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Objective:Continuous glucose monitoring (CGM) technology is used to compare the advantages of insulin degludec (IDeg) as a basal insulin regimen compared with insulin glargine (IGlar) in the treatment of adult type 1 diabetes mellitus.Methods:30 adult patients with T1DM admitted to Heji Hospital Affiliated to Changzhi Medical College from September 2019 to December 2020 were screened. According to the random number table method, the patients were randomly divided into two groups (insulin degludec group and insulin glargine group) at a ratio of 1∶1, respectively treated with IDeg, IGlar and aspartate insulin for 12 weeks. The main outcome measures were the coefficient of variation of blood glucose (CV), mean amplitude of glycemic excursions (MAGE), time in range (TIR), time above range (TAR) and time below range (TBR). The secondary outcome measures were mean blood glucose (MBG), standard deviation of blood glucose (SD), fasting blood glucose (FPG), 2 h postprandial blood glucose (2 h BG), hemoglobin A1c (HbA 1c), means of daily differences (MOOD), and the frequency of hypoglycemic events. Results:At 12 weeks of treatment, the HbA 1c, FPG, 2 h BG, MBG, SD, CV and MAGE of insulin degludec group were lower than those of insulin glargine group, with statistically significant difference (all P<0.05). The TIR in the insulin degludec group was significantly higher than that in the insulin glargine group [73(63, 75)% vs 43(28, 63)%, P<0.001], and the TAR was lower than that in the glycerine group [25(17, 23)% vs 35(33, 64)%, P=0.003]. From the curve spectrum of blood glucose level of the two groups, the stability of blood glucose in the insulin degludec group was better than that in the insulin glargine group. After 12 weeks of treatment, 8 cases (8/15) in insulin degludec group had HbA 1c<7.0%, and 4 cases (4/15) in insulin glargine group had HbA 1c<7.0%, without statistically significant difference ( P=0.264). There were 7 cases (7/15) in the insulin degludec group and 1 case (1/15) in the insulin glargine group who achieved high quality blood glucose control, with statistically significant difference ( P=0.035). At the 12th week of outpatient follow-up, the incidence of nocturnal hypoglycemic events in insulin degludec group was significantly lower than that in insulin glargine group (4/15 vs 11/15, P=0.027). Conclusions:Compared with insulin glargine, insulin degludec can achieve higher blood glucose compliance rate, lower blood glucose level and reduce blood glucose fluctuations in patients with type 1 diabetes.
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Objective To establish a sound and reasonable talent assessment mechanism in the introduction of scientific research talents through the reform of human resources management.Methods Based on the iceberg theory,understand better of the candidates to optimize the matching between personnel and positions.Results We proposed a multi-dimensional assessment system that combines the introduction of talents with tiered assessment of standardized talent rankings,concrete assessment will take into account of the performance and designed tasks.Established talent evaluation criteria are including moral virtues,knowledge,capacity,achievement and contributions to further improve medical ethics,clinical practice,scientific research and education training,public health services,as well as moral characteristics.Conclusions Through innovative administration,the multi-dimensional assessment system could be implemented in the introduction of scientific research talents,according to which different levels of talent will be better matched to avoid "one size fits all" or other problems.The system could also inspire the introduced talents to play a leading role in discipline development,to fulfill the strategy of strengthening hospital with talents,as well as better service for medical health.
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Objective To study the relationship of the levels of serum interleukin-6 (IL-6) and C-reactive protein (CRP) with insulin resistance in normal glucose tolerant first-degree relatives (NGT) of type 2 diabetics.Methods A total of 218 normal glucose tolerance subjects , including 136 NGT of type 2 diabetes , and 82 normal control ( NC) without type 2 diabetes family history were enrolled.The levels of blood glucose, hemoglobin A1c (HbA1c), lipid, insulin, IL-6, and high-sensitivity C-reactive protein (hs-CRP) were measured.Results ⑴Compared with NC, the levels of homeostasis model assessment of insulin resistance (HOMA-IR), hs-CRP , and IL-6 in NGT were significantly increased [1.03~1.94 vs 0.42~0.95 , P <0.01;0.46~2.78 mg/L vs 0.39~1.56 mg/L, P <0.01;(13.6 ±8.99) pg/ml vs (8.08 ±3.67) pg/ml, P <0.01];⑵In NGT, hs-CRP was positively correlated with HOMA-IR and IL-6 ( r =0.326 , P <0.01;r =0.258 , P <0.05 );IL-6 was positively correlated with HOMA-IR ( r =0.350 , P <0.01).Conclusions IL-6 and CRP may correlate with the degree of insulin resistance in NGT of type 2 diabetics.
