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Objective:To investigate the clinical effect of dapagliflozin combined with metformin on type 2 diabetes mellitus (T2DM).Methods:A total of 100 patients with T2DM who received treatment in The Second People's Hospital of Hefei from June 2019 to May 2021 were included in this study. They were randomly divided into a control group ( n = 50) and an experimental group ( n = 50). The control group was treated with metformin, and the experimental group was treated with dagglitazin combined with metformin. All patients were treated for 3 months. Blood glucose index, blood lipid level, and the incidence of adverse reactions were compared between the two groups. Results:After treatment, fasting blood glucose, 2-hour post-prandial blood glucose, and glycosylated hemoglobin in the experimental group were (5.56 ± 0.37) mmol/L, (8.32 ± 0.23) mmol/L, and (6.17 ± 0.26)% respectively, which were significantly lower than (6.96 ± 0.48) mmol/L, (9.58 ± 0.39) mmol/L, and (7.27 ± 0.26)% respectively in the control group ( t = 3.59, 6.92, 5.03, all P < 0.05). The total cholesterol and triglyceride in the experimental group were (3.58 ± 0.53) mmol/L and (1.25±0.26) mmol/L, respectively, which were significantly lower than (4.94 ± 0.58) mmol/L and (1.93 ± 0.18) mmol/L in the control group ( t = 3.16, 4.25, both P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Dapagliflozin combined with metformin can effectively control blood glucose and blood lipid in T2DM patients without increasing adverse reactions.
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Objective:To study the correlation between the time within the target range of blood glucose and the reduction of muscle mass in middle-aged and elderly patients with type 2 diabetes (T2DM).Methods:A total of 245 middle-aged and elderly T2DM patients admitted to the Second People′s Hospital of Hefei from December 2020 to December 2021 were selected. All enrolled patients wore MeiQi blood glucose monitor to obtain time in range (TIR), time above range (TAR), time below range (TBR), mean amplitude of glycemic excursions (MAGE), coefficient of variation (CV), blood glucose standard deviation (SD), largest amplitude of glycemic excursions (LAGE), which was for assessing blood sugar fluctuation. The incidence of muscle mass reduction and sarcopenia was statistically analyzed, and the differences invarious observation indicators between the muscle mass reduction group and the non muscle mass reduction group were compared. Spearman correlation analysis was used to investigate the correlation between clinical indicators and limb skeletal muscle mass index (ASMI), and logistic regression was used to analyze the influencing factors of muscle mass reduction in middle-aged and elderly T2DM patients.Results:The prevalence of muscle mass loss in 245 T2DM patients was 25.71%(63/245), and the prevalence of sarcopenia was 13.06%(32/245). There were statistically significant differences in age, gender, body mass index (BMI), blood phosphorus, homeostatic model assessment of insulin resistance (HOMA-IR), urine albumin creatine ratio (ACR), 25 hydroxyvitamin D, diabetes nephropathy (DN) patient proportion, ASMI, grip strength, and 5 sit up test times between the muscle mass reduction group and the non muscle mass reduction group (all P<0.05). The TIR of the muscle mass reduction group was lower than that of the non muscle mass reduction group, while the TAR and mean blood glucose (MG) were higher than those of the non muscle mass reduction group, with statistically significant differences (all P<0.05). ASMI was negatively correlated with age, males, and HOMA-IR (all P<0.05), but positively correlated with BMI and 25 hydroxyvitamin D (all P<0.05). ASMI was positively correlated with SD and TIR (mean P<0.05), and negatively correlated with CV, LAGE, TAR, and MG (all P<0.05). The results of univariate regression analysis showed that age, male gender, DN, and TAR were risk factors for muscle mass reduction, while BMI, 25 hydroxyvitamin D, and TIR were protective factors for muscle mass reduction (all P<0.05). After adjusting for other related factors, TIR remained a protective factor for decreased muscle mass (all P<0.05). Conclusions:TIR is an independent protective factor for muscle mass loss in middle-aged and elderly T2DM patients, and the incidence of muscle mass loss can be reduced by increasing TIR levels in clinical practice.
