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Comparison of positive rates between glutamic acid decarboxylase antibodies and ElisaRSR™ 3 Screen ICA™ in recently obtained sera from patients who had been previously diagnosed with slowly progressive type 1 diabetes 谷氨酸脱羧酶抗体与ElisaRSR™3 Screen ICA™在新近获得的慢进展型糖尿病患者血清中的阳性率比较
IF 3.2 3区 医学 Pub Date : 2023-04-20 DOI: 10.1111/jdi.14016
Nobuaki Takehana, Tomoyasu Fukui, Yusaku Mori, Munenori Hiromura, Michishige Terasaki, Makoto Ohara, Michiya Takada, Masako Tomoyasu, Yoshihisa Ito, Tetsuro Kobayashi, Sho-ichi Yamagishi

Aims/Introduction

This study aimed to compare the positivity rates of glutamic acid decarboxylase autoantibodies (GADA) and ElisaRSR™ 3 Screen ICA™ (3 Screen ICA), a newly developed assay for the simultaneous measurement of GADA, insulinoma-associated antigen-2 autoantibodies (IA-2A), and zinc transporter 8 autoantibodies (ZnT8A), in recently obtained sera from patients who had been previously diagnosed with slowly progressive type 1 diabetes (SPIDDM).

Materials and Methods

We enrolled 53 patients with SPIDDM who were positive for GADA at the diagnosis and 98 non-diabetic individuals, and investigated the diagnostic accuracy of the 3 Screen ICA (cutoff index ≥30 units) compared with that of GADA. In addition, we compared the clinical characteristics of patients with SPIDDM who were negative or positive on 3 Screen ICA.

Results

The positivity rates of 3 Screen ICA, GADA, IA-2A, and ZnT8A were 88.7, 86.8, 24.5, and 13.2%, respectively. The respective sensitivity, specificity, and positive and negative predictive values for SPIDDM were 88.7, 100, 100, and 94.2% by 3 Screen ICA and 86.8, 100, 100.0, and 93.3% by GADA. There were no significant differences in age at onset, duration of diabetes, body mass index, glycated hemoglobin and C-peptide levels, and the prevalence of autoimmune thyroiditis between patients with SPIDDM who were positive or negative on 3 Screen ICA. However, the prevalence of insulin users was significantly higher in those who were positive than in those who were negative on 3 Screen ICA.

Conclusions

Similar to GADA, 3 Screen ICA may be a useful diagnostic tool for detecting patients with SPIDDM.

本研究旨在比较谷氨酸脱羧酶自身抗体(GADA)和ElisaRSR™3 Screen ICA™(3 Screen ICA)的阳性率,ElisaRSR™3 Screen ICA是一种新开发的同时测量GADA、胰岛素瘤相关抗原-2自身抗体(IA-2A)和锌转运蛋白8自身抗体(ZnT8A)的检测方法。在最近获得的先前诊断为缓慢进展型1型糖尿病(SPIDDM)患者的血清中。材料与方法入选53例确诊为GADA阳性的SPIDDM患者和98例非糖尿病患者,比较3 Screen ICA(截止指数≥30单位)与GADA的诊断准确性。此外,我们比较了3 Screen ICA阴性和阳性的SPIDDM患者的临床特征。结果Screen ICA、GADA、IA-2A和ZnT8A的阳性率分别为88.7、86.8、24.5和13.2%。3 Screen ICA对SPIDDM的敏感性、特异性和阳性、阴性预测值分别为88.7、100、100和94.2%,GADA为86.8、100、100.0和93.3%。3 Screen ICA阳性和阴性的SPIDDM患者在发病年龄、糖尿病病程、体重指数、糖化血红蛋白和c肽水平以及自身免疫性甲状腺炎患病率方面无显著差异。然而,胰岛素使用者的流行率在3 Screen ICA阳性人群中明显高于阴性人群。结论与GADA类似,3 Screen ICA可能是检测SPIDDM患者的有效诊断工具。
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引用次数: 1
Stimulatory effect of imeglimin on incretin secretion 伊米霉素对肠促胰岛素分泌的刺激作用
IF 3.2 3区 医学 Pub Date : 2023-03-28 DOI: 10.1111/jdi.14001
Quan Yingyue, Kenji Sugawara, Harumi Takahashi, Norihide Yokoi, Kento Ohbayashi, Yusaku Iwasaki, Susumu Seino, Wataru Ogawa

