Diabetic remission in a cat treated with an implantable pump to deliver insulin.

Objective To investigate blood glucose profiles of patients with type 2 diabetes mellitus during short-term intensive insulin therapy and to analyze the relationship between blood glucose levels and glycemic remission. Methods A total of 266 patients with newly diagnosed type 2 diabetes who accepted short-term insulin pump therapy in the Department of Endocrinology in the First Affiliated Hospital of Sun Yat-sen University during 2001 to 2014 were included in this study. All patients accepted 2- 3 weeks of short-term insulin pump therapy after diagnosis. They were followed-up for 1 year after the cessation of the pump. Subjects were divided into instant remission group (187 patients, 127 men and 60 women) and instant non-remission group(79 patients, 47 men and 32 women) according to whether they could be relieved immediately after the treatment. According to the follow-up one year, subjects were divided into long-term remission group (127 patients, 89 men and 38 women) and non-remission group(139 patients, 85 men and 54 women). The capillary blood glucose profiles were recorded, relationship between blood glucose levels, standard deviation of blood glucose level and glycemic remission was analyzed. Difference between two groups was analyzed by t test. Logistics regression analysis and Cox regression analysis were used to analyze the influencing factors of glycemic remission. Results Mean blood glucose (MBG) after achieving glycemic targets was (6.2±0.6) mmol/L in all subjects. Instant glycemic remission rate after the cessation of the pump was 70.3% (187/266), one year remission rate was 47.7% (127/266). Compared with instant non-remission group, MBG was lower in instant remission group [(6.1±0.6)vs (6.6±0.7) mmol/L, t= 6.026, P<0.05]. Multivariate logistics regression analysis showed that immediate glycemic remission rate was reduced by 65% (OR=0.350, 95% CI:0.192- 0.638, P<0.05) for every 1 mmol/L increase in MBG. Compared with non-remission group, MBG was lower in one-year remission group [(6.0 ± 0.5)vs(6.5 ± 0.7) mmol/L, t=6.147, P<0.05]. Multivariate regression analysis showed that MBG [OR=0.388, 95% CI(0.224- 0.670), P<0.05] was a predictor of 1-year remission. The risk of recurrence of hyperglycemia in one year increased by 0.814 fold [HR=1.814, 95%CI(1.333-2.469), P<0.05] for every 1 mmol/L increase in MBG. If mean 2-hour postprandial blood glucose and mean fasting blood glucose were substituted for MBG in the analysis, mean 2-hour postprandial blood glucose [OR=0.530, 95%CI(0.368-0.753), P<0.05], but not mean fasting blood glucose was an independent predictor of one year glycemic remission. Conclusions Stricter glycemic control during maintenance phase of short-term intensive insulin therapy in newly diagnosed type 2 diabetes mellitus patients is associated with higher remission rate after treatment. Key words: Diabetes mellitus, type 2; Blood glucose; Insulin pump; Glycemic remission

Objective To compare the efficacy of insulin aspart and human soluble insulin on postprandial glucose control and blood glucose excursion in type 2 diabetic patients managed with insulin pump therapy. Methods All of 345 hospitalized type 2 diabetic patients were randomized divided into two groups. One group underwent insulin pump therapy with insulin aspart (aspart group, 173 cases),another group with human soluble insulin (humulin R group, 172 cases). Capillary glucose concentrations were measured at 9 time points,including preprandial,2 hours postprandial,bedtime (22:00),midnight(0:00) and 3:00 every day during the treatment. The change of blood glucose at each time point and the variation of postprandial blood glucose excursion was compared between the two groups. The frequency of hypoglycemia was also evaluated. Results After treatment, fasting blood glucose and post breakfast and post dinner blood glucose levels were decreased more significantly in the aspart group than those in the humulin R group. And a significantly smaller postprandial blood glucose excursion was shown in the aspart group compared with that in the humulin R group (P< 0.05). The time to achieve good glycemic control in the aspart group was (4.40 ± 2.16) d, significantly shorter than that in the humulin R group[(5.68 ± 2.29) d](P< 0.05). The incidence of hypoglycemia was significantly lower in the aspart group (P <0.05). Conclusion Insulin aspart results in better control of blood glucose and less glycemic variability compare with human soluble insulin in type 2 diabetic patients during delivery by continuous subcutaneous insulin infusion. Key words: Diabetes mellitus,type 2; Insulin infusion system; Drug therapy; Insulin aspart

