Estimación del impacto de utilizar el punto de corte de 100 mg/dL para glucemia en ayunas alterada en una población adulta ambulatoria de Bahía Blanca / Estimation of the impact of using the cutoff point of 100 mg/dL for impaired fasting glucose in an adult outpatient population in Bahía Blanca / Estimativa do impacto da utilização do ponto de corte de 100 mg/dL para glicemia em jejum alterada, em uma população adulta ambulatorial de Bahía Blanca

Resumen El objetivo de este estudio observacional y retrospectivo fue evaluar el punto de corte de 100 mg/dL para glucemia en ayunas alterada (GAA) en una población adulta ambulatoria de la Argentina en 2023. Se obtuvo aprobación del Comité de Ética. Se utilizó Chi cuadrado y concordancia Kappa. Se incluyeron 510 individuos. Se obtuvieron los siguientes resultados para GAA (diferencia en porcentaje estadísticamente significativa entre 100 mg/dL y 110 mg/dL, p=0,0001): total (36 vs. 10); mujeres (31 vs. 9); hombres (51 vs. 14); <40 años (24 vs. 3); ≥40 años (46 vs. 17); mujeres ≥40 años (40 vs. 16); hombres ≥40 años (60 vs. 19). La concordancia fue entre pobre y moderada. El valor de 100 mg/dL clasificó un 26% más de personas con GAA que el valor 110 mg/dL, lo que evidencia su impacto en la prevención de la diabetes, en particular en hombres ≥40 años.

Abstract The aim of this observational and retrospective study was to evaluate the value of 100 mg/dL for impaired fasting glucose (IFG) in an adult outpatient population from Argentina, in 2023. Approval was obtained from the Ethics Committee. Chi-square test and Kappa agreement were used. A total of 510 individuals were included. The following results were obtained for IFG (statistically significant difference in percentage between 100 mg/dL and 110 mg/dL; p=0.0001): total (36 vs. 10); women (31 vs. 9); men (51 vs. 14); <40 years old (24 vs. 3); ≥40 years old (46 vs. 17); women ≥40 years old (40 vs. 16); men ≥40 years old (60 vs. 19). Agreement ranged from poor to moderate. The value of 100 mg/dL classified 26% more people with IFG than the value of 110 mg/dL, making evident its impact on the prevention of diabetes, particularly in men ≥40 years of age.

Resumo O objetivo deste estudo observacional e retrospectivo foi avaliar o ponto de corte de 100 mg/dL para glicemia em jejum alterada (GJA) em uma população adulta ambulatorial da Argentina em 2023. A aprovação foi obtida do Comitê de Ética. Qui-quadrado e concordância Kappa foram utilizados. Foram incluídos 510 indivíduos. Os seguintes resultados foram obtidos para GJA (diferença estatisticamente significativa em percentual entre 100 mg/dL e 110 mg/dL; p=0,0001): total (36 vs. 10); mulheres (31 vs. 9); homens (51 vs. 14); <40 anos (24 vs. 3); ≥40 anos (46 vs. 17); mulheres ≥40 anos (40 vs. 16); homens ≥40 anos (60 vs. 19). A concordância foi entre pobre-e moderada. O valor de 100 mg/dL classificou 26% mais pessoas com GJA do que o valor de 110 mg/dL, demonstrando seu impacto na prevenção do diabetes, principalmente em homens ≥40 anos.

Pharmacological interventions used to control hyperglycemia in surgical and medical intensive care unit patients in a tertiary care hospital

Background: Hyperglycemia with or without diabetes is associated with increased morbidity and mortality in critically ill patients. The management practices to control hyperglycemia vary widely and often do not conform to standard guidelines. Aim and Objective: The aim of the study was to find out various pharmacological interventions used to manage hyperglycemia, frequency, and characteristics of drug-induced hypoglycemic episodes, and factors associated with BGLs at or above 180 mg/dL. Material and Methods: This prospective observational study was conducted in a tertiary care hospital on 369 adult patients admitted in medical or surgical intensive care unit and suffering from hyperglycemia. The pharmacological interventions used to control hypoglycemia, characteristics of drug-induced hypoglycemic episodes, and factors associated with blood glucose level (BGL) at or above 180 mg/dL were evaluated. Result: About 43% of patients received no pharmacological intervention, in 33% of patients basal bolus insulin was used while oral antidiabetic agents were used in 7.3% of patients. Blood glucose was maintained within a target range of 140–180 mg/dL on 45.6% patient-days. Basal bolus insulin was linked to hypoglycemia in 85.7% of hypoglycemic episodes. Previous history of diabetes, use of 0.45% dextrose normal saline, beta-blockers, and statins were associated with BGL above 180 mg/dL. Conclusion: Management of hyperglycemia in ICU patients is less than optimal.