Aims/Introduction

Imeglimin is a new antidiabetic drug structurally related to metformin. Despite this structural similarity, only imeglimin augments glucose-stimulated insulin secretion (GSIS), with the mechanism underlying this effect remaining unclear. Given that glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) also enhance GSIS, we examined whether these incretin hormones might contribute to the pharmacological actions of imeglimin.

Materials and Methods

Blood glucose and plasma insulin, GIP, and GLP-1 concentrations were measured during an oral glucose tolerance test (OGTT) performed in C57BL/6JJcl (C57BL/6) or KK-Ay/TaJcl (KK-Ay) mice after administration of a single dose of imeglimin with or without the dipeptidyl peptidase-4 inhibitor sitagliptin or the GLP-1 receptor antagonist exendin-9. The effects of imeglimin, with or without GIP or GLP-1, on GSIS were examined in C57BL/6 mouse islets.

Results

Imeglimin lowered blood glucose and increased plasma insulin levels during an OGTT in both C57BL/6 and KK-Ay mice, whereas it also increased the plasma levels of GIP and GLP-1 in KK-Ay mice and the GLP-1 levels in C57BL/6 mice. The combination of imeglimin and sitagliptin increased plasma insulin and GLP-1 levels during the OGTT in KK-Ay mice to a markedly greater extent than did either drug alone. Imeglimin enhanced GSIS in an additive manner with GLP-1, but not with GIP, in mouse islets. Exendin-9 had only a minor inhibitory effect on the glucose-lowering action of imeglimin during the OGTT in KK-Ay mice.

Conclusions

Our data suggest that the imeglimin-induced increase in plasma GLP-1 levels likely contributes at least in part to its stimulatory effect on insulin secretion.

目的/介绍依米明是一种与二甲双胍结构相关的新型降糖药物。尽管有这种结构上的相似性,但只有依米霉素增加了葡萄糖刺激胰岛素分泌(GSIS),这种作用的机制尚不清楚。鉴于葡萄糖依赖性胰岛素性多肽(GIP)和胰高血糖素样肽-1 (GLP-1)也能增强GSIS,我们研究了这些肠促胰岛素激素是否可能有助于伊米霉素的药理作用。材料与方法C57BL/6JJcl (C57BL/6)或KK-Ay/TaJcl (KK-Ay)小鼠口服糖耐量试验(OGTT)时,分别在给予单剂量伊美霉素加或不加二肽基肽酶-4抑制剂西格列汀或GLP-1受体拮抗剂exendin-9后,测定血糖和血浆胰岛素、GIP和GLP-1浓度。在C57BL/6小鼠胰岛中检测了伊米霉素(含或不含GIP或GLP-1)对GSIS的影响。结果在OGTT过程中,imimimin降低了C57BL/6和KK-Ay小鼠的血糖,升高了血浆胰岛素水平,同时增加了KK-Ay小鼠血浆GIP和GLP-1水平以及C57BL/6小鼠血浆GLP-1水平。在KK-Ay小鼠OGTT期间,伊美霉素和西格列汀联合用药显著提高血浆胰岛素和GLP-1水平,其程度明显高于单独用药。在小鼠胰岛中,依米霉素可与GLP-1联合增强GSIS,但不与GIP联合。在KK-Ay小鼠OGTT过程中,Exendin-9对依米霉素的降血糖作用只有轻微的抑制作用。结论:我们的数据表明,imigelimo诱导的血浆GLP-1水平升高可能至少部分地促进了胰岛素分泌。
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引用次数: 3
A 7 day inpatient diabetes education program improves quality of life and glycemic control 12 months after discharge 7天的住院糖尿病教育计划可改善出院后12个月的生活质量和血糖控制
IF 3.2 3区 医学 Pub Date : 2023-03-20 DOI: 10.1111/jdi.14008
Mika Kurita, Hiroaki Satoh, Hideyoshi Kaga, Satoshi Kadowaki, Yuki Someya, Yuka Tosaka, Yuya Nishida, Fuki Ikeda, Yoshifumi Tamura, Hirotaka Watada

