格列美脲与二甲双胍联合短期内强化治疗初诊2型糖尿病的疗效及安全性分析

目的 研究格列美脲与二甲双胍联合短期内强化治疗初诊2型糖尿病的疗效及安全性。方法 以天津市武清区河西务医院2015年1月—2016年11月初诊2型糖尿病患者106例随机分两组。A组采用常规饮食、运动等干预,并口服格列美脲治疗,B组在A组基础上联合二甲双胍治疗,共治疗12周。比较两组患者低血糖、肝肾和胃肠不良反应发生率;血糖达标时间;施行治疗前和施行治疗后患者血糖水平、胰岛素分泌指数、胰岛素抵抗指数的差异。结果 两组患者低血糖、肝肾和胃肠不良反应发生率无显著差异,P0.05;B组血糖达标时间短于A组,P0.05;施行治疗前两组血糖水平、胰岛素分泌指数、胰岛素抵抗指数比较无显著差异,P0.05;施行治疗后B组血糖水平、胰岛素分泌指数、胰岛素抵抗指数改善幅度更大,P0.05。结论格列美脲与二甲双胍联合短期内强化治疗初诊2型糖尿病的疗效及安全性高,可有效改善患者血糖水平和胰岛素分泌情况,低血糖风险低,安全可靠,值得推广。     

两种胰岛素方案治疗门诊初诊2型糖尿病患者的疗效及低血糖发生率比较

目的研究两种胰岛素方案治疗门诊初诊2型糖尿病患者的疗效及低血糖发生率。方法选取孝感市中心医院2013年3月—2014年8月84例门诊初诊2型糖尿病患者,抽签随机分为两组,其中42例采用餐前皮下注射门冬胰岛素治疗记为对照组,剩下42例采用餐前注射门冬胰岛素联合晚间注射甘精胰岛素强化治疗记为观察组。结果两组治疗后血糖相关指标比较无明显差异,不具有统计学意义(P0.05);观察组低血糖率11.90%较对照组30.95%显著较低,具有统计学意义(P0.05)。结论两种胰岛素方案治疗初诊2型糖尿病均较为有效,但早期采用强化治疗方案能有效稳定平衡血糖代谢、预防低血糖发生,可作为临床治疗初诊2型糖尿病的首选参考方法。     

缬沙坦联合氨氯地平治疗社区老年原发性高血压合并糖尿病的临床效果及安全性

目的探究在治疗老年性原发性高血压合并糖尿病患者中采用缬沙坦联合氨氯地平治疗的效果以及术后安全性,评估其临床意义,为临床治疗做出指导。方法以天津市滨海新区杭州道街社区卫生服务中心2013年5月—2014年6月间收诊的80例原发性高血压合并糖尿病老年患者的临床资料作为研究对象,按治疗方式不同将患者分成氨氯地平合并缬沙坦组40例(实验组)和单纯缬沙坦组40例(对照组)。测定分析两组患者治疗后情况,包括患者血压水平变化、空腹血糖、饭后2 h血糖以及胰岛素等指标,记录治疗情况。结果治疗后实验组血压水平下降的程度优于对照组(P0.05)。实验组空腹血糖等指标对比对照组均具有显著优势(P0.05)。结论联合氨氯地平缬沙坦治疗高血压合并糖尿病患者在血压下降水平、血糖前后变化水平等方面明显优于单纯使用缬沙坦治疗,不良反应发生率低,值得临床推广使用。     

阿卡波糖对Ⅱ型糖尿病大鼠尿液代谢轮廓的影响

采用超高效液相色谱-质谱联用(UPLC-MS/MS)方法研究了阿卡波糖对Ⅱ型糖尿病大鼠代谢轮廓的影响, 分析了健康组、 糖尿病模型组和糖尿病给予阿卡波糖组的大鼠尿样, 采用主成分分析法(PCA)和偏最小二乘法-判别分析(PLS-DA)对数据进行分析. PCA得分图表明, 健康组、 糖尿病组和阿卡波糖组的代谢轮廓有显著差别, 根据PLS-DA载荷图筛选, 将对各组分离贡献大的化合物的串联质谱分析数据经Human Metabolome Database(HMDB)和Mass Bank.jp等数据库检索, 进行质谱信息匹配, 鉴定出苯乙酰甘氨酸、 肌酐及葡萄糖酸等8种内源性代谢物为潜在生物标记物.     