Bebible nutricional y niveles de glucemia en deportistas del centro de alto rendimiento del Gobierno Autónomo Municipal de La Paz, gestión, 2019 / Nutritional beverage and blood glucose levels in athletes from the high-performance center of the Autonomous Municipal Government of La Paz, 2019

OBJETIVO: determinar los niveles de glucemia basal, antes y después del consumo del bebible nutricional en deportistas del Centro de Alto Rendimiento del Gobierno Autónomo Municipal de La Paz, gestión 2019. MATERIAL Y MÉTODOS: en este estudio cuasi experimental de antes-después, se analizaron los cambios en los niveles de glucemia de 20 deportistas tras la realización de un protocolo de ejercicio de 30 minutos, seguido de la ingesta de un bebible nutricional. Posteriormente se tomaron glucemias en tres momentos: en reposo, inmediatamente post-ejercicio y una hora después de la intervención. El propósito del estudio fue explorar la influencia del bebible nutricional en la regulación glucémica y su potencial efecto. RESULTADOS: el análisis de los niveles de glucemia basal revelaron una distribución equilibrada entre hiperglucemia e hipoglucemia en el 50% de los deportistas. Fue así que durante el ejercicio y antes de la ingesta del bebible, se observaron fluctuaciones en los niveles de glucosa, con un 5% persistiendo en hiperglucemia y un 25% en hipoglucemia. Una hora posterior de la actividad física y del consumo del bebible, se registraron una mejora significativa en los niveles de glucosa, con un 4% de los deportistas presentando hipoglucemia y un 80% alcanzando niveles de normoglucemia. CONCLUSIONES: luego al consumo del bebible nutricional y del tiempo de absorción de los nutrientes, la glucemia del 80% de los participantes fue de normoglucemia. En 270mL aportó 218,1 kcal ­ 13,52 g de proteínas ­ 1,56 g de grasa ­ 38g de hidratos de carbono y 0,73 g de fibra cruda, sin embargo, hace falta ampliar la muestra para afirmar este efecto

OBJECTIVE: to determine basal blood glucose levels before and after consumption of a nutritional beverage in athletes from the High-Performance Center of the Autonomous Municipal Government of La Paz during the year 2019. MATERIAL AND METHODS: in this quasi-experimental before-and-after study, changes in blood glucose levels were analyzed in 20 athletes following a 30-minute exercise protocol, followed by the intake of a nutritional beverage. Subsequently, blood glucose levels were measured at three points of time: at rest, immediately post-exercise, and one hour after the intervention. The study aimed to explore the influence of the nutritional beverage on glycemic regulation and its potential effects. RESULTS: analysis of baseline blood glucose levels revealed a balanced distribution between hyperglycemia and hypoglycemia in 50% of the athletes. Besides, during exercise and before beverage intake, fluctuations in glucose levels were observed, with 5% persisting with hyperglycemia and 25% with hypoglycemia. One hour after physical activity and beverage intake, a significant improvement in glucose levels was recorded in 80% achieving normoglycemia, and 4% of athletes presenting hypoglycemia. CONCLUSIONS: after consuming the nutritional beverage and nutrient absorption time, 80% of participants exhibited normoglycemia. The beverage provided 218.1 Kcal, 13.52 g of protein, 1.56 g of fat, 38 g of carbohydrates, and 0.73 g of crude fiber per 270 mL. However, further sample expansion is needed to confirm this effect.

Association of metabolic status with serum orexin levels in young females

Background: Metabolic syndrome has always been linked with obesity and a sedentary lifestyle due to induction of metabolic derangements. Orexin A and B are recently discovered hypothalamic neuropeptides. Orexin A regulates appetite, food intake, and energy expenditure. Aims and Objectives: Metabolic fuel detectors regulate energy balance at peripheral and central levels. The aim of this study is to assess association of serum orexin levels with metabolic risk markers in women of reproductive age group (RAG). Materials and Methods: The study was conducted in the campus of King George Medical University (KGMU), Uttar Pradesh, Lucknow, INDIA. One hundred and fifty apparently healthy women of RAG, that is, 20–40 years of age were randomly selected. Fasting serum orexin and serum insulin levels were measured using enzyme-linked immunosorbent assay and weight, body mass index (BMI), fasting blood glucose, lipid profile, and blood pressure were estimated in women. Results: The results show that serum orexin levels have significant positive correlation with fasting blood glucose, weight, BMI, and waist circumference along with a weak negative correlation with serum insulin level. Conclusion: In the present study, serum orexin levels significantly correlate with weight, BMI, fasting blood glucose, and weak negative correlation with serum insulin levels. Serum orexin levels did not correlate with the lipid profile of women of RAG.

