2-hour Postprandial Blood Glucose Research Articles

Influence of continuous 4C nursing on quality of life and self-care ability of patients with diabetes retinopathy: An observational study.

This study aims to investigate the impact of continuous 4C nursing on patients with diabetes retinopathy (DR) and its influence on self-care ability. A total of 100 DR patients admitted to our hospital from October 2020 to October 2022 were randomly divided into a control group and an observation group, with 50 cases in each group. The control group received routine care, while the observation group received continuous 4C care. The nursing effects of both groups were compared. After nursing, the observation group showed a lower self-rating anxiety scale score and a higher self-care ability scale score compared to the control group (P < .05). The SQQL-VI scores for all social activities were also higher in the observation group (P < .05). Additionally, the observation group had lower levels of fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin than the control group (P < .05). Moreover, the observation group had higher visual acuity and lower intraocular pressure than the control group (P < .05). The visual impairment rate was lower and the overall compliance rate was higher in the observation group compared to the control group (P < .05). After nursing, both groups showed improvements in symptoms, visual function, physical function, psychological and social activity scores, visual acuity, and patient satisfaction scores. The observation group showed greater improvements compared to the control group (P < .05). The application of continuous 4C nursing in DR patients has shown positive effects, including improved patient compliance and satisfaction, enhanced patient quality of life and visual acuity. These findings suggest that continuous 4C nursing should be widely promoted and applied in clinical practice.

Oral glucose tolerance test clearance in type 2 diabetes patients who underwent remission following intense lifestyle modification: A quasi-experimental study.

Achieving diabetes remission (HbA1c<48mmol/mol without the use of anti-diabetic medication for 3 months) might not assure restoration of a normal glycemic profile [fasting blood sugar level <5.6 mmol/L and Post-Prandial (PP) blood glucose <7.8mmol/L]. The study investigates the factors associated with OGTT clearance in patients under type 2 diabetes remission. Four hundred participants who achieved remission during a one-year online structured lifestyle modification program, which included a plant-based diet, physical activity, psychological support, and medical management (between January 2021 and June 2022), and appeared for the OGTT were included in the study. OGTT clearance was defined by fasting blood glucose < 5.6 mmol/L and 2-hour post-prandial blood glucose <7.8 mmol/L post-consumption of 75g glucose solution. Of the 400 participants, 207 (52%) cleared OGTT and 175 (44%) had impaired glucose tolerance (IGT). A shorter diabetes duration (<5 years) was significantly associated with OGTT clearance (p<0.05). Pre-intervention use of glucose-lowering drugs showed no association with OGTT clearance (p<0.1). Post-intervention, the OGTT-cleared group showed significantly higher weight loss (p<0.05) and a decrease in HbA1c compared to the IGT group (p<0.05). Improvement in Insulin resistance and β-cell function was also higher in the OGTT-cleared group compared to the IGT group (p<0.05). In conclusion, clearing the OGTT is a possibility for those achieving remission through lifestyle interventions. Higher weight loss, a shorter duration of diabetes, and improvement in insulin resistance were significantly associated with OGTT clearance in participants in remission. Future randomized controlled trials with longer follow-ups may help substantiate our findings.

Influence of blood glucose fluctuations on chemotherapy efficacy and safety in type 2 diabetes mellitus patients complicated with lung carcinoma.