Aims

For long-term management of diabetes, patients with type 2 diabetes mellitus require a high level of treatment adherence, which is associated with treatment satisfaction and their quality of life (QOL). To achieve it, patient education about diabetes self-management is essential. We routinely conduct a 7 day inpatient diabetes education program and administer the diabetes treatment-related (DTR)-QOL questionnaire to all participants, both before admission and at discharge. Here, we investigated whether our program improves QOL and post-discharge glycemic control.

Materials and Methods

This retrospective study utilized data from patients with type 2 diabetes mellitus who participated in our program between July 2017 and March 2020 and who had been treated in our outpatient department for more than 1 year. We evaluated the relationship between at admission and at discharge diabetes treatment-related quality of life scores and glycemic control after discharge.

Results

Data from 140 patients were analyzed in this study, which showed a significant improvement in the total, ‘Anxiety and dissatisfaction with treatment’, and ‘Satisfaction-with-treatment’ scores. A significant improvement was evident in HbA1c at 12 months after discharge. Multiple regression analysis showed that HbA1c after 12 months was independently associated with gender, duration of diabetes, and HbA1c at admission.

Conclusions

Our program effectively improves quality of life and post-discharge glycemic control in patients with type 2 diabetes mellitus. It is particularly effective in patients of the male gender, with a shorter duration of diabetes mellitus and higher HbA1c at admission.

目的2型糖尿病患者需要高水平的治疗依从性,这与治疗满意度和生活质量(QOL)有关。为实现这一目标,对患者进行糖尿病自我管理教育至关重要。我们定期对住院患者进行为期7天的糖尿病教育计划,并在入院前和出院时对所有参与者进行糖尿病治疗相关(DTR)-生活质量问卷调查。在这里,我们研究了我们的方案是否改善了生活质量和出院后血糖控制。材料和方法本回顾性研究使用了2017年7月至2020年3月期间参加我们项目的2型糖尿病患者的数据,这些患者在我们的门诊治疗超过1年。我们评估了入院和出院时糖尿病治疗相关生活质量评分与出院后血糖控制之间的关系。结果本研究对140例患者的数据进行了分析,结果显示患者的“焦虑和治疗不满意度”以及“治疗满意度”得分均有显著改善。出院后12个月HbA1c明显改善。多元回归分析显示,12个月后HbA1c与性别、糖尿病病程、入院时HbA1c独立相关。结论本项目有效改善了2型糖尿病患者的生活质量和出院后血糖控制。对于入院时糖尿病持续时间较短、HbA1c较高的男性患者尤其有效。
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引用次数: 1
Associations of sleep quality with the skeletal muscle strength in patients with type 2 diabetes with poor glycemic control 血糖控制不良的2型糖尿病患者睡眠质量与骨骼肌力量的关系
IF 3.2 3区 医学 Pub Date : 2023-03-19 DOI: 10.1111/jdi.14007
Takanori Hayashi, Nobuhiro Wada, Tetsuya Kubota, Chie Koizumi, Yoshitaka Sakurai, Masakazu Aihara, Satoshi Usami, Toshimasa Yamauchi, Naoto Kubota

Aims/Introduction

Patients with type 2 diabetes mellitus are reported to be at a high risk for sarcopenia, and are known to have a poorer sleep quality. However, the association between sleep quality and skeletal muscle in patients with type 2 diabetes mellitus is not yet precisely understood.

Materials and Methods

A total of 110 inpatients with type 2 diabetes mellitus aged 40–90 years were enrolled. The sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). Skeletal muscle mass was measured using bioelectrical impedance analysis. Muscle strength was evaluated by measuring the grip strength. We also performed dietary surveys and measurements of the plasma amino acid levels.

