Introduction: Management of hyperglycemia in type2 diabetes mellitus (T2DM) becomes the top priority. When single antidiabetic drug is ineffective, combination is required for good glycemic control. There is a dearth ...Introduction: Management of hyperglycemia in type2 diabetes mellitus (T2DM) becomes the top priority. When single antidiabetic drug is ineffective, combination is required for good glycemic control. There is a dearth of studies that provide head to head comparison of the ability of combinations and therefore need further study. Objectives: To assess and compare the glycemic control and physical parameter altering effect of glibenclamide, glibenclamide & Pioglitazone, glibenclamide & metformin in T2DM. Methods and materials: 100 T2DM patients were selected from outpatients department of medicine following prefixed inclusion and exclusion criteria. Fasting and postprandial blood glucose (fbg & ppbg) and physical parameters (waist, hip and thigh circumference) were measured before and after treatment with study drugs and adverse effects of these drugs were recorded. Data were analyzed by employing paired t-test and chi-square test. Results: 11 patients lost the follow up. A some total of 89 middle aged, predominantly male, non obese T2DM patients after exposure to the study drugs showed significant (p < 0.05) reduction of blood glucose from baseline. Reduction of blood glucose and waist: hip ratio were observed significantly (p < 0.05) more with glibenclamide and metformin combination with some tolerable side effects. Discussion: Metformin and Pioglitazone both are insulin sensitizer but metformin & glibenclamide combination showed significantly (p < 0.001) more reduction of fbg, ppbg and central obesity (waist: hip ratio) than Pioglitazone & glibenclamide combination. Therefore Judicious use of low dose of glibenclamide and full dose of metformin become safe, effective and cheap for the treatment of type 2 diabetes patients in poor country like India.展开更多
More than 1000 herbal products have been used by diverse cultures of the world to treat hyperglycemia and among them bitter melon (Momordica charantia) is one of the most popular herbal resource. The beneficial effect...More than 1000 herbal products have been used by diverse cultures of the world to treat hyperglycemia and among them bitter melon (Momordica charantia) is one of the most popular herbal resource. The beneficial effects of bitter melon is not limited to hypoglycaemia only, but it also ameliorates diet induced obesity, insulin resistance and exhibit cardioprotective effects. The present study attempts to investigate the effect of bitter melon fruit juice on a newly investigated risk factor, sialic acid in type2 diabetics. A total of 40 type2 diabetic patients, divided into group A (n = 20) and group B (n = 20) were investigated during the present study. The patients of group A were following bitter melon fruit juice treatment along with diet control, whereas the patients of group B were on diet control only. Serum sialic acid (SSA) decreased in group A from 66.20 ± 2.30 mg/dl to 63.50 ± 2.10 mg/dl (<0.11) but, increased in group B from 66.50 ± 1.70 mg/dl to 68.20 ± 2.50 mg/dl (<0.12), compared to baseline. Post-treatment between group comparison revealed a significant difference (<0.05). The beneficial effects on fasting plasma glucose (FPG) and glycohemoglobin (HbA1-c) were also greater in group A compared to group B as was the case with blood lipids, weight and blood pressure. The study provides another mechanism for the cardioprotective effect of bitter melon and further strengthens its value in the management of type2 diabetes.展开更多
The specimens of 111 cervical carcinomas. 68 chronic cervicitis and 43 normal cervical exfoliated epithelial cells were examined for the presence of HSV2 DNA sequences with DNA hybridization using HSV2 BgL Ⅱ N fragm...The specimens of 111 cervical carcinomas. 68 chronic cervicitis and 43 normal cervical exfoliated epithelial cells were examined for the presence of HSV2 DNA sequences with DNA hybridization using HSV2 BgL Ⅱ N fragment probe labelled by 32PdCTP. The result showed that the infection rates of HSV2 in the samples of cervical cancer.chronic cervicitis and normal epithelial cells were 1 4. 41 %(16/111). 27.94%( 19/68) and 25.58% ( 11/43),respectively. It was implied that early stages carcinogenesis of cervical epithelial cells might be correlated with the HSV2 infection.Sixteen HSV 2 positive samples of cervical carcinomas were also examined for the presence of the sequences homologous to human papillomavirus (HPV) type 6B/11. 16 and 18 DNA using dot blot hybridization (Tm17℃). The result indicated that 13 out of 16 were HPV 16 DNA hybridization positive accounting for 81. 2% of all HSV-2 positive samples and none of them were positive for HPV type 6B/11 and 18. The result indicated that double infection of HSV 2 and HPV16 in the same cervical carcinoma tissues may provide a strong evidence of the viral synergistic interaction in the induction of female cervical展开更多
Type 2 diabetes mellitus(T2DM)was identified as the most prevalent form of diabetes.This study employed an integrated strategy combining network pharmacology,metabolomics,and experimental validation to elucidate the t...Type 2 diabetes mellitus(T2DM)was identified as the most prevalent form of diabetes.This study employed an integrated strategy combining network pharmacology,metabolomics,and experimental validation to elucidate the therapeutic mechanisms of red mulberry water extract(RMW)in T2DM.Systematic analysis identified six bioactive constituents,with four key components(cyanidin,quercetin,morin,andβ-carotene)demonstrating significant interactions with diabetes-related targets.Network pharmacology revealed these compounds modulate critical pathways including AMPK(P=2.3×10^(−5)),PI3K-Akt(P=1.8×10^(−4)),and PPAR signaling(P=3.1×10^(−3)).In diabetic mice,treatment significantly improved glycemic control(32.5%reduction in fasting glucose,P<0.01),lipid profiles(36.7%lower TG,P<0.05),antioxidant activity(2.1-fold increased SOD,P<0.05),and inflammation(42%reduced TNF-α,P<0.05).Metabolomic analysis further confirmed alterations in catecholamine and lipid metabolism pathways.These findings collectively demonstrate mulberry's multi-target therapeutic potential through synergistic regulation of glucose metabolism,lipid homeostasis,oxidative stress,and inflammatory responses in diabetes.展开更多
