尔族2型糖尿病肾病(DN)发病的相关临来因素。方法:分析292例维吾尔族2型糖尿病患者的临床资科。结果:维吾尔族2型糖尿病患者糖尿病肾病(DN)发病率为43.49%(127/292)。DN患者的病程、SBP、TC、TG、FBG、HbAIC、LDL-C、BUN和Cr均显著高于NDN患者(P<0.05);但DBP、HDL-C、BMI之间无统计学差异(P>0.05)。Logistic归分析结果显示,DM病程、患病年龄、SBP、FBP、TC、TG、LDL-C、HbA1c、BUN、Cr是DN的危险因素(OR值>1)。结论:维吾尔族2型糖尿病患者的DM病程、患病年龄、SBP、FBP、TC、TG、LDL-C、HbA1c、BUN、Cr等参数与糖尿病肾病并发率之间有相关性。     

2型糖尿病患者血脂水平与心脑血管并发症的相关性分析

目的：探讨2型糖尿病患者血脂水平与其心脑血管并发症的相关性。方法：选择中国医科大学附属盛京医院2011年3月～2012年5月就诊的2型糖尿病患者236例和同期200例健康体检者为研究对象,检测和比较其空腹血糖（FBG）、胆固醇（CH）、甘油三酯（11G）、高密度脂蛋白（HDL）和低密度脂蛋白（LDL）水平。结果：2型糖尿病组患者FBG、血清CH、TG、LDL的含量与对照组比较均显著升高（P〈0．01）,而HDL的含量较对照组显著降低（P〈0．01）;在2型糖尿病组中,有心脑血管并发症的患者血清CH、TG、LDL的含量显著高于无并发症者（P〈0．01）;而血清HDL含量显著低于无并发症者（P〈0．01）。相关性分析结果显示,2型糖尿病患者CH、TG和LDL的含量与其合并心脑血管并发症均存在正相关（r=0．337,P〈0．05;r==0．514,P〈0．05;r=0．438,P〈0．05）,而HDL的含量与其合并心脑血管并发症存在显著负相关（r=-0．237,P〈0．05）。结论：2型糖尿病患者存在显著的糖脂代谢紊乱,且血脂水平与心脑血管并发症的发生密切相关,检测并控制2型糖尿病患者的血脂水平有助于预防其心脑血管病变的发生。     

实施临床路径对2 型糖尿病患者影响的研究

摘要目的：探讨实施临床路径后对2 型糖尿病患者的影响。方法：选择某三甲医院2011 年前未实施临床路径和2011 年实施临 床路径后诊断为2 型糖尿病的患者,观察比较实施临床路径前后2 型糖尿病患者的平均住院日、再住院率、住院费用、药费、耗材 费、检查费以及2 型糖尿病治愈、好转、死亡等效果等指标有无差异。结果：实施临床路径前后2 型糖尿病患者的平均住院日、再 住院率、住院费用、药费、耗材费、检查费以及2 型糖尿病治愈、好转、死亡等效果相比较有明显差异(P<0.01)。结论：2 型糖尿病人 治疗中实施临床路径可显著缩短平均住院日,降低平均住院费、药费、耗材费及检查费用, 再住院率明显降低,实施临床路径后2 型糖尿病治愈、好转、死亡等效果比实施临床路径前明显改善。临床路径的开展和应用, 使患者在最合适的时机得到最合理的检 测、诊断和治疗,大大优化医疗资源,改善治疗结局,具有临床应用价值,值得临床推广和应用。     

实施临床路径对2型糖尿病患者影响的研究

目的：探讨实施临床路径后对2型糖尿病患者的影响。方法：选择某三甲医院2011年前未实施临床路径和2011年实施临床路径后诊断为2型糖尿病的患者,观察比较实施临床路径前后2型糖尿病患者的平均住院日、再住院率、住院费用、药费、耗材费、检查费以及2型糖尿病治愈、好转、死亡等效果等指标有无差异。结果：实施临床路径前后2型糖尿病患者的平均住院目、再住院率、住院费用、药费、耗材费、检查费以及2型糖尿病治愈、好转、死亡等效果相比较有明显差异（P〈0．01）。结论：2型糖尿病人治疗中实施临床路径可显著缩短平均住院日,降低平均住院费、药费、耗材费及检查费用,再住院率明显降低,实施临床路径后2型糖尿病治愈、好转、死亡等效果比实施临床路径前明显改善。临床路径的开展和应用,使患者在最合适的时机得到最合理的检测、诊断和治疗,大大优化医疗资源,改善治疗结局,具有临床应用价值,值得临床推广和应用。     

