2h PG Research Articles

Associations of the Gap Between 2-Hour Post-Load Plasma Glucose and Fasting Blood Glucose With All-Cause or Cardiovascular Mortality in US Normoglycemic Adults.

The gap between 2-hour post-load plasma glucose (2h PG) and fasting blood glucose (FBG) has been shown to be informative of the risk of developing prediabetes and diabetes. We aimed to examine the significance of the gap between 2h PG and FBG in relation to all-cause or cardiovascular disease (CVD) mortality in normoglycemic adults. 3611 normoglycemic participants from the 2005-2016 US National Health and Nutrition Examination Survey were included and dichotomized into the low (2h PG ≤ FBG) and high post-load (2h PG > FBG) groups. Associations of the gap between 2h PG and FBG with all-cause or CVD mortality were evaluated with Kaplan-Meier curves, Cox proportional hazard ratio, and subgroup analysis. The mean age was 38.80years, with a male prevalence of 43.59%. Finally, 1746 (50.22%) and 1865 (49.78%) participants were categorized into the low and high post-load groups, respectively. During a median follow-up of 107months, 130 deaths (36 CVD-related) occurred. Kaplan-Meier curves showed significantly higher all-cause and CVD mortality rates in the high post-load group compared with the low post-load group. The hazard ratio and 95% confidence interval for all-cause and CVD mortality in the high post-load group were 1.816 (1.149-2.870) and 2.302 (1.052-5.038), respectively, with the low post-load group as the reference. The results were robust and consistent in the sensitivity and subgroup analyses. The gap between 2h PG and FBG may be potentially useful for predicting the risk of all-cause and CVD mortality in US normoglycemic adults.

Prediabetes Phenotypes and All-Cause or Cardiovascular Mortality: Evidence from a Population-Based Study.

Fasting plasma glucose (FPG), glycated hemoglobin A1C (HbA1C), and 2-hour post-load plasma glucose (2h PG) are all currently used to define prediabetes. We aimed to determine whether a higher number of prediabetes defects corresponds to an increased all-cause and cardiovascular disease (CVD) mortality. Individuals with prediabetes and available information on FPG, HbA1C, 2h PG, and mortality data were derived from the 2005 - 2016 National Health and Nutrition Examination Survey. Kaplan-Meier survival curves, Cox proportional hazards regression analysis, and stratified analysis were used to compare all-cause and CVD mortality among participants with one, two, and all three defects. Among the 4511 individuals included, 76.31%, 30.89%, and 41.65% met the FPG-, 2h PG-, and HbA1C-defined criteria for prediabetes, respectively. There were 2609 (60.78%), 1420 (29.60%), and 482 (9.62%) adults meeting one, two, and all three criteria for prediabetes, respectively. During a median follow-up of 100 months, a total of 534 (180 CVD-related) deaths occurred. The multivariable-adjusted hazard ratios and 95% confidence intervals in those meeting two and three criteria were 1.341 (1.042-1.727) and 1.369 (1.027-1.824), respectively, for all-cause mortality (P for trend = 0.006), and 1.836 (1.228-2.744) and 2.037 (1.092-3.801), respectively, for CVD mortality (P for trend = 0.002), with those meeting only one criterion as the reference. In subgroup analysis, the association between the number of diagnostic criteria for prediabetes and CVD mortality was observed only in men. A higher number of diagnostic criteria for prediabetes was associated with increased all-cause and CVD mortality.

The effect of empagliflozin (sodium-glucose cotransporter-2 inhibitor) on osteoporosis and glycemic parameters in patients with type 2 diabetes: a quasi-experimental study.

Diabetic osteoporosis (DOP) is a metabolic disease that occurs in patients with diabetes due to insufficient insulin secretion. This condition can lead to sensory neuropathy, nephropathy, retinopathy, and hypoglycemic events, which can increase the risk of fractures. This study aimed to assess the effectiveness of Empagliflozin, a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, in treating diabetic osteoporosis (DOP) and preventing fractures. This quasi-experimental study enrolled 100 patients with diabetic osteoporosis from February 2023 to February 2024. Participants were randomly assigned to an intervention group (n = 50) and a control group (n = 50). The intervention group received Empagliflozin in combination with symptomatic treatment, while the control group received only symptomatic treatment. The treatment duration was six months. Fasting blood glucose (FBG), 2-hour postprandial blood glucose (2h PG), glycosylated hemoglobin A1c (Hb A1c), bone mineral density (BMD), serum phosphorus and calcium concentration were measured after the intervention and the incidence of fracture was followed up for 12 months. The data were analyzed using SPSS 23. Descriptive statistics (mean, standard deviation, and percentage) and analytical methods (t test, Chi square) were also used to analyze the data. After six months of treatment, the intervention group exhibited significantly lower levels of FBG (P < 0.001), 2h-PG (P = 0.001), and HbA1c (P < 0.001) than the control group. Additionally, bone mineral density, serum phosphorus, and calcium levels were significantly higher in the intervention group (P < 0.001). After a 12-months follow-up, the incidence of fractures in the intervention group was 2%, while it was 16.33% in the control group (P < 0.05). Empagliflozin, when combined with symptomatic treatment, demonstrates a positive clinical effect in patients with diabetic osteoporosis. The treatment effectively improves blood glucose metabolism, bone mineral density, and phosphorus and calcium metabolism, ultimately leading to a significant reduction in the incidence of fracture.