To compare the efficacy of insulin aspart and human soluble insulin used in insulin pump therapy on the islets beta cell function in newly diagnosed type 2 diabetic patients. Fifty-nine hospitalized newly diagnosed type 2 diabetic patients, 35 males and 24 females, aged 51 +/- 12, were and randomly divided into 2 groups to undergo insulin pump therapy with insulin aspart (aspart group, n = 30) or human soluble insulin (human insulin group, n = 29) for 2 weeks. The targets of glycemic control included fasting blood glucose (FBG) < 6.1 mmol/L and 2 h postprandial blood glucose (PBG) < 8.0 mmol/L. The changes of blood glucose, and the time and the doses of insulin needed for good glycemic control were compared between the two groups. The frequency of hypoglycemia and pump-related side effects were recorded. On the 2nd day of insulin pump therapy, FBG and 3 meals PBG levels were significantly reduced in both groups while the post-breakfast and post-dinner blood glucose levels were far more decreased in the aspart group than in the human insulin group (8.4 mmol/L +/- 2.8 mmol/L vs 11.3 mmol/L +/- 3.8 mmol/L, and 9.0 mmol/L +/- 2.4 mmol/L vs 10.7 mmol/L +/- 2.8 mmol/L, both P < 0.05). The FBG and 3 meals PBG were significantly lowered in the aspart group than in the human insulin group on the 7th day and after the stopping of insulin pump therapy. The time of good glycemic control of the aspart group was 2.0 d, significantly shorter than that of the human insulin group (6.0 d, P < 0.01). The mean dose of insulin used during insulin pump therapy in the aspart group was 0.6 U/kg, significantly less than that in the human insulin group (0.8 U/kg, P = 0.002). There was no significant difference in the AIR, mean area under the curve (AUC) of insulin and C peptide during IVGTT, HOMA-beta and proinsulin between the two groups before and after insulin pump therapy. No pump-related side effects were observed in both groups. In newly diagnosed type 2 diabetic patients with short term insulin pump therapy, the use of insulin aspart was more effective and faster with less doses of insulin in acquiring good glucose control compared with humulin R.

Objective To study the blood glucose change regularity within 48 hours of elderly patients with diabetes after gastrointestinal surgery and summarize effective blood glucose monitoring and nursing intervention. Methods Using blood glucose meters, blood glucose changes and insulin dosage of a total of 48 elderly patients with diabetes after gastrointestinal surgery have been measured and recorded right after operation and 1h, 2h, 4 h,8 h, 12 h,24 h and 48 h time points after operation. All data of patients were statistically analyzed. Results The blood sugar level of elderly patients with diabetes after gastrointestinal surgery within 24 hours after operation was significantly higher than that of before operation ( P > 0. 05). Especially blood sugar level of patients was higher in right after returning to SICU and 2 h after operation, and insulin dosage was the biggest at 4 h after operation. Conclusions Monitoring blood glucose, using of insulin and postoperative nursing during peri-operative period can keep blood glucose stable, prevent postoperative complications and help patients recover earlier. Key words: Elderly; Gastrointestinal surgery; Diabetes; Blood glucose; Nursing

