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Background:In India, the national prevalence of diabetes mellitus (DM) is estimated at 18.2%. More than half of all diabetic deaths are accounted for by atherosclerotic disease leading to cardiovascular or cerebral complications. Intima media thickness (IMT), a measure of atherosclerotic vascular disease. It can easily be measured especially at the carotids by B mode ultrasonography, a relatively simple way representing a safe, precise, and reproducible measure. It has therefore been proposed as a non-invasive measure of predicting chances of cerebrovascular disease burden in adults. Methods:A total of 60 subjects in the age group of 30-75 years (M:F=37:23) were selected and divided into three groups, group C: Patients of either sex in the age group of 30-75 years with type 2 DM (T2DM) with or without hypertension with ischemic stroke demonstrated on CT scan. Group B: Age-matched T2DM patients of either sex without any prior history of transient ischemic attack or stroke. Group A: Age-matched normal individuals of either sex. The following groups of diabetic patients with stroke were excluded from our study: cardioembolic stroke, patients with hemorrhagic stroke, and patients with stroke due to secondary causes like trauma, impaired coagulation or tumor.Results: Average mean common carotid artery IMT (CCA-IMT) ranged from 0.72 to 0.97 mm across cohorts in people with diabetes.Patients with T2DM with ischemic stroke were found to have significantly higher prevalence of increased CIMT and a value greater than 0.8 mm was found to be associated with the occurrence of stroke. The mean CIMT was significantly higher in diabetic subjects compared to healthy subjects.Conclusions: A high CIMT is a surrogate and reliable marker of higher risk of cerebrovascular accidents amongst type 2 diabetic patients. Our study demonstrates the utility of carotid IMT as a simple non-invasive screening test for the assessment of atherosclerosis risk/prognosis in T2DM.
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Exercise plays a critical role in non-drug treatment of diabetes .However,exercise-associated hypoglycemia (EAH) restrains diabetic patients from exercising .Till now,the underlying mechanism of exercise-associated hypoglycemia is unclear .Here we reviewed studies on pathogenesis of exercise-associated hypoglycemia in diabetes,in order to provide references and ideas for further studies in EAH .
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Objective To observe the influence of glucose fluctuation on paraoxonase-3(PON3) and apoprotein A1(ApoA1) in T2DM patients with coronary heart disease (CHD) . Methods A total of 260 subjects were enrolled in this study and dividied into three groups :T2DM patients with CHD (T2DM +CHD group ,n=100) ,T2DM without CHD (T2DM group ,n=80) and healthy subjects(NC group ,n=80) .The serum PON3 and ApoA1 levels were measured and compared in all the three groups .The 72 h dynamic glucose monitoring (CGMS ) was adopted in T2DM + CHD group ,then according to the MAGE levels ,T2DM+ CHD group was subdivided intotertiles :the lowest tertile subgroup (2.43～3.44 mmol/L ,n=31) ,the middle tertile subgroup (3.45～4.46 mmol/L ,n=39) and the highest tertile subgroup (4.47～5.45 mmol/L ,n= 30) .Influencing factors for PON3 and ApoA1 were analyzed by multivariate linear regression analysis . Results (1)The SBP ,DBP ,FPG ,2 hPG ,HbA1c ,FIns ,ApoB ,BUN ,HOMA-IR , ApoA1 and number of smokers were higher in T2DM + CHD group than in NC group .FPG ,2 hPG ,HbA1c ,FIns and HOMA-IR were higher in T2DM+ CHD group than in T2DM group(P<0.05 or P<0.01) .LDL-C ,Lp-a and hsC-RP were higher ,and the PON3 were lower in T2DM +CHD group than in T2DM group and NC group (P< 0.05 or P< 0.01);(2)With the increase of blood glucose fluctuation range ,the levels of PON3[(0.58 ± 0.10) vs (0.44 ± 0.07) vs (0.25 ± 0.01) ng/ml]and ApoA1 [(2.33 ± 1.04) vs (2.31 ± 0.71) vs(1.05 ± 0.48)g/L]were reduced(all P=0.000);(3)Multiple linear regression analysis showed that BMI ,hsC-RP ,HOMA-IR and MAGE were influencing factors for PON3. And HbA1c ,hsC-RP and MAGE were influencing factors for ApoA1 (P<0.05 or P<0.01) . Conclusion Serum PON3 level is lower and ApoA1 level is higher in T2DM patients with CHD .Glucose fluctuation may be only an influencing factor for ApoA1 level .
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OBJECTIVE: To determine the efficacy of Acrysof(R) intraocular lens (IOL) compared to PMMA IOL about visual acuity & postoperative complications (eg. posterior capsular opacification) in diabetic patients. PATIENTS AND METHODS: We retrospectively reviewed the medical records of 18 patients (21 eyes) which underwent cataract extraction with Acrysof (R) IOL implantation and 58 patients (65 eyes) with PMMA (polymethylmethacrylate) IOL implantation from January 1996 to December 1999 at Chonnam National University Hospital. RESULTS: Postoperative best corrected visual acuity of above or equal to 0.5 was seem in 66.7% in acrysof (R) group, and in 73.9% in PMMA group at 6 months follow-up. Postoperative posterior capsular opacification was 33.3% and 49.2% respectively, and there was statistically significant difference in both group(p=0.021). CONCLUSIONS: Acrysof(R) intraocular lens can be used safely and reduce the rate of posterior capsular opacification in diabetic patients, which can make the positive effect on the treatment of the diabetic retinopathy after cataract surgery.