Association Between Weight-Adjusted Waist Index and Albuminuria in Type 2 Diabetes Mellitus in the Chinese Population.

This study aimed to investigate the relationship between weight-adjusted waist index (WWI) and albuminuria in patients with type 2 diabetes mellitus (T2DM) in the Chinese population. A total of 860 adult patients in the Department of Endocrinology of the Affiliated Hospital of Jiangsu University were retrospectively analyzed from June 2018 to September 2023. Correlations between WWI and albuminuria (albumin-to-creatinine ratio (UACR) ≥ 30 mg/g were defined as albuminuria) were analyzed using the Pearson and Spearman methods. The associations between albuminuria and Age, gender, body mass index (BMI), waist circumference/ hip circumference (WHR), systolic blood pressure(SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2h PG), fasting plasma insulin (FIns), 2-h postprandial insulin (2hINS), glycosylated hemoglobin (HbA1c), WWI, homeostasis model assessment of insulin resistance (HOMA-IR) were analyzed via binary logistic regression. Compared with the normal albumin group, serum urea nitrogen, serum creatinine, UACR, and WWI levels in the albuminuria group were significantly increased, while estimated glomerular filtration rate (eGFR) levels were significantly decreased (P < 0.05). Correlation analyses revealed that WWI was positively correlated with UACR but negatively correlated with urea nitrogen, serum creatinine, and eGFR (P < 0.05). Binary logistic regression analyses indicated that WWI was an independent risk factor for albuminuria in T2DM patients. Receiver operating characteristic curve results showed that the area under the curve for albuminuria as predicted by WWI was 0.605 [95% CI = (0.563-0.646), P < 0.001]. WWI is independently associated with albuminuria in the Chinese patients with type 2 diabetes and may serve as a simple indicator for albuminuria risk assessment.

Effects of dapagliflozin on cardiac function and short-term prognosis of patients with both acute myocardial infarction and type 2 diabetes mellitus.

Dapagliflozin is a selective SGLT2 inhibitor, which has been widely used in the treatment of patients with type 2 diabetes mellitus (T2DM). By blocking the reabsorption of glucose in renal tubules, daglitazine can promote urinary glucose excretion, reduce blood glucose and blood pressure, and also shows a protective effect on the heart in clinical studies. Accordingly, this study was designed to explore the effects of dapagliflozin on cardiac function and short-term prognosis of patients with acute myocardial infarction (AMI) complicated with T2DM. The clinical data of 100 patients with both AMI and T2DM treated at Shibei Hospital of Jingan District from January 2021 to January 2023 were analyzed retrospectively. Totally 47 patients treated with hypoglycemic agents other than SGLT-2i inhibitors on the basis of routine treatment were assigned to the control group, and 53 patients treated with dapagliflozin based on treatment of the control group were assigned to the study group. Relevant blood glucose-related indices and cardiac function-associated indices of the two groups before and after treatment were analyzed and compared: The adverse reactions of the two groups were statistically analyzed, including hypotension, hypoglycemia, diarrhea and abdominal pain, anorexia, and nausea and vomiting. The patients were followed-up for six months, on which the major cardiovascular adverse events (MACE) and incidence of readmission for heart failure in the two groups were analyzed and compared. Treatment, the FBG, 2h PG and HbA1c levels in both groups dropped significantly (P<0.05), with significantly lower levels in the study group (P<0.05). After treatment, both groups showed significantly dropped NT-pro BNP, LVEDD and LVESD levels (P<0.05) and a significantly increased LVEF level (P<0.05), with more significant drops/increase in the study group (P<0.05). No significant difference was found between the two groups in the total incidence of adverse reactions (P=0.586). During the follow-up period, there was no significant difference in the incidence of MACE between the two groups (P>0.05), and the study group showed a significantly lower incidence of readmission for heart failure than the control group (P<0.05). Dapagliflozin can substantially improve the blood glucose and cardiac function of patients with both AMI and T2DM. It can lower the rate of readmission for heart failure, and provide various cardiovascular benefits besides hypoglycemic effect.

Salvia miltiorrhiza bge. f. alba ameliorates type 2 diabetes mellitus-associated non-alcoholic fatty liver disease via the STING pathway.

