ABSTRACT
Objective To explore the clinical effect of cognitive rehabilitation therapy combined with repetitive transcranial magnetic stimulation (rTMS) on diabetes mellitus patients complicated with early cognitive impairment.Methods Eighty patients with type 2 diabetes mellitus complicated with early cognitive impairment admitted to our hospital between February 2016 and February 2018 were randomly divided into a control group and an observation group.Patients in both groups were treated with conventional medications and comprehensive rehabilitation training,while the observation group was additionally treated with rTMS for 4 weeks.The fasting blood glucose (FBG) was detected before and after the treatment.The cognitive status,as well as the latency and amplitude of P300 were evaluated using Montreal cognitive assessment (MoCA),NTS-2000 Instrument for electromyography and evoked potentials before and after the treatment.Results After the treatment,significant decrease was observed within both groups in terms of FBG compared to before the treatment,but no significant differences between the two groups were revealed (P＞0.05).After the treatment,the sub-scores and total scores of the MoCA scale of the two groups were significantly higher than those before treatment,with those of the observation group significantly higher than the control group.After the treatment,the latency of P300 decreased significantly,while the amplitude of P300 increased significantly in both group,with significantly higher improvement in the observation group than the control group (P＜0.05).Conclusion rTMS,in addition to cognitive function rehabilitation,significantly improved cognitive function status in patients with type 2 diabetes mellitus complicated with early cognitive impairment.Such combination is worthy of clinical promotion with its safety,reliability and patient compliance.
ABSTRACT
Objective To investigate the effect of blood glucose level on pulmonary diffusion capacity in elderly patients with type 2 diabetes and its clinical significance.Methods Totally 132 older adults with type 2 diabetes were enrolled in this study.According to blood glucose level,the patients were divided into well-controlled group (n =57) and poor controlled group (n =75).Additionally,52 age-matched non-diabetic healthy subjects were selected as control group.Levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS) and 2-hour postprandial glucose (2h PG) in the diabetic patients were detected,and homeostasis model assessment of insulin resistance (HOMA IR) was calculated.The patients with type 2 diabetes underwent urinary albumin excretion rate (UAER) detection,fundus examination and nerve conduction velocity test.pulmonary ventilation,diffusion of the lungs for carbon monoxide (DLCO) and DLCO corrected by alveolar volume (DLCO/VA) were examined in all subjects.Results Levels of FBG,2h PG,HbA1c and HOMA-IR were higher in poor-controlled group than in good glycemicwell-controlled group (all P＜0.05).Compared with the control group,body mass index (BMI) was increased in diabetic groups (both P＜0.05).The pulmonary ventilation function in the three groups had no significant differences (P＞0.05).DLCO and DLCO/VA were lower in diabetic groups than in the control group(all P＜0.05).DLCO and DLCO/VA in poor-controlled group were lower than those in well controlled group (both P＜0.05).DLCO and DLCO/VA were lower in patients with microangiopathy score ≥ 2 than those without microangiopathy (both P ＜ 0.05).Multiple liner regression analysis showed that DCLO and DLCO/VA were negatively correlated with HbA1c,HOMA-IR,duration of diabetes and microangiopathy (r=-2.51,-2.35,-2.42,-2.37,-2.41,-2.52,-2.47,-2.36,all P＜0.05).Conclusions The pulmonary diffusion capacity is significantly impaired in elderly patients with type 2 diabetes.Pulmonary diffusion capacity is negatively correlated with the blood glucose level.The lung may be one of the target organs of type 2 diabetes mellitus.