社区2型糖尿病患者用药依从性分析

目的探讨社区2型糖尿病患者用药依从性及影响因素,为提高本地区2型糖尿病患者服药依从性提供依据。方法采用自制调查问卷表在患者诊疗时发放。对填表后的216例2型糖尿病患者进行跟踪随访、记录、分析。结果服药依从性良好者占41.6%,服药依从性差者占58.4%,经干预措施后提高到69.2%。服药依从性与患者糖尿病防治知识、生活习惯、经济条件、服药种类和服药次数、担心不良反应及医、护、患的关系有关。依从性好的患者血糖控制效果好,依从性差的患者血糖控制欠佳,波动幅度大。结论糖尿病患者药物治疗依从性的影响因素较多,应加强对2型糖尿病患者的健康教育及社区医护人员的专业培训,普及糖尿病药物的应用知识,提高服药依从性,提高2型糖尿病患者的生活质量。     

2 型糖尿病血管并发症发生机制及中药干预作用的研究进展

糖尿病血管并发症是导致糖尿病患者死亡的主要原因之一。许多糖尿病患者非常重视血糖的控制,而对于糖尿病血管并发症并未予 以足够的关注。随着中药研究领域的开展,人们发现中药在糖尿病慢性血管并发症的治疗中具有明显的优势。从糖脂代谢异常、胰岛素抵抗、 氧化应激以及肾素-血管紧张素-醛固酮系统异常等方面,综述2 型糖尿病血管并发症的发生机制,并简介中药针对各发病机制过程的干预 作用。     

2型糖尿病患者血糖波动与糖尿病视网膜病变的相关性分析

目的:探讨2型糖尿病(T2DM)患者血糖波动与糖尿病视网膜病变(DR)的关系.方法:T2DM患者进行眼底照相或眼底荧光造影,根据DR程度分为糖尿病背景期视网膜病变(BDR)组、糖尿病增殖期视网膜病变(PDR)组、无视网膜病变(NDR)组,记录年龄、性别、体重指数、病程、测量血压、糖化血红蛋白、空腹胰岛素、餐后2h胰岛素、空腹C-肽、餐后2hC-肽、血脂指标.选取三组中上述基线指标具有可比性的病例共106例(BDR组38例,PDR组35例,NDR组33例)纳入观察.采用动态血糖监测系统(CGMS)连续监测患者血糖72 h.结果:各组间平均血糖水平(MBG)、血糖标准差(SDBG)、平均血糖波动幅度(MAGE)及血糖波动最大幅度(LAGE)相比较有统计学差异(P＜0.05).Spearman相关分析显示,糖尿病视网膜病变(DR)与MBG、SDBG、MAGE及LAGE呈正相关(P＜0.05).校正MBG后,糖尿病视网膜病变(DR)与SDBG、MAGE及LAGE的相关系数分别为0.297、0.396、0.284(P＜0.01).结论:血糖波动与糖尿病视网膜病变(DR)的发生发展有关,应尽早干预.     

锌转运蛋白8与1型和2型糖尿病的研究进展

ZnT8(zinc transporter,member8)是锌离子转运蛋白,主要定位于胰岛β细胞,能将胞浆锌离子转运至胰岛素储存/分泌性囊泡内,其转运功能降低会影响胰岛素合成、储存和分泌,能增加2型糖尿病(T2DM)的发病风险。ZnT8蛋白也可作为抗原引起β细胞自身免疫损伤,诱发1型糖尿病(T1DM)。ZnT8基因多态性是引起其锌离子转运功能和免疫原性变化的重要因素,与糖尿病的发生、发展密切相关。该文综述了ZnT8与T1DM和T2DM的研究进展,提示ZnT8可作为糖尿病防治的新药物靶点。     

