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Increasing trend of childhood type 1 diabetes incidence: 20-year observation from Greater Poland Province, Poland. 儿童 1 型糖尿病发病率的增长趋势:波兰大波兰省 20 年的观察结果。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-18 DOI: 10.1007/s00592-024-02339-5
Elżbieta Niechciał, Michał Michalak, Bogda Skowrońska, Piotr Fichna

Aim: Type 1 diabetes is one of the fastest-growing chronic health conditions. Estimating the incidence rate of childhood type 1 diabetes will allow to aid in adequate planning of health care resources. The study's aim was to assess the incidence rate of type 1 diabetes in children below 15 years of age from Greater Poland (Poland) between 2006 and 2018, and then to compare obtained data to records collected between 1998 and 2003 in pediatric population aged 0-14 years from the same area.

Methods: In this cohort study covering the period from January 1998 to December 2018, data were collected for children and adolescents below 14 years of age with newly diagnosed type 1 diabetes living in Greater Poland. The overall population size was taken from the Statistical Office of Poland. Total, sex-, and age-specific incidence rates per 100,000 person-years were calculated for each calendar year.

Results: Over a 20-year period, the incidence rate of type 1 diabetes in children aged 0-14 years rose around 3.6-fold, from 8.4/100,000 in 1998 to 30.8/100,000 in 2018, with the peak incidence recorded in last year of the study. A clear male predominance of type 1 diabetes was seen in all ages. The rate of type 1 diabetes incidence growth was comparable between all age groups, while the highest incidence rate was mostly observed in children aged 5-9 and 10-14 years.

Conclusions: The incidence of type 1 diabetes in children aged 0-14 years is rapidly increasing in Greater Poland.

目的:1 型糖尿病是增长最快的慢性疾病之一。估算儿童 1 型糖尿病的发病率有助于充分规划医疗资源。该研究旨在评估2006年至2018年期间大波兰地区(波兰)15岁以下儿童1型糖尿病的发病率,然后将获得的数据与1998年至2003年期间收集的同一地区0-14岁儿科人群的记录进行比较:在这项覆盖 1998 年 1 月至 2018 年 12 月期间的队列研究中,收集了居住在大波兰地区新诊断出 1 型糖尿病的 14 岁以下儿童和青少年的数据。总体人口数量来自波兰统计局。计算了每个日历年每 10 万人年的总发病率、性别发病率和年龄发病率:20年间,0-14岁儿童的1型糖尿病发病率上升了约3.6倍,从1998年的8.4/100,000上升到2018年的30.8/100,000,研究最后一年的发病率达到峰值。在所有年龄段中,1型糖尿病患者明显以男性为主。各年龄组的1型糖尿病发病率增长率相当,而发病率最高的主要是5-9岁和10-14岁的儿童:结论:在大波兰地区,0-14 岁儿童的 1 型糖尿病发病率正在迅速上升。
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引用次数: 0
Screening for diabetic retinopathy with artificial intelligence: a real world evaluation. 利用人工智能筛查糖尿病视网膜病变:真实世界评估。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-12 DOI: 10.1007/s00592-024-02333-x
Silvia Burlina, Sandra Radin, Marzia Poggiato, Dario Cioccoloni, Daniele Raimondo, Giovanni Romanello, Chiara Tommasi, Simonetta Lombardi

Aim: Periodic screening for diabetic retinopathy (DR) is effective for preventing blindness. Artificial intelligence (AI) systems could be useful for increasing the screening of DR in diabetic patients. The aim of this study was to compare the performance of the DAIRET system in detecting DR to that of ophthalmologists in a real-world setting.

Methods: Fundus photography was performed with a nonmydriatic camera in 958 consecutive patients older than 18 years who were affected by diabetes and who were enrolled in the DR screening in the Diabetes and Endocrinology Unit and in the Eye Unit of ULSS8 Berica (Italy) between June 2022 and June 2023. All retinal images were evaluated by DAIRET, which is a machine learning algorithm based on AI. In addition, all the images obtained were analysed by an ophthalmologist who graded the images. The results obtained by DAIRET were compared with those obtained by the ophthalmologist.

Results: We included 958 patients, but only 867 (90.5%) patients had retinal images sufficient for evaluation by a human grader. The sensitivity for detecting cases of moderate DR and above was 1 (100%), and the sensitivity for detecting cases of mild DR was 0.84 ± 0.03. The specificity of detecting the absence of DR was lower (0.59 ± 0.04) because of the high number of false-positives.

Conclusion: DAIRET showed an optimal sensitivity in detecting all cases of referable DR (moderate DR or above) compared with that of a human grader. On the other hand, the specificity of DAIRET was low because of the high number of false-positives, which limits its cost-effectiveness.

目的:定期筛查糖尿病视网膜病变(DR)可有效预防失明。人工智能(AI)系统可以帮助提高糖尿病患者的 DR 筛查率。本研究旨在比较 DAIRET 系统与眼科医生在实际环境中检测 DR 的性能:方法:在 2022 年 6 月至 2023 年 6 月期间,使用非眼底照相机对连续 958 名 18 岁以上的糖尿病患者进行了眼底照相,这些患者参加了糖尿病和内分泌科以及 ULSS8 Berica(意大利)眼科的 DR 筛查。所有视网膜图像都经过 DAIRET 评估,这是一种基于人工智能的机器学习算法。此外,所有获得的图像均由一名眼科医生进行分析,并对图像进行分级。DAIRET得出的结果与眼科医生得出的结果进行了比较:我们纳入了 958 名患者,但只有 867 名(90.5%)患者的视网膜图像足以由人工分级师进行评估。检测中度及以上 DR 病例的灵敏度为 1(100%),检测轻度 DR 病例的灵敏度为 0.84 ± 0.03。由于假阳性的数量较多,检测无 DR 的特异性较低(0.59 ± 0.04):结论:与人类分级人员相比,DAIRET 在检测所有可转诊 DR(中度或以上 DR)病例方面显示出最佳灵敏度。结论:DAIRET 在检测所有可转诊 DR(中度 DR 或以上)病例方面的灵敏度优于人工分级仪,但由于假阳性病例较多,DAIRET 的特异性较低,限制了其成本效益。
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引用次数: 0
Offlabel use of Medtronic MiniMed 780G in the management of cystic fibrosis related diabetes in people requiring insulin total daily doses below 8 units: encouraging data from our population 美敦力 MiniMed 780G 在治疗囊性纤维化相关糖尿病中的标示外使用:来自我国人群的令人鼓舞的数据:每日胰岛素总剂量低于 8 单位的患者。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-09 DOI: 10.1007/s00592-024-02329-7
Valeria Grancini, Irene Cogliati, Alessia Gaglio, Veronica Resi, Emanuela Orsi

