首页 > 最新文献

Experimental and Clinical Endocrinology & Diabetes最新文献

英文 中文
Video Consultation for Parents with a Child Newly Diagnosed with Type 1 Diabetes: A Qualitative Study. 儿童新诊断为1型糖尿病的家长视频咨询:一项定性研究。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-08-01 Epub Date: 2021-10-20 DOI: 10.1055/a-1655-5471
Jana Doerdelmann, Fabian-Simon Frielitz, Karin Lange, Tanja Meinsen, Sandra Reimers, Tanja Ottersberg, Alexander Katalinic, Olaf Hiort, Simone von Sengbusch

Aims: With the exception of the coronavirus pandemic, video consultations have not been a part of the standard care for children with diabetes in Germany. The "Virtual Diabetes Outpatient Clinic for Children and Adolescents 2.0" (VIDIKI 2.0) study investigated the effect of monthly and supplementary video consultations on standard care over one year. The qualitative substudy investigated the experiences of families with a child newly diagnosed with type 1 diabetes mellitus (T1DM) who received at least four weekly supplementary video consultations.

Methods: Guideline-based qualitative interviews were conducted with seven families with children under the age of eight and T1DM onset shortly before study entry. The answers were analyzed using a qualitative content analysis approach, particularly inductive category formation.

Results: Families of patients with T1DM onset have questions, almost daily, concerning various aspects of insulin therapy. The offer of high-frequency video consultations can reduce the number of trips to the diabetes team, facilitate the organization of daily life and increase the sense of security.

Conclusion: Video consultations as a supplementary offer of health care, especially after diabetes onset, were considered very helpful by the affected families. High-frequency video consultations may provide a tool to overcome existing deficiencies in specialized diabetes care.

目的:除冠状病毒大流行外,视频咨询尚未成为德国糖尿病儿童标准护理的一部分。“儿童和青少年虚拟糖尿病门诊2.0”(VIDIKI 2.0)研究调查了一年多来每月和补充视频会诊对标准治疗的影响。定性亚研究调查了有新诊断为1型糖尿病(T1DM)儿童的家庭的经历,这些家庭每周至少接受4次补充视频咨询。方法:以指南为基础的定性访谈对7个家庭进行了研究,这些家庭有8岁以下的儿童,并在研究开始前不久发病T1DM。使用定性内容分析方法对答案进行分析,特别是归纳类别形成。结果:T1DM起病患者家属几乎每天都会对胰岛素治疗的各个方面提出疑问。提供高频视频会诊,可以减少糖尿病团队的往返次数,方便日常生活的组织,增加安全感。结论:视像会诊作为一种补充性的医疗服务,特别是在糖尿病发病后,被认为对糖尿病患者家庭非常有帮助。高频视频会诊可能为克服糖尿病专科护理的现有缺陷提供一种工具。
{"title":"Video Consultation for Parents with a Child Newly Diagnosed with Type 1 Diabetes: A Qualitative Study.","authors":"Jana Doerdelmann,&nbsp;Fabian-Simon Frielitz,&nbsp;Karin Lange,&nbsp;Tanja Meinsen,&nbsp;Sandra Reimers,&nbsp;Tanja Ottersberg,&nbsp;Alexander Katalinic,&nbsp;Olaf Hiort,&nbsp;Simone von Sengbusch","doi":"10.1055/a-1655-5471","DOIUrl":"https://doi.org/10.1055/a-1655-5471","url":null,"abstract":"<p><strong>Aims: </strong>With the exception of the coronavirus pandemic, video consultations have not been a part of the standard care for children with diabetes in Germany. The \"Virtual Diabetes Outpatient Clinic for Children and Adolescents 2.0\" (VIDIKI 2.0) study investigated the effect of monthly and supplementary video consultations on standard care over one year. The qualitative substudy investigated the experiences of families with a child newly diagnosed with type 1 diabetes mellitus (T1DM) who received at least four weekly supplementary video consultations.</p><p><strong>Methods: </strong>Guideline-based qualitative interviews were conducted with seven families with children under the age of eight and T1DM onset shortly before study entry. The answers were analyzed using a qualitative content analysis approach, particularly inductive category formation.</p><p><strong>Results: </strong>Families of patients with T1DM onset have questions, almost daily, concerning various aspects of insulin therapy. The offer of high-frequency video consultations can reduce the number of trips to the diabetes team, facilitate the organization of daily life and increase the sense of security.</p><p><strong>Conclusion: </strong>Video consultations as a supplementary offer of health care, especially after diabetes onset, were considered very helpful by the affected families. High-frequency video consultations may provide a tool to overcome existing deficiencies in specialized diabetes care.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":"130 8","pages":"519-524"},"PeriodicalIF":1.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39560142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Idiopathic Frozen Shoulder in Individuals with Diabetes: Association with Metabolic Control, Obesity, Antidiabetic Treatment and Demographic Characteristics in Adults with Type 1 or 2 Diabetes from the DPV Registry. 糖尿病患者的特发性肩周炎:与1型或2型糖尿病成人的代谢控制、肥胖、抗糖尿病治疗和人口统计学特征的关联
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-07-01 Epub Date: 2021-08-23 DOI: 10.1055/a-1543-8559
Alexander J Eckert, Maike Plaumann, Sigrid Pehlke, Christof Beck, Steffen Mühldorfer, Uwe Weickert, Markus Laimer, Martin Pfeifer, Lars Stechemesser, ReinhardW Holl

Aims: To examine the association of frozen shoulder (FS) with demographic and diabetes-related outcomes in individuals with type 1 (T1D) or type 2 (T2D) diabetes aged ≥30 years.

Materials and methods: Multivariable logistic regression models, adjusted for demographics were used to calculate the proportion of FS in association with age, gender, diabetes duration, body mass index (BMI), haemoglobin A1C (HbA1c) and diabetes treatment.

