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PubMed2003

Humalog Mix25 improves 24-hour plasma glucose profiles compared with the human insulin mixture 30/70 in patients with type 2 diabetes mellitus.

OBJECTIVE: To compare the effects of Humalog Mix25 (Humalog Mix75/25 in the USA) (Mix25) and human insulin 30/70 (30/70) on the 24-hour inpatient plasma glucose (PG) profile in patients with type 2 diabetes mellitus (T2DM). DESIGN: A randomised, open-label, 8-week crossover study. Study insulins were injected twice daily, 5 minutes before breakfast and dinner. SETTING: Four-week outpatient (dose-adjustment) treatment phase, and 3-day inpatient (test) phase. PATIENTS: Twenty-five insulin-treated patients with T2DM (ages 40-66 years), mean (+/- standard error of the mean) (SEM) HbA1c 7.7% +/- 0.23%, and body mass index (BMI) 29.3 +/- 0.83 kg/m2. OUTCOME MEASURES: 24-hour PG profiles, PG excursions after meals, PG area under the curve (AUC), and 30-day hypoglycaemia rate. RESULTS: The 2-hour PG excursions following breakfast (5.5 +/- 0.34 v. 7.2 +/- 0.34 mmol/l, p = 0.002) and dinner (2.4 +/- 0.27 v. 3.4 +/- 0.27 mmol/l, p = 0.018) were smaller with Mix25 than with 30/70. PG AUC between breakfast and lunch was smaller with Mix25 than with 30/70 (77.6 +/- 3.8 v. 89.5 +/- 4.3 mmol/h/ml, p = 0.001). PG AUC between lunch and dinner, dinner and bedtime, and bedtime and breakfast did not differ between treatments. Pre-meal and nocturnal PG were comparable. The postprandial insulin requirement for lunch meals was supplied equally by the two insulin treatments. The thirty-day hypoglycaemia rate was low (Mix25 0.049 +/- 0.018 v. 30/70 0.100 +/- 0.018 episodes/patient/30 days, p = 0.586) for both treatments. CONCLUSION: In patients with T2DM, Mix25 improved the 24-hour PG profile with lower postprandial PG excursions than with human insulin 30/70.

Adult↗
PubMed2003

Prevalence of carotid stenosis in type 2 diabetic patients asymptomatic for cerebrovascular disease.

Stroke, with an incidence of 2.5 x 10(3) yr(-1) (95% CI, 2.3-2.8 x 10(3) yr(-1)), is the third most frequent cause of death and the first cause of disability in western society. Diabetes is an important risk factor for ischaemic stroke, second only to hypertension, whereas it does not seem to be associated with an increased risk of haemorrhagic stroke. The incidence of stroke in men and women between 45 and 74 yr has been found to be 2.5 and 3.5 times higher in diabetics than in non-diabetic subjects, with a relative risk higher in females than in males with diabetes and greater in both sexes in the 50-to-60-yr age group but decreased in subjects who were 70 and above. It is known that there is an association between ischaemic stroke and carotid stenosis. However, the prevalence of carotid stenosis in Type 2 diabetes mellitus (T2DM) patients has not been well investigated, mainly in the Italian diabetic population. Therefore, the aim of this study was to evaluate the prevalence of carotid artery stenosis in a population of T2DM patients asymptomatic for cerebrovascular disease selected from the files of the Diabetes Clinics, and from the computerised files of General Practitioners (GPs). Three hundred and sixty-five subjects were examined: 187 were non-diabetic (89 males, 98 females) and 178 were T2DM patients (82 males, 96 females). The mean age of all the subjects was 67 +/- 7.8 yr; 66 +/- 7.9 for the non-diabetic subjects and 67 +/- 7.5 yr in the diabetic subjects. In the echo-Doppler examination of the carotid, a degree of stenosis ranging 10-99% was recorded in 143/365 subjects (39.1%), 49/187 non-diabetics (26.2%) and 94/178 diabetics (52.8%). The differences were highly significant (p < 0.001). Severe stenosis was recorded in 17/143 subjects (12%); 12 of these were diabetic (70%) and 5 non-diabetic (30%). The diabetics were three times more likely to develop carotid stenosis than the non-diabetics with an odds ratio of 3.152, (95% CI, 2.032-4.889).