葛根素对2型糖尿病大鼠的治疗作用*

目的:观察葛根素对2型糖尿病(T2DM)大鼠的治疗作用。方法:采用高糖高脂饲料喂养加一次性腹腔注射60 mg/kg链脲佐菌素的方法建立T2DM 大鼠模型,随机分为正常组,模型组,二甲双胍(40 mg/kg)组,葛根素低、中、高剂量(40,80,160 mg/kg)组,每组10只大鼠;造模成功后,灌胃给药4周,每周测量大鼠体重和空腹血糖(FBG),末次给药24 h后取血,收集血清,检测各组大鼠的血糖、血清甘油三酯(TG)、总胆固醇(TC) 、低密度脂蛋白-胆固醇(LDL-C)水平、高密度脂蛋白-胆固醇(HDL-C),血清天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)活性,血清尿素氮(BUN)、肌酐(SCr)、尿酸(UA)水平。结果:干预4周后,与正常组比较,模型组大鼠体重显著降低(P＜0.01),FBG,TC,TG,LDL-C,ALT,AST,BUN,SCr,UA均显著升高(P＜0.01),而HDL-C 显著降低(P＜0.01);与模型组比较,二甲双胍组和葛根素各剂量组大鼠体重均显著增加(P＜0.01),FBG,TC,TG,LDL-C,ALT,AST,BUN,SCr,UA均显著降低(P＜0.01),而HDL-C显著升高(P＜0.01)。结论:葛根素能够减少T2DM大鼠体重降低幅度,降低血脂、血糖水平,可用于T2DM的治疗。     

Adiponectin and its association with insulin resistance and type 2 diabetes

Adiponectin is an adipokine, which is expressed in adipose tissue and is thought to play an important role in glucose metabolism. Hypoadiponectinemia can cause reduction of fatty acid oxidation, decreased glucose uptake in skeletal muscle cells, and increased gluconeogenesis in hepatic cells. The level of plasma glucose can be increased. On the other hand, the decrease of fatty acid oxidation increases the level of free fatty acid (FFA), which increases the insulin resistance, and then decreases the glucose uptake, which ultimately causes increased plasma glucose and type 2 diabetes (T2D). This review describes the process from hypoadiponectinemia to T2D and the genesis of hypoadiponeetinemia at a molecular level.     

Autophagic adaptations in diabetic cardiomyopathy differ between type 1 and type 2 diabetes

Little is known about the association between autophagy and diabetic cardiomyopathy. Also unknown are possible distinguishing features of cardiac autophagy in type 1 and type 2 diabetes. In hearts from streptozotocin-induced type 1 diabetic mice, diastolic function was impaired, though autophagic activity was significantly increased, as evidenced by increases in microtubule-associated protein 1 light chain 3/LC3 and LC3-II/-I ratios, SQSTM1/p62 (sequestosome 1) and CTSD (cathepsin D), and by the abundance of autophagic vacuoles and lysosomes detected electron-microscopically. AMP-activated protein kinase (AMPK) was activated and ATP content was reduced in type 1 diabetic hearts. Treatment with chloroquine, an autophagy inhibitor, worsened cardiac performance in type 1 diabetes. In addition, hearts from db/db type 2 diabetic model mice exhibited poorer diastolic function than control hearts from db/+ mice. However, levels of LC3-II, SQSTM1 and phosphorylated MTOR (mechanistic target of rapamycin) were increased, but CTSD was decreased and very few lysosomes were detected ultrastructurally, despite the abundance of autophagic vacuoles. AMPK activity was suppressed and ATP content was reduced in type 2 diabetic hearts. These findings suggest the autophagic process is suppressed at the final digestion step in type 2 diabetic hearts. Resveratrol, an autophagy enhancer, mitigated diastolic dysfunction, while chloroquine had the opposite effects in type 2 diabetic hearts. Autophagy in the heart is enhanced in type 1 diabetes, but is suppressed in type 2 diabetes. This difference provides important insight into the pathophysiology of diabetic cardiomyopathy, which is essential for the development of new treatment strategies.     