Objective To explore the effects of companion support on insulin pump therapy in adolescents with type 1 diabetes. Methods A total of 60 patients were randomly divided into experimental group and control group, 30 cases respectively. Patients in control group were given routine education, while patients in experimental group received additional intervention of companion support. Changes of blood glucose, the occurrence of negative events during the use of insulin pump and standardized usage of insulin pump were compared between two groups. Blood glucose before sleep in one random day was recorded and the fluctuation of blood glucose was compared between two groups. Results After six months, fasting and postprandial blood glucose, glycated hemoglobin and the occurrence of negative events during the use of insulin pump in experimental group were significantly lower than those in control group (P<0.05) . The waveform stability at one random day before sleep of experimental group was better than that of control group. Conclusions Companion support plays curial roles in controlling blood glucose, improves the standardization of insulin pump operation and effectively reduces the negative events in adolescents with type 1 diabetes undergoing temporary insulin pump therapy. Key words: Diabetes, type 1; Insulin infusion system; Adolescents; Companion support

To assess the perceptions regarding basal bolus insulin injections and the changes in blood glucose levels and glycosylated hemoglobin (HbA1c) before and after 3 months of such treatment in diabetic patients. Quasi-experimental study. Department of Endocrinology, Liaquat National Hospital, Karachi, from December 2014 to March 2015. A total of 222 diabetic patients started on basal bolus insulin injection were enrolled and asked to answer 17 questions. Those with complications of diabetes were excluded. Fasting blood glucose (FBS), random blood glucose (RBS) and HbA1c levels were checked initially, and after 3 months of getting basal bolus insulin. Paired t-test and chi-square test were used for determining p-value with significance at p < 0.05. Majority (n=217, 97.7%) of the patients were previously taking other insulins. Before starting this treatment, the mean FBS was 260.5 ±52.2 mg/dl, RBS was 385.5 ±47.61 mg/dl and HbA1c was 12.76 ±1.92%. After 3 months of treatment, FBS improved to 117.9 ±14.2 mg/dl, RBS was 156.7 ±17.09 mg/dl and HbA1c was 7.72 ±4.41% (p < 0.001). Two hundred and sixteen (97.3%) patients believed that basal bolus insulin was started as their diabetes worsened; 157 (70.70%) thought that their blood glucose control would improve with the use of this form of insulin. One hundred and ninety four (87.4%) had fear of needle injections. Perceptions regarding hypoglycemia with this form of insulin were observed in 157 (70.7%). One hundred and twenty seven (84.1%) of the females and 51 (71.8%) of the males thought that the basal bolus insulin regimen was too expensive (p=0.032). There were many misconceptions in patients who were started on basal bolus insulin. Marked improvement in blood glucose levels and HbA1c were observed after the use of this regimen.

Objective To investigate the influence of streptozocin (STZ)'s dose on the inductive effect of diabetes in C57BL/6J mice, and investigate the dose-effect relationship and the optimal dose range. Methods 145 C57BL/6J mice were randomly divided into 9 diabetic groups (group A to group 1, n = 15 in each group) and I control group (n = I0) to receive intraperitoneal injection of STZ with the dosages of 30, 60, 80, 100, 120, 150, 180, 210, 240 mg/kg and same amount of buffer solution,respectively. Changes of blood glucose, body weight, survival rate at 45 day and serum insulin level were monitored, and the relationship with STZ doses was analyzed. Pancreas and kidneys of the mice were removed for morphological examination, and immunohistochemistry was used for determination of insulin in pancreas and CD in kidneys. Results Compared with control group, blood glucose in group C ～G increased significantly; body weigh, insulin level decreased significantly (P < 0.05), and the STZ dose was positively correlated with mean blood glucose (r = -0.984, P < 0.05) and was negatively correlated with mean serum insulin levels (r = 0.994, P <0.05). The diabetes modeling rates in group C ～ G (86.7% ～ 100%) were higher than those of group A and B (0 and 40%, P<0.05). At the 45th day, the survival rates of group C ～G (46.7% ～ 73.3%) were higher than those of group H and 1 (13.3% and 0, P <0.05). There was no obvious injury of pancreas and kidneys in group B, whereas, in group C and G, pancreatic island atrophy and decreased insulin secretion were observed; deposits of extracellular matrix and macrophage increased in the mesangium were also present. Conclusions 80 ～ 180 mg/kg of STZ dose was ideal for establishing diabetes model in C57BL/6J mice. Within this range, the modeling rate and survival rate was higher, and target organs injury was typical. The STZ dose was positively correlated with blood glucose and negatively correlated with serum insulin levels. Key words: Diabetes meilitus, experimental; Streptozocin; Dose-response relationship, drug; C57 BL/6J mice