高危儿在顺产与剖腹产中娩出时产生糖代谢紊乱的研究分析

目的分析高危儿在顺产与剖腹产中娩出时血糖的特点,探讨防治糖代谢紊乱路径。方法选取2013年12月至2014年6月于广东省连州市妇幼保健计划生育服务中心产科娩出的85例高危儿为研究对象,按娩出方式分为剖腹产组43例,顺产组42例,应用罗氏血糖检测仪分析高危儿娩出后血糖水平(全血血糖低于2.2 mmol/L诊断为低血糖,全血血糖高于7.0 mmol/L诊断为高血糖),并针对血糖异常制定糖代谢紊乱预防方案,比较两组出生后24 h内的血糖水平。结果顺产组糖代谢紊乱率11.9%显著低于剖腹产组30.2%(P0.05);娩出时剖腹产新生儿脐血的血糖(2.14±0.37)mmol/L明显低于顺产组(2.63±0.59)mmol/L(P0.05),出生后24 h内剖腹产组血糖水平与顺产组比较无显著差异(P0.05)。结论剖宫产高危儿较容易发生血糖异常,出现糖代谢紊乱,故在高危儿出生后应及时监测血糖变化,并采取措施防治血糖异常引起的糖代谢紊乱。     

浅析磷酸西格列汀联合二甲双胍治疗新诊断2型糖尿病的降糖效果

目的探讨磷酸西格列汀联合二甲双胍治疗新诊断2型糖尿.病的降糖效果及对胰岛功能的保护作用。方法将2015年12月—2016年12月在广州市增城区人民医院内分泌科治疗的66例新诊断2型糖尿病患者随机分为两组,对照组单服二甲双胍治疗,观察组采用磷酸西格列汀联合二甲双胍治疗,比较两组患者的血糖及胰岛素功能。结果观察组治疗后FPG、2h PG、Hb A1c明显较对照组改善,差异有统计学意义(P<0.05);观察组治疗后HOMA-β、HOMAIR、IAI、血清APN明显较对照组改善,差异有统计学意义(P<0.05)。结论磷酸西格列汀联合二甲双胍治疗新诊断2型糖尿病效果显著,有利于血糖的平稳控制,延缓胰岛功能恶化,保护胰岛β细胞功能,具有积极的临床意义。     

硝苯地平联合硫酸镁治疗妊娠期高血压疾病的临床效果

目的探讨硝苯地平联合硫酸镁治疗妊娠期高血压疾病的临床效果。方法将天津市武清区中医医院妊娠期高血压患者中随机分为研究组和对照组(n=25),研究组患者给予硝苯地平联合硫酸镁治疗,对照组给予硫酸镁治疗,比较两组治疗效果。结果研究组治疗总有效率为88.00%,显著高于对照组的68.00%(P0.05);研究组患者治疗后的血压、2 h尿蛋白定量和血液黏稠度明显优于对照组(P0.05);两组新生儿Apger评分无明显差异(P0.05)。结论硝苯地平联合硫酸镁在妊娠期高血压患者治疗中疗效显著,可以有效控制患者血压水平,具有不良反应发生率小和对胎儿影响小的优点,值得推广和应用。     

小剂量丙泊酚联合氯胺酮镇静对骨科小儿认知功能影响及安全性研究

目的分析应用小剂量丙泊酚(PPF)联合氯胺酮(KTM)镇静麻醉对于骨科患儿认知功能的影响情况并评价镇静治疗用药的安全性。方法将7~12岁的骨科患儿64例随机分成观察组(36例,0.25 mg/kg的PPF+0.25 mg/kg的KTM)和参照组(28例,0.5 mg/kg的PPF+0.5 mg/kg的KTM),在换药镇静前后各12 h采用自制认知功能量表对两组患儿进行评价,并记录、比较镇静后12 h内两组患儿的意识恢复时间、不良反应发生情况。结果认知功能评分方面,两组患儿在换药镇静前无显著差异(P0.05),而在换药镇静后观察组明显高于对照组(P0.05);在安全性上,与对照组相比,观察组患儿的意识恢复时间更短、不良反应发生率更低,且存在显著差异(P0.05)。结论采用小剂量的PPF联合KTM在换药时对骨科患儿进行镇静治疗,可有效减少PPF对患儿神经系统、认知能力的影响及相关不良反应,并促使患儿在镇静治疗后快速恢复意识,值得在骨科临床中应用、实践。     