Cystic fibrosis (CF)-related diabetes (CFRD), characterized by partial to complete impaired insulin secretion, is the most common extra-pulmonary complication of CF. Actually, insulin is the only approved therapy for its management. Advanced hybrid closed loop (AHCL) systems are the gold standard therapy for type 1 diabetes and have been proposed for other insulin-dependent forms of diabetes, including CFRD. With AHCL systems, people with CFRD can better manage several typical disease-related issues, such as minimal insulin requirements, its variability due to exacerbations or concomitant steroid therapies, nutritional behaviors, the co-existence of CF complications as intestinal malabsorption or liver disease. SmartGuard, the AHCL system for Medtronic Minimed 780G, requires a minimum of 8 units per day to operate. In this paper, we expose a case of two young women with CFRD with total daily insulin requirements < 8 UI, using off-label SmartGuard system over a 3 years of follow-up period, suggesting an evaluation of its use also in people with minimal insulin needs, considering its beneficial impact in glucose control and quality of life.

囊性纤维化(CF)相关糖尿病(CFRD)以胰岛素分泌部分或完全受损为特征,是 CF 最常见的肺外并发症。事实上,胰岛素是唯一获准用于治疗该病的疗法。高级混合闭环(AHCL)系统是治疗 1 型糖尿病的金标准疗法,也被建议用于包括 CFRD 在内的其他胰岛素依赖型糖尿病。有了 AHCL 系统,CFRD 患者就能更好地处理几个典型的疾病相关问题,如最低胰岛素需求量、因病情加重或同时使用类固醇疗法导致的胰岛素需求量变化、营养行为、同时存在的 CF 并发症(如肠吸收不良或肝病)等。SmartGuard 是美敦力 Minimed 780G 的 AHCL 系统,每天至少需要 8 个单位才能运行。在本文中,我们揭示了两个年轻女性 CFRD 患者的病例,她们每天的胰岛素总需求量小于 8 UI,在 3 年的随访期间使用了标示外 SmartGuard 系统,考虑到其对血糖控制和生活质量的有益影响,我们建议对其在胰岛素需求量极低的人群中的使用情况进行评估。
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引用次数: 0
iTRAQ proteomics analysis of placental tissue with gestational diabetes mellitus. 妊娠糖尿病胎盘组织的 iTRAQ 蛋白组学分析。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-08 DOI: 10.1007/s00592-024-02321-1
Xiaoping Yin, Fei Yang, Jin Lin, Qin Hu, Xiaoxiao Tang, Li Yin, Xi Yan, Hongbin Zhuang, Guanwei Ma, Liming Shen, Danqing Zhao

Background: Gestational diabetes mellitus is an endocrine and metabolic disorder that appears for the first time during pregnancy and causes varying degrees of short- and/or long-term effects on the mother and child. The etiology of the disease is currently unknown and isobaric tags for relative and absolute quantitation proteomics approach, the present study attempted to identify potential proteins in placental tissues that may be involved in the pathogenesis of GDM and adverse foetal pregnancy outcomes.

Methods: Pregnant women with GDM hospitalised were selected as the experimental group, and pregnant women with normal glucose metabolism as the control group. The iTRAQ protein quantification technology was used to screen the differentially expressed proteins between the GDM group and the normal control group, and the differentially expressed proteins were analysed by GO, KEGG, PPI, etc., and the key proteins were subsequently verified by western blot.

Results: Based on the proteomics of iTRAQ, we experimented with three different samples of placental tissues from GDM and normal pregnant women, and the total number of identified proteins were 5906, 5959, and 6017, respectively, which were similar in the three different samples, indicating that the results were reliable. Through the Wayne diagram, we found that the total number of proteins coexisting in the three groups was 4475, and 91 differential proteins that could meet the quantification criteria were strictly screened, of which 32 proteins were up-regulated and 59 proteins were down-regulated. By GO enrichment analysis, these differential proteins are widely distributed in extracellular membrane-bounded organelle, mainly in extracellular exosome, followed by intracellular vesicle, extracellular organelle. It not only undertakes protein binding, protein complex binding, macromolecular complex binding, but also involves molecular biological functions such as neutrophil degranulation, multicellular organismal process, developmental process, cellular component organization, secretion, regulated exocytosis. Through the analysis of the KEGG signaling pathway, it is found that these differential proteins are mainly involved in HIF-1 signaling pathway, Glycolysis/Gluconeogenesis, Central carbon metabolism in cancer, AMPK signaling pathway, Proteoglycans in cancer, Protein processing in endoplasmic reticulum, Thyroid cancer, Alcoholism, Glucagon signaling pathway.

Discussion: This preliminary study helps us to understand the changes in the placental proteome of GDM patients, and provides new insights into the pathophysiology of GDM.