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Objective:To investigate the characteristics of blood glucose fluctuation and risk factors in type 2 diabetic patients with asymptomatic hypoglycemia.Methods:From September 2018 to July 2021, 342 patients with type 2 diabete mellitus who were hospitalized in the Department of Endocrinology of Hefei Hospital Affilitated to Anhui Medical University were enrolled for a retrospective study. The mean amplitude of glycemic excursions(MAGE), coefficient of variation (CV), 24 hour mean blood glucose level (MG), and time in range (TIR) were obtained by continuous glucose monitoring (CGM). According to the results of CGM and whether the patients have hypoglycemia symptoms, they were divided into three groups: no hypoglycemia group, symptomatic hypoglycemia group, and asymptomatic hypoglycemia group. The differences in blood glucose fluctuations were compared among the three groups. Multivariate logistic regression analysis was used to evaluate the risk factors in type 2 diabete mellitus patients with asymptomatic hypoglycemia. The predictive value of MAGE for asymptomatic hypoglycemia was analyzed by receiver operating characteristic (ROC) curve.Results:Compared with the non-hypoglycemia group, the TIR in asymptomatic hypoglycemia group was higher ( Z=-2.042, P=0.041). The asymptomatic hypoglycemia group had lower MG, higher MAGE and CV compared with the other two groups(all P<0.05). Multivariate logistic regression analysis showed that urinary albumin/creatinine ratio (UACR), MAGE, and CV were the risk factors for asymptomatic hypoglycemia, while MG was the protective factor. After adjustment for other risk factors, MAGE was still associated with asymptomatic hypoglycemia ( OR=1.111, 95% CI 0.999-1.235, P=0.049). The sensitivity and specificity of MAGE in predicting asymptomatic hypoglycemia were 0.769 and 0.776, respectively. Conclusions:Patients with asymptomatic hypoglycemia present with larger TIR and MAGE. MAGE, UACR, and CV were risk factors for asymptomatic hypoglycemia. Moreover, MAGE has some predictive value for the occurrence of asymptomatic hypoglycemia.
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To explore the association between polymorphisms of transcription factor 7-like 2 gene (TCF7L2) and type 2 diabetes mellitus in Hefei district. The results suggest that the genetic variation DG10S478 in the TCF7L2 gene was not associated with type 2 diabetes mellitus in Hefei district ( P>0.05 ). However, its attribution to the susceptibility of type 2 diabetes mellitus in Hefei is not important.
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Objective:To investigate the variation of the drug resistance of Escherichia coli(Eco)against antibacterial in clinical specimens in the hospital, and to evaluate the simultaneous use of antibacterial, to explore to provide the reference for the reasonable clinical use of antibacterial. Method:Eco was separated from all kinds of clinical specimens of out-patients and in-patients in the hospital from August of 2005 to April of 2006,and ESBLs was detected with Kirby-Bauer (K-B) disk diffusion method. It was also counted that the antibacterial drugs ranked the first 30 in sales per month and their use frequencies in the same period in the hospital. Result:The detectable rate of producing ESBLs Eco was 58.6%. Eco was completely sensitive to imipenem. It had lower resistance rates, only 2% and 4% , against piperacillin/tazobactam and cefoperazone/sulbactam; and had 59% and 55% resistance rates respectively against cefotaxime claforan and ceftazidime pentahydrate in the third generation cephalosporin. The third generation cephalosporin and quinolones kept high in sales and their use frequencies ranked the first three. The use of the third generation cephalosporin with anhydrase inhibitors also had an uptrend. Conclusion:There is a direct relation between the use of a great deal of antibacterial and the imitative drug resistance of Eco. It is necessary to strengthen its clinical management and to raise the level of drug use.