Patients with type 2 diabetes mellitus (T2DM) have large fluctuations in blood glucose (BG), abnormal metabolic function and low immunity to varying degrees, which increases the risk of malignant tumor diseases and affects the efficacy of tumor chemotherapy. Controlling hyperglycemia may have important therapeutic implications for cancer patients. To clarify the influence of BG fluctuations on chemotherapy efficacy and safety in T2DM patients complicated with lung carcinoma (LC). The clinical data of 60 T2DM + LC patients who presented to the First Affiliated Hospital of Ningbo University between January 2019 and January 2021 were retrospectively analyzed. All patients underwent chemotherapy and were grouped as a control group (CG; normal BG fluctuation with a mean fluctuation < 3.9 mmol/L) and an observation group (OG; high BG fluctuation with a mean fluctuation ≥ 3.9 mmol/L) based on their BG fluctuations, with 30 cases each. BG-related indices, tumor markers, serum inflammatory cytokines and adverse reactions were comparatively analyzed. Pearson correlation analysis was performed to analyze the correlation between BG fluctuations and tumor markers. The fasting blood glucose and 2-hour postprandial blood glucose levels in the OG were notably elevated compared with those in the CG, together with markedly higher mean amplitude of glycemic excursions (MAGE), mean of daily differences, largest amplitude of glycemic excursions and standard deviation of blood glucose (P < 0.05). In addition, the OG exhibited evidently higher levels of carbohydrate antigen 19-9, carbohydrate antigen 125, carcinoembryonic antigen, neuron-specific enolase, cytokeratin 19, tumor necrosis factor-α, interleukin-6, and high-sensitivity C-reactive protein than the CG (P < 0.05). Pearson analysis revealed a positive association of MAGE with serum tumor markers. The incidence of adverse reactions was significantly higher in the OG than in the CG (P < 0.05). The greater the BG fluctuation in LC patients after chemotherapy, the more unfavorable the therapeutic effect of chemotherapy; the higher the level of tumor markers and inflammatory cytokines, the more adverse reactions the patient experiences.

Educational intervention based on the extended parallel process model improves adherence to diabetic diet and glycaemic control indices: a randomised, double-blind, controlled, factorial field trial.

Nutritional education is pivotal in the medical nutritional therapy of type 2 diabetes mellitus (T2DM). The extended parallel process model (EPPM) is a health education method for inducing desirable health behaviours. The present study aimed to investigate the effect of nutritional education based on the EPPM in T2DM patients on knowledge, attitude, practice, anthropometric indices, glycaemic factors, lipid profile and adherence to the diabetic diet. A randomised, double-blind, controlled, factorial field trial was designed for T2DM patients aged 30-59 years (n 88). Participants were randomly allocated into four groups to receive EPPM-based nutritional education through gain framed message (GFM), loss framed message (LFM), their combination (G\LFM) or usual diabetic education in the control group (CG). Participants were assessed before and after the study duration. After 3 months of intervention, eighty participants finished the study. The EPPM-based intervention increased participants' knowledge, behavioural intention, perceived sensitivity, severity, self-efficacy (P < 0·001 for all) and response efficacy (P = 0·029) in comparison with CG. GFM (P = 0·004) and G\FLM (P = 0·034) reduced carbohydrate intake and LFM (P = 0·034) and G\LFM (P = 0·047) decreased fat intake. Between-group analysis indicated interventions reduced weight (P = 0·046), BMI (P = 0·038), fasting blood sugar (P = 0·030), 2-hour postprandial blood glucose (P = 0·027) and TAG (P = 0·002) in comparison with the CG. Results were NS for protein intake, waist and hip circumference, waist:hip ratio, HbA1c, total cholesterol, LDL and HDL. Nutritional education based on EPPM could increase the knowledge and awareness of T2DM patients. Also, it could be beneficial for blood glucose amendment. Further investigations are recommended.

Effects of DPP4 Inhibitors as Neuroprotective Drug on Cognitive Impairment in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis and Systematic Review.

Type 2 diabetes mellitus is considered as one of the risk factors for cognitive impairment. DPP4 inhibitors are effective drugs for the treatment of type 2 diabetes mellitus. However, the relationship between DPP4 inhibitors and cognitive dysfunction remains unclear. Therefore, we used a meta-analysis to determine the association between DPP4 inhibitors and cognitive impairment in type 2 diabetes mellitus. We systematically searched PubMed, CNKI, and the Cochrane Library at the time of establishment, 2022, and then made inclusion criteria and screened strategies to identify studies with more precise correlations. We included 10 studies with 5,583 participants. The data showed that DPP4 inhibitors significantly reduced the incidence rate of cognitive impairment in type 2 diabetes mellitus (SMD: 0.99; 95% CI [0.59, 1.38]). Furthermore, there was a linear correlation found between cognitive impairment in type 2 diabetes mellitus and fasting blood glucose, 2-hour postprandial blood glucose, and glycosylated hemoglobin. DPP4 inhibitors decreased fasting blood glucose (FPG) (SMD: 0.52; 95% CI [-0.68, -0.37]), blood glucose (2hPPG) at 2 hours after the meal (SMD: 0.82; 95% CI, [-1.2, -0.43]), and HbA1c (SMD: 0.34; 95% CI [-0.48, -0.21]). All data were statistically significant (P < 0.0001). Furthermore, we conducted subgroup analyses of the following measures at various treatment durations and ages: cognitive scores, fasting blood glucose, glycosylated hemoglobin, and two-hour postprandial blood glucose. DPP4 inhibitors significantly improved type 2 diabetic mellitus individuals' cognitive impairment and reduced fasting blood glucose, 2-hour postprandial blood glucose, and glycosylated hemoglobin. Subgroup analysis showed that people aged 60 to 70 years had better treatment effects at 0-180 days. This trial is registered with CRD42023399473.

