The insulin resistance (IR) and the active ingredients of traditional Chinese medicine and their mechanisms to improve IR in the last 3 years are summarized. Retrieve, classify and arrange the recent documentations of china and abroad. IR can drive the occurrence and progress of type 2 diabetes mellitus (T2DM), and there are several molecular mechanisms for the occurrence of IR. IR has been a research focus of diabetes, the control strategies of T2DM have been changed from the "hypoglycemic therapy" into "improve the IR and IR-related metabolic abnormalities, and make a comprehensive prevention and treatment of cardiovascular risk factors". It is demonstrated by experiments that a variety of active ingredients of traditional Chinese medicine can improve IR through different mechanisms to treat diabetes mellitus.
Animals ; Diabetes Mellitus, Type 2 ; complications ; drug therapy ; physiopathology ; Drugs, Chinese Herbal ; analysis ; therapeutic use ; Humans ; Insulin Resistance ; Medicine, Chinese Traditional

OBJECTIVETo study the effect of Shexiang Baoxin pill (SBP) on the vascular endothelial function in patients with diabetes mellitus type 2 (DM2) complicated with angina pectoris.

METHODSTwo weeks after runin, according to the randomizing table, 111 patients were divided into two groups, the XBP group (56 patients) and the control group (55 patients, treated with delayed-released isosorbide mononitrate, DRIM), they were treated for 6 months. In the treatment period, the episodes of angina attack and condition of rescue medication were recorded in the daily card, and brachial arterial changes of endothelium-dependent relaxing function before and after treatment were measured by B-ultrasonography.

RESULTSComparison between the two groups in episodes of angina attack and rescue medication were insignificantly different. In the control group, the basal value of brachial arterial inner diameter before and after treatment was 3.68 +/- 0.56 mm and 3.70 +/- 0.58 mm respectively, those before and after responsive congestion was 5.44 +/- 0.81% vs 5.68 +/- 0.83%, and those before and after taking nitroglycerin was 19.8 +/- 4.9% vs 20. +/- 5.2%, all showed insignificant difference (P > 0.05). In the SBP group, the corresponding basal value was 3.73 +/- 0.62 mm vs 3.71 +/- 0.59 mm, and those after taking nitroglycerin 18.8 +/- 4.5 % vs 19.2 +/- 5.8%, also showed insignificant difference, but those before and after responsive congestion (5.69 +/- 0.79 % vs 9.56 +/- 3.82 %) did show significant difference (P < 0.01).

CONCLUSIONXBP could improve the vascular endothelial function in patients with DM2 complicated with angina pectoris.

Aged ; Angina Pectoris ; complications ; drug therapy ; Angioplasty, Balloon, Coronary ; Diabetes Mellitus, Type 2 ; complications ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; drug effects ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy

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 objectively assess the effect of Qiming Granule in the treatment of diabetic retinopathy (DR) by fluorescence fundus angiography (FFA).

METHODSIn a multi-center, randomized, parallel controlled clinical trial, patients with DR were randomly assigned to the control group (calcium dobesilate capsule) and the test group (Qiming Granule). Changes in the retinal blood circulation time were recorded by FFA after 3 months of medication.

RESULTSSignificant reduction was observed in the retinal arterio-venous circulation time (AVCT) in both groups (P<0.01), the value was 7.635+/-3.149 s before treatment and 5.165 +/-3.382 s after treatment in the treated group, and 7.737+/-3.413 s and 5.313+/-3.472 s in the control group respectively. Qiming Granule also reduced the arm-to-retinal circulation time (ARCT, P<0.05). The value was 17.867+/-3.872 s before treatment and 15.643+/-4.648 s after treatment in the treated group, and 17.217+/-3.833 s and 16.312+/-3.613 s in the control group (P>0.05) respectively. The ARCT in the tested group was reduced, with a statistically significant difference post-medication (P<0.01).

CONCLUSIONAs a Chinese medicine complex prescription, Qiming Granule may alleviate retinal hypoxia and ischemia by increasing retinal blood flow and improving the blood circulation.

Aged ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Retinopathy ; drug therapy ; physiopathology ; Drugs, Chinese Herbal ; adverse effects ; pharmacology ; therapeutic use ; Female ; Fluorescein Angiography ; Humans ; Male ; Middle Aged ; Retinal Vessels ; drug effects ; physiopathology

OBJECTIVETo study the possible pathogenic mechanism of liver injury in type 2 diabetes mellitus (T2DM) and the intervening effect of puerarin on it.

