Diabetes Mellitus, Type 2 ; prevention & control ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Metabolic Syndrome ; prevention & control ; therapy ; Phytotherapy

The identification of the etiology and pathogenesis of diabetes mellitus in TCM viewpoint is directly related with the syndrome differentiation and therapeutic methods. According to the traditional view, the pathogenesis of diabetes mellitus was considered as founding on yin deficiency, with dry heat in the superficiality, therefore the basic therapeutic methods should be supplementing qi and nourishing yin. However, its efficacy in clinical practice was unsatisfactory. In order to establish the efficient therapeutic approaches, the author strongly recommended that physician should get the insight into the pathogenesis and syndromes of the illness and handle the yin-yang equilibrium, pay attention to not only the qi and yin deficiency, but also the yang deficiency, and further, the inner barbaric glucose-toxicity, which not only existed at the late stage, but also showed some cues in the initiative stage. Therefore, the author emphasized that in treating diabetes mellitus, besides the basic treatment for supplementing qi and nourishing yin, one should pay great attention to removing toxin and intensifying yang to achieve yin-yang equilibrium.
Diabetes Mellitus, Type 2 ; drug therapy ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Qi ; Yin-Yang

Necrotizing fasciitis is known to be a highly lethal infection of deep-seated subcutaneous tissue and superficial fascia. Reports of necrotizing fasciitis due to Streptococcus pneumoniae are exceedingly rare. We report a case of necrotizing fasciitis in a 62-yr-old man with liver cirrhosis and diabetes mellitus. He presented with painful swelling of left leg and right hand. On the day of admission, compartment syndrome was aggravated and the patient underwent surgical exploration. Intra-operative findings revealed necrotizing fasciitis and cultures of two blood samples and wound aspirates showed S. pneumoniae. The patient died despite debridement and proper antimicrobial treatment. To the best of our knowledge, this is the first case of fatal necrotizing fasciitis with meningitis reported in Korea. We also review and discuss the literature on pneumococcal necrotizing fasciitis.
Anti-Bacterial Agents/therapeutic use ; Diabetes Mellitus, Type 2/complications/diagnosis ; Fasciitis, Necrotizing/*diagnosis/drug therapy/microbiology/surgery ; Fatal Outcome ; Humans ; Leg/surgery ; Liver Cirrhosis/complications/diagnosis ; Male ; Middle Aged ; Streptococcal Infections/*diagnosis/drug therapy ; Streptococcus pneumoniae/isolation & purification

Hepatic subcapsular steatosis is a rare and specific form of fatty change in the liver. It is a unique finding in diabetic patients receiving continuous ambulatory peritoneal dialysis (CAPD) and intraperitoneal insulin treatment. Intraperitoneal administration of insulin causes a unique pattern of fatty infiltration in the subcapsular location of the liver. Here we report a case of hepatic subcapsular steatosis in a diabetic CAPD patient who received intraperitoneal insulin. A 46-year-old diabetic woman on CAPD presented with general weakness. The patient received a total amount of 110 units of regular insulin via intraperitoneal and subcutaneous injection. Her initial blood chemistry showed increased serum lipid and liver enzyme profiles. Abdominal CT scan images and MRI revealed characteristic findings consistent with hepatic subcapsular steatosis. We assumed that the cause was CAPD and concomitant intraperitoneal insulin treatment; therefore, the patient was switched from CAPD to hemodialysis (HD) and began to receive insulin subcutaneously. Two months after the beginning of HD, the hepatic subcapsular steatosis completely resolved.
Peritoneal Dialysis, Continuous Ambulatory/*adverse effects ; Middle Aged ; Insulin/*administration & dosage/adverse effects ; Injections, Intraperitoneal ; Humans ; Female ; Fatty Liver/diagnosis/*etiology ; Drug Monitoring ; Diabetes Mellitus, Type 2/drug therapy/physiopathology/*therapy ; *Diabetes Complications

OBJECTIVETo observe the effect of Gegen Qinlian Decoction (GQD) in combination with short-term intensive insulin treatment on type 2 diabetes mellitus (T2DM) of dampness-heat syndrome and its influence on dosage of insulin used.

METHODSThe GQD group (n = 14) was treated by GQD and insulin, while the conventional group (n = 16) was given insulin intensive treatment alone.

RESULTSIn the GQD group, the treatment was markedly effective in 5 patients, effective in 6 and ineffective in 3, the total effective rate being 78.6%, much better than that in the conventional group (2, 7, 7 and 56.3% respectively, u = 2.58, P < 0.01). And it took less time for controlling blood glucose (BG) in the GQD group (4.54 +/- 0.50 days) than that in the conventional group (5.31 +/- 0.57 days, P <0.01); furthermore, by the end of the treatment course, as compared with that at the time just after BG being controlled, the daily average insulin dosage used in the GQD group reduced by 9.07 +/- 6.51 U, while it was only 4.38 +/- 5.94 U in the conventional group, showing significant difference between them (P < 0.05).

CONCLUSIONBased on short-term insulin intensive treatment, the combined using of GQD could reduce the dosage of insulin used and shows better clinical curative effect for patients with T2DM of dampness-heat syndrome.

Adult ; Diabetes Mellitus, Type 2 ; drug therapy ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Insulin ; therapeutic use ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy

OBJECTIVETo observe the clinical efficacy of Tiaozhi Jiangtang Tablet (TZJT) on patients suffering from diabetes mellitus with blood stasis syndrome.