Results: The unadjusted percentage of FS was higher in T1D compared to T2D (0.22% vs. 0.06%). In T1D, adjusted regression models revealed higher prevalence of FS in women than men (0.26 [0.20-0.34] % vs. 0.15 [0.11-0.21] %, p=0.010). No significant relationship of age and BMI with FS was found in both diabetes types. Longer diabetes duration was associated with a higher proportion of FS in T1D (p<0.001) and T2D (p=0.004). In T1D, HbA1c >7% was related to a higher proportion of FS compared to HbA1c ≤7% (0.25 [0.19-0.32] vs. 0.12 [0.08-0.20] %, p=0.007), while an inverse relationship was found in T2D (HbA1c ≤7%: 0.08 [0.07-0.10] vs. HbA1c >7%: 0.05 [0.04-0.06] %, p=0.001).

Conclusions: Different associations of FS with gender and HbA1c were observed for T1D and T2D; however, longer diabetes duration increases the risk for FS independent of diabetes type. Musculoskeletal diseases are still underreported in individuals with diabetes and awareness should be raised for FS as a specific diabetes complication.

目的:研究年龄≥30岁的1型(T1D)或2型(T2D)糖尿病患者冻疮(FS)与人口学和糖尿病相关结局的关系。材料和方法:采用经人口统计学调整的多变量logistic回归模型计算FS与年龄、性别、糖尿病病程、体重指数(BMI)、血红蛋白A1C (HbA1c)和糖尿病治疗相关的比例。结果:T1D的未调整FS百分比高于T2D(0.22%比0.06%)。在T1D中,调整后的回归模型显示女性FS患病率高于男性(0.26 [0.20-0.34]% vs. 0.15 [0.11-0.21] %, p=0.010)。在两种糖尿病类型中,年龄和BMI与FS均无显著关系。糖尿病病程越长,T1D中FS的比例越高(pp=0.004)。在T1D中,与HbA1c≤7%相比,HbA1c >7%与更高的FS比例相关(0.25 [0.19-0.32]vs. 0.12 [0.08-0.20] %, p=0.007),而在T2D中,HbA1c≤7%:0.08 [0.07-0.10]vs. HbA1c >7%: 0.05 [0.04-0.06] %, p=0.001)。结论:T1D和T2D患者FS与性别和HbA1c存在不同的相关性;然而,与糖尿病类型无关,较长的糖尿病病程会增加FS的风险。肌肉骨骼疾病在糖尿病患者中仍然被低估,应该提高对FS作为一种特定糖尿病并发症的认识。
{"title":"Idiopathic Frozen Shoulder in Individuals with Diabetes: Association with Metabolic Control, Obesity, Antidiabetic Treatment and Demographic Characteristics in Adults with Type 1 or 2 Diabetes from the DPV Registry.","authors":"Alexander J Eckert,&nbsp;Maike Plaumann,&nbsp;Sigrid Pehlke,&nbsp;Christof Beck,&nbsp;Steffen Mühldorfer,&nbsp;Uwe Weickert,&nbsp;Markus Laimer,&nbsp;Martin Pfeifer,&nbsp;Lars Stechemesser,&nbsp;ReinhardW Holl","doi":"10.1055/a-1543-8559","DOIUrl":"https://doi.org/10.1055/a-1543-8559","url":null,"abstract":"<p><strong>Aims: </strong>To examine the association of frozen shoulder (FS) with demographic and diabetes-related outcomes in individuals with type 1 (T1D) or type 2 (T2D) diabetes aged ≥30 years.</p><p><strong>Materials and methods: </strong>Multivariable logistic regression models, adjusted for demographics were used to calculate the proportion of FS in association with age, gender, diabetes duration, body mass index (BMI), haemoglobin A1C (HbA1c) and diabetes treatment.</p><p><strong>Results: </strong>The unadjusted percentage of FS was higher in T1D compared to T2D (0.22% vs. 0.06%). In T1D, adjusted regression models revealed higher prevalence of FS in women than men (0.26 [0.20-0.34] % vs. 0.15 [0.11-0.21] %, <i>p</i>=0.010). No significant relationship of age and BMI with FS was found in both diabetes types. Longer diabetes duration was associated with a higher proportion of FS in T1D <i>(p</i><0.001) and T2D (<i>p</i>=0.004). In T1D, HbA1c >7% was related to a higher proportion of FS compared to HbA1c ≤7% (0.25 [0.19-0.32] vs. 0.12 [0.08-0.20] %, <i>p</i>=0.007), while an inverse relationship was found in T2D (HbA1c ≤7%: 0.08 [0.07-0.10] vs. HbA1c >7%: 0.05 [0.04-0.06] %, <i>p</i>=0.001).</p><p><strong>Conclusions: </strong>Different associations of FS with gender and HbA1c were observed for T1D and T2D; however, longer diabetes duration increases the risk for FS independent of diabetes type. Musculoskeletal diseases are still underreported in individuals with diabetes and awareness should be raised for FS as a specific diabetes complication.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":"130 7","pages":"468-474"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39337587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Prevalence of Atherosclerotic Cardiovascular Disease, Heart Failure, and Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus: A Primary Care Research Network-based Study. 2型糖尿病患者动脉粥样硬化性心血管疾病、心力衰竭和慢性肾脏疾病的患病率:一项基于初级保健研究网络的研究
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-07-01 Epub Date: 2021-06-21 DOI: 10.1055/a-1508-3912
Geert Goderis, Bert Vaes, Pavlos Mamouris, Eline van Craeyveld, Chantal Mathieu

Aims: This study aims to assess the prevalence of atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), chronic kidney disease (CKD), and their combined presence in type 2 diabetes (T2D) patients in primary care for whom the 2019 ADA/EASD consensus update "Management of Hyperglycemia in Type 2 Diabetes" recommends GLP-1 receptor agonists (GLP-1RA) or sodium-glucose cotransporter-2 inhibitors (SGLT-I) as first-line medications after metformin.

Methods: Data were obtained in 2015 from Intego, a morbidity registration network of 111 general practitioners (GPs) working in 48 practices and including 123 261 registered patients.

Results: Of 123 261 patients, 9616 had T2D. Of these patients, 4200 (43.7%) presented with ASCVD and/or CKD and/or HF. Specifically, 3348 (34.8%) patients had ASCVD, 388 (4.0%) had heart failure, and 1402 (14.6%) had CKD. Compared to patients without any of these comorbidities, patients with at least 1 of these conditions were older (69.7 ±12.6 vs. 63.1±12.5 years), had higher LDL-C values (104.2±35.8 mg/dl vs. 97.2±37.7) and less frequently achieved the systolic blood pressure target of 140 mm Hg (53 vs. 61%) (all p<0.001). Comorbid patients also had significantly more other comorbidities, such as dementia or cancer; received more recommended medications, such as statins; and received less metformin. Most patients with HF (325; 3.4%) had ASCVD (114; 1.2%), CKD (76; 0.8%), or both (135; 1.4%). In total, 478 patients with CKD (5.0%) also had ASCVD.

