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1.
目的探讨授权原理在老年糖尿病管理的应用效果。方法对100例诊断为2型糖尿病的老年患者,随机分为对照组和观察组各50例,对照组采用传统教育,观察组采用授权原理的教育模式,在干预前及干预的第3个月分别对患者进行各临床指标(糖化血红蛋白、空腹血糖、餐后2h血糖)的监测及自我管理进行评估。结果干预后两组患者血糖、糖化血红蛋白、自我管理等方面比较,均有统计学意义(P0.05)。结论授权原理应用于老年糖尿病患者的健康教育有助于提高患者的自我管理能力。  相似文献   

2.
目的:本研究旨在调查糖尿病足的牙周病(PD)流行病学及其临床相关性。方法:选取2005年1月-2015年12月在本协作组医院就诊的4761例糖尿病患者作为研究对象,根据糖尿病足和牙周病的诊断标准筛查其中218例糖尿病足合并牙周病患者的临床资料。采用全自动生化分析仪检测患者血糖水平;采用放射免疫法检测患者血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)及高密度脂蛋白(HDL)水平;采用全自动生化分析仪检测患者糖化血红蛋白(Hb Alc)含量;采用双抗体夹心酶联免疫吸附测定法检测患者血清25(OH)D水平;采用尿酸酶-过氧化物酶偶联法检测患者血尿酸(BUA)水平。结果:4761例糖尿病患者中,218例为糖尿病足伴牙周病(7.2%)。重度糖尿病足伴牙周病患者血糖、TC、TG、LDL、HDL、Hb Alc及BUA水平均高于轻度糖尿病足伴牙周病患者和中度糖尿病足伴牙周病患者,差异均具有统计学意义(P0.05);中度糖尿病足伴牙周病患者血糖、TC、TG、LDL、HDL、Hb Alc及BUA水平均高于轻度糖尿病足伴牙周病患者,差异均具有统计学意义(P0.05)。重度糖尿病足伴牙周病患者血清25(OH)D水平低于轻度糖尿病足伴牙周病患者和中度糖尿病足伴牙周病患者,差异具有统计学意义(P0.05);中度糖尿病足伴牙周病患者血清25(OH)D水平低于轻度糖尿病足伴牙周病患者,差异具有统计学意义(P0.05)。结论:血糖、血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、糖化血红蛋白(Hb Alc)、血清25(OH)D及血尿酸(BUA)水平与糖尿病足伴牙周病的发生及发展密切相关。  相似文献   

3.
目的:探讨定期血糖监测对糖尿病血糖控制及生活方式的影响。方法:随机抽取我中心2010-2011年度确诊的老年2型糖尿病患者110例,随机分为干预组和对照组,每组各55例;2组均接受正规降糖药物治疗及生活方式指导,干预组每周进行一次血糖监测,每3个月测一次糖化血红蛋白,对照组按患者意愿测定血糖指标,通过12个月的观察,研究两组患者在血糖控制及生活方式上的差异。结果:干预组患者空腹血糖(FPG)由定期监测血糖前的(7.26±1.36)mmol/L降至(6.68±1.10)mmol/L;餐后2小时血糖(2HPG)由定期监测血糖前的(12.34±2.29)mmol/L降至(11.09±1.98)mmol/L;糖化血红蛋白由监测前的(7.99±1.61)%降至(6.60±0.87)%;差异具有显著性(P<0.05);生活方式亦有明显改善,差异具有显著性(P<0.05);而对照组的改变不如干预组。结论:通过定期血糖监测可以有效地控制血糖、糖化血红蛋白,促使老年2型糖尿病患者改变不良生活方式。  相似文献   

