Objective To investigate the current situation of self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes mellitus (T2DM) in Sichuan province, and to analyze the influencing factors of SMBG, so as to provide evidence for improving the level of SMBG. Methods By the convenience sampling method, 410 patients with T2DM for more than 1 year were selected from 17 hospitals and community health service centers in 7 cities across Sichuan province, and their SMBG was investigated with a questionnaire. Results Among 410 eligible patients, the average frequency of SMBG was 7.3 times per month. There were 268 patients (65.4%) performed SMBG less than 4 times per month, 94 (22.9%) performed 4-15 times per month, 29 (7.1%) performed 6-29 times per month, and 19 (4.6%) performed over 30 times per month. Just 234 patients (57.1%) monitored the HbA1c in the past 6 months. FPG, 2-hour PPG and HbA1c were negatively correlated with the frequency of SMBG. The influencing factors of SMBG were insulin treatment and education. Conlusion The SMBG status in D2TM patients is relatively poor in Sichuan province, and the compliance of SMBG is expected to be improved by enhancing diabetic education.
Objective To explore the situation and causes of misdiagnosed hypoglycemia in China so as to develop some strategies for reducing misdiagnosis.Methods We searched CBMdisc, CMCC, CJFD and VIP (Jan. 1994-Dec. 2003). All the publisled studies about the misdiagnosis of hypoglycemia were collected to analyse their classifications and causes.Results A total of 172 studies involving 1 478 patients met the inclusion criteria. The studies were either case reports or clinical reviews. The 1 478 cases were misdiagnosed as 31 sorts of diseases, mainly including stroke (71.18%), transient ischemia attack (4.87%), epilepsy (4.13%) and hepatic coma (2.64%) . The causes of misdiagnosis could be classified into 14 categories, including complex manifestations of hypoglycemia (29.07%), lack of knowledge of hypoglycemic encephalopathy (16.44%), insufficient medical history collection (10.21%) and interference of compound diseases (9.86%) etc..Conclusions The misdiagnosis of hypoglycemia is mainly caused by the poor professional skills of doctors or their lack of responsibility, and poor patient management, especially when hypoglycemia are manifested by brain disability.
目的 探讨热性惊厥患儿血清电解质和血糖的变化及其临床意义。 方法 选取2009 年6月－2010 年12月儿科住院的呼吸道感染并发热性惊厥患儿38例和呼吸道感染无惊厥患儿42例，分别作为观察组和对照组，测定和比较两组患儿血清电解质和血糖值。 结果 观察组血清钠离子浓度为（133.05 ± 1.74）mmol/L、氯离子浓度为（100.37 ± 1.79）mmol/L；对照组血清钠离子浓度为（142.19 ± 1.85）mmol/L、氯离子浓度为（104.57 ± 1.55）mmol/L，差异均有统计学意义（P＜0.01）；观察组和对照组血糖浓度依次为（6.93 ± 0.87）、（5.12 ± 0.55）mmol/L，差异有统计学意义（P＜0.01）。观察组在治疗后的血清钠离子、氯离子浓度分别为（140.89 ± 2.68）、（103.29 ± 1.94）mmol/L，均高于发生惊厥时的浓度（P＜0.01）；观察组在治疗后的血糖浓度为（5.31 ± 0.68）mmol/L，明显低于发生惊厥时，差异有统计学意义（P＜0.01）。 结论 婴幼儿发生热性惊厥时存在血钠、血氯水平降低和血糖升高，在热性惊厥患儿的治疗中应纠正血钠水平和高血糖。Objective To explore the clinical significance of the changes in serum electrolytes and blood glucose in the children with febrile convulsion. Methods Thirty-eight children with respiratory infection combined with febrile convulsion and 42 children with single respiratory infection diagnosed between June 2009 and December 2010 were selected as the observation group and control group, respectively. Serum electrolytes and blood glucose concentration were assayed and compared between the two groups. Results The concentrations of serum sodium and chloride were (133.05 ± 1.74) mmol/L and (100.37 ± 1.79) mmol/L in the observation group, while (142.19 ± 1.85) and (104.57 ± 1.55) mmol/L in the control group; the differences between the two groups were significant (Plt;0.01). The concentrations of blood glucose were (6.93 ± 0.87) mmol/L in the observation group and (5.12 ± 0.55)mmol/L in the control group; the difference was significant (Plt;0.01). After the treatment, the serum concentrations of sodium and chloride were (140.89 ± 2.68) and (103.29 ± 1.94)mmol/L in the observation group, which were higher than those before treatment (Plt;0.01). After treatment, the blood glucose concentration was (5.31 ± 0.68）mmol/L in the observation group, which was lower than that before the treatment (Plt;0.01). Conclusion Hyponatremia, low serum chlorine and hyperglycemia occurre in the febrile convulsion in children, which should be corrected in the treatment of febrile convulsion.