背景:妊娠期糖尿病是妊娠期首次出现的一种内分泌和代谢紊乱疾病,会对母婴造成不同程度的短期和/或长期影响。目前,该病的病因尚不清楚,本研究试图通过等位标记的相对和绝对定量蛋白质组学方法,鉴定胎盘组织中可能参与 GDM 发病机制和不良妊娠结局的潜在蛋白质:方法:选择住院治疗的 GDM 孕妇为实验组,糖代谢正常的孕妇为对照组。采用 iTRAQ 蛋白定量技术筛选 GDM 组与正常对照组的差异表达蛋白,并对差异表达蛋白进行 GO、KEGG、PPI 等分析,随后对关键蛋白进行 Western 印迹验证:基于 iTRAQ 的蛋白质组学方法,我们对 GDM 和正常孕妇的三个不同胎盘组织样本进行了实验,鉴定出的蛋白质总数分别为 5906、5959 和 6017 个,三个不同样本的鉴定结果相似,说明结果是可靠的。通过韦恩图,我们发现三组共存的蛋白质总数为 4475 个,严格筛选出符合定量标准的差异蛋白 91 个,其中上调蛋白 32 个,下调蛋白 59 个。通过GO富集分析,这些差异蛋白广泛分布于细胞膜外细胞器,主要分布在细胞外外泌体,其次是细胞内囊泡、细胞外细胞器。它不仅承担着蛋白质结合、蛋白质复合物结合、大分子复合物结合等功能,还涉及中性粒细胞脱颗粒、多细胞生物过程、发育过程、细胞成分组织、分泌、调控外泌等分子生物学功能。通过对KEGG信号通路的分析,发现这些差异蛋白主要参与了HIF-1信号通路、糖酵解/葡萄糖生成、癌症中枢碳代谢、AMPK信号通路、癌症中的蛋白聚糖、内质网中的蛋白质加工、甲状腺癌、酒精中毒、胰高血糖素信号通路等:这项初步研究有助于我们了解 GDM 患者胎盘蛋白质组的变化,并为 GDM 的病理生理学提供了新的见解。
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引用次数: 0
Silencing the FABP3 gene in insulin-secreting cells reduces fatty acid uptake and protects against lipotoxicity. 沉默胰岛素分泌细胞中的 FABP3 基因可减少脂肪酸摄取并防止脂肪毒性。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-04 DOI: 10.1007/s00592-024-02325-x
Ayman Hyder, Basma Sheta, Manar Eissa, Jürgen Schrezenmeir

Background: Long-term exposure of pancreatic islets to fatty acids (FAs), common in obesity, metabolic syndrome, and type 2 diabetes, leads to a compensatory hyperactivity followed by inflammation, apoptosis, dysfunctional beta cells, and results in insulin dependence of the patient. Restriction of fatty uptake by islet beta cells may protect them from lipotoxicity.

Purpose: Pancreatic islet beta cells express the fatty acid binding protein 3 (FABP3) to bind FAs and to orchestrate lipid signals. Based on this, we investigated whether downregulation of FABP3, by Fabp3 silencing, might slow lipid metabolism and protect against lipotoxicity in insulin-secreting cells.

Results: Neither Fabp3 silencing, nor overexpression affected the glucose-stimulated insulin secretion in absence of FAs. Fabp3 silencing decreased FA-uptake, lipid droplets formation, and the expression of the lipid accumulation-regulating gene Dgat1 in Ins1E cells. It reduced FA-induced inflammation by deactivation of NF-κB, which was associated with upregulation of IκBα and deactivation of the NF-κB p65 nuclear translocation, and the downregulation of the cytokines ILl-6, IL-1β, and TNFα. Ins1E cells were protected from the FA-induced apoptosis as assessed by different parameters including DNA degradation and cleaved caspase-3 immunoblotting. Furthermore, FABP3 silencing improved the viability, Pdx1 gene expression, and the insulin-secreting function in cells long-term cultured with palmitic acid. All results were confirmed by the opposite action rendered by FABP3 overexpression.

Conclusion: The present data reveals that pancreatic beta cells can be protected from lipotoxicity by inhibition of FA-uptake, intracellular utilization and accumulation. FABP3 inhibition, hence, may be a useful pharmaceutical approach in obesity, metabolic syndrome, and type 2 diabetes.