双嘧达莫联合厄贝沙坦对IgA肾病的疗效及其安全性分析

目的探究双嘧达莫联合厄贝沙坦对Ig A肾病的疗效及其安全性。方法采取回顾性分析方法对遵义医学院第五附属(珠海)医院2013年7月—2016年7月Ig A肾病患者88例资料进行收集分析,随机分为单药组和联合组。单药组采用单纯厄贝沙坦治疗;联合组采用双嘧达莫联合厄贝沙坦治疗。比较两组患者Ig A肾病治疗效果;治疗前后24 h尿蛋白、血肌酐;不良反应发生率。结果联合组患者Ig A肾病治疗效果比单药组高,P0.05;治疗前两组患者24 h尿蛋白、血肌酐差异不显著,P0.05;联合组治疗后24 h尿蛋白、血肌酐比单药组好,P0.05;联合组不良反应发生率和单药组差异不显著,P0.05。结论双嘧达莫联合厄贝沙坦对Ig A肾病的疗效及其安全性良好,可改善肾功能,无明显副作用,值得推广。     

甲硝唑联合盐酸左氧氟沙星治疗盆腔炎临床观察

目的研究盐酸左氧氟沙星联合甲硝唑注射液治疗盆腔炎在临床上的效果。方法选取天津市武清区中医医院2012年1月至2014年12月收治的盆腔炎患者80例,随机分为观察组与对照组,各40例。对照组患者采用甲硝唑葡萄糖注射液静脉滴注;治疗组在应用甲硝唑同时应用盐酸左氧氟沙星葡萄糖注射液,1周后观察两组患者的治疗效果。结果两组患者之间临床疗效比较发现,观察组的治愈率和总有效率明显要高于对照组,比较差异具有统计学意义(P0.05);两组患者的不良反应发生情况比较,观察组和对照组不良反应发生率无明显差异,无统计学意义(P0.05)。结论治疗盆腔炎应用甲硝唑注射液同时联合盐酸酸左氧氟沙星疗效明显提高,且不增加不良反应发生率。     

Identification of Insulin-Mimetic Plant Extracts: From an In Vitro High-Content Screen to Blood Glucose Reduction in Live Animals

Type 2 diabetes mellitus (T2DM) is linked to insulin resistance and a loss of insulin sensitivity, leading to millions of deaths worldwide each year. T2DM is caused by reduced uptake of glucose facilitated by glucose transporter 4 (GLUT4) in muscle and adipose tissue due to decreased intracellular translocation of GLUT4-containing vesicles to the plasma membrane. To treat T2DM, novel medications are required. Through a fluorescence microscopy-based high-content screen, we tested more than 600 plant extracts for their potential to induce GLUT4 translocation in the absence of insulin. The primary screen in CHO-K1 cells resulted in 30 positive hits, which were further investigated in HeLa and 3T3-L1 cells. In addition, full plasma membrane insertion was examined by immunostaining of the first extracellular loop of GLUT4. The application of appropriate inhibitors identified PI3 kinase as the most important signal transduction target relevant for GLUT4 translocation. Finally, from the most effective hits in vitro, four extracts effectively reduced blood glucose levels in chicken embryos (in ovo), indicating their applicability as antidiabetic pharmaceuticals or nutraceuticals.     

