Diabetes Mellitus, Type 2 ; complications ; drug therapy ; surgery ; Humans ; Obesity ; complications ; drug therapy ; surgery

Adipocytes ; chemistry ; Blood Vessels ; Cytokines

It has been proved recently that insulin signal transduction pathway and insulin resistance exist in islet?-cells.Defects in insulin signaling of the?-cells decrease glucose-stimulated first-phase insulin release, inhibit proliferation of?-cells and promote apoptosis of?-cells.Obesity accelerates the development of insulin resistance of?-cells,which may play a central role in the pathogenesis of type 2 diabetes mellitus.

OBJECTIVETo investigate the effect of compound Danshen Dripping Pill (DSP) on carotid arterial intima-media thickness (IMT) in patients with type 2 diabetes mellitus (T2DM).

METHODSOne hundred and thirty T2DM patients were assigned to four groups, 32 in the Group A, the control group treated with blood glucose (BG) and blood pressure (BP) controlling; 32 in the Group B, with BG, BP and blood lipid (BL) controlling, 32 in Group C with BG, BP, BL controlling and vitamin E administration, and 34 in Group D with BG, BP, BL controlling and DSP administration. Patients in Group D were subdivided by Chinese medicine syndrome differentiation into four types, 8 of Yin-deficiency with flourishing heat type (YDFH), 5 of both qi-yin deficient type (BQYD), 8 of both yin-yang deficient type (BYYD) and 13 of blood-stasis and qi-stagnant type (BSQS). Fasting blood glucose (FBG), BP and BL in patients were observed periodically, and IMT in them were measured by ultrasonography before treatment, as well as at the end of the 1st, 3rd, and 5th year of treatment to dynamically observe the changes of IMT and condition of plaque formation, and analyze the relation between them with FBG, BP and BL.

RESULTSThe 5-year follow-up was performed in 105 patients. In the observation period, level of total cholesterol (TC) showed a decreasing trend and level of high density cholesterol (HDL-C) showed an increasing trend in all the 4 groups, the improvements in Group C and D were slightly better than those in Group B, while significantly superior to those in Group A; the changes of FBG and glycosylated hemoglobin (HbAlc) were insignificant in the 4 groups. IMT and numbers of atheroma plaque increased gradually in all groups in the observation period, however, the changes in Group D were lesser than those in other groups, showing significant difference (P < 0.01). It was showed that the increasing of cervical carotid IMT in T2DM patients was correlated with levels of HbAlc, HDL-C, LDL-C, triglyceride and TC, especially in Group D.

CONCLUSIONDSP might delay the occurrence and development of diabetic macro-vascular disease.

Carotid Arteries ; pathology ; Carotid Intima-Media Thickness ; Diabetes Mellitus, Type 2 ; drug therapy ; pathology ; Diabetic Angiopathies ; pathology ; prevention & control ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Salvia miltiorrhiza ; chemistry ; Tunica Intima ; pathology ; Tunica Media ; pathology

Objective:To observe the expression changes of protein tyrosine phosphatase 1B(PTP1B)mRNA and protein during the differentiation of 3T3-L1 preadipocytes,so as to explore the relationship between PTP1B and adipocytes differentiation.Methods:3T3-L1 preadipocytes were cultured in vitro and were induced to differentiate into mature adipocytes; the differentiation of adipocytes was assessed through detecting expression of peroxisome proliferator-activated receptor-gamma 2(PPAR?2)mRNA by RT-PCR and oil red O staining.Expression of PTP1B in adipocytes was detected by RT-PCR and Western blot during differentiation.Results:With the progression of 3T3-L1 cell differentiation,oil red O staining showed that the lipid droplets increased gradually to 90% of the vision field;meanwhile,the expression of PPAR?2 also increased gradually, suggesting the proliferation and maturation of the preadipocytes.The expression of PTP1B mRNA and protein decreased in 3T3-L1 preadipocytes with their differentiation and maturation;the expression reached the lowest level in mature adipocytes. Conclusion:Expression of PTP1B mRNA and protein decreases during the differentiation of preadipocytes,indicating a role for PTP1B in the maturation of adipocytes.

Objective To investigate the protein level of protein tyrosine phosphatase 1B (PTP1 B) during the differentiation of 3T3-L1 preadipocytes and the effects of tumor necrosis factor-?(TNF-?) and rosiglitazone on the expression of PTP1B during the differentiation,and to explore the relationship between PTP1B and adipecyte differentiation.Methods 3T3-LI preadipecytes were cultured in vitro and differentiated by three groups of inducers: basic inducers only (3-isobutyl-1-methylxanthine+dexamethasone+insulin,group C),20?g/L TNF-?+basic inducers (group CT) and 10~(-5) mol/L rosiglitazone+basic inducers (group CR).Protein level of PTP-1B in adipocytes during differentiation was detected by Western blot.Results Each group showed the relatively high level of PTP1B in 3T3-L1 preadipecytes,going down with the differentiation of adipecytes,and reaching the lowest level in fully-matured adipecytes.Comparing the late period of differentiation in these three groups,CT group was sluggishly differentiated with more PTP1B protein,and CR group showed active differentiation with the lowest level of PTP1B.Conclusion PTP1B decreases with the differentiation of adipoeytes.The effects of TNF-?and rosiglitazone on insulin sensitivity perhaps partly via their influences on PTP1B level in adipecytes.

