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1.
Article in Chinese | WPRIM | ID: wpr-931701

ABSTRACT

Objective:To investigate the prevalence and risk factors of diabetic retinopathy (DR) in patients in Tibet.Methods:A total of 239 patients with DR who received treatment in Department of Endocrinology and Metabolism, Hospital of Chengdu Office of People's Government of Tibet Autonomous Region from December 2017 to December 2018 were included in this study. They were divided into Han nationality and Zang nationality groups according to ethnicity. The condition of DR was evaluated with nonmydriatic ocular fundus photography according to the staging criteria of the severity of retinopathy.Results:The prevalence of DR in Tibet was 18.0%. The prevalence of DR in Tibetan and Han patients with diabetes was 17.5% and 19.2%, respectively. There was no significant difference in the prevalence of DR between Tibetan and Han patients with diabetes ( χ2 = 0.10, P = 0.754). Logistic regression analysis revealed that the risk factors of developing DR in Tibet included diabetes duration ( OR = 1.14, 95% CI: 1.05-1.24, P < 0.05), insulin therapy ( OR = 2.74, 95% CI: 1.09-6.89, P < 0.05), fasting plasma glucose ( OR = 1.37, 95% CI: 1.07-1.75, P < 0.05) and hypertension ( OR = 1.98, 95% CI: 1.02-3.86, P < 0.05). Diabetes duration and fasting plasma glucose are independent risk factors of DR. However, although elevated glycated hemoglobin levels were high in Tibet, they could not be used to predict the risk for developing DR ( OR = 1.01, 95% CI: 0.82-1.25, P > 0.05). Conclusion:Hyperglycemia is an important risk factor of developing DR in Tibet. However, elevated glycated hemoglobin levels cannot be used to predict the risk of developing DR in Tibet. Findings from this study fill the gap in the research on DR prevalence and ethic difference of DR prevalence, providing scientific evidence for prevention and treatment of DR in high-altitude areas.

2.
Chinese Journal of School Health ; (12): 1544-1547, 2021.
Article in Chinese | WPRIM | ID: wpr-904603

ABSTRACT

Objective@#To explore the performances of HbA1c when identifying elevated blood glucose among pre pubertal children, and to provide scientific basis for early screening biomarkers of abnormal blood glucose in children.@*Methods@#A total of 1 208 prepubertal children aged 7 to 10 years old in Xiamen were sampled with the cluster sampling method. Fasting venous blood was drawn to measure the level of HbA1c and FPG. According to American Diabetes Association (ADA) criteria, participants were divided into normal group, HbA1c abnormal group, FPG abnormal group and combined abnormal group. Partial correlation analysis was used to analyze the correlation between HbA1c and FPG. The cutoffs of HbA1c were calculated when FPG was 5.6 mmol/L. Receiver operating curve (ROC) was used to judge the performances of HbA1c while screening abnormal blood glucose.@*Results@#With HbA1c, FPG and the combined indicators as the screening criteria, the prevalence of high blood glucose were 2.2%, 4.0%, and 5.8%, respectively. The partial correlation coefficient of FPG and HbA1c was 0.15( P <0.01), and the correlation coefficient in girls( r =0.22) and non overweight group( r =0.16) were higher. The cutoff of HbA1c was 5.15% if FPG was 5.6 mmol/L. Taking the combined indicator as the reference standard, the AUC of FPG was 0.84 (95% CI =0.79-0.90) and the AUC of HbA1c was 0.69 (95% CI =0.63-0.74).@*Conclusion@#There is a low correlation between HbA1c and FPG in pre pubertal children. The performance of HbA1c is different from FPG when used as the indicator to screen children with abnormal blood glucose. It is recommended to use the combined indicator of HbA1c and FPG to screen abnormal blood glucose in prepubertal children.

