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Advances in Research of MicroRNA in The Pathogenesis of Type 2 Diabetes

Objective　To summarize the relationship of diabetes and its complications with microRNA. Methods　Domestic and international researches were collected by searching to summarize the role of microRNA in diabetes and its complications. Results　MicroRNA could affect the secretion of insulin and interfer metabolism of gulcose in fat cells， muscle cells， and liver cells， which resulting in insulin resistance. At the same time， the microRNA also played an role in damage of vascular endothelial cells and myocardial cell in diabetes. Conclusion　MicroRNA acts an important role in the process of diabetes and its complications.

2型糖尿病肥胖患者口服降糖药失效启用胰岛素治疗方案的探讨

【摘要】　目的　探讨2型糖尿病肥胖患者在口服降糖药继发失效的情况下启用胰岛素治疗方案的选择。　方法　选择2009年1月-2010年12月间40例口服降糖药失效的2型糖尿病肥胖患者，随机分为两组，每组20例。A组原口服药不变，睡前联用长效胰岛素（商品名:来得时）治疗，B组停用口服药，于早晚餐前使用预混胰岛素（商品名：诺和灵30R），治疗共3个月，分别于治疗前后观察空腹血糖、餐后2 h血糖、糖化血红蛋白、血脂、血压、体质量指数的变化，记录低血糖发生次数，并填写问卷调查表，评估患者对治疗方案的满意度和接受度。　结果　两个组治疗后空腹血糖、餐后2 h血糖、糖化血红蛋白均较治疗前明显下降（Plt;0.01），而血脂、血压变化不大；但B组体质量指数有轻微升高（Pgt;0.05），且每日胰岛素用量较A组更大（Plt;0.01），低血糖反应更多（Plt;0.05），满意度和接受度不如A组高（Pgt;0.05）。　结论　对2型糖尿病肥胖患者在口服降糖药继发失效的情况下启用胰岛素治疗，选用口服降糖药联合基础胰岛素的治疗方案具有作用佳、安全性好，体重增加不明显，患者依从性更高的特点。【Abstract】　Objective　To investigate the selection of insulin therapy for obese patients with type 2 diabetes mellitus (T2DM) after the failure of oral antihyperglycemic drugs.　Methods　Forty obese T2DM subjects who failed the therapy of oral antihyperglycemic drugs between January 2009 and December 2010 were divided into 2 groups randomly. Patients in group A (n=20) continued using oral antihyperglycemic agents while long-acting insulin (Lantus) was added at bedtime; Patients in group B (n=20) used premixed insulin (Novolin 30R) injection before breakfast and supper instead of the oral drugs. The treatment lasted for 3 months for both groups. Fasting plasma glucose (FPG), blood glucose 2 hours after breakfast (2hPG), glycated hemoglobin (HbA1c), serum lipids, blood pressure, and body mass index (BMI) were examined before and after the trial respectively. We evaluated the satisfaction and acceptance level in all subjects who underwent the treatment with questionnaires.　Results　FPG, 2hPG, HbA1c after the treatment were significantly lower than those before the treatment in both two groups (Plt;0.01), while serum lipids and blood pressure showed no significant differences. Patients in group B had slightly higher BMI (Pgt;0.05) after the treatment. Compared with patients in group A, they needed a larger insulin dosage (Plt;0.01), had higher hypoglycemia frequency (Plt;0.05) and lower satisfaction and acceptance level (Pgt;0.05).　Conclusion　For obese patients with T2DM who have failed the therapy of oral antihyperglycemic drugs, combined oral antihyperglycemic drugs with basic insulin has better effects, security, and compliance, and less weight gain.

Study on the Relationship between Serum Visfatin and Eldly Type 2 Diabetes Mellitus withMacrovascular Lesion

目的:探讨visfatin与老年2型糖尿病及其大血管并发症和相关代谢指标的关系。方法:将66例老年糖尿病患者分为合并大血管病变组（MCV）35例和非大血管病变组（nMCV）31例，并选64例健康人做对照。采取酶联免疫测定法（ELISA）测定空腹血清visfatin浓度；并测定各组的空腹血糖、胰岛素、血压和血脂水平；用胰岛素抵抗指数（HOMAIR）HOMAIR评价胰岛素抵抗，分析各指标间的相关性及与大血管并发症的相关性。结果:①老年2型糖尿病组血清visfatin浓度高于正常对照组，差异有统计学意义（Plt;0.01）。但正常对照组与2型糖尿病组中nMCV组比较，visfatin浓度差异无统计学意义（Pgt;0.05）。②老年2型糖尿病组中大血管病变组（MCV）血清visfatin浓度明显高于非大血管病变组（nMCV），差异有统计学意义（Plt;0.01）。③相关分析显示，老年2型糖尿病组血清visfatin浓度与腰围（WC）、甘油三酯（TG）均呈显著正相关，与性别、年龄、HOMAIR呈正相关。进一步以visfatin为应变量，以年龄、性别、BMI、WC、收缩压（SBP）、舒张压（DBP）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、空腹血糖（FPG）、空腹胰岛素（FINS）、HOMAIR为自变量进行多元逐步回归分析，TG、WC和年龄是血清visfatin独立相关因素。④在老年T2DM组，以有无大血管并发症为应变量（Y=1，n=0），各指标为自变量，进行logistic回归分析，visfatin进入回归方程。结论:血清visfatin与2型糖尿病的发病不相关，但在老年2型糖尿病中与其大血管并发症有关。

