Baja disponibilidad de recursos y apoyo para atender a personas con diabetes e hipertensión arterial en las Unidades de Salud de la Familia de Paraguay

Introducción: Paraguay asumió el reto de lograr cobertura universal mediante redes basadas en Atención Primaria de la Salud con Unidades de Salud de la Familia (USF) en el primer nivel de atención. Un desafío es la atención integral ante enfermedades no transmisibles, principal causa de mortalidad en el país. Objetivo: analizar la capacidad de las USF para la atención de personas con hipertensión arterial y diabetes en el sistema nacional de salud. El diseño fue no experimental, cuantitativo, transversal, descriptivo con componente analítico. Metodología: Incluyó a 761 USF de 12 regiones sanitarias agrupados en 4 ejes territoriales. Se adaptó el método de evaluación SARA de la OMS con 75 variables, aplicando un cuestionario a profesionales de salud entre noviembre y diciembre de 2022. Se calculó índices de disponibilidad y preparación así como un índice que los integra. La medida continua de estos índices se categorizó en 3 grupos: suficiente >0,75 a 1; intermedio 0,5 a 0,75 y bajo <0,5. Resultados: Solo en el 38 % de las USF el índice de disponibilidad fue suficiente, en el 31,5 % para el índice de preparación y en el 31,1 % para el índice integrador SARA DM/HTA. El desempeño se asoció de forma significativa con el eje territorial no así con el área ni con la cobertura a población indígena Discusión: las USF presentaron limitaciones para la atención de personas con diabetes e hipertensión en estas regiones del país.

Introduction: Paraguay assumed the challenge of achieving universal coverage through networks based on Primary Health Care with Family Health Units (USF) at the first level of care. One challenge is comprehensive care for non-communicable diseases, the main cause of mortality in the country. Objective: to analyze the capacity of the USF to care for people with high blood pressure and diabetes in the national health system. The design was non-experimental, quantitative, cross-sectional, descriptive with an analytical component. Methods: It included 761 USF from 12 health regions grouped into 4 territorial axes. The WHO SARA evaluation method was adapted with 75 variables, applying a questionnaire to health professionals between November and December 2022. Availability and preparation indices were calculated as well as an index that integrates them. The continuous measurement of these indices was categorized into 3 groups: sufficient >0.75 to 1; intermediate 0.5 to 0.75 and low <0.5. Results: Only in 38.0% of the USF the availability index was sufficient, in 31.5% for the readiness index and in 31.1% for the SARA DM/HTA integrating index. The performance was significantly associated with the territorial axis, but not with the area or with the coverage of the indigenous population. Discussion: the USF presented limitations for the care of people with diabetes and hypertension in these regions of the country.

Control metabólico de pacientes diabéticos tipo 2 tratados con empagliflozina: serie de casos / Metabolic control in type 2 diabetic patients treated with empagliflozin: A case series

Introducción La diabetes mellitus tipo 2 es una enfermedad de alta prevalencia y está asociada a mayor morbimortalidad. Debido al bajo porcentaje de compensación, se han buscado nuevas estrategias de tratamiento farmacológico, como los inhibidores del cotransportador sodio-glucosa tipo 2. Objetivo Describir la evolución de pacientes diabéticos tipo 2 insulino-requirentes tratados con empagliflozina en el Hospital Peñaflor, ubicado en el sector poniente de la Región Metropolitana, Chile. El objetivo primario fue evaluar la eficacia del medicamento respecto a hemoglobina glicosilada A1c. Los objetivos secundarios fueron registrar el logro de hemoglobina glicosilada A1c igual o menor a 7,5% según análisis de supervivencia. Luego, consignar el cambio en la velocidad de filtración glomerular y en la excreción urinaria de albúmina post tratamiento. Métodos Revisión de ficha clínica de todos los pacientes tratados con empagliflozina desde noviembre de 2019 a junio de 2023. Media de seguimiento de 19 (de 16,3 a 40) meses. Para comparación entre valores de hemoglobina glicosilada A1c según rangos de seguimiento, se utilizó prueba T de Student de términos pareados o prueba de Wilcoxon. Resultados Se estudió a 58 pacientes, 15 hombres y 43 mujeres (74,1%). Edad 58,5 ± 9,2 años, rango de 35 a 75 años. Hemoglobina glicosilada A1c basal de 10,3 ± 1,6% y 8,98% ± 2,2 en un rango de seguimiento de 18 a 24 meses post tratamiento, resultando en un descenso de 1,27% (p = 0,002; intervalo de confianza 95%: 0,5 a 2,03). El efecto adverso más frecuente fue infección del tracto urinario. Conclusiones Los pacientes diabéticos tipo 2 insulino-requirentes tratados con empagliflozina en el Hospital Peñaflor lograron un mejor control glicémico con pocos efectos adversos.

Background Type 2 diabetes mellitus is a highly prevalent disease and is associated with increased morbidity and mortality. Due to the low percentage of adequate glycemic control, new strategies for the treatment of type 2 diabetes mellitus have been sought, including sodium-glucose cotransporter type 2 inhibitorss. Objective To describe the evolution of patients with type 2 diabetes mellitus with insulin requirements treated with empagliflozin at the Peñaflor Hospital. The primary objective was to evaluate the efficacy of the medication regarding glycosylated hemoglobin A1c (HbA1c). The secondary objectives were: 1) achievement of HbA1c equal to or less than 7.5% according to survival analysis. 2) Change in glomerular filtration rate and urinary albumin excretion post treatment. Methods Review of clinical records of all patients treated with empagliflozin from November 2019 to June 2023. Average follow-up of 19 (16.3 to 40) months. To compare HbA1c values according to follow-up ranges, the paired T test or Wilcoxon test was used. Results We included 58 patients, 15 men and 43 women (74.1%), with an average age of 58.5 ± 9.2 years, ranging from 35 to 75 years. Baseline HbA1c of 10.3 ± 1.6% and 8.98% ± 2.2 in a follow-up of 18 to 24 months post-treatment, resulted in a decrease of 1.27% (p = 0.002; confidence interval 95%: 0.5 to 2.03). The most common adverse effect was urinary tract infection. Conclusions Patients with type 2 diabetes mellitus with insulin requirements treated with empagliflozin at the Peñaflor Hospital achieved better glycemic control with few adverse effects.

