Clinical Observation on Yiqi Yangyin Jiangtang Prescription Combined with Acupoint Injection in the Treatment of Newly-diagnosed Type 2 Diabetes Mellitus / 广州中医药大学学报

Objective To observe the clinical efficacy of Yiqi Yangyin Jiangtang Prescription(mainly composed of Astragali Radix,Rehmanniae Radix,Imperatae Rhizoma,Ophiopogonis Radix,and Puerariae Lobatae Radix)combined with acupoint injection in the treatment of newly-diagnosed type 2 diabetes mellitus(T2DM).Methods One hundred patients with newly-diagnosed T2DM of qi-yin deficiency complicated with blood stasis type were randomly divided into a treatment group and a control group,with 50 patients in each group.The control group was given oral use of Metformin Hydrochloride Tablets,and the treatment group was given the granules of Yiqi Yangyin Jiangtang Prescription orally combined with acupoint injection at unilateral points of Zusanli(ST36),Shenshu(BL23)and Qihai(CV6)on the basis of treatment for the control group.The course of treatment lasted for 4 weeks.Before and after the treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),and serum levels of inflammatory factors of interleukin 6(IL-6),C-reactive protein(CRP),tumor necrosis factor α(TNF-α),as well as the hemorheology indicators of whole blood low-shear viscosity and whole blood high-shear viscosity.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)During the trial,5 cases fell off from the treatment group and 4 cases fell off from the control group,and a total of 91 patients were eventually included in the efficacy statistics,of which 45 cases were in the treatment group and 46 cases were in the control group.(2)After 4 weeks of treatment,the total effective rate of the treatment group was 93.33%(42/45),and that of the control group was 71.74%(33/46).The intergroup comparison(tested by chi-square test)showed that the therapeutic effect of the treatment group was significantly superior to that of the control group(P＜0.01).(3)After treatment,the scores of TCM symptoms of dry mouth and throat,frequent nocturia,shortness of breath and fatigue,hot flushes and night sweating as well as the total TCM syndrome scores in the two groups were significantly lower than those before the treatment(P＜0.05),and the reduction of the scores in the treatment group was significantly superior to that of the control group(P＜0.01).(4)After treatment,the levels of blood glucose and lipid indicators of FPG,2hPG,HbA1c,TC and TG of patients in the two groups were decreased compared with those before treatment(P＜0.05),and the decrease in the treatment group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(5)After treatment,the serum levels of inflammatory factors of IL-6,CRP,and TNF-α in the two groups were all lower than those before treatment(P＜0.01),and the reduction in the treatment group was significantly superior to that in the control group(P＜0.01).(6)After treatment,the levels of hemorheology indicators such as whole blood low-shear viscosity and high-shear viscosity in the two groups were all lower than those before treatment(P＜0.05),and the reduction in the treatment group was significantly superior to that in the control group(P＜0.05).(7)The incidence of adverse reactions in the treatment group was 8.89%(4/45),which was significantly lower than that of the control group(21.74%,10/46),and the difference was statistically significant(P＜0.01).Conclusion Yiqi Yangyin Jiangtang Prescription combined with acupoint injection exerts certain effect in treating patients with newly-diagnosed T2DM of qi-yin deficiency complicated with blood stasis syndrome type.The combined therapy can effectively alleviate the early clinical manifestations,decrease the levels of blood glucose,blood lipids,and inflammatory factors,and improve the hematological indicators and the quality of life of the patients.

