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

No abstract available.
Diabetes Mellitus, Type 2/complications ; Female ; Genital Neoplasms, Female/complications/*drug therapy ; Humans ; Metformin/*therapeutic use

BACKGROUND: Preliminary studies have indicated that Shexiang Baoxin Pill (MUSKARDIA) has a coronary artery dilation effect and increases the coronary blood flow, relieving the symptoms of angina. This study aimed to evaluate the benefit of MUSKARDIA on patients with stable coronary artery disease (CAD) and diabetes mellitus (DM). METHODS: This was a subgroup analysis of a multicenter, randomized, placebo-controlled phase IV trial. CAD patients with a medical history of DM or baseline fasting blood glucose (FBG) ≥7.0 mmol/L were grouped according to the treatment (standard therapy plus MUSKARDIA or placebo). The primary outcome was major adverse cardiovascular events (MACEs), which was the composite outcome of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. The secondary outcome was the composite outcome of all-cause death, non-fatal myocardial infarction, non-fatal stroke, hospitalization for unstable angina or heart failure, and coronary angioplasty. RESULTS: MACEs occurred in 2.6% (9/340) and 4.8% (18/376) of patients in the MUSKARDIA and placebo groups, respectively ( P  = 0.192). Secondary composite outcome was significantly less frequent with MUSKARDIA than with placebo (15.3% [52/340] vs . 22.6% [85/376], P  = 0.017). Risk of MACEs (hazard ratio [HR] = 0.69, 95% confidence interval [CI]: 0.31-1.57) was comparable between two groups. In patients with uncontrolled DM (≥4 measurements of FBG ≥7 mmol/L in five times of follow-up), the risk of secondary outcome was significantly lower with MUSKARDIA (5/83, 6.0%) than with placebo (15/91, 16.5%) (HR = 0.35, 95%CI: 0.13-0.95). CONCLUSION: As an add-on to standard therapy, MUSKARDIA shows a trend of reduced MACEs in patients with stable CAD and DM. Furthermore, MUSKARDIA may reduce the frequency of all-cause death, hospitalization, and coronary angioplasty in this population, especially in those with uncontrolled DM. TRIAL REGISTRATION ChiCTR.org.cn, ChiCTR-TRC-12003513.
Humans ; Coronary Artery Disease/complications* ; Diabetes Mellitus, Type 2/drug therapy* ; Myocardial Infarction/complications* ; Stroke/epidemiology*

Type 2 diabetes mellitus is a progressive process. With the course of the disease progress, microvascular and macrovascular complications always happen. Thrombotic events caused by macrovascular complications, including coronary heart diseases and cerebrovascular diseases, are the main fatal factor for the patients with type 2 diabetes. Endothelial dysfunction, coagulative activation, impaired fibrinolysis, together with hyper-reactive platelets contribute to the diabetic prothrombotic state, which is strongly related to the macrovascular complications. In particular, the hyper-reactive platelets play a fundamental role among them. Type 2 diabetes is characterized by several metabolic dysfunctions such as hyperglycemia, insulin resistance and shortage, oxidative stress, systemic inflammation, obesity, and dyslipidemia. These metabolic dysfunctions work together to promote the formation of hyper-reactive platelets, which are distinctive in type 2 diabetes. The regular antiplatelet drugs, like aspirin, show limited inhibitory effect on them. Hence, studying the mechanism behind the hyper-reactive platelets could provide a brand-new view on the prevention of macrovascular complications and cardiovascular events in type 2 diabetes.
Blood Platelets ; Diabetes Mellitus, Type 2/drug therapy* ; Humans ; Hyperglycemia/complications* ; Insulin Resistance ; Obesity/complications*

Diabetes Mellitus, Type 2 ; complications ; Guideline Adherence ; Humans ; Hypertension ; complications ; drug therapy ; Practice Guidelines as Topic

This paper summarizes professor ZHANG Zhi-long's academic thoughts and his specialized treatment experience for type 2 diabetes mellitus and its complications. There are three aspects: emphasizes the importance of scientific investigation and the classics in TCM, states that spleen deficiency and excessive dampness tend to cause type 2 diabetes mellitus; emphasizes regulating spleen and stomach with acupuncture and formulates acupoint prescription for regulating middle-jiao; emphasizes the evidence based medicine and clinical experiences, seeks the law of treatment for type 2 diabetes mellitus.
Diabetes Mellitus, Type 2 ; complications ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Middle Aged

Albuminuria ; drug therapy ; Diabetes Mellitus, Type 2 ; complications ; drug therapy ; Diabetic Nephropathies ; drug therapy ; Humans ; Tetrazoles ; therapeutic use

Animals ; Calcitriol ; pharmacology ; Diabetes Mellitus, Experimental ; complications ; Diabetes Mellitus, Type 2 ; complications ; Liver ; drug effects ; Liver Diseases ; complications ; drug therapy ; Male ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the role of baseline risk factors in predicting the onset of diabetes among essential hypertensive patients with metabolic syndrome (MS) and to evaluate an ideal therapeutic regime that could reduce the risk factors and risk of onset of diabetes.