4.
为了研究血清晚期氧化蛋白产物与2型糖尿病患者冠状动脉病变并发症的相关性。本研究选择50例2型糖尿病患者和30例健康体检者,取血后用分光光度法测定血清中晚期氧化蛋白产物的含量,使用全自动生化分析仪检测空腹血糖、总胆固醇和甘油三酯水平,使用微柱亲和层析法测定糖化血红蛋白的含量。研究显示血清晚期氧化蛋白产物在2型糖尿病组中的含量显著高于健康体检者组(p0.05);在血糖控制不良组中显著高于血糖控制良好组(p0.05)。2型糖尿病高晚期氧化蛋白产物患者组的空腹血糖、总胆固醇、甘油三酯和糖化血红蛋白水平显著高于低晚期氧化蛋白产物患者组(p0.05)。单因素相关分析显示血清晚期氧化蛋白产物与空腹血糖、总胆固醇、甘油三酯、糖化血红蛋白水平正相关。2型糖尿病患者中,患有冠状动脉病变并发症的患者血清晚期氧化蛋白产物水平显著高于非冠状动脉病变并发症患者(p0.05)。Logistic回归分析显示年龄、平均动脉压和AOPP的水平是2型糖尿病患者冠状动脉病变并发症发生的独立危险因素。本研究表明2型糖尿病患者体内氧化应激反应增强,血清晚期氧化蛋白产物水平升高,与冠状动脉病变并发症密切相关。  相似文献   

5.
目的探讨老年糖尿病患者空腹血糖、糖化血红蛋白和血脂检测的意义和相关性。方法选择2013年1月至2013年12月我院慢病诊疗中心收治的老年糖尿病患者120例为观察组,同期100例健康体检老年人为对照组,比较两组人群空腹血糖、糖化血红蛋白和血脂等指标检测结果,对指标间相关性进行分析。结果观察组患者空腹血糖、糖化血红蛋白和血脂与对照组相比差异均有统计学意义(P0.001,P0.01)。观察组患者的FBG与TC、TG、LDL呈显著正相关(P0.01),与HDL呈负相关(P0.05);HbA1C与TC、TG、LDL呈显著正相关(P0.01),与HDL呈负相关(P0.05)。HbA1C与TC、TG、LDL和HDL的相关性优于FBG。结论老年糖尿病患者血糖和血脂密切相关,患者在监测血糖的同时也要注意监测血脂,积极降脂治疗,对预防和控制糖尿病及并发症有重要的临床意义。  相似文献   

6.
李之珍  胡晓武  许霞  杨飞  孙晓祥 《生物磁学》2011,(21):4123-4125
目的:探讨糖化血红蛋白(HbAlc)与糖尿病诊断、疗效评价及并发症的关系。方法:选择2型糖尿病患者250例和健康体检者150例,分别测定空腹血糖(FPG)、2h血糖(2hPG)及糖化血红蛋白(HbAlc),统计学分析HbAlc与FPG、2hPG的相关性;分析HbAlc与糖尿病并发症发生的关系。结果:糖尿病组FPG、2hPG及HbAlc水平均显著高于对照组(P〈0.01);糖尿病伴有并发症患者的HbAlc明显高于无并发症者(P〈0.05),HbAlc水平与糖尿病并发症的发生率存在高度相关性(P〈0.01)。结论:检测外周血中HbAlc水平对2型糖尿病诊断、疗效评价具有重要,临床价值,控制糖化血红蛋白对预防糖尿病并发症的发生具有重要意义。  相似文献   

7.
目的:探讨糖化血红蛋白(HbAlc)与糖尿病诊断、疗效评价及并发症的关系。方法:选择2型糖尿病患者250例和健康体检者150例,分别测定空腹血糖(FPG)、2h血糖(2hPG)及糖化血红蛋白(HbA1c),统计学分析HbA1c与FPG、2hPG的相关性;分析HbA1c与糖尿病并发症发生的关系。结果:糖尿病组FPG、2hPG及HbA1c水平均显著高于对照组(P<0.01);糖尿病伴有并发症患者的HbAlc明显高于无并发症者(P<0.05),HbA1c水平与糖尿病并发症的发生率存在高度相关性(P<0.01)。结论:检测外周血中HbA1c水平对2型糖尿病诊断、疗效评价具有重要临床价值,控制糖化血红蛋白对预防糖尿病并发症的发生具有重要意义。  相似文献   