Objectives:The combination of atezolizumab plus bevacizumab(A+B)represents one of the standards first-line treatments for unresectable hepatocellular carcinoma(HCC).Metformin has garnered attention for its potential a...Objectives:The combination of atezolizumab plus bevacizumab(A+B)represents one of the standards first-line treatments for unresectable hepatocellular carcinoma(HCC).Metformin has garnered attention for its potential antitumour and immunomodulatory properties beyond glycaemic control.This study aimed to assess metformin’s impact in patients with type 2 diabetes mellitus(T2DM)receiving A+B therapy.Methods:This retrospective analysis of a prospectively-maintained multicentre database included 523 patients with HCC treated with A+B from the ARTE(Atezolizumab-bevacizumab Real-life Experience for Treatment of Hepatocellular Carcinoma)dataset across 18 Italian centres(May 2020-January 2024).We evaluated objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS),overall survival(OS),and time to progression(TTP)using Cox regression analysis and Inverse Probability of Treatment Weighting(IPTW)to address confounding.Results:Among 523 patients,341(65.2%)did not have diabetes and 182(34.8%)had T2DM.In the overall population,metformin showed no significant benefit for PFS(HR=1.15,95%CI[0.88-1.50],p=0.316)or OS(HR=1.28,95%CI[0.94-1.74],p=0.124).In the subgroup with T2DM(N=180),metformin showed no significant benefit for PFS(HR=1.41,95%CI[0.97-2.05],p=0.069),OS(HR=1.23,95%CI[0.81-1.86],p=0.333),or TTP(HR=0.82,95%CI[0.53-1.26],p=0.363).IPTW analysis confirmed these negative findings.Conclusion:This study found no evidence of improved outcomes with metformin use in patients with HCC in particular with T2DM receiving A+B therapy.Routine metformin use should not be expected to enhance A+B efficacy based on current evidence.展开更多
Rheumatoid arthritis(RA)is a chronic systemic autoimmune disease that extends beyond joint inflammation,affecting pulmonary and metabolic pathways.Interstitial lung disease(ILD)is one of its most serious extra-articul...Rheumatoid arthritis(RA)is a chronic systemic autoimmune disease that extends beyond joint inflammation,affecting pulmonary and metabolic pathways.Interstitial lung disease(ILD)is one of its most serious extra-articular complications,while type 2 diabetes mellitus(T2DM)frequently coexists with RA and may exacerbate inflammatory and fibrotic processes.This editorial discusses the study by Sutton et al,the largest population-based analysis to date exploring the link between T2DM and ILD in patients with RA,and reflects on its mechanistic and clinical implications.In a nationwide cohort of more than 120000 hospitalized RA patients,Sutton et al demonstrated that the coexistence of T2DM nearly doubles the odds of developing ILD(odds ratio=2.02;95%confidence interval:1.84-2.22),with additional increases in pulmonary hypertension,pneumothorax,and length of stay.These findings reinforce the concept of a metabolic-pulmonary-autoimmune axis,in which chronic inflammation promotes insulin resistance and metabolic dysfunction,while hyperglycaemia and advanced glycation end-products amplify oxidative stress and fibrogenesis.This reciprocal interaction may induce a self-perpetuating cycle of“metaflammation”,fibrosis,and organ damage.Conclusion:Recognizing diabetes as a silent amplifier of RA-associated ILD redefines the interface between rheumatology,pulmonology,and endocrinology.Early detection and integrated management of metabolic and pulmonary comorbidities should be prioritized,while future studies must determine whether optimizing glycemic control can attenuate pulmonary fibrosis and improve longterm outcomes.展开更多
Background:Diabetes mellitus(DM)is a chronic illness with potentially fatal and debilitating consequences.Problems with glycemic management are a major issue that adds an added strain to public health services.Objecti...Background:Diabetes mellitus(DM)is a chronic illness with potentially fatal and debilitating consequences.Problems with glycemic management are a major issue that adds an added strain to public health services.Objectives:The purpose of this study is to evaluate the prevalence of poor glycemic control and its related variables among type 2 diabetes mellitus(T2DM)patients in southern Jordan.Methods:A cross-sectional study was carried out in the Prince Hashem bin Abdullah II Hospital in Jordan's southernmost province.For the period April–July 2024,516 individuals with T2D were enrolled.A structured questionnaire that had been pre-prepared was used to collect data.As an index of glycemic control,a glycated hemoglobin(Hb A1c)7%cut-off point was adopted.Results:Poor glycemic control was prevalent in 81.0%of T2DM individuals.Inadequate glycemic control was significantly worse in non-married patients and those with 10 or more years of diabetes duration,insulin treatment,dyslipidemia,neuropathy,cardiovascular illness,and glomerular filtration rate(GFR=60 m L/min;[P<0.05]).Moreover,dyslipidemia and insulin administration increased the likelihood of poor glycemic control(odds ratio[OR]:2 and 5,respectively)(P<0.05).Conclusions:Inadequate glycemic control was common among the current study par ticipants.To prevent disease consequences and enhance the health of patients with diabetes,health care professionals should pay special attention to related risk factors such as dyslipidemia,neuropathy,cardiovascular disease(CVD),extended illness duration,and insulin usage.展开更多
Objective:To determine whether immunotherapy can bring new hope for patients with limited-stage small-cell lung cancer(LS-SCLC).We conducted this retrospective study to evaluate whether immunotherapy can achieve bette...Objective:To determine whether immunotherapy can bring new hope for patients with limited-stage small-cell lung cancer(LS-SCLC).We conducted this retrospective study to evaluate whether immunotherapy can achieve better efficacy in LS-SCLC patients.Methods:We evaluated 122 LS-SCLC patients who received concurrent chemoradiotherapy(CCRT)or sequential chemoradiotherapy(SCRT)(Group A)and immunotherapy combined with CCRT/SCRT followed by immunotherapy(Group B),to assess the objective response rate(ORR),disease control rate(DCR),and progression-free survival(PFS).Factors affecting prognosis were also explored using Cox analysis.The prognosis of patients with type 2 diabetes and patients with different TNM stages was compared to guide the selection of clinical regimens.Results:The overall ORR was 55.93%.The overall DCR was 98.31%.The DCR was 100%in Group A and 96.61%in Group B.There was no statistical difference in ORR and DCR.The overall median PFS was 9.86 months(95%CI,8.62-11.10),and the difference in median PFS between the two groups was statistically significant(8.94 vs.11.89 months,p=0.03).The Cox regression analysis showed type 2 diabetes was associated with the survival prognosis.Patients with type 2 diabetes tended to choose immunotherapy combined with CCRT/SCRT.Patients in TNM stage IIIB had a significantly worse prognosis than those in stage I+II+IIIA.Conclusion:We suggest that LS-SCLC patients who receive immunotherapy combined with CCRT/SCRT can achieve longer PFS than those with CCRT/SCRT.Type 2 diabetes and TNM stage affect the survival prognosis.Patients with type 2 diabetes may benefit from immunotherapy combination treatments.展开更多