Evaluation of insulin resistance in rheumatoid arthritis in Eastern India

Background: Increase in insulin resistance predisposes to cardiovascular disease. Studies from various parts of world show increase prevalence of IR in rheumatoid arthritis (RA) but there is little data from India. Aims and Objectives: To evaluate the prevalence of IR in RA and after 6 months of treatment with disease-modifying antirheumatic drugs. Materials and Methods: This hospital-based longitudinal observational study was done between July 2018 and June 2019 in the Division of Rheumatology, Department of General Medicine, S.S. Hospital, BHU, in treatment-naive RA patients with age ?18 years. Exclusion criteria were known diabetes, preexisting dyslipidemias, or any other chronic illness. Detailed history and examination were done. Fasting glucose and fasting insulin were done to calculate the homeostatic model for assessment of IR (HOMA IR). Results: The most common age group in our study was 31–40 years (38%). The mean age of onset of disease was 39.5 years. Female-to-male ratio was 5.25:1. The mean duration of illness was 3 years with baseline mean disease activity score (DAS) 28 score 6.2698 ± 1.07437. Baseline mean cholesterol level, triglyceride, high-density lipoprotein, low-density lipoprotein, and very low-density lipoprotein were 169.40 ± 33.802 mg/dL, 164.42 ± 91.585 mg/dL, 47.66 ± 11.825 mg/dL, 99.88 ± 27.059 mg/dL, and 34.42 ± 19.186 mg/dL, respectively. Baseline fasting blood glucose levels, fasting insulin levels, and HOMA IR were 99.40 ± 20.761 mg/dL, 11.84770 ± 4.351550 m IU/L,and 2.905 ± 1.2272, respectively. After treatment of 6 months, lipid profile, fasting insulin, and HOMA IR improved significantly. However, there was no significant correlation found between IR and disease activity before and after treatment. Conclusion: The patients of RA are at higher risk of IR and dyslipidemia and early diagnosis with the initiation of treatment for RA can reverse the IR in RA patients.

Observation of cardiac profile among the adult population of Sreemangal

Background: Cardiovascular diseases are a leading cause of morbidity and mortality worldwide. The prevalence and risk factors of CVDs vary across different populations and regions. This study aimed to observe the cardiac profile among the adult population of Sreemangal, Bangladesh, to identify the prevalence and risk factors of CVDs in this population. Methods: This prospective observational study was conducted over a six-month period at a public health camp in Sreemangal, Bangladesh. A total of 137 adult participants were purposively selected. Data were collected through a structured questionnaire and physical examination, including measurements of blood pressure and laboratory analysis of blood samples. Results: The study found that 44.53% of participants had elevated blood pressure, and 21.90% had stage 1 hypertension. Interestingly, 36.50% of participants were unaware of their hypertension status. Furthermore, 26.28% of participants had a known history of diabetes, but blood glucose level analysis revealed an additional 14.85% of participants were prediabetic, and 6.93% were diabetic based on fasting blood glucose levels. A statistically significant association was found between increasing age and the stage of hypertension (p<0.001), and between fasting and normal blood glucose levels and the stage of hypertension (p<0.005 and p<0.05, respectively). Conclusions: The findings of this study underscore the need for targeted interventions to prevent and manage CVDs in the adult population of Sreemangal, Bangladesh. These interventions should include regular screening for CVD risk factors, health education to increase awareness of these risk factors, and strategies to promote healthy lifestyle behaviors.

Asociación y riesgo de hipercolesterolemia en prediabéticos de un centro médico de Villa El Salvador, Lima, Perú / Association and risk of hypercholesterolemia among patients with prediabetes from a medical center in Villa El Salvador, Lima, Peru

RESUMEN Objetivo: Evaluar la asociación y el riesgo de hipercolesterolemia en pacientes adultos prediabéticos atendidos en un centro médico del distrito de Villa El Salvador en Lima, Perú. Materiales y métodos: Estudio analítico, prospectivo y transversal, con datos de historias clínicas de consultas médicas de 749 pacientes atendidos en un policlínico del distrito de Villa El Salvador, Lima, Perú. Se incluyó a pacientes adultos asintomáticos que asistieron a evaluaciones de rutina y preventivas. Se excluyó a pacientes con enfermedades endocrino-metabólicas o en tratamiento con fármacos hipoglucemiantes. Las variables de estudio fueron sexo, hipercolesterolemia y prediabetes. El análisis de asociación se realizó por medio de la prueba de chi cuadrado y el riesgo fue evaluado por medio de la oportunidad relativa; asimismo, se realizó el análisis multivariado por medio de regresión logística binaria y se consideró como punto de corte en decisión de significancia estadística el valor alfa igual a 0,05 y un nivel de confianza de 95 %. Resultados: Hubo asociación estadísticamente significativa entre prediabetes e hipercolesterolemia. Las mujeres prediabéticas tuvieron 1,66 veces más riesgo de desarrollar hipercolesterolemia que las mujeres con niveles de glucosa basal normales, mientras que los hombres con prediabetes tuvieron 2,37 veces más riesgo de tener colesterol alto que los hombres con niveles de glucemia basal normales. Conclusiones: La prediabetes se asocia con la hipercolesterolemia, lo cual aumenta su riesgo. Es justificable realizar la medición conjunta del colesterol total en ayunas junto con la medición de la glucosa basal en campañas preventivo-promocionales de salud y en consultas periódicas, así como durante el seguimiento de pacientes con factores de riesgo de diabetes, prediabetes e hipercolesterolemia, a fin de reducir las consecuencias hemodinámicas y cardiovasculares del colesterol elevado en la sangre y el agravamiento de la morbimortalidad conjunta de la hiperglucemia crónica.