Results

A high total score on the PSQI was significantly associated with reduced muscle strength, and the association persisted even after adjustments for confounders. On the other hand, adjusted analysis did not reveal any significant associations between the PSQI total score and the skeletal muscle mass. In regard to the associations with subscores of the PSQI, the scores for sleep latency, sleep efficiency, and daytime dysfunction were significantly negatively associated with the muscle strength. Although poor sleep quality was associated with a high confectionery intake and low plasma arginine, citrulline, and ornithine levels, neither confectionery intake levels nor the plasma levels of these amino acids was associated with the muscle strength.

Conclusions

Our study revealed a significant association between the sleep quality and muscle strength in patients with type 2 diabetes mellitus. These results suggest that poor sleep quality is an important risk factor for sarcopenia in patients with type 2 diabetes mellitus.

据报道,2型糖尿病患者发生肌肉减少症的风险很高,睡眠质量也较差。然而,2型糖尿病患者睡眠质量与骨骼肌之间的关系尚不清楚。材料与方法入选年龄40 ~ 90岁的住院2型糖尿病患者110例。采用匹兹堡睡眠质量指数(PSQI)评估睡眠质量。骨骼肌质量测量采用生物电阻抗分析法。通过测量握力来评估肌肉力量。我们还进行了饮食调查和血浆氨基酸水平的测量。结果PSQI总分高与肌肉力量降低显著相关,即使在调整混杂因素后,这种关联仍然存在。另一方面,校正分析并未显示PSQI总分与骨骼肌质量之间有任何显著关联。在与PSQI亚分的关联方面,睡眠潜伏期、睡眠效率和日间功能障碍得分与肌肉力量呈显著负相关。虽然睡眠质量差与糖果摄入量高和血浆精氨酸、瓜氨酸和鸟氨酸水平低有关,但糖果摄入量和这些氨基酸的血浆水平都与肌肉力量无关。结论我们的研究揭示了2型糖尿病患者的睡眠质量和肌肉力量之间的显著关联。这些结果提示,睡眠质量差是2型糖尿病患者肌肉减少症的重要危险因素。
{"title":"Associations of sleep quality with the skeletal muscle strength in patients with type 2 diabetes with poor glycemic control","authors":"Takanori Hayashi,&nbsp;Nobuhiro Wada,&nbsp;Tetsuya Kubota,&nbsp;Chie Koizumi,&nbsp;Yoshitaka Sakurai,&nbsp;Masakazu Aihara,&nbsp;Satoshi Usami,&nbsp;Toshimasa Yamauchi,&nbsp;Naoto Kubota","doi":"10.1111/jdi.14007","DOIUrl":"https://doi.org/10.1111/jdi.14007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>Patients with type 2 diabetes mellitus are reported to be at a high risk for sarcopenia, and are known to have a poorer sleep quality. However, the association between sleep quality and skeletal muscle in patients with type 2 diabetes mellitus is not yet precisely understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 110 inpatients with type 2 diabetes mellitus aged 40–90 years were enrolled. The sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). Skeletal muscle mass was measured using bioelectrical impedance analysis. Muscle strength was evaluated by measuring the grip strength. We also performed dietary surveys and measurements of the plasma amino acid levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A high total score on the PSQI was significantly associated with reduced muscle strength, and the association persisted even after adjustments for confounders. On the other hand, adjusted analysis did not reveal any significant associations between the PSQI total score and the skeletal muscle mass. In regard to the associations with subscores of the PSQI, the scores for sleep latency, sleep efficiency, and daytime dysfunction were significantly negatively associated with the muscle strength. Although poor sleep quality was associated with a high confectionery intake and low plasma arginine, citrulline, and ornithine levels, neither confectionery intake levels nor the plasma levels of these amino acids was associated with the muscle strength.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study revealed a significant association between the sleep quality and muscle strength in patients with type 2 diabetes mellitus. These results suggest that poor sleep quality is an important risk factor for sarcopenia in patients with type 2 diabetes mellitus.</p>\u0000 </section>\u0000 </div>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 6","pages":"801-810"},"PeriodicalIF":3.2,"publicationDate":"2023-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5707317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Association of glucagon-like peptide-1 receptor agonist treatment with gastric residue in an esophagogastroduodenoscopy 胰高血糖素样肽-1受体激动剂治疗与食管胃十二指肠镜胃残留物的关系
IF 3.2 3区 医学 Pub Date : 2023-03-15 DOI: 10.1111/jdi.14005
Toshiko Kobori, Yukiko Onishi, Yoko Yoshida, Tazu Tahara, Takako Kikuchi, Tetsuya Kubota, Masahiko Iwamoto, Tomonobu Sawada, Reo Kobayashi, Hiroaki Fujiwara, Masato Kasuga