Evaluation of the Efficacy of Auricular Acupoint Pressure Patch Combined with Modified Huangqi Decoction in Treating Diabetic Nephropathy

Objective: To explore the efficacy of auricular acupoint pressure patch combined with modified Huangqi Decoction in treating diabetic nephropathy. Methods: 60 patients with diabetic nephropathy treated in our hospital from January 2021 to December 2022 were selected for this study. The patients were randomly divided into two groups using the random number table method, with 30 patients in each group. Among them, the control group was treated with conventional Western medicine, while the experimental group was treated with auricular acupoint pressure patches combined with modified Huangqi Decoction. The patients’ fasting blood glucose (FPG), 2-hour postprandial blood glucose (2hPG), glycated hemoglobin (HbA1c), urinary protein quantification, urea nitrogen (BUN), serum creatinine (SCr), and other indicators were detected and recorded before and after treatment. Results: Before treatment, there was no statistically significant difference in the FPG, the 2hPG, and the HbA1c between the two groups of patients (P &gt; 0.05); after treatment, the FPG, the 2hPG, and the HbA1c of the patients in the experimental group were significantly lower than those in the control group (P &lt; 0.05). Before treatment, there was no statistically significant difference in the urinary protein quantification, the BUN, and the SCr between the two groups of patients (P &gt; 0.05); after treatment, the urinary protein quantification, BUN, and SCr of the patients in the experimental group were significantly lower than those in the control group (P &lt; 0.05). The experimental group showed better improvement in symptoms such as fatigue, backache, and frequency of nocturia (P &lt; 0.05). Conclusion: Auricular acupoint pressure patch combined with modified Huangqi Decoction effectively treats diabetic nephropathy and it helps control blood sugar and renal function indicators and improve clinical symptoms, therefore improving the patients’ quality of life.

Effect of different nutrients on blood glucose, inflammatory response and oxidative stress in gestational diabetes mellitus: a network meta-analysis.

We searched PubMed, Web of Science, Embase, The Cochrane Library, China Biomedical Literature Database and other databases from inception to June 2023. The included studies were randomised controlled trials (RCT). The studies were screened by four authors, divided into two independent pairs. A total of eighteen studies were included, including 1362 patients, involving twelve intervention measures. The different nutrients had a significant effect on improving blood glucose, reducing inflammation levels and reducing oxidative stress compared with placebo (P < 0.05). Cumulative probability ranking showed that vitamin A + vitamin D + vitamin E ranked first in lowering fasting blood glucose (standardised mean difference (SMD) = 41.30, 95 % CI (2.07, 825.60)) and postprandial 2-h blood glucose (SMD = 15.19, 95 % CI (4.16, 55.53)). In terms of insulin resistance index, the first highest probability ranking is vitamin D (SMD = 5.12, 95 % CI (0.76, 34.54)). In terms of reducing the high-sensitivity C-reactive protein level, the first in probability ranking is VE (SMD = 2.58, 95 % CI (1.87,3.55)). The results of cumulative probability ranking showed that Mg + Zn + Ca + VD ranked first in reducing TNF-α (SMD = 1.90, 95% CI (0.40, 9.08)) and IL-6 (SMD = 1.83, 95 % CI (0.37, 9.12)). In terms of reducing malondialdehyde levels, the first ranked probability is VB1 (SMD = 4.99, 95 % CI (1.85, 13.46)). Cumulative probability ranking results showed that Ca + VD ranked first in reducing total antioxidant capacity (SMD = 0.66,95 % CI (0.38, 1.15)) and glutathione (SMD = 1.39, 95 % CI (0.43, 4.56)). In conclusion, nutritional interventions have significant effects on improving blood glucose, inflammatory levels and oxidative stress in patients with gestational diabetes. Due to the high uncertainty in the results and differences in the number and quality of studies included, the reliability of the conclusions still needs to be validated by conducting large-sample, high-quality RCT studies.