3.
Article in Chinese | WPRIM | ID: wpr-942212

ABSTRACT

OBJECTIVE@#To investigate the situation of quality of life in patients with type 2 diabetes and its associated factors.@*METHODS@#Questionnaires, physical examination and glycated hemoglobin test were conducted in 747 patients with type 2 diabetes. Hemoglobin A1c (HbA1c) was a proxy for glycemic control, diabetes specific quality of life scale (DSQL) score was a proxy for quality of life. Factors associa-ted with DSQL were analyzed by multiple linear regression and structural equation modeling (SEM).@*RESULTS@#A total of 747 patients were included in this study. The mean HbA1c level was (7.1±1.2)%, with 35.1% reaching the target (262/747). There were significant differences in disease duration, me-dication and use of insulin, smoking, and body mass index (BMI) between the two groups with good and poor glycemic control (P < 0.05). The total score of DSQL was 44.92±13.32, in which average phy-siological factors were the highest, then followed by scores of psychological factors. Multiple linear regression showed that monthly household income, comorbidities, depression, duration of illness, insulin, hospitalization, and self-efficacy were significantly associated with the total score of DSQL (P < 0.05). SEM showed that blood glucose control was significantly associated with the scores of physical factors (0.166), psychological factors (0.076), and social factors (0.124) of DSQL, respectively. Depression had effects on the physical factors (0.342), psychological factors (0.217), and treatment factors (0.050) of DSQL (P < 0.05).@*CONCLUSION@#Glycemic control in our study is relatively poor but the quality of life remains well. More attention should be paid to patients who are male, with long diagnosis duration, poor medication adherence, smoking, with depression and with low diabetes-related skills. In practice, health practitioners should be aware of psychological needs of patients, and offer mental health education to patients and their families, in order to help patients manage blood glucose and improve their quality of life.


Subject(s)
Beijing , Blood Glucose , Diabetes Mellitus, Type 2/epidemiology , Female , Glycated Hemoglobin A , Humans , Male , Quality of Life
4.
Article in Chinese | WPRIM | ID: wpr-909197

ABSTRACT

Objective:To investigate the relationship between pre-delivery glycated hemoglobin A1c (HbA1c) level and pregnancy outcome in patients with gestational diabetes mellitus (GDM).Methods:A total of 200 GDM patients who received treatment in Zhuji Maternal and Child Health Hospital, China between April 2018 and April 2020 were included in this study. All patients were subjected to health education, medical nutrition therapy, exercise intervention and necessary drug treatment. These patients were divided into GDM-1 (HbA1c > 7.0%, n = 30), GDM-2 (HbA1c 5.5%-7.0%, n = 30) and GDM-3 (HbA1c < 5.5%, n = 106) groups according to HbA1c levels within pre-delivery 1-3 days. An additional 400 healthy pregnant women who concurrently received health examination were included in the healthy control group (NC group). HbA1c level was compared between GDM patients and healthy controls. Pregnancy outcome was compared among patients with different HbA1c levels. Results:The incidences of pregnancy-induced hypertension, pathologic excess of amniotic fluid volume, cesarean section, asphyxia, neonatal hyperbilirubinemia, neonatal hypoglycemia, giant infant and premature delivery were significantly higher than those in the NC group ( χ2 = 4.59, 8.11, 9.19, 7.42, 10.05, 11.52, 35.75, 21.12, all P < 0.05). The incidences of pregnancy-induced hypertension, pathologic excess of amniotic fluid volume, cesarean section, asphyxia, neonatal hyperbilirubinemia, neonatal hypoglycemia, giant infant and premature delivery in the GDM-1 group were 10.00% (3/30), 30.00% (9/30), 33.33% (10/30), 26.67% (8/30), 30.00% (9/30), 36.67% (11/30), 50.00% (15/30), 30.00% (9/30), respectively, and they were 4.69% (3/64), 14.06% (9/64), 28.13% (18/64), 14.06% (9/64), 18.75% (12/64), 18.75% (12/64), 39.06% (25/64), 15.63% (10/64), respectively in the GDM-2 group, and 0.94% (1/106), 6.60% (7/106), 14.15% (15/106), 9.43% (10/106), 4.72% (5/106), 4.72% (5/106), 18.87% (20/106), 9.43% (10/106), respectively in the GDM-3 group. There were significant differences in these indexes among the three groups ( χ2= 6.07, 11.91, 7.56, 5.97, 15.97, 21.59, 14.47, 8.07, all P < 0.05). Conclusion:Pre-delivery HbA1c level in GDM patients is related to pregnancy outcomes such as pregnancy-induced hypertension, pathologic excess of amniotic fluid volume, cesarean section, asphyxia, neonatal hyperbilirubinemia, neonatal hypoglycemia, giant infant and premature delivery. Strict control of blood glucose is of great significance to improve the outcomes of pregnant patients with GDM and their newborns.