To elucidate the functional role and underlying mechanism of Salvia miltiorrhiza bge. f. alba (SMBFA) in patients with type 2 diabetes mellitus (T2DM) accompanied by non-alcoholic fatty liver disease (NAFLD). A retrospective analysis was conducted on 90 patients with T2DM-NAFLD who met the inclusion criteria. The control group was comprised of 45 patients treated with Fenofibrate, while the observation group consisted of 45 patients who received SMBFA in addition to the control treatment. An in vivo mouse model of T2DM-NAFLD was established using a high-fat diet combined with streptozotocin. Serum levels of fasting plasma glucose (FPG), 2-hour postprandial glucose (2h PG), hemoglobin A1c (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), and triglyceride (TG) were measured in both patients and mice using an automated biochemical analyzer. Liver indices and function were also evaluated. ELISA assays were performed to quantify inflammatory cytokine levels. Western blotting was utilized to assess the protein levels related to the stimulator of interferon genes (STING)-interferon regulatory factor 3 (IRF3) pathway. After treatment, significant reductions in blood glucose indices, HOMA-IR, lipid metabolism markers, liver function indices, and inflammatory cytokines were observed in both groups of T2DM-NAFLD patients. Notably, the decreases were more pronounced in the observation group compared to the control group. Similarly, in T2DM-NAFLD mouse models, the levels of these parameters were significantly lower in the observation group than in the normal control (NC) group. Additionally, SMBFA suppressed the elevated levels of STING, p-IRF3, and p-TANK-binding kinase 1 in the T2DM-NAFLD mice. SMBFA exhibits the potential to regulate glucose and lipid metabolism, inhibit insulin resistance, and protect liver function by modulating the STING signaling pathway.

Correlation Between Postpartum Myometrial Elasticity and Obstetric Complications in Pregnant Women with Gestational Diabetes Mellitus.

To investigate postpartum myometrial elasticity in pregnant women with gestational diabetes mellitus (GDM) using shear wave elastography (SWE) and analyze the correlation between myometrial SWE values and obstetric complications. Clinical data of women who gave birth at Affiliated Hospital of Yangzhou University from August 2022 to July 2023 were retrospectively analyzed and divided into two groups based on GDM diagnosis: the GDM group and the healthy control group. SWE was used to measure the elasticity values of the anterior and posterior myometrial walls in both groups. Differences in placental attachment position and SWE values at the placental attachment site were compared between the two groups. Spearman correlation analysis was utilized to evaluate the correlation between SWE values and obstetric complications. Glycated hemoglobin (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR), fasting plasma glucose (FPG), 2-hour postprandial glucose (2h PG), triglycerides (TG), and total cholesterol (TC) levels were higher in the GDM group than in the healthy control group (P<0.05). There was a statistically significant difference in placental attachment position between the two groups (P<0.05). In both the GDM (17.52±0.42 vs 25.29±0.74, P=0.001) and control groups (14.06±5.01 vs 22.20±6.34, P=0.001), mean SWE values were significantly lower for anterior versus posterior placental attachment, and mean SWE values were also significantly higher in the GDM versus control group for both anterior (17.52±0.42 vs 14.06±5.01, P=0.001) and posterior placental attachment (25.29±0.74 vs 22.20±6.34, P=0.001). Spearman correlation analysis showed that postpartum hemorrhage (r=0.632, P=0.017), preeclampsia (r=0.818, P=0.014), premature rupture of membranes (r=0.710, P=0.012), placental abruption (r=0.732, P=0.031), and ketoacidosis (r=0.729, P=0.022) were negatively correlated with average myometrial SWE values in the GDM group (P<0.05). SWE values at the placental attachment site were higher in GDM patients than in healthy pregnant women, and myometrial elasticity was positively correlated with obstetric complications.

Effects of COVID-19 time on the development of pre-impaired glucose tolerance state in children and adolescents with overweight and obesity.

We aimed to characterize the effects of COVID-19 Pandemic on 2 h plasma glucose (2 h PG) values after an OGTT postulating a correlation between 2 h PG spectrum and the decline of β-cell function. Particularly, we tried to evaluate the effects on the risk of showing 2 h plasma glucose values in the highest range of normal values in children and adolescent with obesity during COVID-19 Pandemic compared to those evaluated during the 13 years before. Data from 532 children and adolescents with obesity and overweight (before COVID-19 Pandemic, 209M/262F, 2008-2019; during COVID-19 Pandemic, 40M/21F, 2020-2021) who had undergone a complete evaluation and had performed an OGTT were analyzed. The two groups were further divided into three sub-groups based on the 2 h PG, group 1 (2 h PG < 5.55 mmol/L), group 2 (5.56 < 2 h PG < 6.60 mmol/L), group 3 (6.61 < 2h PG < 7.72 mmol/L), respectively. The prevalence of 2 h PG values distribution in children was evaluated between before and during COVID-19 Pandemic period and the main differences between the two groups 3 of each period were analyzed. A significant difference (P = 0.01) in terms of distribution of the prevalence of 2h PG values was documented between the group before COVID-19 (35.6%, 45.9% and 18.5%) and the group during COVID-19 Pandemic (31.1%, 31.1% and 37.8%). A roughly doble higher prevalence of subjects with pre-IGT was documented in the COVID-19 group. In addition, group 3 of COVID-19 time showed significantly higher values for waist circumference (WC), Waist/Height ratio (WtHR), fasting glucose and HOMA-IR compared to the group 3 of the period before COVID-19 Pandemic (all P < 0.05). During COVID-19 time a higher percentage of children are in the highest range of normal 2 h PG values which is known to be associated with a significant impairment of β-cell function and insulin sensitivity and have higher risk of developing IGT.