Based On Satiety Mechanism: The Effect of Dietary Therapy in Terms of Substitute Meal in Overweight and Diabetic Patients

Obesity is a widespread public health concern that poses a threat to global well-being. Effective dietary management stands out as a key component in the care of obesity and diabetes. It not only aids in regulating body fat and blood glucose levels but also demonstrates significant prowess in reducing fasting blood glucose and postprandial 2-hour blood glucose levels. Furthermore, it proves useful in assisting diabetic patients in achieving glycemic index targets and formulating tailored diet plans. However, not all patients possess the knowledge to establish a balanced diet. This is where meal substitutes step in, offering a convenient, pre-made solution. A well-balanced meal substitute can deliver ample satiety while ensuring essential nutrients, thus preventing overindulgence. Satiety, the sensation that increases fullness and reduces unnecessary food intake, plays a pivotal role in weight loss and overall health maintenance. It arises from the stomach's response to food ingestion, signaling to a person that they are comfortably full and no longer in need of further sustenance. Consequently, the exploration of meal substitutes as a novel form of diabetes intervention therapy has gained increasing attention in recent years.

PDX1 Methylation, NGN3 and Pax6 Expression Levels in Pregnant Women with Gestational Diabetes Mellitus and their association with neonatal blood sugars and birth weight.

To investigate the correlation of maternal PDX1 methylation, NGN3 and Pax6 expression levels with neonatal blood sugars and birth weight in pregnant women with GDM and non GDM. This was a prospective cohort study. Total 80 pregnant women who were examined and delivered in the Department of Obstetrics of Affiliated Hospital of Hebei University from January 2019 to June 2022 were recruited and divided into two groups according to the results of oral glucose tolerance test (OGTT): the control group and the observation group, with 40 cases in each group. PDXl methylation rate was measured by the methylation-specific PCR method, whereas gene expression levels of PDX1, NGN3 and Pax6 were measured by RT-PCR meanwhile, neonatal blood glucose and hemoglobin A1c (HbA1c) levels were also measured. In comparison with the control group, the observation group had higher levels of FBG, 2-hour postprandial blood glucose (2hPBG) and HbA1c (P<0.05). Neonatal birth weight and insulin levels in the observation group were significantly higher than those in the control group, while Apgar scores and blood glucose were lower than those in the control group(P<0.05). Moreover, the observation group had significantly lower gene expression levels of PDX1, NGN3 and Pax6, and a higher PDX1 methylation rate than the control group (P<0.05). Correlation analysis revealed a negative correlation between neonatal blood glucose levels and PDX1, NGN3 and Pax6 levels in the observation group, with statistical significance (P<0.05). Changes in maternal PDX1 methylation, NGN3 and Pax6 expression levels may lead to abnormal glucose metabolism in neonates, which has a close bearing on neonatal hypoglycemia and blood glucose levels caused by GDM.

Sertraline and Fluoxetine in Adult Patients with Comorbid Depression and Type II Diabetes Mellitus: A Randomized Controlled Trial

Background: Depressive disorders are more common in patients with diabetes mellitus (DM) compared to the general population. Objectives: Due to heterogeneous evidence on the impact of antidepressants on serum glucose profile, this study was conducted to examine the effects of sertraline and fluoxetine on serum glucose levels in patients with comorbid depression and diabetes. Methods: In this randomized controlled trial, 40 adult patients with DM and depression were randomly allocated into two groups (n = 20 per group). The first group received 50 - 200 mg/day of sertraline, and the second group received 20 - 60 mg/day of fluoxetine. The Beck Depression Inventory (BDI-II) was used to determine depression severity, and body mass index (BMI), blood pressure, serum lipid profile, fasting blood sugar (FBS), 2-hour post-prandial blood glucose, and HbA1c were measured at the baseline and 12 weeks after the intervention. Results: Body mass index (P = 0.40), systolic blood pressure (P = 0.41), FBS (P = 0.46), 2-hour post-prandial blood glucose (P = 0.53), HbA1c (P = 0.59), serum total cholesterol (P = 0.78), and LDL cholesterol (P = 0.62) insignificantly reduced in both groups after the intervention compared to the baseline; however, the reduction in serum triglyceride level was statistically significant (P = 0.04). Also, the depression severity score was reduced in both groups; however, the difference was not statistically significant (P = 0.27). Conclusions: In adult patients diagnosed with comorbid depression and type II diabetes mellitus, three months of treatment with sertraline or fluoxetine comparably mitigated depressive symptoms and reduced HbA1c, FBS, and 2-hour post-prandial blood glucose.

