Objective　To observe the effect of losartan on urinary albumin excretion in streptozotocin diabetic rats.Methods　The following groups of rats were studied:normal control rats(NC),diabetic control rats (DC),diabetic rats treated with losartan 〔20mg/(kg*d)〕(DL) and diabetic rats treated with perindopril （2mg/(kg*d)〕(DP).Urinary albumin was observed at the 4th、8th、12th and 16th week.Results　Urinary albumin excretion of diabetic rats treated with losartan or perindopril were significantly lower than that of diabetic untreated group (P＜0.01).The effect was not different between losartan treated and perindopril treated rats.Conclusion　The results suggested that losartan can reduce urinary albumin excretion in diabetic rats.

The study of cases with T2DM(n=60) and normal control(n=46) showed that T2DM group exhibited the higher level of leptin and lower level of soluble leptin receptor than did(normal) control.

Objective To evaluate the transcutaneous oxygen pressure (TcPO2 )and its clinical significance in patients with type 2 diabetic peripheral neuropathy (DPN). Methods A total of 222 hospitalized patients with type 2 diabetes mellitus (T2DM)from the Department of endocrinology of Lianyungang First People's Hospital in Jiangsu Province were enrolled in this study from October 2014 to September 2015.And 50 healthy controls were also selected in this study as control group (NC group). TcPO2 was tested in supine position in all the subjects by TCM400 TcPO2 detector. Patients with T2DM then were divided into two groups according to Nerve conduction velocity (NCV):DPN group (n = 102) and non-DPN group (NDPN group,n = 120).Anthropometric and metabolic parameters were assessed in each group. Results TcPO2 in supine positionwas lower in DPN group than in NC and NDPN group. TcPO2 was positively correlated with diabetes duration,TCSS scores,HbA1 c,SUA,FPG and NCV.Compared with normal TcPO2 group,the prevalence of DPN was increasedin low TcPO2 group,while NCV of motor nerve and sensory nerve were decreasedin low TcPO2 group.Logistic analysis showed that TcPO2 was an independent risk factor for DPN. Conclusion TcPO2 in supine position was decreased in patients with DPN,and is a risk factor for DPN,which may provides valuable information for DPN diagnosis.

Objective To explore the influence of case management on short-term intensive insulin therapy effect,including treatment compliance,safety and glucose metabolic index in newly diagnosed type 2 diabetic patients in outpatient clinic. Methods A total of 100 newly diagnosed type 2 diabetic patients in outpatient clinic were enrolled in this study and randomly divided into 2 groups:intervention group (n=52)and control group (Con,n = 48 ). The intervention group received standard insulin injection case management provided by a team composed of doctors and nurse case manager. The control group received routine insulin injection education in outpatient. Attitudes and compliance of insulin treatment,incidence of hypoglycemia,fasting blood glucose (FBG) and glycated haemoglobin A1c (HbA1 c ) were compared between the two groups at baseline and after 3 months follow up. Results After intervention,the total score and scores by dimension of insulin treatment attitude were higher in intervention group than in Con group[(76.30 ± 4.06 )vs (60.53 ± 3.18 )score,P < 0.01 ]. Insulin treatment compliance was better in intervention group than in Con group (82.7％ vs 64.6％,P < 0.05 ). The hypoglycemia incidence was lower in intervention group than in Con group (19.2％ vs 31.3％,P >0.05),although without statistical difference. FBG and HbA1 c were all lower in intervention group than in Con group [(6.79 ± 1.41 )vs (7.51±1.15)mmol/L,(6.62±0.69)％ vs (7.15±0.75)％,P <0.05]. Conclusion Case management could effectively improve the insulin treatment attitude and compliance,and then optimize glycemic control innewly diagnosed type 2 diabetic patients treated with short-term intensive insulin therapy in outpatient clinic.

Medical nutrition therapy (MNT)is the basic and long-term treatment of diabetes patients. At present,the dietary structure of type 2 diabetes mellitus(T2DM)patients in China has yet to be further improved. This article focused on the effect,dietary structure,food selection and guarantee of compliance of MNT in T2DM.We recommended that the dietary pattern should be designed based on the traditional dietary habits around the country,combined with people living and working reality. The rational utilization of network platform can improve the efficiency and compliance of nutrition education.

