一例成人隐匿性自身免疫性糖尿病足并低蛋白血症的护理

目的:探讨糖尿病足临床治疗方法,为糖尿病足患者提供专业正确治疗和护理。方法:对广西玉林市第一人民医院内分泌科一例成人隐匿性糖尿病足并低蛋白血症进行护理,给予抗感染,控制血糖同时做好心理护理、饮食指导、支持治疗及皮肤护理,落实VSD负压封闭引流技术。结果:经过有效治疗及护理取得较好疗效,治愈出院。结论:细致落实各项基础护理及专科护理,有利于糖尿病足创口愈合,缩短糖尿病足患者住院时间,提高患者生活质量。     

2型糖尿病患者高胰岛素血症的研究

2 型糠尿病患者的高胰岛素血症为众多学者所关注。本文对148 例2 型糠尿病患者进行研究,结果显示高胰岛素血症者(A 组)42 例,占28-4 % ,空腹胰岛素为28-7 ±10-2mIu/L,胰岛素/ 血糖比为3-9 ±0-5 ,较对照组(B组) 明显增高,二者有显著性差异;且高胰岛素血症组高血压、冠心病、高血脂、肥胖的发生率明显增高。提示:2 型糖尿病高胰岛素血症患者存在胰岛素抵抗,其X综合症的发生率明显增高     

高原藏族新生儿高胆红素血症299例临床分析

目的 分析该院近2年新生儿高胆红素血症的发生情况、胆红素峰值及病因,为高原新生儿胆红素研究提供数据,为新生儿胆红素血症的预防及规范化管理提供依据。方法 回顾性总结了自2019年1月—2021年7月以黄疸相关主诉就诊于西藏自治区人民医院儿科的藏族近足月儿（>35周）,描述了胆红素峰值分布情况、不同胎龄间的比较、伴发症分析及脑病患儿特征描述。结果 299例新生儿高胆红素血症病例数据中严重高胆红素血症109例（36.5%）,急性胆红素脑病病例6例,占严重高胆红素血症的5.5%.发现黄疸日龄4天（范围：1～26d）,平均入院日龄7天（范围:1～30d）,TSB峰值为342.45±65.23μmol/L。纳入病例中有91%伴有不同程度的感染,2例存在ABO自身免疫性溶血。结论 该研究数据展示了藏族近足月新生儿胆红素峰值分布情况,严重高胆红素血症患儿及脑病患儿的占比较高。因此,加大新生儿黄疸相关科普知识受众面,建立系统、全面的随访,为严重高胆红素血症的预防及规范化管理提供依据。     

腹部电针治疗单纯性肥胖并高脂蛋白血症

单纯性肥胖病是一种全身内分泌代谢疾病，其合并高脂蛋白血症是近年来临床常见多发病。肥胖并高脂蛋白血症增加了心、脑血管、糖尿病等的发病率，严重影响人们的健康和生活质量，而减肥降脂药毒副作用较大，经济负担大，应用受到限制。腹部电针治疗单纯性肥胖并高脂蛋白血症，简单易行，无毒副作用，疗效确切逐渐被广大患者认可，笔者经临床观察30例整理后报道如下：     

81例糖尿病合并肺部感染临床分析

目的：探讨糖尿病合并肺部感染的临床治疗特点。方法：对2009年9月至2012年11月收入本院的81例糖尿病患者合并肺部感染进行回顾性的分析。结果：显效66例（81．48％）,缓解9例（11．11％）;无效6例（7．4％）。结论：糖尿病患者易发生肺部感染,而血糖控制情况与糖尿病患者合并肺部感染关系极为密切。应监测患者血糖定期做胸部X线检查,以便达到早诊断早治疗的目的。     

糖尿病合并肺部感染12例临床分析

目的本研究的目的旨在进一步规范该类病人的血糖管理。方法选取我科近年来入院患者中糖尿病合并肺部感染的患者12例,进行临床整体观察。结果糖尿病患者因免疫力低下易发生肺部感染,部分患者症状轻微,且空腹血糖不高,原则应使用胰岛素治疗,目前临床易忽略,而导致急性严重的并发症、合并症。结论减少糖尿病的并发症、合并症以预防为主,有效提高治疗的效果。     