68-LB: Early Pharmacological Intervention (EPIC) to Preserve Beta-Cell Function in Prediabetes (PreDM)

Beta cell failure is the key pathophysiologic determinant in progression from PreDM to type 2 diabetes (T2D). Lifestyle modifications frequently are insufficient to prevent T2D onset and drugs that modify disease progression by targeting pathophysiologic defects in PreDM may be required. Methods: EPIC seeks to answer whether a specific drug provides greater benefit to prevent PreDM progression and to assess the effect of two years of treatment with antidiabetic drugs in 200 individuals with IFG and/or IGT on insulin sensitivity (IS) and beta cell function (BCF). At baseline, participants received 2h-OGTT and two-step hyperglycemic clamp (HC) (+125 and +400 mg/dl) with GLP-1RA infusion. Subjects then were randomized to metformin (MET), pioglitazone (PIO), saxagliptin (SAXA) or dapagliflozin (DAPA). 55 participants have completed the intervention (35F/20M; age = 51 ± 3 ys) Matsuda Index of IS was quantitated from OGTT. Beta Cell Function (BCF) was quantitated: (i) from OGTT as (ΔC-Pep/ΔG) x (Matsuda) and (ii) from HC as ΔC-Pep (First Phase, AIR x Matsuda; ΔC-Pep (Second Phase, +400 mg/dL x Matsuda; and (Second Phase + Exenatide) x Matsuda. Results: A1c did not change significantly in any group, while FPG (106 ±4 to 100 ± 3 mg/dl) and 2h PG (150 ±8 to 141 ± 11) decreased significantly in all groups (p&amp;lt;0.05 for PIO &amp;gt; SAXA). Matsuda Index increased in all groups (p&amp;lt;0.01 for PIO vs all other groups). Weight increased significantly in PIO (+2.5kg p&amp;lt;0.05), did not change with SAXA, decreased with DAPA and MET (both p = NS). BCF during OGTT tended to increase in all groups (p&amp;lt;0.10 for trend). No significant changes in AIR, second phase (+400 mg/dl), and second phase (+400) + Exenatide were seen for MET, SAXA, DAPA, but significantly increased with PIO (AIR 7.1 to 22.8; 2ND STEP 10 to 45.4; 2nd STEP + Exenatide 19 to 79 (all p &amp;lt;0.01). Conclusion: Early drug intervention in prediabetes with pioglitazone preserves beta cell function and improves insulin sensitivity better than MET, SAXA, and DAPA. Disclosure A. Chavez: None. A. Merovci: None. S. Neppala: None. L. A. Cruz Moreno: None. G. Baskoy: None. F. M. Acosta: None. A. A. Hansis-Diarte: None. C. L. Puckett: None. J. M. Adams: None. M. Abdul-Ghani: None. C. L. Triplitt: Speaker's Bureau; Novo Nordisk. E. Cersosimo: None. R. A. DeFronzo: Speaker's Bureau; AstraZeneca. Advisory Panel; AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Novo Nordisk. Research Support; AstraZeneca, Boehringer-Ingelheim, Merck &amp; Co., Inc. Funding National Institutes of Health (R01DK024092-3AZ, ISSDAPA0002)

Association between serum complement 1q and the associated factors of acute ischemic stroke in patients with type 2 diabetes.

The aim of this study was to examine the association between serum complement 1q (C1q) and the associated factors of acute ischemic stroke in patients with type 2 diabetes (T2DM). The baseline clinical variables of the participants were collected, and the levels of blood lipids, blood sugar, inflammatory cytokines, and C1q in the three groups were then compared. The variables which affected the associated factors of acute ischemic stroke in T2DM cases were determined. The levels of C1q in the DAIS group were increased significantly compared with those in the T2DM group. Receiver operating characteristic curve analyses showed that the AUC for C1q and the combined diagnosis of acute ischemic stroke were 0.830 (95%CI 0.747-0.914), with a sensitivity of 0.854 and specificity of 0.780. The results of Pearson's correlation analyses demonstrated that C1q was associated positively with low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (PBG), 2-h postprandial blood glucose (2h PG), and high-sensitive C reaction protein (hs-CRP) (all p < .05). Stratified analysis showed that there was a positive relationship between C1q and the associated factors of acute ischemic stroke for partial LDL-C, and hs-CRP strata. Logistic model analysis suggested that C1q was an independent risk factor for acute ischemic stroke in patients with T2DM. After adjusting for potential confounders, a one-standard deviation (SD) increase in C1q level was strongly related to an approximately 1.5-fold increased risk of acute ischemic stroke in cases with a hs-CRP ≥1.78mg/L. In DAIS patients, the levels of C1q were increased significantly and were an independent associated factor which affected the occurrence of acute ischemic stroke.