Aged↗
PubMed2004

Drug-induced severe hypoglycaemia in Type 2 diabetic patients aged 80 years or older.

Our knowledge about the risk of hypoglycaemia associated with diabetes treatment is derived from studies that often exclude elderly people. Aim of this study was to determine the incidence and risk factors for developing severe hypoglycaemia among persons aged 80 yr or older, with Type 2 diabetes mellitus (T2DM). During a 2-yr period, all episodes of severe hypoglycaemia occurred in T2DM patients aged 80 yr or older were identified. Hypoglycaemia was defined as a symptomatic event requiring treatment with i.v. glucose and confirmed by a blood glucose determination of less than 50 mg/dl. A detailed history and blood laboratory profile were obtained for each patient. During the period of the survey a total of 124 diabetic subjects aged 80 yr or older were hospitalised and severe hypoglycaemia was reported in 31 patients (25%). This group of patients had a marked comorbidity and was found to have HbA1c values of 5.1% indicating that their diabetes was well controlled. Of these hypoglycaemic episodes, 23 (74%) occurred in patients taking glibenclamide. Diabetes therapy was prescribed by general practitioners in 24 of these patients. Seventeen subjects concomitantly received drugs that potentiated hypoglycaemia. Only 10 patients performed regular blood glucose self-monitoring. In conclusion, severe hypoglycaemia is a serious and not uncommon problem among elderly patients with T2DM; it is more frequent in patients undergoing aggressive diabetes management and in users of a long-acting sulphonylurea (eg, glibenclamide). A normal HbA1c level in this age group appears to be a powerful indicator of the risk of severe hypoglycaemia and should alert clinicians to change therapy. Finally, each patient's risk for hypoglycaemia should be considered and therapy should be individualised accordingly; in our opinion, a great number of episodes of serious hypoglycaemia may be prevented by teaching the principles of blood glucose monitoring and involving general practitioners in outpatient management of diabetes mellitus in the elderly.

Aged↗
PubMed2004

The effect of oral folic acid on glutathione, glycaemia and lipids in Type 2 diabetes.

Plasma homocysteine is an established risk factor for vascular disease and precursor of the anti-oxidant glutathione. This study was designed to investigate the relationship of changes in homocysteine (Hcy) induced by oral folate to glutathione and measures of glycaemia and lipid metabolism in Type 2 diabetes (T2DM). Twenty-seven patients (26 male, 1 female, aged 48-68 years) with T2DM and microalbuminuria were treated with folic acid 10 mg daily for 3 months. During the study, diastolic blood pressure (p=0.04), HbA1c (p=0.04), serum triglycerides (p=0.04) and serum total/HDL-cholesterol ratio (p=0.004) all increased and serum HDL-cholesterol fell (p=0.006). The increased red cell folate correlated with a reduction in microalbuminuria (p=0.001). Overall, plasma glutathione increased (p=0.016) despite reduction in its precursor Hcy (p<0.001). Change in glutathione correlated inversely with change in HbA1c (p<0.02), total cholesterol (p=0.003) and triglycerides (p<0.02) and positively with HDL-cholesterol (p=0.033). Increase in glutathione correlated with levels of vitamin B6 (p<0.05). Metformin treatment protected against the rise in blood pressure (BP) (p=0.02), independently of changes in plasma glutathione. In summary, oral folic acid supplementation in T2DM reduced plasma Hcy and increased glutathione levels. HbA1c, triglycerides and HDL-cholesterol deteriorated during the trial: their levels correlated inversely with changes in glutathione. The increase in glutathione may depend on an adequate supply of B6, as changes in glutathione correlated with vitamin B6 levels. Reduced Hcy and increased glutathione may both mediate improvement in vascular function and outcome. Some aspects of the response to folate may be different in patients on metformin.