背景:肥胖、代谢综合征和 2 型糖尿病患者的胰岛长期暴露于脂肪酸(FAs)中,会导致代偿性胰岛功能亢进,继而引发炎症、细胞凋亡、β细胞功能障碍,并导致患者对胰岛素产生依赖性。目的:胰岛β细胞表达脂肪酸结合蛋白3(FABP3),以结合脂肪酸并协调脂质信号。在此基础上,我们研究了通过Fabp3沉默下调FABP3是否可能减缓脂质代谢并保护胰岛素分泌细胞免受脂毒性的影响:结果:无论是Fabp3沉默还是过表达,都不会影响葡萄糖刺激的胰岛素分泌。沉默 Fabp3 可减少 Ins1E 细胞对 FA 的吸收、脂滴的形成以及脂质积累调节基因 Dgat1 的表达。它通过使 NF-κB 失活减少了 FA 诱导的炎症,这与 IκBα 的上调、NF-κB p65 核转位的失活以及细胞因子 ILl-6、IL-1β 和 TNFα 的下调有关。通过不同参数(包括 DNA 降解和裂解的 caspase-3 免疫印迹)的评估,Ins1E 细胞在 FA 诱导的细胞凋亡中受到保护。此外,在长期使用棕榈酸培养的细胞中,沉默 FABP3 可提高细胞活力、Pdx1 基因表达和胰岛素分泌功能。所有结果都得到了 FABP3 过表达所产生的相反作用的证实:本研究数据表明,胰岛β细胞可以通过抑制脂肪酸的摄取、细胞内利用和积累而免受脂肪毒性的影响。因此,抑制 FABP3 可能是治疗肥胖症、代谢综合征和 2 型糖尿病的有效药物方法。
{"title":"Silencing the FABP3 gene in insulin-secreting cells reduces fatty acid uptake and protects against lipotoxicity.","authors":"Ayman Hyder, Basma Sheta, Manar Eissa, Jürgen Schrezenmeir","doi":"10.1007/s00592-024-02325-x","DOIUrl":"https://doi.org/10.1007/s00592-024-02325-x","url":null,"abstract":"<p><strong>Background: </strong>Long-term exposure of pancreatic islets to fatty acids (FAs), common in obesity, metabolic syndrome, and type 2 diabetes, leads to a compensatory hyperactivity followed by inflammation, apoptosis, dysfunctional beta cells, and results in insulin dependence of the patient. Restriction of fatty uptake by islet beta cells may protect them from lipotoxicity.</p><p><strong>Purpose: </strong>Pancreatic islet beta cells express the fatty acid binding protein 3 (FABP3) to bind FAs and to orchestrate lipid signals. Based on this, we investigated whether downregulation of FABP3, by Fabp3 silencing, might slow lipid metabolism and protect against lipotoxicity in insulin-secreting cells.</p><p><strong>Results: </strong>Neither Fabp3 silencing, nor overexpression affected the glucose-stimulated insulin secretion in absence of FAs. Fabp3 silencing decreased FA-uptake, lipid droplets formation, and the expression of the lipid accumulation-regulating gene Dgat1 in Ins1E cells. It reduced FA-induced inflammation by deactivation of NF-κB, which was associated with upregulation of IκBα and deactivation of the NF-κB p65 nuclear translocation, and the downregulation of the cytokines ILl-6, IL-1β, and TNFα. Ins1E cells were protected from the FA-induced apoptosis as assessed by different parameters including DNA degradation and cleaved caspase-3 immunoblotting. Furthermore, FABP3 silencing improved the viability, Pdx1 gene expression, and the insulin-secreting function in cells long-term cultured with palmitic acid. All results were confirmed by the opposite action rendered by FABP3 overexpression.</p><p><strong>Conclusion: </strong>The present data reveals that pancreatic beta cells can be protected from lipotoxicity by inhibition of FA-uptake, intracellular utilization and accumulation. FABP3 inhibition, hence, may be a useful pharmaceutical approach in obesity, metabolic syndrome, and type 2 diabetes.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141496813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Cai's herbal tea enhances mitochondrial autophagy of type 1 diabetic mellitus β cells through the AMPK/mTOR pathway and alleviates inflammatory response. 蔡氏凉茶通过AMPK/mTOR途径增强1型糖尿病β细胞线粒体自噬,并缓解炎症反应。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-02 DOI: 10.1007/s00592-024-02316-y
Hongchun Li, Yanfei Gao, Mengdi Li, Yue Dong, Jie Chen, Bingyue Zhang, Kaiqiang Li, Yuqun Cai

Background: This study investigates the therapeutic mechanisms of Cai's Herbal Tea in Type 1 Diabetes Mellitus (T1DM) mice, focusing on its effects on mitochondrial change and autophagy via the AMP-activated protein kinase (AMPK)-mammalian target of rapamycin (mTOR) pathway.

Methods: The composition of Cai's Herbal Tea was analyzed by Ultra-High Performance Liquid Chromatography-Quadrupole Time of Flight Mass Spectrometry (UHPLC-Q/TOF-MS). C57BL/6 mice and Min6 pancreatic beta cells were divided into control, diabetic mellitus (DM)/high glucose (HG), and treatment groups (low, medium, and high doses of Cai's Tea, and Metformin). Key physiological parameters, pancreatic islet health, Min6 cell morphology, viability, and insulin (INS) secretion were assessed. Small Interfering RNA-AMPK (si-AMPK) was utilized to confirm the pathway involvement.

Results: Cai's Herbal Tea improved body weight, pancreatic islet pathological injury, and INS secretion whereas reduced total triglycerides, fasting blood sugar, and Interferon gamma (INF-γ) in T1DM mice, particularly at higher doses. In Min6 cells, Cai's Tea mitigated HG-induced damage and proinflammatory response, enhancing cell viability and INS secretion. Notably, it reduced swelling and improved cristae structure in treated groups of mitochondria and promoted autophagy via the AMPK-mTOR pathway, evidenced by increased LC3II/LC3I and P-AMPK/AMPK ratios, and decreased P-mTOR/mTOR and P62 expressions in pancreatic islet β-cells. Furthermore, these effects were converted by si-AMPK interference.

Conclusion: Cai's Herbal Tea exhibits significant therapeutic efficacy in T1DM mice by improving mitochondrial health and inducing autophagy through the AMPK-mTOR pathway in pancreatic islet β-cells. These findings highlight its potential as a therapeutic approach for T1DM management.