Objective To investigate the influence of blood glucose fluctuation on ser202 phosphorylation sites of tau protein(p-Tau) in hippocampus of diabetic rats; to explore the possible mechanism of blood glucose fluctuation impacting on tau protein hyperphosphorylation. Methods Healthy male Sprague Dawley rats were randomly divided into normal control group (NC group) and diabetes group. After diabetic rats model was established, all the diabetic rats were randomly divided into diabetic continuous hyperglycemia group (DC group) and diabetic blood glucose fluctuant group (DF group). Rats in DF group were given glucose solution intraperitoneal injection twice at regular time everyday. 30 minutes after each intraperitoneal injection, insulin subcutaneously injections were given. Rats in the NC group and DC groups were given the same volume of saline subcutaneous injection. Specimens were collected in 8 weeks, the levels of p-Tau and total tau in rat hippocampus were detected by immunohistochemical staining and Western blotting. The immunoreactive positive products were analyzed by image analysis system. Glycogen synthase kinase-3β(GSK-3β) mRNA was detected by realtime PCR. Results (1) Blood glucose fluctuation of rats in DC and DF group were greater than NC group. And the mean blood glucose, standard deviation of mean blood glucose (SDBG), and large amplitude of glycemic excursion (LAGE) levels were increased significantly compared to NC group, the difference has statistical significance (all P 0.05). (2) Compared with NC group, the hippocampal p-Tau level of DC group and DF group were increased (P<0.05); Compared with DC group, the hippocampal p-Tau expression of DF group was increased (P<0.05). Compared with DC group, a higher hippocampal GSK-3β mRNA level was found in DF group (P<0.05). Conclusions On the basis of diabetes animal model, giving glucose solution intraperitoneal injection and insulin subcutaneously injection 30 minutes later twice at regular time everyday could establish experimental model of diabetic blood glucose fluctuation. Blood glucose fluctuation may aggravate the diabetic rats hippocampal p-Tau. The possible mechanism seems to be an up regulation of the GSK-3β. (Chin J Endocrinol Metab, 2017, 33: 776-780) Key words: Blood glucose fluctuation; Diabetes mellitus; Hippocampus; Tau protein phosphorylation

Objective To compare the curative effect of insulin glargine combined with insulin lispro and combined with insulin aspart on type 2 diabetes mellitus (T2DM), and study the corresponding influence on blood glucose fluctuation and blood glucose excursion. Methods A total of 70 patients with T2DM who were hospitalized in the People’s Hospital of Huozhou from July 2015 to July 2017 were randomly divided into observation group (n=35) and control group (n=35) according to their order of admission. Patients in observation group were treated with insulin glargine combined with insulin lispro, and patients in control group were treated with insulin glargine combined with insulin aspart. Levels of fast blood glucose (FBG), 2-hour postprandial blood glucose (2 h PG), glycosylated hemoglobin (HbA1c), fasting insulin (Fins) secretion, islet β-cell function index (HOMA-β), insulin resistance index (HOMA-IR) and total treatment response rate were compared between the two groups 12 weeks after treatment. The average blood glucose level, amplitude of blood glucose excursion, blood glucose excursion coefficient, time of reaching target of blood glucose, daily amount of insulin for reaching target of blood glucose and the incidence of hypoglycemia of the two groups were calculated. Results The curative effect was significantly better in observation group than control group 12 weeks after treatment (P 0.05). The levels of Fins and HOMA-β were significantly increased, while levels of FBG, 2 h PG, HbA1c and HOMA-IR were significantly decreased in both groups after treatment (P<0.05), and changes in above indicators were more obvious in observation group (P<0.05). Conclusions Compared with insulin glargine combined with insulin aspart, insulin glargine combined with insulin lispro can control blood glucose fluctuation, reduce blood sugar excursion and the incidence of hypoglycemia, and control blood glucose more effectively. Key words: Insulin glargine; Insulin lispro; Insulin aspart; Type 2 diabete mellitus; Blood glucose fluctuation

