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ObjectiveThere are few reports on the correlation between blood glucose fluctuation and body mass index(BMI) in patients with type 2 diabetes mellitus (T2DM). This study aims to evaluate the correlation between the two by comparing the differences of glucose fluctuation in T2DM patients with different BMI.MethodsA total of 672 patients with T2DM admitted to the General Hospital of Eastern Theater Command from June 2017 to October 2018 were selected as subjects. They were divided into 4 groups according to the quartile of BMI. The age, height, weight, course of diabetes, hemoglobin, uric acid, glycosylated hemoglobin, HOMA-IR (insulin resistance index) and HOMA-β (islet β cell function index) were collected. The blood glucose of the patients was continuously monitored within 3 days by wearing a continuous glucose monitor (CGMS). The standard deviation of daily blood glucose (SBDG), the mean of daily differences (MODD) and the mean amplitude of glycemic excursion(MAGE) were calculated to analyze the effect of BMI on blood glucose fluctuation.ResultsThe index of blood glucose fluctuation was negatively correlated with BMI, HbA1c and HOMA-β, but positively with HOMA-IR. Compared with the 1st and 2nd quartiles of BMI, the fluctuation level of patients in the 3rd and 4th quartiles was lower. Multivariate logistic regression analysis showed that after adjustment of age, sex, cholesterol, triglyceride and hemoglobin, the risk of hyperglycemia fluctuation in the fourth quartile group was lower than that in the first quartile group (OR=0.594, 95%CI: 1.825~2.062).ConclusionThe fluctuation of blood glucose in patients with higher BMI is lower than that in patients with lower BMI.
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Objective The alterations of gut microbiota is closely related to metabolic diseases. The aim of this study was to analyze the effects of antibiotics on glucose metabolism and gut microbiota in mice, and to further explore the mechanism of gut microbiota in reducing blood glucose in db/db diabetic mice by broad-spectrum antibiotics. Methods 16 C57BL/KsJ-db/db mice were randomly divided into antibiotic group and control group with 8 mice in each group. Antibiotic group: broad-spectrum antibiotics(vancomycin 10mg/(kg·d), carbenicillin 50mg/(kg·d), metronidazole 50mg/(kg·d), neomycin 30mg/(kg·d)); Control group: 1% cellulose sodium solution as placebo treatment. Fasting blood glucose and body weights were recorded once a week during the study. At the same time, feces were collected for 16S rDNA gene sequencing analysis. The changes of fasting blood glucose, body weight, the relative abundance of microbiota, Shannon index, Simpson index and GLP-1 were compared between the two groups. Results After 5 weeks of treatment with broad-spectrum antibiotics (Vancomycin , Carbenicillin , Metronidazole , and Neomycin ), fasting blood glucose levels in db/db diabetic mice were significantly decreased (9.59±4.49mmol/L vs 19.71±8.74mmol/L,P=0.016). At the same time, antibiotics can also affect the gut microbiota of mice. The relative abundance of Proteobacteria in mice treated with antibiotics was significantly higher than that in control group (0.471±0.12 vs 0.177±0.12, P<0.05), and the OTUs of Proteobacteria, Enterobacteriaceae, Gamma-proteobacteria, and Enterobacteriales increased in mice treated with antibiotics compared with controls. In addition, we also showed antibiotics could change the diversity of gut microbiota, and the diversity of gut microbiota in antibiotic treated mice decreased significantly (Shannon index 3.135 vs 5.359, P<0.01); Simpson index 0.794 vs 0.946, P<0.01). Conclusion Broad-spectrum antibiotics can significantly reduce the fasting blood glucose level and the diversity of gut microbiota of db / db diabetic mice, and the alterations of gut microbiota may play an essential role in the process of reducing blood glucose by broad-spectrum antibiotics.
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Objective Diabetes mellitus (DM) is often complicated by thyroid hormone abnormality. The aim of this study was to investigate the relationship between the thyroid hormone level and glycemic fluctuation in patients with euthyroid type 2 DM (T2DM).Methods A total of 143 euthyroid T2DM patients were treated in the Department of Endocrinology of Nanjing General Hospital from January 2014 to December 2015. The continuous blood glucose monitoring system was used for 72-hour continuous monitoring of blood glucose fluctuation indexes, including the standard deviation (SD) of the glucose level, the mean amplitude of glycemic excursions (MAGE), and the absolute mean of daily differences (MODD). According to the percentile of the MAGE level, the patients were divided into groups Q1 (MAGE<4.1864, n=35), Q2 (4.1864≤MAGE<5.3764, n=37), Q3 (5.3764≤MAGE<6.8484, n=35), and Q4 (MAGE≥6.8484, n=36), compared the thyroid hormone level and such thyroid function parameters as serum free triiodothyronine (FT3), triiodothyronine (T3), free thyroxine (FT4) and FT3/FT4 among the four groups, and analyzed the correlation between the thyroid hormone level and glycemic indexes.Results The levels of serum FT3, T3 and FT3/FT4 were decreased with the increase of MAGE (P<0.05), and those of FT3 and FT3/FT4 were 4.11±0.77 and 0.38±0.37 in group Q1, 4.06±0.55 and 0.34±0.37 in Q2, 3.49±0.57 and 0.33±0.06 in Q3, and 3.68±0.65 and 0.31±0.09 in Q4, with statistically significant differences between any two groups (P<0.05). There were also statistically significant differences among the four groups (P<0.05) in the T3 and FT4 levels (P<0.05). The levels of FT3 and T3 were correlated negatively with SD, MODD and MAGE (P<0.05), and so was that of FT3/FT4 with MAGE (r=-0.243, P<0.05).Conclusion MAGE reduces the levels of FT3 and FT3/FT4 in patients with euthyroid T2DM probably by inhibiting the conversion of T4 to T3.