ABSTRACT
Objective:To describe the current status and efficacy of additional acarbose combined with insulin therapy in adult patients with type 1 diabetes mellitus (T1DM) .Methods:Adult T1DM patients with acarbose combined with insulin (acarbose group) or insulin alone (insulin group), age≥18 years and disease course≥1 year, who were registered in the T1DM Translational Medicine Research Project of Guangdong Province from June 2011 to December 2014 were enrolled in the study. The hemoglobin A1c (HbA 1c), body weight, body mass index (BMI), waist-to-hip ratio (WHR), insulin dosage and hypoglycemia of acarbose group and insulin group after 1 year were compared. Results:A total of 717 adult patients with T1DM were included (62 cases in acarbose group and 655 cases in insulin group). At the time of enrollment, the onset age of acarbose group was higher than that of insulin group [(31.1±12.3)years vs (27.4±12.4)years, P=0.019]; There were no significant differences in gender, age, course of disease, body weight, BMI, WHR, proportion of carbohydrate heat ≥50%, proportion of exercise time ≥150 min per week, HbA 1c, dosage of insulin, occurence of hypoglycemia and proportion of patients with dyslipidemia between the 2 groups (all P>0.05). After 1 year of follow-up, the HbA 1c in acarbose and insulin group decreased from baseline ( P=0.014, P<0.001), the body weight and BMI increased from baseline (all P<0.05), but WHR, insulin dosage and hypoglycemia occurrence were not statistically significant between the two groups (all P>0.05). After 1 year of follow-up, there were no significant difference in changes of HbA 1c, body weight, BMI, WHR, insulin dosage and hypoglycemia occurrence in acarbose group compared with insulin group from baseline (all P>0.05). Conclusions:In the clinical practice of T1DM treatment, acarbose is used more frequently in patients with a slightly older age of onset. Treatment of T1DM with insulin combined with acarbose did not increase the incidence of hypoglycemia, and no benefit was observed in improving HbA 1c, maintaining body weight, and reducing insulin use.
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The thyroid function test is universally used for the evaluation of thyroid function. However, there are factors other than endocrine diseases, such as special physiological conditions, interference in laboratory measurement, or disorders in other systems that should be taken into consideration. When encountering thyroid function test results that are not in line with clinical manifestation, a comprehensive evaluation is essential for a correct and timely diagnosis. We presented a case of a significant rise in serum total triiodothyronine(TT 3) secondary to multiple myeloma. Through case studies and literature review, we intended to provide clinicians with experience for better interpretation of abnormal thyroid function test results.
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The blood samples of 294 Chinese Han patients with type 1 diabetes mellitus(T1DM) and 199 controls were collected and their genomic DNAs were extracted. The single nucleotide polymorphisms rs17534481, rs12095738, rs2988276, and rs6668182 of CD247 gene were detected. The results showed that rs17534481 polymorphism of CD247 gene was associated with T1DM in Chinese Han population, and T allele was a protective factor for type 1 diabetes mellitus( OR=0.667, P=0.037). There was no significant difference in genotype frequency and allele frequency of rs12095738, rs2988276, and rs6668182 between type 1 diabetes group and control group( P>0.05).
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Objective To explore the effect of walking on residual beta cell function and glycemic control in patients with type 1 diabetes mellitus.Methods A total of 117 type 1 diabetes mellitus patients who usually walked less than 5000 steps per day were given health education about exercise and divided into three groups according to their self-estimates of the number of walking steps they had taken daily in the previous 4 months:an absent exercise group (＜ 5000 steps/day),a basic exercise group (5000-10000 steps/day) and an active exercise group (＞ 10000 steps/day).Among them,34 were in absent group (23.5％ for males),45 were in basis exercise group (40.0％ for males) and 38 were in active exercise group (52.6％ for males).Fasting C-peptide,postprandial C-peptide,and postprandial C-peptide to glucose ratio were used to evaluate the residual beta cell function,while glycated hemoglobin A1c (HbA1c) and insulin dose-adjusted HbAlc (IDAAlc) were used to evaluate their glycemic control.Results The beta cell function and glycemic control showed a tendency to improve with increases in the number of walking steps.Fasting C-peptide,postprandial Cpeptide and the postprandial C-peptide to glucose ratio also increased significantly,while HbA1c and IDAA1c decreased significantly.After balancing the initial difference in the analysis of covariance,significant differences were still found among the 3 groups in the subjects' beta cell function and glycemic control during the follow-up.Linear regression showed that a large number of steps independently predicted better beta cell function.Conclusions In patients with type 1 diabetes mellitus,walking exercise may be effective for improving residual beta cell function and glycemic control.
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The impact of glucagon on diabetes mellitus has become a hot area at present .Researchers hold that both the lack of isletβcells and islet αcells dysfunction exist in Type 1 diabetes mellitus (T1DM).Glucagon plays an important role in the occur-rence and development of T1DM, such as regulating the blood glucose and βcell function.Currently, a new therapy model represented by incretin is emerging , aiming at adjusting islet αcells function.And it has the prospect of becoming a new treatment of T 1DM be-sides insulin.Here we summarize the effect of glucagon on blood glucose and βcell function in T1DM, as well as the progress of T1DM treatment with glucagon as the therapeutic target .
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The aim of this Post-Marketing Surveillance study was to assess efficacy, safety and acceptance of acarbose treatment in Chinese type 2 diabetic patients under day-to-day practice conditions. A total of 2 480 patients were enrolled by 231 physicians throughout China into an open, prospective, uncontrolled, nonrandomised, multi-centre study. Main efficacy parameters were the changes in fasting and postprandial blood glucose concentrations as well as in HbA1c levels after acarbose treatment. The majority of patients had been previously treated with other oral anti-diabetic medication or insulin and received concomitant anti-diabetics during the mean observation period of 13.5 weeks. Most patients started on a daily acarbose dose of 50 mgt. i. d. Acarbose treatment reduced fasting blood glucose concentrations by 56. 1 mg/dl ( 18 mg/dl glucose = 1 mmol/Lglucose) and 2h-postprandial values by 111.3 mg/dl over the studyperiod. HbA1c decreased by 1.9％ and body weight by 0.9 kg. 76 acarbose-related adverse events occurred; two patients experienced serious adverse events.The attending physicians assessed treatment efficacy as "very good" or "good" for 90.1％ of the patients, tolerability for 89.1％ and acarbose acceptance for 87.1％ of the patients. Acarbose is efficacious, safe and well accepted by Chinese type 2 diabetic patients under day-to-day routine conditions, both as anti-diabetic mono therapy and in combination with other anti-diabetic drugs.