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Investigating the Association Between Diet-Induced "Leaky Gut" and the Development of Prediabetes. 研究饮食诱导的“肠漏”与糖尿病前期发展之间的关系。
Nosipho R Dimba, Nhlakanipho Mzimela, Palesa Mosili, Phikelelani S Ngubane, Andile Khathi

Introduction: Chronic consumption of a high-calorie diet compromises the gut microbiota and the integrity of the intestinal wall, which causes translocation of bacterial lipopolysaccharides (LPS) into the blood. This elicits the secretion of pro-inflammatory cytokines, resulting in inflammation. However, how a high-fat high carbohydrate diet affects intestinal permeability and its possible role in the development of prediabetes have not been investigated. This study investigated the effects of HFHC diet-induced prediabetes on gut microbiota and intestinal permeability in male Sprague Dawley rats.

Methods: The animals were randomly assigned into the non-prediabetic (NPD) and diet-induced prediabetic (PD) groups (n=6) for 20 weeks. Then, the fecal samples were analyzed to measure the gut microbiota level of Firmicutes, Bacteroidetes, and Proteobacteria in both animal groups. Blood glucose, plasma insulin, serum zonulin, plasma LPS, soluble CD14, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), and intestinal fatty-acid binding protein (IFABP) concentrations were measured.

Results: The PD group had a reduction in the Firmicutes and an increase in Bacteroidetes and Proteobacteria levels compared to those in the NPD group. Blood glucose, insulin concentration, serum zonulin, and plasma sCD14 concentrations in the PD group increased significantly, while plasma LPS concentrations were similar to the NPD group. Concentrations of plasma TNF-α, IL-6, CRP, and IFABP, an intracellular protein expressed in the intestine, increased in PD compared to the NPD group.

Conclusions: the study results cumulatively suggest that chronic consumption of the HFHC diet may be associated with the dysregulation of gut microbiota, leading to increased intestinal permeability.

长期摄入高热量饮食会损害肠道微生物群和肠壁的完整性,从而导致细菌脂多糖转移到血液中。这会引起促炎细胞因子的分泌,从而导致炎症。然而,目前还没有研究高脂肪高碳水化合物饮食如何影响肠道通透性,以及这是否在糖尿病前期的发展中发挥作用。本研究研究了HFHC饮食诱导的糖尿病前期对雄性Sprague-Dawley大鼠肠道微生物群和肠道通透性的影响。将动物随机分为非糖尿病前期组(NPD)和饮食诱导糖尿病前期组组(PD)(n=6),为期20周。20周后,对粪便样本进行分析,以测量两组动物的厚壁菌门、拟杆菌门和变形杆菌的肠道微生物群水平。此外,还测量了血糖、血浆胰岛素、血清zonulin、血浆LPS、可溶性CD14、肿瘤坏死因子α、白细胞介素-6、C反应蛋白和肠道脂肪酸结合蛋白的浓度。粪便样本显示,与NPD相比,PD组厚壁菌门水平降低,拟杆菌门和变形杆菌门增加。与NPD相比,PD组的血糖和胰岛素浓度显著升高。与NPD相比,PD组的血清zonulin和血浆sCD14浓度增加,而血浆LPS浓度相似。与NPD相比,PD患者的血浆TNF-α、IL-6和CRP浓度增加。IFABP是一种在肠道中表达的细胞内蛋白,与NPD相比,其在PD中的浓度增加。总之,这些结果表明,长期食用HFHC饮食可能与肠道微生物群失调有关,导致肠道通透性增加。关键词:糖尿病前期,高脂肪高碳水化合物,肠道微生物群,带状蛋白,脂多糖,肠道通透性。
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引用次数: 0
The Ca2+/Calmodulin-dependent Calcineurin/NFAT Signaling Pathway in the Pathogenesis of Insulin Resistance in Skeletal Muscle. 骨骼肌胰岛素抵抗发病机制中的Ca2+/钙调素依赖性钙调磷酸酶/NFAT信号通路
Magdalena Danowska, Marek Strączkowski

Skeletal muscle is the tissue directly involved in insulin-stimulated glucose uptake. Glucose is the primary energy substrate for contracting muscles, and proper metabolism of glucose is essential for health. Contractile activity and the associated Ca2+signaling regulate functional capacity and muscle mass. A high concentration of Ca2+and the presence of calmodulin (CaM) leads to the activation of calcineurin (CaN), a protein with serine-threonine phosphatase activity. The signaling pathway linked with CaN and transcription factors like the nuclear factor of activated T cells (NFAT) is essential for skeletal muscle development and reprogramming of fast-twitch to slow-twitch fibers. CaN activation may promote metabolic adaptations in muscle cells, resulting in better insulin-stimulated glucose transport. The molecular mechanisms underlying the altered insulin response remain unclear. The role of the CaN/NFAT pathway in regulating skeletal muscle hypertrophy is better described than its involvement in the pathogenesis of insulin resistance. Thus, there are opportunities for future research in that field. This review presents the role of CaN/NFAT signaling and suggests the relationship with insulin-resistant muscles.