8.
《遗传》2020,(5)
近年来的研究发现,一些2型糖尿病(type 2 diabetes mellitus, T2DM)易感基因位点不仅与T2DM的发病风险有关,还会影响生活方式干预效果。为进一步探究T2DM易感基因单核苷酸多态性(singlenucleotide polymorphism,SNP)位点对生活方式干预降低高危人群血糖应答效果的修饰作用,本课题组在德清农村社区开展了生活方式干预试验(2017年6月~12月,对干预组的研究对象进行强化生活方式干预,对照组仅接受常规健康知识宣教),并对研究对象进行SNP基因分型。研究发现,对于rs9502570,干预组中的CC+CT基因型人群的空腹血糖降低值显著高于TT基因型(P=0.031);干预组中CC+CT基因型人群的糖化血红蛋白值降低值为0.03%,TT基因型人群的糖化血红蛋白值升高了0.27%(P=0.012);CC+CT和TT基因型干预组和对照组的空腹血糖和糖化血红蛋白前后差值差之间也有统计学差异(均为P0.001)。对于rs10811661,干预组中TT基因型人群的空腹血糖降低值显著高于CC+CT基因型(P=0.021);TT和CC+CT基因型干预组和对照组的空腹血糖前后差值差之间亦有统计学差异(P0.001)。上述研究结果表明,rs9502570、rs10811661两个位点会在一定程度上修饰高危人群对T2DM生活方式干预降低血糖的应答效果,为今后进一步研制糖尿病高危人群个体化干预措施提供了客观依据。  相似文献   

9.
目的:观察白子菜复合制剂对2型糖尿病患者血糖、血脂、胆固醇的影响。方法:共选取88名2型糖尿病患者,随机分为干预组和对照组,两组均给予膳食运动指导的基础上干预组再给予白子菜复合制剂干预,采用一般线性模型分析两组患者间基线、4w、8w、12w以及同组内不同时间点的空腹血糖、空腹胰岛素、糖化血红蛋白、血脂及胆固醇等指标。结果:两组空腹血糖均较基线下降且干预组优于对照组(P=0.012);干预组糖化血红蛋白较基线值降低,且优于对照组(P=0.023);两组间甘油三酯、低密度脂蛋白较基线值降低,优于对照组(P=0.043、P=0.029)。空腹胰岛素、总胆固醇、高密度脂蛋白较基线值差异无统计学意义(P值分别为0.17、0.13、0.056)。结论:白子菜复合制剂能有效改善2型糖尿病患者空腹血糖、血脂及低密度脂蛋白,具有临床推广意义。  相似文献   

10.
目的:通过对代谢综合征(Ms)患者进行积极健康教育指导,探索促进代谢综合征患者的健康对策,减轻代谢综合征对人体的危害,提高生活质量。方法:对我科住院健康体检中确诊的215例代谢综合征患者进行健康教育指导,其中包括饮食、运动、药物应用指导、定时检测、生活方式和行为等护理干预,一年后统计分析干预前后患者危险因素,血糖、血脂、体重指数、血压等指标的变化。结果:干预后患者危险因素显著减少,空腹血糖、血甘油三脂、总胆固醇、体重指数、收缩压与舒张压等指标与干预前比较差异有统计学意义(P〈0.01)。结论:表明健康教育对延缓MS的进展及减少并发症的发生是一种有效的干预手段。  相似文献   

11.
目的:研究西格列汀对早期2型糖尿病肾病患者肾小球、肾小管标志性蛋白/酶的影响。方法:早期2型糖尿病肾病患者72例,随机数字表分为对照组36例、治疗组36例;两组均采用糖尿病饮食管理、运动治疗,在控制血糖、血脂、血压的基础上,治疗组给予磷酸西格列汀100 mg 1粒/次,1次/天,持续服药6月。观察治疗前、后两组血肌酐(Scr)、尿素氮(BUN)、糖化血红蛋白(Hb A1c)、血脂、空腹血糖(FBG)、餐后2小时血糖(2 h PBG)、血清胱抑素-C(Cys-C)及24 h尿微量白蛋白(24 h UAE)、尿N-乙酰-β-氨基葡萄糖苷酶(NAG)、尿β2-微球蛋白(β2-MG)的变化。结果:治疗后,治疗组血脂、Hb A1c、FBG、2 h PBG较对照组明显下降,差异有显著性(P0.05)。两组患者24 h UAE、NAG、β2-MG和Cys-C较治疗前均下降,差异有显著性(P0.05);两组治疗后相比,差异具有统计学意义(P0.05)。结论:西格列汀可以有效控制早期DN患者的血糖水平,减少血清Cys-C、尿微量白蛋白水平,减轻肾小管损伤,有利于延缓DN的病程和进展。  相似文献   