背景:本研究探讨了蔡氏凉茶对1型糖尿病(T1DM)小鼠的治疗机制,重点关注其通过AMP激活蛋白激酶(AMPK)-雷帕霉素哺乳动物靶标(mTOR)通路对线粒体变化和自噬的影响:采用超高效液相色谱-四极杆飞行时间质谱(UHPLC-Q/TOF-MS)分析蔡氏凉茶的成分。将 C57BL/6 小鼠和 Min6 胰岛β细胞分为对照组、糖尿病组(DM)/高糖组(HG)和治疗组(低、中、高剂量的蔡氏茶和二甲双胍)。主要生理参数、胰岛健康状况、Min6细胞形态、存活率和胰岛素(INS)分泌情况都得到了评估。利用小干扰 RNA-AMPK(si-AMPK)确认参与途径:结果:蔡氏凉茶改善了 T1DM 小鼠的体重、胰岛病理损伤和 INS 分泌,同时降低了总甘油三酯、空腹血糖和γ干扰素(INF-γ),尤其是在较大剂量时。在 Min6 细胞中,蔡氏茶减轻了 HG 诱导的损伤和促炎反应,提高了细胞活力和 INS 分泌。值得注意的是,蔡氏茶减少了线粒体的肿胀,改善了处理组线粒体的嵴结构,并通过 AMPK-mTOR 途径促进自噬,这体现在胰岛β细胞中 LC3II/LC3I 和 P-AMPK/AMPK 比率增加,P-mTOR/mTOR 和 P62 表达减少。结论:蔡氏凉茶对胰岛β细胞有抑制作用:结论:蔡氏凉茶通过胰岛β细胞中的 AMPK-mTOR 通路改善线粒体健康并诱导自噬,对 T1DM 小鼠有显著疗效。这些研究结果凸显了花茶作为治疗 T1DM 方法的潜力。
{"title":"Cai's herbal tea enhances mitochondrial autophagy of type 1 diabetic mellitus β cells through the AMPK/mTOR pathway and alleviates inflammatory response.","authors":"Hongchun Li, Yanfei Gao, Mengdi Li, Yue Dong, Jie Chen, Bingyue Zhang, Kaiqiang Li, Yuqun Cai","doi":"10.1007/s00592-024-02316-y","DOIUrl":"https://doi.org/10.1007/s00592-024-02316-y","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the therapeutic mechanisms of Cai's Herbal Tea in Type 1 Diabetes Mellitus (T1DM) mice, focusing on its effects on mitochondrial change and autophagy via the AMP-activated protein kinase (AMPK)-mammalian target of rapamycin (mTOR) pathway.</p><p><strong>Methods: </strong>The composition of Cai's Herbal Tea was analyzed by Ultra-High Performance Liquid Chromatography-Quadrupole Time of Flight Mass Spectrometry (UHPLC-Q/TOF-MS). C57BL/6 mice and Min6 pancreatic beta cells were divided into control, diabetic mellitus (DM)/high glucose (HG), and treatment groups (low, medium, and high doses of Cai's Tea, and Metformin). Key physiological parameters, pancreatic islet health, Min6 cell morphology, viability, and insulin (INS) secretion were assessed. Small Interfering RNA-AMPK (si-AMPK) was utilized to confirm the pathway involvement.</p><p><strong>Results: </strong>Cai's Herbal Tea improved body weight, pancreatic islet pathological injury, and INS secretion whereas reduced total triglycerides, fasting blood sugar, and Interferon gamma (INF-γ) in T1DM mice, particularly at higher doses. In Min6 cells, Cai's Tea mitigated HG-induced damage and proinflammatory response, enhancing cell viability and INS secretion. Notably, it reduced swelling and improved cristae structure in treated groups of mitochondria and promoted autophagy via the AMPK-mTOR pathway, evidenced by increased LC3II/LC3I and P-AMPK/AMPK ratios, and decreased P-mTOR/mTOR and P62 expressions in pancreatic islet β-cells. Furthermore, these effects were converted by si-AMPK interference.</p><p><strong>Conclusion: </strong>Cai's Herbal Tea exhibits significant therapeutic efficacy in T1DM mice by improving mitochondrial health and inducing autophagy through the AMPK-mTOR pathway in pancreatic islet β-cells. These findings highlight its potential as a therapeutic approach for T1DM management.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141490463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Urban diabetes: analysis of diabetes prevalence in cities of the Lombardy region participating in the cities changing diabetes project. 城市糖尿病:参与城市改变糖尿病项目的伦巴第大区城市糖尿病发病率分析。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-01 DOI: 10.1007/s00592-024-02324-y
Livio Luzi, Stefano Massarini, Anna Ferrulli, Pamela Senesi, Michele Carruba, Cristina Romano, Sergio Di Lembo, Maria Bianchi, Paolo Bulgheroni, Marco Villa, Federico Serra, Andrea Lenzi

Aim: The urban population increases by about 60 million people/year. Urbanization, unhealthy lifestyle and aging of the population are reflected in a constant growth in the prevalence of diabetes. In 2014, Steno Diabetes Centre in Copenhagen, University College London and Novo Nordisk, launched the Cities Changing Diabetes® program with the aim of creating a unified movement that would stimulate policy-makers to prioritize urban diabetes.

Methods: The socio-demographic data derive from (1) ISTAT (National Institute of Statistics of Italy), (2) ATS Metropolitan City of Milan, (3) ATS Val Padana-Cremona, (4) ATS Insubria-Varese, (5) The unemployment rates of the various municipalities have been extrapolated from an ISTAT-MEF elaboration published by Sole 24 Ore journal.

Results: In the different sanitary districts of the Metropolitan City of Milan, a strong linear correlation was found between the prevalence of diabetes and the prevalence of heart disease (R = 0.695, p < 0.001), as well as between the prevalence of diabetes and of nephropathies (R = 0.316, p < 0.001). The analysis concerning the province of Cremona showed a fair correlation between the prevalence of diabetes and cardiovascular disease (R = 0.658, p < 0.001). Even for the municipalities of Varese, the analysis documented a good correlation between the prevalence of diabetes and heart disease (R = 0.419, p < 0.001), but not between diabetes and nephropathies.

Conclusions: Interesting differences in the relationship of diabetes prevalence with several diseases and socio-demographic factors have been found when comparing the metropolitan City of Milan with two smaller size cities as Varese and Cremona. Our present data confirm the hypothesis that urban diabetes will be the challenge for our society during the next decades.

