Effects of glucose excursion on cognitive function in aged type 2 diabetes / 中华老年医学杂志

Objective To investigate the relationship between glucose excursion and cognitive function in aged type 2 diabetes. Methods A total of 248 aged type 2 diabetes were recruited in this study,all of them wore continuous glucose monitoring system (CGMS) for 3 d to evaluate the glucose excursion including mean amplitude of glycemic excursions (MAGE) which was used for assessing intra-day glycemia variability,and mean daily difference (MODD) which represented day-to-day glycemic variability.During the period of CGMS monitoring,all subjects accepted mini mental status examination (MMSE) for evaluating cognitive function.The relationships of MAGE and MODD with performance on cognitive tests were assessed. Results The over intra-day glucose excursion group had lower MMSE score than the narrow intra-day glucose excursion group[(24.25±6.75)vs.(25.97±0.47),P=0.025].The MMSE score was decreased in over day-to-day glucose excursion group compared with the narrow day-to-day glucose excursion group [(24.21 ± 6.47) vs. (26.01 ± 5.49),P =0.019]. A statistically significant association was observed between MAGE and the score of MMSE(r=- 0.308,P＜0.001),and between MODD and MMSE(r=-0.226,P =0.001).Conclusions Glucose excursion may affect cognitive function in aged type 2 diabetes.The over glucose excursion decreases the score of MMSE.

Relationship between blood glucose excursion and cognitive performance in diabetic patients over 60 years old / 中华全科医师杂志

Objective To explore relationship between excursion of blood glucose levels and cognitive performance in diabetic patients over aged 60 years.Methods A total of 108 diabetic patients over aged 60 years were recruited in this study and they wore under continuous blood glucose monitoring system (CGMS) for three days to evaluate excursion of their mean blood glucose (MBG) level and its standard deviation (SD).All the participants accepted cognitive function tests during continuous blood glucose monitoring, including mini mental status examination (MMSE), Montreal cognitive assessment (MOCA) and clock drawing test (CDT).Relationship of the SD of blood glucose level and cognitive performance in the three cognitive tests was assessed.Data were analyzed with CGMS software version 3.0.Results The SD reversely correlated with scores of MMSE (r = - 0.324, P ＜ 0.01 ) and CDT ( r =-0.325, P = 0.001 ), but they did not significantly correlate with MOCA scores (r = -0.212, P =0.081 ).Statistically significant difference was observed between the SD and scores of all three cognitive tests adjusted for glycosylated hemoglobin Alc (HbAlc) level (r = -0.387, -0.046 and -0.292, P =0.029, ＜0.001 and ＜ 0.001, respectively).The SD reversely correlated with scores of MMSE, MOCA and CDT adjusted for MBG (r= -0.314, -0.466 and -0.345, P ＜0.01, respectively).Results of multivariate linear regression analysis showed that the SD reversely correlated to scores of MMSE, MOCA and CDT (β = - 0.378, - 0.224 and - 0.346, all P ＜ 0.05).Conclusions Excursion of blood glucose levels can influence their cognitive performance in diabetic patients over aged 60 years, leading to decrease in their overall cognitive function and activities as its excursion large enough.

Efficacy of continuous glucose monitoring system combined with insulin pump in diabetic pafients aged 60 years and over / 中华全科医师杂志

Objective To observe hypoglycemic efficacy of continuous glucose monitoring system (CGMS)combined with continuous insulin infusion(CSII)in the elderly diabetic patients aged 60 years and over.Methods A total 0f 100 elderly diabetic patients were randomly divided into two groups.50 were treated with CGMS or self-monitoring blood glucose(SMBG)and CSII.and whose insulin dose was adjusted based on results of monitoring,and the other 50 with SMBG and insulin pump as controls.whose insulin dose was adiusted based on the results of SMBG for three days.After two weeks.all the patients were monitored by CGMS for blood glucose.Results Mean blood level of glucose and mean amplitude of glycemic excursions(MAGE)were significantly lower in CGMS+CSII group than those in controls[(6.6±2.3)mmol/L vs.(7.5±2.1)mmol/L,and(3.9±0.9)mmol/L vs.(5.1±0.6)mmol/L,respectively,P＜0.05 1.Average insulin dose used was significantly lower in CGMS+CSII group than that in controls [(0.64±0.21)U/kg vs.(0.82±0.41)U/kg,P＜0.05],and duration of hypoglycemia was less in the former than that in the latter[(20±3)min vs.(40± 9)min,P＜0.05 ].Conclnsions CGMS combined with CSII can decrease blood glucose.glucose excursions.average dose of insulin and duration of hypoglycemia in the elderly diabetic patients,as well as prevent occurrence of hypoglycemia.

Study on correlation between glucose excursions and oxidative stress in the elderly type 2 diabetic patients / 中华老年医学杂志

ObjectiveTo investigate the correlation between glucose excursions and oxidative stress in the elderly type 2 diabetic patients. MethodsFifty five elderly type 2 diabetic patients (32 males and 23 females) were recruited. All the patients were submitted to continuous glucose monitoring system (CGMS) for three days. According to the result of CGMS monitoring ,the patients were divided into two groups: high glucose excursion group (30 cases) and low glucose excursion group (25 cases). In high glucose excursion group, the therapy was adjusted for 4 weeks based on the CGMS monitoring. After the treatments, the specimens of blood were collected again to detect the related indexes. Results(1) There were no differences in age, blood pressure, fasting blood glucose and glycosylated hemoglobin between the two groups (all P>0.05). The stardard deviation of blood glucose was higher, and the maximun and average amplitude of glycemic excursion were significantly lower in high glucose excursion group than in low glucose excursion group (t= 5. 4620,5. 9416,3. 8281, all P<0.05) ;(2) Compared with low glucose excursion group, plasma concentration of 8-iso-PGF2a was obviously higher in high glucose excursion group[(57.56 ± 3.86)ng/L vs.(34. 21±3. 82) ng/L, t= 18. 221, P=0. 0000)] . (3) Stepwise regression analysis showed that the standard deviation of blood glucose was involved in regression model (β= 1. 959, P= 0. 013).ConclusionsIn elderly patients with type 2 diabetes mellitus, glucose excursion is related with oxidation stress, which suggests that the glucose excursion may be the risk factor for oxidation stress.

Promotion of Sophora subprosrate polysaccharide on nitric oxide and interleukin-2 production in murine T lymphocytes: implicated Ca2+ and protein kinase C.

SSP1, a polysaccharide isolated from Sophora subprosrate, increased the productions of nitric oxide (NO) and interleukin-2 (IL-2) in murine splenic T lymphocytes. SSP1-treated T lymphocytes showed an enhanced activity of protein kinase C (PKC) from the cellular membrane fraction as well as an increase in concentration of cytoplasmic free Ca2+. The results showed that SSP1 activated T cells to release NO and secrete IL-2 by modulating activity of PKC and level of intracellular free calcium. Nifedipine, a Ca2+ blocker, inhibited the activation of T cells by SSP1, indicating a role of Ca2+ in the activation of T cells. SSP1-treated T cells showed an enhanced translocation of PKC, indicating that SSP1 activated T cells via the activation of PKC.