骨骼肌是直接参与胰岛素刺激的葡萄糖摄取的组织。葡萄糖是收缩肌肉的主要能量基质,葡萄糖的适当代谢对健康至关重要。收缩活性和相关的Ca2+信号调节功能能力和肌肉质量。高浓度的Ca2+和钙调素(CaM)的存在会激活钙调神经磷酸酶(CaN),这是一种具有丝氨酸-苏氨酸磷酸酶活性的蛋白质。与CaN和转录因子(如活化T细胞的核因子(NFAT))相关的信号通路对于骨骼肌发育和快速抽搐到慢速抽搐纤维的重新编程至关重要。CaN激活可能促进肌肉细胞的代谢适应,从而产生更好的胰岛素刺激的葡萄糖转运。胰岛素反应改变的分子机制尚不清楚。CaN/NFAT通路在调节骨骼肌肥大中的作用比其在胰岛素抵抗发病机制中的作用更好地描述。因此,未来在该领域进行研究是有机会的。这篇综述介绍了CaN/NFAT信号传导的作用,并提出了与胰岛素抵抗肌肉的关系。
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引用次数: 0
Pioglitazone-Enhanced Brown Fat Whitening Contributes to Weight Gain in Diet-Induced Obese Mice. 吡格列酮增强的棕色脂肪美白有助于饮食诱导的肥胖小鼠的体重增加。
Piaojian Yu, Wei Wang, Wanrong Guo, Lidan Cheng, Zhiping Wan, Yanglei Cheng, Yunfeng Shen, Fen Xu

Introduction: Pioglitazone is an insulin sensitizer used for the treatment of type 2 diabetes mellitus (T2DM) by activating peroxisome proliferator-activated receptor gamma. This study aimed to investigate the effects of pioglitazone on white adipose tissue (WAT) and brown adipose tissue (BAT) in diet-induced obese (DIO) mice.

Methods: C57BL/6 mice were treated with pioglitazone (30 mg/kg/day) for 4 weeks after a 16-week high-fat diet (HFD) challenge. Body weight gain, body fat mass, energy intake, and glucose homeostasis were measured during or after the treatment. Histopathology was observed by hematoxylin and eosin, oil red O, immunohistochemistry, and immunofluorescence staining. Expression of thermogenic and mitochondrial biogenesis-related genes was detected by quantitative real-time PCR and western blotting.

Results: After 4-week pioglitazone treatment, the fasting blood glucose levels, glucose tolerance, and insulin sensitivity were significantly improved, but the body weight gain and fat mass were increased in DIO mice. Compared with the HFD group, pioglitazone did not significantly affect the weights of liver and WAT in both subcutaneous and epididymal regions. Unexpectedly, the weight of BAT was increased after pioglitazone treatment. Histological staining revealed that pioglitazone ameliorated hepatic steatosis, reduced the adipocyte size in WAT, but increased the adipocyte size in BAT.

Conclusion: Though pioglitazone can promote lipolysis, thermogenesis, and mitochondrial function in WAT, it leads to impaired thermogenesis, and mitochondrial dysfunction in BAT. In conclusion, pioglitazone could promote the browning of WAT but led to the whitening of BAT; the latter might be a new potential mechanism of pioglitazone-induced weight gain during T2DM treatment.

