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ABSTRACT Introduction: Type 2 diabetes mellitus (T2DM), also known as non-insulin-dependent diabetes mellitus (NIDDM), accounts for more than 90% of the total number of diabetes mellitus cases and often occurs in middle-aged and elderly people. Objective: To investigate the effect of exercise intervention on insulin resistance in obese type 2 diabetes patients. Methods: Eighty-six obese diabetic patients were screened as experimental subjects in physical examinations and randomly divided into observation and control groups. Visceral fat volume, fasting blood glucose, and fasting insulin of all subjects were measured before and after completion of the 6-month experimental implementation. The insulin resistance was calculated for both groups and the values for each indicator were compared statistically between groups. Results: Control of body weight, body mass index, blood glucose, blood lipids and insulin resistance index were better in the observation group than in the control group, and the difference was statistically significant (P < 0.05). Conclusions: Basal intervention with quantitative exercise can significantly improve insulin resistance in obese type 2 diabetes patients and the effect is better than treatment with diet and conventional exercise. Level of evidence II; Therapeutic studies - investigation of treatment results.
RESUMO Introdução: O diabetes mellitus tipo 2 (T2DM), também conhecido como diabetes mellitus não insulino-dependente (NIDDM), é responsável por mais de 90% do total de casos de diabetes mellitus e, com frequência ocorre em pessoas de meia-idade e idosos. Objetivo: Investigar o efeito da intervenção com exercícios sobre a resistência à insulina em pacientes obesos com diabetes tipo 2. Métodos: Oitenta e seis pacientes diabéticos obesos foram selecionados como participantes experimentais em exames físicos e foram divididos randomicamente em grupos de observação e controle. Gordura visceral, glicose e insulina sanguíneas em jejum de todos os indivíduos foram medidas antes e depois do término do experimento de seis meses. A resistência à insulina foi calculada para ambos os grupos e os valores de cada indicador foram comparados estatisticamente entre os grupos. Resultados: O controle de peso, índice de massa corporal, glicose e lípides sanguíneos e o índice de resistência à insulina foram melhores no grupo observação do que no grupo controle, e a diferença foi estatisticamente significativa (P < 0,05). Conclusões: A intervenção basal com exercícios quantitativos pode melhorar significativamente a resistência à insulina em pacientes obesos com diabetes tipo 2 e seu efeito é melhor do que a dieta e a terapia com exercícios convencionais. Nível de Evidência II; Estudos terapêuticos - Investigação dos resultados do tratamento.
RESUMEN Introducción: La diabetes mellitus tipo 2 (DMT2), también conocida como diabetes mellitus no insulinodependiente (DMNID), representa más del 90% de todos los casos de diabetes mellitus y suele afectar a personas de mediana edad y ancianos. Objetivo: Investigar el efecto de la intervención con ejercicios sobre la resistencia a la insulina en pacientes obesos con diabetes tipo 2. Métodos: Se seleccionaron 86 pacientes diabéticos obesos como participantes experimentales en exámenes físicos y se dividieron aleatoriamente en grupos de observación y control. Se midieron la grasa visceral, la glucosa y la insulina en ayunas de todos los individuos antes y después de finalizar el experimento de seis meses. Se calculó la resistencia a la insulina en ambos grupos y se compararon estadísticamente los valores de cada indicador entre los grupos. Resultados: El control del peso, el índice de masa corporal, la glucosa y los lípidos en la sangre y el índice de resistencia a la insulina fueron mejores en el grupo de observación que en el grupo de control, y la diferencia fue estadísticamente significativa (P < 0,05). Conclusiones: La intervención inicial con ejercicios cuantitativos puede mejorar significativamente la resistencia a la insulina en pacientes obesos con diabetes tipo 2 y su efecto es mejor que la dieta y la terapia con ejercicios convencionales. Nivel de Evidencia II; Estudios terapéuticos - Investigación de los resultados del tratamiento.