5.
Article in Chinese | WPRIM | ID: wpr-908659

ABSTRACT

Objective:To analyze the correlation of glycosylated hemoglobin (HbA 1c) level in the late pregnancy gestational diabetes mellitus (GDM) patients and fetal weights, neonatal Apgar scores, maternal and infant adverse outcomes. Methods:One hundred and eighty-seven pregnant women who were diagnosed with GDM from January 2015 to July 2019 and delivered in Yixing People′s Hospital after standard diagnosis and treatment were divided into four groups (A group: HbA 1c<6.0%, 65 cases; B group: HbA 1c: 6.0% - 6.5%, 49 cases; C group: HbA 1c 6.6%-7.0%, 39 cases; D group: HbA 1c>7.0%, 34 cases) according to the HbA 1c examination results at 28 to 32 weeks of gestation. General data, fetal weights, neonatal Apgar scores and maternal and infant adverse outcomes were compared among the four groups. The correlation between GDM HbA 1c and fetal weights, neonatal Apgar scores and maternal and infant adverse outcomes were analyzed by unconditional Logistic regression. Results:In general data of GDM pregnant women with different HbA 1c levels, only oral glucose tolerance test (OGTT) fasting blood glucose: (4.68 ± 0.60), (4.89 ± 0.69), (5.23 ± 0.90), (6.48 ± 2.17) mmol/L; postprandial 1 h blood glucose: (9.84 ± 1.56), (10.09 ± 1.84), (10.6 ± 2.01), (12.74 ± 4.12) mmol/L; postprandial 2 h blood glucose: (8.65 ± 1.49), (8.86 ± 1.76), (9.28 ± 2.15), (11.56 ± 4.93) mmol/L, showed statistically significant differences ( P<0.05). Among the newborns of GDM pregnant women with different HbA 1c levels, there were statistically significant differences in the macrosomic infant rates: 1.54%(1/65), 10.20%(5/49), 12.82%(5/39), 17.65%(6/34); rates of neonatal Apgar scores<7 points:13.85%(9/65), 16.33%(8/49), 25.64%(10/39), 44.12%(15/34); the proportion of maternal and infant adverse outcomes: 24.62%(16/65), 24.49%(12/49), 28.21%(11/39), 50.00%(17/34), showed statistically significant differences ( P<0.05). After adjusting OGTT by unconditional Logistic regression analysis, HbA 1c (6.6%-7.0% and>7.0%) was independent risk factor for macrosomic infants: OR = 1.430, 95% CI = 1.035-1.977, P = 0.030; OR = 2.042, 95% CI = 1.311-3.180, P = 0.001; maternal and infant adverse outcomes: OR = 1.774, 95% CI = 1.130-2.874, P = 0.010; OR = 3.387, 95% CI = 1.608-7.133, P = 0.001. HbA 1c>7.0% was independent risk factors for neonatal Apgar scores<7 points: OR = 1.848 95% CI = 1.086-3.143, P = 0.023. Conclusions:There was a significant correlation between HbA 1c in GDM pregnant women in the late pregnancy and macrosomic infants, neonatal Apgar scores, and maternal and infant adverse outcomes. In particular, GDM pregnant women with HbA 1c>7.0% should be alert to the risk of macrosomic infants, neonatal Apgar score<7 points, and maternal and infant adverse outcomes.

6.
Article in Chinese | WPRIM | ID: wpr-801483

ABSTRACT

Objective@#To investigate the correlation between blood glucose and aneurysm rupture, and analyze the correlation factors of aneurysm rupture.@*Methods@#The clinical data of 128 patients with intracranial aneurysms in the First Affiliated Hospital of Kunming Medical University from January 2017 to August 2018 were retrospectively analyzed. Among them, intracranial aneurysm rupture was in 85 cases (rupture group), and unruptured was in 43 cases (unruptured group). The patient′s clinical features and aneurysm morphological features were recorded.@*Results@#The blood glucose, daughter sac rate and regularity of morphology rate in ruptured group were significantly higher than those in unruptured group: (6.74 ± 2.61) mmol/L vs. (5.77 ± 2.11) mmol/L, 60.00% (51/85) vs. 11.63% (5/43), and 68.24% (58/85) vs. 30.23% (13/43), the aneurysm width was significantly smaller than that in unruptured group: (4.53 ± 2.25) mm vs. (5.67 ± 2.68) mm, and there were statistical differences (P<0.05 or <0.01). There were no statistical difference in gender, age, blood pressure, diabetes, hypertension, smoking history, glycosylated hemoglobin, blood lipids, aneurysm length, aneurysm neck, aneurysm length ratio to neck between 2 groups (P>0.05). Univariate Logistic regression analysis result showed that blood glucose, aneurysm width, daughter ascus and irregular shape were the risk factors of rupture of aneurysm (P<0.05 or <0.01). Multivariate Logistic regression analysis result showed that blood glucose, aneurysm width, daughter sac and irregular shape were the independent risk factors of rupture of aneurysm (OR = 1.364, 0.709, 9.441 and 3.935; 95% CI 1.073 to 1.734, 0.565 to 0.889, 2.879 to 30.963 and 1.330 to 11.646; P = 0.011, 0.003, 0.000 and 0.013). The patients were grouped again according to the aneurysm width, and univariate Logistic regression analysis result showed that aneurysm width ≤ 3 mm was the risk factors of rupture of aneurysm (OR = 0.294, 95% CI 0.094 to 0.916, P = 0.035).@*Conclusions@#Irregular shape and daughter sac of aneurysm are the independent risk factors of aneurysm rupture, but aneurysm rupture has nothing to do with recent blood sugar levels.