Conclusions: At the primary care level, 44% of T2D patients suffer from ASCVD, CKD, and/or HF, and thus qualify for GLP-1RA or SGLT2-I therapy.

目的:本研究旨在评估动脉粥样硬化性心血管疾病(ASCVD)、心力衰竭(HF)、慢性肾脏疾病(CKD)的患病率及其在2型糖尿病(T2D)患者中的联合存在,2019年ADA/EASD共识更新“2型糖尿病高血糖的管理”推荐GLP-1受体兴奋剂(GLP-1RA)或钠-葡萄糖共转运蛋白-2抑制剂(SGLT-I)作为二甲双胍后的一线药物。方法:2015年数据来自Intego,这是一个由48家诊所的111名全科医生(gp)组成的发病率登记网络,包括123261名登记患者。结果:123261例患者中有9616例发生T2D。在这些患者中,4200例(43.7%)表现为ASCVD和/或CKD和/或HF。具体来说,3348例(34.8%)患者患有ASCVD, 388例(4.0%)患者患有心力衰竭,1402例(14.6%)患者患有CKD。与没有这些合并症的患者相比,至少有1种合并症的患者年龄较大(69.7±12.6岁vs 63.1±12.5岁),LDL-C值较高(104.2±35.8 mg/dl vs 97.2±37.7),收缩压达到140 mm Hg目标的频率较低(53% vs 61%)(所有结论:在初级保健水平,44%的T2D患者患有ASCVD、CKD和/或HF,因此符合GLP-1RA或SGLT2-I治疗的条件。
{"title":"Prevalence of Atherosclerotic Cardiovascular Disease, Heart Failure, and Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus: A Primary Care Research Network-based Study.","authors":"Geert Goderis,&nbsp;Bert Vaes,&nbsp;Pavlos Mamouris,&nbsp;Eline van Craeyveld,&nbsp;Chantal Mathieu","doi":"10.1055/a-1508-3912","DOIUrl":"https://doi.org/10.1055/a-1508-3912","url":null,"abstract":"<p><strong>Aims: </strong>This study aims to assess the prevalence of atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), chronic kidney disease (CKD), and their combined presence in type 2 diabetes (T2D) patients in primary care for whom the 2019 ADA/EASD consensus update \"Management of Hyperglycemia in Type 2 Diabetes\" recommends GLP-1 receptor agonists (GLP-1RA) or sodium-glucose cotransporter-2 inhibitors (SGLT-I) as first-line medications after metformin.</p><p><strong>Methods: </strong>Data were obtained in 2015 from Intego, a morbidity registration network of 111 general practitioners (GPs) working in 48 practices and including 123 261 registered patients.</p><p><strong>Results: </strong>Of 123 261 patients, 9616 had T2D. Of these patients, 4200 (43.7%) presented with ASCVD and/or CKD and/or HF. Specifically, 3348 (34.8%) patients had ASCVD, 388 (4.0%) had heart failure, and 1402 (14.6%) had CKD. Compared to patients without any of these comorbidities, patients with at least 1 of these conditions were older (69.7 ±12.6 vs. 63.1±12.5 years), had higher LDL-C values (104.2±35.8 mg/dl vs. 97.2±37.7) and less frequently achieved the systolic blood pressure target of 140 mm Hg (53 vs. 61%) (all p<0.001). Comorbid patients also had significantly more other comorbidities, such as dementia or cancer; received more recommended medications, such as statins; and received less metformin. Most patients with HF (325; 3.4%) had ASCVD (114; 1.2%), CKD (76; 0.8%), or both (135; 1.4%). In total, 478 patients with CKD (5.0%) also had ASCVD.</p><p><strong>Conclusions: </strong>At the primary care level, 44% of T2D patients suffer from ASCVD, CKD, and/or HF, and thus qualify for GLP-1RA or SGLT2-I therapy.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":"130 7","pages":"447-453"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39253102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Is Telemedicine the Preferred Visit Modality in Patients with Type 1 Diabetes? 远程医疗是1型糖尿病患者首选的就诊方式吗?
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-07-01 Epub Date: 2021-07-22 DOI: 10.1055/a-1532-4610
Alena Kirzhner, Taiba Zornitzki, Viviana Ostrovsky, Hilla Knobler, Tal Schiller

Background: The COVID-19 pandemic limits access to diabetes clinics. Remote communication by phone calls and WhatsApp messages became available in the past years. However, the current need to avoid face-to-face meetings necessitates further expansion of telemedicine services. There are limited data whether the option of virtual meetings is a preferred therapeutic modality for patients with type 1 diabetes (T1D).

Objective: To assess in a cohort of T1D patients, their preference and perception of telemedicine.

Methods: T1D patients who are followed in a hospital-affiliated diabetes clinic were asked to fill a structured questionnaire aimed to determine their attitude towards telemedicine and their preference of virtual versus conventional visits. The questionnaire was offered to consecutive T1D patients who visited the clinic between August to October 2020.

Results: Seventy one T1D patients that fulfilled the questionnaire were included. Median age was 38 years, 39% were male, and median duration of diabetes was 18 years. Fourteen percent of the participants preferred only virtual visits, 24% only conventional visits and 62% preferred a combination of these modalities. Sex, origin, education, duration of diabetes, mode of insulin treatment and distance from the clinic were not associated with patients' preference, but older patients (≥ 61 years) tended to prefer conventional visits. Sixty-six percent felt confident in their ability to download data from their personal medical devices.

Conclusions: Patients from a wide range of treatment modalities are willing to use telemedicine. However, virtual meetings cannot fully replace conventional visits in T1D especially in the older age group.