The Nursing Effect of Individualized Management on Patients With Diabetes Mellitus Type 2 and Hypertension.

It focused on clinical effects of individualized nursing and health education (INHE) on patients with diabetes mellitus type 2 (T2DM) and hypertension. 68 patients were randomly rolled into two groups, 34 cases in the control group (group A) received routine nursing and remaining 34 cases in the experimental group (group B) received INHE. The disease knowledge mastery (DKM) and the effect of rehabilitation nursing of patients were compared. The results suggested that DKM of patients in group B was obviously greater (P < 0.05). The total effective rate (TER) in group B was 91.45%, which was observably greater than that (76.35%) in group A (P < 0.05). After nursing, the fasting plasma glucose (FPG), 2-hour postprandial glucose (2h PG), systolic blood pressure (SBP), and diastolic blood pressure (DBP) levels of all patients decreased, and those in group B were much lower (P < 0.05). Scores of the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) of the two groups were 56.34 ± 8.12 points and 56.33 ± 8.01 points in group A, respectively; and those in group B were 42.52 ± 6.77 points and 41.71 ± 7.23 points, respectively; and they were all decreased and those in the group B were obviously smaller (P < 0.05). In summary, INHE can effectively improve the psychological cognition of patients with T2DM and hypertension and strengthen the control of blood pressure and blood sugar.

The Detection of Thyroid Nodules in Prediabetes Population and Analysis of Related Factors.

PurposeTo explore the detection of thyroid nodules (TN) and related influencing factors in the population of prediabetes (PreDM) in northwest China’s Gansu Province.Materials and MethodsA multi-stage stratified cluster random sampling method was used to select adult Han residents in Gansu Province for investigation, and recorded the clinical data of the subjects. The χ2 test was used to analyze the difference in TN detection rate of the PreDM population. Logistic regression analyzed the risk factors of TN in the PreDM population.ResultsThis study included 2659 people with normal glucose tolerance (NGT) and PreDM, of which 440 people were detected with TN. Among the PreDM population, the TN detection rate was higher than in the NGT population (24.48% vs 15.00%; P<0.05). The detection rate of TN in the impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and IFG+IGT group was also significantly higher than that in the NGT population (X2=4.117, X2=13.187, X2=13.016, all P<0.05), and of which, the IFG+IGT group was the highest (32.20%). The general trend of TN in the IFG, IGT and PreDM population all increased with age. General data showed that BMI, waist-to-height ratio, waist circumference, TG, TC, LDL-C, FPG, 2h PG, HbA1c and TSH indicators in the TN group were higher than those in the Non-TN group (P<0.05). The logistic regression suggested that the risk factors for TN in the PreDM population were female, age increase, high SP, high TSH, high FPG, high LDL-C, hypertension and family history of diabetes (all P<0.05).ConclusionThe detection rate of TN in the PreDM population is high, especially in the IFG+IGT population. Middle-aged and elderly people with hypertension and abnormal glucose and lipid metabolism should be treated reasonably and regularly, and their TN should be screened and followed up.

Effect of acupuncture for regulating spleen and stomach on aspirin resistance in patients with type 2 diabetes mellitus: a randomized controlled trial