METHODSA randomized parallel clinical trial in essential hypertensive patients of grade 1 or 2 was conducted. Two of the three components (1) increased waist circumference and/or BMI; (2) increased triglycerides (TG) and/or decreased high-density lipoprotein cholesterol; (3) impaired glucose tolerance (IGT) were present define the MS. The three intervention therapy groups were: indapamide + fosinopril (I + F, n = 151); atenolol + nitrendipine (A + N, n = 160); atenolol + nitrendipine + metformin (A + N + M, n = 152). Each case was followed-up monthly and the dosage of medicine taken be adjusted according to their BP level. The plasma glucose during fasting and two hours after taking 75 g glucose orally was also measured every six months. The new onset of diabetes was diagnosed according to the criteria. OGTT, insulin release test, lipid analysis, body weight and waist circumference were measured again at the last follow-up.

RESULTS(1) The lowering of BP was similar among the three groups (P > 0.05). 23 new diabetes onsets occurred, being 10 in group I + F and 8 in group A + N and 5 in group A + N + M, respectively (P > 0.05); (2) Proportions of patients' risk factors decreased significantly in group A + N or A + N + M, e.g. the proportions of high TG in each group reduced by 14.7% and 9.3% respectively (P < 0.05), the central fat distribution reduced by 16.7% and 15.9% respectively (P < 0.05) and the IGT reduced by 6.6% and 29.6% respectively (P < 0.05). However no changes were found in group I + F; (3) After 1 year and 5 months' follow-up, the proportions of main risk factors (high TG, central fat distribution and IGT) in the three groups were 91%, 96%, 83% and 90%, 88%, 47%, respectively. The difference of IGT was significant between two groups (P < 0.01) and the proportions of having three risk factors were 70% and 31% in the two groups (P < 0.01); (4) I + F group was better than A + N group in reduction of TG and central fat distribution. And A + N + M group improved in all risk factors.

CONCLUSIONSIGT alone or combined with increased TG plus abdominal obesity are the most important risk factors in predicting a new onset of diabetes among essential hypertensive patients with MS. Metformin in combination with atenolol plus nitrendipine can significantly prevent the onset of diabetes as well as improve patients' metabolic abnormality.

Adult ; Diabetes Mellitus, Type 2 ; prevention & control ; Drug Therapy, Combination ; Female ; Glucose Intolerance ; Humans ; Hypertension ; complications ; drug therapy ; Male ; Metabolic Syndrome ; complications ; drug therapy ; Middle Aged ; Risk Factors

OBJECTIVETo evaluate the effect of treatment for tonifying qi, nourishing yin, activating blood circulation and removing stasis on insulin resistance (IR) in patients of type 2 diabetes mellitus (T2DM) complicated with hypertension.

METHODSForty-five patients of T2DM with hypertension enrolled from authors' special clinics were equally randomized into two groups: the test group (20 patients) and the control group (25 patients). Both groups received orally hypoglycemic drugs, such as glipizide sustained-release tablets, pioglitazone, and metformin, and antihypertensive drug as nifedipine sustained-release tablets as well. Additionally, Sanqidan Granules (SQD), a Chinese patent medicine was given to the test group. The course of treatment lasted for 8 weeks. The clinical efficacy of Chinese medicine syndromes, blood pressure, T2DM related indices and blood lipids in the two groups were observed.

RESULTSThe effect in improving Chinese medicine syndromes in the test group was better than that in the control group significantly (P <0.05). After treatment, all the indices were examined, except FINS and TG were improved in the test group, showing significant difference as compared with those before treatment; while in the control group, significant difference was only shown in terms of fasting blood glucose (FBG), HbA1 c, systolic blood pressure (SBP) and HDL-C (P <0.01). Comparison between groups showed that the effect in the former was better than that in the latter group in terms of decreasing FBG, HbA1c, SBP and increasing of HDL-C (P <0.05), while a downward trend of ISI in the test group was shown but with no statistical significance (P = 0.230).

CONCLUSIONSSQD can relieve the clinical symptoms in patients of syndrome of qi-yin deficiency and inner blockage of blood stasis, increase the insulin sensitivity and reduce the IR in patients, so as to decrease their FBG, blood pressure and HbAlc. It also can increase HDL-C level, and lower TC and LDL-C levels, which is beneficial to anti-atherosclerosis.

Aged ; Diabetes Mellitus, Type 2 ; complications ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypertension ; complications ; drug therapy ; Male ; Middle Aged ; Yin Deficiency ; drug therapy