Adult↗
PubMed2004

Thyroid dysfunction in patients with type 2 diabetes mellitus in Jordan.

OBJECTIVE: To investigate the prevalence of thyroid dysfunction and autoimmunity in type 2 diabetic patients. METHODS: The study was conducted at the National Center for Diabetes, Endocrinology and Genetics, Jordan University Hospital, Amman, Jordan, between March 2000 and September 2000. A group of 908 type 2 diabetic patients (T2DM) were recruited in the study and underwent investigations for thyroid functions; free thyroxine (FT4), free tri-iodothyronine (FT3) and thyroid stimulating hormone (TSH). Six hundred had performed thyroid autoantibodies, thyroid peroxidase antibodies (TPOab) or antimicrosomal antibodies (AMA) and thyroglobulin antibodies (Tgab). They were compared with 304 non-diabetics, of those 282 had performed thyroid antibodies. RESULTS: Fifty-three (5.9%) of diabetic patients were known to have thyroid disease. As a direct result of screening, new thyroid disease cases were diagnosed in 6.6% of the patients. Thus, the overall prevalence of thyroid disease was found to be 12.5%. The most common was subclinical hypothyroidism (4.1%). In the control group, the prevalence of thyroid disease was 6.6%. The most common was subclinical hypothyroidism (5%). There was a significant difference between diabetics and control subjects p=0.0064. Positive TPOab was found in 8.3% of T2DM patients (N=600) versus 10.3% in the control group (N=282) p=0.412. Positivity for both TPOab and Tgab was found to be 2.5% of T2DM versus 6% of the control subjects p=0.0155. CONCLUSION: This study suggests that diabetic patients should be screened for asymptomatic thyroid dysfunction.

Adult↗
PubMed2004

Continuous glucose monitoring: physiologic and pathophysiologic significance.

Diabetes mellitus is a complex disorder of the energy metabolism. In the present paper, we have tried to illustrate the changes in the regulation of blood glucose levels encountered in the two main types of diabetes: Type 2 (T2DM) and Type 1 (T1DM) diabetes mellitus, compared with healthy, non-diabetic subjects. For this we used the MiniMed CGMS (Continuous Glucose Monitoring System) which allows the continuous in vivo blood glucose measurement over a 3-day period. The study group comprised 19 diabetic patients (14 T1DM and 5 T2DM cases) and 4 non-diabetic controls. The recording in normal subjects showed a glycemic variation between 46 and 118 mg/dl, suggesting the existence of a strong and efficient glycemic control mechanism. In T2DM patients, both on diet only or on oral antidiabetic treatment, the oscillation of blood glucose levels was significantly higher compared to that recorded in non-diabetic subjects. In T1DM patients with stable metabolic control blood glucose fluctuations were comparable with those recorded in long-term type 2 diabetic patients but the "mean" values of blood glucose over 72 hours were lower. The CGMS is a valuable tool in the detection of unrecognized hypoglycemic episodes and hyperglycemic postprandial peaks and allows the patient and the health care team to adjust the treatment regimen in order to improve glycemic control. From our point of view, the CGMS could offer valuable information for the knowledge of glycemic regulation in normal people and for the diabetogenic mechanisms in prediabetic IGT and IFG patients.

Adolescent↗
PubMed2004

Neural redox stress and remodeling in metabolic syndrome, type 2 diabetes mellitus, and diabetic neuropathy.

Diabetic polyneuropathy (DPN) is the most common complication of diabetes and may frequently be the presenting symptom in type 2 diabetes mellitus (T2DM). Metabolic syndrome and T2DM are associated with multiple metabolic toxicities. These substrate toxicities support the formation of reactive oxygen species (ROS), which are so damaging to cells, tissues and organs and play an important role in the development of multiple diabetic complications. The importance of redox stress (ROS) and their effect on the neuronal unit are discussed. There are at least 5 major pathways involved in the development of DPN: metabolic, vascular, immunologic-autoimmune, neurohormonal growth factor deficiency, and extracellular matrix neuronal unit remodeling. Each of these five pathways are reviewed and related to neural redox stress and the role of ROS. The identification of the toxic substrates (A-FLIGHT acronym), earlier diagnosis of T2DM at the stage of impaired glucose tolerance or impaired fasting glucose, and aggressive global risk reduction with the use of a simple RAAS acronym will assist the clinician in slowing the natural progressive history, and possibly preventing the complications associated with DPN. The pain, foot ulceration, limb loss, organ dysfunction, and the associated morbidity and financial burden all contribute to the need for a better understanding of DPN and the role of redox stress and global risk reduction.