Tiliacora triandra (Colebr.) Diels Leaf Aqueous Extract Inhibits Hepatic Glucose Production in HepG2 Cells and Type 2 Diabetic Rats

This study investigated the effects of Tiliacora triandra (Colebr.) Diels aqueous extract (TTE) on hepatic glucose production in hepatocellular carcinoma (HepG2) cells and type 2 diabetic (T2DM) conditions. HepG2 cells were pretreated with TTE and its major constituents found in TTE, epicatechin (EC) and quercetin (QC). The hepatic glucose production was determined. The in vitro data were confirmed in T2DM rats, which were supplemented daily with 1000 mg/kg body weight (BW) TTE, 30 mg/kg BW metformin or TTE combined with metformin for 12 weeks. Results demonstrate that TTE induced copper-zinc superoxide dismutase, glutathione peroxidase and catalase genes, similarly to EC and QC. TTE decreased hepatic glucose production by downregulating phosphoenolpyruvate carboxykinase (PEPCK) and glucose-6-phosphatase (G6Pase) and increasing protein kinase B and AMP-activated protein kinase phosphorylation in HepG2 cells. These results correlated with the antihyperglycemic, antitriglyceridemic, anti-insulin resistance, and antioxidant activities of TTE in T2DM rats, similar to the metformin and combination treatments. Consistently, impairment of hepatic gluconeogenesis in T2DM rats was restored after single and combined treatments by reducing PEPCK and G6Pase genes. Collectively, TTE could potentially be developed as a nutraceutical product to prevent glucose overproduction in patients with obesity, insulin resistance, and diabetes who are being treated with antidiabetic drugs.     

A facile and economic method for the synthesis of (S)-N-Boc-3′-hydroxyadamantylglycine

Research on Chemical Intermediates - (S)-N-Boc-3′-hydroxyadamantylglycine (I) is an important intermediate of saxagliptin for type 2 diabetes mellitus (T2DM). It was prepared from...     

Solanum anguivi Lam. Fruits: Their Potential Effects on Type 2 Diabetes Mellitus

Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder of glucose homeostasis associated with a status of insulin resistance, impaired insulin signaling, β-cell dysfunction, impaired glucose and lipid metabolism, sub-clinical inflammation, and increased oxidative stress. Consuming fruits and vegetables rich in phytochemicals with potential antidiabetic effects may prevent T2DM and/or support a conservative T2DM treatment while being safer and more affordable for people from low-income countries. Solanum anguivi Lam. fruits (SALF) have been suggested to exhibit antidiabetic properties, potentially due to the presence of various phytochemicals, including saponins, phenolics, alkaloids, ascorbic acid, and flavonoids. For the saponin fraction, antidiabetic effects have already been reported. However, it remains unclear whether this is also true for the other phytochemicals present in SALF. This review article covers information on glucose homeostasis, T2DM pathogenesis, and also the potential antidiabetic effects of phytochemicals present in SALF, including their potential mechanisms of action.     

Antihyperglycemic and Lipid Profile Effects of Salvia amarissima Ortega on Streptozocin-Induced Type 2 Diabetic Mice

Salvia amarissima Ortega was evaluated to determinate its antihyperglycemic and lipid profile properties. Petroleum ether extract of fresh aerial parts of S. amarissima (PEfAPSa) and a secondary fraction (F6Sa) were evaluated to determine their antihyperglycemic activity in streptozo-cin-induced diabetic (STID) mice, in oral tolerance tests of sucrose, starch, and glucose (OSTT, OStTT, and OGTT, respectively), in terms of glycated hemoglobin (HbA1c), triglycerides (TG), and high-density lipoprotein (HDL). In acute assays at doses of 50 mg/kg body weight (b.w.), PEfAPSa and F6Sa showed a reduction in hyperglycemia in STID mice, at the first and fifth hour after of treatment, respectively, and were comparable with acarbose. In the sub-chronic test, PEfAPSa and F6Sa showed a reduction of glycemia since the first week, and the effect was greater than that of the acarbose control group. In relation to HbA1c, the treatments prevented the increase in HbA1c. In the case of TG and HDL, PEfAPSa and F6Sa showed a reduction in TG and an HDL increase from the second week. OSTT and OStTT showed that PEfAPSa and F6Sa significantly lowered the postprandial peak at 1 h after loading but only in sucrose or starch such as acarbose. The results suggest that S. amarissima activity may be mediated by the inhibition of disaccharide hydrolysis, which may be associated with an α-glucosidase inhibitory effect.     

