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Effect of a Dietary Intervention on Insulin Requirements and Glycemic Control in Type 1 Diabetes: A 12-Week Randomized Clinical Trial 饮食干预对 1 型糖尿病患者胰岛素需求和血糖控制的影响:为期 12 周的随机临床试验
Q2 Medicine Pub Date : 2024-03-14 DOI: 10.2337/cd23-0086
H. Kahleová, Tatiana Znayenko-Miller, Karen Smith, Cyrus Khambatta, Robby Barbaro, Macy Sutton, D. Holtz, Mark Sklar, Desiree Pineda, Richard Holubkov, Neal D. Barnard
This study compared the effects of a low-fat vegan diet to those of a portion-controlled diet in people with type 1 diabetes. Over 12 weeks, the average total daily dose of insulin decreased significantly and insulin sensitivity increased significantly in the vegan group, while no significant changes were observed in the group receiving the portion-controlled diet. Total and LDL cholesterol decreased in the vegan group, as did the ratio of blood urea nitrogen to creatinine. A1C decreased in both groups. These findings suggest that a low-fat vegan diet may yield improvements in insulin sensitivity, insulin requirements, glycemic control, and markers of cardiovascular and renal health compared with a portion-controlled diet in people with type 1 diabetes.
这项研究比较了低脂素食与控制饮食份量对 1 型糖尿病患者的影响。在 12 周的时间里,素食组的胰岛素日平均总剂量显著下降,胰岛素敏感性显著提高,而接受控制饮食份量组则没有观察到明显变化。素食组的总胆固醇和低密度脂蛋白胆固醇下降,血尿素氮与肌酐的比率也有所下降。两组的 A1C 都有所下降。这些研究结果表明,与控制份量的饮食相比,低脂素食可能会改善 1 型糖尿病患者的胰岛素敏感性、胰岛素需求量、血糖控制以及心血管和肾脏健康指标。
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引用次数: 0
Similarities and Differences in Diabetes Diagnosis Stories Among Adults With Type 1 or Type 2 Diabetes in Appalachian Ohio 俄亥俄州阿巴拉契亚地区 1 型或 2 型糖尿病成人糖尿病诊断故事的异同
Q2 Medicine Pub Date : 2024-03-13 DOI: 10.2337/cd23-0081
Andrew Pugh, M. Ritholz, Elizabeth A. Beverly
This qualitative study examined adults’ recollections of their reactions to their diabetes diagnosis and explored the similarities and differences among those diagnosed with type 1 versus type 2 diabetes. Based on semistructured interviews, the authors identified three themes: 1) shared emotional reactions of fear, sadness, confusion, and worry; 2) perceived differences in expressing concerns for diabetes complications; and 3) differences in perceiving the diagnosis as a surprise versus an inevitability. How health care professionals deliver diabetes diagnoses may be crucial to individuals’ acceptance of the condition and coping strategies. HCPs should consider assessing people’s emotional reactions to their diagnosis.
这项定性研究考察了成年人对糖尿病诊断反应的回忆,并探讨了被诊断为 1 型糖尿病和 2 型糖尿病患者之间的异同。根据半结构式访谈,作者确定了三个主题:1)恐惧、悲伤、困惑和担忧等共同的情绪反应;2)在表达对糖尿病并发症的担忧方面的感知差异;3)将诊断视为意外还是必然的差异。医护人员如何提供糖尿病诊断可能对个人接受病情和应对策略至关重要。医护人员应考虑评估患者对诊断结果的情绪反应。
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引用次数: 0
Dental Extractions Associated With Reduced Insulin Requirements in an Individual Using Concentrated Insulin: A Case Study 使用浓缩胰岛素的患者拔牙后胰岛素需求量减少:病例研究
Q2 Medicine Pub Date : 2024-02-16 DOI: 10.2337/cd23-0101
Morgan P. Stewart, Roxanne Powers, Kathryn Litten
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引用次数: 0
Patterns and Trends in Continuous Glucose Monitoring Utilization Among Commercially Insured Individuals With Type 1 Diabetes: 2010–2013 to 2016–2019 2010-2013 年至 2016-2019 年商业保险 1 型糖尿病患者使用连续葡萄糖监测的模式和趋势
Q2 Medicine Pub Date : 2024-01-19 DOI: 10.2337/cd23-0051
Mary E. Lacy, Katherine E. Lee, Omer Atac, Kory R Heier, John Fowlkes, Anna Kucharska-Newton, Daniela C. Moga
Prior studies suggest that only ∼30% of patients with type 1 diabetes use continuous glucose monitoring (CGM), but most studies to date focused on children and young adults seen by endocrinologists or in academic centers. This study examined national trends in CGM utilization among commercially insured children and adults with type 1 diabetes. Overall, CGM utilization was 20.12% in 2010–2013 and 49.78% in 2016–2019, reflecting a 2.5-fold increase in utilization within a period of <10 years. Identifying populations with low CGM use is a necessary first step in developing targeted interventions to increase CGM uptake.
先前的研究表明,只有 30% 的 1 型糖尿病患者使用持续葡萄糖监测 (CGM),但迄今为止的大多数研究都集中在内分泌科医生或学术中心的儿童和年轻成人患者身上。本研究调查了全国范围内有商业保险的儿童和成人 1 型糖尿病患者使用 CGM 的趋势。总体而言,2010-2013 年 CGM 使用率为 20.12%,2016-2019 年为 49.78%,反映出在不到 10 年的时间内,CGM 使用率增加了 2.5 倍。确定 CGM 使用率低的人群是制定有针对性的干预措施以提高 CGM 使用率的必要第一步。
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引用次数: 0
Lower Incidence of Hypoglycemia With Angiotensin Receptor Blocker Versus ACE Inhibitor Therapy in People With or Without Diabetes 血管紧张素受体阻滞剂与血管紧张素转换酶抑制剂相比,在糖尿病患者或非糖尿病患者中的低血糖发生率更低
Q2 Medicine Pub Date : 2024-01-12 DOI: 10.2337/cd23-0039
I. Khanimov, B. Zingerman, B. Rozen-zvi, M. Shimonov, E. Leibovitz
This article describes a study examining the association between treatment with ACE inhibitors or angiotensin receptor blockers (ARBs) and incident hypoglycemia in patients with or without diabetes who were admitted to the internal medicine departments of a tertiary hospital in the Tel Aviv district of Israel. The authors found that treatment with ARBs, but not ACE inhibitors, compared with treatment with neither, was associated with a reduced risk of hypoglycemia regardless of diabetes status.
本文介绍了一项研究,该研究探讨了在以色列特拉维夫地区一家三甲医院内科住院的糖尿病或非糖尿病患者中,使用血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂(ARBs)治疗与低血糖事件之间的关系。作者发现,无论是否患有糖尿病,使用血管紧张素受体阻滞剂(而非血管紧张素转换酶抑制剂)治疗与两者都不使用相比,都能降低低血糖风险。
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引用次数: 0
Best Practice Perspectives on Improving Early Detection and Management of Chronic Kidney Disease Associated With Type 2 Diabetes in Primary Care 从最佳实践角度看基层医疗机构如何改进 2 型糖尿病相关慢性肾病的早期检测和管理
Q2 Medicine Pub Date : 2024-01-12 DOI: 10.2337/cd23-0074
J. Goldman, Robert Busch, Eden Miller
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引用次数: 0
Lack of Association of A1C With Postoperative Complications in Children With Type 1 or Type 2 Diabetes. A1C缺乏与1型或2型糖尿病儿童术后并发症的相关性
Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2023-08-01 DOI: 10.2337/cd23-0002
Grace Kim, McKenna C Richards, Abigail B Smith, Kathleen M Strybos, Xiaofan Huang, Kristen Staggers, Stephen A Stayer, Rahul G Baijal