7.
Journal of Clinical Hepatology ; (12): 2537-2541, 2019.
Article in Chinese | WPRIM | ID: wpr-751311

ABSTRACT

@#ObjectiveTo investigate the clinical features of diabetic patients with bacterial liver abscess and different levels of glycosylated hemoglobin (HbAlc). MethodsA total of 118 adult diabetic patients with bacterial liver abscess who were admitted to our hospital from December 2014 to December 2018 were enrolled, and according to the level of HbAlc, they were divided into well-controlled group with 32 patients, fairly-controlled group with 31 patients, and poorly-controlled group with 55 patients. The three groups were compared in terms of general data, clinical manifestations, laboratory results, complications, and pathogen test results. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. ResultsThere were significant differences in mean age and length of hospital stay between the three groups (F=2.933 and 3.310, both P<0.05). Compared with the other two groups, the poorly-controlled group had a significantly younger mean age of onset (P=0.016) and a significantly longer length of hospital stay (P=0.044). Hypertension was the most common underlying disease in diabetic patients with liver abscess, followed by biliary tract diseases and cerebral infarction, and there was a significant difference in cerebral infarction between the three groups (χ2=6.135, P=0037). Compared with the well-controlled group, the poorly-controlled group had significantly fewer and less typical signs of abdominal tenderness (χ2=6.178, P=0.046), and compared with the other two groups, the poorly-controlled group tended to have a significant increase in C-reactive protein (χ2=5.985, P=0.049) and were more likely to develop sepsis (χ2=6.247, P=0.044). ConclusionFor diabetic patients with bacterial liver abscess, the patients with a poorly controlled HbAlc level often have a young age of onset, a long length of hospital stay, and atypical clinical signs and are likely to develop sepsis, which may lead to insufficient attention in clinical practice, delay diagnosis and treatment, and even endanger life, and therefore, such patients should be taken seriously in clinical practice.

8.
Article in Chinese | WPRIM | ID: wpr-746240

ABSTRACT

Measurement of glycosylated hemoglobin (HbA1c) is an important indicator for assessing long term glycemic control in individuals with diabetes mellitus.There are more than 300 different assay methods for the analysis of HbA1c.This review outlines the current developments about biosensors assay as well as the situation of POCT analyzers in the market for HbA1c detection at present.

9.
Article in Chinese | WPRIM | ID: wpr-746180

ABSTRACT

Objective To observe and analyze the effect of HbA1c level on macular microcirculation in patients with type 2 diabetes mellitus (T2DM).Methods A cross-sectional study.One hundred and twenty-four T2DM patients (124 eyes) without diabetic retinopathy who diagnosed by the examination of fundus color photography in Lixiang Eye Hospital Of Soochow University during September to December 2017 were enrolled in this study.There were 59 males (59 eyes) and 65 females (65 eyes),with the mean age of 65.06±7.99 years old.All patients underwent BCVA,fundus color photography,and OCT angiography (OCTA).The history of diabetes,hypertension and dyslipidemia were recorded in detail.According to the HbA 1 c level,patients were divided into three groups,HbA1c ideal control group (group A,HbA1c <7%,67 eyes),HbA1c control group (group B,7%≤HbA1c≤9%,44 eyes),and HbA1c poor control group (group C,HbA1c>9%,13 eyes),respectively.The 3 mm × 3 mm range of the macular area was scanned by OCTA instrument.The vascular density (VD) and skeleton density (SD) of nonsegmented retinal layer (NRL),superficial retinal layer (SRL) and deep retinal layer (DRL) in the macular area and foveal avascular zone (FAZ) area,non-circularity index,axial rate (AR) of SRL were measured.The correlation between HbA1c,BCVA and VD,SD ofNRL,SRL,DRL was analyzed statistically with Spearman correlation test.The correlation between systemic factors and the above indicators was analyzed statistically with linear regression analysis.Results The results of linear regression analysis showed that HbA1 c was significantly correlated with VD (t=-3.237,-3.156,-2.050) and SD (t=-0.3.45,-3.034,-2.248) of NRL,SRL and DRL (P<0.05);but no correlation with FAZ,non-circularity index and AR (t=1.739,0.429,1.155;P>0.05).The differences of VD (F=6.349,5.981,3.709),SD (F=7.275,6.085,1.904) and AR (F=0.027) of NRL,SRL and DRL in group A,B and C were statistically significant (P<0.05);but the differences of FAZ (F=1.904),non-circularity index (F=0.280) was not statistically significant (P>0.05).Significant differences (P<0.05) of VD and SD of NRL were found between group A and B (t=1.987,2.201),group A and C (t=3.365,3.572),group B and C (t=2.010,2.076).Significant differences (P<0.05) of VD and SD of SRL were found between group A and B (t=2.087,2.168),group A and C (t=3.197,3.194).There were significant differences (P< 0.05) in SD of DRL between group A and B (t=2.239),group A and C (t=-2.519).There was significant difference in VD of DRL between group A and C (t=2.363).The results of Spearman correlation analysis showed that HbA1c was negatively correlated with VD (r=-0.273,-0.255,-0.222;P=0.002,0.004,0.013) and SD (r=-0.275,-0.236,-0.254;P<0.05) ofNRL,SRL,DRL;positively correlated with FAZ and BCVA (r=0.221,0.183;P<0.05).BCVA was negatively correlated with VD (r=-0.210,-0.190,-0.245) and SD (r=-0.239,-0.207,-0.296) of NRL,SRL,and DRL (P<0.05),but not correlated with FAZ (r=0.099,P>0.05).Conclusion The decrease of macular perfusion and the morphological change of FAZ accompanied by HbA1c increased.