Glycated hemoglobin (HbA1c) measurement in frozen whole blood depends on baseline values of fresh samples

Glycated hemoglobin (HbA1c) has been recently adopted as a diagnostic marker of type 2 diabetes. However, its usage is currently limited to fresh blood samples. To allow retrospective HbA1c measurement in blood banks developed in large epidemic studies, here, we contribute to validate HbA1c assessment in frozen versus fresh blood samples from a cohort of diabetic/nondiabetic adult subjects. HbA1c was measured by HPLC in 237 fresh whole blood samples and on the same samples after a 12-month storage and a further 6-month-refrozen storage. Mean HbA1c?±?SD in fresh, frozen, and refrozen samples was 6.9?±?1.2, 6.6?±?1.1, and 6.4?±?1.0 % for the Diabetes Control and Complications Trial and 52?±?13, 49?±?12, and 46?±?11 mmol/mol for the International Federation of Clinical Chemistry and Laboratory Medicine reference, respectively. A significant correlation was found between fresh/frozen and fresh/refrozen (R?=?0.994 and 0.993, P?<?0.001) samples. HbA1c relative error ratio (%RER) between frozen/refrozen and fresh samples significantly correlated with HbA1c and depended on fresh value range, increasing in the five HbA1c classes (<6.0, 6.0–6.5, 6.5–7, 7–8, ≥8 %, corresponding to <42, 42–48, 48–53, 53–64, ≥64 mmol/mol, P?<?0.001). In particular, the 6.5 % (48 mmol/mol) HbA1c diagnostic cutoff of fresh samples identified two classes reflecting significant differences in %RER (2.8?±?2.0 and 3.3?±?1.7; P?<?0.05) between frozen and fresh samples. In conclusion, our results demonstrate a high correlation between data from fresh and frozen samples, with a very limited %RER between the two measurements, which increases with baseline HbA1c levels. Accordingly, when analyzing biobank frozen specimens for diagnostic purpose, the effect of the HbA1c range should be taken into account.

富含微量元素中药煎剂对2型糖尿病疗效观察

为了观察富含微量元素中药煎剂对2型糖尿病（T2DM）的疗效,将门诊64名血糖控制不满意的T2DM患者分为增加富含微量元素中药煎剂组（观察组）和不增加组（对照组）,服药3个月后比较。结果表明,观察组的空腹血糖（FPG）、空腹血清胰岛素（Fins）和糖化血红蛋白（HbA1c）3月后明显下降（P〈0．01）;3月后观察组的FPG、Fins和HbA1c较对照组明显下降（P〈0．01）。可见增加富含微量元素中药煎剂对血糖难以控制的T2DM的FPG、Fins和HbA1c能够起到有效控制作用。     

Stevioside Attenuates Insulin Resistance in Skeletal Muscle by Facilitating IR/IRS-1/Akt/GLUT 4 Signaling Pathways: An In Vivo and In Silico Approach

Type-2 diabetes mellitus (T2DM), the leading global health burden of this century majorly develops due to obesity and hyperglycemia-induced oxidative stress in skeletal muscles. Hence, developing novel drugs that ameliorate these pathological events is an immediate priority. The study was designed to analyze the possible role of Stevioside, a characteristic sugar from leaves of Stevia rebaudiana (Bertoni) on insulin signaling molecules in gastrocnemius muscle of obesity and hyperglycemia-induced T2DM rats. Adult male Wistar rats rendered diabetic by administration of high fat diet (HFD) and sucrose for 60 days were orally administered with SIT (20 mg/kg/day) for 45 days. Various parameters were estimated including fasting blood glucose (FBG), serum lipid profile, oxidative stress markers, antioxidant enzymes and expression of insulin signaling molecules in diabetic gastrocnemius muscle. Stevioside treatment improved glucose and insulin tolerances in diabetic rats and restored their elevated levels of FBG, serum insulin and lipid profile to normalcy. In diabetic gastrocnemius muscles, Setvioside normalized the altered levels of lipid peroxidase (LPO), hydrogen peroxide (H₂O₂) and hydroxyl radical (OH*), antioxidant enzymes (CAT, SOD, GPx and GSH) and molecules of insulin signaling including insulin receptor (IR), insulin receptor substrate-1 (IRS-1) and Akt mRNA levels. Furthermore, Stevioside enhanced glucose uptake (GU) and oxidation in diabetic muscles by augmenting glucose transporter 4 (GLUT 4) synthesis very effectively in a similar way to metformin. Results of molecular docking analysis evidenced the higher binding affinity with IRS-1 and GLUT 4. Stevioside effectively inhibits oxidative stress and promotes glucose uptake in diabetic gastrocnemius muscles by activating IR/IRS-1/Akt/GLUT 4 pathway. The results of the in silico investigation matched those of the in vivo study. Hence, Stevioside could be considered as a promising phytomedicine to treat T2DM.     