Evaluation of Combined Serum C-Peptide and Glycated Hemoglobin in the Clinical Diagnosis of Diabetes

This study investigates the application effectiveness of combined serum C-peptide and glycated hemoglobin testing in the clinical diagnosis of diabetes. The research involved 80 diabetic patients treated at our hospital between January 2022 and January 2023, meeting the inclusion criteria. Additionally, 80 individuals undergoing health examinations during the same period constituted the healthy control group. Blood glucose indicators were measured in both groups, and complications were recorded. Serum C-peptide and glycated hemoglobin were individually and jointly tested, with an analysis of sensitivity, specificity, and other diagnostic indicators for diabetes. General participant data in the patient and healthy control groups were comparable (P &gt; 0.05). In the patient group, C-peptide (C-PR), fasting blood glucose (FBG), and 2-hour postprandial blood glucose (2 h PBG) levels were higher than those in the control group, while glycated hemoglobin (HbA1c) levels were lower (P &lt; 0.05). Those in the patient group with low C-PR levels and HbA1c levels &gt;7.5% showed a higher incidence of complications (P &lt; 0.05). The combined test of serum C-peptide and glycated hemoglobin in the patient group demonstrated higher accuracy, sensitivity, and specificity compared to individual diagnostic tests (P &lt; 0.05). The combined test proves to be effective in the clinical diagnosis of diabetes, offering elevated accuracy, sensitivity, and specificity compared to singleindicator testing. This approach bears substantial clinical significance.

Total Astragalus saponins can reverse type 2 diabetes mellitus-related intestinal dysbiosis and hepatic insulin resistance in vivo.

Intestinal flora homeostasis in rats with type 2 diabetes mellitus (T2DM) was evaluated to explore the effects of total Astragalus saponins (TAS) on hepatic insulin resistance (IR). Six-week-old male Sprague-Dawley rats were fed high-fat and high-sugar diet for 4 weeks and intraperitoneally injected with streptozotocin to induce T2DM, and they were then randomly divided into control, model, metformin, and TAS groups. Stool, serum, colon, and liver samples were collected after 8 weeks of drug administration for relevant analyses. TAS reduced fasting blood glucose, 2-hour postprandial blood glucose, area under the curve of oral glucose tolerance test, glycated serum protein, homeostasis model assessment of insulin resistance, total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels in T2DM rats but increased insulin, C-peptide, and high-density lipoprotein cholesterol levels. Moreover, TAS improved the morphology and structure of liver and colon tissues and improved the composition of the intestinal microbiome and bacterial community structure at different taxonomic levels. In addition, TAS increased the protein expression of hepatic IRS-1, PI3K, PDK1, and p-AKT and decreased the protein expression of p-GSK-3β. Meanwhile, TAS increased the mRNA expression of liver PDK1, PI3K, and GS and decreased the mRNA expression of GSK-3β. TAS can ameliorate T2DM-related abnormal glucose and blood lipid metabolism, intestinal dysbiosis, and IR.

Combined efficacy of low-calorie diets and aerobic training on nutritional status of obese patients with early type 2 diabetes.