Aims/Introduction

Previous studies have reported that the glucagon-like peptide-1 receptor agonist (GLP-1RA) delays gastric emptying, and gastric emptying was assessed by the 13C breath test or paracetamol absorption technique. However, neither of them is clinically familiar in real-world clinical practice. The purpose of the present study was to investigate the association between GLP-1RA treatment and gastric residue in an esophagogastroduodenoscopy.

Materials and Methods

This study was a matched pair case–control study. The study population consisted of 1,128 individuals with diabetes who had esophagogastroduodenoscopy at our clinic between July 2020 and June 2022. To account for differences in characteristics, such as age, sex, insulin treatment and glycated hemoglobin, we carried out a one-to-one nearest neighbor propensity score matching analysis between diabetes patients with and without GLP-1RA treatment. After matching, we compared the presence of gastric residue in an esophagogastroduodenoscopy by the McNemar test between patients with and without GLP-1RA treatment.

Results

After the propensity score matching, we selected 205 pairs. In the propensity score-matched comparison, the proportion of gastric residue was statistically significantly higher in the GLP-1RA treatment group (0.49% vs 5.4%, P = 0.004). The details of GLP-1RA prescribed for the 11 patients with gastric residue were liraglutide once daily 1.8 mg (n = 2), dulaglutide once weekly 0.75 mg (n = 5), semaglutide once weekly 0.5 mg (n = 2) and semaglutide once weekly 1.0 mg (n = 2).

Conclusion

GLP-1RA treatment is associated with gastric residue in an esophagogastroduodenoscopy in patients with diabetes.

既往研究报道胰高血糖素样肽-1受体激动剂(GLP-1RA)延迟胃排空,胃排空通过13C呼吸试验或扑热息痛吸收技术评估。然而,在现实世界的临床实践中,它们都不是临床所熟悉的。本研究的目的是探讨GLP-1RA治疗与食管胃十二指肠镜检查中胃残留物之间的关系。材料与方法本研究为配对病例对照研究。研究人群包括1128名糖尿病患者,他们在2020年7月至2022年6月期间在我们的诊所接受了食管胃十二指肠镜检查。为了解释年龄、性别、胰岛素治疗和糖化血红蛋白等特征的差异,我们在接受和未接受GLP-1RA治疗的糖尿病患者之间进行了一对一的最近邻倾向评分匹配分析。匹配后,我们通过McNemar试验比较了接受GLP-1RA治疗和未接受GLP-1RA治疗的患者在食管胃十二指肠镜检查中胃残留物的存在。结果经倾向评分匹配后,共筛选出205对。倾向评分匹配比较中,GLP-1RA治疗组胃残渣比例显著高于对照组(0.49% vs 5.4%, P = 0.004)。11例胃残渣患者的GLP-1RA处方为利拉鲁肽1次/ d 1.8 mg (n = 2)、杜拉鲁肽1次/周0.75 mg (n = 5)、塞马鲁肽1次/周0.5 mg (n = 2)、塞马鲁肽1次/周1.0 mg (n = 2)。结论糖尿病患者食管胃十二指肠镜检查发现GLP-1RA治疗与胃残渣相关。
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引用次数: 6
Risk heterogeneity of bullous pemphigoid among dipeptidyl peptidase-4 inhibitors: A population-based cohort study using Japanese Latter-Stage Elderly Healthcare Database 二肽基肽酶-4抑制剂中大疱性类天疱疮的风险异质性:一项基于人群的队列研究,使用日本晚期老年保健数据库
IF 3.2 3区 医学 Pub Date : 2023-03-10 DOI: 10.1111/jdi.14004
Yumi Harano, Yasutaka Mitamura, Peng Jiang, Takako Fujita, Akira Babazono

Aims/Introduction

Although the association between dipeptidyl peptidase-4 (DPP-4) inhibitors and bullous pemphigoid (BP) has begun to be established, some studies have suggested there are risk differences among DPP-4 inhibitors. We conducted a population-based cohort study to examine the risk differences.