Objective To investigate the optimal insulin regimens according to the pyramidal cells'change in the parietal lobe of brain on rabbit diabetes mellitus model. Methods Forty male rabbit were random divided into 5 group, including control group (group N) , model group (group D), group received multiple subcutaneous injection of insulin (group A) , group received isophane protamine biosyn-thetic human injection (pre-mixed 50R) (group B) , group received isophane protamine biosynthetic human injection (pre-mixed 30R) (group C). Homemade rabbit diabetes mellitus models induced by alloxan were divided into 4 groups. After 30 day, therapy group treatedwith insulin inject were put to death. Other group animal were sacrificed at the same time. The insulin dose and period at the targeted blood glucose level among 3 insulin groups, blood glucose, brain weight, the rate of apoptosis of the pyramidal cells and pathohistology change in the parietal lobe of the brain between untreated group and control groups were compared. Results Insulin dose needed by group B is less than group A and C. The largest amount of insulin was used in group C to get to the targeted blood glucose levels. There was significant difference among 3 groups ( P B > C. Conclusions Subcutaneous injection of pre-mixed 30R may be the optimal insulin treatment protocol. This regimen supplies more basal insulin and less bolus insulin. The blood glucose drops steadily, and the nerval tissue can be protected. Intensive insulin therapy by multiple subcutaneous injection (triple daily injections with short-acting insulin and once daily injection of intermediate-acting insulin or long-acting insulin) was not preferably recommended. Key words: Insulin/AD; Flavone /PD; Diabetes mellitus; experimental /DT/PA; Pyramidal cells /ME

Objective To assess the clinical safety and efficacy of multi-parameter bolus advisor in insulin pump therapy and explore clinical application value of the multi-parameter bolus advisor. Methods A total of 158 diabetic patients from endocrine departments of 10 tertiary comprehensive hospitals were randomly (2∶1∶1) assigned to three groups from May 2012 to July 2013, including therapy with insulin in the form of continuous subcutaneous insulin infusion (CSII) with multi-parameter bolus advisor (BA-CSII group), common CSII system (CO-CSII group), and multiple daily injection (MDI group). The insulin dosage, blood glucose controlling, and incidence of hyperglycemia or hypoglycemia episodes during the hospitalization were compared and analyzed by chi-square test, Mann-Whitney U test and Kruskal-Wallis H test among the three groups. Results After treatment, the ratio of postprandial blood glucose reaching the individualized target in BA-CSII group was significantly higher than CO-CSII group (78.1% vs 52.3%, χ2=7.955, P 0.05). Moreover, during the hospitalization, the average daily insulin dosage of BA-CSII group was lower than that in MDI group ((44.4±17.0)vs (55.7±27.3) U, P>0.05), and that of CO-CSII group ((39.3±11.6)vs (55.7±27.3) U, Z=-2.690, P 0.05). Conclusions The application of multi-parameter bolus advisor can improve postprandial glucose control in intensively treated diabetics, with less hypoglycemia risk and lower insulin dosage. Accordingly, automated bolus advisor was proven to be a safe and effective feature for insulin-pump system. Key words: Multi-parameter bolus advisor; Insulin intensive therapy; Continuous subcutaneous insulin infusion