METHODSSixty patients were randomly assigned into 2 groups, the TZJT group (n = 30) treated with TZJT tablet and asprin, the control group (n = 30) treated with asprin alone.

RESULTSThe improvement of symptoms was more significant in the TZJT group than that in the control group (P < 0.05). Levels of serum endothelin (ET), nitric oxide (NO) content and blood viscosity were decreased in both groups after treatment, and the effect of TZJT plus asprin was superior to that of asprin alone.

CONCLUSIONTZJT combined with asprin is effective in improving the serum content of ET and NO and reducing blood viscosity.

Adult ; Aged ; Aged, 80 and over ; Coronary Artery Disease ; drug therapy ; etiology ; Diabetes Mellitus, Type 2 ; complications ; drug therapy ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy

No abstract available.
Aged ; Anti-Bacterial Agents/therapeutic use ; Bursitis/*diagnosis/drug therapy/microbiology ; Cefoperazone/therapeutic use ; Diabetes Mellitus, Type 2/complications/*diagnosis ; Humans ; Male ; Nocardia/genetics/*isolation & purification ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S/chemistry/genetics ; Sequence Analysis, RNA ; Sulbactam/therapeutic use

No abstract available.
Antidiarrheals/*therapeutic use ; Benzimidazoles/*therapeutic use ; Diabetes Mellitus, Type 2/*complications ; Diarrhea/diagnosis/*drug therapy/etiology/physiopathology ; Endoscopy, Gastrointestinal ; Gastrointestinal Transit/*drug effects ; Humans ; Male ; Middle Aged ; Serotonin 5-HT3 Receptor Antagonists/*therapeutic use ; Treatment Outcome

PURPOSE: The short insulin tolerance test is a simple and reliable method of estimating insulin sensitivity. This study was designed to compare the insulin sensitizing effects of thiazolidinediones (TZDs) on the degree of insulin resistance, determined by a short insulin tolerance test (Kitt) in type 2 diabetic patients. PATIENTS AND METHODS: Eighty-three subjects (mean age = 57.87 +/- 10.78) with type 2 diabetes mellitus were enrolled and received daily one dose of rosiglitazone (4mg) or pioglitazone (15mg). The mean follow-up duration was 25.39 +/- 9.66 months. We assessed insulin sensitivity using HOMA-IR and the short insulin tolerance test before and after TZDs treatment. RESULTS: When we compared patients' characteristics before and after TZDs treatment, the mean fasting glucose level was significantly decreased (183.27 +/- 55.04 to 137.35 +/- 36.42mg/dL, p < 0.001) and the mean HbA1C level was significantly decreased (9.24 +/- 1.96 to 8.11 +/- 1.39%, p < 0.001). Also, Kitt values were significantly increased (2.03 +/- 1.14 to 2.67 +/- 0.97%/min, p = 0.003), whereas HOMA-IR was significantly decreased (2.98 +/- 0.68 to 1.04 +/- 0.24, p < 0.05). When classifying insulin resistance by Kitt values, insulin resistant subjects' values were increased (< 2.5%/min; 1.51 +/- 0.53%/min to 2.63 +/- 0.88, p < 0.001), whereas the values decreased in insulin sensitive subjects (> or = 2.5%/min; 3.50 +/- 0.75%/min to 2.75 +/- 1.12%/min, p = 0.002). CONCLUSION: The glucose lowering effects of TZDs by improving insulin resistance could be determined by using Kitt. However, Kitt may be a beneficial tool to determine TZDs' effects only when patients' Kitt values are less than 2.5%/min.
Aged ; Blood Glucose/metabolism ; Diabetes Mellitus, Type 2/blood/*diagnosis/*drug therapy ; Drug Tolerance ; Female ; Humans ; Hypoglycemic Agents/therapeutic use ; Insulin/diagnostic use ; *Insulin Resistance ; Male ; Middle Aged ; Thiazolidinediones/*therapeutic use

OBJECTIVETo observe the efficacy of integrative Chinese and western medicine (ICWM) in treating diabetic foot.

METHODSSixty-three patients were randomly divided into the treated group (n = 33) and the control group (n = 30). Both groups were treated by same baseline treatment with vasodilator, anti-agglutination agents and external treatment, to the treated group, Chinese drugs were given additionally according to the Syndrome Differentiation.

RESULTSIn the treated group, the treatment showed markedly effective in 12 patients, effective in 18 and ineffective in 3, the total effective rate being 90.0%, while in the control group, the corresponding numbers were 9, 14, 7 and 76.7%, comparison between the two groups showed significant difference (chi 2 = 15.8, P < 0.05). The case number of Grade II, III and IV in the treated group reduced, and those recovered to Grade 0 increased, as compared with those in the control group, the difference was significant (P < 0.05). Patients with healing of ulcerative wound and fresh wound granulation in the treated group, as compared with those in the control group, the difference was significant (P < 0.05). Levels of fasting blood glucose and blood glucose 2 hrs after meal were all improved in both groups, which showed significant difference as compared with those before treatment (P < 0.05).

CONCLUSIONThe efficacy of ICWM treatment in treating diabetic foot was better than the treatment of western medicine alone.

Aged ; Combined Modality Therapy ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Foot ; drug therapy ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Insulin ; therapeutic use ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Scopolamine Hydrobromide ; therapeutic use