吡格列酮是一种胰岛素增敏剂,通过激活过氧化物酶体增殖物激活受体γ用于治疗2型糖尿病(T2DM)。本研究旨在研究吡格列酮对饮食诱导肥胖(DIO)小鼠白色脂肪组织(WAT)和棕色脂肪组织(BAT)的影响。C57BL/6小鼠在16周高脂肪饮食(HFD)挑战后用吡格列酮(30mg/kg/天)治疗4周。在治疗期间或之后测量体重增加、体脂质量、能量摄入和葡萄糖稳态。苏木精和伊红、油红O、免疫组织化学和免疫荧光染色观察组织病理学。通过实时定量PCR和蛋白质印迹检测产热基因和线粒体生物发生相关基因的表达。吡格列酮治疗四周后,DIO小鼠的空腹血糖水平、糖耐量和胰岛素敏感性显著改善,但体重增加和脂肪量增加。与HFD组相比,吡格列酮对皮下和附睾区域的肝脏重量和WAT没有显著影响。出乎意料的是,吡格列酮治疗后BAT的重量增加了。组织学染色显示吡格列酮改善了肝脂肪变性,降低了WAT的脂肪细胞大小,但增加了BAT的脂肪细胞尺寸。虽然吡格列酮可以促进WAT的脂解、产热和线粒体功能,但它也会导致BAT的产热受损和线粒体功能障碍。总之,吡格列酮可促进WAT的褐变,但可导致BAT变白,后者可能是吡格列酮诱导T2DM治疗过程中体重增加的一种新的潜在机制。
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引用次数: 1
A Questionnaire Survey of German Thyroidologists on the Use of Thyroid Hormones in Hypothyroid and Euthyroid Patients: The THESIS (Treatment of Hypothyroidism in Europe by Specialists: An International Survey) Collaborative. 德国甲状腺医生对甲状腺功能减退和甲状腺功能正常患者使用甲状腺激素的问卷调查:论文(欧洲专家治疗甲状腺功能减退:一项国际调查)合作。
I. Vardarli, T. Brandenburg, L. Hegedüs, R. Attanasio, E. Nagy, E. Papini, P. Perros, F. Weidemann, K. Herrmann, D. Führer
OBJECTIVETo identify the attitudes of German thyroid specialists towards the clinical treatment of hypothyroidism using thyroid hormones (TH).METHODSAll members of the thyroid section of the German Endocrine Society (DGE) were e-mailed an invitation to participate in a web-based survey about substitution with TH.RESULTSOut of 206 members of the DGE's thyroid section, 163 (79.1%) responses were received and included in the analysis. Of responding members, 98.6% used levothyroxine (LT4) as the treatment of choice, and 45.4% also prescribed combination therapy with liothyronine (LT4+LT3) in their clinical practice (p<0.001). LT4+LT3 combination was favored in patients with persistent hypothyroidism symptoms despite biochemical euthyroidism on LT4 treatment (p<0.001). Of all respondents, 26.4% never indicated TH therapy for euthyroid patients (p<0.001), while the remainder would consider THs for one or more indications (62.9% for euthyroid infertile women with high anti-thyroid antibody levels (p<0.001), 7.1% in patients with severe hypercholesterolemia, as complementary treatment (p=0.007), and 57.1% in patients with simple goiter (p<0.001)). In conditions that could interfere with LT4 absorption, most respondents still preferred tablets and did not expect a significant difference when switching from one LT4 formulation to another.CONCLUSIONFor German thyroid specialists, LT4 is the treatment of choice for hypothyroidism. Combination therapy with LT4+LT3 was considered for patients with persistent symptoms. Even in conditions that could affect bioavailability, German thyroid specialists prefer LT4 tablets rather than other LT4 formulations, such as liquid or soft-gel capsules. The widespread use of thyroid hormone for non-hypothyroid conditions is not consistent with current evidence and needs further study.