Caracterización del paciente diabético como antecedente para una intervención educativa / Characterization of diabetic patients as a background for an educational intervention

Introducción: La diabetes mellitus es una enfermedad no transmisible con una elevada comorbilidad, sobre todo, vinculada a la enfermedad renal crónica. La caracterización del paciente diabético, según variables epidemiológicas y los conocimientos de la enfermedad renal crónica que presentan, deben preceder a la valoración clínica y a la intervención educativa dirigida a modificar estilos de vida como parte de la atención primaria de salud. Objetivos: Caracterizar a pacientes diabéticos del Policlínico Santa Clara, según variables epidemiológicas seleccionadas, y la comorbilidad vinculada con la enfermedad renal crónica. Métodos: Se realizó un estudio descriptivo-exploratorio a los pacientes diabéticos en el consultorio médico de la familia 16-11 del Policlínico Santa Clara, de octubre del 2019 a junio del 2022. La población estuvo conformada por 79 pacientes diabéticos y la muestra por 60, según criterios de inclusión y exclusión. Se utilizaron técnicas de análisis estadístico: análisis de frecuencias simples, estadística descriptiva y la prueba de independencia de Chi cuadrado. Resultados: Predominó el sexo masculino; grupo etario de 55-59; diabetes mellitus tipo 2 y cifras elevadas de tensión arterial correlacionadas con la diabetes. Además, existió un nivel bajo de conocimientos acerca de las enfermedades renales crónicas. Conclusiones: Los resultados obtenidos permiten confirmar la relevancia de este tipo de estudios para elevar el nivel de conocimientos sobre la relación entre el padecimiento de diabetes mellitus y la enfermedad renal crónica, para contribuir a mejorar la calidad de vida de este grupo poblacional a través de una intervención educativa previamente orientada.

Introduction: diabetes mellitus is a non-communicable disease with high comorbidity and especially linked to chronic kidney disease. Characterization of diabetic patients according to epidemiological variables and knowledge of their chronic kidney disease must precede the clinical assessment and educational intervention aimed at modifying lifestyles as part of primary health care. Objectives: to characterize diabetic patients from Santa Clara Polyclinic according to selected epidemiological variables as well as the comorbidity linked to chronic kidney disease. Methods: a descriptive exploratory study was carried out on diabetic patients belonged to the 16-11 doctor's office in Santa Clara Polyclinic from October 2019 to June 2022. The population was made up of 79 diabetic patients and 60 formed the sample according to inclusion and exclusion criteria. Statistical analysis techniques such as descriptive statistics, simple frequency analysis and the Chi- square independence test were used. Results: males, age group 55-59 years, type 2 diabetes mellitus and high blood pressure levels correlated with diabetes predominated. Besides, a low level of knowledge on chronic kidney diseases was identified. Conclusions: the obtained results confirm the relevance of this type of studies to raise the level of knowledge on the relationship between diabetes mellitus and chronic kidney disease in order to contribute to the improvement of the quality of life of this population group through a previously oriented educational intervention.

Evidencias del efecto del grano integral en las enfermedades crónicas no transmisibles

Los cereales integrales son una categoría de alimentos fundamental para la dieta humana y representan una fuente invaluable de carbohidratos, proteínas, fibras, fitoquímicos, minerales y vitaminas. Muchos estudios han demostrado que el consumo de cereales integrales está relacionado con un menor riesgo de enfermedades crónicas no transmisibles. Sin embargo, varios de sus efectos positivos para la salud parecen desaparecer cuando se refinan los cereales. La pregunta de investigación es cuál sería el efecto de los cereales integrales en la prevención de enfermedades crónicas no transmisibles. Este artículo describe los efectos positivos del consumo de cereales integrales en la prevención de estas enfermedades. Para ello, se realiza una descripción narrativa que revisa los antecedentes disponibles sobre: a) situación epidemiológica en Chile y su relación con la alimentación; b) consumo de cereales integrales en el mundo y en Chile; y c) el efecto del consumo de cereales integrales en la reducción del riesgo de enfermedad cardiovascular. obesidad, diabetes tipo 2 y cáncer. Los antecedentes generales son muy alentadores sobre el efecto positivo del consumo de cereales integrales sobre determinadas enfermedades, especialmente las de origen metabólico. Sin embargo, la incertidumbre de algunas asociaciones negativas merece mayor atención.

Whole grains are a fundamental food category for the human diet and represent an invaluable source of carbohydrates, proteins, fibers, phytochemicals, minerals and vitamins. Many studies have shown that consumption of whole grains is linked to a lower risk of chronic non-communicable diseases. However, several of its positive health effects seem to disappear when grains are refined. The research question is what would be the effect of whole grains in the prevention of Chronic Non-Communicable Diseases. This article describes the positive effects of whole grain consumption in these diseases.To this end, a narrative description is made that reviews the available background on: a) epidemiological situation in Chile and its relationship with diet; b) consumption of whole grains in the world and in Chile; and c) the effect of whole grain consumption on reducing the risk of cardiovascular disease. obesity, type 2 diabetes, and cancer. The general background is very encouraging for a positive effect of whole grain consumption on certain diseases, especially those of metabolic origin. However, the uncertainty of some negative associations deserves further attention.

Interacciones potenciales entre productos herbolarios con fármacos hipoglucemiantes en adultos mayores con diabetes mellitus, en una zona rural mexicana / Potenciais interacções entre produtos à base de plantas e medicamentos hipoglicemiantes em adultos mais velhos com diabetes mellitus no Mexico rural / Potential interactions between herbal products with hypoglycemic drugs in older adults with diabetes mellitus in rural Mexico

Introducción: El 50% de la población mundial usa tratamientos alternativos como productos herbarios. El 20% los consume de manera simultánea con algún tratamiento farmacológico para el control la Diabetes Mellitus tipo 2; enfermedad prevalente en adultos mayores. Es escasa la información acerca de las interacciones medicamentosas que pudieran producirse, siendo responsables de más de 7,000 muertes al año. Objetivo: Identificar los productos herbarios de mayor consumo del Adulto Mayor con Diabetes Mellitus Tipo 2, en Chapulco, Puebla, México y describir las posibles interacciones medicamentosas entre fármaco hipoglucemiante ­ producto herbario reportados en la literatura científica. Metodología: Estudio observacional, prolectivo, transversal, descriptivo, en una población de 35 adultos mayores diabéticos, con edad promedio de 70±7 años. Para la identificación de los productos herbarios de uso común y sus aplicaciones terapéuticas se aplicó el cuestionario U-PLANMED. Resultados: Se identificaron 50 productos herbarios y 18 combinaciones entre estos a la vez. El 40% de los participantes consumen simultáneamente más de dos productos herbarios con uno o dos fármacos hipoglucemiantes. Entre los productos de mayor consumo se encuentran el nopal (Opuntia ficus-indica L.), la manzanilla (Matricaria chamomilla L.) y el zacate de limón (Cymbopogon citratus DC. Stapf.). Las interacciones medicamentosas potenciales identificadas, principalmente en estudios experimentales en animales, sugieren que, existe una acción hipoglucemiante del producto herbario al aumentar la capacidad orgánica sobre la secreción/liberación de insulina endógena. Conclusiones: Se ha evidenciado la presencia de interacciones medicamentosas ante el consumo simultaneo de fármacos prescritos para el control de la diabetes mellitus tipo 2 con productos herbarios. Es necesario que, los profesionales en atención a la salud identifiquen el uso de dichos productos y orienten a los adultos mayores sobre las posibles repercusiones en los niveles de glucosa ante el consumo.

