ABSTRACT
Objective:To investigate the long-term effect of the implantation of human umbilical cord-derived mesenchymal stem cells (HUC-MSCs) for type 1 diabetes mellitus.Methods:Fifteen patients with type 1 diabetes mellitus were treated with HUC-MSCs from September 2009 to December 2011 at Department of Endocrinology and Metabolism, the Second People′s Hospital. Patients were followed-up for 10 years and the parameters were collected including fasting blood glucose, HbA 1C, mean amplitude of glycemic excursions (MAGE), fasting C-peptide, daily insulin doses and glutamic acid decarboxylase antibody (GADA). Results:Among 15 patients, 1 patient (6.67%) was found with breast cancer. All patients with type 1 diabetes mellitus decreased daily insulin doses due to frequent hypoglycemia one week later. Six months later, 4 patients (26.67%) stopped insulin injection. While among the 4 patients, 1 patient (6.67%) had not yet used insulin until today and GADA was negative, the other 3 patients (20.00%) restarted insulin within 3-5 years after implantation with significantly less daily insulin doses [(18.00±1.00)U vs (29.00±1.73)U, P<0.01]. The remaining 11 patients (73.33%) with type 1 diabetes mellitus who did not stop insulin also had significantly lower daily insulin doses [(18.09±0.83)U vs (29.64±0.89)U, P<0.01]. The level of MAGE was signicantly decreased compared to those of pre-implantation [(6.14±0.25)mmol/L vs (9.72±0.32)mmol/L, P <0.01], while fasting C-peptide level was significantly improved[(0.91±0.03)nmol/L vs (0.11±0.01)nmol/L, P <0.01]. There were no significant differences in fasting blood glucose and HbA 1C before and after implantation. Conclusions:The implantation of HUC-MSCs for the treatment of type 1 diabetes mellitus can restore the function of islet β cells, decrease daily insulin doses and reduce blood glucose fluctuations in the long term. Although precise mechanisms are unknown, this therapy is expected to be an effective strategy for treatment of type 1 diabetes mellitus.
ABSTRACT
OBJECTIVE:To observe the clinical efficacy of sitagliptin combined with benazepril in the treatment of diabetic nephropathy(DN). METHODS:Sixty DN patients admitted to our hospital during Sept. 2014-Jun. 2015 were divided into sitagliptin group,benazepril group,drug combination group according to random number table,with 20 cases in each group. Based on routine treatment,sitagliptin group was given sitagliptin 100 mg orally,qd;benazepril group was given Benazepril 10 mg orally,qd;drug combination group was given sitagliptin 100 mg+benazepril 10 mg orally,qd. The drug dosage would be doubled if the blood pressure of patients in 3 groups had not yet reached the standard. Treatment course of 3 groups lasted for 12 weeks. The levels of 24 h urine protein,IL-6 and Cys-C were measured in 3 groups before and after treatment. Clinical efficacies and the occurrence of ADR were observed. RESULTS:Total response rate of drug combination group(90.00%)was significantly higher than those of sitagliptin group (65.00%)and benazepril group(70.00%);there was statistically significance(P0.05). No obvious ADR was found in 3 groups during treatment. CONCLUSIONS:Both sitagliptin and benazepril can decrease the levels of 24 h urine protein,IL-6 and Cys-C,while drug combination shows better effect and clinical response rate,and does not influence the safety of drug use.