Key Points of Surgical Treatment of Type 2 Diabetes Mellitus

Efficacy of Roux-en-Y Gastric Bypass for Obesity and Its Comorbidities: A Meta-Analysis

ObjectiveTo systematically review the efficacy of Roux-en-Y gastric bypass for obesity and its comorbidities. MethodsSuch databases as PubMed, EMbase, The Cochrane Library (Issue 11, 2013), CBM, CNKI, VIP and WanFang Data, etc. were electronically searched from inception to November 2013, for including all studies on Roux-en-Y gastric bypass for obesity and its comorbidities. According to inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and evaluated methodological quality of included studies. And then meta-analysis was performed using RevMan 5.3 software. ResultsA total of 25 before and after self-control studies involving 2 966 cases with overweight or obesity were included. The results of meta-analysis showed that:after Roux-en-Y gastric bypass operation, the patients had significant reduction in BMI (MD=-16.40, 95%CI-17.42 to-15.38, P < 0.000 01), type 2 diabetes mellitus prevalence (RR=0.23, 95%CI 0.17 to 0.31, P < 0.000 01), and hypertension prevalence (RR=0.34, 95%CI 0.26 to 0.43, P < 0.000 01); besides, fasting glucose, blood pressure and serum lipid levels obviously decreased (P < 0.000 01). ConclusionRoux-en-Y gastric bypass for obesity patients is effective in reducing weight loss, type 2 diabetes mellitus incidence and cardiovascular disease incidence. Due to the limitation of the design of the included studies, the conclusion needs to be verified by further conducting high quality randomized controlled trials with large sample-size.

Research progress on type 2 diabetic retinopathy in adolescents

The incidence of obesity and type 2 diabetes mellitus (T2DM) in adolescents has been rapidly increasing over the past two decades due to dramatic changes in dietary structure and physical activity. The incidence of diabetic retinopathy (DR), a serious vision-threatening complication of diabetes, is also increasing yearly in the adolescent population with T2DM. Due to the insidious onset of retinal diseases in the early stages, regular screening is important for the timely diagnosis of DR. However, there are still problems such as low attention of the population and insufficient screening rate. In the future, we should strengthen the health education of the adolescent population and optimize the control of risk factors such as blood glucose and blood pressure. At the same time, appropriate screening strategies should be actively developed, and the use of telemedicine and emerging technologies should be promoted for early detection of treatable lesions to improve patient prognosis.

Correlation between type 2 diabetes mellitus and kidney cancer: a meta-analysis

ObjectiveTo systematically review the correlation between type 2 diabetes mellitus (T2DM) and the risk of kidney cancer. MethodsPubMed, EMbase, Web of Science, CBM, VIP and CNKI databases were electronically searched to collect cohort studies on the association between T2DM and kidney cancer from inception to August 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis then performed by using Stata 15.0 software. ResultsA total of 17 cohort studies involving 2 003 165 T2DM patients were included. The results of meta-analysis showed that patients with T2DM had a higher kidney cancer risk than controls (RR=1.51, 95%CI 1.39 to 1.64, P<0.001). Subgroup analysis showed that the incidence of kidney cancer in T2DM patients was higher in different gender, region, population, follow-up time, diabetes assessment method and other subgroups. ConclusionsCurrent evidence shows that T2DM is a risk factor for kidney cancer.

Survey and Analysis of Insulin-treated Type 2 Diabetes Patients’ Self-monitoring of Blood Glucose

目的　了解接受胰岛素治疗的糖化血红蛋白＞7.5%的2型糖尿病患者自我血糖监测现状及存在的问题，为帮助患者建立健康行为提供理论依据。 方法　对2008年12月－2011年2月住院治疗的128例符合纳入标准的患者进行问卷调查。调查内容包括患者一般资料、血糖控制情况、自我监测相关知识及技能等内容。 结果　共发放问卷128份，收回128份，其中有效问卷122份。糖尿病患者血糖自我监测知识获取渠道单一，且相关知识匮乏；不能制定正确血糖自我监测方案，不能对检测结果进行正确记录和汇报；血糖检测操作不正确，检测频率达不到标准要求。 结论　接受胰岛素治疗的2型糖尿病患者自我监测现状并不容乐观，患者自我监测行为缺乏。为此，提高糖尿病患者健康教育水平，帮助其建立并维持健康行为，是糖尿病教育工作的重点和挑战。