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Background Apoptosis is a primary clinical pathological mechanism of diabetic retinopathy (DR).Oxidative stress and high glucose can activate cell apoptosis pathway and thus leads to cellular damage.It is confirmed that tert-butyl hydroquinone (tBHQ) plays an antioxidation effect,however,whether it has a protective role on retinal cells in DR is still unelucidated.Objective This study was to investigate the effect of tBHQ on vascular endothelial growth factor (VEGF) and bcl-2 expressions in retina of type 2 diabetic rats and its possible mechanism via nuclear factor erythroid 2-related factor 2/antioxidant response element (Nrf2/ARE) signal pathway.Methods Fifty clean healthy male SD rats were included in this experimental study.Ten rats were fed with normal diet as the normal control group,and other rats were fed with high fatty and high sugar food for 4 weeks.After 12 hours of fasting,streptozotoin (STZ) (30 mg/kg) was intraperitoneally injected to induce the type 2 diabetic models.The model rats were randomly divided into the diabetic control group and tBHQ group and 1％ tBHQ was added into the high fatty and sugar food 1 week after modeling in the tBHQ group.Fasting plasma glucose (FPG) level,blood total cholesterol (TC) level,blood triglyceride (TG) level,high density lipoprotein-cholesterol (HDL-C),low density lipoproteincholesterol (LDL-C) and fasting serum insulin (FINs) were detected 4 and 12 weeks after modeling,respectively,and radio immunoassay was used to detect the FIN levels of the rats.The relative expression of VEGF and bcl-2 in retinas of the rats were assayed by immunohistochemistry and fluorescence real-time quantitative PCR (qRT-PCR).The use of the animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State and Technology Commission.Results Type 2 diabetic models were successfully established in 35 rats with successful rate 92.1％.The FIN levels were significantly different among different groups and time points (Fgroup =22.480,P =0.000;Ftime =7.636,P =0.008).The FPG,TC,TG and LDL-C levels were significantly different among the groups (FPG:Fgroup =78.531,P =0.000;TC:Fgroup =28.049,P =0.000;TG:Fgroup =13.108,P =0.000;LDL-C:Fgroup =6.804,P＜0.05).Immunohistochemistry showed that VEGF and bcl-2 were mainly expressed in retinal ganglion cell layer,inner plexiform layer and outer plexiform layer.The expressions of VEGF and bcl-2 proteins were significantly different among different groups (VEGF:Fgroup =11.805,P =0.000;bcl-2:Fgroup =22.943,P =0.000);the expression level of bcl-2 protein was higher in 12 weeks after modeling than that in 4 weeks after modeling in the tBHQ group (P＜0.05).The expressions of VEGF and Bcl-2 mRNA in rat retinas were significantly different among different groups and time points (VEGF:Fgroup =79.220,P =0.000;Ftimo =6.090,P＜0.05;Bcl-2:Fgroup =105.000,P=0.000;Ftime =13.170,P=0.001).Four and eight weeks after modeling,the expressions of VEGF and Bcl-2 mRNA in the diabetic control group and tBHQ group were significantly higher than that in the normal control group,and the expressions of Bcl-2 mRNA in the tBHQ group were significantly higher than that in the model control group (all at P＜0.05);the expression of Bcl-2 mRNA was higher at 12 weeks after modeling than that at 4 weeks in the tBHQ group (P＜0.05).Conclusions tBHQ produces anti-oxidative-damage and anti-apoptosis effects on retinal cells by up-regulating VEGF expression and down-regulating bcl-2 expression in DR rats.In addition,tBHQ may have effects on lowering high blood sugar,regulating insulin and blood lipid levels.
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Objective To investigate the changes in visual acuity and macular edema lesions after laser treatment of diabetic retinopathy.Methods 92 patients with diabetic retinopathy were chosen for this study,they were treated with laser treatment,proliferative diabetic retinopathy (NPDR group) to take the whole retinal photocoagulation treatment of patients with non-proliferative diabetic retinopathy (PDR group) patients to take time full retinal photocoagulation treatment.Before and after treatment,visual acuity and macular edema changes were observed.Results Compared to pre-treatment,visual acuity after treatment in both two groups were significantly improved (0.49 ± 0.08)° vs (0.43 ± 0.09)°;(0.48 ±0.09)°vs (0.44 ±0.07)°],the difference was statistically significant (t =3.728,2.104,all P ＜ 0.05).Between NPDR and PDR group,the vision improvement had no statistically significant difference (P ＞ 0.05) ; compared with before treatment,foveal retinal thickness were significantly lower after treatment [(253.41 ± 66.73) μm vs (393.36 ± 92.18) μm; (287.25 ± 61.57) pm vs (388.02 ± 89.83) μm],the difference was statistically significant (t =6.233,3.541,all P ＜ 0.05) ; the thickness of the retinal foveal in NPDR group was significantly lower than PDR group,the difference was statistically significant (t =2.445,P ＜ 0.05).Conclusion Laser in the treatment of diabetic retinopathy can significantly improve visual acuity and macular edema,and it is better in non-proliferative diabetic retinopathy,which worthy of further promotion in clinical practice.
