RESUMO
INTRODUCTION: The aim of this study was to compare the efficacy of vildagliptin as add-on therapy to short-term continuous subcutaneous insulin infusion (CSII) with CSII monotherapy in hospitalized patients with type 2 diabetes mellitus (T2DM). METHODS: A total of 200 hospitalized patients with inadequately controlled T2DM were randomized into groups, with one group receiving CSII monotherapy (CSII group, n =100) and the other group receiving CSII plus vildagliptin as add-on (CSII + Vig group, n = 100). Of these, 191 completed the 7-day trial (CSII group, n = 99; CSII + Vig group, n = 92) and included in the analysis. The glycemic control and variability of the patients were measured using all-day capillary blood glucose (BG) monitoring. Weight and fasting C-peptide levels were evaluated before and after the interventions. RESULTS: Mean BG concentrations during the whole treatment period were lower and the time to reach target BG was reduced in the CSII + Vig group compared with the CSII group (9.89 ± 3.37 vs. 9.46 ± 3.23 mmol/L, P < 0.01; 129 ± 4 vs. 94 ± 5 h, P < 0.01, respectively). Similarly, the indicators of glycemic variability, namely the standard deviation of BG and the largest amplitude of glycemic excursion, were significantly decreased in the CSII + Vig group compared with the CSII group (2.68 ± 1.05 vs. 2.39 ± 1.00 mmol/L, P < 0.01; 7.19 ± 2.86 vs. 6.23 ± 2.73 mmol/L, P < 0.01, respectively). CONCLUSIONS: Short-term CSII with vildagliptin as add-on therapy may be an optimized treatment for hospitalized patients with T2DM compared with short-term CSII monotherapy.
RESUMO
Th17 lymphocytes and its main cytokine, IL-17, play an important role in autoimmune thyroid diseases, such as intractable Graves disease (GD). IL-17 signals are transmitted through its receptor, IL-17RA. The intrathyroid expression of IL-17RA in intractable GD is not understood. In this study, ELISA was used to measure serum IL-17 levels in patients with untreated GD, intractable GD or GD in remission and healthy controls. Real-time PCR, flow cytometry and immunofluorescence staining evaluated IL-17RA mRNA and protein expression in thyrocytes. IL-6, chemokine ligand 10 (CXCL10) and intercellular adhesion molecule (ICAM)-1 expression was measured in IL-17-stimulated thyrocyte cultures to evaluate the functional status of IL-17RA. Our data indicates that serum IL-17 levels are significantly increased in intractable GD and affected thyrocytes show functional IL-17R expression. These changes facilitate the IL-17-mediated upregulation of IL-6, CXCL10, and ICAM-1. The IL-17/IL-17R interaction could be a potential target for therapeutic interventions in intractable GD.