1例糖尿病合并脑梗死患者的护理

目的:探讨1例糖尿病合并脑梗死患者的护理措施。方法:选取广西中医药大学第一附属医院于2017年2月~2017年3月护理的1例糖尿病合并脑梗死的患者,对其进行临床评估和护理诊断,并给予患者相应的护理措施,以促进患者的病情改善。结果:该患者住院期间血糖波动大,右侧肢体偏瘫对其生活信心打击大,因此,对治疗的依从性差,态度消极。通过反复沟通,循序渐进的进行护理干预,在患者出院时患者治疗依从性好,积极主动进行肢体功能康复训练,空腹血糖6.7~8.4mmol/L,餐后2h血糖8.0~11.7mmol/L右侧上下肢肌力3级恢复至肌力4级。结论:对于需要改变患者的不良疾病行为时,应充分尊重患者个人意愿,并且需要从小方面着手,过程中观察患者接受程度循序渐进,当患者依从性较差时,及时交流找出原因,早期制定护理方案,尽快促进患者病情改善,并提高患者的生活质量。     

80例非胰岛素依赖性糖尿病患者前臂尺,桡骨骨密度分析

用单光子吸收法（ＳＰＡ）对杭州市汉族５０岁以上的８０例非胰岛素依赖性糖尿病（ＮＩＤＤＭ）患者和年龄、性别与ＮＩＤＤＭ患者相配对的４３１名正常人的前臂尺、桡骨骨密度（ＢＭＤ）进行测定，发现女性轻中型和重型组、男性重型组ＮＩＤＤＩＭ患者的尺桡骨平均ＢＭＤ显著地低于正常人（Ｐ＜０．０１）；本组ＮＩＤＤＭ患者（男女合计）的一般性骨质疏松症（ＧＯＰ）和进行性骨质疏松症（ＰＯＰ）的发病率分别为６３．７５％和８．７５％，与正常人组相比较差异非常显著（Ｐ＜０．０１）；不同病程ＮＩＤＤＭ患者组别间尺桡骨平均ＢＭＤ的差异不显著（Ｐ＞０．０５），提示ＮＩＤＤＭ的病程与ＢＭＤ的相关程度不密切。     

原发性高血压与高纤维蛋白原血症：（附68例分析）

本文测定了68例原发性高血压患者的血浆纤维蛋白原浓度,并与50例正常血压者作了对照,发现原发性高血压组的血浆纤维蛋白原浓度为700.3±211.4 mg/dl,比对照组高(P相似文献   

浅谈老年糖尿病人的家庭护理

目的：院提高老年糖尿病人家庭护理的质量和纠正病人不良的生活习惯,使其保持良好的心理状态,活动能力,促进康复治疗。方法院通过理论研究,在家庭中对老年患者进行心理护理,饮食治疗,运动疗法,用药指导,并发症的预防,随访与记录以及健康教育。结果院防止急性并发症的发生和减低慢性并发症的风险,对已经发生的并发症进行有效控制,提高患者生活质量,延长患者寿命。结论院积极有效的家庭护理得到老年患者和社会的认可,对老年糖尿病的治疗具有关键性的作用。     

糖尿病与胃轻瘫的关系

介绍了糖尿病与胃轻瘫的关系。糖尿病胃轻瘫的发病机理可能与糖尿病植物神经病变、平滑肌变性、高血糖等有关。诊断胃排空时间的方法有Ｘ线监视、胃肠电分析、Ｂ型超声及核素标记的试餐（金标准）。采用促胃动力药物如胃复安、多潘立酮、西沙比利、红霉素入Ｒｅｎｚａｐｒｉｄｅ对糖尿病胃轻瘫有一定的疗效。一旦被诊断为糖尿病胃轻瘫,宜及早使用促胃动力药,可改善糖尿病胃轻瘫的大部分症状和体征。     

Thyroid Disorders in Patients of Type 2 Diabetes Mellitus

The study was planned to assess the prevalence of thyroid disorders in type 2 diabetes in North Indian population and to correlate the serum insulin and glycosylated haemoglobin levels with thyroid hormones. It is a case control study. One hundred and twenty patients of type 2 diabetes were included in the study along with 117 adults of the same age group and normal glucose levels as controls. All blood samples were taken from subjects who fasted for at least 12 h before the blood collection. Glycosylated hemoglobin was determined by ion exchange chromatography and serum insulin and thyroid hormones were assessed through enzyme linked immunosorbent assay. Fasting blood glucose and glycosylated haemoglobin levels were significantly higher in diabetics showing a poor glucose control. Serum tri-iodothyronine values were significantly lower in diabetics. There was a significant correlation between glycosylated haemoglobin and thyroid hormones. There was no correlation between serum insulin and thyroid hormones.     