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Background Several types of cells participate in the formation of proliferative membrane in proliferative retinopathy (PVR),and the proliferation,migration and epithelial-mesenchymal transition (EMT) of retinal pigment epithelium (RPE) cells play an important role.Many studies have confirmed high blood glucose is the basic pathogenesis of diabetic retinopathy (DR).However,whether EMT could be induced in RPE cells under the high glucose condition has not been reported.Objective This study was to investigate the effects of high glucose on the migration and EMT of RPE cells in high glucose culture model in vitro.Methods Human RPE cell line D407 were cultured and passaged in DMEM/F12 medium with 10％ fetal bovine serum,and 6-8 generations of cells were used in experiment.The cells were divided into 3 groups based on different glucose concentrations in medium.The glucose at the final concentration 5.5 mmol/L or 60.0 mmol/L was respectively used in the normal control group or high glucose group,and the DMEM with 5.5 mmol/L glucose and mannitol was used in the hypertonic control group.The migration rate of the cells were detected 0,24,48 and 72 hours after scratching by wound-scratch test.Real-time PCR was used to detect the relative expressions of zonula occludens-1 (ZO-1) and α-smooth muscle actin (α-SMA) in the cells.Results Cultured cells showed a polygon shape with the clear nucleolus and dense arrangement in the normal control group and the hypertonic control group,but the cells were larger and elongated with the lapse of culture time with the indistinct structure and loose arrangement.At 48 hours after scratching,migrating cells were seen in the scratching area,and the scratching area disappeared at 72 hours after scratching in the high glucose group,but the scratching area still was existed in the normal control group or hypertonic control group.The migrating rate of the cells was higher in the high glucose group than that in the normal control group or hypertonic control group,showing total differences among 3 groups and various time points (Fgroup =328.600,P =0.000 ; Ftime =773.270,P=0.000).Compared with the normal control group,the expression level of ZO-1 mRNA was significantly lower,and α-SMA mRNA level was higher 48 hours and 72 hours in the high glucose group than those in the normal control group (all at P＜0.05).Conclusions High glucose induce the migration and EMT of RPE cells in vitro,which may be associated with the pathogenesis of proliferative diabetic retinopathy.
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Background In recent years,some researches show that getting younger over the diabetes mellitus (DM) was an obrious trend.But studies of early diabetic retinopathy in young people with diabetes were few.Both patients and doctors did not put enough importance on it.Objective This study was to evaluate the earlier dynamic changes of retina morphology and function caused by type 2 DM in young population.Methods A cohort study was designed.One hundred and thirty-six young patients who were initially diagnosed as type 2 DM in Cangzhou Central Hospital were included from January to March in 2010 and 91 healthy individuals with the matched age were enrolled at the same period.Glycated hemoglobin (HbAlc) level in blood was assayed yearly,and ophthalmoscope,optical coherence tomography (OCT) and visual contrast sensitivity (CS) examinations were performed to evaluate the dynamic changes of retinal nerve fiber layer (RNFL) thickness around optical disc,retinal function and retinal microvessels of DM patients.In addition,the correlation between RNFL thickness or CS and average HbAlc level in DM patients was assessed.This study followed Declaration of Helsinki,and written informed consent was obtained from each subject.Results The levels of HbAlc in DM patients were (7.5 ±1.6) ％,(7.2 ±1.6) ％,(7.4 ±1.6) ％,(7.6±1.6)％ and (7.7 ±1.6)％ in 2010,2011,2012,2013 and 2014,respectively,and HbAlc≥7.0％ was observed in 74 patients (54.4％).The RNFL thicknesses of full optic disk and superior 1/4 quadrant of the optic disk were significantly declined in 2012,2013 and 2014 in the DM group compared with the normal control group (full disk:t =2.216,5.003,7.303;all at P ＜ 0.05.superior 1/4 quadrant:t =2.382,5.657,7.194;all at P ＜ 0.05),but no significant differences were found