目的了解德国甲状腺专科医生对临床应用甲状腺激素治疗甲状腺功能减退症的态度。方法通过电子邮件邀请德国内分泌学会(DGE)甲状腺分会的所有成员参加一项关于TH替代的网络调查。结果在DGE甲状腺科206名成员中,收到163份(79.1%)回复并纳入分析。在回应的成员中,98.6%的人在临床实践中选择左旋甲状腺素(LT4)作为治疗选择,45.4%的人在临床实践中也处方与碘甲状腺原氨酸(LT4+LT3)联合治疗(p<0.001)。LT4+LT3联合治疗虽有生化甲状腺功能亢进,但仍有持续甲状腺功能减退症状的患者更受青睐(p<0.001)。在所有应答者中,26.4%的人从未对甲状腺功能正常的患者进行过甲状腺激素治疗(p<0.001),而其余的人会考虑将甲状腺激素治疗用于一种或多种适应症(62.9%的抗甲状腺抗体水平高的甲状腺功能正常的不孕妇女(p<0.001), 7.1%的患者患有严重的高胆固醇血症,作为补充治疗(p=0.007), 57.1%的患者患有单纯甲状腺肿(p<0.001))。在可能干扰LT4吸收的条件下,大多数应答者仍然倾向于片剂,并且在从一种LT4制剂切换到另一种制剂时,并不期望有显着差异。结论对于德国甲状腺专科医生来说,LT4是甲状腺功能减退的首选治疗方法。对于持续症状的患者,考虑LT4+LT3联合治疗。即使在可能影响生物利用度的情况下,德国甲状腺专家也更喜欢LT4片剂,而不是其他LT4制剂,如液体或软凝胶胶囊。甲状腺激素在非甲状腺功能减退疾病中的广泛应用与目前的证据不一致,需要进一步研究。
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引用次数: 5
Hyperuricemia Associated with Low Skeletal Muscle in the Middle-Aged and Elderly Population in China. 中国中老年人群与低骨骼肌相关的高尿酸血症
Lingyan Chen, Li Wu, Qian Li, Yu Hu, Hui Ma, Huan-Dong Lin, Xin Gao
BACKGROUNDPrevious studies have presented inconsistent results on the relationship between serum uric acid and skeletal muscle mass (SMM). We aimed to explore whether a higher serum uric acid level was associated with low SMM in the Chinese population.METHODSWe performed a cross-sectional analysis of 6595 subjects aged 45 years or older. They were tested for fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, uric acid, blood urea nitrogen, creatinine, and estimated glomerular filtration rate. SMM was accessed by dual-energy x-ray absorptiometry using two approaches: weight-adjusted appendicular skeletal muscle mass (ASM)% and ASM/BMI (body mass index (kg/m2)). Low SMM was defined as a cut-off point of ASM/BMI<0.789 for men and<0.512 for women.RESULTSCompared with their normal group, patients with hyperuricemia had lower ASM% (29.33±2.33 vs 30.03±2.34 for males and 24.71±1.99 vs 25.19±2.07 for females, P<0.01) and ASM/BMI (0.83±0.10 vs 0.85±0.10 for male and 0.60±0.07 vs 0.62±0.07 for female), with a higher prevalence of the associated low SMM in both sexes (35.2 vs 26.5% for male and 10.5 vs 5.9% for female, P<0.01). Pearson analysis showed that ASM% and ASM/BMI were negatively correlated with SUA (male: ASM/BMI, r=-0.097, ASM%, r=-0.146; female: ASM/BMI, r=-0.151, ASM%, r=-0.157; all P<0.001). Logistic regression analysis showed a positive association of hyperuricemia with adjusted risk of low SMM association.CONCLUSIONSIn a middle-aged and elderly Chinese population, hyperuricemia is independently and positively associated with low SMM and can vary by age and gender.