Diabetic kidney disease (DKD)is one of the most common and severe microvascular complications of type 2 diabetes mellitus (T2DM). It is also a major cause of end-stage renal disease (ESRD), making early identification...Diabetic kidney disease (DKD)is one of the most common and severe microvascular complications of type 2 diabetes mellitus (T2DM). It is also a major cause of end-stage renal disease (ESRD), making early identification and intervention crucial. Insulin resistance (IR)is a key pathophysiological mechanism of T2DM and plays a central role in the progression of DKD. In recent years, a series of novel surrogate indicators of IR, such as the triglyceride-glucose (TyG) index, TyG-body mass index (TyG-BMI), triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), and metabolic score for insulin resistance (METS-IR), have attracted widespread attention due to their simplicity and cost-effectiveness. This article reviews the research progress of novel surrogate indicators of insulin resistance (IR) in type 2 diabetic kidney disease (DKD), aiming to provide references for the early prevention and improved prognosis of DKD.展开更多
Objective:To investigate the effects of switching to either Prandilin 25R monotherapy or Prandilin 25R combined with ganagliflozin proline tablets after short-term intensive continuous subcutaneous insulin infusion du...Objective:To investigate the effects of switching to either Prandilin 25R monotherapy or Prandilin 25R combined with ganagliflozin proline tablets after short-term intensive continuous subcutaneous insulin infusion during hospitalization in elderly patients with type 2 diabetes mellitus on glycemic control,glycometabolic indicators,and cardiovascular risk factors,and to evaluate the safety of the two regimens.Methods:A total of 78 elderly patients with type 2 diabetes mellitus admitted to our hospital from January 2025 to September 2025 were selected and randomly divided into a control group and an observation group,with 39 cases in each group.The control group received monotherapy with insulin lispro protamine recombinant injection(Prandilin 25R)after intensive continuous subcutaneous insulin infusion,while the observation group received Prandilin 25R combined with ganagliflozin proline tablets.Continuous glucose monitoring(CGM)was performed for 14 days during the intensive continuous subcutaneous insulin infusion therapy phase in the hospital,followed by routine fingertip blood glucose monitoring after 14 days.Glycemic control indicators,glycometabolic indicators,and the incidence of adverse reactions were compared between the two groups.Results:After treatment,the mean amplitude of glycemic excursions and the 24-hour blood glucose standard deviation were significantly lower in the observation group than in the control group,while the time spent within the target blood glucose range was significantly higher(p<0.05).The levels of glycated hemoglobin,fasting blood glucose,and 2-hour postprandial blood glucose were better in the observation group than in the control group;moreover,the body mass index,systolic blood pressure,and blood lipid levels improved more significantly in the observation group than in the control group(p<0.05).There was no statistically significant difference in the incidence of hypoglycemia between the two groups.Conclusion:Combination therapy with ganagliflozin proline tablets after short-term intensive continuous subcutaneous insulin infusion therapy can effectively improve glycemic variability in elderly patients with type 2 diabetes mellitus,with good safety.This suggests that ganagliflozin proline tablets have a hypoglycemic advantage in the combination regimen and possess high clinical promotional value.展开更多
Objective:To analyze the application value of phased nursing care in patients undergoing laser treatment for melasma.Methods:A total of 68 patients with melasma who received laser treatment at the Dermatology Departme...Objective:To analyze the application value of phased nursing care in patients undergoing laser treatment for melasma.Methods:A total of 68 patients with melasma who received laser treatment at the Dermatology Department of Yichang Central People’s Hospital from June 2023 to June 2025 were selected as the study subjects.According to differences in nursing plans,patients were randomly divided into two groups,with 34 patients in each group:the control group received routine nursing care,while the observation group received phased nursing care.The wound healing,negative emotions,and self-efficacy of the two groups before and after nursing were compared.Results:The duration of erythema in the observation group was shorter than that in the control group,and the area of pigmentation was smaller than that in the control group(p<0.05).After nursing,the SAS and SDS scores of the observation group were lower than those of the control group(p<0.05),and the GSES scores of the observation group were higher than those of the control group(p<0.05).Conclusion:Phased nursing care can significantly improve wound healing in patients undergoing laser treatment for melasma,reduce negative emotions,and enhance self-efficacy.展开更多