10.
Journal of Chinese Physician ; (12): 383-386, 2019.
Article in Chinese | WPRIM | ID: wpr-744882

ABSTRACT

Objective To investigate the correlation between serum carcinoembryonic antigen (CEA) levels and vascular endothelial growth factor (VEGF) levels in diabetics.Methods 92 cases of hospitalized diabetics (they were divided into the pre-treatment group and after-treatment group by intensive hypoglycemic treatment) were collected,and 94 cases of healthy controls were chosen as control group.Serum levels of CEA,hemoglobin Alc (HbAlc),VEGF and another indicators were detected and compared among the three groups.The correlations between VEGF,CEA,and HbA1c were analyzed respectively.Results The serum levels of CEA and VEGF in pre-treatment group were significantly higher than that in after-treatment group and healthy control group.In diabetics,the CEA level was positively correlated with HbA1 c (r =0.91,P < 0.05) and VEGF (r =0.90,P < 0.05),while there was no correlation between HbA1 c and VEGF after intensive treatment (r =0.17,P > 0.05).Conclusions The level of VEGF was positively correlated with CEA,and VEGF maybe one of the pathogenesis of high CEA in diabetes mellitus.

11.
Article in Chinese | WPRIM | ID: wpr-744100

ABSTRACT

Objective To investigate the effect of flash glucose monitoring (FGM) on ambulatory glucose profile of only oral antidiabetic drugs treated patients with type 2 diabetes mellitus. Methods Twenty-eight type 2 diabetic mellitus patients with only oral antidiabetic drugs treatment from August 2017 to January 2018 were enrolled. All the patients were exposed to FGM for 14 d without changing the original treatment and encouraged to manage self-behavior by adjusting diet and activity based on the blood glucose data obtained from the real-time scanning. The changes in glucose profile during the FGM period were observed, including estimated glycated hemoglobin (HbA1c), standard deviation of blood glucose, variable coefficient of blood glucose, mean amplitude of glycemic excursions, time in range (blood glucose 3.9 to 10.0 mmol/L), area under the curve hyperglycemia (blood glucose> 10.0 mmol/L) and area under the curve hypoglycemia (blood glucose<3.9 mmol/L). The blood glucose levels on second day and thirteenth day were used as baseline and end point respectively. Results All of the 28 patients did not change their anti-diabetic drug therapy and there were no adverse events occurred. The estimated HbA1c was significantly lower than the baseline HbA1c: (6.90 ± 1.48)% vs. (7.57 ± 1.35)%, and there was statistical difference (P = 0.004). The standard deviation of blood glucose, variable coefficient of blood glucose, mean amplitude of glycemic excursions, area under the curve hyperglycemia and area under the curve hypoglycemia at end were significantly lower than those at baseline: (2.07 ± 0.86) mmol/L vs. (2.44 ± 0.86) mmol/L, 0.26 ± 0.11 vs. 0.30 ± 0.11, (5.32 ± 2.75) mmol/L vs. (6.76 ± 3.06) mmol/L, 265 (0, 1 310) vs. 351 (107, 2 177) and 0 (0, 0) vs. 0 (0, 19), the time in range at end was significantly higher than that at baseline: (1 069 ± 386) min vs. (921 ± 449) min, and there were statistical differences (P<0.05 or<0.01). The rate of scanning was (12.92 ± 4.87) times/d. Conclusions FGM could be applied by type 2 diabetic mellitus patients to make self-glycemic management without changing therapy, reduce the estimated HbA1c,and hypoglycemia, and improve the glucose fluctuations, which may result from real-time scanning to find abnormal glycemia and adjust daily behavior.