To observe the effect of acupuncture for regulating spleen and stomach on aspirin resistance in patients with type 2 diabetes mellitus (T2DM) and explore the effect mechanism. A total of 68 T2DM patients complicated with aspirin resistance were randomized into an observation group and a control group, 34 cases in each one. On the base of the conventional treatment for diabetes, aspirin enteric-coated tablets were prescribed for oral administration, 100 mg each time, once daily in the control group. In the observation group, on the basis of the treatment as the control group, acupuncture was used for regulating spleen and stomach at Zhongwan (CV 12), Zusanli (ST 36), Yinlingquan (SP 9), Hegu (LI 4), etc., once daily. The treatment for 1 week was as one course and 4 courses of treatment were required totally in two groups. Before and After treatment, the indexes of platelet function (platelet aggregation rate [PAG] and salicylic acid concentration), the indexes of vascular endothelial function (6-keone prostaglandin F1α[6-keto-PGF1α], thromin B2 [TXB2] and cyclooxysynthase-2 [COX-2]), blood glucose (fasting plasma glucose [FPG], 2 h plasma glucose [2h PG] and glycosylated hemoglobin [HbA1c]), insulin resistance index (HOMA-IR), blood lipid indexes (total cholesterol [TC], triacylglycerol [TG], high-density lipoprotein cholesterol [HDL-C] and low-density lipoprotein cholesterol [LDL-C]) and the total score of TCM symptoms were observed in the patients of two groups. Clinical therapeutic effect and safety was compared in the patients between the two groups after treatment and the recurrence rate of cardiocerebrovascular events was followed up 6 months after treatment. After treatment, PAG, salicylic acid concentration, TXB2, COX-2, FPG, 2h PG, HbA1c, HOMA-IR, LDL-C, TC, TG and the total scores of TCM symptoms were all reduced as compared with those before treatment in the two groups (P<0.01, P<0.05), and 6-keto-PGF1αand HDL-C were increased as compared with those before treatment in the two groups (P<0.01, P<0.05). In comparison with the control group, the aforementioned indexes in the observation group were all improved significantly (P<0.01). The total effective rate was 91.2% (31/34) in the observation group, higher than 70.6% (24/34) in the control group (P<0.05). In follow up visit, the recurrence rate of cardiocerebrovascular events was 14.7% (5/34) in the observation group, lower than 29.4% (10/34) in the control group (P<0.05). The therapies were safe and had no obvious adverse reactions in both two groups. Acupuncture for regulating spleen and stomach combined with aspirin enteric-coated tablets relieve insulin resistance and reduces blood glucose and lipid as well as the recurrence rate of cardiocerebrovascular events in the patients with T2DM, which is probably related to the regulation of insulin resistance and the improvement of vascular endothelial function. This combined therapy achieves the better effect on aspirin resistance as compared with simple aspirin enteric-coated tablets.

The Efficacy of Hydroxychloroquine Combined with Huangqi Tablets in the Treatment of Diabetic Nephropathy.

Objective This study aimed to analyze the effect of hydroxychloroquine combined with Huangqi tablets in the treatment of diabetic nephropathy (DN). Methods Eighty patients with DN were enrolled and divided into two groups by a random number table. 27 patients received routine treatment + hydroxychloroquine (group A), while 27 patients received routine treatment + hydroxychloroquine + Huangqi tablets (group B) and 26 patients received routine treatment (group C). Results FPG, 2h PG, and HbA1c levels as well as TC and TG levels were lower in group B than in groups A and C at the end of 3 months of treatment and were lower in group A than in group C (P < 0.05). SCR, BUN, and 24-hour urine protein were reduced in group B after therapy, whereas eGFR was increased and the difference between groups A and C was significant (P=0.05). After treatment, VEGF, IGF-1, and TGF-1 levels were lower in group B than in groups A and C and in group A than in group C (P=0.05). Total symptom scores at 2, 4, and 6 months after treatment was lower in group B than in groups A and C, and they were lower in group A than in group C at all time points (P < 0.05). The total effective rates of treatment in groups A, B, and C were 66.67%, 88.89%, and 38.46% (P < 0.05). The incidence of adverse reactions in groups A, B, and C was 37.04%, 25.93%, and 11.54% (P > 0.05). Conclusion Hydroxychloroquine combined with Huangqi tablets in the treatment of DN showed the best efficacy, with better control of blood glucose and lipids, which can more effectively delay the progression of renal lesions and effectively inhibit the expression of VEGF, IGF, and TGF-β1 in tethered cells with high safety.

Effect Of Nursing Intervention Based on Behavioral Shaping Therapy on Blood Glucose Index, Self-Efficacy and Subjective Well-Being in Elderly Patients with T2DM

Objective: To investigate the effect of nursing intervention based on behavioral shaping therapy on blood glucose index, self-efficacy and subjective well-being in elderly patients with type 2 diabetes mellitus (T2DM). Methods: 100 elderly patients with T2DM admitted to our hospital from February 2019 to January 2020 were selected and divided into control group and observation group according to the random number table method, 50 cases in each group. The control group adopted the nursing method of routine education combined with motivation interview, and the observation group adopted the nursing method of behavior shaping on the basis of the control group. The fasting plasma glucose (FPG), 2h postprandial plasma glucose (2h PG), glycosylated hemoglobin (HbAlc) level, self-management ability score, diabetes management self-efficacy scale (DMSES) score and subjective well-being score were compared between the two groups before and after intervention. Results: The levels of FPG, 2h PG and HbAlc in the two groups were significantly decreased, and those of the observation group were significantly lower than those in the control group (P&lt;0.05). After intervention, the total scores of self-management ability, DMSES and subjective well-being of the two groups were significantly increased, and the observation group was significantly higher than the control group (P&lt;0.05). Conclusion: Behavioral shaping therapy combined with routine education and motivation interview can significantly improve the self-management ability, self-efficacy, blood glucose index and subjective well-being of elderly patients.