ABSTRACT Objective: To evaluate the association and risk of hypercholesterolemia among adult patients with prediabetes treated at a medical center in the district of Villa El Salvador in Lima, Peru. Materials and methods: An analytical, prospective and cross-sectional study conducted with data from medical consultation records of 749 patients treated at a polyclinic in the district of Villa El Salvador in Lima, Peru. Asymptomatic adult patients who had routine and preventive checkups were included in the research. Patients with endocrine and metabolic disorders or being treated with hypoglycemic drugs were excluded. The study variables were sex, hypercholesterolemia and prediabetes. The association analysis was performed using the chi-square test and the risk was evaluated by means of the odds ratio. In addition, the multivariate analysis was conducted through a binary logistic regression, and an alpha value of 0.05 and a confidence level of 95 % were considered as the cut-off point to determine the statistical significance. Results: There was a statistically significant association between prediabetes and hypercholesterolemia. Females with prediabetes were 1.66 times more likely to develop hypercholesterolemia than females with normal baseline glucose levels, while males with prediabetes were 2.37 times more likely to have high cholesterol than males with normal baseline blood glucose levels. Conclusions: Prediabetes is associated with hypercholesterolemia, thus increasing its risk. It is justifiable to carry out the joint measurement of fasting total cholesterol and baseline glucose in disease prevention and health promotion campaigns, regular checkups and follow-up of patients with risk factors for diabetes, prediabetes and hypercholesterolemia. This helps reduce the hemodynamic and cardiovascular consequences of high cholesterol levels and the worsening of the joint morbidity and mortality of chronic hyperglycemia.

A nephrological perspective of herbal remedies on the progression of chronic kidney disease: A systematic review

Medicinal herbs are currently making a comeback as they appear to offer advantages over pharmaceuticals in combating chronic kidney disease progression. Conclusive evidence of their safety and efficacy is lacking. Therefore, this unfunded review was conducted to provide a more detailed picture of this issue, serving as a fruitful addition to the literature pool concerned with phytochemicals safety and efficacy in this disease. A systematic approach using specific search terms was used to find 49 articles meeting the study’s inclusion criteria after the study authors scrutinized the articles from different perspectives independently. Many plants were able to delay disease progression by lowering blood pressure via suppression of the renin-angiotensin system, antioxidant and anti-inflammatory effects, and increasing nitric oxide levels; lowering blood glucose levels; improving lipid profile via lipid resistance and oxidation induction; lowering proteinuria; and lowering serum uric acid levels as uricostatic or uricosuric agents, or both. In contrast, some herbal preparations increased blood pressure, induced insulin resistance, and promoted uric acid production through their adrenergic components or mineralocorticoid-like effects. In conclusion, based on the validity of the results obtained, recommendations were made for the proper use of herbal medicines in patients with vulnerable kidneys and for future research directions.

Correlation between cardiovascular risk and glycemic control among patients with diabetes

Background: Cardiovascular diseases (CVD) continue to be the leading cause of mortality in patients with diabetes. Uncontrolled blood glucose levels are thought to increase the likelihood of CVD in individuals with diabetes. Therefore, stratification of cardiovascular risk in people with diabetes is crucial. Objective: To assess the relationship between cardiovascular risk, as measured by the Jakarta Cardiovascular Score (JCS), and blood glucose control, as shown by hemoglobin A1c (HbA1c) levels, in individuals with diabetes. Materials and Methods: A cross-sectional analytic analysis was undertaken in a private clinic between April and June 2022. This study examined 110 diabetes patients who had not experienced any cardiovascular complications. Correlation analysis was employed to investigate the association between the risk of CVD and levels of HbA1c. Results: According to JCS, a significant proportion of patients (86.4%) were classified as high risk for CVD. The recorded HbA1c values varied from 5% to 16.20%. Around 90% of the study participants exhibited uncontrolled blood glucose levels, as evidenced by an HbA1c value exceeding 7%. Nevertheless, individuals with HbA1c levels below 7% exhibited a more excellent average total risk score. The JCS and HbA1c levels showed a weak negative connection, with a correlation coefficient (r) of -0.198 and a P value of 0.038. Conclusion: There is a weak negative correlation between the cardiovascular risk score of diabetic patients and their blood glucose control.

Introduction and application of non-parametric regression method in medical research / 复旦学报（医学版）

This article introduced the basic theory of non-parametric regression and its application in medical and public health research for methodological reference.We conducted Cox proportional hazard models with restricted cubic splines using chronic disease management data from a Center for Disease Control and Prevention.We aimed to explore the separate and combined effects of mean fasting blood glucose level and glucose variability on all-cause mortality among individuals with type 2 diabetes.A non-linear association was observed between glucose variability and the risk of all-cause mortality.The association between glucose variability and all-cause mortality was stronger at higher mean fasting blood glucose levels compared to lower levels.The non-parametric regression methods comprehensively explored dose-response relationships between continuous exposure and outcome,revealing the combined effects of continuous exposures,which provided recommendations for targeted interventions.The method showed promising application value in medical and public health research.