Diabetes Mellitus, Type 2↗
PubMed2005

[Association study of apolipoprotein e gene polymorphism and cerebral infarction in type 2 diabetic patients].

In order to explore the association of apolipoprotein E (ApoE) gene polymorphism with cerebral infarction in type 2 diabetic patients of Han nationality in Northeast China , the genotypes of ApoE gene were analyzed by polymerase chain reaction -restriction fragment length polymorphism (PCR-RFLP) in the 208 cases, including 69 cases in control (CON) group and 67 in type 2 diabetes mellitus (T2DM) group as well as 72 in type 2 diabetes mellitus with cerebral infarction (T2DMCI) group. Plasma lipid content in T2DMCI was also detected for 70 cases. The distribution of genotypes in ApoE gene,epsilon(2)epsilon(3),epsilon(3)epsilon(3) as well as epsilon(3)epsilon(4) was no significant difference in three groups (epsilon(2)epsilon(3) : 13.2%,epsilon(3)epsilon(3) : 67.6%,epsilon(3)epsilon(4) : 16.2%in CON group;epsilon(2)epsilon(3) : 19.4%,epsilon(3)epsilon(3): : 70.1%epsilon(3)epsilon(4) : 9%in T2DM group;epsilon(2)epsilon(3) : 15.2%,epsilon(3)epsilon(3) : 75%,epsilon(3)epsilon(4) : 4.2%in T2DMCI group). The allele frequencies of epsilon(2),epsilon(3) and epsilon(4) were not significantly different in the three groups, either(epsilon(2) : 9.6%,epsilon(3) : 82.4%,epsilon(4) : 8.1%in CON group; epsilon(2) :10.5%,epsilon(3) :84.3%,epsilon(4) : 5.2%in T2DM group; epsilon(2) :11.8%,epsilon(3) :84.7%,epsilon(4) : 3.5%in T2DMCI group). The levels of total cholesterol (TC), tryglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C) were not significantly different among the different genotypes in T2DMCI group. The study confirmed that the polymorphisms of ApoE gene are neither associated with the T2DMCI, nor with the levels of plasma lipid in T2DMCI.

Apolipoproteins E↗
PubMed2005

[Study on association between gestational diabetes mellitus and sulfonylurea receptor-1 gene polymorphism].

OBJECTIVE: To investigate allelic frequency of sulfonylurea receptor-1 (SUR1) in gestational diabetes mellitus (GDM) women of Han nationality in north China in order to find out susceptible gene associated with GDM, and to assess the association between SUR1 allele and body mass index (BMI) and secretion of insulin. METHODS: Seventy cases of pregnant women were selected. It included 35 cases of pregnant women with GDM (GDM group), 35 cases of normal pregnant women (normal control group). Another 35 women patients with type 2 diabetes in the same period as T2DM group. By using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), we detected the distribution of SUR1 alleles frequency in all individuals of three groups. We also examined BMI, fasting insulin (INS(0)) and 2 h insulin levels (INS(120)). RESULTS: There was significantly increased c alleles frequency of SUR1 in GDM and T2DM women compared with normal pregnancy (70.0%, 71.4% and 52.9%, P < 0.05). Also significantly increased A alleles frequency of SUR1 in GDM and T2DM women was found compared with normal pregnancy (41.4%, 44.3% and 24.3%, P < 0.05). In GDM group, women carrying cc genotype had a higher BMI [(29.2 +/- 5.6) kg/m(2)], INS(0) [(14.9 +/- 8.7) mU/L] and INS(120) [(40.2 +/- 12.1) mU/L] as compared with those in carriers of other genotypes (ct and tt) (all P < 0.05). Also they had a lower insulin sensitivity (HOMA-IR) (3.9 +/- 2.5) as compared with carriers of ct genotype. Women carrying AA genotype had a higher INS(0) as compared with carriers of other genotypes (AG and GG) [(15.4 +/- 3.2), (12.1 +/- 4.5) and (11.5 +/- 4.8) mU/L, both P < 0.05]. Logistic regression analysis showed there was relationship between SUR1 cc genotype and severity of GDM (P = 0.005, RR = 25.128). CONCLUSIONS: There are -3t-->c and A/G polymorphism of SUR1 gene in the Han nationality. Alleles c of SUR1 are significantly implicated in the susceptibility to GDM. It suggests that the defect in SUR1 gene (cc and AA) may contribute to insulin hypersecretion, which might be the cause of increased body weight and decreased insulin sensitivity and genotype cc of SUR1 is connected with severe type of GDM. It might be the predictable index of GDM conversion to type 2 diabetes.