METHODSMice with T2DM (KKAy) were randomly divided into two groups, the model group and the puerarin group. And the C57BL/J mice of the same age were set up as normal controls. They were sacrificed at 28 weeks old for observing serum fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST) by automatic biochemistry; liver cell apoptosis by flow cytometry; pathomorphology by electron microscope; and mRNA expressions of bcl-2 and bax genes by RT-PCR; as well as the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), Na(+)-K(+)-ATPase; and content of malondialdehyde (MDA) in liver tissue by spectrophotometer.

RESULTSIn KKAy mice, blood levels of FBG, TG, TC, ALT, AST and liver cell apoptosis rate were higher; the bax mRNA expression was higher and bcl-2 mRNA was lower markedly; the activities of SOD, GSH-Px, Na(+)-K(+)-ATPase in liver tissue were lower, and MDA content was higher than those in the normal control significantly (all P <0.01). Besides, mitochondria swelling and damage were found in liver tissue. While in the puerarin group after treatment, all the above-mentioned changes were alleviated to some extent.

CONCLUSIONSObvious liver injury emerges in KKAy mice. Puerarin shows a protective effect on the T2DM caused oxidative damage by way of up-regulating bcl-2 to inhibit oxidative stress, and improving the energy metabolic dysfunction in liver of mice.

Animals ; Diabetes Mellitus, Experimental ; complications ; drug therapy ; pathology ; Diabetes Mellitus, Type 2 ; complications ; drug therapy ; pathology ; Isoflavones ; therapeutic use ; Liver ; metabolism ; physiopathology ; Liver Diseases ; drug therapy ; etiology ; Male ; Mice ; Mice, Inbred C57BL ; Mitochondria, Liver ; pathology ; Oxidative Stress ; Phytotherapy ; Proto-Oncogene Proteins ; metabolism ; Proto-Oncogene Proteins c-bcl-2

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

OBJECTIVETo observe the effect and mechanism of curcumin derivative B06 on kidney from rats with hyperlipidemia and type 2 diabetes.

METHODSThirty five male SD rats were randomly divided into five groups(n = 7): the normal control group, high-fat group, high-fat + B06-treatd group, diabetic group, diabetic + B06-treated group. After fed with high-fat diet for 4 weeks, the later two groups were in- jected with streptozotocin intraperitoneally to induce type 2 diabetes mellitus. B06-treated groups were given B06 by gavage at a dosage of 0.2 mg/kg . d for 8 weeks. After the treatment, the serum creatinine, blood urea nitrogen and uric acid were detected biochemically, the morphology of kidney was observed with light and transmission electron microscopy, the expression of collagen fibers was observed with Masson staining, the protein expression of collogen IV and fibronectin in kidney were determined by Immunohistochemistry.

RESULTSIt was showed that the levels of the serum creatinine and blood urea nitrogen elevated significantly in diabetic group. In high-fat and diabetic groups, increased glomerular mesangial matrix and collagen fiber and thicken glomerular basal membrane were observed under light microscopy, swelling and fusion of foot process were found under electron microscope; increased green matrix within glomeruli was observed under Masson staining. collogen IV and fibronectin protein expression were significantly enhanced in high-fat group and diabetic group. After B06's intervention, the levels of serum creatinine and blood urea nitrogen were decreased in diabetic groups, the morphological change of kidney was obviously relieved, Collogen IV and fibronectin protein expression reduced.

CONCLUSIONCurcumin derivative B06 exerts a protective effect on kidney in type 2 diabetic rats, reduced expressions of collogen IV and fibronectin, inhibition of the accumulation of extracellular matrix and glomerular mesangial proliferation, and then prevention of renal fibrosis may be the mechanism.

Animals ; Blood Urea Nitrogen ; Collagen Type IV ; metabolism ; Creatinine ; blood ; Curcumin ; pharmacology ; Diabetes Mellitus, Experimental ; complications ; drug therapy ; Diabetes Mellitus, Type 2 ; Drugs, Chinese Herbal ; Fibronectins ; metabolism ; Kidney ; metabolism ; physiopathology ; Kidney Diseases ; drug therapy ; Male ; Rats ; Rats, Sprague-Dawley ; Streptozocin ; Uric Acid ; blood

OBJECTIVETo observe the efficacy and safety of vardenafil in the treatment of erectile dysfunction (ED) in aged men with diabetes mellitus (DM).

METHODSOne hundred outpatients with diagnosed ED (40 diabetic and 60 non-diabetic) received vardenafil at the initial dose of 20 mg and sustained dose of 10 mg once a week for 8 weeks, and their erectile functions were evaluated by IIEF and EQS.

RESULTSThe scores on IIEF and EQS in the diabetic ED group were 18.9 +/- 0.2 and 25.1 +/- 1.4 after the vardenafil treatment, significantly higher than 8.1 +/- 0.5 and 9.1 +/- 1.3 before the treatment (P < 0.01), and the non-diabetic group scored 21.1 +/- 0.2 and 34.2 +/- 1.2 on IIEF and EQS after the treatment, as compared with the statistically lower scores of 10.1 +/- 0.3 and 10.1 +/- 1.7 before it (P < 0.01). The total rate of effectiveness was 65% in the diabetic and 73.30% in the non-diabetic group, with statistical differences (P < 0. 05).

