ABSTRACT
Objective To investigate the relationship between heart rate variability ( HRV) and chronic complications in pa-tients with type 2 diabetes mellitus (T2DM).Methods A total of 96 patients with T2DM was given chronic complication assessment . Demographic data were obtained .Diabetic retinopathy , diabetic kidney disease , diabetic peripheral neuropathy ( DPN) , and peripher-al artery disease ( PAD) were diagnosed according to international clinical classification .The parameters of HRV in the patients with diabetes and non-diabetes were examined with24 h Holter recorder .Results The HRV parameters of type 2 diabetic patients were significantly lower than those of non-diabetes ( P <0.05 ) .HRV time domain parameters [ standard deviation of normal RR intervals (SDNN), standard deviation of 5-minute mean RR intervals (SDANN), root mean square difference among successive RR normal in-tervals ( RMSSD) ] were especially impaired in diabetic patients with retinopathy compared to those without retinopathy .HRV parame-ters except low-to-high frequency ratio ( LF/HF) and MNN were lower in diabetic patients with kidney disease than those without kid-ney disease .HRV parameters were no significant difference between patients with or without PAD .Conclusions HRV of diabetic pa-tient is lower.Diabetic retinopathy and kidney disease impact on the HRV .
ABSTRACT
The professional care by multi-disciplinary team and priority of prevention should be carried out in the treatment of diabetic foot disease to reduce diabetic amputation.This article describes the professional experience in the treatment of four complicated cases with diabetic foot disease and emphasizes the importance of the co-operation among different specialists,including diabetologists and wound,vascular,orthopedic surgeons,etc.as well as of varied therapies applied in staged management of the diabetic foot care,by treating these patients with diabetic foot disease as early as possible.
ABSTRACT
According to the alanine aminotransferase (ALT)level, 4 509 patients were assigned into group A (n=449, with raised ALT)and group B (n=4 060, normal ALT). Between the patients of group A and B, differences existed in age [(48.5 ± 11.3 vs 55.7 ± 11.4) years, P＜0.01], duration of diabetes [( 36.8 ±45.0 vs 56.2±58.8 ) months, P＜0. 01], body mass index[BMI, (27.7±3.9 vs 25.8±3.4) kg/m2, P＜0.01], waist-tohip ratio (0.95±0.06 vs 0. 93±0.07, P＜0. 01 ), diastolic blood pressure [( 78± 10 vs 75± 10) mm Hg, 1 mm Hg=0. 133 kPa, P＜0. 01], fasting blood glucose [(9.04±2.91 vs 8.63 ±3.05 ) mmol/L, P = 0. 008], 2 h blood glucose after meal[( 13.85±4.67 vs 13.07 ± 4. 92 ) mmol/L, P=0. 002], HbA1c(8. 11% ± 1.82% vs 7.74% ±1.96%, P＜0. 01 ), fasting serum insulin[( 10.59±7.31 vs 7.97±7.18) mU/L, P＜0. 01], postprandial insulin [(48.96±43.80 vs 35.25 ±32.37 ) mU/L, P＜0. 01], homeostasis model assessment for insulin resistance ( HOMA-IR, 4.11±-2.85 vs 3.00 ± 2.92, P＜ 0. 01 )、 triglycerides [( 2.77 ± 2.50 vs 2. 19 ± 2.99 ) mmol/L, P＜0. 01], and high-density lipoprotein-cholesterol [HDL-C, ( 1.20 ± 0. 30 vs 1.29 ± 0. 83 ) mmol/L, P = 0. 01].Logistic regression analysis showed that HbA1C, postprandial insulin, and HOMA-IR, uric acid and urinary albumin were positively, and HDL-C negatively related with the ALT level. It suggests that raised ALT seems to be an index related to the clustering of cardiovascular risk factors, insulin resistance, and earlier onset of type 2 diabetes.