Introduction: 50% of the world's population uses alternative treatments such as herbal products. Twenty percent use them in conjunction with some form of pharmacological treatment to control type 2 diabetes mellitus, a disease prevalent in older adults. There is little information on the drug interactions that may occur, which are responsible for more than 7,000 deaths per year. Objective: To identify the most consumed herbal products among older adults with type 2 diabetes mellitus in Chapulco, Puebla, Mexico, and to describe the possible drug-drug interactions between hypoglycemic drugs and herbal products reported in the scientific literature. Methodology: Observational, prospective, cross-sectional, descriptive study in a population of 35 diabetic older adults with a mean age of 70±7 years. The U-PLANMED questionnaire was used to identify commonly used herbal products and their therapeutic applications. Results: Fifty herbal products and 18 combinations of them were identified. Forty percent of the participants used more than two herbal products simultaneously with one or two hypoglycemic drugs. The most used products included prickly pear cactus (Opuntia ficus-indica L.), chamomile (Matricaria chamomilla L.), and lemon grass (Cymbopogon citratus DC. Stapf.). Potential drug-drug interactions identified mainly in experimental animal studies suggest that there is a hypoglycemic effect of the herbal product by increasing the organic capacity on endogenous insulin secretion/release. Conclusions: The presence of drug-drug interactions has been demonstrated with the simultaneous consumption of drugs prescribed for the control of type 2 diabetes mellitus with herbal products. It is necessary for health care professionals to recognize the use of such products and to inform older adults about the possible repercussions on glucose levels when consuming them.

Introdução: 50% da população mundial utiliza tratamentos alternativos como os produtos à base de plantas. Vinte por cento utilizam-nos em conjunto com algum tipo de tratamento farmacológico para controlar a diabetes mellitus tipo 2, uma doença prevalente em adultos mais velhos. Há pouca informação sobre as interacções medicamentosas que podem ocorrer e que são responsáveis por mais de 7.000 mortes por ano. Objetivos: Identificar os produtos fitoterápicos mais consumidos entre os idosos com diabetes mellitus tipo 2 em Chapulco, Puebla, México, e descrever as possíveis interações medicamentosas entre medicamentos hipoglicemiantes e produtos fitoterápicos relatados na literatura científica. Metodologia: Estudo observacional, prospetivo, transversal e descritivo numa população de 35 idosos diabéticos com uma idade média de 70±7 anos. O questionário U-PLANMED foi utilizado para identificar os produtos fitoterápicos mais utilizados e suas aplicações terapêuticas. Resultados: Foram identificados 50 produtos à base de plantas e 18 combinações dos mesmos. Quarenta por cento dos participantes utilizaram mais de dois produtos à base de plantas em simultâneo com um ou dois medicamentos hipoglicemiantes. Os produtos mais utilizados foram o cato de figo da Índia (Opuntia ficus-indica L.), a camomila (Matricaria chamomilla L.) e o capim-limão (Cymbopogon citratus DC. Stapf.). As potenciais interacções medicamentosas identificadas principalmente em estudos experimentais em animais sugerem que existe um efeito hipoglicémico do produto à base de plantas através do aumento da capacidade orgânica na secreção/libertação de insulina endógena. Conclusões: A presença de interacções medicamentosas foi demonstrada com o consumo simultâneo de medicamentos prescritos para o controlo da diabetes mellitus tipo 2 com produtos à base de plantas. É necessário que os profissionais de saúde reconheçam o uso de tais produtos e informem os idosos sobre as possíveis repercussões nos níveis de glicose ao consumi-los.

Práticas de autocuidado com os pés realizadas por homens com diabetes mellitus / Foot self-care practices performed by men with diabetes mellitus

Identificar o conhecimento e as formas de adesão as práticas de autocuidado com os pés por homens com diabetes mellitus. Método: Pesquisa do tipo exploratória, descritiva com abordagem qualitativa, realizada em duas unidades de atenção primária e uma unidade de atenção secundária do município de Fortaleza-CE. recebeu aprovação do Comitê de Ética em Pesquisa da UNIFOR de n. 5.100.589. Resultados: Dentro do universo de homens com diabetes foram entrevistados 26 homens na faixa etária de 45 a 81 anos, predominando-se aqueles com 48 a 69 de idade (84,6%), a escolaridade variou do analfabeto a ensino superior completo, sendo em sua maioria com fundamental incompleto (42,3%). Conclusão: Percebeu-se que os pacientes com maior nível de conhecimento apresentaram mais chances de praticar o autocuidado. Entretanto, notou-se que os déficits mesmo quando são isolados, podem oferecer o mesmo potencial de risco.(AU)

To identify the knowledge and forms of adherence to foot self-care practices by men with diabetes mellitus. Method: This is an exploratory, descriptive study with a qualitative approach, carried out in two primary care units and one secondary care unit in the city of Fortaleza-CE. The study received approval from the UNIFOR Research Ethics Committee (n. 5.100.589). Results: Within the universe of men with diabetes, 26 men aged between 45 and 81 were interviewed, with a predominance of those aged between 48 and 69 (84.6%). The level of education ranged from illiterate to complete higher education, with the majority having incomplete primary education (42.3%). Conclusion: Patients with a higher level of knowledge were more likely to practice self-care. However, it was noted that deficits, even when isolated, can offer the same risk potential.(AU)