目的:城市人口每年增加约 6000 万。城市化、不健康的生活方式和人口老龄化反映在糖尿病患病率的持续增长上。2014 年,哥本哈根斯泰诺糖尿病中心、伦敦大学学院和诺和诺德公司共同发起了 "城市改变糖尿病®"计划,旨在创建一个统一的运动,激励政策制定者优先考虑城市糖尿病问题:社会人口数据来源于:(1)意大利国家统计局(ISTAT);(2)米兰大都会 ATS;(3)Val Padana-Cremona ATS;(4)Insubria-Varese ATS;(5)各城市的失业率是根据《Sole 24 Ore》杂志发表的 ISTAT-MEF 阐释推算出来的:结果:在米兰大都会的不同卫生区,糖尿病患病率与心脏病患病率之间存在很强的线性相关(R = 0.695,p 结论:糖尿病患病率与心脏病患病率之间存在有趣的差异:将米兰大都市与瓦雷泽和克雷莫纳这两个较小的城市进行比较,发现糖尿病患病率与多种疾病和社会人口因素的关系存在有趣的差异。我们目前的数据证实了一个假设,即城市糖尿病将在未来几十年内成为我们社会面临的挑战。
{"title":"Urban diabetes: analysis of diabetes prevalence in cities of the Lombardy region participating in the cities changing diabetes project.","authors":"Livio Luzi, Stefano Massarini, Anna Ferrulli, Pamela Senesi, Michele Carruba, Cristina Romano, Sergio Di Lembo, Maria Bianchi, Paolo Bulgheroni, Marco Villa, Federico Serra, Andrea Lenzi","doi":"10.1007/s00592-024-02324-y","DOIUrl":"https://doi.org/10.1007/s00592-024-02324-y","url":null,"abstract":"<p><strong>Aim: </strong>The urban population increases by about 60 million people/year. Urbanization, unhealthy lifestyle and aging of the population are reflected in a constant growth in the prevalence of diabetes. In 2014, Steno Diabetes Centre in Copenhagen, University College London and Novo Nordisk, launched the Cities Changing Diabetes® program with the aim of creating a unified movement that would stimulate policy-makers to prioritize urban diabetes.</p><p><strong>Methods: </strong>The socio-demographic data derive from (1) ISTAT (National Institute of Statistics of Italy), (2) ATS Metropolitan City of Milan, (3) ATS Val Padana-Cremona, (4) ATS Insubria-Varese, (5) The unemployment rates of the various municipalities have been extrapolated from an ISTAT-MEF elaboration published by Sole 24 Ore journal.</p><p><strong>Results: </strong>In the different sanitary districts of the Metropolitan City of Milan, a strong linear correlation was found between the prevalence of diabetes and the prevalence of heart disease (R = 0.695, p < 0.001), as well as between the prevalence of diabetes and of nephropathies (R = 0.316, p < 0.001). The analysis concerning the province of Cremona showed a fair correlation between the prevalence of diabetes and cardiovascular disease (R = 0.658, p < 0.001). Even for the municipalities of Varese, the analysis documented a good correlation between the prevalence of diabetes and heart disease (R = 0.419, p < 0.001), but not between diabetes and nephropathies.</p><p><strong>Conclusions: </strong>Interesting differences in the relationship of diabetes prevalence with several diseases and socio-demographic factors have been found when comparing the metropolitan City of Milan with two smaller size cities as Varese and Cremona. Our present data confirm the hypothesis that urban diabetes will be the challenge for our society during the next decades.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141475716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Diabetes mellitus in stroke unit: prevalence and outcomes-the Verona acute coronary syndrome and stroke in diabetes outcome (VASD-OUTCOME) study. 中风患者中的糖尿病:患病率和结果--维罗纳糖尿病急性冠状动脉综合征和中风结果(VASD-OUTCOME)研究。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-01 DOI: 10.1007/s00592-024-02318-w
Marco Dauriz, Alessandro Csermely, Lorenza Santi, Elena Tregnaghi, Alberto Grotto, Tiziano Lucianer, Anna Altomari, Elisabetta Rinaldi, Stefano Tardivo, Bruno Bonetti, Enzo Bonora

Background: Cerebrovascular accidents (CVA) represent a major complication in diabetes (DM). Real-life evidence as to whether modern management of CVA and DM have softened this relationship is limited. Therefore, we estimated prevalence and impact of DM on in-hospital survival and complications in a contemporary cohort of subjects with CVA.

Methods: We retrospectively evaluated the records of 937 patients admitted for CVA at the Stroke Unit of Verona University Hospital during a 3-year period. Pre-existing or de novo DM was ascertained by prior diagnosis, glucose-lowering therapy at admission/discharge or admittance plasma glucose ≥ 200 mg/dL. Multiple regressions were applied to test DM as predictor of in-hospital mortality, complications (composite of infections, cardio- and cerebrovascular complications, major bleeding and pulmonary complications), duration and costs of hospitalization.

Results: Diabetes prevalence was 21%, of which 22% de novo diagnoses. Compared to non-DM, diabetic individuals were older and carried an increased burden of cardiovascular risk factors. Compared to known DM, de novo DM individuals were younger, had higher admittance plasma glucose and poorer cardiovascular comorbidities. Overall, DM versus non-DM individuals did not show significantly increased risk of death (14.0 vs. 9.3%; crude-OR 1.59 95% CI 0.99-2.56). Controlling for confounders did not improve significance. DM resulted independent predictor for in-hospital complications (36.2% vs. 26.9%; adj-OR 1.49, 1.04-2.13), but not for duration and costs of hospitalization.

Conclusion: DM frequently occurs in patients admitted for stroke and carries an excess burden of adverse in-hospital complications, urgently calling for strategies to anticipate DM diagnosis and tailored treatment in high-risk individuals.