Materials and Methods

Using the claims databases of the Fukuoka Prefecture Wide-Area Association of Latter-Stage Elderly Healthcare between April 1, 2013 and March 31, 2017, we conducted a retrospective cohort study to compare patients receiving one DPP-4 inhibitor with those who were prescribed another antidiabetic drug. The primary outcome was an adjusted hazard ratio (HR) of the development of bullous pemphigoid during a 3-year follow-up. The secondary outcome was the development of BP requiring systemic steroids immediately after the diagnosis. These were estimated using Cox proportional hazards regression models.

Results

The study comprised 33,241 patients, of which 0.26% (n = 88) developed bullous pemphigoid during follow-up. The percentages of patients with bullous pemphigoid who required immediate systemic steroid treatment was 0.11% (n = 37). We analyzed four DPP-4 inhibitors: sitagliptin, vildagliptin, alogliptin, and linagliptin. Vildagliptin and linagliptin raised the risk of BP significantly (primary outcome, vildagliptin, HR 2.411 [95% confidence interval (CI) 1.325–4.387], linagliptin, HR 2.550 [95% CI 1.266–5.136], secondary outcome, vildagliptin HR 3.616 [95% CI 1.495–8.745], linagliptin HR 3.556 [95% CI 1.262–10.024]). A statistically significant risk elevation was not observed with sitagliptin and alogliptin (primary outcome, sitagliptin, HR 0.911 [95% CI 0.508–1.635], alogliptin, HR 1.600 [95% CI 0.714–3.584], secondary outcome, sitagliptin, HR 1.192 [95% CI 0.475–2.992], alogliptin, HR 2.007 [95% CI 0.571–7.053]).

Conclusions

Not all the DPP-4 inhibitors could induce bullous pemphigoid significantly. Therefore, the association warrants further investigations before generalization.

虽然二肽基肽酶-4 (DPP-4)抑制剂与大疱性类天疱疮(BP)之间的关联已经开始确立,但一些研究表明DPP-4抑制剂之间存在风险差异。我们进行了一项基于人群的队列研究,以检查风险差异。材料与方法利用2013年4月1日至2017年3月31日福冈广域老年保健协会的索赔数据库,我们进行了一项回顾性队列研究,比较服用一种DPP-4抑制剂的患者和服用另一种降糖药的患者。主要结局是3年随访期间发生大疱性类天疱疮的调整风险比(HR)。次要结果是诊断后需要立即全身性类固醇的BP发展。这些是使用Cox比例风险回归模型估计的。结果本研究共纳入33,241例患者,其中0.26% (n = 88)在随访期间出现大疱性类天疱疮。大疱性类天疱疮患者需要立即全身类固醇治疗的百分比为0.11% (n = 37)。我们分析了四种DPP-4抑制剂:西格列汀、维格列汀、阿格列汀和利格列汀。维格列汀和利格列汀显著提高了BP风险(主要结局,维格列汀,危险度2.411[95%可信区间(CI) 1.325-4.387],利格列汀,危险度2.550 [95% CI 1.266-5.136],次要结局,维格列汀危险度3.616 [95% CI 1.495-8.745],利格列汀危险度3.556 [95% CI 1.262-10.024])。西格列汀和阿格列汀未观察到有统计学意义的风险升高(主要结局,西格列汀,HR 0.911 [95% CI 0.508-1.635],阿格列汀,HR 1.600 [95% CI 0.714-3.584],次要结局,西格列汀,HR 1.192 [95% CI 0.475-2.992],阿格列汀,HR 2.007 [95% CI 0.571-7.053])。结论并非所有DPP-4抑制剂均能显著诱导大疱性类天疱疮。因此,在推广之前,这种关联值得进一步调查。
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引用次数: 1
Effect of a reused insulin needle remaining in a patient's body 重复使用的胰岛素针留在病人体内的效果
IF 3.2 3区 医学 Pub Date : 2023-03-05 DOI: 10.1111/jdi.14003
Yong-jie Qiao, Yu Xin-yuan, Rui-ling Xu, Xiao-yang Song, Shuo Ye, Ping Zhen, Sheng-hu Zhou, Hao-qiang Zhang