摘要:目的：探讨低血糖指数膳食干预对2 型糖尿病病人营养治疗效果的影响。方法：选择住院2 型糖尿病病人109例,随机分为营养组56例和对照组53例。营养组由营养师根据患者情况提供低血糖指数营养治疗饮食,对照组则自行控制饮食。分别于住院第1天与3个月复查时对两组患者进行膳食调查及相关生化指标测定, 以观察营养治疗的效果。结果:采用干预措施后, 两组空腹血糖、餐后2 h血糖、糖化血红蛋白、血清胆固醇、甘油三酯等生化指标均降低, 但营养组与对照组相比效果更为明显(P＜005)；营养组的饮食结构更为合理。结论：低血糖指数膳食可有效控制2 型糖尿病病人的血糖、血脂水平,对促进患者康复有积极意义。Abstract: Objective: To observed the effect of nutrition therapy of low glycemic index foods on type 2 diabetic patients. Methods: A total of 109 subjects with the hospitalized diabetes were randomly allocated into two groups: The nutrition group(56 cases) were provided with weighed individual low glycemic index foods and the control group(53 cases) went on diet dominated by themselves. patients in both groups were investigated on meals, diabetic nutrition knowledge and were detected for correlative biochemical indices. Results：After the nutrition treatment, patients biochemical indices of fasting bloodglucose, blood sugar 2 hours after meal, hemoglobin of glycosylation, cholesterol and triglyceride in serum in both groups were significantly lower. Compared with the control group, the effect of the nutrition group was even better. The acknowledgement rate of nutrition knowledge on diabetes of the nutrition group improved significantly, and their meals were more scientifically arranged. Conclusion: The nutrition therapy of low glycemic index foods would be very helpful for type 2 diabetic patients to control their bloodsugar level and improve the nutritional state and outcome.
Objectives To summarize the regulation of glucagon-like peptide-1（GLP-1） level by metabolism of gastrointestinal nutrients. Methods Domestic and international publications online involving regulation of GLP-1 level by metabolism of gastrointestinal nutrients in recent years were collected and reviewed. Results GLP-1 influenced insulin secretion and sensitivity， and played a leading role in recovery of glucose metabolism. Metabolism of gastrointestinal nutrients regulated GLP-1 level. Studies had shown that GLP-1 was a candidate mediator of the effects of gastric bypass （GBP） for type 2 diabetes mellitus（T2DM）. Conclusions It plays an important role in anti-T2DM effects of GBP that metabolism of gastrointestinal nutrients regulated GLP-1 level. The corresponding studies can provide a novel clinical field to treat T2DM.
创伤、手术、感染、烧伤等极度应激状况下的危重患者常出现应激性高血糖； 非糖尿病危重患者类似糖尿病的症状； 糖尿病危重患者则高血糖程度明显加重。 创伤后出现不同水平的高血糖，随着血糖的增高，其死亡危险性也呈阶梯样成倍增长［1，2］……
ObjectiveTo investigate the change of blood glucose and its clinical significance in patients with acute pancreatitis (AP). MethodsThe regularity of blood glucose change and the relation between the regularity and the prognosis were analyzed in 115 patients with AP and hyperglycemia.ResultsBlood glucose was increased with a median (M) of 8.7 mmol/L，18.45 mmol/L and 27.22 mmol/L, which gradually decreased to normal value within 3-17 days, 7-26 days and 24-46 days after treatment,respectively in patients with mild AP, type Ⅰ of severe acute pancreatitis (SAP) and type Ⅱ of SAP. There was marked statistical difference among the three groups. A smaller dose of regular insulin was used for 36 patients with mild AP; however, a larger dose of regular insulin was used for all 30 patients with SAP.ConclusionThe level of blood glucose, the dose of regular insulin and the duration of hyperglycemia increase with the severity of AP.
Objective To investigate the effect of glucagon-like peptide-1(GLP-1) on impaired glucose tolerance due to stress postoperatively. Methods The rats were allocated randomly to one of three groups, group Ⅰ was subdivided into group Ⅰg which received an intravenous glucose load (0.5 g/kg glucose), and group Ⅰglp which received the same glucose load with GLP-1 (0.3 nmol/kg) during intravenous glucose tolerance test (IVGTT). Rats in group Ⅱg and group Ⅱglp in group Ⅱ were infused respectively the same intravenous glucose tolerance test as group Ⅰ on the first, third and fifth day after 65% liver resection. And rats in group Ⅲ were injected the same glucose load with GLP-1 (0.45 nmol/kg) during IVGTT on the first day after hepatectomy. The peak glucose levels, glucose levels at 30 minutes and the area under the curve (AUC0-30) were investigated among groups. Results The peak glucose levels, glucose levels at 30 minutes and AUC0-30 were significantly lower in group Ⅰglp than those in group Ⅰg. And the values were significantly higher in group Ⅱg than those in group Ⅰg on the first, third and fifth day after operation. There was no significant difference between group Ⅱglp and group Ⅱg in the peak glucose levels on the first day after liver resection, but the peak glucose levels and AUC0-30 were significantly lower in group Ⅲ than those in group Ⅱg and group Ⅱglp, and the glucose levels at 30 minutes were significantly lower in group Ⅲ than those in group Ⅱg too on the first day. The peak glucose levels were significantly lower in group Ⅱglpthan those in group Ⅱg on the third and fifth postoperative day and in group Ⅱglp on the first day too, and the glucose levels at 30 minutes and AUC0-30 were also significantly lower in group Ⅱglp than those in group Ⅱg, but they were similar between group Ⅱglp and group Ⅰg. Conclusion Glucose intolerance is a feature of stress after hepatectomy, and GLP-1, injected in conjunction with the IVGTT, increased the clearance of glucose. The contribution of GLP-1 to reducing blood glucose was decreased significantly at early phase postoperatively, but its action was enhanced by the way of dosage dependence. The action of GLP-1 was enhanced with the degree of stress reduction and then returned to normal.