12.
CES med ; 32(1): 23-30, ene.-abr. 2018.
Article in English | LILACS-Express | LILACS | ID: biblio-974530

ABSTRACT

Abstract Introduction: Glucagon-like peptide 1 agonists inhibit glucose-dependent glucagon secretion, decrease gastric emptying and appetite through neural mechanisms, contribute to glucose regulation and show reduction in glycated hemoglobin A. Methods: A bibliographic search was made on Medline® about pharmacology of the agonist glucagon-like peptide-1 receptor, Liraglutide, Lixisenatide, Albiglutide, Exenatide, Exenatide with long-acting release. Results: The GLP1 receptor agonist are agents involved with glycemic balance, weight loss induction and are associated with lower risk of hypoglycemia. They have shown efficacy in the treatment of hypoglycemia in patients with type-2 diabetes. Conclusions: GLP1 receptor agonist are part of the therapies for diabetes that have shown benefits in metabolic control, effectiveness in weight reduction and changes in glycated hemoglobin. More studies are needed to evaluate its long-term safety.


Resumen Introducción: Los agonistas del péptido 1 similar al glucagón inhiben la secreción del glucagón dependiente de glucosa, también disminuyen el vaciamiento gástrico y el apetito a través de mecanismos neurales contribuyen a la regulación de la glucosa y muestran reducción en la hemoglobina A glicada. Métodos: Búsqueda bibliográfica en Medline sobre la farmacología de los agonistas del receptor del péptido 1 similar al glucagón: liraglutide, lixisenatide, albiglutide, exenatide, exenatide con liberación de acción prolongada. Resultados: Los agonistas del receptor del péptido 1 similar al glucagón son agentes involucrados con el equilibrio glucémico, inducen pérdida de peso, se asocian a un menor riesgo de hipoglucemias y han mostrado eficacia en el tratamiento de la hiperglucemia en pacientes con diabetes tipo 2. Conclusiones: Los agonistas del receptor del péptido 1 similar al glucagón forman parte de las terapias para la diabetes que han mostrado beneficios en el control metabólico, efectividad en la reducción de peso y cambios en la hemoglobina A glicosilada. Aún faltan estudios que evalúen su seguridad a largo plazo.

13.
Article in Chinese | WPRIM | ID: wpr-702059

ABSTRACT

Objective To analyze the CT features of type 2 diabetes mellitus complicated with pulmonary tuberculosis and its relationship with glycosylated hemoglobin (HbAlc) level.Methods A total of 120 patients with type 2 diabetes mellitus complicated with pulmonary tuberculosis were selected from January 2015 to January 2017 in the Second Hospital of Datong Coal Mine Group LTD.According to the level of HbA1 c,the patients were divided into three groups,of which A group(HbA1c < 7%) 32 cases,B group(HbA1c,7% ~ 9%)40cases,C group (HbA1c >9%)48cases.MSCT examinations were performed before treatment and 6 months after treatment.The morphological characteristics and therapeutic effects of pulmonary lesions were compared among the three groups.Results The mean lesiondiameter of C group [(6.1 ± 2.1) cm] was significantly higher than that of A group [(3.4 ± 1.2) cm] and B group [(4.3 ± 1.7) cm],which of B group was significantly higher than that of A group,the differences were statistically significant (t =9.478,6.735,3.039,all P < 0.05).The large shadow (83.3 %),multiple cavities (83.3 %),and cavitation(75.0%) in C group were significantly higher than those in A group and B group,which in B group were significantly higher than those in A group,the differences were statistically significant(x2 =9.525,7.018,6.865,all P < 0.05).The proportion of lymph node enlargement in C group(83.3%) was significantly higher than that in A group,the difference was statistically significant(x2 =4.444,P < 0.05).After 6 months of standardized anti tuberculosis treatment,the effective rate of C group(68.8%) was significantly lower than that of B group(85.0%)and A group (100.0%),which of B group was significantly lower than that of A group,the difference were statistically significant (x2 =5.236,12.308,3.171,all P < 0.05).Conclusion The CT features of type 2 diabetes mellitus complicated with pulmonary tuberculosis are closely related to the level of HbAlc.With the increase of HbAlc level,the diameter of lung lesions increased and invasively increased.