Diabetes is one of the most common chronic diseases at present, and insulin pen injection therapy plays an important role in the treatment of diabetes. However, the majority of patients might reuse disposable insulin pen needles for various reasons, which leads to related complications. As far as we know, this article is the first to describe a patient whose needle remained in the right upper limb while reusing a disposable insulin injection needle for subcutaneous insulin injection with the non-dominant hand. The patient went to the doctor 1 week later. The needle moved from the lateral area of the proximal upper arm (the injection site) to the posterolateral area of the distal upper arm. The needle was then successfully removed by surgery. The reuse of disposable insulin pen needles might lead to serious complications. It is suggested to strengthen the education of people living with diabetes to help them use insulin pen needles safely.

糖尿病是目前最常见的慢性疾病之一,胰岛素笔注射治疗在糖尿病的治疗中起着重要的作用。然而,由于各种原因,大多数患者可能会重复使用一次性胰岛素笔针,从而导致相关并发症。据我们所知,这篇文章是第一个描述一个病人在用非惯用手重复使用一次性胰岛素注射针进行皮下胰岛素注射时,针头留在右上肢的病例。病人一周后去看医生。针头从上臂近端外侧(注射部位)移至上臂远端后外侧。然后通过手术成功地取出了针头。重复使用一次性胰岛素笔针可能会导致严重的并发症。建议加强对糖尿病患者的教育,帮助他们安全使用胰岛素笔针。
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引用次数: 1
Signaling pathways that regulate adaptive β-cell proliferation for the treatment of diabetes 调节适应性β细胞增殖治疗糖尿病的信号通路
IF 3.2 3区 医学 Pub Date : 2023-03-05 DOI: 10.1111/jdi.14002
Jun Shirakawa

The decline in β-cell mass due to the failure of β-cell compensation is one cause of the development of type 2 diabetes. Therefore, elucidation of the mechanism by which an adaptive increase in β-cell mass occurs in vivo will lead to the development of a cure for diabetes. Insulin and insulin receptor (IR)-mediated signaling pathways play an important role in the mechanism that increases β-cell mass by compensatory β-cell proliferation in response to chronic insulin resistance. However, whether IR is required for compensatory β-cell proliferation remains controversial in some situations. It might be possible that IR acts as a scaffold for the signaling complex independent of its ligand. It has also been reported that the forkhead box protein M1/polo-like kinase 1/centromere protein A pathway plays a central role in adaptive β-cell proliferation during diet-induced obesity, hyperglycemia, pregnancy, aging and acute insulin resistance. We recently reported that the cross-talk of islets with fat tissue, in addition to the liver, through humoral factors is involved in adaptive β-cell proliferation. This accommodative response of β-cell proliferation through adipocytes was observed particularly under an acute insulin resistance state in an IR/insulin signal-independent and forkhead box protein M1/polo-like kinase 1/centromere protein A pathway-dependent manner. A remaining barrier for the treatment of human diabetes using β-cells is the differences between human and rodent islets. In this review, the focus is on signaling pathways that regulate adaptive β-cell proliferation for the treatment of diabetes considering the abovementioned issues.

