OBJECTIVE:To investigate the effect of insulin use intervention and self management of blood glucose in the treat-ment of cystic fibrosis related diabetes. METHODS:In prospective cohort study,during Apr. 2007-Apr. 2013,1 295 CFRD inpa-tients selected from 14 hospitals of Shanghai were randomly divided into trial group (743 cases) and control group (552 cases). Control group maintained the dose of insulin,and trial group adjusted the dose of insulin every week and received patient education about self management of blood glucose. Blood glucose,blood lipid,quality of life,the ability of self management and other in-dex were detected,recorded and compared between 2 groups 1 year after intervention. RESULTS:1 year after intervention,fasting blood glucose,postprandial 2 h blood glucose and HbA1c of trial group were significantly lower than those of control gorup,with statistical significance(P<0.05). The time of blood glucose reaching the standard,the dose of insulin,the number of hyperglycemia and hypoglycemia in trial group were all significantly shorter or lower than control group,with statistical significance (P<0.05). There was statistically significant difference in the rate of standard blood glucose between trial group [93.5%(695/743)] and control group [59.6%(329/552)]. TG of trial group decreased while HDL increased,there was statistically significant difference between 2 groups (P<0.05). There was statistically significant difference in the quality of life score between trial group (196.24 ± 15.80) and control group(180.33±16.29)(P<0.05). The ability of self management in trial group was significantly higher than control group, with statistical significance(P<0.05). CONCLUSIONS:Insulin use intervention and self management of blood glucose can control the level of blood glucose in CFRD patients,and improve the quality of life,medication compliance and therapeutic effect.

Objective To explore the relationship between pulse pressure (PP) and artery atherosclerosis in elders. Methods Totally 2358 eiders( > 60y) with the risk factors of artery atherosclerosis from Yangpu District DOI:10.3760/cma.j.issn.1008-6315.2009.09.006Central Hospital and 11 Community Health Service Centers were enrolled . The basic information includes age, sex, height,body mass, history of smoking, blood pressure, heart rate, history of coronary heart disease, ischemic stoke, chronic kidney diseases and diabetes,etc. The fasting blood sugar(FBS) ,blood lipid( total cholesterel,triglyceride, low-density lipreprotein, high-deusity liproprotein), serum creatinine, serum uric acid, serum alanine aminotransferase were measured. The elders were divided into two groups according to the PP( PP <60 mm Hg and PP≥60 mm Hg) to analyse the relationship between PP and age, BMI, SBP, DBP, HR, FBS, TC, TG, LDL-C, HDL-C, Cr, Ccr, UA, AST and history of coronary heart disease,ischemic stoke,chronic renal disease, and diabetes. Results Serum levels of FBS,TC,TG, LDL-C, UA in the group with PP less than 60 nun Hg were ( 5.6±1.7 ) mmol/L, (4.3±1.3 ) mmol/L, ( 1.5±1.2) mmol/L, ( 2.5±1.1 ) mmol/L, UA ( 246.8±131.2 ) μmol/L, that in the group with PP over or equal to 60 mm Hg group were (6.3±2.6) mmol/L, (4.8±1.2) mmol/L, ( 1.9±1.1 ) mmol/L, (2.9±1.2) mmol/L, (291.4±133.6) μmol/L, Serum levels of FBS, TC, TG, LDL-C, UA in the group with PP over 60 mm Hg were obviously elevated as compared with that in the group with PP lower than 60 ram Hg(P <0.01 ) ; The preven-lence rates of coronary heart disease ischemic stoke,chronic,renal disease, diabetes in the group with PP less than 60 mm Hg were 10.8% ,26.0%, 12.4%, 17.6%, that in the group with PP over or equal to 60 mm Hg group were 17.8% 、31.7% ,16.9% ,23.8% (P <0.01 ). The preveulence of coronary heart disease ischemic stoke,chronic re-nal disease, diabetes were significandy increased in the group with PP over or equal to 60 mm Hg group. Logistic re-gression analysis showed PP was closely related to FBS, BMI, age, LDL-C, UA, HDL-C ( β = 0.103,0.093.0.097, 0.089 ,0.076 , - 0.057, P < 0.05 ). Conclusions For those elders with the basis of artery atherosclerosis, high PP can inhance the development of artery atheresclerosis and also inhance the occurance and development of cardio-ce-rebrovascular and renal diseases.