Related ED Risk Factors and Clinic Therapy Evaluation in 120 Type 2 Male Diabetic Mellitus

摘要:目的: 总结2型糖尿病患者阴茎勃起功能障碍(ED)的相关危险因素及临床治疗评价。 方法 :分析收集两家医院120例住院及门诊2型糖尿病男性患者的性功能状况、年龄、糖尿病病程、血压、糖化血红蛋白、血脂、吸烟与否等指标,以及接受真空负压吸引联合万艾可治疗的79名患者追踪3个月的疗效评分。 结果 :男性2型糖尿患者中ED的患病率为658%,多因素回归分析显示患者年龄、糖尿病病程、糖化血红蛋白与ED的发生独立相关,而血压、血脂等因素〖WTBX〗P ＞005,无显著性差异。接受真空负压吸引联合万艾可治疗的79例ED患者其有效率达到759%。 结论 :男性2型糖尿病患者中ED是常见的合并症,患病率随年龄、糖尿病病程、糖化血红蛋白的增加而增加。真空负压吸引联合万艾可治疗糖尿病合并ED疗效可靠。Abstract: Objective: Make a conclusion on related ED risk factors and clinic therapy evaluation in 120 Type 2 male diabetic mellitus. Methods : Analyze and collect 120 cases in two hospitals regarding sexual function,age,diabetes course,blood pressure,HbA1c,bolldfat, smokingcondition,etc;follow up 79 cases for 3months and evaluate therapy as a result of vacuum subpressure absorption associated with viagra (sildenafil) therapy. Results : The ED rate in Type 2 male diabetic is 658%;the multifactorial regression analysis shows that occurrence of ED is respectively related with age,diabetes course,HbA1c;there isn’t obvious discrdpancy in blood pressure,blood fat,etc(P ＞005); the effective rate of vacuum subpressure absorption associated with Viagra (sildenafil) therapy in 79 cases is759%. Conclusion : It’s common complications to get ED among the Type 2 male Diabetics and the case rate goes up with the increase of age,diabetes course, HbA1c;it’s reliable to take therapy of vacuum subpressure absorption associated with Viagra.

Contimuous Subcutaneous Insulin Infusion versus Multiple Daily Insulin Injections in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A Systematic Review

Objective?To compare the effect of continuous subcutaneous insulin infusion (CSII) with that of multiple daily insulin injections (MDI) in the patients with newly-diagnosed type 2 diabetes, and to provide evidence for clinical treatment. Methods?We searched MEDLINE and Chinese Science and Technology Full-text Database up to Dec. 2009 to identify randomized controlled trials (RCTs) that had been conducted with patients with newly diagnosed type 2 diabetes mellitus. The selection of studies, data extraction and assessment of methodological quality were performed independently by two reviewers. Meta-analyses were performed using RevMan 5.0.23 software. The following outcomes were assessed: glycaemic control, insulin requirements, HOMA-IR, HOMA-β, hypoglycaemia and diabetic remission after follow-up. Results?Eight RCTs involving 597 newly-diagnosed type 2 diabetic patients were included. The methodological quality of the most studies was lower. The funnel plot comparing insulin requirement of CSII therapy with that of MDI therapy showed asymmetry, indicating that there was publication bias. The results of meta-analyses showed that: CSII had the same effect on improving fasting blood glucose (WMD= –0.21, 95%CI –0.42 to 0.00, P=0.05) and postprandial blood glucose (WMD= –0.24, 95CI% –0.57 to 0.08, P=0.14) as MDI in newly-diagnosed type 2 diabetes. CSII therapy took 2.74 days fewer than MDI therapy (WMD= –2.74, 95CI% –3.33 to –2.16, Plt;0.000 01) and needed lower insulin requirements (reducing 7.78 units per day) (WMD= –7.78, 95CI% –9.25 to –6.31, Plt;0.000 01) to get target glucose control. The rate of hypoglycaemia of CSII therapy decreased 69% (OR= 0.31, 95%CI 0.12 to 0.80, P=0.01) compared with that of MDI. The rate of diabetes remission after short-term intensive insulin therapy increased 46% (OR=1.46, 95%CI 1.01 to 2.10, P=0.04) in CSII therapy compared with that in MDI therapy. Conclusion?In newly-diagnosed type 2 diabetes, CSII therapy is better than MDI therapy. But because of the low quality of the included studies, the conclusion should be combined with patients and physicians’ experience, advantages and disadvantages in the clinical application.