背景以往的研究对血清尿酸与骨骼肌质量(SMM)之间的关系给出了不一致的结果。我们的目的是探讨中国人群中较高的血清尿酸水平是否与低SMM相关。方法我们对6595名年龄在45岁及以上的受试者进行了横断面分析。检测空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白-胆固醇、低密度脂蛋白-胆固醇、尿酸、血尿素氮、肌酐和肾小球滤过率。采用双能x线骨密度仪测量SMM,采用两种方法:体重调整后的阑尾骨骼肌质量(ASM)%和ASM/BMI(体重指数(kg/m2))。低SMM被定义为男性ASM/BMI<0.789,女性<0.512的分界点。结果与正常组相比,高尿酸血症患者的ASM%(男性29.33±2.33 vs 30.03±2.34,女性24.71±1.99 vs 25.19±2.07,P<0.01)和ASM/BMI(男性0.83±0.10 vs 0.85±0.10,女性0.60±0.07 vs 0.62±0.07)较低,且相关的低SMM患病率在两性中较高(男性35.2 vs 26.5%,女性10.5 vs 5.9%, P<0.01)。Pearson分析显示,ASM%和ASM/BMI与SUA呈负相关(男性:ASM/BMI, r=-0.097, ASM%, r=-0.146;女性:ASM/BMI, r=-0.151, ASM%, r=-0.157;所有P < 0.001)。Logistic回归分析显示高尿酸血症与低SMM相关的校正风险呈正相关。结论:在中国中老年人群中,高尿酸血症与低SMM独立且正相关,且随年龄和性别而变化。
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引用次数: 3
Is the size of insulinoma predictive for its endocrine behavior? An endoscopic ultrasound study. 胰岛素瘤的大小能否预测其内分泌行为?内窥镜超声检查。
Jan Adelmeyer, Franziska Göbel, P. Kann
OBJECTIVEThe insulinoma is a rare tumor of the pancreas, that can lead to spontaneous hypoglycemia due to an excessive insulin secretion. The 72-hour fast is the gold standard for finding the correct diagnosis. Endoscopic ultrasound (EUS) is an established examination method to identify the suspicious lesion. Previous studies correlate the measured size of insulinoma and their endocrine behavior. This study was designed to find a relation between these variables.METHODSWe took the data of patients which had a histological confirmed insulinoma after receiving an endoscopic ultrasound in our department. Size and echogenicity were correlated with the endpoint of the 72-hour fast and hormone levels.RESULTSA total of 45 patients were identified. Most insulinoma were small with a volume of < 2cm3 (median 1.15cm3). There was no correlation between the duration of fasting, hormone levels and the size of the insulinoma. In addition, in a subgroup analysis, no connection could be established between the size of the insulinoma and the amount of insulin that was released after oral glucose exposure. We found out that homogeneous tumors were significantly smaller and had a lower Ki-67 index. Furthermore, there was a tendency towards a shorter period of duration for the 72-hour fast for the small tumors.DISCUSSIONThis data suggests that the measured size of insulinoma by EUS is not related to the time until termination of the 72-hour fast and measured hormone levels. The echogenicity seems more important, showing that homogenous tumors are an indicator for a higher differentiation, which can result in a shorter duration of fasting period. The differences in the secretion behavior of the insulinomas could complicate the correlation of size and duration of the 72-hour fast.
目的:胰岛素瘤是一种罕见的胰腺肿瘤,由于胰岛素分泌过多,可导致自发性低血糖。72小时的禁食是找到正确诊断的黄金标准。超声内镜(EUS)是一种确定可疑病变的常用检查方法。先前的研究将胰岛素瘤的大小与其内分泌行为联系起来。本研究旨在找出这些变量之间的关系。方法收集本科经内镜超声检查组织学证实的胰岛素瘤患者的资料。大小和回声强度与72小时禁食终点和激素水平相关。结果共鉴定出45例患者。大多数胰岛素瘤体积较小,< 2cm3(中位为1.15cm3)。禁食时间、激素水平和胰岛素瘤大小之间没有相关性。此外,在亚组分析中,胰岛素瘤的大小与口服葡萄糖暴露后释放的胰岛素量之间没有联系。我们发现同质性肿瘤明显更小,Ki-67指数更低。此外,小肿瘤的72小时禁食时间有缩短的趋势。这些数据表明,EUS测量的胰岛素瘤大小与72小时禁食结束前的时间和测量的激素水平无关。回声性似乎更重要,表明同质性肿瘤是高分化的一个指标,这可能导致禁食时间缩短。胰岛素瘤分泌行为的差异可能使72小时禁食的大小和持续时间的相关性复杂化。
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引用次数: 1
Young Awardees in Endocrinology Presenting Hot Topics. 年轻的内分泌学获奖者展示热门话题。
M. Reincke, H. Biebermann
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引用次数: 0
'That Time of the Month' - Investigating the Influence of the Menstrual Cycle and Oral Contraceptives on the Brain Using Magnetic Resonance Imaging. “每个月的那个时候”——利用磁共振成像研究月经周期和口服避孕药对大脑的影响。