14.
Article in Chinese | WPRIM | ID: wpr-733878

ABSTRACT

Objective To analyze the clinical effect of insulin detemir combined with repaglinide in the treatment of type 2 diabetes mellitus (T2DM).Methods From January 2016 to July 2017,100 patients with T2DM in the First People's Hospital of Jiande were randomly divided into the observation group and control group according to the digital table,with 50 cases in each group.The control group was treated by low neutral protamine zinc human insulin( N) and repaglinide,the observation group was treated by insulin detemir combined with repaglinide .The clinical treatment effect was compared between the two groups.Results The total effective rate of the observation group was 96%,which was significantly higher than 78% of the control group,the difference was statistically signifi-cant (χ2=22.014,P<0.05).Before treatment,the biochemical indicators between the two groups had no statistically significant differences (t =0.125,1.225,0.125,1.225,0.142,all P >0.05).After treatment,the biochemical indicators of the observation group were better than those of the control group (t =5.064,5.035,5.064,5.035,5.165,all P <0.05 ).Conclusion Though insulin detemir combined with repaglinide and traditional insulin combined with repaglinide can lower blood glucose in patients with T 2DM,but the former combination effect is better.

15.
Article in Chinese | WPRIM | ID: wpr-733877

ABSTRACT

Objective To explore the correlation between serum cystatin C,lipoprotein associated phospho-lipase A2 (LP-PLA2) and lower limb vascular disease in patients with type 2 diabetes mellitus.Methods From August 2014 to December 2016,a total of 187 type 2 diabetic patients in Weihai Central Hospital were selected. According to the ankle brachial index (ABI),the patients were divided into without lower limb vascular disease group (SDM group,85 cases) and with lower limb vascular disease group (T2DM+LLVD group,102 cases).Meanwhile,82 healthy people were selected as control group.The cystatin C,LP-PLA2,hemoglobin (HbAlc),triglyceride,total cholesterol,high density lipoprotein cholesterol ( HDL-C) and low density lipoprotein cholesterol ( LDL-C) were calculated.Results Compared with the control group [(0.788 ±0.084)mg/L],the cystatin C was significantly high-er in the SDM group[(0.913 ±0.135)mg/L] and the T2DM +LLVD group[(1.114 ±0.225)mg/L],and the difference was statistically significant (t=5.511,9.121,all P<0.01).The cystatin C in T2DM+LLVD group was higher than that in the SDM group ( t =7.209,P <0.01 ).Compared with the control group [( 342.76 ± 33.49)ng/mL],LP-PLA2 was significantly higher in the T2DM+LLVD group[(513.54 ±94.26)ng/mL],and the difference was statistically significant ( t =11.428,P<0.01 ).Compared with the SDM group [( 352.28 ± 67.82)ng/mL],the cystatin C and LP-PLA2 levels were significantly higher that in the T2DM+LLVD group,and the difference was statistically significant (t=7.209,13.181,all P<0.01).Conclusion Cystatin C and LP-PLA2 play important roles in type 2 diabetic patients with lower limb vascular disease.Cystatin C and LP -PLA2 may become the forecast indicators in type 2 diabetic patients with lower limb vascular disease.

16.
Article in Chinese | WPRIM | ID: wpr-733873

ABSTRACT

Objective To investigate the correlation between cardiac function and homocysteine (Hcy) level in type 2 diabetes mellitus (T2DM) patients.Methods From May 2015 to April 2016,120 patients with T2DM in the Sixth People's Hospital of Cixi were selected.According to the level of Hcy,the patients were divided into DM group (Hcy level <15μmol/L,42 cases) and Hcy+DM group (Hcy level≥15 μmol/L,78 cases).And 50 healthy people were selected as control group.The correlations between various physiological and cardiac functional parameters and Hcy level among the three groups were analyzed.Results The levels of Hcy,HbA1c and FBG in the DM group were significantly higher than those in the control group [Hcy:(11.26 ±2.16)μmol/L vs.(8.24 ±1.25)μmol/L,HbA1c:(7.46 ±1.47)%vs.(5.02 ±1.73)%,FBG:(7.87 ±2.75) mmol/L vs.(5.78 ±2.83)mmol/L,all P<0.05].The E/A value and LVEF value in the DM group were significantly lower than those in the control group (all P<0.05).The Hcy,HbA1c,and FBG levels in the Hcy +DM group were significantly higher than those in the DM group,and the E/A value and LVEF value in the Hcy +DM group were significantly lower than those in the DM group (all P <0.05 ).Spearman's correlation coefficient analysis showed that there was a positive correlation between HbA1c and FBG levels and Hcy levels (r=0.157,0.112,all P<0.05),but there was a negative correlation between E/A and LVEF values and Hcy levels (r=-0.264,-0.394,all P<0.05).Logistic regression analysis showed that the independent risk factor affecting the E/A and LVEF values was Hcy levels ( P =0.015,0.001 ). Conclusion The level of Hcy in patients with diabetes can reflect the status of heart function.The higher the level of Hcy,the worse the heart function.The detection of Hcy level can help to predict and evaluate cardiac function in patients.