背景:COVID-19大流行限制了糖尿病诊所的可及性。通过电话和WhatsApp消息进行远程通信在过去几年中成为可能。然而,由于目前需要避免面对面会议,因此必须进一步扩大远程医疗服务。虚拟会议是否是1型糖尿病(T1D)患者首选的治疗方式,数据有限。目的:了解一组T1D患者对远程医疗的偏好和认知。方法:在医院附属糖尿病诊所随访的T1D患者填写了一份结构化问卷,旨在确定他们对远程医疗的态度以及他们对虚拟与传统就诊的偏好。该问卷提供给2020年8月至10月期间就诊的连续T1D患者。结果:纳入71例完成问卷调查的T1D患者。中位年龄为38岁,39%为男性,糖尿病的中位病程为18年。14%的参与者只喜欢虚拟访问,24%的人只喜欢传统访问,62%的人喜欢这些方式的组合。性别、原籍、教育程度、糖尿病病程、胰岛素治疗方式和距离与患者的偏好无关,但年龄≥61岁的患者倾向于常规就诊。66%的人对自己从个人医疗设备中下载数据的能力充满信心。结论:各种治疗方式的患者都愿意使用远程医疗。然而,虚拟会议不能完全取代T1D的传统访问,特别是在老年群体中。
{"title":"Is Telemedicine the Preferred Visit Modality in Patients with Type 1 Diabetes?","authors":"Alena Kirzhner,&nbsp;Taiba Zornitzki,&nbsp;Viviana Ostrovsky,&nbsp;Hilla Knobler,&nbsp;Tal Schiller","doi":"10.1055/a-1532-4610","DOIUrl":"https://doi.org/10.1055/a-1532-4610","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic limits access to diabetes clinics. Remote communication by phone calls and WhatsApp messages became available in the past years. However, the current need to avoid face-to-face meetings necessitates further expansion of telemedicine services. There are limited data whether the option of virtual meetings is a preferred therapeutic modality for patients with type 1 diabetes (T1D).</p><p><strong>Objective: </strong>To assess in a cohort of T1D patients, their preference and perception of telemedicine.</p><p><strong>Methods: </strong>T1D patients who are followed in a hospital-affiliated diabetes clinic were asked to fill a structured questionnaire aimed to determine their attitude towards telemedicine and their preference of virtual versus conventional visits. The questionnaire was offered to consecutive T1D patients who visited the clinic between August to October 2020.</p><p><strong>Results: </strong>Seventy one T1D patients that fulfilled the questionnaire were included. Median age was 38 years, 39% were male, and median duration of diabetes was 18 years. Fourteen percent of the participants preferred only virtual visits, 24% only conventional visits and 62% preferred a combination of these modalities. Sex, origin, education, duration of diabetes, mode of insulin treatment and distance from the clinic were not associated with patients' preference, but older patients (≥ 61 years) tended to prefer conventional visits. Sixty-six percent felt confident in their ability to download data from their personal medical devices.</p><p><strong>Conclusions: </strong>Patients from a wide range of treatment modalities are willing to use telemedicine. However, virtual meetings cannot fully replace conventional visits in T1D especially in the older age group.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":"130 7","pages":"462-467"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39209522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
A Risk Assessment Tool for Identifying Osteoporosis in Older Women with Type 2 Diabetes Mellitus. 老年女性2型糖尿病骨质疏松症的风险评估工具
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-07-01 Epub Date: 2021-12-15 DOI: 10.1055/a-1702-5168
Fenghui Pan, Wenxia Cui, Lei Gao, Xiaoting Shi, Mingrui Zhang, Man Li, Haiyan Yang, Yun Hu

Purpose: To develop a simple and clinically useful assessment tool for osteoporosis in older women with type 2 diabetes mellitus (T2DM).

Methods: A total of 601 women over 60 years of age with T2DM were enrolled in this study. The levels of serum sex hormones and bone metabolism markers were compared between the osteoporosis and non-osteoporosis groups. The least absolute shrinkage and selection operator regularization (LASSO) model was applied to generate a risk assessment tool. The risk score formula was evaluated using receiver operating characteristic analysis and the relationship between the risk score and the bone mineral density (BMD) and T-value were investigated.

Results: Serum sex hormone-binding globulin (SHBG), cross-linked C-telopeptide of type 1 collagen (CTX), and osteocalcin (OC) were significantly higher in the osteoporosis group. After adjustment for age and body mass index (BMI), SHBG was found to be correlated with the T-value or BMD. Then, a risk score was specifically generated with age, BMI, SHBG, and CTX using the LASSO model. The risk score was significantly negatively correlated with the T-value and BMD of the lumbar spine, femoral neck, and total hip (all P<0.05).

Conclusion: A risk score using age, BMI, SHBG, and CTX performs well for identifying osteoporosis in older women with T2DM.

目的:为老年女性2型糖尿病(T2DM)患者骨质疏松症提供一种简单、实用的评估工具。方法:本研究共纳入601例60岁以上的2型糖尿病女性。比较骨质疏松组和非骨质疏松组血清性激素和骨代谢指标水平。采用最小绝对收缩和选择算子正则化(LASSO)模型生成风险评估工具。采用受试者操作特征分析对风险评分公式进行评价,并探讨风险评分与骨密度(BMD)和t值的关系。结果:骨质疏松组血清性激素结合球蛋白(SHBG)、1型胶原交联c端肽(CTX)、骨钙素(OC)明显升高。在调整年龄和体重指数(BMI)后,发现SHBG与t值或BMD相关。然后,使用LASSO模型,根据年龄、BMI、SHBG和CTX具体生成风险评分。风险评分与腰椎、股骨颈、全髋的t值、BMD呈显著负相关(均P0.05)。结论:使用年龄、BMI、SHBG和CTX的风险评分可以很好地识别老年女性T2DM患者的骨质疏松症。
{"title":"A Risk Assessment Tool for Identifying Osteoporosis in Older Women with Type 2 Diabetes Mellitus.","authors":"Fenghui Pan,&nbsp;Wenxia Cui,&nbsp;Lei Gao,&nbsp;Xiaoting Shi,&nbsp;Mingrui Zhang,&nbsp;Man Li,&nbsp;Haiyan Yang,&nbsp;Yun Hu","doi":"10.1055/a-1702-5168","DOIUrl":"https://doi.org/10.1055/a-1702-5168","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a simple and clinically useful assessment tool for osteoporosis in older women with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>A total of 601 women over 60 years of age with T2DM were enrolled in this study. The levels of serum sex hormones and bone metabolism markers were compared between the osteoporosis and non-osteoporosis groups. The least absolute shrinkage and selection operator regularization (LASSO) model was applied to generate a risk assessment tool. The risk score formula was evaluated using receiver operating characteristic analysis and the relationship between the risk score and the bone mineral density (BMD) and T-value were investigated.</p><p><strong>Results: </strong>Serum sex hormone-binding globulin (SHBG), cross-linked C-telopeptide of type 1 collagen (CTX), and osteocalcin (OC) were significantly higher in the osteoporosis group. After adjustment for age and body mass index (BMI), SHBG was found to be correlated with the T-value or BMD. Then, a risk score was specifically generated with age, BMI, SHBG, and CTX using the LASSO model. The risk score was significantly negatively correlated with the T-value and BMD of the lumbar spine, femoral neck, and total hip (all <i>P<</i>0.05).</p><p><strong>Conclusion: </strong>A risk score using age, BMI, SHBG, and CTX performs well for identifying osteoporosis in older women with T2DM.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":"130 7","pages":"426-433"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39729367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Diurnal Salivary Cortisol Profiles in Patients with Cushing's Syndrome. 库欣综合征患者的日唾液皮质醇谱。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-07-01 Epub Date: 2022-01-17 DOI: 10.1055/a-1719-5381
Leah T Braun, Frederick Vogel, Stephanie Zopp, German Rubinstein, Katharina Schilbach, Heike Künzel, Felix Beuschlein, Martin Reincke