Objective: To investigate the clinical efficacy and safety of auricular acupressure therapy in elderly patients with type 2 diabetic neurogenic bladder, and to provide a feasible external treatment intervention plan b...Objective: To investigate the clinical efficacy and safety of auricular acupressure therapy in elderly patients with type 2 diabetic neurogenic bladder, and to provide a feasible external treatment intervention plan based on traditional Chinese medicine (TCM) for such patients. Methods: A randomized controlled study was conducted, selecting elderly patients with type 2 diabetic neurogenic bladder who met the inclusion criteria and randomly dividing them into a control group and an observation group. The control group received conventional comprehensive diabetes management and bladder function training, while the observation group additionally received auricular acupressure therapy, involving continuous stimulation of relevant auricular points such as Shenmen, Subcortex, Sympathetic, Kidney, Bladder, and Urethra, for a treatment duration of two courses. Changes in maximum urinary flow rate, bladder residual urine volume, TCM syndrome scores, and quality of life index (QOL) were compared between the two groups before and after treatment, and adverse reactions during treatment were recorded and analyzed. Results: After treatment, the observation group demonstrated superior improvement in clinical symptoms such as dysuria and urinary retention compared to the control group, with a significant increase in maximum urinary flow rate, a notable decrease in bladder residual urine volume and TCM syndrome scores, and a concurrent improvement in quality-of-life scores. The differences between the groups were statistically significant (p < 0.05). No serious adverse events occurred during treatment, and minor local discomfort resolved spontaneously after management, indicating overall good safety. Conclusion: As a simple and persistent TCM external treatment method, auricular acupressure therapy can further improve urinary function and quality of life in elderly patients with type 2 diabetic neurogenic bladder when combined with conventional treatment, with high safety and certain clinical promotion value.展开更多
Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and wheth...Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and whether this association differs by baseline body-mass index(BMI).Methods:This retrospective cohort study used electronic health records from the TriNetX U.S.research network.Adults aged 20 years or older diagnosed with T2DM between 2016 and 2024 were included if they received any hypoglycemic agents within 3 months before and after diagnosis.Following 1:1 propensity score matching,both the GLP-1 RA user and non-user groups included 183,264 patients.The study outcome was defined as a diagnosis of malignant neoplasms.Hazard ratios(HRs)for overall and site-specific cancer risk were estimated using Cox proportional hazards models.Kaplan–Meier analysis and stratified analysis by BMI were performed.Results:Early GLP-1 RA use demonstrated a modest but significant association with reduced overall cancer risk(HR 0.93;95%CI:0.90–0.96).Reduced risks were noted for cancers of the digestive(HR 0.81),respiratory(HR 0.66),and female genital(HR 0.87)systems.In stratified analysis,benefits were more pronounced in patients with BMI≥30,particularly for pancreatic and colorectal cancers.Conclusion:Early initiation of GLP-1 receptor agonists in patients with diagnosed T2DM was associated with a modest reduction in overall cancer risk,particularly among individuals with obesity.These findings highlight the dual metabolic and oncologic value of prompt GLP-1 RA therapy.展开更多
Objective:To investigate the effects and potential mechanisms of action of Panax notoginseng(Burk)F.H.Chen(P.notoginseng,San Qi)flowers in type 2 diabetes mellitus(T2DM)using network pharmacology,in vivo experiments,a...Objective:To investigate the effects and potential mechanisms of action of Panax notoginseng(Burk)F.H.Chen(P.notoginseng,San Qi)flowers in type 2 diabetes mellitus(T2DM)using network pharmacology,in vivo experiments,and RNA sequencing(RNA-seq).Methods:Network pharmacology analysis was performed to identify and correlate the drug targets of flower buds of P.notoginseng(PNF)with T2DM disease targets and to predict the key targets and pathways involved in the therapeutic effects of PNF in T2DM.In vivo experiments were conducted to assess the effects of PNF on glucose and lipid metabolism in mice with T2DM.RNA-seq was performed,and the results were integrated with network pharmacology data to assess the therapeutic mechanisms of PNF in T2DM.The results from transcriptomics and network pharmacology were validated using real-time polymerase chain reaction.Results:A total of 27 intersecting targets were identified by overlapping 35 drug targets with T2DM targets.Further topological analysis using the Centiscape 2.2 tool revealed five core targets,including signal transducer and activator of transcription 3(STAT3).Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis indicated that the JAK/STAT signaling pathway is a key mechanism underlying the therapeutic effects of PNF in T2DM.In vivo experiments confirmed that PNF effectively regulates glycolipid metabolism in a mouse model of diabetes.KEGG pathway enrichment analysis of RNA-seq data highlighted the JAK2/STAT3 and PI3K/AKT pathway as a potential mechanism.PNF high-dose(PNFH)increased the gene expression levels of PIK3R1 and AKT2,decreased the expression of PCK1,JAK2,and STAT3,and showed a trend toward increasing INSR expression without reaching statistical significance.Conclusion:PNF improves glycolipid metabolism disorders in T2DM,potentially by modulating the JAK2/STAT3 and PI3K/AKT signaling pathway.展开更多
OBJECTIVE:To investigate the mechanism of action of Qinlian Jiangxia decoction(芩连姜夏汤,QLJXD)in the treatment of type 2 diabetes mellitus(T2DM)complicated by hyperlipidemia using network pharmacology,molecular dock...OBJECTIVE:To investigate the mechanism of action of Qinlian Jiangxia decoction(芩连姜夏汤,QLJXD)in the treatment of type 2 diabetes mellitus(T2DM)complicated by hyperlipidemia using network pharmacology,molecular docking,molecular dynamics simulation and in vivo experiments.METHODS:Drug components,targets and disease targets were identified using databases such as TCM systems pharmacology database and analysis platform and Gene Cards.The intersecting targets were subjected to protein-protein interaction analysis using the search tool for the retrieval of interacting genes/proteins database.Subsequently,Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis of the intersecting targets were conducted using the Metascape platform to identify core components and targets.The results were validated using molecular docking,molecular dynamics simulations and in vivo experiments.RESULTS:QLJXD contains 76 active ingredients and 136 disease targets.The core ingredients are quercetin,β-sitosterol,wogonin and baicalein,while the core targets are fatty acid binding protein 4(FABP4)and peroxisome proliferative activated receptor gamma(PPARG).Molecular docking and molecular dynamics simulations revealed that the core ingredients bound well to the core targets.Animal experiments demonstrated that QLJXD effectively inhibited the expression of FABP4 and increased the expression of PPARG,thereby enhancing disorders of glycolipid metabolism.CONCLUSION:The putative therapeutic efficacy of QLJXD in the management of T2DM complicated with hyperlipidemia may be ascribed to the synergistic actions of multiple components,such as quercetin,β-sitosterol,wogonin,and baicalein,which collectively modulate FABP4 and PPARG molecular targets.展开更多