Identificar el conocimiento y las formas de adherencia a las prácticas de autocuidado de los pies por hombres con diabetes mellitus. Método: Se trata de un estudio exploratorio, descriptivo, con abordaje cualitativo, realizado en dos unidades de atención primaria y una unidad de atención secundaria de la ciudad de Fortaleza, Ceará. El estudio recibió aprobación del Comité de Ética en Investigación de la UNIFOR (n. 5.100.589). Resultados: Dentro del universo de hombres con diabetes, fueron entrevistados 26 hombres con edades comprendidas entre 45 y 81 años, predominando los de edades comprendidas entre 48 y 69 años (84,6%), su nivel de escolaridad osciló entre analfabetos y estudios superiores completos, siendo la mayoría con estudios primarios incompletos (42,3%). Conclusión: Los pacientes con un mayor nivel de conocimientos eran más propensos a practicar el autocuidado. Sin embargo, se observó que los déficits, incluso aislados, pueden ofrecer el mismo potencial de riesgo.(AU)

Diabetes, hemoglobin A1c, and cognitive performance in older adults: is there any impact of frailty? Evidence from the ELSI-Brazil study

Abstract The aim of this study was to evaluate the association between diabetes and cognitive performance in a nationally representative study in Brazil. We also aimed to investigate the interaction between frailty and diabetes on cognitive performance. A cross-sectional analysis of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline data that included adults aged 50 years and older was conducted. Linear regression models were used to study the association between diabetes and cognitive performance. A total of 8,149 participants were included, and a subgroup analysis was performed in 1,768 with hemoglobin A1c data. Diabetes and hemoglobin A1c levels were not associated with cognitive performance. Interaction of hemoglobin A1c levels with frailty status was found on global cognitive z-score (P-value for interaction=0.038). These results suggested an association between higher hemoglobin A1c levels and lower cognitive performance only in non-frail participants. Additionally, undiagnosed diabetes with higher hemoglobin A1c levels was associated with both poor global cognitive (β=-0.36; 95%CI: -0.62; -0.10, P=0.008) and semantic verbal fluency performance (β=-0.47; 95%CI: -0.73; -0.21, P=0.001). In conclusion, higher hemoglobin A1c levels were associated with lower cognitive performance among non-frail participants. Higher hemoglobin A1c levels without a previous diagnosis of diabetes were also related to poor cognitive performance. Future longitudinal analyses of the ELSI-Brazil study will provide further information on the role of frailty in the association of diabetes and glycemic control with cognitive decline.

Causas precipitantes de crisis hiperglicémicas agudas en pacientes internados en el Centro Médico Nacional - Hospital Nacional / Precipiting causes of acute hyperglycemic crisis in patients in the Centro Médico Nacional - Hospital Nacional

Introducción: las crisis hiperglicémicas agudas son las emergencias endocrinológicas más frecuentes en la práctica clínica y junto a la hipoglucemia se las describe como las complicaciones metabólicas agudas graves del paciente diabético. Objetivo: identificar las causas precipitantes de crisis hiperglicémicas agudas en pacientes internados en el Centro Médico - Hospital Nacional. Metodología: estudio observacional, descriptivo, de corte transversal de pacientes internados en el Centro Médico Hospital Nacional, durante el periodo de mayo 2021 a octubre del 2023. Los datos fueron obtenidos con la revisión de las fichas clínicas. Resultados: de los 100 pacientes evaluados, la crisis hiperglicémica aguda más frecuente fue la Cetoacidosis diabética (CAD) 53 %, seguida del Estado hiperosmolar hiperglicémico (EHH) 25 % y el estado mixto 22 %. Los desencadenantes más frecuentes fueron el abandono del tratamiento, debut de la enfermedad e infecciones. La mortalidad global fue del 12 %. Conclusión: la causa más frecuente de descompensación fueron el abandono del tratamiento, la diabetes de novo y procesos infecciosos.

Introduction: hyperglycemic crises are the most frequent endocrinological emergencies in clinical practice and, along with hypoglycemia, are described as serious acute metabolic complications in diabetic patients. Objective: to identify the precipiting causes of acute hyperglycemic crisis in hospitalized patients in the Centro Médico Nacional - Hospital National. Methodology: this was an observational, descriptive, cross -sectional study of patients hospitalized at the Centro Médico Nacional - Hospital National, from May 2021 to October 2023. The data were obtained from a review of the clinical records. Results: Of the 100 patients evaluated, the most frequent acute hyperglycemic crisis was diabetic ketoacidosis (CAD) 53 %, followed by the hyperglycemic hyperosmolar state (EHH) 25 % and the mixed state 22 %. The most frequent triggers were the abandonment of treatment, disease debut and infections. Global mortality was 12 %. Conclusion: the most frequent causes of decompensations were abandoning treatment, novo diabetes and infectious processes.

Complicaciones vasculares en pacientes diabéticos con hemoglobina glicosilada alterada internados en el Centro Médico Nacional - Hospital Nacional periodo 2022 - 2023 / Vascular complications in diabetic patients with altered glycated hemoglobin admitted to Centro Médico Nacional - Hospital Nacional period 2022 ­ 2023

Introducción: la diabetes mellitus es una enfermedad crónica que, al no ser controlada, puede desencadenar en complicaciones macro y microvasculares. Uno de los indicadores de un adecuado control glucémico es la hemoglobina glicosilada. Objetivos: determinar la frecuencia de complicaciones macro y microvasculares en pacientes diabéticos tipo 2 con hemoglobina glicosilada alterada internados en el Hospital Nacional de Itauguá periodo 2022 - 2023 Metodología: estudio observacional, descriptivo de corte transversal que incluyó a 170 pacientes adultos internados en el servicio de clínica médica del Hospital Nacional (Itauguá, Paraguay) durante los años 2022 y 2023. Resultados: la edad media fue de 58 ± 12 años, con predominio del sexo femenino (51 %). La complicación más frecuentemente diagnosticada fue la enfermedad del pie relacionada a la diabetes con 83 pacientes (49 %), seguido por retinopatía diabética 23 (14 %). El valor promedio de hemoglobina glicosilada fue de 10 ± 2 %. Solamente 6 (4 %) del total de pacientes presentó un valor de HbA1C≥ 7,1 %. La comorbilidad asociada más frecuente fue la hipertensión arterial 87 (51 %). El 91 % de los pacientes conocía ser portador de la enfermedad, el 80 % recibía algún tipo de tratamiento. Conclusiones: el pie diabético fue la complicación vascular diagnosticada con mayor ,frecuencia, especialmente en pacientes con HbA1C≥ 7,1 %.