Background: Quantification of salivary cortisol is one of the highly sensitive and specific screening parameters for Cushing's syndrome (CS). However, only late-night salivary cortisol is part of the standard screening procedure. In this study, we aimed to analyze salivary cortisol day profiles in patients with different types of CS to test whether specific patterns might be relevant for diagnosis and subtyping.

Material and methods: Among 428 patients including those with confirmed Cushing's syndrome (N=111, of those 75 with Cushing's disease, 27 patients with adrenal CS and nine patients with ectopic CS), autonomous cortisol secretion (N=39) or exclusion of CS (control group, N=278) salivary cortisol was measured five times a day.

Results: At each of the five time points, salivary cortisol was significantly higher in patients with CS compared to the control group (p≤0.001). Using the entire profile instead of one single salivary cortisol at 11 p.m. improved diagnostic accuracy (85 vs. 91%) slightly. Patients with ACTH-dependent CS had higher salivary cortisol levels than patients with adrenal CS. Also, morning cortisol was significantly higher in patients with ectopic CS than in patients with Cushing's disease (p=0.04). Nevertheless, there was a strong overlap between diurnal profiles, and the diagnostic yield for subtyping was low.

Discussion: The study results show that using diurnal salivary cortisol profiles for CS diagnosis results in a limited increase in diagnostic accuracy. With significant differences between Cushing subtypes, cortisol profiles are not useful in everyday clinical practice for subtyping of CS.

背景:唾液皮质醇定量检测是库欣综合征(Cushing's syndrome, CS)高度敏感和特异的筛查参数之一。然而,只有深夜唾液皮质醇是标准筛查程序的一部分。在这项研究中,我们旨在分析不同类型CS患者的唾液皮质醇日谱,以测试特定模式是否可能与诊断和分型相关。材料与方法:在428例患者中,包括确诊库欣综合征患者(N=111例,其中75例库欣综合征患者,27例肾上腺CS, 9例异位CS),测定自主皮质醇分泌(N=39)或排除CS(对照组,N=278)的唾液皮质醇,每天5次。结果:在5个时间点,CS患者的唾液皮质醇均显著高于对照组(p≤0.001)。在晚上11点用整个档案而不是一个唾液皮质醇。诊断准确性略有提高(85比91%)。acth依赖性CS患者的唾液皮质醇水平高于肾上腺性CS患者。此外,异位CS患者的早晨皮质醇显著高于库欣病患者(p=0.04)。然而,在昼夜剖面之间有很强的重叠,分型的诊断率很低。讨论:研究结果表明,使用每日唾液皮质醇谱诊断CS导致诊断准确性有限的增加。由于库欣亚型之间存在显著差异,皮质醇谱在日常临床实践中无法用于CS亚型。
{"title":"Diurnal Salivary Cortisol Profiles in Patients with Cushing's Syndrome.","authors":"Leah T Braun,&nbsp;Frederick Vogel,&nbsp;Stephanie Zopp,&nbsp;German Rubinstein,&nbsp;Katharina Schilbach,&nbsp;Heike Künzel,&nbsp;Felix Beuschlein,&nbsp;Martin Reincke","doi":"10.1055/a-1719-5381","DOIUrl":"https://doi.org/10.1055/a-1719-5381","url":null,"abstract":"<p><strong>Background: </strong>Quantification of salivary cortisol is one of the highly sensitive and specific screening parameters for Cushing's syndrome (CS). However, only late-night salivary cortisol is part of the standard screening procedure. In this study, we aimed to analyze salivary cortisol day profiles in patients with different types of CS to test whether specific patterns might be relevant for diagnosis and subtyping.</p><p><strong>Material and methods: </strong>Among 428 patients including those with confirmed Cushing's syndrome (N=111, of those 75 with Cushing's disease, 27 patients with adrenal CS and nine patients with ectopic CS), autonomous cortisol secretion (N=39) or exclusion of CS (control group, N=278) salivary cortisol was measured five times a day.</p><p><strong>Results: </strong>At each of the five time points, salivary cortisol was significantly higher in patients with CS compared to the control group (p≤0.001). Using the entire profile instead of one single salivary cortisol at 11 p.m. improved diagnostic accuracy (85 vs. 91%) slightly. Patients with ACTH-dependent CS had higher salivary cortisol levels than patients with adrenal CS. Also, morning cortisol was significantly higher in patients with ectopic CS than in patients with Cushing's disease (p=0.04). Nevertheless, there was a strong overlap between diurnal profiles, and the diagnostic yield for subtyping was low.</p><p><strong>Discussion: </strong>The study results show that using diurnal salivary cortisol profiles for CS diagnosis results in a limited increase in diagnostic accuracy. With significant differences between Cushing subtypes, cortisol profiles are not useful in everyday clinical practice for subtyping of CS.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":"130 7","pages":"434-438"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39704470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Out-of-Hospital Management of Diabetic Emergencies in Germany: Structural and Process Quality. 德国糖尿病急诊的院外管理:结构和过程质量。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-07-01 Epub Date: 2021-07-20 DOI: 10.1055/a-1523-7562
David J F Holstein, Judith D Holstein, Daniel Fischer, Meinhard Mende, Brian M Frier, Andreas Holstein

Aims: To collect and analyse representative data of structural and process quality in the management of diabetic emergencies in Germany in 2020.