Study of oxidative stress and C-Reactive protein in type-2 diabetes mellitus

Background: Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion and insulin action or both. T2DM is associated with chronic low grade inflammation, possibly through a pathway involving a cytokine-mediated acute-phase response to infection and other inflammatory processes. authors aim to study C-reactive protein (CRP) which is an acute-phase reactant produced primarily in the liver hepatocytes. Oxidative stress levels in newly diagnosed T2M patients were analysed with respect to malondialdehyde (MDA) and nitric oxide (NO).Methods: Case-control study comprising of aged-sex matched subjects: newly diagnosed T2DM cases (n=30) and controls (n=30). The serum samples of subjects were analysed for levels of MDA by Buege and Aust method, while NO levels by Cortas and Wakid’s kinetic cadmium reduction method using spectrophotometer. CRP levels were analysed by using turbidimetry. Statistical analysis was done using Mini-tab 17 software with 95% confidence interval.Results: Serum levels of MDA, NO and CRP in newly diagnosed T2DM patients were significantly increased as compared to healthy controls.Conclusions:  Authors concluded that the oxidative stress and inflammation plays a pivotal role in the aetiology of hyperglycemia in T2DM. Oxidative stress and inflammatory markers might help prognosis of T2DM in hyperglycemic individuals with the help of which precautionary measure can be taken to reduce the rate of disease progression. Treatment involving anti-oxidant and anti-inflammatory medications might help to rescue vital organs from damage.

Glycemic control of newly-diagnosed type 2 diabetes with different baseline body mass index under the standardized metabolic disease management model / 中华内分泌代谢杂志

Objective To explore the glycemic control of newly-diagnosed type 2 diabetes with different levels of baseline body mass index ( BMI ) after 6 months treatment under the standardized metabolic disease management model. Methods ( 1) 163 patients of newly-diagnosed type 2 diabetes were divided into normal weight (BMI 18.5-23.9 kg/m2), overweight (BMI 24.0-27.9 kg/m2), and obese (BMI≥28 kg/m2) groups according to baseline BMI, the blood glucose and lipids levels were compared among 3 groups. ( 2) The blood glucose levels were compared among 3 groups after 6 months of standardized management. ( 3) The overweight and obese patients were divided into group weight loss≥5％and group weight loss<5％ or weight gain in 6 months. The blood glucose levels were compared. Results ( 1) At baseline, overweight and obese groups had higher homeostasis model assessment for insulin resistance and lower high density lipoprotein-cholesterol compared with normal weight group. ( 2) After 6 months of treatment, HbA1C and HbA1C reduction showed no difference among 3 groups ( normal, overweight and obese) after adjusted by baseline HbA1C. The rate of HbA1C<7％among 3 groups were 77.78％, 83.95％, and 80.43％(P>0.05). (3) After 6 months of treatment, 32.28％ overweight and obese patients lost weight by ≥5％, while HbA1C and HbA1C reduction showed no difference between 2 groups ( weight loss≥5％and weight gain or weight loss<5％) after adjusted by baseline HbA1C. Both groups achieved good glycemic control [(6.27±1.38 vs 6.43±0.66)％], but have no significantly(P>0.05). Group weight loss≥5％ had better glucose control (92.68％ vs 77.91％, P<0.05) . Conclusions As BMI increased, insulin resistance and lipid disorders were more serious in newly-diagnosed type 2 diabetes. After 6 months of standardized metabolic management, newly-diagnosed type 2 diabetes with different baseline BMI and weight changes both achieved good glycemic control. In addition, patients losing weight equal to or more than 5％achieved higher attainment of HbA1C targets.

Glycemic control of newly-diagnosed type 2 diabetes with different baseline body mass index under the standardized metabolic disease management model / 中华内分泌代谢杂志

Objective@#To explore the glycemic control of newly-diagnosed type 2 diabetes with different levels of baseline body mass index (BMI) after 6 months treatment under the standardized metabolic disease management model.@*Methods@#(1) 163 patients of newly-diagnosed type 2 diabetes were divided into normal weight (BMI 18.5-23.9 kg/m2), overweight (BMI 24.0-27.9 kg/m2), and obese (BMI≥28 kg/m2) groups according to baseline BMI, the blood glucose and lipids levels were compared among 3 groups. (2) The blood glucose levels were compared among 3 groups after 6 months of standardized management. (3) The overweight and obese patients were divided into group weight loss≥5% and group weight loss<5% or weight gain in 6 months. The blood glucose levels were compared.@*Results@#(1) At baseline, overweight and obese groups had higher homeostasis model assessment for insulin resistance and lower high density lipoprotein-cholesterol compared with normal weight group. (2) After 6 months of treatment, HbA1C and HbA1C reduction showed no difference among 3 groups (normal, overweight and obese) after adjusted by baseline HbA1C. The rate of HbA1C<7% among 3 groups were 77.78%, 83.95%, and 80.43% (P>0.05). (3) After 6 months of treatment, 32.28% overweight and obese patients lost weight by ≥ 5%, while HbA1Cand HbA1Creduction showed no difference between 2 groups (weight loss≥5% and weight gain or weight loss<5%) after adjusted by baseline HbA1C. Both groups achieved good glycemic control [(6.27±1.38 vs 6.43±0.66)%], but have no significantly(P>0.05). Group weight loss≥5% had better glucose control (92.68% vs 77.91%, P<0.05).@*Conclusions@#As BMI increased, insulin resistance and lipid disorders were more serious in newly-diagnosed type 2 diabetes. After 6 months of standardized metabolic management, newly-diagnosed type 2 diabetes with different baseline BMI and weight changes both achieved good glycemic control. In addition, patients losing weight equal to or more than 5% achieved higher attainment of HbA1C targets.