Acetylation Pharmacogenetics and Renal Function in Diabetes Mellitus Patients

Activities of human hepatic drug metabolizing enzymes N-acetyl transferase (NATS) had earlier been recognized as a cause of inter-individual variation in the metabolism of drugs. Therefore acetylation of many drugs in human exhibit genetic polymorphism. The aim of the study was to investigate if acetylator status predispose diabetic mellitus patients more to the complications of renal disease, One hundred and twenty (120) diabetics consisting of (50) Type 1 (T₁) and 70 Type 2 (T₂) diabetes mellitus patients and 100 healthy individuals as controls were classified as slow or rapid acetylator using sulphamethazine (SMZ) as an in vivo probe. The percentage acetylation, recovery of SMZ, creatinine clearance and presence of urinary albumin were determined. A significant difference (P < 0.05) was observed in the percentage of SMZ acetylated between slow and rapid acetylators in control, T₁ and T₂ subjects. The ratios of slow to rapid acetylators for T₁, T₂ and control subjects were 1:4, 3:2 and 2:3 respectively. No significant differences were observed in the percentage of SMZ recovered in the urine of slow and rapid acetylators that are diabetics. The difference in creatinine clearance of slow and rapid acetylators in T₁ and T₂ were significant (P < 0.05). 29% out of 120 (24.2%) diabetics (T₁ and T₂) exhibited albuminuria out of which 25 (86.2%) had slow acetylator status. These findings suggest that slow acetylator status in diabetes mellitus could be a predisposing factor in the development of renal complications. This underscores the need for a rapid pharmacogenetic testing and therapeutic drug monitoring in such patients. However this inference could be further validated with a larger sample size.     

Adiponectin Gene Polymorphism and its Association with Type 2 Diabetes Mellitus

Mutations in different regions of adiponectin gene have been reported to be associated with obesity, atherosclerosis and type 2 diabetes mellitus. The present study was aimed to investigate the association among SNP 45 T > G of adiponectin gene and type 2 diabetes in South Indian population. 75 clinically diagnosed case of type 2 diabetes were studied and compared with 75 apparently healthy controls. The genotype frequency of SNP45 T > G in exon 2 of adiponectin gene was determined by PCR based restriction enzyme analysis using the restriction enzyme SmaI. (recognition site: CCC↓GGG). Three kind of genotypes: wild type TT (470 bp), heterozygous type TG (470 bp, 336 bp, 134 bp) and homozygote mutant type GG (336 bp, 134 bp) were studied. A positive association has been found between SNP45 T > G and type 2 diabetes in the study population (P = 0.010, OR = 3.797, 95% CI = 1.312–10.983). Therefore, SNP45T > G in adiponectin gene may be one of the risk factors for type 2 diabetes.     

Evaluation of Oxidative Stress in Type 2 Diabetes Mellitus and Follow-up Along with Vitamin E Supplementation

Increased oxidative stress is a widely accepted participant in the development and progression of diabetes and its complications. The present study has been undertaken to evaluate oxidative stress in type 2 diabetes mellitus and effect of vitamin E supplementation on oxidative stress. In all 120 subjects were enrolled in the present study, 40 subjects are age and sex matched controls. Test group comprised of clinically diagnosed (n = 80) type 2 diabetic patients. Biochemical parameters like serum MDA, nitric oxide, superoxide dismutase, erythrocyte reduced glutathione and platelet aggregation were analyzed in control and diabetic group. Test group is further categorized as Group I (n = 40) diabetics were treated by only hypoglycemic drugs and Group II (n = 40) diabetics were treated by hypoglycemic drugs with vitamin E supplementation. All above biochemical parameters were again reassessed after 3 months follow-up in both group and its values were compared with its respective baseline levels. The study shows, reduction of oxidative stress, improvement in antioxidant enzymes and endothelial dysfunction in group II, those were on treatment of hypoglycemic drugs along with vitamin E supplementation. Hence the present study may conclude that vitamin E supplementation along with hypoglycemic drugs may be beneficial to type 2 DM patients to minimize vascular complications.     