between them in 2010 and 2011 (all at P＞0.05).In the DM group,RNFL thicknesses of full optic disk were (99.94±10.01) μm and (96.32±10.32) μm in 2013 and 2014,which were significantly lower than (104.55±9.23) μm in 2010 (t=7.819,13.959,both at P＜0.05);the RNFL thicknesses of superior 1/4 quadrant around disk were (118.64± 13.98) μm and (115.06 ± 14.35) μm in 2013 and 2014,which were significantly lower than (127.48± 13.67) μm in 2010 (t =10.504,14.758,both at P＜0.05),However,the RNFL thicknesses were not significantly changed among the different time points in the normal control group (all at P＞0.05).In addition,the CS values of 3.0,6.0,12.0,18.0 c/d in 2013 and 2014 in the DM group were lower than those in the normal control group (all at P＜0.05),and the CS values in 2013 and 2014 were reduced in comparison with 2010 in the DM group (all at P＜0.05).Positive correlations were found between the differences of RNFL thickness or CS and the average HbAlc level in the DM group (r =0.640,F =8.991,P =0.000;r =0.541,F =7.572,P =0.000).Retinal microaneurysms were seen in two type 2 DM patients by ophthalmoscope at the end of follow-up.Conclusions The young people with type 2 DM have poor blood glucose control.The RNFLs are thinning and visual functions are declining in young type 2 DM patients with the lapse of disease course,and these retinal damages are associated with poor control of blood glucose.
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Background Conventional studies showed that the primary pathological change of diabetic retinopathy (DR) is retinal microangiopathy.However,recent studies found that the disorder of visual function appears prior to retinal microangiopathy in diabetic patients.Thereby,this findings can not be explained by conventional view.Objective The aim of the study was to find the change of retinal nerve fiber layer (RNFL) by frequency domain optical coherence tomography(OCT) in the diabetic patients without retinal microangiopathy and with non-proliferative DR (NPDR) and investigate the relationship between the change of RNFL thickness and DR.Methods Sixty eyes of 56 patients with 2 type diabetes mellitus were enrolled in Shanxi Eye Hospital from October 2012 to September 2013.The patients were divided into the non-diabetic retinopathy (NDR) group (30 eyes of 26 patients) and NPDR group (30 eyes of 30 patients) depending on the findings of fundus fluorescine angiography (FFA) according to the DR International Clinical Classification System.Thirty normal eyes of 30 age-and gendermatched healthy volunteers were included as controls.RNFL thicknesses around optical disc and macular zone were measured by OCT,including average RNFL thickness in 360°,superior nasal,superior temporal,temporal,inferior temporal,inferior nasal and nasal RNFL thicknesses.The measuring results were compared between the three groups.Results The total average thickness values of RNFL around the optic disc for the NDR group,NPDR group and the control group were (97.46-± 8.65) μm,(100.69 ± 16.35) pm and (109.22 ± 8.69) μm,respectively,and the parameters in the NDR group and NPDR group were significantly lower than those in the normal control group (P=0.001,0.006).The RNFL thicknesses were thinning at the superior temporal,temporal,inferior temporal,inferior nasal quadrants around optical disc in NDR group compared with the normal control group (P=0.001,0.001,0.001,0.010),and RNFL thickness values of all the quadrants were decresed in the NPDR group compared with the normal control group,and significant differences were seen in superior temporal and nasal quadrants (P =0.001,0.046).The total average thickness values of RNFL around macular zone for the NDR group,NPDR group and the normal control group were (33.47±3.39),(36.81±3.21) and (38.18±2.16) μm,and parameters in the NDR group was significantly lower than that in the normal control group (P =0.001).The RNFL thicknesses of all the quadrants around macular zone in the NDR group were thinned in comparison with the normal control group (all at P＜0.01),and the RNFL thicknesses at the superior nasal,superior temporal and temporal quadrants were significantly decreased in comparison with the normal control group (P=0.026,0.015,0.001).Conclusions The thinning of the RNFL thickness occurs prior to retinal microangiopathy in diabetic patients,and it may be an early pathological stage for DR.