UHPLC-MS-Based Serum and Urine Metabolomics Reveals the Anti-Diabetic Mechanism of Ginsenoside Re in Type 2 Diabetic Rats

Panax ginseng was employed in the treatment of “Xiao-Ke” symptom, which nowadays known as diabetes mellitus, in traditional Chinese medicine for more than a thousand years. Ginsenoside Re was the major pharmacologic ingredient found abundantly in ginseng. However, the anti-diabetic of Ginsenoside Re and its underlying mechanism in metabolic level are still unclear. Serum and urine metabolomic method was carried out to investigate the anti-diabetic pharmacological effects and the potential mechanism of Ginsenoside Re on high-fat diet combined streptozotocin-induced type 2 diabetes mellitus (T2DM) rats based on ultra-high-performance liquid chromatography coupled with quadrupole exactive orbitrap mass spectrometry (UHPLC-Q-Exactive Orbitrap/MS). Serum and urine samples were collected from the control group (CON), T2DM group, metformin (MET) treatment group, and ginsenoside Re treatment group after intervention. The biochemical parameters of serum were firstly analyzed. The endogenous metabolites in serum and urine were detected by UHPLC-MS. The potential metabolites were screened by multivariate statistical analysis and identified by accurate mass measurement, MS/MS, and metabolite databases. The anti-diabetic-related metabolites were analyzed by KEGG metabolic pathway, and its potential mechanism was discussed. The treatment of ginsenoside Re significantly reduced the blood glucose and serum lipid level improved the oxidative stress caused by T2DM. Biochemical parameters (urea nitrogen, uric acid) showed that ginsenoside Re could improve renal function in T2DM rats. Respective 2 and 6 differential metabolites were found and identified in serum and urine of ginsenoside Re compared with T2DM group and enriched in KEGG pathway. Metabolic pathways analysis indicated that the differential metabolites related to T2DM were mainly involved in arachidonic acid metabolism, Vitamin B6, steroid hormone biosynthesis, and bile secretion metabolic pathways. This study verified the anti-diabetic and anti-oxidation effects of ginsenoside Re, elaborated that ginsenoside Re has a good regulation of the metabolic disorder in T2DM rats, which could promote insulin secretion, stimulated cannabinoid type 1 receptor (CB₁), and CaMKK β to activate AMPK signaling pathway, inhibited insulin resistance, and improved blood glucose uptake and diabetic nephropathy, so as to play the role of anti-diabetic.     

Effects of Micronutrients on Oxidative Stress and Islet Function in Type 1 Diabetes Mellitus Rats： Relationships to Th2 Type Cytokines, Interleukin-4, and Interluekin-10

To observe the effects of the micronutrients on oxidative and autoimmune destruction of islets so as to prevent a person from the onset and development of type 1 Diabetes Mellitus(T1DM),the interleukin-4 and interleukin-10 expressions of lymphocytes in peripheral blood and spleen of T1DM rats were determined by flow cytometry.GSH-Px activity and MDA level in the rats' pancreas were measured using biochemical methods.The insulin contents in serum and β cell insulin secret storage were tested by RIA and IHC,respectively.There was an increase in the percentages of IL-4 and IL-10 positive lymphocytes in the peripheral blood and spleen of the groups of rats supplemented with various combinations of micronutrients(p<0.01 and p<0.05,respectively);the blood glucose concentration decreased(p<0.05);both the functional β cell in islets and the insulin content in pancreatic tissue increased(p<0.05 and p<0.01);the GSH-Px activity and MDA level of pancreas in the rats enhanced and decreased respectively(p<0.01 and p<0.05).The results suggest that micronutrients may alleviate the islet lesions by upregulating the expressions of IL-4 and IL-10 and lowering oxidative stress in diabetic rats.