文摘Introduction: Management of hyperglycemia in type2 diabetes mellitus (T2DM) becomes the top priority. When single antidiabetic drug is ineffective, combination is required for good glycemic control. There is a dearth of studies that provide head to head comparison of the ability of combinations and therefore need further study. Objectives: To assess and compare the glycemic control and physical parameter altering effect of glibenclamide, glibenclamide & Pioglitazone, glibenclamide & metformin in T2DM. Methods and materials: 100 T2DM patients were selected from outpatients department of medicine following prefixed inclusion and exclusion criteria. Fasting and postprandial blood glucose (fbg & ppbg) and physical parameters (waist, hip and thigh circumference) were measured before and after treatment with study drugs and adverse effects of these drugs were recorded. Data were analyzed by employing paired t-test and chi-square test. Results: 11 patients lost the follow up. A some total of 89 middle aged, predominantly male, non obese T2DM patients after exposure to the study drugs showed significant (p < 0.05) reduction of blood glucose from baseline. Reduction of blood glucose and waist: hip ratio were observed significantly (p < 0.05) more with glibenclamide and metformin combination with some tolerable side effects. Discussion: Metformin and Pioglitazone both are insulin sensitizer but metformin & glibenclamide combination showed significantly (p < 0.001) more reduction of fbg, ppbg and central obesity (waist: hip ratio) than Pioglitazone & glibenclamide combination. Therefore Judicious use of low dose of glibenclamide and full dose of metformin become safe, effective and cheap for the treatment of type 2 diabetes patients in poor country like India.
文摘More than 1000 herbal products have been used by diverse cultures of the world to treat hyperglycemia and among them bitter melon (Momordica charantia) is one of the most popular herbal resource. The beneficial effects of bitter melon is not limited to hypoglycaemia only, but it also ameliorates diet induced obesity, insulin resistance and exhibit cardioprotective effects. The present study attempts to investigate the effect of bitter melon fruit juice on a newly investigated risk factor, sialic acid in type2 diabetics. A total of 40 type2 diabetic patients, divided into group A (n = 20) and group B (n = 20) were investigated during the present study. The patients of group A were following bitter melon fruit juice treatment along with diet control, whereas the patients of group B were on diet control only. Serum sialic acid (SSA) decreased in group A from 66.20 ± 2.30 mg/dl to 63.50 ± 2.10 mg/dl (<0.11) but, increased in group B from 66.50 ± 1.70 mg/dl to 68.20 ± 2.50 mg/dl (<0.12), compared to baseline. Post-treatment between group comparison revealed a significant difference (<0.05). The beneficial effects on fasting plasma glucose (FPG) and glycohemoglobin (HbA1-c) were also greater in group A compared to group B as was the case with blood lipids, weight and blood pressure. The study provides another mechanism for the cardioprotective effect of bitter melon and further strengthens its value in the management of type2 diabetes.
文摘The specimens of 111 cervical carcinomas. 68 chronic cervicitis and 43 normal cervical exfoliated epithelial cells were examined for the presence of HSV2 DNA sequences with DNA hybridization using HSV2 BgL Ⅱ N fragment probe labelled by 32PdCTP. The result showed that the infection rates of HSV2 in the samples of cervical cancer.chronic cervicitis and normal epithelial cells were 1 4. 41 %(16/111). 27.94%( 19/68) and 25.58% ( 11/43),respectively. It was implied that early stages carcinogenesis of cervical epithelial cells might be correlated with the HSV2 infection.Sixteen HSV 2 positive samples of cervical carcinomas were also examined for the presence of the sequences homologous to human papillomavirus (HPV) type 6B/11. 16 and 18 DNA using dot blot hybridization (Tm17℃). The result indicated that 13 out of 16 were HPV 16 DNA hybridization positive accounting for 81. 2% of all HSV-2 positive samples and none of them were positive for HPV type 6B/11 and 18. The result indicated that double infection of HSV 2 and HPV16 in the same cervical carcinoma tissues may provide a strong evidence of the viral synergistic interaction in the induction of female cervical
文摘Type 2 diabetes mellitus(T2DM)was identified as the most prevalent form of diabetes.This study employed an integrated strategy combining network pharmacology,metabolomics,and experimental validation to elucidate the therapeutic mechanisms of red mulberry water extract(RMW)in T2DM.Systematic analysis identified six bioactive constituents,with four key components(cyanidin,quercetin,morin,andβ-carotene)demonstrating significant interactions with diabetes-related targets.Network pharmacology revealed these compounds modulate critical pathways including AMPK(P=2.3×10^(−5)),PI3K-Akt(P=1.8×10^(−4)),and PPAR signaling(P=3.1×10^(−3)).In diabetic mice,treatment significantly improved glycemic control(32.5%reduction in fasting glucose,P<0.01),lipid profiles(36.7%lower TG,P<0.05),antioxidant activity(2.1-fold increased SOD,P<0.05),and inflammation(42%reduced TNF-α,P<0.05).Metabolomic analysis further confirmed alterations in catecholamine and lipid metabolism pathways.These findings collectively demonstrate mulberry's multi-target therapeutic potential through synergistic regulation of glucose metabolism,lipid homeostasis,oxidative stress,and inflammatory responses in diabetes.