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Background The primary pathological basis of diabetic retinopathy (DR) is new blood formation due to anoxia and inflammation,which results in breakdown of blood-retinal barrier (BRB).Vascular endothelial growth factor (VEGF) is a key factor promoting neovascularization.Researches determined that lycium barbarum polysaccharides (LBP) can protect cells against oxidative damage.However,the study of LBP in ophthalmology is lack.Objective This study was to investigate the effects of LBP on the dynamic pathological change of retinal vessels and expression of VEGF in retina of diabetic rats.Methods One hundred and seventeen SPF male SD rats were randomly divided into the normal control group,the diabetic mellitus (DM) group and the LBP group according to random number table.Type 1 DM models were induced by intraperitoneal injection of streptozotocin (STZ,55 mg/kg) in the rats of the DM group and the LBP group,and then 250 mg/kg LBP was intragastically administered in the rats of the LBP group.The morphological change of retinal vessels was dynamically observed by retinal stretched preparation with Evans blue (EB) in 4,10 and 16 weeks after modeling.E B (45 mg/kg) was slowly injection via jugular vein,and 1％ polyoxymethylene was infused into the left ventricule.The eyeballs were extracted and retina were isolated.EB content in the retinas (mg/g) was calculated using retinal stretched preparation method at the time points mentioned above.Expressions of VEGF protein and mRNA in the retinas were detected by immunohistochemistry and real-time quantitative PCR at various time points,respectively.Results Retinal stretched preparation with EB exhibited that the abnormal degree in the shape,diameter of vessels and leakage of the retinal blood vessels were significantly slighter in the LBP group than those of the DM group in 4,10,16 weeks after modeling.At 4,10,16 weeks,EB content in the retinas was (12.17±1.55),(16.46±1.60) and (19.55±1.49) mg/g,which was significantly lower than (15.76± 1.90),(21.61 ±2.05) and (26.30±2.28) mg/g of the DM group (P＜0.05).Immunochemistry showed that the expression of VEGF protein primarily located at retinal ganglion cells (RGCs) layer.The staining intensity for VEGF protein was weaker in the LBP group than that of the DM group.The expression levels of VEGF protein (A value) in the LBP group were 0.234±0.011,0.331±0.023 and 0.536±0.031at various time points,with significant decline in comparison with 0.281±0.018,0.533±0.055 and 0.765±0.075 of the DM group (all at P＜0.05).Real-time quantitative PCR revealed that the expression levels of VEGF mRNA were 0.157±0.013,0.505 ±0.114 and 1.577±0.074 in the LBP group at various time points,which were significantly lower than 0.235±0.209,1.043±0.084 and 2.446±0.061 of the DM group (all at P＜0.05).Conclusions LBP can alleviate the DM-induced retinal vasculopathy,lessen the leakage of vessels well,and further protect the BRB.
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Diabetes-related macular exudation is a common fundus change associated with diabetes mellitus,charactered by hard exudates of macular area.It is one of main causes of lowing vision in diabetic patients.The incidence of diabetes-related macular exudation is increasing recent years,and therefore the diabetic maculopathy is also a matter of urgent concern.Domestic and international studies suggested that many systemic factors,such as blood glucose level,blood pressure,hypertension,higher blood lipid,inflammatory factors and genetic predisposition,exert impacts in the pathogenesis and development of diabetic retinopathy.However,whether the hard exudates of macular area also is associated with systemic factors mentioned above is unclear up to now.Since the hard exudates of diabetic maculopathy may leads to permanent loss of visual function,it is very important for us to find the effective prevent and managing approaches.This paper aimed to review the progress in this field and summarize the relevant risk factors that must be strictly controlled.
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Background Vitrectomy is an effective method to proliferative diabetic retinopathy (PDR) in type 2 diabetic patients.Postoperative vitreous hemorrhage is a major cause of vision loss.Objective This study was to analyze the related factors of vitreous hemorrhage after vitrectomy in proliferative retinopathy with type 2 diabetes.Methods Three hundred and five eyes of 305 cases who received vitrectomy for PDR from type 2 diabetes were retrospectively investigated.The clinical data of 14 eyes with vitreous hemorrhage after vitrectomy were analyzed.Results Vitreous hemorrhage after vitrectomy occurred in 14 eyes with the incidence 4.6％.The PDR was grade ⅣV in 3 eyes,grade Ⅴ in 4 eyes and grade Ⅵ in 7 eyes.Pars plana vitrectomy with intraocular laser photocoagulation was performed on all the 14 eyes,and 1 eye accepted scleral condensation and 8 eyes accepted silicone oil tamponade.Visual acuity was improved in 6 eyes,unchanged in 4 eyes and worsen in 4 eyes after initial surgery.Vitreous hemorrhage appeared in postoperative 1-7 days in 9 eyes,8 days-3 months in 1 eye,3-6 months in 2 eyes and over 6 months in 2 eyes.The cause for postoperative vitreous hemorrhage included residual neovascular membrane,insufficient photocoagulation range and intensity,neovascularization and instable blood glucose level.Vitreous hemorrhage disappeared in 5 eyes after medicine therapy,and reoperation in 9 eyes.In the end of the follow up,visual acuity improved in 9 eyes,unchanged in 2 eyes and worsen in 3 eyes.Retinas reattached in 13 eyes.However,the retina was still detached in 1 eye with silicone oil tamponade.Conclusions Postoperative vitreous hemorrhage usually occurs within 1 week.The main related factors are residual retinal neovascular membrane,inadequate intraocular laser photocoagulation and unstable blood glucose level.Medicine therapy is effective for postoperative vitreous hemorrhage in type 2 diabetic patients,but re-vitrectomy is needed for excessive vitreous bleeding.