The purpose of this study was to evaluate the combined efficacy of low-calorie diets and aerobic training on the nutritional status of obese patients with early type 2 diabetes mellitus. 120 consecutive obese patients with early type 2 diabetes were admitted to our hospital between August 2021 and December 2022. The patients enrolled were equally and randomly allocated into the control group (60 cases, given conventional diabetes diet intervention) and the study group (60 cases, given a low-calorie diet intervention combined with aerobic training). The parameters, including the nutritional status, fasting insulin (FINS), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), blood lipid level, and quality of life, were compared between the two groups. Before treatment, there were no measurable differences in the levels of fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbAlc), albumin (ALB), prealbumin (PA), and hemoglobin (Hb) between the two groups (p>0.05), whereas two months after treatment, the FBG, 2hPG, and HbAIc levels were greatly lower, and the levels of ALB, PA, and Hb were significantly higher in the study group than those in the control group (p<0.05). Before treatment, no statistically significant differences were found in FINS and HOMA-IR values between the two groups (p>0.05). Two months after treatment, however, the study group showed lower FINS and HOMA-IR values as compared to the control group, with statistically significant differences (p<0.05). Before treatment, there was no statistically significant difference in the levels of triacylglycerol, total cholesterol, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) between the two groups (p>0.05), while the four levels in the study group were significantly lower than those in the control group two months after treatment (p<0.05). Similarly, there were no statistically significant differences in scores of physiological, psychological, social, and therapy-related problems between the two groups before treatment (p>0.05), whereas the abovementioned scores were evidently higher in the study group than control group two months after treatment (p<0.05). A low-calorie diet intervention combined with aerobic training exerted good effects in terms of greatly enhancing the nutritional status among obese patients with early type 2 diabetes mellitus, which was deemed appropriate for clinical promotion and implementation.

Correlation Between Abdominal Fat Distribution and Serum Uric Acid in Patients Recently Diagnosed with Type 2 Diabetes.

To investigated the link between the distribution of abdominal fat and the concentration of serum uric acid (SUA) in individuals recently diagnosed with type 2 diabetes. Studied 364 individuals had been diagnosed with type 2 diabetes within one month, and evaluated factors such as the distribution of fat in the abdomen, indicators related to glucose and lipid metabolism. The participants' SUA concentrations were divided into a normal control group (CG) and a hyperuricemia group (HG). The HG group had elevated abdominal subcutaneous fat area (SFA), visceral fat content (VFA), body mass index (BMI), fasting blood glucose (FBG), 2-hour postprandial blood glucose (PBG), glycosylated albumin (GA), serum creatinine (SCr), triacylglycerol (TG), and lower values in glomerular filtration rate (eGFR), high-density lipoprotein cholesterol (HDL-C) when compared to the CG group (P < 0.05). Among the obese individuals, the hyperuricemia subgroup exhibited higher measurements in waistline, hipline, VFA, SFA, BMI, PBG, SCr, TG, and lower HDL-C (P < 0.05) compared to the subgroup with normal uric acid levels. In the non-obese group, the hyperuricemia subgroup showed higher VFA, SCr, and FBG levels, and lower HDL-C (P < 0.05). There was a positive correlation between VFA and serum uric acid (SUA) levels (r = 0.329, P < 0.0001). Logistic regression analysis indicated a 24% increased risk of hyperuricemia with every 10cm2 increase in abdominal VFA. Generate the Receiver Operating Characteristic (ROC) curve analysis revealed that VFA was the most effective predictor of hyperuricemia and insulin resistance (P < 0.05). Newly diagnosed type 2 diabetes patients exhibit a strong correlation between abdominal visceral fat and SUA concentration, the former is identified as an autonomous risk factor for hyperuricemia and an effective indicator for assessing the presence of hyperuricemia and predicting insulin resistance.

UJI EFEKTIVITAS DAN KEAMANAN KOMBINASI METFORMIN-VILDAGLIPTIN PADA DIABETES MELITUS TIPE 2 DI RSPAL Dr. RAMELAN SURABAYA

Metformin is the first-line therapy for Diabetes Mellitus (DM), which has not been able to control blood glucose in type 2 DM. One of the Dipeptidyl Peptidase IV Inhibitor (DPP4-I) groups, namely vildagliptin, has been included in the National Formulary which is used as a combination for the therapy of DM patients Type 2. Research objectives to know the effectiveness and safety of the combination of metformin-vildagliptin in type 2 DM at RSPAL Dr. Ramelan Surabaya. This research method uses a quantitative method with an observational study design, with retrospective data collection based on the Medical Records of Type 2 DM patients who first received metformin-vildagliptin combination therapy (n = 30) carried out observations, and recorded the results of Fasting Blood Glucose (GDP) examinations, Postprandial 2-hour blood glucose (GD2JPP), and HbA1C at baseline and after 3 months of therapy, and observed the safety of the combination. Results The metformin-vildagliptin combination reduced GDP 33.13 ± 40.73 mg/dL, GD2JPP 34.30 ± 48.81 mg/dL, and HbA1C 0.89 ± 0.86%. Did not show any side effects of hypoglycemia, but 3.33% experienced nausea/vomiting and dyspepsia. It was concluded that the combination of metformin-vildagliptin was able to reduce GDP, GD2JPP, and HbA1C.