12.
Diabetes is a chronic metabolic disorder that has a significant impact on the health care system. The reduction of glycated hemoglobin A1c is highly associated with the improvements of glycemic control and diabetic complications. In this study, we identified a traditional Chinese medicinal formula with a HbA1c-lowering potential from clinical evidences. By surveying 9,973 diabetic patients enrolled in Taiwan Diabetic Care Management Program, we found that Chu-Yeh-Shih-Kao-Tang (CYSKT) significantly reduced HbA1c values in diabetic patients. CYSKT reduced the levels of HbA1c and fasting blood glucose, and stimulated the blood glucose clearance in type 2 diabetic mice. CYSKT affected the expressions of genes associated with insulin signaling pathway, increased the amount of phosphorylated insulin receptor in cells and tissues, and stimulated the translocation of glucose transporter 4. Moreover, CYSKT affected the expressions of genes related to diabetic complications, improved the levels of renal function indexes, and increased the survival rate of diabetic mice. In conclusion, this was a translational medicine study that applied a “bedside-to-bench” approach to identify a novel HbA1c-lowering formula. Our findings suggested that oral administration of CYSKT affected insulin signaling pathway, decreased HbA1c and blood glucose levels, and consequently reduced mortality rate in type 2 diabetic mice.  相似文献   

13.
Hemoglobin (Hb) obtained from the hemolysate of normal subjects and diabetic patients was separated into HbA1a1, HbA1a2, HbA1b, HbA1c and HbA0 (major Hb) by Bio-Rex 70 cation exchange column chromatography. The glycosylated Hbs were further separated reproductively by cation exchange high performance liquid chromatography (HPLC), using 50 mM sodium phosphate buffer pH 5.80 with 0-0.2 M NaCl linear gradient system. HbA1b and HbA1c were separated into two subfractions (HbA1b1 and HbA1b2) and three subfractions (HbA1c1, HbA1c2, HbA1c3), respectively. The percentages of each subfraction except HbA1c1 in diabetic patients were significantly higher than those in normal subjects. Furthermore, HbA1c1, HbA1c2 and HbA1c3 correlated well with fasting blood glucose levels in the prior 5 month period, while subfractions in HbA1b revealed no significant correlation with blood glucose levels. The percentages of each subfraction of HbA1c in patients either with diabetic cataracts or with diabetic neuropathy were almost the same as those in the patients without complications. However, the percentages of each of the three groups were markedly higher than those of the normal subjects. These results suggest that glycosylation of hemoglobin in diabetic patients may be increased in various sites of the molecule in parallel with the blood glucose levels during the preceding 4-5 months.  相似文献   

14.
In subjects with impaired insulin action, alterations of the serum sodium and potassium concentrations have been reported. The resulting cationic imbalance, along with the osmotic effect of the elevated sugar levels, could influence the course of diabetes mellitus management. Therefore, this study was conducted to compare the fasting blood glucose and HbA1c levels with those of the serum electrolytes. Blood samples were collected for assessment of HbA1c, fasting blood glucose (FBS), and electrolytes using different automated methods. A significant association between the serum sodium and FBS levels among types 1 and 2 insulin-treated patients, and type 2 oral agent patients was observed. A total of 138 diabetic subjects were randomly selected from any gender aged between 25 and 65?years at the University Diabetes Center, King Saud University, Riyadh KSA. The subjects were classified into types 1 or 2 DM using ADA criteria. Blood samples were collected for assessment of HbA1c, FBS, and electrolytes using different automated methods. It showed a significant association between serum sodium, FBS among type 1, type 2 insulin treated, and type 2 oral agent groups. However, the association of sodium and HbA1c was insignificant when analyzed individually. A statistically significant association (P?相似文献   