背景:脑血管意外(CVA)是糖尿病(DM)的主要并发症之一。关于 CVA 和 DM 的现代管理是否缓和了这种关系,现实生活中的证据很有限。因此,我们估算了当代 CVA 患者队列中 DM 的患病率及其对院内存活率和并发症的影响:我们回顾性评估了维罗纳大学医院卒中科在 3 年内收治的 937 名 CVA 患者的病历。通过既往诊断、入院/出院时接受降糖治疗或入院时血浆葡萄糖≥200 mg/dL,确定是否存在既往或新发糖尿病。应用多元回归检验了糖尿病对院内死亡率、并发症(感染、心脑血管并发症、大出血和肺部并发症的综合)、住院时间和费用的预测作用:糖尿病发病率为21%,其中22%为新诊断。与非糖尿病患者相比,糖尿病患者年龄更大,心血管风险因素负担更重。与已知的糖尿病患者相比,新确诊的糖尿病患者更年轻,入院时血浆葡萄糖更高,心血管合并症更严重。总体而言,糖尿病患者与非糖尿病患者相比,死亡风险并没有明显增加(14.0% 对 9.3%;粗OR 1.59 95% CI 0.99-2.56)。对混杂因素的控制并没有提高显著性。DM是院内并发症的独立预测因子(36.2% vs. 26.9%;adj-OR 1.49,1.04-2.13),但不是住院时间和费用的独立预测因子:结论:DM 常常发生在脑卒中患者中,并带来过多的院内不良并发症,因此迫切需要制定策略,对高危人群进行 DM 诊断和有针对性的治疗。
{"title":"Diabetes mellitus in stroke unit: prevalence and outcomes-the Verona acute coronary syndrome and stroke in diabetes outcome (VASD-OUTCOME) study.","authors":"Marco Dauriz, Alessandro Csermely, Lorenza Santi, Elena Tregnaghi, Alberto Grotto, Tiziano Lucianer, Anna Altomari, Elisabetta Rinaldi, Stefano Tardivo, Bruno Bonetti, Enzo Bonora","doi":"10.1007/s00592-024-02318-w","DOIUrl":"https://doi.org/10.1007/s00592-024-02318-w","url":null,"abstract":"<p><strong>Background: </strong>Cerebrovascular accidents (CVA) represent a major complication in diabetes (DM). Real-life evidence as to whether modern management of CVA and DM have softened this relationship is limited. Therefore, we estimated prevalence and impact of DM on in-hospital survival and complications in a contemporary cohort of subjects with CVA.</p><p><strong>Methods: </strong>We retrospectively evaluated the records of 937 patients admitted for CVA at the Stroke Unit of Verona University Hospital during a 3-year period. Pre-existing or de novo DM was ascertained by prior diagnosis, glucose-lowering therapy at admission/discharge or admittance plasma glucose ≥ 200 mg/dL. Multiple regressions were applied to test DM as predictor of in-hospital mortality, complications (composite of infections, cardio- and cerebrovascular complications, major bleeding and pulmonary complications), duration and costs of hospitalization.</p><p><strong>Results: </strong>Diabetes prevalence was 21%, of which 22% de novo diagnoses. Compared to non-DM, diabetic individuals were older and carried an increased burden of cardiovascular risk factors. Compared to known DM, de novo DM individuals were younger, had higher admittance plasma glucose and poorer cardiovascular comorbidities. Overall, DM versus non-DM individuals did not show significantly increased risk of death (14.0 vs. 9.3%; crude-OR 1.59 95% CI 0.99-2.56). Controlling for confounders did not improve significance. DM resulted independent predictor for in-hospital complications (36.2% vs. 26.9%; adj-OR 1.49, 1.04-2.13), but not for duration and costs of hospitalization.</p><p><strong>Conclusion: </strong>DM frequently occurs in patients admitted for stroke and carries an excess burden of adverse in-hospital complications, urgently calling for strategies to anticipate DM diagnosis and tailored treatment in high-risk individuals.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141475715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Remission of type 2 diabetes: position statement of the Italian society of diabetes (SID) 2 型糖尿病的缓解:意大利糖尿病学会 (SID) 的立场声明。
IF 3.1 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-06-28 DOI: 10.1007/s00592-024-02317-x
Danila Capoccia, Frida Leonetti, Andrea Natali, Domenico Tricò, Sebastio Perrini, Paolo Sbraccia, Valeria Guglielmi, On behalf of the Italian Society of Diabetes (SID)

The primary cause of the pandemic scale of type 2 diabetes (T2D) is the excessive and/or abnormal accumulation of adiposity resulting from a chronic positive energy balance. Any form of weight loss dramatically affects the natural history of T2D, favoring prevention, treatment, and even remission in the case of significant weight loss. However, weight regain, which is often accompanied by the recurrence or worsening of obesity complications such as T2D, is an inevitable biological phenomenon that is an integral part of the pathophysiology of obesity. This can occur not only after weight loss, but also during obesity treatment if it is not effective enough to counteract the physiological responses aimed at restoring adiposity to its pre-weight-loss equilibrium state. Over the past few years, many controlled and randomized studies have suggested a superior efficacy of bariatric surgery compared to conventional therapy in terms of weight loss, glycemic control, and rates of T2D remission. Recently, the therapeutic armamentarium in the field of diabetology has been enriched with new antihyperglycemic drugs with considerable efficacy in reducing body weight, which could play a pathogenetic role in the remission of T2D, not through the classical incretin effect, but by improving adipose tissue functions. All these concepts are discussed in this position statement, which aims to deepen the pathogenetic links between obesity and T2D, shift the paradigm from a “simple” interaction between insulin resistance and insulin deficiency, and evaluate the efficacy of different therapeutic interventions to improve T2D management and induce diabetes remission whenever still possible.