The different patterns of insulin response during Oral Glucose Tolerance Test (OGTT) in transfused young patients with β-Thalassemia.

Background and aim:Dysregulation of glucose metabolism is a common complication of transfusions in Transfusion Dependent Thalassemia (TDT) patients. For early diagnosis of glucose disturbances, screening is recommended. The age of starting and the type of screening vary; the more common methods are assessment of RPG, FPG, 2h PG and 2 hours OGTT. The combined assessment of glucose tolerance and insulin response during OGTT is rarely recommended. The main objective of the study is the evaluation of simultaneous assessment of Glucose Tolerance (GT) and Insulin Response (IR) during OGTT in patients with TDT.Methods:43 TDT patients aged 12-28years, without clinical evidence of glucose disturbances, were randomly selected for the study. The 2-hour OGTT in 30 minutes intervals was applied. Plasma glucose and insulin were assessed in all samples using routine laboratory methods.Results:Of 43 patients 31(72%) had Normal GT; of them 9 (29%) had normal insulin response (NIR), 14 (45%) high IR and 8(26%) delayed peak IR. Delayed peak IR was found in 8 of the 9 patients with Impaired GT and in 2 of the 3 with diabetic GT. Deficient IR (hypoinsulinemia) was found in two patients.Conclusions:Simultaneous assessment of GT and IR during OGTT in TDT patients, seems to be a most sensitive and creditable screening test for early diagnosis of glucose disturbances. High IR and delayed peak IR in normoglycemic patients are valuable indices for diagnosis of the pre-diabetic state that precede the development of glucose disturbances in TDT patients and start proper follow and management. (www.actabiomedica.it).

Comparative Study Of Resistance And Aerobic Exercise In Pre-diabetes: An Rct

PURPOSE: Although the benefit of aerobic exercise in IGR is proven, the impact of resistance exercise on IGR is still unclear. Therefore, the differences between aerobic and resistance exercise on IGR was analyzed to provide a theoretical and practical basis for DM prevention and IGR management. METHODS: Single-blind RCT. IGR participants were divided into 3 groups randomly: aerobic exercise (A, n= 26), resistance exercise (R, n= 23), and control (C, n=21). The effect of aerobic and resistance exercise on IGR was analyzed and the relationship with obesity was investigated after 12-weeks intervention. RESULTS: (1) FPG in groups A and R was decreased significantly by 6.17% and 4.81%, and OGTT 2h PG was also decreased significantly by 20.39% and 16.50%. 69.2% in group A showed a decrease in blood glucose level to normal value with a significant difference compared with group C. (2) HOMA2-IR in groups A and R was significantly decreased by 8.34% and 18.31%, with a significant difference compared with group C. 3) A significant decrease of BMI (3.1±3.2 kg/m2, showed a moderately positive correlation with the decreased FPG) and waist (3.1±2.7 cm) was found in group A with a significant difference compared with group C. BMI(1.1±2.9 kg/m2) and waist(1.5±3.8 cm) also decreased significantly in group R, but no significant difference between groups. The change of body composition showed in figure 1. CONCLUSION: (1) Both resistance and aerobic exercise lowered blood glucose and decreased blood glucose to normal level in a large percentage of IGR. (2) Both aerobic and resistance exercise improved IR in IGR. The effect of resistance exercise on IR improvement was superior to that of aerobic exercise. (3) Aerobic exercise lowered weight and waist significantly in IGR, and decreased blood glucose through weight loss. But the improvement of IR by both aerobic and resistance exercise might not be related to the control of obesity. Supported by SGA China (2014B007), Sun Yat-sen University (1709089).

Long-Term Postpartum Outcomes of Insulin Resistance and β-cell Function in Women with Previous Gestational Diabetes Mellitus.

