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Objective To analyze the efficacy and safety of glimepiride treatment as initial monotherapy in newly diagnosed patients with type 2 diabetes mellitus (T2DM).Methods This was a subgroup analysis of the GREAT study,which investigated the efficacy and safety of glimepiride as initial monotherapy in Chinese patients with T2DM.This analysis was performed in 209 patients with disease duration less than 6 months and never received any anti-diabetic drugs.The change of HbA1C,fasting plasm glucose (FPG),2 h postprandial blood glucose (2hPPG),homeostasis model assessment for β-cell function index (HOMA-β),homeostasis model assessment for insulin-resistance index(HOMA-IR),the percentage of patients with HbA1C ＜ 7.0％ at endpoint and the incidence of hypoglycemia were evaluated after 16-weeks treatment.Results After 16-weeks glimepiride treatment,HbA1C value reduced significantly from baseline to endpoint,the reduction was statistically significant (9.21％ ± 1.65％ to 6.69％±0.83％,P＜0.001),69.7％ of the patients achieved HbA1C ＜7.0％ at study endpoint.Glimepiride-treated patients also achieved a significant improvement in FPG [from (10.15 ± 2.13) mmol/L to (7.23 ± 1.50) mmol/L,P＜0.001] and 2hPPG [from (17.21 ±4.14) mmol/L to (11.62 ± 3.34) mmol/L].HOMA-β was improved from 17.21± 15.19 [11.62 (2.90,115.8)] to 41.13 ± 44.12 [28.00 (5.1,360.00)],and HOMA-IR was reduced from 2.32± 1.90 [1.76 (0.60,12.80)] to 2.07 ± 1.74 [1.63 (0.4,12.3)].The incidence of all reported symptomatic hypoglycemia was 18.2％,and the incidence of confirmed hypoglycemia was 3.8％.Conclusion This analysis showed that glimepiride treatment as an initial mono-therapy could effectively improve blood glucose control in newly diagnosed patients with T2DM,and the treatment may improve islet β cell function,and the safety profile is reasonably good.
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Objectives To investigate the epidemiological and clinical characteristics of dyslipidemia as well as its treatment and influence on accompanying diseases in impaired glucose status among inpatients. Methods A cross-sectional survey was conducted among the inpatients registered in ten university hospitals of Guangdong, China during the week before the Diabetes Day in 2004. The fasting blood glucose (FBG), lipid profiles, BMI, waist to hip ratio (WHR) and concomitant disorders of the first screen during the hospitalization period were recorded. Those who had FBG level from 5.6 to 6. 9 mmol/L and not been previously diagnosed diabetes (PDM) underwent oral glucose tolerance test (OGTF). Results Of the 8753 inpatients investigated, 1067 eases had complete medical records(CMR case) including PDM cases and previously non-diagnosed diabetes ones with FBG ≥ 5. 6 mmol/L. Of the previously non-diagnosed diabetes cases with FBG levels from 5.6 to 6.9 mmmol/L, 65.8% accepted OGTT. Of the CMR cases, 41.9% had PDM, 21.7% was newly diagnosed diabetes mellitus (NDM), 29. 1% had impaired glucose regulation (IGR) and only 7.3% had normal glucose tolerance (NGT). The TG levels in NDM and PDM group were higher than those in IGR and NGT group (P < 0.05, respectively). The HDL-C levels in IGR, NDM and PDM group were lower than those in NGT group (P < 0.05, respectively). Sixty-nine point six percent of the diabetes mellitus (DM) inpatients was accompanied with dyslipidemia and the rate was higher than those in NGT (56.4%) and IGR inpatients (52.5%, P <0.05, respectively). Only 22. 8% of the PDM inpatients underwent treatment of dyslipidaemia and just 3.4% achieved the target suggested by the guideline of ATP-Ⅲ. BMI was higher and waistline longer in the PDM and NDM inpatients than those in the NGT cases (P <0.05, respectively). Seventy-two point eight percent of the PDM inpatients was complicated with more than one type of vascular diseases. Nine point seven percent and 0. 2% of the NDM inpatients were tormented by diabetic nephropathy and diabetic retinopathy respectively. Conclusions More inpatients with accompany DM or IGR had concomitant dyslipidemia than those with NGT, which included hypertriglyccridemia, hypo-high-density lipoproteinemia and metabolic syndrome. Concomitant vascular diseases were more frequently found in PDM inpatients than in the others. Some of the NDM and IGT inpatients were complicated with microvascular diseases.