Influencing factors of telangiectasia secondary to diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the influencing factors of abnormal telangiectasia secondary to diabetic retinopathy(DR).METHODS: Prospective studies. A total of 153 cases(240 eyes)with DR treated in our hospital from January 2021 to January 2023 were selected to analyze the risk factors of abnormal telangiectasia secondary to DR and its predictive efficacy.RESULTS: The patients were divided into dilated group(77 eyes of 40 cases)and non-dilated group(163 eyes of 113 cases)according to whether they had secondary abnormal telangiectasia. There were significant differences in diabetic macular edema, hard exudates grade and fasting blood glucose level between the two groups(P&#x0026;#x003C;0.05). Logistic regression analysis showed that diabetic macular edema, high hard exudates grade and high blood glucose level were the risk factors for abnormal telangiectasia secondary to DR(P&#x0026;#x003C;0.05).CONCLUSION: The occurrence of telangiectasia secondary to DR may be related to diabetic macular edema, grade 3 hard exudates and high blood glucose level.

Distribution characteristics and potential interaction between uric acid level and blood glucose status in elderly hypertension patients / 公共卫生与预防医学

Objective To study the distribution characteristics of blood uric acid level and blood glucose status and their potential interaction in elderly hypertensive patients. Methods The randomized study enrolled elderly patients with essential hypertension who were treated in our hospital from January 2020 to January 2022 and received antihypertensive therapy. Collected patients’ sociodemographic information, medical history, treatment history, etc., and detected their blood uric acid and blood glucose levels. Analyzed and described the subjects’ basic characteristics and the distribution of blood uric acid and blood glucose, and the potential interaction between them. Results A total of 205 subjects were included in this study, including 108 males and 97 females, with an average age of 70.94 years and an average BMI of 23.19kg/m2. During the study period, the average blood pressure level was controlled at SBP 151.34±10.96mmHg and DBP 96.24±9.87mmHg, and the proportion of excellent blood pressure control reached 89.27%. The blood uric acid level of the subjects was elevated by increasing of subjects' age and BMI (P < 0.05), and blood glucose only elevated by the increasing of BMI (P < 0.001). High BMI, high DBP, family history of hypertension, high blood uric acid level, and current history of diabetes were risk factors for elevated hypertension grade. Conclusions High DBP, high BMI, high blood uric acid level, current history of diabetes and family history of hypertension are risk factors in elderly hypertensive patients, we could make clinical treatment strategies for these patients accordingly.

Effects of different frequency of blood glucose monitoring on glucose control in overweight/obese young and middle aged people with prediabetes / 中国实用护理杂志

Objective:To explore the effectiveness of blood glucose monitoring at different frequencies on the control of blood glucose in overweight/obese prediabetes population on the basis of health education, and to provide a basis for blood glucose monitoring and management in prediabetes population.Methods:A randomized controlled study was used. 90 prediabetes patients from the Physical Examination Center/Endocrine Clinic/Endocrine Ward of the First Affiliated Hospital of China Medical University from January to March 2021 were selected by continuous sampling method, and were randomly divided into the group A, B and C by lottery method, with 30 patients in each group, and the study period was 12 months. Group A, B and C received unified health education guidance at enrollment, 6-month follow-up, and 12-month follow-up. Group A underwent blood glucose monitoring every 6 months, group B underwent blood glucose monitoring every 3 months, group C underwent blood glucose monitoring every month. Recorded and compared the levels of glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2-hour post-load blood glucose (2 hPG), and body mass index (BMI) of three groups at the time points of enrollment, 6-month follow-up, and 12-month follow-up.Results:There were 15 males and 15 females in the group A, 14 males and 16 females in the group B, 12 males and 18 females in the group C. The ages in the group A, B and C were (48.37 ± 10.80), (49.20 ± 9.25) and (44.77 ± 12.28) years old respectively. At the time point of 12-month follow-up, the HbA1c in the group A, B and C were (6.01 ± 0.36)%, (5.82 ± 0.35)% and (5.64 ± 0.27)%, the difference was significant ( F=9.72, P<0.05); the FPG in the group A, B and C were (5.64 ± 0.88), (5.05 ± 0.53) and (4.98 ± 0.48)mmol/L, the difference was significant ( F=9.23, P<0.05); the 2 hPG in the group A, B and C were (9.38 ± 1.23), (8.23 ± 0.72) and (7.71 ± 0.86) mmol/L, the difference was significant ( F=23.89, P<0.05); the BMI in the group A, B and C were (28.52 ± 4.24), (27.02 ± 2.67) and (25.56 ± 1.34) kg/m 2, the difference was significant ( F=7.37, P<0.05). Conclusions:On the basis of health education, compared with the routine blood glucose monitoring once every six months, blood glucose monitoring once every three months and once every month can improve the blood glucose control and BMI level of overweight/obese young and middle-aged people with prediabetes, and provide a basis for seeking an effective and economic blood glucose monitoring mode in clinical practice.