Verena Schuster, A. Jansen
The stereotypic and oversimplified relationship between female sex hormones and undesirable behavior dates to the earliest days of human society, as already the ancient Greek word for the uterus, "hystera" indicated an aversive connection. Remaining and evolving throughout the centuries, transcending across cultures and various aspects of everyday life, its perception was only recently reframed. Contemporarily, the complex interaction of hormonal phases (i. e., the menstrual cycle), hormonal medication (i. e., oral contraceptives), women's psychological well-being, and behavior is the subject of multifaceted and more reflected discussions. A driving force of this ongoing paradigm shift was the introduction of this highly interesting and important topic into the realm of scientific research. This refers to neuroscientific research as it enables a multimodal approach combining aspects of physiology, medicine, and psychology. Here a growing body of literature points towards significant alterations of both brain function, such as lateralization of cognitive functions, and structure, such as gray matter concentrations, due to fluctuations and changes in hormonal levels. This especially concerns female sex hormones. However, the more research is conducted within this field, the less reliable these observations and derived insights appear. This may be due to two particular factors: measurement inconsistencies and diverse hormonal phases accompanied by interindividual differences. The first factor refers to the prominent unreliability of one of the primarily utilized neuroscientific research instruments: functional magnetic resonance imaging (fMRI). This unreliability is seemingly present in paradigms and analyses, and their interplay, and is additionally affected by the second factor. In more detail, hormonal phases and levels further influence neuroscientific results obtained through fMRI as outcomes vary drastically across different cycle phases and medication. This resulting vast uncertainty thus tremendously hinders the further advancement of our understanding of how female sex hormones might alter brain structure and function and, ultimately, behavior.This review summarizes parts of the current state of research and outlines the essential requirements to further investigate and understand the female brain's underlying physiological and anatomical features.
女性性激素和不良行为之间的刻板和过度简化的关系可以追溯到人类社会的早期,就像古希腊语中表示子宫的“hystera”一样,表明了一种令人厌恶的联系。几个世纪以来,它的存在和发展超越了文化和日常生活的各个方面,直到最近才被重新定义。目前,激素阶段的复杂相互作用(即。(如月经周期),激素药物(如:(口服避孕药),妇女的心理健康和行为是多方面和更多反映讨论的主题。这种正在进行的范式转变的驱动力是将这个非常有趣和重要的话题引入科学研究领域。这指的是神经科学研究,因为它使多模态方法结合了生理学、医学和心理学的各个方面。越来越多的文献指出,由于激素水平的波动和变化,大脑功能(如认知功能的偏侧化)和结构(如灰质浓度)都发生了重大变化。这尤其关系到女性的性激素。然而,在这一领域进行的研究越多,这些观察结果和得出的见解就越不可靠。这可能是由于两个特殊的因素:测量不一致和不同的激素阶段伴随着个体间的差异。第一个因素是指主要使用的神经科学研究仪器之一:功能磁共振成像(fMRI)的显著不可靠性。这种不可靠性似乎存在于范式和分析以及它们之间的相互作用中,并且还受到第二个因素的影响。更详细地说,激素的阶段和水平进一步影响通过功能磁共振成像获得的神经科学结果,因为不同的周期阶段和药物的结果差异很大。由此产生的巨大不确定性极大地阻碍了我们进一步了解女性性激素如何改变大脑结构和功能,并最终改变行为。本文总结了部分研究现状,并概述了进一步研究和了解女性大脑潜在生理和解剖特征的基本要求。
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引用次数: 1
Fundamentals of Diabetes Management. 糖尿病管理基础。
B. Kulzer, J. Aberle, T. Haak, M. Kaltheuner, J. Kröger, R. Landgraf, M. Kellerer