β细胞代偿失败导致的β细胞质量下降是2型糖尿病发生的原因之一。因此,阐明体内β细胞质量的适应性增加的机制将导致糖尿病治疗的发展。胰岛素和胰岛素受体(IR)介导的信号通路在慢性胰岛素抵抗中通过代偿性β细胞增殖增加β细胞质量的机制中起重要作用。然而,在某些情况下,补偿性β细胞增殖是否需要IR仍然存在争议。IR可能作为信号复合物的支架而独立于其配体。也有报道称叉头盒蛋白M1/polo样激酶1/着丝粒蛋白A通路在饮食诱导的肥胖、高血糖、妊娠、衰老和急性胰岛素抵抗期间的适应性β细胞增殖中起核心作用。我们最近报道,除了肝脏外,胰岛与脂肪组织通过体液因子的串扰参与了适应性β细胞增殖。特别是在急性胰岛素抵抗状态下,通过IR/胰岛素信号不依赖和叉头盒蛋白M1/polo样激酶1/着丝粒蛋白A途径依赖的方式观察到β细胞增殖的调节反应。利用β细胞治疗人类糖尿病的另一个障碍是人类和啮齿动物胰岛之间的差异。在这篇综述中,重点是考虑到上述问题,调节适应性β细胞增殖的信号通路对糖尿病的治疗。
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引用次数: 2
Graft failure after allogeneic islet transplantation in a patient with type 1 diabetes and a high anti-glutamic acid decarboxylase antibody titer 抗谷氨酸脱羧酶抗体滴度高的1型糖尿病患者异体胰岛移植后移植失败
IF 3.2 3区 医学 Pub Date : 2023-03-01 DOI: 10.1111/jdi.13996
Noriko Kodani, Daisuke Chujo, Aiko Terakawa, Kyoji Ito, Fuyuki Inagaki, Nobuyuki Takemura, Shinichi Matsumoto, Tsuyoshi Tajima, Norio Ohmagari, Kumiko Ajima, Tadashi Takaki, Yzumi Yamashita, Koya Shinohara, Hiroshi Kajio, Takuya Awata, Masayuki Shimoda

Pancreatic islet transplantation is a β-cell replacement therapy for people with insulin-deficient diabetes who have difficulty in glycemic control and suffer from frequent severe hypoglycemia. However, the number of islet transplantations carried out is still limited in Asia. We report a case of allogeneic islet transplantation in a 45-year-old Japanese man with type 1 diabetes. Although the islet transplantation was successfully carried out, graft loss was observed on the 18th day. Immunosuppressants were used in accordance with the protocol, and donor-specific anti-human leukocyte antigen antibodies were not detected. Autoimmunity relapse was also not observed. However, the patient had a high titer of anti-glutamic acid decarboxylase antibody from before the islet transplantation, and autoimmunity might thus have affected the β-cells in the transplanted islet. The evidence is still scarce to reach conclusions, and further data accumulation is required to enable proper patient selection before islet transplantation.

胰岛移植是一种用于胰岛素缺乏型糖尿病患者的β细胞替代疗法,这些糖尿病患者血糖控制困难,经常出现严重的低血糖。然而,在亚洲进行的胰岛移植数量仍然有限。我们报告一例异体胰岛移植在一个45岁的日本男性1型糖尿病。虽然胰岛移植成功,但在第18天观察到移植物的损失。按照方案使用免疫抑制剂,未检测到供体特异性抗人白细胞抗原抗体。自身免疫复发也未见。然而,患者在胰岛移植前具有高滴度的抗谷氨酸脱羧酶抗体,因此自身免疫可能影响了移植胰岛中的β细胞。证据仍然很少,无法得出结论,需要进一步的数据积累,以便在胰岛移植前正确选择患者。
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引用次数: 1
A novel view of the insulin signaling pathway based on prediction of protein structure by the AI platform AlphaFold 人工智能平台AlphaFold基于蛋白质结构预测的胰岛素信号通路的新观点
IF 3.2 3区 医学 Pub Date : 2023-02-14 DOI: 10.1111/jdi.13988
Kyosuke Sato, Kenji Sugawara, Wataru Ogawa

The predicted structures of major proteins involved in the insulin signaling pathway obtained from the AlphaFold Protein Structure Database.

从AlphaFold蛋白结构数据库获得胰岛素信号通路中主要蛋白的预测结构。
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引用次数: 2
期刊
Journal of Diabetes Investigation
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