Methods: A standardised questionnaire comprising detailed items concerning clinically relevant parameters on the structural and process quality of out-of-hospital management of diabetic emergencies was sent nationwide to medical directors of emergency medical service districts (EMSDs). Results were compared with those from a similar study conducted in 2001.

Results: The return rate of the questionnaires represented 126 EMSDs, serving a total population of > 40.1 million. Only 4% of ambulances carried glucagon (6% in 2001). In 2020, blood glucose determination increased significantly to 71% of all emergency interventions and to 29% of suspected cardiac emergencies (24% and 15%, respectively, in 2001). In 100% of EMSDs severe hypoglycaemia (SH) was treated by paramedics by administering intravenous dextrose before the arrival of a doctor compared to 63% in 2001. The potential value of nasal glucagon was acknowledged by 43% of responders. In selected patients, treatment of SH was conducted without hospital admission in 78% of EMDs (60% in 2001). Fifty-three percent of medical directors acknowledged the need for further training in diabetic emergencies (47% in 2001). Cooperation for medical education between emergency teams and a diabetes centre was reported by 14% (41% in 2001).

Conclusion: Structural and process quality of the management of diabetic emergencies in Germany has improved considerably since 2001. Persisting deficiencies could be improved by providing better medical equipment in ambulances and ongoing education to the entire emergency teams.

目的:收集和分析2020年德国糖尿病急诊管理中结构和流程质量的代表性数据。方法:向全国各急诊科区长发放一份标准化问卷,问卷内容包括糖尿病急诊科院外管理结构和流程质量的临床相关参数。研究结果与2001年进行的一项类似研究的结果进行了比较。结果:问卷回收率为126份,服务人群> 4010万人。只有4%的救护车携带胰高血糖素(2001年为6%)。到2020年,血糖测定在所有紧急干预措施中占71%,在疑似心脏紧急情况中占29%(2001年分别为24%和15%)。在100%的emsd患者中,护理人员在医生到达之前通过静脉注射葡萄糖治疗严重低血糖,而2001年这一比例为63%。43%的应答者承认鼻胰高血糖素的潜在价值。在选定的患者中,78%的emd(2001年为60%)在不住院的情况下进行了SH治疗。53%的医务主任承认有必要对糖尿病紧急情况进行进一步培训(2001年为47%)。据报告,14%的应急小组与糖尿病中心合作开展医学教育(2001年为41%)。结论:自2001年以来,德国糖尿病急诊管理的结构和流程质量有了显著改善。可以通过在救护车上提供更好的医疗设备和对整个急救队进行持续教育来改善持续存在的不足。
{"title":"Out-of-Hospital Management of Diabetic Emergencies in Germany: Structural and Process Quality.","authors":"David J F Holstein,&nbsp;Judith D Holstein,&nbsp;Daniel Fischer,&nbsp;Meinhard Mende,&nbsp;Brian M Frier,&nbsp;Andreas Holstein","doi":"10.1055/a-1523-7562","DOIUrl":"https://doi.org/10.1055/a-1523-7562","url":null,"abstract":"<p><strong>Aims: </strong>To collect and analyse representative data of structural and process quality in the management of diabetic emergencies in Germany in 2020.</p><p><strong>Methods: </strong>A standardised questionnaire comprising detailed items concerning clinically relevant parameters on the structural and process quality of out-of-hospital management of diabetic emergencies was sent nationwide to medical directors of emergency medical service districts (EMSDs). Results were compared with those from a similar study conducted in 2001.</p><p><strong>Results: </strong>The return rate of the questionnaires represented 126 EMSDs, serving a total population of > 40.1 million. Only 4% of ambulances carried glucagon (6% in 2001). In 2020, blood glucose determination increased significantly to 71% of all emergency interventions and to 29% of suspected cardiac emergencies (24% and 15%, respectively, in 2001). In 100% of EMSDs severe hypoglycaemia (SH) was treated by paramedics by administering intravenous dextrose before the arrival of a doctor compared to 63% in 2001. The potential value of nasal glucagon was acknowledged by 43% of responders. In selected patients, treatment of SH was conducted without hospital admission in 78% of EMDs (60% in 2001). Fifty-three percent of medical directors acknowledged the need for further training in diabetic emergencies (47% in 2001). Cooperation for medical education between emergency teams and a diabetes centre was reported by 14% (41% in 2001).</p><p><strong>Conclusion: </strong>Structural and process quality of the management of diabetic emergencies in Germany has improved considerably since 2001. Persisting deficiencies could be improved by providing better medical equipment in ambulances and ongoing education to the entire emergency teams.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":"130 7","pages":"454-461"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39201932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Novel Insight into the Mechanism of Metabolic Surgery Causing the Diversity in Glycemic Status in Type 2 Diabetes. 代谢手术导致2型糖尿病患者血糖状态差异机制的新见解
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-07-01 Epub Date: 2022-01-03 DOI: 10.1055/a-1708-3214
Mengxiao Zhou, Lijuan Wang, Lujin Zhou, Xiaotong Chang, Xiaobo Zhu

Metabolic surgery results in diverse glycemic status in patients with type 2 diabetes (T2D), including hyperglycemia without remission, significant amelioration of hyperglycemia with partial remission, complete restoration of euglycemia, or with prolonged remission, hyperglycemia recurrence in relapses after remission, or post-bariatric hypoglycemia. Unfortunately, it is not known how metabolic surgery leads to this diverse consequence. Here, we discuss the diversity of glycemic status associated with metabolic surgery and the potential mechanisms of T2D remission. We also highlight the relationship between the change in low-grade inflammation and T2D remission after metabolic surgery. We hypothesize that the level of inflammatory and anti-inflammatory cytokines controls the efficacy of metabolic surgery in patients with T2D. This hypothesis may provide further insight into the mechanism of the beneficial effects of metabolic surgery patients with T2D.