Mental ability performance among adults with type 2 diabetes in primary care

Aim and method The present university-based outpatient clinic, cross-sectional study assessed cognitive performance in a sample of 137 adults, with the primary objective of determining differences in cognitive performance as a function of gender and hypertension status in a type 2 diabetes cohort.Results Approximately 64% of the sample was 65 years old and younger, and 50 subjects had > 13 years of education. Global mental ability scores were relatively similar by age grouping, and higher-ordered cognitive functioning and reading literacy were strongly correlated, r (98) = 0.62, P < 0.01. Approximately 30% of the sample posted global mental ability scores in the slow learner range on tasks measuring attention, immediate memory and verbal reasoning. Males achieved higher cognitive functioning scores compared to females on multiple mental ability tasks. The presence of hypertension was associated with significantly worse cognitive performance compared to those subjects without hypertension, t = 2.11, P = 0.03. Approximately 57% of the hypertension group was classified as mild cognitive impaired.Conclusion While approximately half of the general population can be expected to demonstrate an average range of performance on cognitive ability measures, such an expectation could be inappropriately generalised to persons diagnosed with type 2 diabetes, even among those who were high school educated.     

Exosomes are the novel players involved in the beneficial effects of exercise on type 2 diabetes

Exosomes contain regulatory signals such as lipids, proteins, and nucleic acids which can be transferred to adjacent or remote cells to mediate cell-to-cell communication. Exercise is a positive lifestyle for metabolic health and a nonpharmacological treatment of insulin resistance and metabolic diseases. Moreover, exercise is a stressor that induces cellular responses including gene expression and exosome release in various types of cells. Exosomes can carry the characters of parent cells by their modified cargoes, representing novel mechanisms for the effects of exercise. Here, we present a review of exosomes as the perspective players in mediating exercise's beneficial impacts on type 2 diabetes (T2D).     

A proteomic approach to obesity and type 2 diabetes

The incidence of obesity and type diabetes 2 has increased dramatically resulting in an increased interest in its biomedical relevance. However, the mechanisms that trigger the development of diabetes type 2 in obese patients remain largely unknown. Scientific, clinical and pharmaceutical communities are dedicating vast resources to unravel this issue by applying different omics tools. During the last decade, the advances in proteomic approaches and the Human Proteome Organization have opened and are opening a new door that may be helpful in the identification of patients at risk and to improve current therapies. Here, we briefly review some of the advances in our understanding of type 2 diabetes that have occurred through the application of proteomics. We also review, in detail, the current improvements in proteomic methodologies and new strategies that could be employed to further advance our understanding of this pathology. By applying these new proteomic advances, novel therapeutic and/or diagnostic protein targets will be discovered in the obesity/Type 2 diabetes area.     

槟榔碱对2型糖尿病大鼠肝脏胰岛素抵抗的作用

目的：探讨槟榔碱对2型糖尿病大鼠肝脏胰岛素抵抗的影响及其机制。方法：采用高果糖饲料饲养Wistar大鼠12周制备2型糖尿病大鼠模型,实验动物随机分为5组（n=8）：对照组、模型组、模型＋不同浓度的槟榔碱（0,0．5,1,5mg／kg）组。4周后通过检测血糖、血脂、胰岛素、RT-PCR检测肝脏组成型雄甾烷受体（CAR）、孕甾烷x受体（PXR）、糖代谢相关基因：葡萄糖-6-磷酸酶（G6Pase）、磷酸烯醇式丙酮酸羧激酶（PEPCK）和炎症相关因子：白细胞介素-6（IL-6）、肿瘤坏死因子α（TNF-α）mRNA表达,Western blot检测大鼠肝内p-AKT和葡萄糖转运体4（GLUT4）蛋白表达。结果：1,5mg／kg槟榔碱显著降低糖尿病大鼠体重、空腹血糖、空腹胰岛素、血脂和糖代谢相关基因及炎症相关因子mRNA水平,提高CAR、PXR mRNA水平及p-AKT、GLUT4蛋白水平。结论：槟榔碱可能通过提高CAR和PXR的表达,导致肝脏糖代谢关键酶PEPCK、G6Pase基因表达或者炎性因子肿瘤坏死因子-α（TNF-α）、白介素-6（n-6）表达降低,改善2型糖尿病大鼠肝脏胰岛素抵抗。