Objective To investigate the expression of protein tyrosine phosphatase(PTP)1B in pancreas of obese rats induced by high fat diet.Methods Twenty male SD rats were randomly divided into control group on regular diet(n=10),and obesity model group on high fat diet(n=10).After twelve weeks,fasting serum insulin,blood glucose,triglyceride,total cholesterol,epididymal fat weight were measured and the histomorphological change in liver were observed;glucose tolerance test and insulin releasing test were performed; The protein expression of PTP-1B in pancreas of rats was determined with Western blotting and immunohistochemistry.The phosphorylation of insulin receptor substrate-1(IRS-1)and insulin receptor(IR)were detected by immuno-precipitation.Results(1)The insulin sensitive index was significantly decreased in the high-fat-diet rats compared with the normal rats(0.36?0.18 vs 0.91?0.28,P

BACKGROUNDMolecular hydrogen, as a novel antioxidant, has been proven effective in treating many diseases. This study aimed to evaluate the therapeutic effects of hydrogen saturated saline in treatment of a rat model of diabetes mellitus and a rat model of insulin resistant.

METHODSA rat diabetes mellitus model was established by feeding a high fat/high carbohydrate diet followed by injection of a small dose of streptozotocin, and an insulin resistant model was induced with a high glucose and high fat diet. Hydrogen saturated saline was administered to rats with both models conditions on a daily basis for eight weeks. A pioglitazone-treated group and normal saline-treated group served as positive and negative controls. The general condition, body weight, blood glucose, blood lipids, and serum insulin levels of rats were examined at the 8th week after treatment. The oxidative stress indices, including serum superoxide dismutase (SOD), glutathione (GSH) and malondialdehyde (MDA) were also evaluated after eight weeks of treatment using the commercial kits.

RESULTSHydrogen saturated saline showed great efficiency in improving the insulin sensitivity and lowering blood glucose and lipids. Meanwhile, the therapeutic effects of hydrogen saturated saline were superior to those of pioglitazone. Hydrogen saturated saline markedly attenuated the MDA level and elevated the levels of antioxidants SOD and GSH.

CONCLUSIONHydrogen saturated saline may improve the insulin resistance and alleviate the symptoms of diabetes mellitus by reducing the oxidative stress and enhancing the anti-oxidant system.

Animals ; Diabetes Mellitus, Experimental ; drug therapy ; Hydrogen ; therapeutic use ; Hypoglycemic Agents ; therapeutic use ; Insulin Resistance ; Oxidative Stress ; drug effects ; Rats ; Sodium Chloride ; chemistry ; Thiazolidinediones ; therapeutic use

BACKGROUNDThere is no agreement as to whether intensive glucose control in type 2 diabetes can reduce the incidence of macrovascular events in these patients. We performed a meta-analysis comparing intensive glucose control or conventional glucose control in randomized controlled trials.

METHODSDatabases including MEDLINE, EMBASE, and Cochrane controlled trials register, the Cochrane Library, and Science Citation Index were searched to find relevant trials. Outcome measures were the incidence of major macrovascular events.

RESULTSSix trials involving 28 065 patients were included. Analysis suggested that there was an obviously decreased incidence of major macrovascular events in patients having intensive glucose treatment vs. controls (RR 0.92; 95%CI 0.87, 0.98; P = 0.005). However, intensive glycemia control strategies in type 2 diabetes showed no significant impact on the incidence of death from any cause compared with conventional glycemia control strategies, intensive 14.7%, controls 12.0% (RR 0.95; 95%CI 0.80, 1.12; P = 0.55), as well as on the incidence of cardiovascular death, intensive 3.7%, controls 3.6% (RR 1.10, 95%CI 0.79, 1.53; P = 0.57).

CONCLUSIONSControl of glycemia to normal (or near normal levels) in type 2 diabetes appears to be effective in reducing the incidence of major macrovascular events, but there were no significant differences of either the mortality from any cause or from cardiovascular death between the two glycemia-control strategies.

Blood Glucose ; analysis ; Diabetes Mellitus, Type 2 ; blood ; complications ; drug therapy ; mortality ; Diabetic Angiopathies ; prevention & control ; Glycated Hemoglobin A ; analysis ; Humans ; Randomized Controlled Trials as Topic

The aim of this Post-Marketing Surveillance study was to assess efficacy,safety and acceptance of acarbose treatment in Chinese type 2 diabetic patients under day-to-day practice conditions.A total of 2 480 patients were enrolled by 231 physicians throughout China into an open,prospective,uncontrolled,non- randomised,multi-centre study.Main efficacy parameters were the changes in fasting and postprandial blood glucose concentrations as well as in HbA-(1C) levels after acarbose treatment.The majority of patients had been previously treated with other oral anti-diabetic medication or insulin and received concomitant anti-diabetics during the mean observation period of 13.5 weeks.Most patients started on a daily acarbose dose of 50 mg t.i.d. Acarbose treatment reduced fasting blood glucose concentrations by 56.1 mg/dl ( 18 mg/dl glucose = 1 mmol/L glucose) and 2h-postprandial values by 111.3 mg/dl over the study period.HbA-(1C) decreased by 1.9% and body weight by 0.9 kg.76 acarbose-relatod adverse events occurred;two patients experienced serious adverse events. The attending physicians assessed treatment efficacy as“very good”or“good”for 90.1% of the patients, tolcrability for 89.1% and acarbose acceptance for 87.1% of the patients.Acarbose is efficacious,safe and well accepted by Chinese type 2 diabetic patients under day-to-day routine conditions,both as anti-diabetic mono- therapy and in combination with other anti-dlabetic drugs.