ATP-Binding Cassette Transporters↗
PubMed2004

The relationship between levels of alpha1-acid glycoprotein and metabolic parameters of diabetes mellitus.

The aim of this study was to investigate the relationship of alpha1-acid glycoprotein (AGP, orosomucoid), which is an acute-phase reactant, in patients with Type 1 (T1DM) and Type 2 diabetes mellitus (T2DM), with the metabolic parameters and complications of diabetes mellitus. A total of 119 diabetic patients (89 T2DM, 30 T1DM) and 33 healthy controls were included in the study. The mean AGP level in the diabetic group was not different from the control group (82.4 +/- 28.9 and 81.6 +/- 16.6 mg/dl, respectively), but it was higher in T2DM than in T1DM subjects (86.6 +/- 28.3 and 69.7 +/- 26.9, respectively). AGP plasma levels showed a significant correlation with age and body mass index (r = +0.348 and r = +0.296, respectively). AGP plasma levels resulted higher in obese diabetic patients (97.7 +/- 28.0) than in non-obese diabetic patients (77.6 +/- 28.7 mg/dl) and controls (81.6 +/- 16.6), and also higher in diabetic subjects with poor glycaemic control (85.1 +/- 33.3 mg/dl) than in diabetic subjects with optimal glycaemic control (79.5 +/- 23.1 mg/dl). A relationship between AGP and macro- and microvascular complications of diabetes mellitus was not found. In conclusion, inflammatory findings were more prominent in obese diabetic patients.

Acute-Phase Proteins↗
PubMed2005

[PPARdelta + 294T/C gene polymorphism related to plasma lipid, obesity and left ventricular hypertrophy in subjects with metabolic syndrome].

OBJECTIVE: To investigate the relationship between PPARdelta + 294T/C gene polymorphism and lipid profile, obesity and left ventricular hypertrophy (LVH) in patients with metabolic syndrome (MS). METHODS: This study was conducted in 300 patients with MS and 174 patients with essential hypertension (EH) and 143 patients with type 2 diabetes mellitus (T2DM). MS was diagnosed according to 1999 WHO criteria. Fasting insulin (FINS), fasting blood glucose (FBG), plasma lipids levels were measured, LVH was examined by Doppler echocardiography. The PPARdelta + 294T/C gene polymorphism were analyzed using polymerase chain reaction and subsequently digested by BSLI restriction endonuclease. RESULTS: The frequencies of the PPARdelta + 294T/C genotypes were not different among three groups. Compared with T2DM and EH, MS patients had significantly higher body mass index (BMI), plasma total cholesterol, TG and LDL-C levels (P < 0.01 or P < 0.05). LVM, LVMI and incidence rate of LVH were significantly higher in MS and EH patients than that in T2DM (P < 0.01). MS patients with CC genotype had significantly higher total cholesterol and LDL-C levels than those with TT and TC genotypes (total cholesterol in CC genotype: 6.13 +/- 1.86 mmol/L vs in TC genotype: 5.14 +/- 1.10 mmol/L, P < 0.05, and CC genotype: 6.13 +/- 1.86 mmol/L vs TT genotype: 4.99 +/- 1.42 mmol/L, P < 0.01; LDL-C in CC genotype: 3.82 +/- 1.52 mmol/L vs in TC genotype: 3.14 +/- 0.88 mmol/L, P < 0.05, and in CC genotype: 3.82 +/- 1.52 mmol/L vs in TT genotype: 2.90 +/- 0.87 mmol/L, P < 0.01). BMI and LVMI in MS patients with C allele carriers (CC + TC) were significantly higher than that of TT genotype (LVMI in CC + TC: 46 +/- 10 g/m(2.7) vs in TT: 44 +/- 10 g/m(2.7); BMI in CC + TC: 26 +/- 3 kg/m(2) vs in TT: 25 +/- 3 kg/m(2), P < 0.05). CONCLUSIONS: It is indicated that PPARdelta + 294T/C gene polymorphism in subjects with MS may be involved in the occurrence of obesity and dyslipidemia. MS patients with C allele had a predominant LVH than subjects with TT genotype.