Endothelial Dysfunction in Type 2 Diabetes Mellitus

Endothelial dysfunction is an imbalance in the production of vasodilator factors and when this balance is disrupted, it predisposes the vasculature towards pro-thrombotic and pro-atherogenic effects. This results in vasoconstriction, leukocyte adherence, platelet activation, mitogenesis, pro-oxidation, impaired coagulation and nitric oxide production, vascular inflammation, atherosclerosis and thrombosis. Endothelial dysfunction is focussed as it is a potential contributor to the pathogenesis of vascular disease in diabetes mellitus. Under physiological conditions, there is a balanced release of endothelial-derived relaxing and contracting factors, but this delicate balance is altered in diabetes mellitus and atherosclerosis, thereby contributing to further progression of vascular and end-organ damage. This review focuses on endothelial dysfunction in atherosclerosis, insulin resistance, metabolic syndrome, oxidative stress associated with diabetes mellitus, markers and genetics that are implicated in endothelial dysfunction.     

Association of Aberrations in One Carbon Metabolism with Intimal Medial Thickening in Patients with Type 2 Diabetes Mellitus

The present work was aimed to study the association of one carbon genetic variants, hyperhomocysteinemia and oxidative stress markers, i.e., serum nitrite, plasma malondialdehyde (MDA) and glutathione (GSH) on intimal medial thickening (IMT) in patients with type 2 diabetes mellitus (T2D). A total number of 76 subjects from ACS Medical College and Hospital, Chennai, India were included in the study, i.e., Group I (n = 42) of T2D and Group II (n = 34) of age- and sex matched healthy controls. The glycated haemoglobin was measured by ion-exchange resin method; plasma homocysteine by Enzyme Linked Immunosorbant Assay method; serum nitrite (nitric oxide, NO), plasma MDA and GSH by spectrophotometric methods; the IMT by high frequency ultrasound. The polymorphisms of one carbon genetic variants were genotyped using polymerase chain reaction-restriction fragment length polymorphism and amplified fragment length polymorphism methods. Results indicate that methyltetrahydrofolate homocysteine methyl transferase (MTR) A2756G allele was found to be protective in T2D and the other variants were not significantly associated with T2D. Glutamate carboxypeptidase II (GCP II) C1561T (r = 0.34; p = 0.05) and methylene tetrahydrofolate reductase (MTHFR) C677T (r = 0.35; 0.04) showed positive correlation with plasma homocysteine in T2D cases. In this study, MTR A2756G allele was found to be protective in T2D; GCP II C1561T and MTHFR C677T showed positive association with plasma homocysteine in T2D cases. Among all the genetic variants, MTR A2756G was found influence IMT. RFC 1 G80A and TYMS 5′-UTR 2R3R showed synergistically interact with MTR A2756G in influencing increase in IMT.     

胆囊收缩素与糖尿病合并胆囊结石的关系

目的 探讨在糖尿病合并胆囊结石的情况下胆囊收缩素可能起到的影响和作用.方法 综合近几年相关研究方面的文献并进行综述.结果 在糖尿病患者体内胆囊收缩素的水平较正常值有明显的改变,异常水平的胆囊收缩素对胆囊结石的形成起到了很大的影响作用.另外,胆囊收缩素的受体异常也可以引起胆囊结石.结论 胆囊收缩素在糖尿病合并胆囊结石的发病中产生了很大的影响.     

元极疗法调治糖尿病的临床研究(附31例报告)

以元极医学理论为指导,病人自己坚持练功,元极教师发放三元能量,对３１例糖尿病人进行调治,血糖、尿糖降低显著,症状明显改善。病人调治第１５ｄ和第３０ｄ,有效率均达９０．３％,表明以元极功法调治糖尿病患者,对于改善病情,提高病人生活质量是一种有效的方法。