文摘Objectives:The combination of atezolizumab plus bevacizumab(A+B)represents one of the standards first-line treatments for unresectable hepatocellular carcinoma(HCC).Metformin has garnered attention for its potential antitumour and immunomodulatory properties beyond glycaemic control.This study aimed to assess metformin’s impact in patients with type 2 diabetes mellitus(T2DM)receiving A+B therapy.Methods:This retrospective analysis of a prospectively-maintained multicentre database included 523 patients with HCC treated with A+B from the ARTE(Atezolizumab-bevacizumab Real-life Experience for Treatment of Hepatocellular Carcinoma)dataset across 18 Italian centres(May 2020-January 2024).We evaluated objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS),overall survival(OS),and time to progression(TTP)using Cox regression analysis and Inverse Probability of Treatment Weighting(IPTW)to address confounding.Results:Among 523 patients,341(65.2%)did not have diabetes and 182(34.8%)had T2DM.In the overall population,metformin showed no significant benefit for PFS(HR=1.15,95%CI[0.88-1.50],p=0.316)or OS(HR=1.28,95%CI[0.94-1.74],p=0.124).In the subgroup with T2DM(N=180),metformin showed no significant benefit for PFS(HR=1.41,95%CI[0.97-2.05],p=0.069),OS(HR=1.23,95%CI[0.81-1.86],p=0.333),or TTP(HR=0.82,95%CI[0.53-1.26],p=0.363).IPTW analysis confirmed these negative findings.Conclusion:This study found no evidence of improved outcomes with metformin use in patients with HCC in particular with T2DM receiving A+B therapy.Routine metformin use should not be expected to enhance A+B efficacy based on current evidence.
文摘Rheumatoid arthritis(RA)is a chronic systemic autoimmune disease that extends beyond joint inflammation,affecting pulmonary and metabolic pathways.Interstitial lung disease(ILD)is one of its most serious extra-articular complications,while type 2 diabetes mellitus(T2DM)frequently coexists with RA and may exacerbate inflammatory and fibrotic processes.This editorial discusses the study by Sutton et al,the largest population-based analysis to date exploring the link between T2DM and ILD in patients with RA,and reflects on its mechanistic and clinical implications.In a nationwide cohort of more than 120000 hospitalized RA patients,Sutton et al demonstrated that the coexistence of T2DM nearly doubles the odds of developing ILD(odds ratio=2.02;95%confidence interval:1.84-2.22),with additional increases in pulmonary hypertension,pneumothorax,and length of stay.These findings reinforce the concept of a metabolic-pulmonary-autoimmune axis,in which chronic inflammation promotes insulin resistance and metabolic dysfunction,while hyperglycaemia and advanced glycation end-products amplify oxidative stress and fibrogenesis.This reciprocal interaction may induce a self-perpetuating cycle of“metaflammation”,fibrosis,and organ damage.Conclusion:Recognizing diabetes as a silent amplifier of RA-associated ILD redefines the interface between rheumatology,pulmonology,and endocrinology.Early detection and integrated management of metabolic and pulmonary comorbidities should be prioritized,while future studies must determine whether optimizing glycemic control can attenuate pulmonary fibrosis and improve longterm outcomes.
文摘Background:Diabetes mellitus(DM)is a chronic illness with potentially fatal and debilitating consequences.Problems with glycemic management are a major issue that adds an added strain to public health services.Objectives:The purpose of this study is to evaluate the prevalence of poor glycemic control and its related variables among type 2 diabetes mellitus(T2DM)patients in southern Jordan.Methods:A cross-sectional study was carried out in the Prince Hashem bin Abdullah II Hospital in Jordan's southernmost province.For the period April–July 2024,516 individuals with T2D were enrolled.A structured questionnaire that had been pre-prepared was used to collect data.As an index of glycemic control,a glycated hemoglobin(Hb A1c)7%cut-off point was adopted.Results:Poor glycemic control was prevalent in 81.0%of T2DM individuals.Inadequate glycemic control was significantly worse in non-married patients and those with 10 or more years of diabetes duration,insulin treatment,dyslipidemia,neuropathy,cardiovascular illness,and glomerular filtration rate(GFR=60 m L/min;[P<0.05]).Moreover,dyslipidemia and insulin administration increased the likelihood of poor glycemic control(odds ratio[OR]:2 and 5,respectively)(P<0.05).Conclusions:Inadequate glycemic control was common among the current study par ticipants.To prevent disease consequences and enhance the health of patients with diabetes,health care professionals should pay special attention to related risk factors such as dyslipidemia,neuropathy,cardiovascular disease(CVD),extended illness duration,and insulin usage.