Clinical implications of circulating miRNA-101 expression level in patients with newly diagnosed type 2 diabetes mellitus / 中国临床药理学与治疗学

AIM:To investigate the serum miRNA-101 expression level in patients with newly diagnosed type 2 diabetes mellitus (T2DM),and to evaluate the clinical implications of miRNA-101 expression level variation.METHODS:qRT-PCR was used to determine the serum miRNA-101 expression level.Pearson correlation analysis was performed to observe the relationship between two variables.Multiple stepwise linear regression analysis was used to assess the association of serum miRNA-101 level and other parameters.RESULTS:Serum miRNA-101 level in patients with newly diagnosed T2DM was significantly higher than that in control subjects (P ＜ 0.05).The serum level of miRNA-101 was positively correlated with the glycosylated hemoglobin A1c (HbA1c,P ＜0.05).Multiple linear regression analysis revealed that the circulating miRNA-101 was in significant positive correlation with HbA1c (P ＜ 0.05) after adjustment for age,sex and body weight.CONCLUSION:Enhanced circulating miRNA-101 level in newly diagnosed T2DM patients may be associated with elevation of HbA1 c.

Efficacy of saxagliptin combined with acarbose in the treatment of newly diagnosed type 2 diabetes mellitus / 中国生化药物杂志

Objective To investigate the clinical effect and analysis of Shah Glenn Dean combined with acarbose in the treatment of newly diagnosed elderly patients with type 2 diabetes mellitus.Methods 60 cases of newly diagnosed elderly patients treated in our hospital during the period from January 2015 to January 2017 in patients with type 2 diabetes mellitus is selected as the object of this study, they were randomly divided into control group and study group, 30 cases in each group.The control group was treated with acarbose treatment, the study group was treated with Shah Glenn Dean combined acarbose treatment, treatment time was 3months, glycosylated hemoglobin, after two groups of patients were in different treatment of hypoglycemia were observed and compared the rate of change, body mass index and blood glucose level changes.Results The patients in the control group, the incidence of hypoglycemia was 23.33%, patients in the study group, the incidence of hypoglycemia was 6.67%, patients in the study group,the incidence of hypoglycemia was significantly lower than that of control group, the difference was statistically significant between the groups(P <0.05); glycosylated hemoglobin levels in the study group were significantly lower than that of the control group of two patients, the difference was statistically significant between the groups(P <0.05); the total cost of the patients in the treatment group compared with the control group had no significant difference, the difference was not statistically significant.Conclusion Significant clinical therapeutic effect of saxagliptin combined with acarbose in the treatment of newly diagnosed elderly patients with type 2 diabetes, can make the patient's blood glucose levels were significantly lower,with high security, the incidence of hypoglycemia was significantly reduced, but also can reduce the weight of patients, the total cost in the course of treatment did not increase that will not cause economic burden on patients, it is worthy of clinical application.