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AimTo study the effects of glipizide and met formin on the serum IGF-1,IGF-2 in patients with type Ⅱ diabetes mellitus; Methods The effect of glipizide(n ＝ 40) and metformin(n ＝ 25) on serum IGF-1, IGF-2 in patients with type Ⅱ diabetes mellitus were compared with self- controlled study. Results In metformin-treated patients ,there were not significantly changes in fasting IGF-1 and IGF-2 concentrations, In glipizide-treated patients, there were markedly increased IGF-1 concentrations(181.8+ 104.5) vs (209.0+ 88.2) ng· ml-1(P＜0.05) while serum IGF-2 was not change. There was a significant reduction of blood glucose in two groups at the end of treatment(both P＜0.01), but C-peptide level was markedly increased(P＜0.05) only in glipizide-treatedpatients.Conclusion The changes of IGF-1 is markedly different between metformin-treated and glipizide-treated patients with type Ⅱ diabetes mellitus.
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Objective To understand the death rate and the main death causes of the senile diabetic inpatients. Methods The histories of all the death cases of senile diabetic inpatients in this hospital from 1992 to 1999 were reviewed. The death rate and causes of senile diabetics were compared with those of the non-senile diabetics. Results Senile diabetics among the total diabetic inpatients increased within 8 years (56.93% during 1992-1995 vs. 67.63% during 1996-1999,P80 yrs group being 23.60%, P
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Objective The aim of the present study was to assess the changes of IGF-1,IGF-2,IGFBP-1 and IGFBP-3 in diabetes nephropathy,the relationships between IGFs,IGFBPs and ?_1-,?_2- microglobulin.Methods A total of 130 type-2 diabetic participants(male:52,female:78)aged 37~75 yeares in Guangdong Provincial People's Hospital were enrolled from Feb.2000 to May 2003.Serum IGF-1,IGF-2,IGF binding protein 1(IGFBP-1),IGFBP-3,creatinine(Cr),cholesterol,triglycerides,HDL,LDL,apolipoprotein B100(apoB100),apoA,HbA_1c,fasting and postprandial C-peptide,serum and urine ?_1-MG and ?_2-MG were measured.Patients were divided into clinical albuminuria(DN,n=24),microalbuminuria(MA,n=40),and normal(NOR,n=66)groups according sCr and urine Alb/Cr ratio.Results In multiple linear regression analysis,determinants of S ?_1-MG were IGF-2 、TC and age(r=0.492,P=0.0001);U ?_1-MG were IGF-2、age(r=0.307,P=0.007); S ?_2-MG were IGFBP-1、HDL and age(r=0.528,P=0.0001);U ?_2-MG were IGFBP-1、CP120 and age(r=0.407,P=0.0001);s-Cr were IGFBP-1、CP0 and age(r=0.499,P=0.0001)。Serum IGF-2 and IGFBP-1 were significantly increased in DN group[IGF-2:(889.48?65.94)?g/L vs (711.57?28.73)?g/L,P=0.03;IGFBP-1:(94.91?17.48)?g/L vs(54.81?5.04)?g/L,P=0.009].Conclusion Serum IGFBP-1 and IGF-2 are significantly increased in type 2 diabetes with nephropathy.The disorders of IGFs and lipid metabolism may contribute to the development of diabetic nephropathy.
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Dynamic ~(13)N-NH_3 positron emission tomography (PET) imaging was performed in 8 normal subjects and 6 cases of hypopituitarism. The pituitary images were small and delayed, and blood perfusion and radioactive uptake were decreased in hypopituitarism. ~(13)N-NH_3 PET imaging shows diagnostic value in hypopituitarism.