Not meeting recommended A1C targets may be associated with postoperative complications in adults, but there are no studies reporting on the relationship between preoperative A1C and postoperative complications in children with type 1 or type 2 diabetes. The objective of this study was to determine whether elevated A1C levels were associated with an increased incidence of postoperative complications in children with diabetes presenting for elective noncardiac surgery or diagnostic procedures. It found no such association, suggesting no need to delay elective surgery in children with diabetes until A1C is optimized.

未达到推荐的A1C指标可能与成人术后并发症有关,但没有研究报告1型或2型糖尿病儿童术前A1C与术后并发症之间的关系。本研究的目的是确定在接受选择性非心脏手术或诊断程序的糖尿病儿童中,A1C水平升高是否与术后并发症发生率增加有关。研究没有发现这种关联,这表明在A1C优化之前,没有必要推迟糖尿病儿童的选择性手术。
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引用次数: 0
Factors Associated With Improved A1C Values Among People Using High-Dose Insulin With Uncontrolled Type 2 Diabetes. 使用大剂量胰岛素的2型糖尿病患者A1C值改善的相关因素
Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2023-08-21 DOI: 10.2337/cd23-0006
Wuenseslao Hernandez, Shannon R Walter, Ryan A Popp

Uncontrolled diabetes negatively affects millions of people in the United States and contributes to significant health burden. Many people with diabetes require high insulin doses to achieve glycemic control, but glycemia in this group has historically been difficult to manage. This retrospective, case-control study evaluated which therapeutic interventions and patient factors were associated with an improvement in A1C in people with type 2 diabetes using high-dose insulin at a county health system serving primarily low-income patients. Medication nonadherence was found to be the most influential factor affecting glycemic control in these individuals.

不受控制的糖尿病对美国数百万人产生了负面影响,并造成了巨大的健康负担。许多糖尿病患者需要高剂量的胰岛素来控制血糖,但这一群体的血糖历来难以控制。这项回顾性病例对照研究评估了哪些治疗干预措施和患者因素与在主要为低收入患者服务的县卫生系统使用高剂量胰岛素的2型糖尿病患者A1C改善相关。药物不依从性被发现是影响这些人血糖控制的最有影响的因素。
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引用次数: 0
Good To Know: Continuous Glucose Monitoring and Nutrition. 了解更多信息:持续葡萄糖监测与营养。
Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-07-15 DOI: 10.2337/cd24-pe03
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引用次数: 0
Perceptions of Continuous Glucose Monitoring Systems in the T1D Exchange Diabetes Registry: Satisfaction, Concerns, and Areas for Future Improvement. T1D交换糖尿病登记中持续血糖监测系统的认知:满意度、关注点和未来改进领域
Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2023-08-23 DOI: 10.2337/cd23-0005
Elizabeth Holt, Huyen Nguyen, Jeoffrey Bispham, Jingwen Liu, Katherine Chapman, Mike Grady

Manufacturers continue to improve performance and usability of continuous glucose monitoring (CGM) systems. As CGM becomes a standard of care, especially for people on insulin therapy, it is important to routinely gauge how satisfied people with diabetes are with this technology. This article describes survey feedback from a large cohort of people with diabetes using older and current CGM systems and highlights areas of current satisfaction, concern, and future system improvement.

制造商不断提高连续血糖监测(CGM)系统的性能和可用性。随着CGM成为一种标准的护理,尤其是对接受胰岛素治疗的人来说,定期衡量糖尿病患者对这项技术的满意度很重要。本文描述了一大群糖尿病患者使用老年人和当前CGM系统的调查反馈,并强调了当前满意度、关注点和未来系统改进的领域。
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引用次数: 0
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Clinical Diabetes
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