Correlation between Plasma Concentration of Nateglinide and Clinical Efficacy in Newly Diagnosed Type 2 Diabetes / 中国药师

Objective:To study the correlation between plasma concentration and clinical efficacy in newly diagnosed type 2 diabe-tes treated with nateglinide. Methods:On the basis of diet control and exercise, 73 cases of newly diagnosed type 2 diabetes received nateglinde therapy for 2 months. Adverse events were routinely monitored during the therapy. Fasting blood glucose(FBG), 2h post-prandial blood glucose(2h-PG), fasting C-peptide(F-CP), 2h C-peptide(P-CP) and glycosylated hemoglobin (HbA1c) were ob-served before and after the treatment. LC-MS was used to determine the plasma concentration of nateglinide on the last day of treat-ment. Results:FBG, 2h-PG, HbAlc and P-CP after the treatment had significant changes when compared with those before the treat-ment (P0. 05). The difference in HbA1c and P-CP before and after the treatment both showed a significantly positive correlation with plasma concentration of nateglinide (P<0. 05). Conclusion:Nateglinide displays good clinical efficacy and safety in newly diagnosed type 2 diabetes, and its plasma concentration can be used to evaluate the pancreatic islets function and glucose-lowing effects.

Cloning,Expression and Diagnostic Application of Different Fragments of Human Carboxypeptidase / 现代检验医学杂志

Objective To obtain different fragments of human carboxypeptidase H,and evaluate the diagnostic application of the recombination carboxypeptidase H in detecting autoantibody.Methods The coding gene of carboxypeptidase H was ob-tained by RT-PCR.The corresponding prokaryotic expression vectors were constructed and transformed into E.coli to in-duce the expression of the recombination different fragments of carboxypeptidase H.Using these antigen fragments as the coating antigens,the enzyme-linked immunosorbent assay (ELISA)was established for the detection of carboxypeptidase H autoantibody in 95 newly diagnosed type 2 diabetes patients.Results Three fragments of human carboxypeptidase H were obtained,in which the 42~476aa fragment antigen was ideal one.Using the full-length carboxypeptidase H as coating anti-gen,the positive rate of carboxypeptidase H autoantibody was 8.42%.Conclusion Because of the favorable antigenicity,the 42~476aa fragment antigen of carboxypeptidase H could be the candidate antigen for discrimination and diagnosis of latent autoimmune diabetes in adults.

Role of Detecting GADA and ZnT8A in Newly Diagnosed Type 2 Diabetes Patients / 现代检验医学杂志

Objective To analysis the positive rates of glutamic acid decarboxylase autoantibody (GADA)and zinc transporter 8 autoantibody (ZnT8A)in newly diagnosed type 2 diabetes patients.Methods GADA and ZnT8A were detected in 101 ca-ses of newly diagnosed type 2 diabetes mellitus patients using ELISA.Results The positive rate of GADA was 21.78%,the positive rate of ZnT8A was 17.82%,and the common positive rate of GADA and ZnT8A was 8.91%.There were no corre-lations between GADA or ZnT8A autoantibodies and the patient’s sex (t=-0.724,-0.550;0.903,1.359,P >0.05),age (t=-0.724,-0.550;0.903,1.359,P >0.05),blood glucose (r=0.290,0.110;-0.264,-0.047,P >0.05),cholesterol (r=-0.047,0.004;0.154,-0.138,P >0.05),triglyceride (r=-0.092,-0.054;-0.217,-0.023,P >0.05),and low density lipoprotein (r= - 0.045,- 0.027;0.202,- 0.025,P > 0.05).Conclusion It should be screened autoantibodies timely for newly diagnosed type 2 diabetic patients in order to diagnosis the Latent autoimmune diabetes in adults early.

The efficacy comparison between glargine and biphasic insulin aspart 30(BIAsp 30) after CSII in newly diagnosed type 2 diabetes mellitus / 中国糖尿病杂志

Objective To compare the efficacy and safety of glargine(Lantus) versus biphasic insulin aspart 30 (30% free and 70% protamine-bound, BIAsp 30) after continuous subcutaneous insulin infusion treatment (CSII) in newly diagnosed type 2 diabetes mellitus. Methods A 20 week open and random study was performed. All 60 patients with newly diagnosed T2DM were randomly divided into two groups. Group B patients was treated by glargine and group A received treatment with BIAsp 30 administered immediately before dinner and breakfast. Blood glucose at 7 time points, glycosylated hemoglobin A1c(HbA1c) and hypoglycemia were observed. Results The postprandial glucose(PPG) was significantly lower in group B than in group A (P<0.05), and the frequency of hypoglycaemic episodes was lower in group B than in group A (P<0.05). The fasting blood glucose(FBG) was not different between two groups (P>0.05). And there was no difference between two groups in HbA1c and other adverse events. Conclusions Glargine is surperior to BIAsp30, not only in controlling the PPG but also in reducing the incidence of hypoglycemia.