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Background Retinal photocoagulation iconsidered to be an effective therapy fodiabetiretinopathy (DR).Fundufluorescein angiography (FFA) iused to determine if panretinal photocoagulation (PRP) ineeded.SometimeFFiunsuitable fosome Dpatients,and funduphotography igenerally applied.However,whethecolofunduphotography can substitute foFFin evaluating Dgrading and advising foadministering the photocoagulation protocol iunclear.Objective Thistudy wato compare the grading outcomebetween colofunduphotography and FFin assessing DR.Methodprospective case serieself-controlled study wadesigned.Thiclinical study waapproved by the EthiCommittee of Shanghai Tenth People'Hospital,and written informed consenwaobtained from each patienprioto entering the series.Five 50° non-stereoscopiphotographwere taken in 238 eyeof 136 patientwho methe criteriof type 2 diabetes,and then the FFwaperformed.The imagewere analyzed based on the 2003 International DiabetiRetinopathy Disease Severity Scale.The comparison of the grading outcomein assessing Dbetween colofunduphotography and FFwaevaluated by the Kappagreementesusing SPS17.0.ResultFunduphotography showed mild non-proliferative D(NPDR) in 17.2％ of case(41/238),moderate NPDin 20.2％ of case(48/238),severe NPDin 27.7％ of case(66/238) and PDeyein 34.9％ of case(83/238).FFshowed mild NPDin 20.2％ of case(48/238),moderate NPDin 17.6％ of case(42/238),severe NPDin 19.3％ of case(46/238) and PDin 42.9％ of case(102/238).The concordance foDgrading between funduphotography and FFwasubstantial (κ =0.653,P＜0.01).In evaluating whetheiwanecessary to administePRP (to severe NPDand PDpatients),good concurrence waobserved between funduphotography and FF(κ=0.812,P＜0.01).ConclusionThe merge image from five 50° non-stereoscopiphotographpresentagood indicatofothe selection of PRP in Dpatientwith type 2 diabetes.However,the physicianshould be cautiouin the evaluation of retinal non-perfusion areand neovascularization by funduphotography.
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Background Diabetiretinopathy(DR) icommon ophthalmivasculadisease which can lead to blindness,and itpathogenesiicomplex.C-peptide iby-producin insulin synthesis,and loof studieindicate thaC-peptide iclosely related with diabetimicrovasculacomplications.Objective Thistudy wato explore the clinical significance of the detection of C-peptide to assesthe prognosiof non-proliferative DR(NPDR).Methodretrospective case-observational study wadesigned.The clinical datof 205 casewith NPDwere collected in Wuhan Puren Hospital from January 1,2009 to January 1,2010.The patientwere diagnosed by fundufluorescein angiography (FFA) and the stageof theidiseasewere determined based on the Dstaging developed by the Chinese Ophthalmological Society fundustudy group.Twenty-seven-month follow-up waperformed fothe patientto record the parameterof theiblood biochemistry,changein theiphysical conditions,and changein theiblood pressure and DM.The patientwere assigned to the PDgroup and NPDgroup athe end of the follow-up.The independenrisk factofoNPDwaanalyzed using the univariate analysis,and multivariate logistiregression analysiwaused to evaluate the correlation of varioufactorwith pooprognosiof NPDR.Receiveoperating characteristi(ROC) curve wadrawn to assesthe prediction efficiency of C-peptide fothe prognosiof NPDR.ResultThe clinical datof 205 patientwith NPDwere reviewed,and 15 patientfailed to show up fovisitarate of 7.3％.One hundred and ninety patientwith NPDfinished follow-up with mean age of (41.54± 8.15)years.Of the 190 patients,69 patient(36.3％) advanced to PDR,and 121 patient(63.7％) were NPDduring the follow-up.Significandifferencewere seen in age,hypertension history,smoking history,DM course and C-peptide levelbetween