Influence of saxagliptin combined insulin four times to strengthen the volatility therapy on blood glucose variability in patients with type 1 diabetes / 中国基层医药

Objective To observe the effect of saxagliptin combined insulin four times to strengthen the vola-tility on blood glucose variability in patients with type 1 diabetes.Methods According to random number table meth-od,60 patients with type 1 diabetes were divided into DPP4 group(28 cases)and the control group(32 cases).The control group was given insulin four times to strengthen the volatility(insulin aspart/insulin lispro +insulin glargine /insulin detemir),the DPP4 group on the basis of insulin four times to strengthen the volatility plus the saxagliptin 5mg/d,all patients into the group after1 -3D and 13 -15D using CGMS(Medtronic)continuously monitor the blood glucose.Results (1)Within the group comparison:the DPP4 group:1 -3d after treatment:MAGE and SDBG,MBG, LAGE,PT10.0,PT3.9 were lower than before treatment,including MAGE [(6.91 ±1.63)mmol/L vs.(6.31 ± 1.42)mmol/L,t =0.993],SDBG[(2.63 ±0.81)mmol/L vs.(2.41 ±0.51)mmol/L,t =0.751],MBG[(11.51 ± 1.24)mmol/L vs.(10.87 ±2.01)mmol/L,t =1.077],LAGE[(9.43 ±1.73)mmol/L vs.(8.56 ±1.97)mmol/L, t =1.125],PT10.0[(12.99 ±5.61)% vs.(9.66 ±5.03)%,t =1.427],PT3.9[(5.51 ±2.43)% vs.(5.07 ± 2.44)%,t =1.141],there were statistically significant differences compared with before treatment(all P 0.05);13 -15d after treatment:MAGE[(6.88 ±1.49)mmol/L vs.(2.97 ±0.86)mmol/L,t =3.021],SDBG[(2.77 ±0.73)mmol/L vs.(1.12 ±0.43)mmol/L,t =1.964],MBG [(11.67 ±1.46)mmol/L vs.(7.44 ±0.93)mmol/L,t =2.760],LAGE[(9.55 ±1.77)mmol/L vs.(6.53 ±1.21)mmol/L, t =2.409],PT10.0[(13.58 ±5.14)% vs.(4.72 ±2.37)%,t =2.657],PT3.9[(5.36 ±2.05)% vs.(3.05 ± 2.60)%,t =1.840]were decreased,there were statistically significant differences compared with before treatment (P 0.05 );13 -15d after treatment:MAGE [(6.91 ±1.63 )mmol/L vs.(6.07 ± 1.36)mmol/L,t =1.223],SDBG[(2.63 ±0.81)mmol/L vs.(1.91 ±0.93)mmol/L,t =0.984],MBG[(11.51 ± 1.24)mmol/L vs.(8.82 ±1.13)mmol/L,t =1.808],LAGE[(9.43 ±1.73)mmol/L vs.(7.06 ±1.57)mmol/L, t =1.963],PT10.0[(12.99 ±5.61)% vs.(6.74 ±3.35)%,t =2.012],PT3.9[(5.51 ±2.43)% vs.(4.73 ± 2.57)%,t =1.541]were decreased,there were statistically significant differences in MBG,LAGE,PT10.0 compared with before treatment(all P <0.05).Group comparision:1 -3d after treatment:the DPP4 group:MAGE[(4.81 ± 1.15)mmol/L vs.(6.31 ±1.42)mmol/L,t =2.351],SDBG[(2.14 ±0.69)mmol/L vs.(2.41 ±0.51)mmol/L, t =1.332],MBG[(9.76 ±1.58)mmol/L vs.(10.87 ±2.01)mmol/L,t =0.856],LAGE[(7.74 ±1.88)mmol/L vs.(8.56 ±1.97)mmol/L,t =2.102],PT10.0 [(7.47 ±4.96)% vs.(9.66 ±5.03)%,t =2.667],PT3.9 [(4.64 ±2.14)% vs.(5.07 ±2.44)%,t =1.890]were all significantly lower than the control group,there were statistically significant differences in MAGE,LAGE,PT10.0 between the two groups(all P <0.05).13 -15d after treatment:the above indictors,the DPP 4 group was decreased obviously compared with the control group,MAGE [(2.97 ±0.86)mmol/L vs.(6.07 ±1.36)mmol/L,t =2.854],SDBG[(1.12 ±0.43)mmol/L vs.(1.91 ± 0.93)mmol/L,t =2.328],MBG[(7.44 ±0.93)mmol/L vs.(8.82 ±1.13)mmol/L,t =2.125],LAGE[(6.53 ± 1.21)mmol/L vs.(7.06 ±1.57)mmol/L,t =2.111],PT10.0[(4.72 ±2.37)% vs.(6.74 ±3.35)%,t =2.312] and PT3.9 [(3.05 ±2.60)% vs.(4.73 ±2.57)%,t =2.237],there were statistically significant differences between the two groups (P <0.05 or P <0.01).Conclusion The combination of DPP4 inhibitors and insulin four renforcement can improve blood glucose fluctuation in patients with type 1 diabetes,reduce the dosage of insulin and not increase incidence of hypoglycemic events.

Analysis of 20 cases with endocrine myopathy misdiagnosed as polymyositis / 中国基层医药

Objective To investigate the causes of misdiagnosis and improve the level of diagnosis and treatment for endocrine myopathy,through the study the clinical data of 20 patients with endocrine myopathy who were misdiagnosed as polymyositis were analyzed.Methods 20 cases were retrospectively analyzed who suffered from proximal weakness as the main performance and misdiagnosed as polymyositis,through the method of supervision to track,review of the observation and methods of medical record information query.Results The main types of diseases which were misdiagnosed including 18 patients of thyroid diseases(13 patients of hypothyroidism,5 patients of hyper-thyroidism),2 patients of parathyroid disease(1 patient of hyperparathyroidism,1 patient of hypoparathyroidism). Conclusion Mastering polymyositis and endocrine myopathy in the identification of main points,improving the ability of differential diagnosis,so that doctor can avoid misdiagnosis.