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Objective To evaluate effects of glycemic control on refraction in diabetic patients.Methods Twenty newly diagnosed diabetic patients were included in this study. The random blood glucose,glycosylated hemoglobin A1c( HbA1c) levels, fasting C-peptide and postprandial 2 h C-peptide levels were measured before treatment. The patients with random blood glucose ≥ 12. 0 mmol/L and HbA1c ≥ 10. 0%were selected. Refraction, intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length, and axial length were measured on admission and at the end of week 1,2, 3 and 4 during glycaemic control. Results A transient hyperopic change occurred in all the patients receiving glycemic control with a mean maximum hyperopic changes of 1.6 D ( 0. 50 D ～ 3.20 D). There was a positive correlation between the magnitude of the maximum hyperopic changes and the HbA1 c levels on admission ( r = 0.84, P ＜ 0.05 ). There was a positive correlation between the magnitude of the maximum hyperopic changes and the daily rate of blood glucose reduction over the first 7 days of the treatment ( r = 0.53, P ＜ 0.05 ). There was no significant correlation between the magnitude of the maximum hyperopic changes and the levels of random blood glucose on admission. No significant correlation was observed between the maximum hyperopic changes and fasting C-peptide or postprandial 2 h C-peptide.There were no significant correlations between the magnitude of the maximum hyperopic changes and age,blood press, body mass index, triglyceride, total cholesterol, low-density lipoprotein or high-density lipoprotein. No significant changes were observed in the intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length and axial length during glycemic control. Conclusions Transient hyperopic changes occur after glycemic control in diabetic patients with severe hyperglycaemia. The degrees of transient hyperopia are highly dependent on HbA1c levels before treatment and the rate of reduction of glucose level over the first 7 days of treatment. This is probably due to the decrease of refractive power by lens hydration, not morphological change of lens.
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Objective To investigate insulin resistance in type 1 diabetes(T1DM)with euglycemic-hyperinsulinemic clamp.Methods Eight cases of newly diagnosed T1DM and 8 cases of newly diagnosed type 2 diabetes(T2DM)were selected.Their insulin sensitivity index(ISI)was evaluated with euglycemic-hyperinsulinemic clamp after 2 week insulin intensive treatment and compared with that of 10 heMthy volunteers(normal control group,NC group).Results Age,BMI,fasting insulin(Fins),fasting C-peptide in the TI DM group were significantly lower than those in the NC group.while waist-to-hip ratio (WHR),systolic blood pressure(SBP),diastolic blood pressure(DBP),TC,TG,LDL-C,HDL-C were not significantly different between the T1DM and NC groups.Age,BMI,WHR,Fins,fasting C-peptide,SBP,TC,TG in the T1DM group were significantly lower than those in the T2DM group.The ISI of the NC,TlDM and T2DM groups were 12.83±1.09,9.95±0.50,3.80±0.20,respectively.There was significant difference among the three groups(P＜0.05).Conclusion The ISI in T1DM Was significantly lower than that in NC group,but higher than that in T2DM.
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To investigate the changes in the expression of G proteins ? subunit mRNA in non functioning thyroid adenoma (NFTA) and thyroid papillary cancer (TPC). Eleven thyroid specimens were obtained during surgery, 6 of which from patients with NFTA and 5 from patients with TPC. The expression levels of stimulating and inhibiting G protein ? subunit mRNAs were determined by reverse transcription polymerase chain reaction (RT PCR). The expression levels of Gsa mRNA in TPCs were significantly higher than those in normal thyroids and NFTAs( P
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Objective Hyperglycemic clamp technique (HGCT) was performed to evaluate the effect of short-term intensive insulin therapy on the first and second-phase (1PH and 2PH) insulin secretion and maximum insulin secretion (MIS) in newly diagnosed type 2 diabetics. Methods Twelve volunteers with normal glucose tolerance (NC group) and six newly diagnosed type 2 diabetics (DM group) were included and HGCT was performed to assess the function of pancreatic islet beta cell. Then HGCT was repeated in the 6 patients following two week intensive insulin therapy. Results The levels of secreted insulin in 1PH, 2PH and MIS were 257?36 mU/L, 63?5 mU/L and 80?5 mU/L in NC group respectively, and 95?19 mU/L, 34?9 mU/L and 39?12 mU/L in DM group respectively. 1PH insulin secretion was significantly improved in the diabetics following 2 week treatment compared with that before the treatment (135?27 mU/L vs 95?19 mU/L, P=0.01). The insulin secretions in 2PH and MIS were slightly increased (40?9 mU/L vs 34?9 mU/L, P=0.09, 46?11 mU/L vs 39?12 mU/L,P=0.08, respectively). Conclusions Short-term intensive insulin therapy can improve the insulin secretions significantly in 1PH and slightly in 2PH and MIS in newly diagnosed type 2 diabetics.
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In order to investigate influence of hypothyroidism on pituitary growth hormone (GH) reserve, a study was conducted on 14 patients with primary hypothyroidism (females 12, males 2; age range 15-58 yrs.) by measuring the response of GH to insulin-induced hypoglycaemia. Twenty healthy persons were used as normal controls. The serum peak GH values after hypoglycaemia were 18.84+7.17 ug/L in the patient group and 35.31 +3.98 ug/L in the controls. The difference was statistically significant (t = 2.157, p
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Serum calcium inorganic phosphate and parathyroid hormone (PTH) were measured in 24 patients with hyperthyroi-dism before and after antithyroid treatment. The levels of serum calcium dropped from 2.47 + 0.05 mmol / L (M + SE) to 2.30 +0.04 mmol/L following treatment (t = 2.83, p0.05). The levels of serum PTH rose from 51.88+ 7.15 pg / ml before the treatment to 75.17 +7.41 pg / ml after the treatment (t = 4.44, p
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Two-hundred-eighty-four patients with Graves' disease were followed up retrospectively and prospectively for from 6 months to 25 years after cessation of antithyroid drugs. The remission rate was found to be 65.6% (149/227) at 2 years, 53.5% (68/127) at 5 years and 38.8% (19/49) at 10 years and over. In order to study the remission rate with respect to the duration of treatment, the patients were divided into 3 groups: short-term (6.7?1.5 mos), mid-term(14.3 ?2.3mos)and long-term(26.1 ? 8.3mos). The remission rate was not statistically different among the 3 groups. T3 suppression and TRH stimulation tests were performed on 62 cases at discontinuation of the drugs and repeated on 20 cases 1 year later. Response to T3 suppression varied significantly among different groups immediately following cessation of therapy, but no similar difference Was demonstrated 1 year later. The present study indicates that serum levels of T3 and T4 and size of the goiter before treatment and the results of T3 suppression test as well may be of some value in predicting the outcome of anti-thyroid drug therapy. Since most of the patients with long-term remission were those who had received short-term therapy, it is suggested that about 6-month drug administration would seem to be just as effective as therapy of I onger durations.
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Patients with thyrotoxicosis had a normal circadian rhythm of ACTH and F,but the level of serum F was lower than controls due to excessive degradation.The responsiveness of ACTH to dexamet-hasone suppression or insulin hypoglycemic stimulation was normal.Whereas the circadian secretion of ACTH and F was also normal in patients with primary hypothyroidism,and the concentration of F was inreased with normal ACTH level.There were stunted responses of ACTH to suppressing and stimulating tests,which were thought to be due to the fact that the corticotropes were impaired by hypertrophy or hyperplasia of thyrotropes in primary hypothyroidism.