Effects of different levels of ophthalmic surgical stimulation on blood glucose changes in patients with type 2 diabetes mellitus / 沈阳医学院学报

Objective:To investigate the effects of different levels of ophthalmic surgical stimulation on blood glucose in patients with type 2 diabetes mellitus(T2DM).Methods:From Mar to Oct 2021,236 patients with T2DM who underwent ophthalmic surgery in our hospital were enrolled,including 71 cases of secondary surgery,89 cases of tertiary surgery,and 76 cases of quaternary surgery.According to the operation time,the 236 patients were divided into groups A(＜60 min),B(60-120 min)and C(＞120 min).The preoperative and postoperative blood glucose levels were compared in patients with different levels of surgery,and in groups A,B and C.Results:The postoperative blood glucose level was lower than that before surgery in secondary and tertiary surgery,and it was higher than that before surgery in quaternary surgery(P＜0.05).The fluctuation value of blood glucose in secondary and tertiary surgery was higher than that in quaternary surgery(P＜0.05).In groups A,B and C,the postoperative blood glucose level was lower than that before surgery in secondary and tertiary surgery(P＜0.05).In group A,there was no significant difference in the blood glucose before and after surgery in quaternary surgery(P＞0.05),and in groups B and C,the postoperative blood glucose was higher than that before surgery in quaternary surgery(P＜0.05).In group A,there was no difference in the fluctuation value of blood glucose at different levels of surgery(P＞0.05).In group B,the fluctuation value of blood glucose in patients with secondary and tertiary surgery was higher than that in quaternary surgery(P＜0.05).In group C,the fluctuation value of blood glucose in patients with tertiary and quaternary surgery was higher than that in patients with secondary surgery(P＜0.05).Conclusions:For ophthalmic surgery patients with T2DM,the postoperative blood glucose values of patients undergoing secondary and tertiary surgery generally show a downward trend,while the postoperative blood glucose value of patients undergoing quaternary surgery generally shows an upward trend.It is suggested that clinical workers should actively manage the perioperative blood glucose of patients with high-level surgery.

Effects of intraoperative blood glucose fluctuation and postoperative insulin resistance on cognitive dyfunction in elderly patients after thoracoscopic radical resection of lung cancer under general anesthesia / 天津医药

Objective To analyze the influence of intraoperative blood glucose fluctuation and postoperative insulin resistance(IR)on postoperative cognitive dyfunction(POCD)in elderly patients undergoing thoracoscopic radical resection of lung cancer under general anesthesia.Methods A total of 352 elderly patients undergoing thoracoscopic radical resection of lung cancer under general anesthesia were collected and divided into the POCD group(n=84)and the non-POCD group(n=268).The covariates between the two groups were balanced by propensity score matching method(PSM).Eighty-four cases in each group were successfully matched.The data between the two groups before and after PSM were compared.After PSM,receiver operating characteristic(ROC)curve of blood glucose fluctuation amplitude for predicting POCD was drawn,and patients were divided into the low-level blood glucose fluctuation group(n=97)and the high-level blood glucose fluctuation group(n=71)according to the cut-off value.According to the existence of postoperative IR,patients were divided into the IR group(n=53)and the non-IR group(n=115).Then,incidences of POCD between groups were compared.Logistic regression was used to analyze the influencing factors of POCD.Results Before PSM,the POCD group had older age,higher blood glucose fluctuation amplitude,IR ratio,operation time,anesthesia time,propofol dosage,remifentanil dosage and sufentanil dosage in anesthesia maintenance period than those in the non-POCD group(P＜0.05).The POCD group had higher blood glucose fluctuation amplitude and IR ratio than those in the non-POCD group after PSM(P＜0.05).After PSM,the incidences of POCD in the high-level blood glucose fluctuation group and the IR group were higher than those in the low-level blood glucose fluctuation group and the non-IR group(P＜0.05).Logistic regression analysis showed that higher intraoperative blood glucose fluctuation(OR=9.140,95%CI:4.338-19.257)and postoperative IR(OR=4.034,95%CI:1.163-13.991)were risk factors of POCD.Conclusion The risk of POCD in elderly patients undergoing thoracoscopic radical lung cancer surgery under general anesthesia is increased in patients with higher intraoperative blood glucose fluctuation and postoperative IR.

Establishment and evaluation of a streptozotocin-induced diabetic encephalopathy rat model / 中国组织工程研究

BACKGROUND:Animal models of diabetic encephalopathy that have been studied mainly include streptozotocin-induced model,high-sugar and high-fat diet-induced model and spontaneous animal model.Establishing a simple,easy,short-cycle,safe and effective model of diabetic encephalopathy can help to explore the subsequent pathogenesis and screen therapeutic drugs. OBJECTIVE:To further explore and evaluate the method of building diabetic encephalopathy rat models. METHODS:Twenty Sprague-Dawley rats were randomly divided into control(n=10)and model(n=10)groups.Rats in the model group were given a single injection of 45 mg/kg streptozotocin in the left lower abdominal cavity,and those in the control group were given the same amount of citrate buffer.During the experiment,the body mass,feed intake,water intake and blood glucose were measured.After 8 weeks,the glucose tolerance and oxidative stress levels were measured,and the pathological changes of brain tissue and the expression of apoptotic proteins were compared between groups. RESULTS AND CONCLUSION:Compared with the control group,the food intake,water intake,encephalization quotient,blood glucose and area under the blood glucose curve were significantly increased in the model group,while the body mass decreased significantly(P<0.01).Histopathological examination of the brain showed that compared with the control group,the number of surviving nerve cells was significantly reduced in the model group(P<0.01),with more significant pathological damage of nerve cells.Compared with the control group,the activities of serum superoxide dismutase,catalase and glutathione in the model group were significantly decreased(P<0.01),and the content of oxidative malondialdehyde was significantly increased(P<0.05).The expression levels of apoptosis-related proteins Bax and Caspase-3 in brain tissue increased in the model group compared with the control group,while the expression of Bcl-2 decreased(P<0.01).In conclusion,an 8-week injection of 45 mg/kg streptozotocin can cause obvious pathological damage to the brain tissue of diabetic rats,to successfully establish the rat model of diabetic encephalopathy.