the PDgroup and PDgroup (age:=13.78,P＜0.05 ; hypertension history:x2 =21.57,P＜0.05 ;smocking history:x2 =26.96,P＜0.05;DM course:t=6.89,P＜0.05;C-peptide:t=20.50,P＜0.05).pooprognosiwacorrelated with age (OR:1.04,95％ CI:1.01-1.07),hypertension history (OR:1.05,95％ CI:1.02-1.08),smokinghistory (OR:1.07,95％CI:1.04-1.11),DM course (0R:1.18,95％CI:1.13-1.25) oC-peptide conten(0R:1.09,95％ CI:1.06-1.12).The areundethe ROcurve wa0.835 (P＜0.05,95％ CI:0.818-0.843) when the C-peptide waincluded,buwalarge than 0.769 (P ＜ 0.05,95％ CI:0.754-0.780) when Cpeptide waexcluded.ConclusionThe levelof blood C-peptide are lowein the PDpatientthan those in the NPDpatients,and the lowelevel of blood C-peptide in the NPDpopulation increasetheirisk of developing PDR.Testing foblood C-peptide level can benefithe prognosiof NPDR.
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Background: Autonomic neuropathy is a serious complication of diabetes mellitus. Cardiac autonomic neuropathy (CAN) is chronic diabetic complication with variable prevalence and clinical manifestations. Prevalence of CAN remains less explored domain among type 2 diabetic population. Aim: To analyse the prevalence of CAN in type 1 and type 2 DM. Materials and methods: A total of 152 cases with DM were selected for the study following strict inclusion and exclusion criteria. All the cases underwent a battery of cardiovascular reflex tests designed by Ewing. Results: We observed that overall prevalence of CAN was 51.9%. Prevalence of sympathetic and parasympathetic CAN was 28.9% and 44% respectively. When compared, prevalence of CAN in type 1 patients was significantly different from type 2. Further, significant difference was noted between parasympathetic and sympathetic CAN in these patients. Conclusion: Study concludes that, prevalence of CAN in type 1 DM is higher than type 2. Parasympathetic CAN prevalence is higher than sympathetic CAN in both groups.
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@#ObjectiveTo search detecting urine transforming growth factor-β1(TGF-β1) of type 2 diabetes mellitus(DM) in diagnosing early diabetic nephropathy in old patients.MethodsTGF-β1,microalbumin,microglobulin α1 and microglobulin β2 in urine from 53 cases of old type 2 diabetics and 27 cases of normal controls were detected.ResultsTGF-β1 was(21.2±7.32) ng/mmolCr in diabetics whose urine albumin were normal and was(58.79±25.93) ng/mmolCr in diabetics whose urine microalbumin was abnormal(P<0.01).Both were significantly higher than that of the normal control which was(7.79±3.58) ng/mmolCr(P<0.01).TGF-β1 was direct remarkably correlative with microablumin(r=0.5415),microglobulin α1(r=0.6282) and microglobulin β2(r=0.3248)(P<0.01 respectively),but was nothing with glycohemoglobin(r=0.2304,P>0.05).ConclusionTGF-β1 detection may be used as a sensitive and reliable guideline to diagnose early diabetic nephropathy in old diabetics.
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PURPOSE: Flavobacterium indologenes is known to cause keratitis very rarely. Authors have experienced 1 case of keratitis from Flavobacterium indologenes with history of diabetes mellitus, thereby reporting it. METHODS: History taking, slit lamp examination, staining and culture, sensitivity test about antibiotics were performed on 1 case of keratitis. RESULTS: Flavobacterium indologenes was detected in staining and culture that was performed on the first visit. Piperacillin was used based on the sensitivity test about antibiotics. Improvement of corneal lesion and symptom was observed with the use of piperacillin. CONCLUSIONS: Flavobacterium indologenes can be considered as a casual pathogen in keratitis with condition susceptible to opportunistic infection such as systemic illness or abnormal ocular immunity.