Effects of dietary intervention combined with insulin aspart on serum nesfatin-1 and CTRP12 levels and pregnancy outcomes in pregnant women with gestational diabetes mellitus.

To analyze the effects of dietary intervention combined with insulin aspart on the serum levels of nesfatin-1, C1q/TNF related protein-12 (CTRP12), and pregnancy outcomes in pregnant women with gestational diabetes mellitus (GDM). In this retrospective cohort study, 513 women with GDM admitted to Tangshan Central Hospital (Tangshan, China) between January 2019 and December 2022 were selected and divided into an observation group (dietary intervention combined with insulin aspart therapy; n = 284) and a control group (insulin aspart therapy, n = 229). The general characteristics, clinical outcomes, serum nesfatin-1 and CTRP12 levels, 2-hour postprandial blood glucose levels, pregnancy outcomes, and perinatal outcomes of the 2 groups were compared. After treatment, the total effective rate in the observation group was significantly higher than that of the control group (97.54% vs 86.03%, respectively; P < .001). Compared with the pretreatment levels, nesfatin-1 and CTRP12 levels were decreased in both groups; nesfatin-1 and CTRP12 levels in the observation group were significantly higher than those in the control group. After treatment, the preprandial and 2-hour postprandial blood glucose levels in the observation group were significantly lower than those in the control group. Compared with the control group, the observation group had significantly fewer cesarean sections, and a significantly lower incidence of postpartum hemorrhage, premature rupture of membranes, and other adverse pregnancy outcomes. After treatment, the risks of preterm birth, macrosomia, fetal distress, neonatal asphyxia, neonatal hypoglycemia, and other adverse perinatal outcomes were significantly lower in the observation group than in the control group. In pregnant women with GDM, dietary intervention combined with insulin aspart can improve clinical outcomes; reduce nesfatin-1, CTRP12, and blood glucose levels; and reduce the incidence of adverse pregnancy outcomes.

Clinical efficacy of Huanglian Wendan decoction in treating type 2 diabetes mellitus: A systematic review and meta-analysis.

Huanglian Wendan decoction (HLWDD) is a traditional Chinese prescription, which has been used to treat type 2 diabetes mellitus (T2DM) in recent years. However, no studies have evaluated its underlying clinical efficacy. Therefore, we used systematic review and meta-analysis to explore the clinical efficacy of HLWDD in treating T2DM. The randomized controlled trials of HLWDD on T2DM were retrieved from Chinese and foreign databases. The primary outcomes included fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG), and glycosylated hemoglobin, type A1c (HbA1c). The secondary outcomes included fasting serum insulin, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c). Statistical analyses were performed using Review Manager and Stata software. Mean difference (MD) with 95% confidence intervals (CI) were used to describe results. The grades of recommendation assessment, development and evaluation approach was used to rate the quality of the evidence; and trial sequential analysis was used to evaluate the required information size and treatment benefits. Twenty-three randomized controlled trials were included in this study. We showed that HLWDD can improve FBG (MD = -0.99, 95% CI: -1.10 to -0.88), 2hPG (MD = -1.57, 95% CI: -1.97 to -1.17), HbA1c (MD = -1.11, 95% CI: -1.42 to -0.80), HOMA-IR (MD = -0.80, 95% CI: -1.80 to -0.51), TC (MD = -0.65, 95% CI: -0.88 to -0.42), TG (MD = -0.32, 95% CI: -0.38 to -0.27), LDL-c (MD = -0.54, 95% CI: -0.66 to -0.41), and HDL-c (MD = 0.08, 95% CI: 0.02-0.15) levels in T2DM patients. Trial sequential analysis suggested that the eficacy of HLWDD in improving FBG, 2hPG, HbA1c, HOMA-IR, TC, TG, LDL-c, and HDL-c was sufficient to draw a firm conclusion. Grades of recommendation assessment showed that HLWDD only has high or moderate quality of evidence in improving FBG, and TG. HLWDD can improve blood glucose and blood lipid levels in T2DM patients, and may be a potential drug to treat T2DM.