Effects of high-intensity interval training and moderate-intensity continuous training on body composition and glucose metabolism in overweight or obese patients with type 2 diabetes:a Meta-analysis / 中国组织工程研究

OBJECTIVE:To systematically evaluate the effects of high-intensity interval training(HIIT)and moderate-intensity continuous training(MICT)on body composition and glucose metabolism-related indexes in overweight or obese patients with type 2 diabetes and to compare the improvement effect of the two exercise modalities,thereby providing a reference basis for the development of exercise prescription for overweight or obese patients with type 2 diabetes. METHODS:The Cochrane Library,PubMed,EMbase,Web of Science,CNKI,CBM,WanFang,and ClinicalTrials.gov were searched for randomized controlled trials comparing the effects of HIIT and MICT interventions on body composition and glucose metabolism-related indicators in overweight or obese patients with type 2 diabetes.The search was conducted from database inception to June 2022.Meta-analysis of outcome indicators was performed using RevMan 5.4. RESULTS:(1)A total of 13 randomized controlled trials with 371 subjects were included,and the overall quality of the included studies was relatively high.(2)There was no significant difference in the improvement of body composition between HIIT and MICT[body mass:weighted mean difference(WMD)=2.44,95%confidence interval(CI):-3.01-7.89,P＞0.05;body mass index:WMD=0.28,95%CI:-1.21-1.77,P＞0.05;waist circumference:WMD=2.16,95%CI:-2.04-6.35,P＞0.05;body fat percentage:WMD=0.47,95%CI:-2.11-3.05,P＞0.05).(3)The results of subgroup analysis showed that there was a significant difference in body mass and body mass index between the"training cycle≥12 weeks"subgroup and the"training frequency≤3 times/week"subgroup(training cycle≥12 weeks subgroup:WMD=4.25,95%CI:0.90-7.59,P=0.01;WMD=2.71,95%CI:1.92-3.51,P＜0.000 01;training frequency≤3 times/week subgroup:WMD=5.14,95%CI:1.7-8.57,P=0.003;WMD=1.67,95%CI:0.66-2.67,P=0.001).(4)The results of sensitivity analysis showed that there was a significant difference in body fat percentage between the HIIT and MICT groups(WMD=2.17,95%CI:1.20-3.14,P＜0.000 1),while there was no significant difference in the improvement of glucose metabolism between the HIIT and MICT groups(fasting blood glucose:WMD=0.31,95%CI:-0.17-0.79,P＞0.05;glycosylated hemoglobin:WMD=0.01,95%CI:-0.19-0.20,P＞0.05;insulin resistance index:WMD=-0.14,95%CI:-0.71-0.42,P＞0.05).(5)The results of subgroup analysis showed that fasting blood glucose was significantly different in the subgroup of"training frequency≤3 times/week"(WMD=0.92,95%CI:0.25-1.60,P=0.007)and glycosylated hemoglobin was significantly different in the"training frequency＞3 times/week"subgroup(WMD=-0.2,95%CI:-0.3 to-0.1,P＜0.000 1). CONCLUSION:Overall,there is no significant difference between HIIT and MICT in improving body composition such as body mass,body mass index,waist circumference,body fat percentage as well as improving glucose metabolic indexes such as fasting blood glucose,glycated hemoglobin and insulin resistance index in overweight or obese patients with type 2 diabetes.When the training period is≥12 weeks and the training frequency is≤3 times/week,MICT has a better effect on the improvement of body mass as well as body mass index.

Analysis of the interaction of fasting blood glucose and serum uric acid on di-abetic retinopathy / 眼科新进展

Objective To investigate the impact of the interaction of fasting blood glucose(FBG)and serum uric acid(SUA)on diabetic retinopathy(DR).Methods A total of 306 diabetes mellitus(DM)patients diagnosed and re-ceived comprehensive ophthalmic examination in the First Affiliated Hospital of Gannan Medical University from January 2019 to January 2021 were selected.According to the presence or absence of DR,these patients were divided into the DR group(178 patients)and the non-DR(NDR)group(128 patients).The general clinical data of patients in the two groups were compared.The least absolute shrinkage and selection operator(LASSO)regression method and multivariate Logistic regression analysis were used to screen the independent influencing factors of DR in DM patients,and the odds ratio of risk factors was calculated.The sensitivity analysis of the results was performed using the E-value method.The interaction of FBG and SUA on DR in DM patients was analyzed by an additive interaction model.The Nomogram model to predict DR in DM patients was constructed and verified internally.The receiver operating characteristic curve(ROC)was used to evalu-ate the effects of FBG,SUA and both FBG and SUA on DR in DM patients.Results Compared with the NDR group,the course of DM in the DR group was significantly longer,the proportion of patients with history of oral medication was signif-icantly lower,the proportion of patients with history of insulin therapy was significantly higher,and the levels of total cho-lesterol,triglyceride,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,blood urea nitrogen,serum creatinine,SUA and FBG were significantly higher(all P＜0.05).The history of insulin therapy,course of DM≥9.66 years,TG≥2.07 mmol·L-1,SUA ≥ 297.73 μmol·L-1 and FBG ≥8.92 mmol·L-1 were the risk factors for DR in DM pa-tients,while the history of oral medication was the protective factor for DR in DM patients.The Nomogram model based on the above independent risk factors was accurate in predicting the occurrence of DR in DM patients.SUA and FBG had inter-active effects on DR in DM patients.The value of SUA-FBG interaction in the diagnosis of DR was greater than that of both alone.Conclusion SUA≥ 297.73 μmol·L-1 and FBG ≥8.92 mmol·L-1 are the risk factors for DR in DM patients.The value of interaction of FBG and SUA in the diagnosis of DM accompanied by DR is greater than that of both alone.