15.
目的:探讨胰岛素联合六味地黄丸治疗老年早期糖尿病肾病患者的临床疗效。方法:收集我院收治的老年早期糖尿病肾病患者100例,随机分为对照组和实验组,每组各50例,对照组患者血糖情况给予胰岛素1次~2次/d,实验组患者在此基础上给予六味地黄丸1丸/次,2次/d,口服。连续4周。治疗结束后,对患者血清糖基化血红蛋白(Hb A1c)、同型半胱氨酸(HCY)、胱抑素C(Cys-C)水平的变化及临床疗效进行检测并比较。结果:与治疗前相比,两组患者的Hb A1c、HCY、Cys-C均下降(P0.05);与对照组相比,实验组患者Hb A1c、HCY、Cys-C水平较低(P0.05),实验组患者治疗总有效率较高(P0.05)。结论:胰岛素联合六味地黄丸能够有效改善老年早期糖尿病肾病患者的糖稳态及肾功能,临床疗效较好。  相似文献   

16.
OBJECTIVE: To evaluate the impact of obesity on glycemic control and the risk of progressing to cardiovascular disease (CVD) in obese and nonobese type 2 diabetic patients in primary care settings. METHODS: One hundred and ninety patients (64 men, 126 women) with type 2 diabetes (mean duration 9.2 years) were studied after an overnight fast. Weight, height, waist and hip circumferences and blood pressure were measured and blood samples were taken for glucose, glycated hemoglobin (HbA(1c)), total cholesterol, triglyceride, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol and creatinine determinations. RESULTS: About 85% of the patients had HbA(1c) levels > 7.0%, and 48% had a diastolic blood pressure (BP) >83 mm Hg, while 40% had a total cholesterol/HDL-cholesterol ratio greater than 6. The prevalence rates of hypercholesterolemia, hypertriglyceridemia, high BP and ratios of total cholesterol to HDL-cholesterol between the obese and nonobese patients were similar irrespective of sex (p > 0.05). Multiple linear regression analysis confirmed that ethnicity, sex, age and duration of diabetes had significant impact on the cardiovascular risk in this population. CONCLUSION: Both obese and nonobese diabetic patients had poor glycemic control and their risk of CVD was not independent of age, sex, ethnicity and duration of diabetes. We suggest strict metabolic control and improved diabetes health education at the primary care level.  相似文献   

17.
Poor health is widely recognized as a consequence of social disadvantage, but health problems may also help transmit social disadvantage over time and generations. Experimentally assigned health exposures, namely those tested in randomized controlled trials, may provide opportunities to estimate the causal effects of health on socioeconomic status (SES). We revisit data from the Diabetes Control and Complications Trial, a randomized controlled trial of glucose control therapy in Type 1 diabetic patients, and use treatment assignment as an instrument for health status to test the causal effect of treatment-related health improvement on subsequent SES measured during the trial's follow-up study, the Epidemiology of Diabetes Interventions and Complications study. We used the Two-Factor Hollingshead Index of Social Position, which comprises education and occupation, to measure SES. Glycated hemoglobin (HbA1c) served as a proxy for health status. Ordinary least squares (OLS) regression models showed that lower HbA1c at the trial's end was associated with higher SES at both the start of the follow-up and 17 years later. However, instrumental variable analyses showed no causal effect of HbA1c on SES, suggesting that OLS estimates are biased by endogeneity. Sensitivity analyses showed robustness to several alternate specifications. While the HbA1c advantage conferred by random assignment to treatment within the trial did not produce higher Hollingshead Index scores, we note that occupation and education categories may be harder to affect than are outcomes such as income. This analysis offers evidence that clinical trial data may be a rich and unrecognized resource for estimating health effects on SES.  相似文献   