Introduction: diabetes mellitus is a chronic disease that, if not controlled, can lead to macro- and microvascular complications. One of the indicators of adequate glycemic control is glycosylated hemoglobin. Objectives: to determine the frequency of macro and microvascular complications in type 2 diabetic patients with altered glycosylated hemoglobin admitted to the Hospital Nacional from 2022 to 2023 Methodology: this was an observational, descriptive, cross-sectional study that included 170 adult patients admitted to the Internal Medicine service of the Hospital Nacional (Itauguá, Paraguay) during the years 2022 and 2023. Results: the mean age was 58 ± 12 years, with a predominance of the female sex (51 %). The most frequently diagnosed complication was foot disease related to diabetes with 83 patients (49 %), followed by diabetic retinopathy 23 (14 %). The average value of glycosylated hemoglobin was 10 ± 2 %. Only 6 (4 %) of the total patients had an HbA1C value ≤7 %. The most frequent associated comorbidity was arterial hypertension 87 (51 %). 91 % of the patients knew they were carriers of the disease, 80 % received some type of treatment. Conclusions: diabetic foot was the most frequently diagnosed vascular complication, especially in patients with HbA1C ≥7.1 %.

Diabetes mellitus e saúde materna durante a pandemia de covid-19 no Brasil / Diabetes mellitus and maternal health during the COVID-19 pandemic in Brazil / Diabetes mellitus y salud materna durante la pandemia de la COVID-19 en Brasil

A pandemia do novo coronavírus (covid-19) é um grave problema de saúde pública. Adicionalmente, a hiperglicemia na gestação (diabetes preexistente, diabetes diagnosticado pela primeira vez na gestação e diabetes mellitus gestacional) é uma das complicações maternas mais frequentes na população obstétrica. A sobreposição desses problemas pode refletir na saúde materna e fetal. Desse modo, o objetivo deste estudo é reunir evidências acerca da saúde materna de mulheres com hiperglicemia na gestação durante a pandemia de covid-19 no Brasil. Trata-se de uma revisão narrativa, em que a fonte de dados compreendeu artigos publicados até maio de 2023 nas bases de dados Medline, via PubMed, Lilacs e WHO COVID-19 Research Database. Foram listados 167 artigos e, após a aplicação dos critérios de elegibilidade, cinco estudos foram incluídos, compreendendo 1.469 gestantes e puérperas com diabetes mellitus gestacional ou diabetes preexistente. Quanto à saúde materna, os principais desfechos foram relacionados à infecção por covid-19, como gravidade da doença e risco de morte. Além disso, foi observada maior prevalência de transtornos mentais comuns, como ansiedade e depressão. Portanto, a saúde materna de mulheres com hiperglicemia na gestação foi impactada negativamente durante a pandemia de covid-19 no país.

The new coronavirus (COVID-19) pandemic is a major public health issue. Hyperglycemia during pregnancy (pre-existing diabetes, diabetes first diagnosed in pregnancy and gestational diabetes mellitus) is a frequent maternal complication in the obstetric population. Their overlap may impact maternal and fetal health. Thus, this narrative review gathered evidence on the maternal health of women with gestational hyperglycemia during the COVID-19 pandemic in Brazil. Articles published until May 2023 in the Medline (via PubMed), Lilacs and WHO COVID-19 Research Database online databases were eligible. Bibliographic search retrieved a total of 167 articles, of which five remained after applying the inclusion criteria, resulting in a sample of 1,469 pregnant and postpartum women with gestational diabetes or pre-existing diabetes. Regarding maternal health, the main outcomes were related to COVID-19 infection, such as disease severity and risk of death. Additionally, results showed a higher prevalence of common mental disorders such as anxiety and depression. In conclusion, the maternal health of women with gestational hyperglycemia was negatively impacted during the COVID-19 pandemic.

La pandemia del nuevo coronavirus (COVID-19) es un grave problema de salud pública. Además, la hiperglucemia durante el embarazo (diabetes preexistente, diabetes diagnosticada por primera vez durante el embarazo y diabetes mellitus gestacional) es una de las complicaciones maternas más frecuentes en la población obstétrica. La superposición de estos problemas puede afectar la salud materna y fetal. Por lo tanto, el objetivo de este estudio es recopilar evidencia sobre la salud materna de las mujeres con hiperglucemia en el embarazo durante la pandemia de la COVID-19 en Brasil. Se trata de una revisión narrativa, y la fuente de datos comprendió artículos publicados hasta mayo de 2023 en las bases de datos MEDLINE vía PubMed, LILACS y WHO COVID-19 Research Database. Se enumeró un total de 167 artículos y, después de aplicar los criterios de elegibilidad, se incluyeron cinco estudios con 1.469 mujeres embarazadas y puérperas con diabetes gestacional o diabetes preexistente. En cuanto a la salud materna, los principales resultados se relacionaron con el contagio por COVID-19, como la gravedad de la enfermedad y el riesgo de muerte. Además, se observó una mayor prevalencia de trastornos mentales comunes, como la ansiedad y la depresión. Por lo tanto, la salud materna de las mujeres con hiperglucemia durante el embarazo se ha visto afectada negativamente durante la pandemia de la COVID-19 en Brasil.

Translation, cross-cultural adaptation, and validation of health and self-management in diabetes questionnaire (HASMID-10) into Brazilian Portuguese

ABSTRACT BACKGROUND: Considering the ability of the health and self-management in diabetes questionnaire (HASMID-10) to verify the impact of self-management on diabetes, we highlight its relevance to scientific research and clinical applicability. However, to date, no study has been conducted to scientifically support its use in other languages. OBJECTIVE: To translate, cross-culturally adapt, and validate the HASMID-10 into the Brazilian Portuguese. DESIGN AND SETTING: A translation, cross-cultural adaptation, and validation study conducted at Ceuma University. METHODS: Study was conducted in accordance with the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and Consensus-based Standards for the Selection of Health Measurement Instruments. We included participants of both sexes diagnosed with diabetes, aged between 18 and 64 years, and without cognitive deficits or any other limitations that would prevent them from answering the questionnaire. We assessed participants using the problem areas in diabetes (PAID) scale and HASMID-10. We assessed reliability using a test-retest model with a 7-day interval between assessments. We used intraclass correlation coefficient (ICC), 95% confidence interval (CI), standard error of measurement (SEM), minimum detectable difference (MDD), Spearman correlation coefficient, and floor and ceiling effects. RESULTS: Sample comprised 116 participants, most of whom were women, overweight, non-practitioners of physical activity, and nonsmokers. We observed significant correlations (P = 0.006; rho = −0.256) between the HASMID-10 and PAID, adequate reliability (ICC = 0.780) and internal consistency (Cronbach's alpha = 0.796). No ceiling or floor effects were observed. CONCLUSION: HASMID-10 has adequate measurement properties and may be used for Brazilians.