基金funded by the National Natural Science Foundation of China(grant no.82273162)the National Natural Science Foundation of China(grant no.82203272)the Science and Technology Development Foundation of Nanjing Medical University(grant NMUB20240119)。
文摘Objective:To determine whether immunotherapy can bring new hope for patients with limited-stage small-cell lung cancer(LS-SCLC).We conducted this retrospective study to evaluate whether immunotherapy can achieve better efficacy in LS-SCLC patients.Methods:We evaluated 122 LS-SCLC patients who received concurrent chemoradiotherapy(CCRT)or sequential chemoradiotherapy(SCRT)(Group A)and immunotherapy combined with CCRT/SCRT followed by immunotherapy(Group B),to assess the objective response rate(ORR),disease control rate(DCR),and progression-free survival(PFS).Factors affecting prognosis were also explored using Cox analysis.The prognosis of patients with type 2 diabetes and patients with different TNM stages was compared to guide the selection of clinical regimens.Results:The overall ORR was 55.93%.The overall DCR was 98.31%.The DCR was 100%in Group A and 96.61%in Group B.There was no statistical difference in ORR and DCR.The overall median PFS was 9.86 months(95%CI,8.62-11.10),and the difference in median PFS between the two groups was statistically significant(8.94 vs.11.89 months,p=0.03).The Cox regression analysis showed type 2 diabetes was associated with the survival prognosis.Patients with type 2 diabetes tended to choose immunotherapy combined with CCRT/SCRT.Patients in TNM stage IIIB had a significantly worse prognosis than those in stage I+II+IIIA.Conclusion:We suggest that LS-SCLC patients who receive immunotherapy combined with CCRT/SCRT can achieve longer PFS than those with CCRT/SCRT.Type 2 diabetes and TNM stage affect the survival prognosis.Patients with type 2 diabetes may benefit from immunotherapy combination treatments.
文摘Diabetic kidney disease (DKD)is one of the most common and severe microvascular complications of type 2 diabetes mellitus (T2DM). It is also a major cause of end-stage renal disease (ESRD), making early identification and intervention crucial. Insulin resistance (IR)is a key pathophysiological mechanism of T2DM and plays a central role in the progression of DKD. In recent years, a series of novel surrogate indicators of IR, such as the triglyceride-glucose (TyG) index, TyG-body mass index (TyG-BMI), triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), and metabolic score for insulin resistance (METS-IR), have attracted widespread attention due to their simplicity and cost-effectiveness. This article reviews the research progress of novel surrogate indicators of insulin resistance (IR) in type 2 diabetic kidney disease (DKD), aiming to provide references for the early prevention and improved prognosis of DKD.
文摘Objective:To investigate the effects of switching to either Prandilin 25R monotherapy or Prandilin 25R combined with ganagliflozin proline tablets after short-term intensive continuous subcutaneous insulin infusion during hospitalization in elderly patients with type 2 diabetes mellitus on glycemic control,glycometabolic indicators,and cardiovascular risk factors,and to evaluate the safety of the two regimens.Methods:A total of 78 elderly patients with type 2 diabetes mellitus admitted to our hospital from January 2025 to September 2025 were selected and randomly divided into a control group and an observation group,with 39 cases in each group.The control group received monotherapy with insulin lispro protamine recombinant injection(Prandilin 25R)after intensive continuous subcutaneous insulin infusion,while the observation group received Prandilin 25R combined with ganagliflozin proline tablets.Continuous glucose monitoring(CGM)was performed for 14 days during the intensive continuous subcutaneous insulin infusion therapy phase in the hospital,followed by routine fingertip blood glucose monitoring after 14 days.Glycemic control indicators,glycometabolic indicators,and the incidence of adverse reactions were compared between the two groups.Results:After treatment,the mean amplitude of glycemic excursions and the 24-hour blood glucose standard deviation were significantly lower in the observation group than in the control group,while the time spent within the target blood glucose range was significantly higher(p<0.05).The levels of glycated hemoglobin,fasting blood glucose,and 2-hour postprandial blood glucose were better in the observation group than in the control group;moreover,the body mass index,systolic blood pressure,and blood lipid levels improved more significantly in the observation group than in the control group(p<0.05).There was no statistically significant difference in the incidence of hypoglycemia between the two groups.Conclusion:Combination therapy with ganagliflozin proline tablets after short-term intensive continuous subcutaneous insulin infusion therapy can effectively improve glycemic variability in elderly patients with type 2 diabetes mellitus,with good safety.This suggests that ganagliflozin proline tablets have a hypoglycemic advantage in the combination regimen and possess high clinical promotional value.
文摘Objective:To analyze the application value of phased nursing care in patients undergoing laser treatment for melasma.Methods:A total of 68 patients with melasma who received laser treatment at the Dermatology Department of Yichang Central People’s Hospital from June 2023 to June 2025 were selected as the study subjects.According to differences in nursing plans,patients were randomly divided into two groups,with 34 patients in each group:the control group received routine nursing care,while the observation group received phased nursing care.The wound healing,negative emotions,and self-efficacy of the two groups before and after nursing were compared.Results:The duration of erythema in the observation group was shorter than that in the control group,and the area of pigmentation was smaller than that in the control group(p<0.05).After nursing,the SAS and SDS scores of the observation group were lower than those of the control group(p<0.05),and the GSES scores of the observation group were higher than those of the control group(p<0.05).Conclusion:Phased nursing care can significantly improve wound healing in patients undergoing laser treatment for melasma,reduce negative emotions,and enhance self-efficacy.
基金Clinical Study on the Treatment of Neurogenic Bladder in Elderly Patients with Type 2 Diabetes Mellitus by Auricular Point Pressing Needle TherapyZhejiang Provincial Traditional Chinese Medicine Science and Technology Project,Zhejiang Provincial People’s Hospital(Project No.:2024ZL252)。
文摘Objective: To investigate the clinical efficacy and safety of auricular acupressure therapy in elderly patients with type 2 diabetic neurogenic bladder, and to provide a feasible external treatment intervention plan based on traditional Chinese medicine (TCM) for such patients. Methods: A randomized controlled study was conducted, selecting elderly patients with type 2 diabetic neurogenic bladder who met the inclusion criteria and randomly dividing them into a control group and an observation group. The control group received conventional comprehensive diabetes management and bladder function training, while the observation group additionally received auricular acupressure therapy, involving continuous stimulation of relevant auricular points such as Shenmen, Subcortex, Sympathetic, Kidney, Bladder, and Urethra, for a treatment duration of two courses. Changes in maximum urinary flow rate, bladder residual urine volume, TCM syndrome scores, and quality of life index (QOL) were compared between the two groups before and after treatment, and adverse reactions during treatment were recorded and analyzed. Results: After treatment, the observation group demonstrated superior improvement in clinical symptoms such as dysuria and urinary retention compared to the control group, with a significant increase in maximum urinary flow rate, a notable decrease in bladder residual urine volume and TCM syndrome scores, and a concurrent improvement in quality-of-life scores. The differences between the groups were statistically significant (p < 0.05). No serious adverse events occurred during treatment, and minor local discomfort resolved spontaneously after management, indicating overall good safety. Conclusion: As a simple and persistent TCM external treatment method, auricular acupressure therapy can further improve urinary function and quality of life in elderly patients with type 2 diabetic neurogenic bladder when combined with conventional treatment, with high safety and certain clinical promotion value.
