ABSTRACT
AIMS/INTRODUCTION: Early initiation of basal insulin therapy is recommended for normalizing fasting blood glucose in type 2 diabetes mellitus. However, basal insulin treatment might not adequately control postprandial glucose levels. The present study evaluated whether the combination of the α-glucosidase inhibitor, acarbose, and basal insulin improved blood glucose control under daily-life treatment conditions in a large sample of Korean patients. MATERIALS AND METHODS: The present study was a multicenter, prospective, observational study under daily-life treatment conditions. A total of 539 patients with type 2 diabetes who were treated with basal insulin and additional acarbose were enrolled and followed up for 20 weeks. Changes in hemoglobin A1c, fasting and postprandial blood glucose were evaluated at baseline and at the end of the observation period. The physician and patient satisfaction of the combination treatment and safety were assessed. RESULTS: Hemoglobin A1c decreased by 0.55 ± 1.05% from baseline (P < 0.0001). Fasting and postprandial blood glucose levels were reduced by 0.89 ± 3.79 and 2.59 ± 4.77 mmol/L (both P < 0.0001). The most frequently reported adverse drug reactions were flatulence (0.37%) and abnormal gastrointestinal sounds (0.37%), and all were mild in intensity and transient. In the satisfaction evaluation, 79.0% of physicians and 77.3% of patients were 'very satisfied' or 'satisfied' with the combined basal insulin and acarbose therapy. CONCLUSIONS: Combination therapy of basal insulin and acarbose in patients with type 2 diabetes improved glucose control, and had no drug-specific safety concerns, suggesting that the treatment might benefit individuals who cannot control blood glucose with basal insulin alone.
ABSTRACT
The precipitation reaction between the orthophosphate and Fe2+ ions was studied to describe the optimum condition for the removal of orthophosphate from the aqueous solution. The effects of pH, Fe:P molar ratio, and alkalinity were evaluated for the initial orthophosphate concentrations in the range from 1.55 to 31.00 mg/L - PO4(3-) -P. The optimum pH was found to be 8.0 in all orthophosphate concentration ranges. When the stoichiometric moles of Fe2+ were added, the removal efficiencies were significantly less than the theoretical values. It is likely that the precipitation of Fe(OH)2(s) is partially formed. For the initial orthophosphate concentration of 3.10 mg/L PO4(3-) -P or greater, the removal efficiencies with the Fe:P molar ratio of 3.0:1.0 approached to the theoretical values, yielding greater than 98.5%. If the molar ratio of Fe:P was great enough, the precipitation reaction was completed within 1 h. As the alkalinity increases, the experimental removal efficiencies were significantly greater than the theoretical values. This is because the formation of vivianite is favoured over FeCO3(s). Finally, it was demonstrated that the orthophosphate (1.40-6.80 mg/L PO4(3-) -P) in the secondary effluents from wastewater treatment plants was effectively removed by dosing sufficient amount of Fe2+ ions.
Subject(s)
Ferrous Compounds/chemistry , Phosphates/isolation & purification , Water Purification , Chemical Precipitation , Hydrogen-Ion Concentration , Models, ChemicalABSTRACT
The effect of chemical oxygen demand/sulfate (COD/SO(4)(2-)) ratio on fermentative hydrogen production using enriched mixed microflora has been studied. The chemostat system maintained with a substrate (glucose) concentration of 15 g COD L(-1) exhibited stable H(2) production at inlet sulfate concentrations of 0-20 g L(-1) during 282 days. The tested COD/SO(4)(2-) ratios ranged from 150 to 0.75 (with control) at pH 5.5 with hydraulic retention time (HRT) of 24, 12 and 6h. The hydrogen production at HRT 6h and pH 5.5 was not influenced by decreasing the COD/SO(4)(2-) ratio from 150 to 15 (with control) followed by noticeable increase at COD/SO(4)(2-) ratios of 5 and 3, but it was slightly decreased when the COD/SO(4)(2-) ratio further decreased to 1.5 and 0.75. These results indicate that high sulfate concentrations (up to 20,000 mg L(-1)) would not interfere with hydrogen production under the investigated experimental conditions. Maximum hydrogen production was 2.95, 4.60 and 9.40 L day(-1) with hydrogen yields of 2.0, 1.8 and 1.6 mol H(2) mol(-1) glucose at HRTs of 24, 12 and 6h, respectively. The volatile fatty acid (VFA) fraction produced during the reaction was in the order of butyrate>acetate>ethanol>propionate in all experiments. Fluorescence In Situ Hybridization (FISH) analysis indicated the presence of Clostridium spp., Clostridium butyricum, Clostridium perfringens and Ruminococcus flavefaciens as hydrogen producing bacteria (HPB) and absence of sulfate reducing bacteria (SRB) in our study.
