Decreasing complexity of glucose time series derived from continuous glucose monitoring is correlated with deteriorating glucose regulation / 医学前沿

Most information used to evaluate diabetic statuses is collected at a special time-point, such as taking fasting plasma glucose test and providing a limited view of individual's health and disease risk. As a new parameter for continuously evaluating personal clinical statuses, the newly developed technique "continuous glucose monitoring" (CGM) can characterize glucose dynamics. By calculating the complexity of glucose time series index (CGI) with refined composite multi-scale entropy analysis of the CGM data, the study showed for the first time that the complexity of glucose time series in subjects decreased gradually from normal glucose tolerance to impaired glucose regulation and then to type 2 diabetes (P for trend < 0.01). Furthermore, CGI was significantly associated with various parameters such as insulin sensitivity/secretion (all P < 0.01), and multiple linear stepwise regression showed that the disposition index, which reflects β-cell function after adjusting for insulin sensitivity, was the only independent factor correlated with CGI (P < 0.01). Our findings indicate that the CGI derived from the CGM data may serve as a novel marker to evaluate glucose homeostasis.

Low-carbohydrate diets lead to greater weight loss and better glucose homeostasis than exercise: a randomized clinical trial / 医学前沿

Lifestyle interventions, including dietary adjustments and exercise, are important for obesity management. This study enrolled adults with overweight or obesity to explore whether either low-carbohydrate diet (LCD) or exercise is more effective in metabolism improvement. Forty-five eligible subjects were randomly divided into an LCD group (n = 22) and an exercise group (EX, n = 23). The subjects either adopted LCD (carbohydrate intake < 50 g/day) or performed moderate-to-vigorous exercise (⩾ 30 min/day) for 3 weeks. After the interventions, LCD led to a larger weight loss than EX ( - 3.56 ± 0.37 kg vs. - 1.24 ± 0.39 kg, P < 0.001), as well as a larger reduction in fat mass ( - 2.10 ± 0.18 kg vs. - 1.25 ± 0.24 kg, P = 0.007) and waist circumference ( - 5.25 ± 0.52 cm vs. - 3.45 ± 0.38 cm, P = 0.008). Both interventions reduced visceral and subcutaneous fat and improved liver steatosis and insulin resistance. Triglycerides decreased in both two groups, whereas low-density lipoprotein cholesterol increased in the LCD group but decreased in the EX group. Various glycemic parameters, including serum glycated albumin, mean sensor glucose, coefficient of variability (CV), and largest amplitude of glycemic excursions, substantially declined in the LCD group. Only CV slightly decreased after exercise. This pilot study suggested that the effects of LCD and exercise are similar in alleviating liver steatosis and insulin resistance. Compared with exercise, LCD might be more efficient for weight loss and glucose homeostasis in people with obesity.

Approach to the patient with acute suppurative thyroiditis: diagnosis and treatment / 中华内分泌代谢杂志

Acute suppurative thyroiditis (AST) is a rare non-specific infectious disease of thyroid gland.The signs and symptoms of AST may mimic those of a variety of noninfectious inflammatory conditions or other anterior neck infectious diseases.AST is a progressive disease and is also potentially life threatening if devoid of prompt diagnosis and proper treatment.Herein,we report a case in order to call attention to the diagnosis and treatment of AST.

Research progress of dead-in-bed syndrome in type 1 diabetes / 中华内分泌代谢杂志

Dead-in-bed syndrome (DBS) is a rare but devastating sudden death condition that mainly affects young patients with type 1 diabetes.Its mechanism is quite complicated and may involve multiple factors.Acute onset of recurrent and severe nocturnal hypoglycemia,abnormal cardiac repolarization,genetic factors,and obstructive sleep apnea may all contribute to ventricular arrhythmias and even sudden death.The future research plans include elucidating and understanding the underlying mechanisms and triggers for DBS,developing a risk stratification system,using real-time continuous glucose monitoring system to detect severe nocturnal hypoglycemia,and initiating appropriate therapeutic interventions to uhimately prevent the tragedy.