Based on my training experience in the United States,here introduced the situation of diabetes education and management in the United States,diabetes educator certification and the education program of outpatients and inpatients. This information can provide advice to improve the current status of diabetes education in China.

In recent years,more and more attention has been attached on diabetic cognitive dysfunction. The clinical manifestations are decreased visual spatial ability,executive function,mental activity and abstract logical reasoning. Diabetic cognitive dysfunction is irreversible. Therefore,timely and accurate assessment and diagnosis,early detection and early intervention to delay the progression of the disease are particularly critical. Cognitive assessment scale is particularly important in the screening of diabetic cognitive dysfunction. At present,there are many types of clinical evaluation scales. The application of screening scale in diabetic cognitive dysfunction is reviewed in this paper.

It is widely accepted that diabetes is intimately linked to diet. The latest researches showed that diet-microbiota interactions acted as moderators of human diabetes. Gluten-free diet and hydrolyzed protein decreased the incidence of type 1 diabetes mellitus (T1DM)by the mechanism of changes in gut microbiota and immune micro-environment. Consuming more dairy products decreased the incidence of type 2 diabetes mellitus (T2DM). High fat diet can induce insulin resistance (IR),thus increasing the incidence of T2DM. Parental dietary affected on offspring diabetes by the epigenetic mechanism. Low carbohydrate diet,dietary fiber and legumes were effective to the treatment of diabetes. Prediction of postprandial glucose level and treatment based on gut microbiota contributed to control the glucose of diabetic patients. An in-depth understanding of these mechanisms provides new ideas for the individualized and precise treatment of diabetes.

Objective To investigate the clinical risk factors of diabetic ketoacidosis (DKA ) combined with elevated serum amylase(AMS). Methods Totally 263 patients with DKA were enrolled in our study. They were divided into 2 groups according to the level of AMS:DKA with normal AMS (DKA,n=188);DKA with elevated AMS(HAMS,n = 75 ). HAMS patients then were divided into two subgroups according to the diagnosis with acute pancreatitis(AP)(HAMS+ AP,n = 25 )and without AP (HAMS,n = 50 ). TG,FPG and AMS were measured and analyzed with univariate analysis and multivariate analysis. Results HAMS group patients had a ratio of 28.5％ with elevated AMS and 9.5％ with AP.HAMS group had higher FPG,TG,HbA1 c,Na+ ,osmolality,BUN and Scr than DKA group(P <0.05).The levels of FPG,TG,osmolality,BUN and the time of CO2 CP recovery in HAMS+AP subgroup were all significantly higher than those in HAMS patients without AP (P < 0.05 ). Correlation analysis showed that HAMS was positively correlated with TG,FPG,Na+ ,Osmolality and BUN(P <0.05).Logistic regression analysis showed that hypertriglyceridemia was the independent risk factor of DKA combined with HAMS(OR 1.244,P <0.01),and was the independent risk factor of DKA combined with AP(OR 1.211,P <0.05). Conclusion Hypertriglyceridemia is the related risk factor of DKA combined with HAMS and AP. This study provides a theoretical basis to early screen patients with hyperamylasemia in DKA.

Objective To investigate the changes of blood glucose and insulin after intake of staple food containing potato,sorghum or wheat in healthy adults. Methods This study had a cross-over design. A total of 12 healthy adults were recruited and randomly averaged into 3 groups. After fasting for 10 hours,all the subjects were treated with steamed buns of potato,sorghum and wheat flours(100 g in raw flour),respectively. Serum glucose,insulin,triglyceride(TG),total cholesterol(TC)and uric acid(SUA) were measured at fasting,0.5 h,1 h,2 h and 3 h. After a wash period for 3 days,subjects crossed over to alternate group at second intervention and third intervention on the 5 th and 9 th day. During each intervention,the entire above index were tested. Results Postprandial insulin levels at 3 h was significantly higher in the potato steamed buns group(4.74 μU/ml)than in the sorghum steamed buns (1.65 μU/ml)group(P =0.028). There were no statistical differences in blood glucose and fasting,0.5 h,1 h,2 h insulin level. Conclusion Postprandial insulin level at 3 h was higher in potato flour steamed buns than in sorghum flour steamed buns.