18.
The present study investigated the effect of long-term heat acclimation and experimental diabetes on serum activity of transaminases (AST, ALT), ALP, LDH and elastase complex, as well as blood glucose and HbA1c level in Wistar rats. The heat acclimation model was established with the artificial heat chamber (35±1 °C and 30-40% humidity) for a period of 28 days, while the control groups were held on 20±2 °C. Experimental diabetes was induced by single streptozotocine (STZ) injection (55 mg/kg bodyweight) The changes caused by insulin treatment (2 IU/100 g body weight, 14 days, twice daily) in both thermal groups were also investigated.STZ-diabetes leads to significant increase in blood glucose and HbA1c level, AST, ALT and ALP activities in both thermal groups (normothermic and heat acclimated), decrease in LDH activity in normothermic animals and increase in heat-acclimated ones. Treatment with insulin restores the blood glucose, HbA1c and enzymes activities regardless of the previous thermal exposure.Prolonged acclimation of control animals to elevated ambient temperature resulted in significant decrease in blood glucose level, AST, ALT, ALP and LDH activities and non-significant changes in HbA1c. Compared to diabetic rats from room temperature, heat-acclimated diabetic ones have significantly higher blood glucose, AST, ALP and LDH activity, lower HbA1c concentration and no significant changes in ALT. Most of the changes observed in heat-acclimated insulin-treated diabetic rats did not significantly differ compared to those from room temperature.The overall two-way ANOVA analyses showed that diabetic state causes significant changes in the blood glucose, HbA1c, AST, ALT and ALP activity, while heat acclimation causes significant changes only in HbA1c level and AST activity. Both of the factors (diabetic state and heat acclimation) have significant common effects on AST, ALP and LDH activity.  相似文献   

19.
Involvement of complications is considered to be one of the major factors in the prognosis of diabetes mellitus (DM). Recent studies indicate that most diabetic complications such as nephropathy and hypertension are vascular-originated. Renin-angiotensin involvement, especially changes in ACE activity level, is considered to be a key factor since ACE converts angiotensin I to angiotensin II which is a potent vasoconstrictor and plays a vital role in the regulation of blood pressure. Our present study focused on ACE activity levels along with blood glucose and HbA(1c) levels in diabetic patients with (n=18) or without (n=25) nephropathy as compared to control subjects (n=25). Blood glucose levels were significantly higher in both diabetic groups compared to controls (p<0.001). On the other hand, compared to controls, blood HbA(1c) levels were slightly higher in DM patients without complications whereas they were significantly increased in nephropatic DM patients (p<0.001). There was a very strong increase (p<0.001) at the level of ACE activity in both of the diabetic groups (with nephropathy: 47.11+/-3.70 U l(-1); without complications: 43.72+/-2.93 U l(-1); controls: 25.15+/-2.30 U l(-1)). ACE activity levels were also significantly higher in diabetic patients with nephropathy than in type II DM patients without complication (p<0.01). Our results demonstrate that ACE activity levels are increased in diabetic patients. Additional significant increase in ACE activity levels in diabetic patients with complications such as nephropathy supports the hypothesis that ACE activity has an essential role in the development of complications in diabetes.  相似文献   

20.
糖尿病健康教育在糖尿病治疗中的效果分析   总被引:1,自引:1,他引:0  
目的:为了提高糖尿病患者的糖尿病知识水平,从而增加患者对治疗的依从性。方法:对住院患者进行糖尿病教育,用同一份试卷分别于教育前后做出评估,并比较患者教育6个月前后的空腹血糖(FPG)、餐后2h血糖(2hPBs)、糖化血红蛋白(HbA1c)、胆固醇(TC)和甘油三酯(TG),并记录体重指数(BMI)、腰臀比。结果:(1)教育6个月后,患者参加教育后的自觉运动、控制饮食和糖尿病知识水平较教育前明显提高,差异有显著性(P<0.05)。(2)教育6个月后,体重指数(BMI)、腰臀比,空腹血糖(FPG)、餐后2h血糖(2hPBs)、糖化血红蛋白(HbA1c)、胆固醇(TC)和甘油三酯(TG)降低,差异有显著性(P<0.05)。结论:糖尿病教育对于预防和治疗糖尿病有非常重要的意义,患者参加教育后对治疗的依从性较教育前明显提高。  相似文献   

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