Aged↗
PubMed2005

[Analysis of correlative factors affecting IIEF-5 scores of type 2 diabetic patients].

OBJECTIVE: To investigate the correlative factors affecting the IIEF-5 scores of the patient with type 2 diabetic mellitus (T2DM). METHODS: A total of 149 T2DM patients were investigated for the relationships between their IIEF-5 score and such factors as age, body mass index (BMI), fasting plasma glucose (FPG), 2hPG, insulin (INS), GHbA1c, C-peptide, nitric oxide (NO), testosterone (T), estradiol (E2), the ratio of testosterone to estradiol (T/E), erythrocyte aldose reductase (AR), drinking, smoking, concomitant diseases, complications and medication. RESULTS: The scores of the groups of smoking, complication, medication and concomitant disease were significantly lower than those of the controls. There was significant negative correlation between IIEF-5 scores and age, BMI, FPG, 2hPG, INS, GHbA1c and AR (P < 0.05), and significant positive correlation between IIEF-5 scores and NO (P < 0.05). But there was no correlation between drinking, T, E2 and T/E2 (P > 0.05). CONCLUSION: Many factors may affect the IIEF-5 scores of T2DM patients.

Adult↗
PubMed2004

Glycemic optimization may reduce lipid peroxidation independent of weight and blood lipid changes in Type 2 diabetes mellitus.

The aim of this study was to determine the effect of diet-therapy on lipid peroxidation in patients with Type 2 diabetes mellitus (T2DM). Fifteen T2DM patients of both sexes, aged between 35-70 years, were given the diet suggested for patients with diabetes by the American Diabetic Association. This diet comprised 50-60% carbohydrate, 10-15% protein, 20-30% fat and about 35 g fiber was given for weight maintenance. Weight and body mass index did not change significantly during 8 weeks of study. Also, no statistically significant difference was observed in serum total cholesterol, triglycerides, LDL- and HDL-cholesterol from before to after dietary intervention. However, the levels of fasting blood sugar, HbA1c and malondialdehyde were lowered significantly after dietary intervention. It was concluded that glycemic optimization, independent of weight and blood lipid profile, through a well-designed diet is likely to be the most effective factor in reducing the process of oxidative stress in T2DM. This may have preventive implications for such diabetic complications as atherosclerosis.

Adult↗
PubMed2005

[Proportion of proinsulin two minutes after arginine stimulation: a pilot study].