17.
Article in Chinese | WPRIM | ID: wpr-712222

ABSTRACT

Objective To investigate the reasons of unacceptable external quality assessment results for hemoglobin A1c (HbA1c), and improve quality level.Methods At the end of February 2017, five samples of HbA1c for external quality assessment (EQA) were sent to participated laboratories by post.After testing and reporting results by laboratories , the EQA organizer made statistical analysis and sent results back to laboratories.Meanwhile , messages would be sent to participants those had unacceptable EQA results . Investigating reasons of unacceptable results in 2017 through the EQA System based on web , which was developed by National Central for Clinical Laboratories , calculating the failure rate , analyzing the concrete reasons and combining EQA failure rates with current coefficient of variation .Results The EQA failure rate on HbA1c was 11.2%and reporting rates of reasons for failures was 70.4%(126/179).In the reasons for unacceptable results , technological (27.8%,35/126) and equipment's defects (26.2%,33/126) were the main reason categories , while malfunction ( 12.7%, 16/126 ) and methods defection ( 10.3%, 13/126 ) were the main reason subclass .The unexplainable results after survey account for 8.7%( 11/126 ) .In the group for coefficient of variation ( CV ) over 2%, the percentage of laboratories that had five samples get acceptable results was higher than that of group for CV less than 2%,and the percentage of laboratories that had at most four samples get acceptable results was lower than that of group for CV less than 2%.Conclusions The result of the reasons of unacceptable external quality assessment results for HbA 1c is generally satisfactory.The laboratory, manufacturer and EQA organizers should find and solve the working problems by analyzing EQA data , to improve the testing quality.

18.
Article in Chinese | WPRIM | ID: wpr-712221

ABSTRACT

Objective To perform a methodological evaluation study of 4 HPLC based systems and a capillary electrophoresis based system , with the International Federation of Clinical Chemistry and Laboratory Medicine ( IFCC) glycated hemoglobin reference method as a comparative method .Methods 40 hemolysis samples of variety concentrations were prepared .The samples were measured by IFCC reference method and 5 glycated hemoglobin testing systems , respectively and trueness verification was performed according to the Clinical &Laboratory Standards Institute (CLSI) guideline EP9-A3.Whole blood samples were used to test the systems'precision, linearity and analytical interferences .Results The average CV of IFCC reference method results of 40 hemolysis samples was 1.4%( range from 0.2%to 2.5%).No outlier was found in the results of the 5 testing system.The slopes ranged from 0.9902 to 1.0267, and intercepts from -0.1526 mmol/mol to +0.1512 mmol/mol, squared correlation coefficient from 0.9962-0.9971, biases at two medical decision level were less than 0.3%HbA1c.Within-laboratory precisions were less than 2% (NGSP unit).Bias between all test results and predicted results were less than 5%.High concentration of glucose showed certain interference to glycated Hemoglobin tests but had little influence in clinical practice.Conclusions The results of the 5 testing system are comparable to the IFCC reference method , the results of precision and linearity evaluation meet the requirements of related guidelines .

19.
Article in Chinese | WPRIM | ID: wpr-712218

ABSTRACT

Hemoglobin A1c ( HbA1c ) is a glycated hemoglobin characterized by non-enzymatic binding of glucose to the N-terminal valine residue on the β-chain of the hemoglobin A , is widely utilized as a golden biomarker for diabetes mellitus management because it provides valuable information for long -term glycemic control and assessment of patient risk for chronic complications .In 2010 the American Diabetes Association (ADA) suggested a cut-off value of 6.5% (48 mmol/mol) HbA1c to diagnose diabetes.The rapid development of measurement technology has led to the application of kits based on different principles to detect HbA1c .This review summarizes the common HbA 1c methods including high performance liquid chromatography, immunoassay, enzymatic, and electrophoresis, and briefly introduces the development of measurement technology for HbA1c.

20.
Article in Chinese | WPRIM | ID: wpr-712217

ABSTRACT

Hemoglobin A1c(HbA1c)as the important marker confirmed by UK Prospective Diabetes Study and Diabetes Control and Complications Trial Research 2 epidemiological survey results is closely related to diabetes and its complications ,it has been included in the diagnostic criteria of diabetes mellitus by international organizations such as International Diabetes Federation , American Diabetes Association , World Health Organization ( WHO ) since 2010.The Chinese Guidelines for Type 2 Diabetes ( 2017 Edition ) issued by the Chinese Diabetes Society are still not formally included in the diagnostic criteria of diabetes in China.The reason is that although the standardization of HbA 1c testing in China has been improved gradually, the differences between different regions are still large.Reviewing the process of HbA1c standardization in the world and exploring the road of standardization in our country , it is believed that through the joint efforts of all parties , the goal will be achieved .

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