Pathological Mechanism of Diabetes Based on NF-κB Signaling Pathway and Traditional Chinese Medicine Intervention： A Review / 中国实验方剂学杂志

As people's living standards improve， the development trend of diabetes has gradually become severe. Diabetes is a chronic inflammatory disease associated with abnormal expression of nuclear factor-kappa B （NF-κB） in patients. NF-κB exists in various tissue cells and participates in the regulation of a variety of genes related to immune function and inflammation. Varieties of factors can activate NF-κB when the body is stimulated by external factors， so as to produce inflammation and other reactions. Previous studies on NF-κB mainly focus on cancer， and the pathological mechanism of the treatment of diabetes by related signaling pathways and the progress of traditional Chinese medicine （TCM） treatment have not been systematically elaborated on. By referring to the relevant literature in China and abroad， it was found that NF-κB is not isolated in the development and progression of diabetes but is associated with signal molecules related to inflammation， oxidative stress， and energy metabolism， and it is involved in mediating inflammation， pancreatic β cell apoptosis， insulin signal transduction， and other physiological functions. Therefore， blocking the transmission of NF-κB signaling pathway is beneficial to the treatment of diabetes. At present， Western medicine for the treatment of diabetes mainly includes oral hypoglycemic drugs and insulin injections， but the adverse reactions are obvious. TCM has been characterized by multi-target， extensive action， and excellent curative effects in the treatment of diabetes. TCM and its compounds with functions of tonifying Qi and promoting blood circulation， regulating qi and eliminating phlegm， clearing heat and detoxifying， and nourishing Yin and moistening dryness can effectively intervene in the abnormal expression of NF-κB signaling pathway in vivo through anti-inflammatory effects. In this paper， the association between NF-κB signaling pathway and diabetes was summarized， and the modern research progress of TCM intervention of NF-κB signaling pathway in the treatment of diabetes in the past five years was reviewed， so as to lay a laboratory foundation for the study of a new pathological mechanism of diabetes based on NF-κB signaling pathway and provide new targets and research direction for the prevention and treatment of diabetes and development of related TCM.

Mechanism of Astragaloside Ⅳ on db/db Mice with Type 2 Diabetes Mellitus and Non-alcoholic Fatty Liver Disease Based on AMPK Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo study the mechanism of astragaloside Ⅳ （AS Ⅳ） on db/db mice with type 2 diabetes mellitus （T2DM） and non-alcoholic fatty liver disease （NAFLD） based on network pharmacology and experimental validation. MethodA total of 24 db/db mice were randomly divided into four groups： model group， metformin group， and low-dose and high-dose AS Ⅳ groups. Six C57 mice were used as the blank group. The low-dose and high-dose AS Ⅳ groups were given AS Ⅳ of 0.015 and 0.030 g·kg-1 by gavage， and the metformin group was given 0.067 g·kg-1 by gavage. The blank and model groups were given equal volumes of distilled water by gavage. After intragastric administration， fasting blood glucose （FBG） was detected， and an oral glucose tolerance test was performed. Serum lipid level and liver histopathology were detected. The target and enrichment pathway of AS Ⅳ for treating T2DM and NAFLD were predicted by network pharmacology， and the main enrichment pathway was verified by molecular biology techniques. The protein expressions of AMPK， p-AMPK， sterol regulatory element-binding protein-1 （SREBP-1）， and fatty acid synthetase （FAS） in liver tissue were detected by Western blot. ResultCompared with the blank group， the levels of body mass， liver weight coefficient， fasting blood glucose， serum total cholesterol， triglyceride， and low-density lipoprotein cholesterol in mice treated with AS Ⅳ were decreased （P<0.05， P<0.01）. The pathology of liver tissue showed significant improvement in lipid accumulation， and imaging results showed that the degree of fatty liver was reduced after AS Ⅳ therapy. Network pharmacological prediction results showed that vascular endothelial growth factor α （VEGFA）， galactoagglutinin 3 （LGALS3）， serine/threonine kinase B2 （Akt2）， RHO-associated coiled-coil protein kinase 1 （ROCK1）， serine/threonine kinase B1 （Akt1）， signaling and transcriptional activator protein （STAT3）， and messtimal epidermal transformation factor （MET） were key targets in "drug-disease" network. The results from the Kyoto encyclopedia of genes and genomes （KEGG） enrichment showed that the AMP-dependent protein kinase （AMPK） signaling pathway was strongly associated with T2DM and NAFLD. Western blot results showed that compared with the blank group， the expression levels of p-AMPK/AMPK in the model group were significantly down-regulated， while those of SREBP-1 and FAS proteins were significantly up-regulated （P<0.01）. Compared with the model group， the expression levels of p-AMPK/AMPK in the metformin group and high-dose AS Ⅳ group were significantly up-regulated， while those of SREBP-1 and FAS proteins were significantly down-regulated （P<0.05， P<0.01）. ConclusionAS Ⅳ regulates the expression of lipid proteins by activating the AMPK signaling pathway， thereby improving lipid metabolism.

Effect of South African Herb Hoodia gordonii on Liver Glucolipid Metabolism and PI3K/Akt/FoxO1 Signalling Pathway in db/db Mice / 中国实验方剂学杂志

ObjectiveTo observe the effects of the South African herb Hoodia gordonii （HG） on glucolipid metabolism in diabetic db/db mice and explore the possible mechanisms of HG on the liver of db/db mice based on the phosphoinositide-3 kinase （PI3K）/protein kinase B （Akt）/factor forkhead protein O1 （FoxO1） signaling pathway. MethodA total of 30 db/db mice were randomly divided into five groups according to fasting blood glucose： model group， metformin group （0.195 g·kg-1）， and low dose （0.39 g·kg-1）， medium dose （0.78 g·kg-1）， and high dose （1.56 g·kg-1） HG groups， with six m/m mice in each group， and another six m/m mice were set as normal group. The mice in the normal and model groups were given saline of 9 mL·kg-1 by gavage. Body weight， water intake， and fasting blood glucose of the mice in each group were measured weekly. After six weeks of continuous administration， serum insulin （FINS）， low-density lipoprotein cholesterol （LDL）， total cholesterol （TC）， triglyceride （TG）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， urea， and creatinine （CREA） were measured， and liver sections were embedded and stained with hematoxylin-eosin （HE）， periodic acid-Schiff （PAS）， and oil red O. Protein expression of PI3K p85， p-Akt， and p-FoxO1 in liver was detected by immunohistochemistry. The mRNA expression of PI3K， Akt， and FoxO1 in liver tissue was detected by real-time polymerase chain reaction （Real-time PCR）. ResultAfter six weeks of administration intervention， it was found that fasting blood glucose was significantly downregulated in mice in the three HG groups （P<0.05）. The level of islet resistance index was significantly reduced in both the low and medium dose HG groups （P<0.05）. The expression levels of TC， TG， and LDL were reduced in all HG groups （P<0.05， P<0.01）. Pathologically， HG could alleviate hepatocyte steatosis， reduce the volume and content of lipid droplets in liver， and increase the distribution of glycogen granules in liver to some extent in mice. Immunohistochemical assays revealed that PI3K p85 protein expression was significantly increased in the low， medium， and high dose HG groups compared with the model group （P<0.01）. p-Akt protein expression was significantly increased in the medium and high dose HG groups （P<0.05， P<0.01）. p-FoxO1 protein expression was significantly increased in the low， medium， and high dose HG groups （P<0.05， P<0.01）. Compared with the model group， PI3K mRNA was increased in low dose， medium dose， and high dose HG groups （P<0.05）， and Akt mRNA was increased in high dose HG group （P<0.05）. FoxO1 mRNA was decreased in low dose， medium dose， and high dose HG groups （P<0.05）. ConclusionHG can ameliorate the disorder of glucolipid metabolism in db/db mice， which may be related to its activation of the hepatic PI3K/Akt/FoxO1 signaling pathway.