OBJECTIVE: To seek an easy way to evaluate islet beta cell function. METHODS: 214 residents of Shanghai, aged 20-70, all of Han nationality, were divided into 3 groups according the 1999 WHO standard: 39 in the normal glucose tolerance (NGT) group, aged 52 years +/- 6 years, with the BMI of 22.3 kg/m(2) +/- 0.4 kg/m(2); 29 in the impaired glucose tolerance (IGT) group, aged 54 years +/- 9 years, with the BMI of 24.4 kg/m(2) +/- 0.6 kg/m(2); and 146 in the T2DM group, that was subdivided into 2 subgroups: 43 in the newly diagnosed T2DM (NT2DM) group, aged 52 years +/- 9 years, with the BMI of 24.4 kg/m(2) +/- 0.5 kg/m(2), and 103 in the previously diagnosed T2DM (PT2DM) group, aged 57 years +/- 9 years, with the BMI of 23.5 kg/m(2) +/- 0.3 kg/m(2). Arginine at the dose of 10% 50 ml was injected intravenously in fasting situation. Two, four, and six minutes after blood samples were collected from a needle indwelling in the contralateral vein to examine the levels of plasma glucose (PG), true insulin (TI), and proinsulin (PI). RESULTS: (1) The TI and TI/PG levels of all groups peaked 2 minutes after arginine stimulation and then gradually decreased, however, the levels 6 minutes after stimulation were still higher than the baseline values. The peak values of TI and TI/PG were arranged from high to low in the order of IGT, NGT, NT2DM and PT2DM. The peak values of NT2DM and PT2DM groups were significantly lower than those of the NGT and IGT groups (all P < 0.01). The peak values of the NT2DM group were significantly higher than those of the PT2DM group (both P < 0.01). (2) The PI value of the IGT, NT2DM and PT2DM groups peaked 2 minutes after the stimulation and then gradually decreased with the peak values significantly higher than that of the NGT group (all P < 0.05). The fasting PI/TI and PI/(TI + PI) of the NGT group were all significantly lower than those of the IGT group (both P < 0.05). (3) The changes of PI/TI in each groups manifested almost the mirror image of TI/PG mentioned above, and the lowest PI/TI levels were observed 2 minutes after stimulation. The similar changes of PI/(TI + PI) were found. The lowest points of groups 2 minutes after stimulation was arranged from low to high in the order of NGT, IGT, NT2DM and PT2DM. CONCLUSION: The PI/TI and PI/(TI + PI) values 2 minutes after arginine stimulation may be used as predictors for beta cell function in clinical practice.

Adult↗
PubMed2006

Implications of microcirculation-research based information on prevention and treatment of diabetes mellitus type 2: a perspective.

Diabetes mellitus type 2 (T2DM) is a worldwide pandemic disease. T2DM and hypertension (HT) are closely related and classified as non-communicable diseases. These conditions represent as part of metabolic syndrome. Ageing is an independent risk factor of both diseases. Accumulation of reactive oxygen species (ROS) or imbalance of ROS and antioxidant system, which cause endothelial dysfunction (ED) through depletion of nitric oxide (NO), is likely to be the main risk factor in ageing, T2DM and HT. The organ that is rich in capillary blood supply like the islets of Langerhans and renal glomeruli, is theoretically prone to ED after long exposure to accumulation of various oxidants derived from dietary products, such as superoxide radical (O2-), hydroxyl radical (OH), malondialdehyde (MDA) and peroxynitrite (ONOO-), a potent long lived oxidant and cytotoxic. Preventive measures to correct imbalance of oxidant and antioxidation pathways and the sequential effects should be implemented since birth or childhood period by ways of proper diet, exercise, adequate supply of natural antioxidants and lifestyle modifications.

Diabetes Mellitus, Type 2↗
PubMed2006

[Effects of Jiangtang Bushen Recipe on serum C-reactive protein, tumor necrosis factor-alpha and interleukin-6 in patients with type 2 diabetes mellitus].