Effects ofvertical integration onthe healthcare system inChina: a systematic review andmeta-analysis.

Vertical integration is one possible way to improve the performance of a healthcare system; however, its effects are inconsistent, and there is a lack of evidence from undeveloped nations. This study aims to systematically review the evidence regarding effects of vertical integration on healthcare systems in China. We searched PubMed, Embase, Cochrane Library, Web of Science, ProQuest Health & Medicine Collection, China Knowledge Resource Integrated Database and Wanfang databases from April 2009 (initiation of new healthcare reform) to May 2021 for randomized controlled trials (RCTs), controlled before and after (CBA) trials, cohort studies and interrupted time series (ITS) trials. Vertical integration in the included studies must involve both primary health institutions and secondary or tertiary hospitals. After screening 3109 records, we ultimately analysed 47 studies, including 27 CBA trials, 18 RCTs and 2 ITS trials. The narrative synthesis shows that all but three studies indicated that vertical integration improved efficiency (utilization and cost of health services), quality of public health services and medical services, health provider-centred outcomes (knowledge and skill) and patient-centred outcomes (patients' clinical outcomes, behaviour and satisfaction). Despite the heterogeneity of vertical integration interventions across different studies, the meta-analysis reveals that it lowered diastolic blood pressure (mean difference (MD) -8.41, 95% confidence interval (CI) -15.18 to -1.65) and systolic blood pressure (MD-5.83, 95% CI -9.25 to -2.40) among hypertension patients, and it lowered HbA1c levels (MD -1.95, 95% CI -2.69 to -1.21), fasting blood glucose levels (MD -1.02, 95% CI -1.53 to -0.50) and 2-hour postprandial blood glucose levels (MD -1.78, 95% CI -2.67 to -0.89). The treatment compliance behaviour was improved for hypertension participants (risk ratio (RR) 1.08, 95% CI 1.04-1.13) and for diabetes patients (RR 1.32, 95% CI 1.08-1.61). Vertical integration in China can improve efficiency, quality of care, health provider-centred outcomes and patient-centred outcomes, but high-quality original studies are highly needed.

Observation on the Effect of Individualized Nutrition Combined with Exercise Therapy for Pregnant Women with Gestational Diabetes Mellitus

Objective: To analyze the effect of individualized nutrition combined with exercise therapy for pregnant women with gestational diabetes mellitus. Methods: From March 2021 to March 2023, 100 pregnant women with gestational diabetes in our hospital were randomly divided into a control group and an observation group (50 cases in each group). The control group received routine nursing care, and the observation group received individualized nutrition and exercise therapy, and the intervention effects of the two groups were compared. Results: The fasting, 2-hour postprandial blood glucose, and glycosylated hemoglobin of the observation group were lower than those of the control group; the weight gain of each time period during pregnancy was lower than that of the control group; the incidence of adverse pregnancy events was lower than that of the control group; the quality-of-life score was higher than that of the control group (P &lt; 0.05). Conclusion: Among pregnant women with gestational diabetes, individualized nutrition, and exercise therapy intervention can improve their blood sugar indicators, help control their weight during pregnancy, prevent adverse pregnancy events, and significantly improve their quality of life.

Meta-Analysis of the Effect of Continuous Care on Patients with Type 2 Diabetes

A meta-analysis was conducted to assess the effect of continuing care in patients with type 2 diabetes mellitus. Methods: A review of the PUBMED, CNKI, and Wan Fang databases was done, to find ten randomized controlled trials that used continuous care for patients with type 2 diabetes mellitus, and Review Manager 5.4 the Meta analysis was performed. Results: Meta-analysis showed that continuation of care could improve fasting blood glucose [MD=-2.17, 95% CI (-3.10, -1.23), P&lt;0.00001], 2-hour postprandial blood glucose [MD=-2.58, 95% CI (-3.21, -1.96), P&lt;0.00001], and glycosylated hemoglobin [MD=-1.20, 95%CI (-2.04, -0.36), P=0.005]. Conclusion: Continuous care is of great significance for the control of blood glucose in patients with type 2 diabetes.