Determination and Mechanism Prediction of Potential Active Ingredients in Erdongtang Based on UHPLC-QqQ-MS and Network Pharmacology / 中国实验方剂学杂志

ObjectiveTo establish an ultra-high performance liquid chromatography-tandem triple quadrupole mass spectrometry（UHPLC-QqQ-MS） for determination of the active ingredients in Erdongtang， and to predict the targets and pathways of anti-insulin resistance action of this formula. MethodThe analysis was performed on an ACQUITY UPLC BEH C18 column（2.1 mm×100 mm， 1.7 μm） with the mobile phase of 0.1% formic acid aqueous solution（A）-acetonitrile（B） for gradient elution（0-3 min， 90%-87%A； 3-6 min， 87%-86%A； 6-9 min， 86%-83%A； 9-11 min， 83%-75%A； 11-18 min， 75%-70%A； 18-19 min， 70%-52%A； 19-22 min， 52%A； 22-25 min， 52%-5%A； 25-27 min， 5%-90%A； 27-30 min， 90%A）. The contents of active ingredients in Erdongtang was detected by electrospray ionization（ESI） and multiple reaction monitoring（MRM） mode under positive and negative ion modes. On this basis， network pharmacology was applied to predict the targets and pathways of Erdongtang exerting anti-insulin resistance effect. ResultThe 20 active ingredients in Erdongtang showed good linear relationships within a certain mass concentration range， and the precision， stability， repeatability and recovery rate were good. The results of determination showed that the ingredients with high content in 15 batches of samples were baicalein（1 259.39-1 635.78 mg·L-1）， baicalin（1 078.37-1 411.52 mg·L-1）， the ingredients with medium content were mangiferin（148.59-217.04 mg·L-1）， timosaponin BⅡ（245.10-604.89 mg·L-1）， quercetin-3-O-glucuronide（89.30-423.26 mg·L-1）， rutin（46.91-1 553.61 mg·L-1）， glycyrrhizic acid（55.97-391.47 mg·L-1）， neomangiferin（37.45-127.03 mg·L-1）， nuciferine（0.89-63.48 mg·L-1）， hyperoside（6.96-136.78 mg·L-1）， liquiritin（30.89-122.78 mg·L-1）， liquiritigenin（26.64-110.67 mg·L-1）， protodioscin（58.57-284.26 mg·L-1）， the ingredients with low content were wogonin（7.16-20.74 mg·L-1）， pseudoprotodioscin（5.49-22.96 mg·L-1）， ginsenoside Rb1（7.31-23.87 mg·L-1）， ginsenoside Rg1（10.78-28.33 mg·L-1）， ginsenoside Re（7.78-24.76 mg·L-1）， ophiopogonin D（2.08-4.29 mg·L-1）， methylophiopogonanone A（0.74-1.67 mg·L-1）. The results of network pharmacology indicated that the mechanism of anti-insulin resistance exerted by Erdongtang might be related to the phosphatidylinositol 3-kinase/protein kinase B（PI3K/Akt） signaling pathway. ConclusionThe established UHPLC-QqQ-MS has the advantages of simple sample processing， strong exclusivity and high sensitivity， and can simultaneously determine the contents of the main ingredients from seven herbs in Erdongtang， which can lay the foundation for the development of Erdongtang compound preparations. The results of the network pharmacology can provide a reference for the mechanism study of Erdongtang in the treatment of type 2 diabetes mellitus.

The influence of renally inappropriate medication on the frailty of elderly patients with diabetes / 中国药房

OBJECTIVE To investigate the effects of renally inappropriate medication （RIM） on the frailty of elderly patients with diabetes. METHODS The data of elderly patients with diabetes mellitus admitted to a third-grade class A hospital in Yunnan province from January to December 2022 were collected， and Beers criteria （2019 edition） and Chinese version of FRAIL scale were used to evaluate RIM and the frailty of the patients； the patients were divided into the trial group （with RIM） and the control group （without RIM） according to whether there was RIM. The propensity score matching was used to balance confounding factors between two groups， and the influence of RIM on the frailty of elderly diabetic patients was analyzed by the Logistic regression model. RESULTS Among the 367 patients， 80 patients （21.80%） had RIM， the drugs involved RIM were spironolactone （82.56%）， rivaroxaban （13.95%） and gabapentin （3.49%）. After reaching the balance between groups using the propensity score matching method， the incidence of frailty was 77.94% in trial group and 27.94% in control group （P＜0.001）； the difference was not statistically significant in other confounding factors between the two groups （P＞0.05）. Results of Logistic regression analysis showed that the risk of frailty in the experimental group was 3.118 times that of the control group （odds ratio was 3.118，95% confidence interval was 1.758-5.530， P＜0.001）. CONCLUSIONS RIM is a risk factor for the frailty of elderly patients with diabetes， which can be considered as an indicator for early identification and screening of the frailty of elderly diabetes patients.