Objective To investigate the effect of different hypoglycemic methods on tibial osteotomy (HTO) in patients with diabetes mellitus, and to seek a more scientific and reasonable clinical intervention model. Methods From February 2016 to January 2017, sixty patients with knee osteoarthritis and diabetes mellitus were randomly divided into the control group and the observation group, with 30 cases in each group.Patients in the control group were treated with Acarbose and Aspartic Insulin 30 injection method for blood glucose intervention.Patients in the observation group were treated with vildagliptin and Aspartic Insulin 30 injection.The changes of fasting blood glucose (FPG), postprandial 2 h blood glucose (2 hPG), glycosylated hemoglobin (HbAlc), body mass index (BMI) and other indicators of the two groups were measured before treatment, before surgery and 6 months after surgery, and the adverse reactions of the two groups of patients were compared. Results Repeated measures analysis of variance showed that there were statistically significant differences in FPG and 2 hPG of the two groups collected before treatment, before surgery and 6 months after surgery (F=85.40, 617.06; P<0.05). Independent sample t test showed that HbAlc in the control and the observation group ( (7.9±0.9)%, (7.5±0.8)%) were significantly lower than those before treatment ( (9.8±1.5)%, (9.5±1.2) %) (t=5.95, 7.60, P<0.05), at 6 months after surgery, BMI ( (25.83±1.78) kg/m2) in the observation group was significantly lower than that in the control group ( (27.35±2.41) kg/m2) (t=2.78, P<0.05). The number of adverse reactions in the observation group was 2 cases (6.67%), significantly lower than that of the control group of 13 cases (43.33%), the difference between the two groups was statistically significant (χ2=10.756, P<0.05). Conclusion Vildagliptin combined with Aspartic Insulin 30 injection can not only effectively control the perioperative blood glucose levels in patients with HTO, but also can help the patients to control the body weight and reduce the incidence of adverse reactions.This method has a positive effect on the recovery of HTO. Key words: Diabetes Mellitus; Vildagliptin; Osteoarthritis; High Tibial Osteotomy

Objective To investigate the application value of laparoscopic Roux-en-Y gastric bypass (LRYGB) in treating nonobese type 2 diabetes mellitus, and analyze the clinical indexes which influence operative effect. Methods Clinical data of 32 patients with nonobese type 2 diabetes mellitus undergoing LRYGB in the Department of Gastrointestinal Surgery in the People’s Hospital of Lishui between June 2011 and June 2014 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were divided into complete remission group, partial remission group and invalid group according to postoperaive hypoglycemic effect. Among the 12 patients of complete remission group, 6 were males and 6 were females with an average age of (50±10) years old. Among the 19 patients of partial remission group, 9 were males and 10 were females with an average age of (51±7) years old. One male patient was in invalid group with the age of 64 years old. Waist circumference, weight, body mass index (BMI), fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPG), glycosylated hemoglobin A1c, C-peptide, insulin, triglyceride, total cholesterol, homeostatic model assessment of insulin resistance (HOMA-IR) and homeostatic model assessment of β-cell function (HOMA-β) of all the patients were recorded before and 3, 6 and 12 months after surgery. Clinical indexes before and after surgery, and between complete remission group and partial complete remission group were compared using t test. Results At 12 months after surgery, 12 patients got complete remission and 19 patients got partial remission of type 2 diabetes, and the total effective rate was 96.9%. The duration of type 2 diabetes and waist circumference in the complete remission group patients before surgery was (5±3) years and (87±7) cm respectively, which were significantly shorter than (8±4) years and (92±8) cm of the partial remission group (t=2.54, 2.23, P<0.05); FPG and 2hPG of the complete remission group patients before surgery were (7.0±1.6) mmol/L and (11.9±3.8) mmol/L respectively, which were significantly lower than (11.4±3.3) mmol/L and (19.0±5.7) mmol/L of the partial remission group (t=4.96, 3.82, P<0.05); 2-hour postprandial C-peptide (2hCp), 2-hour postprandial insulin (2hIns) and HOMA-β of the complete remission group patients before surgery were (3.0±1.0) ug/L, (59±42) mU/L and 66±22, which were significantly higher than (2.4±0.8) ug/L, (26±12) mU/L and 35±20 of the partial remission group(t=2.19, 3.27, 4.10, P<0.05); HOMA-IR of the complete remission group patients before surgery was 3.6±2.3, which was significantly lower than 5.8±2.2 of the partial remission group (t=2.70, P<0.05). Conclusions LRYGB has a good curative effect on nonobese type 2 diabetes; the patients with shorter duration of disease, smaller waist circumferences, lower FPG and 2hPG, higher 2hCp and 2hIns, lower HOMA-IR and higher HOMA-β usually can achieve better curative effects, and these 8 indexes may become the predictors of curative effect of LRYGB on nonobese type 2 diabetes. Key words: Laparoscopic Roux-en-Y gastric bypass; Diabetes mellitus, type 2; Treatment outcome