2 型糖尿病(T2D)大流行的主要原因是长期能量正平衡导致脂肪过度和/或异常堆积。任何形式的体重减轻都会极大地影响 T2D 的自然病史,有利于预防、治疗,甚至在体重大幅减轻的情况下缓解病情。然而,体重反弹往往伴随着 T2D 等肥胖并发症的复发或恶化,是一种不可避免的生物学现象,是肥胖病理生理学不可分割的一部分。这种现象不仅会在减肥后出现,而且如果肥胖治疗不能有效抵消旨在将脂肪含量恢复到减肥前平衡状态的生理反应,也会在治疗过程中出现。在过去几年中,许多对照和随机研究表明,与传统疗法相比,减肥手术在减轻体重、控制血糖和 T2D 缓解率方面具有更优越的疗效。最近,糖尿病学领域的治疗手段也在不断丰富,新的降糖药物在减轻体重方面具有相当大的疗效,这些药物可能在 T2D 的缓解过程中发挥致病作用,但不是通过传统的增量素效应,而是通过改善脂肪组织功能。本立场声明讨论了所有这些概念,旨在深化肥胖与 T2D 之间的病理联系,改变胰岛素抵抗与胰岛素缺乏之间 "简单 "相互作用的范式,并评估不同治疗干预措施的疗效,以改善 T2D 的管理,并在可能的情况下诱导糖尿病缓解。
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引用次数: 0
Continuous glucose monitoring with FreeStyle Libre PRO sensor in patients with type 2 diabetes and end-stage renal failure on haemoDIALysis (FSLPRO-DIAL pilot study). 使用 FreeStyle Libre PRO 传感器对接受血液透析的 2 型糖尿病和终末期肾衰竭患者进行连续葡萄糖监测(FSLPRO-DIAL 试验研究)。
IF 3.1 3区 医学 Q1 Medicine Pub Date : 2024-06-26 DOI: 10.1007/s00592-024-02323-z
Zoé Henry, Emmanuel Villar, Cécile Chauvet, Amélie Belloi, Ionut Prunescu, Fanny Doroszewski, Cédric Luyton, Lucien Marchand

Aims: For end-stage renal disease (ESRD) patients with diabetes on haemodialysis, diabetes control is difficult to achieve. Hypoglycaemia is a major problem in these frailty subjects. Continuous glucose monitoring (CGM) devices appear therefore to be a good tool to help patients monitor their glycaemic control and to help practitioners optimize treatment. We aimed to compare the laboratory value of Hba1c with the sensor-estimated value of Hba1c (= glucose management indicator, GMI) in ESRD patients with type 2 diabetes (T2D) (with or without insulin treatment) on haemodialysis. Secondly, we aimed to identify CGM-derived monitoring parameters [time in range, time in hypo/hyperglycaemia, glycaemic variability (coefficient of variation, CV)] to identify patients at risk of frequent hypo- or hyperglycaemia.

Methods: The FSLPRO-DIAL pilot study (NCT04641650) was a prospective monocentric cohort study including 29 subjects with T2D who achieve the protocol. Inclusion criteria were: age ≥ 18 years, haemodialysis duration for at least 3 months, type 2 diabetes with no change in treatment for at least 3 months. Demographic data and blood sample were collected at the day of inclusion. Freestyle Libre pro IQ sensor (blinded CGM) was inserted for 14 days. After this period, all CGMs data were collected and analysed.

Results: Data were available for 27 patients. Mean age was 73 ± 10, mean BMI 27.2 kg/m2, mean duration of diabetes 16.9 years and mean dialysis duration 2.9 years. Twenty-four subjects were treated with insulin. Mean HbA1c was 6.6% (SD 1.2), and mean GMI was 6.7% (SD 0.9) (no significant difference, p = 0.3). Twelve subjects (44.4%) had a discordance between HbA1c and GMI of < 0.5%, 11 (40.8%) had a discordance between 0.5 and 1%, and only 4 (14.8%) had a discordance of > 1%. Mean time in range (70-180 mg/dl) was 71.9%, mean time below range (< 70 mg/dl) was 5.6%, and mean time above range (> 180 mg/dl) was 22.1%. Mean CV was 31.8%. For 13 out of 27 patients, we reduced antidiabetic treatment by stopping treatments or reducing insulin doses.

Conclusion: In this pilot study, there was no global significant difference between HbA1c and GMI in this particular cohort with very well-controlled diabetes. However, the use of the sensor enabled us to identify an excessive time in hypoglycemia in this fragile population and to adapt their treatment.

目的:对于接受血液透析的终末期肾病(ESRD)糖尿病患者来说,糖尿病控制很难实现。低血糖是这些体弱患者的主要问题。因此,连续血糖监测(CGM)设备似乎是帮助患者监测血糖控制和帮助医生优化治疗的好工具。我们旨在比较接受血液透析的 ESRD 2 型糖尿病(T2D)患者(无论是否接受胰岛素治疗)的 Hba1c 实验室值与传感器估计的 Hba1c 值(= 血糖管理指标,GMI)。其次,我们旨在确定 CGM 衍生的监测参数[范围内时间、低血糖/高血糖时间、血糖变异性(变异系数,CV)],以识别有频繁低血糖或高血糖风险的患者:FSLPRO-DIAL试验研究(NCT04641650)是一项前瞻性单中心队列研究,包括29名符合方案的T2D患者。纳入标准为:年龄≥18岁,血液透析时间至少3个月,2型糖尿病治疗至少3个月无变化。在纳入当天收集人口统计学数据和血液样本。Freestyle Libre pro IQ 传感器(盲式 CGM)植入 14 天。14 天后,收集并分析所有 CGM 数据:结果:27 名患者的数据可用。平均年龄为 73 ± 10 岁,平均体重指数为 27.2 kg/m2,平均糖尿病病程为 16.9 年,平均透析时间为 2.9 年。24 名患者接受了胰岛素治疗。平均 HbA1c 为 6.6%(标清 1.2),平均 GMI 为 6.7%(标清 0.9)(无显著差异,P = 0.3)。有 12 名受试者(44.4%)的 HbA1c 和 GMI 之间的不一致性达到了 1%。在范围内(70-180 毫克/分升)的平均时间为 71.9%,低于范围(180 毫克/分升)的平均时间为 22.1%。平均变异率为 31.8%。在 27 名患者中有 13 名患者,我们通过停止治疗或减少胰岛素剂量来减少抗糖尿病治疗:结论:在这项试点研究中,HbA1c 和 GMI 在糖尿病控制良好的特定人群中没有全面的显著差异。然而,传感器的使用使我们能够发现这一脆弱群体中低血糖时间过长的情况,并调整治疗方法。
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引用次数: 0
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