Correlation analysis of serum lipids, HbA1C levels and insulin resistance in obese type 2 diabetes patients / 公共卫生与预防医学

Objective To investigate the changes of blood lipid and glycosylated hemoglobin (HbA1c) levels in obese type 2 diabetes (T2DM) patients and their relationship with insulin resistance (Homa-IR). Methods A total of 120 cases of T2DM newly diagnosed in Motuo County, Tibet from February to October 2022 were selected as the observation group. According to BMI, the patients were divided into diabetes normal weight group (46 cases), overweight group (43 cases) and obesity group (31 cases); 145 healthy subjects were selected as the control group. The levels of HbA1c, fasting blood glucose (FPG), fasting insulin (FINS), serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL-C), and low-density lipoprotein (LDL-C) were detected in the study subjects, and Homa-IR and Homa-β indices were calculated. The height, weight, and abdominal circumference were measured. The differences in the levels of the above indicators between the observation group patients and the control group, as well as among various subgroups within the observation group were compared. The influencing factors of Homa-IR in obese T2DM patients were analyzed. Results Compared with the control group, a significant increase in BMI, abdominal circumference, blood pressure, HbA1c, FBG, FINS, TC, TG, LDL-C, UA, visceral fat area, and the levels of Home-IR and Home-β was found in the observation group (all P<0.05). There were significant differences in BMI, abdominal circumference, and the levels of FINS, Homa IR, Homa-β, and HbA1c in diabetes patients with different BMI (all P<0.05). Correlation analysis showed that TG levels in obese T2DM patients in the observation group were significantly correlated with HbA1c (r=0.396, P=0.027), Homa-IR (r=0.405, P=0.024), and Home-β (r=-0.401, P=0.025); LDL-C was significantly correlated with Homa-IR (r=0.411, P=0.022) and Homa-β (r=-0.412, P=0.021); HbA1c was significantly positively correlated with BMI (r=0.371, P=0.040). Conclusion Insulin resistance is closely related to TG, LDL-C, and BMI in obese T2DM patients from the Motuo ethnic minority of Tibet, suggesting that these factors may play a role in the occurrence of T2DM.

Research progress on diabetes and human papilloma virus infection and vaccination / 公共卫生与预防医学

Diabetes is a common chronic non-infectious disease. Diabetic patients not only suffer from metabolic disorders, but are also prone to immune deficiencies and are at a higher risk of being infected with human papillomavirus (HPV). Many studies at home and abroad have shown that the HPV infection rate of patients with diabetes is higher than that of non-diabetic patients. Patients with diabetes can benefit from HPV vaccination, and the tolerance is good. HPV vaccination is recommended for diabetic patients. This article reviews the research on diabetes, HPV infection, and HPV vaccine, which will provide references for HPV vaccination in diabetic patients.

Probability and trend of premature death of four major chronic diseases in Linyi City in 2013-2021 / 公共卫生与预防医学

Objective To analyze the mortality rate and probability of premature death caused by four major noninfectious chronic diseases (NCDs)in Linyi City from 2013 to 2021, and to provide data support for scientific formulation of chronic disease prevention and control strategy. Methods The mortality data of major chronic diseases in Linyi City from 2013 to 2021 were analyzed. The crude mortality, age-standardized mortality and premature death probability were calculated. The annual percent change (APC) was adopted to analyze the temporal trend of mortality and probability of premature death. Results The average annual crude mortality of four major NCDs was 538.98/100,000, and the age-standardized mortality was 387.3/100,000. The crude mortality rate increased from 517.37/100 000 in 2013 to 563.13/100 000 in 2021 (APC=0.89％, P=0.01). The age-standardized mortality rate decreased from 410.19/100,000 to 364.92/100,000 (APC=-1.8％, P=0.01). The crude mortality and age-standardized mortality of four major NCDs in males were higher than those in females (P<0.05). The average annual probability of premature death caused by four major NCDs was 13.37%. The probability of premature death decreased from 14.49％ in 2013 to 12.32％ in 2021（APC=-2.1％, P=0.00）. From 2013 to 2021, the probability of premature death from malignant tumors, cardiovascular and cerebrovascular diseases, and chronic respiratory diseases in Linyi City dropped from 6.14%, 7.47%, and 1.21% to 5.52%, 6.46%, and 0.5%, respectively (APCs were -1.2%, -2.1%, and -11.3%, respectively, and P values were 0.04, 0.00, and 0.00, respectively). The probability of premature death from diabetes remained stable. The probability of premature death caused by four major NCDs in males was higher than that in females (P<0.05). Conclusion The probability of premature death of the four major NCDs in Linyi has showed a downward trend during 2013-2021. It is suggested to strengthen the prevention and control of diabetes in the next step.

Mechanism studies underlying the alleviatory effects of isoliquiritigenin on abnormal glucolipid metabolism triggered by type 2 diabetes / 药学学报

Isoliquiritigenin (ISL) is an active chalcone compound isolated from licorice. It possesses anti-inflammatory and anti-oxidative activities. In our previous study, we uncovered a great potential of ISL in treatment of type 2 diabetes mellitus (T2DM). Therefore, this study aims to reveal the mechanism underlying the alleviatory effects of ISL on T2DM-induced glycolipid metabolism disorder. High-fat-high-sugar diet (HFD) combined with intraperitoneal injection of streptozotocin (STZ) were used to establish T2DM mice model. All animal experiments were carried out with approval of the Committee of Ethics at Beijing University of Chinese Medicine. HepG2 cells were used in in vitro experiments, and sodium palmitate (SP) was applied to establish insulin resistance (IR) model cells. The effects of ISL on body weight, fasting blood glucose levels, and pathological changes in the livers of mice were examined. Enzyme-linked immune sorbent assay (ELISA) and real-time quantitative PCR (RT-qPCR) were applied to detect the regulatory effects of ISL on key targets involved in glucolipid metabolism. Additionally, molecular docking and analytical dynamics simulation methods were used to analyze the interaction between ISL and key target protein. The results indicate that ISL significantly downregulates the transcriptional levels and inhibits the activities of key enzymes involved in gluconeogenesis, including pyruvate carboxylase (PC), phosphoenolpyruvate carboxykinase (PEPCK), and fructose-1, 6-bisphosphatase (FBP). It also downregulates the transcriptional and protein levels of hepatocyte nuclear factor 4α (HNF4α) and cAMP response element binding protein (CREB), the two transcriptional factors involved in gluconeogenesis. Thus, ISL inhibits hepatic gluconeogenesis in T2DM mice. In addition, ISL reduces total cholesterol (TC) and triglyceride (TG) levels in the livers of T2DM mice. Moreover, ISL downregulates the mRNA levels of lipogenesis genes and upregulates those of genes involved in fatty acid oxidation, lipid uptake, and lipid export. In conclusion, ISL suppresses hepatic gluconeogenesis, promotes lipolysis, and restrains lipogenesis in T2DM mice, thereby improving the abnormal glycolipid metabolism caused by T2DM.