代谢手术导致2型糖尿病(T2D)患者不同的血糖状态,包括无缓解的高血糖,部分缓解的高血糖显著改善,完全恢复正常血糖,或长期缓解,缓解后复发的高血糖复发,或减肥后低血糖。不幸的是,目前尚不清楚代谢手术是如何导致这种不同的后果的。在这里,我们讨论了与代谢手术相关的血糖状态的多样性以及t2dm缓解的潜在机制。我们还强调了代谢手术后低度炎症变化与T2D缓解之间的关系。我们假设炎症和抗炎细胞因子的水平控制着t2dm患者代谢手术的疗效。这一假设可能为t2dm患者代谢手术的有益作用机制提供进一步的见解。
{"title":"Novel Insight into the Mechanism of Metabolic Surgery Causing the Diversity in Glycemic Status in Type 2 Diabetes.","authors":"Mengxiao Zhou,&nbsp;Lijuan Wang,&nbsp;Lujin Zhou,&nbsp;Xiaotong Chang,&nbsp;Xiaobo Zhu","doi":"10.1055/a-1708-3214","DOIUrl":"https://doi.org/10.1055/a-1708-3214","url":null,"abstract":"<p><p>Metabolic surgery results in diverse glycemic status in patients with type 2 diabetes (T2D), including hyperglycemia without remission, significant amelioration of hyperglycemia with partial remission, complete restoration of euglycemia, or with prolonged remission, hyperglycemia recurrence in relapses after remission, or post-bariatric hypoglycemia. Unfortunately, it is not known how metabolic surgery leads to this diverse consequence. Here, we discuss the diversity of glycemic status associated with metabolic surgery and the potential mechanisms of T2D remission. We also highlight the relationship between the change in low-grade inflammation and T2D remission after metabolic surgery. We hypothesize that the level of inflammatory and anti-inflammatory cytokines controls the efficacy of metabolic surgery in patients with T2D. This hypothesis may provide further insight into the mechanism of the beneficial effects of metabolic surgery patients with T2D.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":"130 7","pages":"484-492"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39781676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Evaluation of Meal Carbohydrate Counting Errors in Patients with Type 1 Diabetes. 1型糖尿病患者膳食碳水化合物计数误差的评价。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-07-01 Epub Date: 2021-05-25 DOI: 10.1055/a-1493-2324
Sina Buck, Collin Krauss, Delia Waldenmaier, Christina Liebing, Nina Jendrike, Josef Högel, Boris M Pfeiffer, Cornelia Haug, Guido Freckmann

Aim: Correct estimation of meal carbohydrate content is a prerequisite for successful intensified insulin therapy in patients with diabetes. In this survey, the counting error in adult patients with type 1 diabetes was investigated.

Methods: Seventy-four patients with type 1 diabetes estimated the carbohydrate content of 24 standardized test meals. The test meals were categorized into 1 of 3 groups with different carbohydrate content: low, medium, and high. Estimation results were compared with the meals' actual carbohydrate content as determined by calculation based on weighing. A subgroup of the participants estimated the test meals for a second (n=35) and a third time (n=22) with a mean period of 11 months between the estimations.

Results: During the first estimation, the carbohydrate content was underestimated by -28% (-50, 0) of the actual carbohydrate content. Particularly meals with high mean carbohydrate content were underestimated by -34% (-56, -13). Median counting error improved significantly when estimations were performed for a second time (p<0.001).

Conclusions: Participants generally underestimated the carbohydrate content of the test meals, especially in meals with higher carbohydrate content. Repetition of estimation resulted in significant improvements in estimation accuracy and is important for the maintenance of correct carbohydrate estimations. The ability to estimate the carbohydrate content of a meal should be checked and trained regularly in patients with diabetes.

目的:正确估计膳食碳水化合物含量是糖尿病患者胰岛素强化治疗成功的前提。本调查对成人1型糖尿病患者的计数误差进行了调查。方法:74例1型糖尿病患者对24份标准化试验餐的碳水化合物含量进行估算。试验餐按碳水化合物含量分为三组:低、中、高。将估算结果与根据称重计算确定的膳食实际碳水化合物含量进行比较。另一组参与者对测试餐进行了第二次(n=35)和第三次(n=22)评估,两次评估之间的平均间隔为11个月。结果:在第一次估算时,碳水化合物含量被低估了实际碳水化合物含量的-28%(- 50,0)。特别是平均碳水化合物含量高的食物被低估了-34%(-56,-13)。当第二次进行估计时,中位数计数误差显著改善(结论:参与者通常低估了测试餐的碳水化合物含量,特别是在碳水化合物含量较高的餐中。)重复估算可显著提高估算精度,对维持正确的碳水化合物估算非常重要。糖尿病患者估计一餐碳水化合物含量的能力应定期检查和训练。
{"title":"Evaluation of Meal Carbohydrate Counting Errors in Patients with Type 1 Diabetes.","authors":"Sina Buck,&nbsp;Collin Krauss,&nbsp;Delia Waldenmaier,&nbsp;Christina Liebing,&nbsp;Nina Jendrike,&nbsp;Josef Högel,&nbsp;Boris M Pfeiffer,&nbsp;Cornelia Haug,&nbsp;Guido Freckmann","doi":"10.1055/a-1493-2324","DOIUrl":"https://doi.org/10.1055/a-1493-2324","url":null,"abstract":"<p><strong>Aim: </strong>Correct estimation of meal carbohydrate content is a prerequisite for successful intensified insulin therapy in patients with diabetes. In this survey, the counting error in adult patients with type 1 diabetes was investigated.</p><p><strong>Methods: </strong>Seventy-four patients with type 1 diabetes estimated the carbohydrate content of 24 standardized test meals. The test meals were categorized into 1 of 3 groups with different carbohydrate content: low, medium, and high. Estimation results were compared with the meals' actual carbohydrate content as determined by calculation based on weighing. A subgroup of the participants estimated the test meals for a second (n=35) and a third time (n=22) with a mean period of 11 months between the estimations.</p><p><strong>Results: </strong>During the first estimation, the carbohydrate content was underestimated by -28% (-50, 0) of the actual carbohydrate content. Particularly meals with high mean carbohydrate content were underestimated by -34% (-56, -13). Median counting error improved significantly when estimations were performed for a second time (p<0.001).</p><p><strong>Conclusions: </strong>Participants generally underestimated the carbohydrate content of the test meals, especially in meals with higher carbohydrate content. Repetition of estimation resulted in significant improvements in estimation accuracy and is important for the maintenance of correct carbohydrate estimations. The ability to estimate the carbohydrate content of a meal should be checked and trained regularly in patients with diabetes.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":"130 7","pages":"475-483"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39017797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Neuropeptides, Inflammation, Biofilms, and diabetic Foot Ulcers. 神经肽、炎症、生物膜和糖尿病足溃疡。
IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Pub Date : 2022-07-01 Epub Date: 2021-07-05 DOI: 10.1055/a-1493-0458
Shaoling Yang, Liye Hu, Rui Han, Yiwen Yang