CONCLUSIONVardenafil can significantly improve erectile function and is well tolerated in the aged males with diabetic ED.

Aged ; Aging ; physiology ; Diabetes Mellitus, Type 2 ; complications ; Erectile Dysfunction ; drug therapy ; etiology ; physiopathology ; Humans ; Imidazoles ; therapeutic use ; Male ; Middle Aged ; Phosphodiesterase Inhibitors ; therapeutic use ; Piperazines ; therapeutic use ; Sulfones ; therapeutic use ; Treatment Outcome ; Triazines ; therapeutic use ; Vardenafil Dihydrochloride

To study the therapeutic effect and possible mechanism of icariin on myocardial ischemia-reperfusion injury ( MIRI) model in diabetes rats. The model of diabetic rats were induced by Streptozotocin (STZ), then the model of MIRI was established by ligating the reversible left anterior descending coronary artery for 30 min, and then reperfusing for 120 min. totally 40 male SD were randomly divided into five groups: the control group (NS), the ischemia reperfusion group (NIR), the diabetes control group (MS), the diabetic ischemia reperfusion group (MIR) and the diabetic ischemia reperfusion with icariin group (MIRI). The changes in blood glucose, body weight and living status were observed; the enzyme activity of serum CK-MB, LDH, GSH-Px and myocardium SOD and the content MDA and NO in myocardium were detected; the myocardial pathological changes were observed by HE staining; the myocardial Caspase-3, the Bcl-2, Bax protein expressions were detected by Western blot. The result showed that the diabetes model was successfully replicated; myocardial ischemia-reperfusion injury was more serious in diabetes rats; icariin can increase NO, SOD, GSH-Px, Bcl-2 protein expression, decrease MDA formation, CK-MB and LDH activities and Caspase-3 and Bcl-2 protein expressions and myocardial damage. The result suggested that icariin may play a protective role against ischemia reperfusion myocardial injury in diabetes rats by resisting oxidative stress and inhibiting cell apoptosis.
Animals ; Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Creatine Kinase ; metabolism ; Diabetes Mellitus, Type 2 ; complications ; Drugs, Chinese Herbal ; administration & dosage ; Flavonoids ; administration & dosage ; Humans ; Ischemia ; drug therapy ; etiology ; physiopathology ; Male ; Malondialdehyde ; metabolism ; Myocardial Reperfusion Injury ; drug therapy ; etiology ; metabolism ; physiopathology ; Myocardium ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism ; bcl-2-Associated X Protein ; metabolism

The vascular endothelial function is impaired in the very early stage of atherosclerosis in diabetic patients. The goal of this study was to identify the mechanism underlying the improvement in vascular endothelial function by sitagliptin in type 2 diabetes mellitus patients. This study was an open-labeled prospective observational single arm trial. Forty patients were treated with 50 mg of sitagliptin once daily for 12-weeks. The flow-mediated dilation (FMD) and plasma adiponectin were measured at baseline and 12 weeks after initiating treatment. The %FMD was significantly increased after treatment (4.13 +/- 1.59 vs 5.12 +/- 1.55, P < 0.001), whereas the nitroglycerin-mediated dilation (NMD) did not change. The plasma adiponectin levels significantly increased (13.0 +/- 11.3 vs 14.3 +/- 12.8, P < 0.001). The changes in the FMD were significantly correlated with those of the plasma adiponectin (r = 0.322, P < 0.05). A multivariate linear regression analysis demonstrated that the improvement in the FMD is associated with the plasma adiponectin (P < 0.05). The treatment of type 2 diabetes mellitus patients with sitagliptin reverses vascular endothelial dysfunction, as evidenced by increase in the FMD, and improvement of the adiponectin levels (UMIN Clinical Trials Registry System as trial ID UMIN000004236).
Adiponectin/blood ; Aged ; Aged, 80 and over ; Atherosclerosis/complications/drug therapy ; Diabetes Mellitus, Type 2/complications/*drug therapy ; Dipeptidyl-Peptidase IV Inhibitors/pharmacology/*therapeutic use ; Drug Administration Schedule ; Endothelium, Vascular/*drug effects/physiopathology ; Female ; Humans ; Male ; Middle Aged ; Nitroglycerin/therapeutic use ; Prospective Studies ; Pyrazines/pharmacology/*therapeutic use ; Regression Analysis ; Triazoles/pharmacology/*therapeutic use ; Vasodilation/drug effects ; Vasodilator Agents/therapeutic use