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<p><b>OBJECTIVE</b>To study the pharmacokinetics and bioavailability of ginkgolides sustained-release tablet and conventional tablet in Beagle dogs.</p><p><b>METHOD</b>The concentrations of ginkgolides in plasma were determined by LC-MS. The main pharmacokinetic parameters of ginkgolides sustained-release tablet and conventional tablet in vivo were obtained using Pharmacokinetic software DAS 2.0.</p><p><b>RESULT</b>The C(max) of grinkgolide A in ginkgolide sustained-release tablet and conventional tablet were 443.51, 1 039.30 microg x L(-1), respecitvely. t(max) were 2.92, 1.08 h, respectively. AUC(0-12h) were 1 808.21, 2 041.37 h x microg(-1) x L(-1), respectively. MRT were 5.18, 3.18 h, respectively. The relative bioavailability of ginkgolides A was 88.58%. The C(max) of ginkgolide B in ginkgolide sustained-release tablet and conventional tablet were 407.13, 547.38 microg x L(-1), respectively. t(max) were 2.92, 1.08 h, respectively. AUC(01-12 h) were 1 987.31, 1 748.04 h x microg(-1) x L(-1), respectively. MRT were 6.05, 4.98 h, respectively. The relative bioavailability of ginkgolides B was 113.69%.</p><p><b>CONCLUSION</b>The ginkgolides sustained-release tablets have good sustained release characteristics and are bioequivalent to the reference formulation.</p>
Subject(s)
Animals , Dogs , Male , Area Under Curve , Biological Availability , Chromatography, High Pressure Liquid , Methods , Delayed-Action Preparations , Pharmacokinetics , Ginkgolides , Pharmacokinetics , Lactones , Mass Spectrometry , Methods , Quality Control , Tablets , Pharmacokinetics , Therapeutic EquivalencyABSTRACT
Objective To investigate the mechanism for rhein to improve the insulin sensitivity in diabetes mellitus. Methods Male Wistar rats were randomly divided into normal control group (NC,n=15) and diabetic group (DM,n=40) induced by STZ and high-fat diet.Diabetic rats were randomly divided into diabetic control group (DM-C,n=15) and diabetic group treated with rhein (DM-T,n=15).Then DM-T group was given intragastric administration with rhein at the dose of 100 mg/ (kg-1?d-1) for 11 weeks.FBG,fasting serum insulin (FIns),triglyceride (TG),total cholesterol (TC),insulin sensitivity index (ISI) and other biochemical parameters in each group were measured.The protein expressions of PPAR-? and GluT-4 were determined by immunohistochemistry and Western blot. Results At the end of the 17th week,compared with NC group,DM-C group showed higher FBG and TG,lower ISI,lower protein expressions of PPAR-? and GluT-4 in the adipose tissue.Compared with DM-C group,DM-T group showed lower FBG [(15.73?3.08 vs 22.57?3.23) mmol/l,P
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Objective To investigate the effects of rhein on insulin sensitivity of diabetic rats induced by high fat feeding and low dose streptozotocin (STZ), and the possible mechanisms. Methods (1) Fifty-five Wistar rats were randomly divided into normal control group (NC,n=15) and diabetes group (DM, n=40). The NC rats were fed with regular chow and DM rats were fed with high fat diet. Five weeks later, the DM rats were injected with STZ 30 mg/kg once. The 30 diabetic rats were randomly divided into two subgroups, diabetic control group (DM-C) and diabetic group treated with rhein (DM-T). DM-T rats received intragastric administration of rhein and DM-C rats were given equal doses of solvent. All rats were sacrificed eleven weeks later, the blood sample was collected. The body weight, fasting blood glucose (FBG), HbA1C, triglycerides (TG), tolal cholesterol (TC), glycosylated serum protein (GSP) and Fasting insulin (FINS) concentrations were examined.The insulin sensitive index (ISI) and homeostasis model assessment for insulin resistance (HOMA-IR) werecalculated. (2) The PPART and GLUT-2 expression in hepatic tissue were detected by immunohistoehemistry and Western-blot. Results At the end of experiment the FBG [(22.57±3.23 vs 7.11±1.44) mmol/L,P<0.01],HbA1C[(12.49±1.96 vs 8.36±0.84)%, P<0.01], TG [(0.89±0.29 vs 0.58±0.17)nunoL/L,P<0.01],GSP [(57.29±4.14 vs 13.43±2.70)μmoL/L, P<0.01] and tumor necrosis factor-α [TNF-α,(1.365±0.133 vs 1.233±0.159) μg/L, P<0.05] and the liver weight index (0.032±0.004 vs 0.024±0.002, P<0.01) in DM-C rats were higher than those in NC rats. Besides, the ISI of DM-C rats decreased [In(ISI),-5.46±0.61 vs -4.81±0.75, P<0.05] and HOMA-IR elevated [In(HOMA-IR),2.34±0.64 vs 1.70±0.78,P<0.05]. The expression of PPARγ [11 131.7(5 723.1-18 979.4) vs 48 782.1(21 576.7-108 829.5), P<0.01] and GLUT-2 (0.98±0.35 vs 1.29±0.27, P<0.05) of DM-C rats decreased markedly compared with NC rats. Compared with DM-C rats, FBG [(15.94±3.16) mmol/L], HbA1C[(10.51±1.74)%], GSP[(47-31±6.09) μmol/L] in DM-T and the In (HOMA-IR), (1.86±0.30) rats decreased (P<0.05 or P<0.01), and In (ISI), of DM-T rats increased (-4.97±0.29, P<0.05). The expressions of PPARγ [35 156.3(24 554.3-86 660.9)] and GLUT-2 (1.55±0.55) of DM-T rats were up-regulated markedly compared with DM-C rats (P<0.05 or P<0.01). Conclusion Rhein decreased FBG, HbA1C and GSP, and improved the insulin sensitivity in diabetic rats, which might be related to the up-regulated expressions of PPARγ and GLUT-2 in hepatic tissue.