A diabetic foot ulcer (DFU) is a serious complication in patients with diabetes mellitus (DM). A DFU is the most common cause of non-traumatic limb amputation, and patients with DFUs have increased mortality rates within 5 years after amputation. DFUs also increase the risk of cardiovascular and cerebrovascular diseases; therefore, with the increasing incidence and prevalence of diabetic foot wounds, DFUs are gradually becoming a major public health problem. The pathophysiology of DFUs is complicated and remains unclear. In recent years, many studies have demonstrated that the pathophysiology of DFUs is especially associated with neuropeptides, inflammation, and biofilms. Neuropeptides, especially substance P (SP) and calcitonin gene-related peptide (CGRP), play an important role in wound healing. SP and CGRP accelerate the healing of cutaneous wounds by promoting neovascularization, inhibiting the release of certain proinflammatory chemokines, regulating macrophage polarization, and so on. However, the expression of SP and CGRP was downregulated in DM and DFUs. DFUs are characterized by a sustained inflammatory phase. Immune cells such as neutrophils and macrophages are involved in the sustained inflammatory phase in DFUs by extracellular traps (NETs) and dysregulated macrophage polarization, which delays wound healing. Furthermore, DFUs are at increased risk of biofilm formation. Biofilms disturb wound healing by inducing a chronic inflammatory response, inhibiting macrophage phagocytosis and keratinocyte proliferation migration, and transferring antimicrobial resistance genes. To understand the relationships among neuropeptides, inflammation, biofilms, and DFUs, this review highlights the recent scientific advances that provide possible pathophysiological insights into the delayed healing of DFUs.

糖尿病足溃疡(DFU)是糖尿病(DM)患者的严重并发症。DFU是非创伤性肢体截肢的最常见原因,DFU患者在截肢后5年内死亡率增加。DFUs还会增加患心脑血管疾病的风险;因此,随着糖尿病足外伤的发病率和流行率的增加,dfu逐渐成为一个重大的公共卫生问题。DFUs的病理生理机制复杂且尚不清楚。近年来,许多研究表明,DFUs的病理生理与神经肽、炎症和生物膜密切相关。神经肽,尤其是P物质(SP)和降钙素基因相关肽(CGRP)在创面愈合中起着重要作用。SP和CGRP通过促进新生血管、抑制某些促炎趋化因子的释放、调节巨噬细胞极化等作用,加速皮肤创面愈合。而SP和CGRP在DM和DFUs中表达下调。dfu的特征是持续的炎症期。免疫细胞如中性粒细胞和巨噬细胞通过细胞外陷阱(NETs)和巨噬细胞极化失调参与DFUs的持续炎症期,从而延迟伤口愈合。此外,dfu的生物膜形成风险增加。生物膜通过诱导慢性炎症反应,抑制巨噬细胞吞噬和角化细胞增殖迁移,以及转移抗菌耐药基因来干扰伤口愈合。为了了解神经肽、炎症、生物膜和DFUs之间的关系,本文综述了最近的科学进展,这些进展可能为DFUs延迟愈合提供了病理生理学上的见解。
{"title":"Neuropeptides, Inflammation, Biofilms, and diabetic Foot Ulcers.","authors":"Shaoling Yang,&nbsp;Liye Hu,&nbsp;Rui Han,&nbsp;Yiwen Yang","doi":"10.1055/a-1493-0458","DOIUrl":"https://doi.org/10.1055/a-1493-0458","url":null,"abstract":"<p><p>A diabetic foot ulcer (DFU) is a serious complication in patients with diabetes mellitus (DM). A DFU is the most common cause of non-traumatic limb amputation, and patients with DFUs have increased mortality rates within 5 years after amputation. DFUs also increase the risk of cardiovascular and cerebrovascular diseases; therefore, with the increasing incidence and prevalence of diabetic foot wounds, DFUs are gradually becoming a major public health problem. The pathophysiology of DFUs is complicated and remains unclear. In recent years, many studies have demonstrated that the pathophysiology of DFUs is especially associated with neuropeptides, inflammation, and biofilms. Neuropeptides, especially substance P (SP) and calcitonin gene-related peptide (CGRP), play an important role in wound healing. SP and CGRP accelerate the healing of cutaneous wounds by promoting neovascularization, inhibiting the release of certain proinflammatory chemokines, regulating macrophage polarization, and so on. However, the expression of SP and CGRP was downregulated in DM and DFUs. DFUs are characterized by a sustained inflammatory phase. Immune cells such as neutrophils and macrophages are involved in the sustained inflammatory phase in DFUs by extracellular traps (NETs) and dysregulated macrophage polarization, which delays wound healing. Furthermore, DFUs are at increased risk of biofilm formation. Biofilms disturb wound healing by inducing a chronic inflammatory response, inhibiting macrophage phagocytosis and keratinocyte proliferation migration, and transferring antimicrobial resistance genes. To understand the relationships among neuropeptides, inflammation, biofilms, and DFUs, this review highlights the recent scientific advances that provide possible pathophysiological insights into the delayed healing of DFUs.</p>","PeriodicalId":12241,"journal":{"name":"Experimental and Clinical Endocrinology & Diabetes","volume":"130 7","pages":"439-446"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39072278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
期刊
Experimental and Clinical Endocrinology & Diabetes
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1