Objective To compare two different dumping cooking methods (boiling vs. frying) in their effect on postprandial glucose level in diabetic patients using continuous glucose monitoring (CGM). Methods 10 type 2 diabetes mellitus (T2DM) in-patients in the Department of Endocrinology of Peking Union Medical College Hospital between February and May 2011 were enrolled, whose fasting and preprandial glucose levels were controlled with a insulin pump. On day 2 and day 4 in the study period, the patients were given fried dumplings and boiled dumplings for lunch respectively, with the same nutrient contents. The starch digestibility of these two kinds of dumplings were compared using in vitro resistant starch digestion, measuring the concentrations of rapidly digestible starch, slowly digestible starch, and resistant starch. CGM was used to record blood glucose changes, in order to evaluate glycemic effect of these two dumpling cooking methods on postprandial glucose levels at 9 time points (0, 15, 30, 60, 90, 120, 150, 180, and 240 minutes), peak blood glucose, and area under the curve (AUC) in 4 time periods (0-60, 63-120, 123-180, and 183-240 minutes). Results The percentage of rapidly digestible starch was remarkably lower in fried dumplings than in boiled dumplings (30.8% vs. 77.0%), but the content of slowly digestible starch in fried dumplings was higher than that in boiled ones (63.7% vs. 20.7%), and the content of resistant starch in both dumplings were similarly low (1.9% and 2.3%). The average time to the peak glucose value was shorter in fried dumplings compared with boiled dumplings [(93±53) minutes vs. (156±61) minutes, P=0.02], but the average glucose levels at all the 9 time points and the AUC in all the 4 time periods were not significantly different (all P>0.05). Conclusions Compared with fried dumplings, boiled dumplings show faster starch digestion, but long time to the peak postprandial glucose level. Fried dumplings may raise the glucose level faster than boiled dumplings do in T2DM patients. Key words: Fried; Boiled; Postprandial blood glucose; Continuous glucose monitor

To explore the insulin requirement profiles and analyze the related factors of type 2 diabetics on insulin pump therapy. A total of 296 patients were admitted to hospital for 1-2 weeks of insulin pump therapy and received a diet of 25-30 kcal/kg ideal body weight per day. Insulin infusion was adjusted to achieve normoglycemia. It was defined as fasting capillary blood glucose of no more than 7.0 mmol/L and capillary blood glucose at 2 hours after each of three meals of no more than 10.0 mmol/L. After goal-reaching for 3 days, the insulin requirement profiles and related factors were analyzed. The average time of achieving normoglycemia was (5.1 ± 2.9) days. The total daily insulin dose per kilogram was (0.80 ± 0.27) U/kg and the ratio of total basal insulin dose to total bolus insulin dose 40%: 60%. Patients with central obesity needed a higher ratio of total basal insulin dose to total daily insulin dose (P < 0.05). Associations existed between the ratio of total basal insulin dose to total daily insulin dose and disease duration, waist circumference and ratio of 2 hour-postprandial C-peptide to fasting C-peptide (r = 0.169, 0.143, -0.107, all P < 0.05). Multivariate linear regression analyses showed that waist circumference, disease duration and ratio of 2 hour-postprandial C-peptide to fasting C-peptide were independently related with the ratio of total basal insulin dose to total daily insulin dose. Also waist circumference, fasting plasma glucose and hemoglobin A1c levels were independently associated with total daily insulin dose per kilogram. The ratio of total basal insulin dose to total bolus insulin dose is 40%: 60% in Chinese type 2 diabetics with insulin pump therapy. And it is associated with central obesity level and β-cell function. Parameters indicating glycemic control and central obesity should be taken into consideration for total insulin requirements.