Analysis of medication and glycemic control of patients with type 2 diabetes under chronic disease management in Xi'an pharmacies / 药物流行病学杂志

Objective To investigate the medication and blood glucose control of type 2 diabetes patients under chronic diseases management in Xi'an chain pharmacies,and provides reference for improving the management policy of diabetes at grassroots level.Methods A number of chain pharmacies in the sixth district of Xi'an were selected by random sampling method,and on-site interviews were conducted by questionnaire survey to patients with type 2 diabetes under the management of chronic diseases.The basic information of patients,medication status(medication plan,drug adherence,etc.),diabetes-related conditions(blood glucose status,family history,course and complications,etc.)were collected.Multivariate logistic regression was used to analyze the relevant factors of blood glucose control in patients.Results A total of 403 patients were surveyed,the largest number of patients use oral hypoglycemic drugs alone(53.4％),followed by insulin medication(including insulin only and insulin in combination with oral hypoglycemic drugs)(35.7％),and the differences between disease course and glycemic control among patients with different drug regimens were statistically significant(P＜0.05).Only 43.7％of patients had good medication compliance.In addition,the patient's fast plasma glucose compliance rate was only 39.2％.The results of multivariate logistic regression analysis showed that good medication compliance(OR=1.744,95％CI 1.104 to 2.754,P=0.017)were independent influencing factors for achieving glycemic control.Conclusion The medication compliance of type 2 diabetes patients with poor blood glucose control in chronic disease management of chain pharmacies in Xi'an needs to be strengthened.Pharmacies should emphasize and give full play to the professional and service advantages of pharmacists to realize the functional role of pharmacies and strengthen diabetes management.

Efficacy of the combination of semaglutide, insulin degludec, and metformin in the treatment of type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity / 中国基层医药

Objective:To investigate the efficacy of the combination of semaglutide, insulin degludec, and metformin in the treatment of type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity.Methods:A total of 160 patients with type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity were included in this case-control study after receiving treatment at Bayannur Hospital from April 2022 to March 2023. These patients were divided into a control group and an observation group based on different treatment regimens, with 80 patients in each group. The control group was treated with degludec insulin combined with metformin, while the observation group was treated with semaglutide, degludec insulin, and metformin. The treatment lasted for 12 weeks in both groups. The changes in fasting plasma glucose, 2-hour postprandial blood glucose (2 h PG), glycosylated hemoglobin, time in range for 2 h PG, fasting insulin, Homeostatic Model Assessment for Insulin Resistance index, body mass index, and visceral fat area and adverse reactions were monitored.Results:The overall response rate in the observation group was 100% (80/80), which was significantly higher than 97.5% (78/80) in the control group (χ 2 = 11.03, P < 0.05). After treatment, the levels of 2 h PG, glycosylated hemoglobin, fasting insulin, Homeostatic Model Assessment for Insulin Resistance index, body mass index, visceral fat area in the observation group were (7.35 ± 0.17) mmol/L, (6.08 ± 0.24)%, (10.30 ± 2.58) μU/mL,(2.69 ± 0.66), (24.40 ± 0.68) kg/m 2, (80.20 ± 8.94) cm 2, respectively, which were significantly lower than (7.92 ± 0.24) mmol/L, (6.34 ± 0.27)%,(13.71 ± 3.13) μU/mL,(3.57 ± 0.83), (26.77 ± 3.49) kg/m 2, (116.12 ± 34.09) cm 2 respectively in the control group ( t = -0.73, -3.74, -4.20, -4.15, -3.35, -5.10, all P < 0.05). The time in range for 2 h PG in the observation group was (72.68 ± 4.09)%, which was significantly higher than (50.16 ± 10.00)% in the control group ( t = -10.42, P < 0.05). The incidence of adverse reactions in the observation group was 3.8% (3/80), which was slightly, but not significantly, higher than 2.5% (2/80) in the control group ( P > 0.05). Conclusion:The combination of semaglutide, degludec insulin, and metformin demonstrates an ideal clinical effect in the treatment of type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity. This combined approach can effectively regulate fasting and postprandial blood glucose levels, markedly decrease the body mass index and visceral fat levels, and improve insulin resistance while not significantly increasing the incidence of adverse reactions.