Clinical Research of Integrated TCM into Intensive Insulin Treatment in Newly Diagnosed Type 2 Diabetic Patients / 中国中医药信息杂志

Objective To investigate the remission rate of the therapy of integrated TCM into intensive insulin treatment, and the relationship between each factor and the remission rate. The effect of TCM on improving ?-cell fimction and remission rate was also studied. Methods Forty-seven newly diagnosed type 2 diabetic patients were shortly treated with both continuous subcutaneous insulin infusion (CSII) and Chinese medicine. The remission rate was observed. The relationship between each factor and remission was analyzed by logistic regression. The ?-cell function of patients in remission group were evluated at the end of the treatment and during the period of follow-up. Results After treatment of (11.8?2.5)d, BMI and the ratio of the days of blood glucose reaching the standard and the total treatment days were the mainly factors affecting the remission. The remission rate at the end of treatment, one month after treatment and follow-up period (about six month) was 46.8%, 55.3%, 53.3% respectively. In following up, the remission rate in the Chinese medicine group and the control group was 66.7%, 44.4% respectively. Conclusions About half of newly diagnosed type 2 diabetic patients obtain clinical remission after the short-term intensive treatment of integrated insulin and Chinese medicine. Chinese medicine may have positive impaction on remission and extending honeymoon period.

The levels of intraeythrocytic glutathion and its related factors in IGT and newly diagnosed type 2 diabetes patients / 医学研究生学报

Objective:To evaluate the antioxidant status in IGT and newly diagnosed type 2 diabetes patients, we detected the levels of serum Vitamin E(Vit E), vitamin C(Vit C) and intraerythrocytic glutathion(GSH).Methods:The levels of serum Vit E, Vit C and intraerythrocytic GSH were measured in 32 IGT and 41 newly diagnosed type 2 diabetes patients, and the associated factors with GSH/GSSG (oxidized glutathione) were evaluated.Results:Significant decrease of serum Vit C intraerythrocytic GSH and GSH/GSSG were noted in IGT and newly diagnosed type 2 diabetes patients. There were negative correlation between GSH/GSSG and blood glucose, triglyceride, HbA_(1c) in IGT and newly diagnosed type 2 diabetes patients.Conclusion:The results showed that antioxidant defenses are decreased in IGT and newly diagnosed type 2 diabetes patients. To improve the metabolism of blood glucose and triglyceride may have some beneficial effects on antioxidant defenses in IGT and newly diagnosed type 2 diabetes patients.

Short-term intensive insulin therapy in newly diagnosed type 2 diabetic patients / 医学研究生学报

Objective:To investigate the effect of short-term intensive treatment with insulin on metabolic control,?-cell function and insulin resistance in newly diagnosed type 2 diabetic patients. Methods:Thirty-eight newly diagnosed type 2 diabetic patients were randomly divided into two groups and treated with continuous subcutaneous insulin infusion(CSII) or multiple daily insulin injection(MDI) for 1 month.Fasting blood glucose(FBG) and lipid profiles were measured,and oral glucose tolerance test(OGTT)was performed before and after the treatment.The second phase insulin and C peptide secretions were measured by calculating area under curve(AUC) in OGTT.HOMA model was used to evaluate ?-cell function((HOMA-?)) and insulin resistance. Results:Excellent control of FBG was achieved after 1 month intensive treatment.(HOMA-?) was improved significantly. Conclusion:The excellent metabolic control and ?-cell function improvement can be achieved by short-term intensive insulin therapies like CSII or MDI.