Aims The objective of the present study was to explore the long-term postpartum glucose metabolism in women with previous GDM, and study the mechanism of hyperglycemia from gestation to postpartum by investigating the postpartum insulin resistance and insulin secretion. Methods A total of 321 females with previous GDM were followed up once during 1- to 6-years postpartum. Characteristics during pregnancy, perinatal period, and postpartum were compared between postpartum NGT and hyperglycemic women. HOMA-IR and HOMA-β were used to assess insulin resistance and insulin secretion levels with different glucose statuses. Results The prevalence of postpartum hyperglycemia had a fluctuant increase from 25.9% at 1 year, to 53.7% at 5 year. 75 g OGTT 2 hPG during pregnancy was an independent predictor of postpartum hyperglycemia with an OR of 2.15 (95% CI 1.245, 3.722) (P=0.006). After ROC analysis, the best equilibrium between sensitivity (70.3%) and specificity (60.4%) for 2 hPG was 9.03 mmol/L. HOMA-IR was increased in postpartum normal glucose tolerance (NGT), prediabetes, and T2DM (1.64 vs. 2.14 vs. 4.27, P=0.006). After ROC analysis, the best equilibrium between sensitivity (70.3%) and specificity (60.4%) for 2 hPG was 9.03 mmol/L. HOMA-IR was increased in postpartum normal glucose tolerance (NGT), prediabetes, and T2DM (1.64 vs. 2.14 vs. 4.27, β were used to assess insulin resistance and insulin secretion levels with different glucose statuses. P=0.006). After ROC analysis, the best equilibrium between sensitivity (70.3%) and specificity (60.4%) for 2 hPG was 9.03 mmol/L. HOMA-IR was increased in postpartum normal glucose tolerance (NGT), prediabetes, and T2DM (1.64 vs. 2.14 vs. 4.27, β were used to assess insulin resistance and insulin secretion levels with different glucose statuses. Conclusions 75 g OGTT 2h PG during pregnancy higher than 9.03 mmol/L is regarded as an independent risk factor of postpartum hyperglycemia. Insulin resistance with insufficient insulin secretion compensation is still common phenomenon during long-term postpartum. Women with heavier insulin resistance in the postpartum period are more likely develop prediabetes, while decreased β-cell function contributes more to T2DM development.β were used to assess insulin resistance and insulin secretion levels with different glucose statuses.

Effects of "hospital-community-family" model in continuous nursing among diabetics

Objective To explore the effects of hospital-community-family continuous nursing model in continuous nursing among diabetics. Methods From February 2018 to February 2019, a total of 102 diabetic out-patients at the Third Affiliated Hospital of South Medical University were selected by stratified random sampling. Patients were divided into control group and observation group with the random number table, 51 cases in each group. Control group carried out routine follow-up nursing. Observation group implemented hospital-community-family continuous nursing. We compared the fasting blood glucose (FBG) , 2-hour postprandial blood glucose (2h PG) , glycosylated hemoglobin (HbA1c) , scores of the Champion Health Belief Model Scale (CHBMS) , Health-Promoting Lifestyle Profile-Ⅱ (HPLP-Ⅱ) and Quality of Life Scale for Patients with Type 2 Diabetes Mellitus (DMQLS) of two groups before and after intervention. Results After intervention, the FBG, 2 h PG and HbA1c of observation group were (7.11±1.25) mmol/L, (9.15±1.24) mmol/L and (8.15±0.59) % respectively lower than those [ (8.56±1.31) mmol/L, (11.21±1.35) mmol/L and (10.99±1.12) %]of control group with statistical differences (t=5.719, 8.026, 16.022; P<0.05) . After intervention, the scores of CHBMS, HPLP-Ⅱ and DMQLS of observation group were (4.16±0.34) , (4.09±0.35) and (165.24±5.21) respectively higher than those [ (3.52±0.42) , (3.24±0.41) and (154.18±4.39) ]of control group with statistical differences (t=8.458, 11.260, 11.593; P<0.05) . Conclusions Application of hospital-community-family continuous nursing in patients with type 2 diabetes mellitus helps the glucose control, improves health belief, health behavior and quality of life which is worthy of being used widely in clinical application. Key words: Diabetes mellitus; Glucose control; Continuous nursing; Hospital-community-family

A Meta-Analysis of the Treatment of Diabetic Nephropathy using Astragalus Injection combined with Captopril

To observe the effectiveness and safety of using astragalus injection combined with captopril for diabetic nephropathy. The method is using computer database searches and manual retrieval of relevant journals. Astragalus injection combined with captopril was the test drug group. The data was analyzed using Review Manager 5.1 according to the evaluation criteria of RCT recommended by Cochrane 4.2.2. 11RCT and total 641 cases of early and clinical diabetic nephropathy were included. Astragalus injection combined with captopril was more excellent than the control group in the lower of 24hUAER [MD=-21.09, (-37.21,-4.96), P<0.01], 24h urinary protein [MD =- 0.38, (- 47, -0.28), P <0.01], the efficient [RR=1.29, (1.06,1.57), P=0.01], BUN [MD=-0.36, (-0.62,-0.11), P=0.004], SCr [MD=-4.13, (-7.94,-0.33), P=0.03], FPG [MD=-0.96, (-1.67,-0.24), P=0.009], TC [MD=-1.42, (-1.66,-1.18), P<0.01], and TG [MD=-0.45, (-0.59,-0.32), P<0.01]. There was no significance in 2h PG [MD=-0.07, (-0.65,0.51), P=0.81], and blood pressure (2 =0.15, P=0.69).. Astragalus injection combined with captopril was effect and safe in the lower of 24hUAER and the efficient for the patients with diabetic nephropathy. It also needs more randomized controlled trials for high-quality evaluation.