UNLABELLED: OBJECTIVE To observe the effect of Jiangtang Bushen Recipe (JBR) on inflammatory cytokines in patients with type 2 diabetes mellitus (T2DM), and explore its therapeutic mechanism. METHODS Sixty-four patients with T2DM were randomly divided into the treated group (n = 34) and the control group (n = 30). Education course, dietary treatment and conventional hypoglycemic agent were given to both groups, and JBR, mainly composed of Cibot Rhizome, Radix Dipsaci, Glossy Privet Fruit; Ecliptae Herba, Radicis Lycii, Radix Astragali, Rehmannia Dride Rhizome, etc., was given additionally to patients in the treated group, one dose a day for 4 weeks by boiled water and taking in two times. Fasting blood glucose (FBG), fasting insulin (FINS), interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a) and C-reactive protein (CRP) were measured, and insulin sensitive index (ISI) and clinical TCM symptom score were calculated before and after treatment. RESULTS: After treatment, the clinical symptom score dropped in both groups (P < 0.01), and it was lower in the treated group than that in the control group (P < 0.01). At the same time, serum levels of FINS, CRP, TNF-alpha and IL-6 decreased and ISI increased significantly, the effect showed in the treated group was also superior to that in the control group (P < 0.05). CONCLUSION: JBR, which could tonify Pi and Shen, nourish Yin and clear away heat, can improve insulin resistance and alleviate clinical symptoms of T2DM patients, the mechanism may be related with its actions in regulating the production of inflammatory cytokines and inhibiting inflammatory reac-

Adult↗
PubMed2005

Clinical pictures of type 2 diabetes in Thai children and adolescents is highly related to features of metabolic syndrome.

Prevalence of type 2 diabetes (T2DM) in children and adolescents has increased, parallelled to the increased prevalence of obesity around the world. The objectives of this study are (1) to identify the clinical presenting features of T2DM in Thai children and adolescents, and (2) to identify evidence of feature of metabolic syndrome in these affected. We analyzed 26 T2DM patients who were treated by Pediatric endocrinologists in our hospital. The study showed that their mean ages (+/- SD) at diagnosis was 12.1 +/- 2.3 years, all were obese and 96% had acanthosis nigricans. Fifty three percents (53%) presented with clinical signs and symptoms which included DKA (19.2%), clinical triad of polyuria, polydipsia and weight loss (15.4%), only polyuria, polydipsia (11.5%) and abnormal menstruation (7%). The rest of 46.2% had no clinical symptoms. The initial fasting or random plasma glucose found above diagnostic range in 84.5%, the rest of 15.5% were diagnosed by using oral glucose tolerance test. Dyslipidemia was found in 75%. Fifteen percents had no family history. Eighty percents had three or more than three features of metabolic syndrome. In conclusions, clinical picture of type 2 diabetes in Thai youth varied from asymptomatic to severe illness (DKA). Almost all had clinical features of metabolic syndrome. Childhood obesity has become epidemic in our population. Such clinical picture should alert all pediatricians to be aware of chronic diseases and for making an early diagnosis and preventing long-term complications in the future.

Adolescent↗
PubMed2006

Association of angiotensin converting enzyme gene I/D polymorphism with type 2 diabetes mellitus.

OBJECTIVE: To investigate the association of angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism with type 2 diabetes mellitus (T2DM). METHODS: Two hundred and nine patients with T2DM diagnosed based on the criteria for diabetes mellitus in 1999 by WHO and 221 controls were recruited from general population of Dongcheng District in Beijing. All subjects were genotyped for the I/D polymorphism of ACE gene by PCR-fragment length polymorphism (FLP) assay. Blood pressure, levels of plasma glucose, lipids and serum insulin were determined. Body mass index (BMI), waist-hip ratio (WHR) and homeostasis model assessment-insulin resistance index (HOMA-IR) were calculated. RESULTS: The genotype frequencies for ACE genes DD, ID, and II were 19.1%, 42.1%, and 38.8% in patients, respectively, and 9.6%, 49.4%, and 41.0% in controls, respectively. The ACE DD genotype frequency was significantly higher in patients than in controls (chi2 = 7.61, P = 0.022). Multivariate logistic regression analysis showed that the ACE DD genotype was a risk factor for T2DM, with the OR of 2.35 (95% CI 1.17-4.71) adjusted for age, sex, BMI, WHR, blood pressure, and serum cholesterol levels. CONCLUSION: The ACE DD genotype is associated with the increased susceptibility to type 2 diabetes mellitus.

Adult↗