基金financial support fromthe Chung Shan Medical University Hospital,Taiwan(CSH-2022-A-009).
文摘Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and whether this association differs by baseline body-mass index(BMI).Methods:This retrospective cohort study used electronic health records from the TriNetX U.S.research network.Adults aged 20 years or older diagnosed with T2DM between 2016 and 2024 were included if they received any hypoglycemic agents within 3 months before and after diagnosis.Following 1:1 propensity score matching,both the GLP-1 RA user and non-user groups included 183,264 patients.The study outcome was defined as a diagnosis of malignant neoplasms.Hazard ratios(HRs)for overall and site-specific cancer risk were estimated using Cox proportional hazards models.Kaplan–Meier analysis and stratified analysis by BMI were performed.Results:Early GLP-1 RA use demonstrated a modest but significant association with reduced overall cancer risk(HR 0.93;95%CI:0.90–0.96).Reduced risks were noted for cancers of the digestive(HR 0.81),respiratory(HR 0.66),and female genital(HR 0.87)systems.In stratified analysis,benefits were more pronounced in patients with BMI≥30,particularly for pancreatic and colorectal cancers.Conclusion:Early initiation of GLP-1 receptor agonists in patients with diagnosed T2DM was associated with a modest reduction in overall cancer risk,particularly among individuals with obesity.These findings highlight the dual metabolic and oncologic value of prompt GLP-1 RA therapy.
基金supported by the Creation and Talent Introduction Base of Prevention and Treatment of Diabetes and Its Complications withTraditional Chinese Medicine(B20055).
文摘Objective:To investigate the effects and potential mechanisms of action of Panax notoginseng(Burk)F.H.Chen(P.notoginseng,San Qi)flowers in type 2 diabetes mellitus(T2DM)using network pharmacology,in vivo experiments,and RNA sequencing(RNA-seq).Methods:Network pharmacology analysis was performed to identify and correlate the drug targets of flower buds of P.notoginseng(PNF)with T2DM disease targets and to predict the key targets and pathways involved in the therapeutic effects of PNF in T2DM.In vivo experiments were conducted to assess the effects of PNF on glucose and lipid metabolism in mice with T2DM.RNA-seq was performed,and the results were integrated with network pharmacology data to assess the therapeutic mechanisms of PNF in T2DM.The results from transcriptomics and network pharmacology were validated using real-time polymerase chain reaction.Results:A total of 27 intersecting targets were identified by overlapping 35 drug targets with T2DM targets.Further topological analysis using the Centiscape 2.2 tool revealed five core targets,including signal transducer and activator of transcription 3(STAT3).Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis indicated that the JAK/STAT signaling pathway is a key mechanism underlying the therapeutic effects of PNF in T2DM.In vivo experiments confirmed that PNF effectively regulates glycolipid metabolism in a mouse model of diabetes.KEGG pathway enrichment analysis of RNA-seq data highlighted the JAK2/STAT3 and PI3K/AKT pathway as a potential mechanism.PNF high-dose(PNFH)increased the gene expression levels of PIK3R1 and AKT2,decreased the expression of PCK1,JAK2,and STAT3,and showed a trend toward increasing INSR expression without reaching statistical significance.Conclusion:PNF improves glycolipid metabolism disorders in T2DM,potentially by modulating the JAK2/STAT3 and PI3K/AKT signaling pathway.
文摘OBJECTIVE:To investigate the mechanism of action of Qinlian Jiangxia decoction(芩连姜夏汤,QLJXD)in the treatment of type 2 diabetes mellitus(T2DM)complicated by hyperlipidemia using network pharmacology,molecular docking,molecular dynamics simulation and in vivo experiments.METHODS:Drug components,targets and disease targets were identified using databases such as TCM systems pharmacology database and analysis platform and Gene Cards.The intersecting targets were subjected to protein-protein interaction analysis using the search tool for the retrieval of interacting genes/proteins database.Subsequently,Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis of the intersecting targets were conducted using the Metascape platform to identify core components and targets.The results were validated using molecular docking,molecular dynamics simulations and in vivo experiments.RESULTS:QLJXD contains 76 active ingredients and 136 disease targets.The core ingredients are quercetin,β-sitosterol,wogonin and baicalein,while the core targets are fatty acid binding protein 4(FABP4)and peroxisome proliferative activated receptor gamma(PPARG).Molecular docking and molecular dynamics simulations revealed that the core ingredients bound well to the core targets.Animal experiments demonstrated that QLJXD effectively inhibited the expression of FABP4 and increased the expression of PPARG,thereby enhancing disorders of glycolipid metabolism.CONCLUSION:The putative therapeutic efficacy of QLJXD in the management of T2DM complicated with hyperlipidemia may be ascribed to the synergistic actions of multiple components,such as quercetin,β-sitosterol,wogonin,and baicalein,which collectively modulate FABP4 and PPARG molecular targets.