Diabetes is a chronic disease that poses considerable challenges for people with diabetes in their daily therapy. In addition to drug therapy, the therapy behaviour of the person with diabetes plays a significant role in the prognosis of the disease. In diabetes therapy, it is therefore important to define therapy goals together with the person with diabetes, taking into account a multitude of biological, somatic, social and behavioural factors, and to support those affected as best as possible in implementing therapy goals into their personal living environment and their self-management. The most important superordinate therapy goals for diabetes are described in the evidence-based guidelines for type 1 and type 2 diabetes [1, 2], as well as in the Disease Management Program (DMP) requirements guideline (DMP-A-RL) [3]. ▪ Maintaining or improving the quality of life limited by diabetes: For people with diabetes, maintaining the quality of life is the most important goal of diabetes therapy [4]. This means remaining as physically and psychologically healthy as possible despite and with diabetes, being able to realise one’s own life goals and being socially integrated – without being limited in areas of life that are important for people, such as family/relationship, job, interests, leisure time, etc. Study results show relatively consistently that these goals, which are important for people with diabetes, have not yet been achieved worldwide [5, 6]. ▪ Preventing symptoms of the disease: Elevated, decreased or even highly-fluctuating glucose levels (increased glucose variability) can lead to symptoms such as an increased urge to urinate (polyuria), a strong feeling of thirst (polydipsia), fatigue, weakness and tiredness. Symptoms that should be avoided during therapy also include dry or itchy skin, neuropathic symptoms and fluctuations in lens refractive power due to osmotic effects of increased glucose levels. ▪ Preventing acute complications: It is important to prevent side effects of antihyperglycaemic therapy, in particular hypoglycaemia – especially severe hypoglycaemia in which the affected person is dependent on external help (e. g., by relatives or medical staff). As well, it is important to prevent severe hyperglycaemic metabolic derailments (e. g., diabetic ketoacidosis) because of the associated burdens and dangers for the person with diabetes, as well as the associated health risks, which can be lethal in some cases. Fundamentals of Diabetes Management
糖尿病是一种慢性疾病,对糖尿病患者的日常治疗提出了相当大的挑战。除药物治疗外,糖尿病患者的治疗行为对疾病的预后也起着重要作用。因此,在糖尿病治疗中,重要的是与糖尿病患者一起确定治疗目标,考虑到多种生物、躯体、社会和行为因素,并尽可能地支持那些受影响的人在他们的个人生活环境和自我管理中实施治疗目标。1型和2型糖尿病的循证指南[1,2]以及疾病管理计划(DMP)要求指南(DMP- a - rl)[3]中描述了糖尿病最重要的上级治疗目标。▪维持或改善受糖尿病限制的生活质量:对于糖尿病患者来说,维持生活质量是糖尿病治疗最重要的目标[4]。这意味着即使患有糖尿病,也要尽可能保持身体和心理健康,能够实现自己的生活目标,融入社会——不受家庭/关系、工作、兴趣、休闲时间等对人们重要的生活领域的限制。研究结果相对一致地表明,这些对糖尿病患者很重要的目标尚未在全球范围内实现[5,6]。▪预防疾病症状:血糖水平升高、降低甚至剧烈波动(血糖变异性增加)可导致尿频增加(多尿)、强烈口渴感(渴渴)、疲劳、虚弱和疲倦等症状。治疗期间应避免的症状还包括皮肤干燥或发痒、神经病变症状以及由于葡萄糖水平升高的渗透效应引起的晶状体屈光度波动。▪预防急性并发症:重要的是要预防抗高血糖治疗的副作用,特别是低血糖——特别是严重低血糖,患者依赖外部帮助(如亲属或医务人员)。此外,预防严重的高血糖代谢脱轨(如糖尿病酮症酸中毒)也很重要,因为这会给糖尿病患者带来相关的负担和危险,以及相关的健康风险,在某些情况下可能是致命的。糖尿病管理基础
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引用次数: 0
Position Paper on the Diagnosis and Treatment of Peripheral Arterial Disease (PAD) in People with Diabetes Mellitus. 糖尿病患者外周动脉病变(PAD)的诊断与治疗立场文件
B. Balletshofer, D. Böckler, H. Diener, J. Heckenkamp, W. Ito, Marcos Katoh, H. Lawall, N. Malyar, Y. Oberländer, P. Reimer, K. Rittig, M. Zähringer
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引用次数: 1
期刊
Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
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