1.Diagnosis and treatment strategy of periodontitis with diabetes.
Xue Xue SHI ; Jin Hua GAO ; Xiu Yun REN
Chinese Journal of Stomatology 2023;58(6):615-620
The number of diabetic patients visiting stomatology for periodontal disease is increasing, and the symptoms are relatively severe, and often complications increase the complexity of periodontal treatment. This article briefly describes the research progress and clinical manifestations of the epidemiology and related pathological mechanisms of periodontitis with diabetes, focusing on the treatment and providing reference for stomatologists in the clinical diagnosis and treatment of patients with diabetic periodontitis.
Humans
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Periodontitis/therapy*
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Diabetes Mellitus/therapy*
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Periodontal Diseases
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Dental Care
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Diabetes Mellitus, Type 2
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Diabetes Complications/complications*
7.Hyper-reactive platelets and type 2 diabetes.
Journal of Central South University(Medical Sciences) 2022;47(3):374-383
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
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Diabetes Mellitus, Type 2/drug therapy*
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Humans
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Hyperglycemia/complications*
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Insulin Resistance
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Obesity/complications*
8.Effectiveness and safety of Shexiang Baoxin Pill (MUSKARDIA) in patients with stable coronary artery disease and concomitant diabetes mellitus: a subgroup analysis of a randomized clinical trial.
Jingmin ZHOU ; Haiming SHI ; Fusui JI ; Yang WU ; Yulan ZHAO ; Jun QIAN ; Junbo GE
Chinese Medical Journal 2023;136(1):82-87
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
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Coronary Artery Disease/complications*
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Diabetes Mellitus, Type 2/drug therapy*
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Myocardial Infarction/complications*
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Stroke/epidemiology*
9.Status Quo and Research Progress in Diagnosis and Treatment of Patients With Diabetes Mellitus and Chronic Kidney Disease.
Piao-Yu DAI ; Qiong-Jing YUAN ; Zhang-Zhe PENG ; Yan-Yun XIE ; Li-Jian TAO ; Ling HUANG
Acta Academiae Medicinae Sinicae 2023;45(6):987-996
As the incidence of diabetes mellitus is rapidly increasing worldwide,that of related complications,such as diabetic kidney disease(DKD),also increases,conferring a heavy economic burden on the patients,families,society,and government.Diabetes mellitus complicated with chronic kidney disease(CKD)includes DKD and the CKD caused by other reasons.Because of the insufficient knowledge about CKD,the assessment of diabetes mellitus complicated with CKD remains to be improved.The therapies for diabetes mellitus complicated with CKD focus on reducing the risk factors.In clinical practice,DKD may not be the CKD caused by diabetes.According to clinical criteria,some non-diabetic kidney disease may be misdiagnosed as DKD and not be treated accurately.This review summarizes the status quo and research progress in the assessment,diagnosis,and treatment of diabetes mellitus complicated with CKD and predicts the directions of future research in this field.
Humans
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Diabetes Mellitus, Type 2/complications*
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Diabetic Nephropathies/etiology*
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Renal Insufficiency, Chronic/therapy*
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Risk Factors
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Diabetes Mellitus/therapy*
10.Professor Zhang Zhi-long's experience in the treatment for type 2 diabetes mellitus and its complications.
Chinese Acupuncture & Moxibustion 2010;30(8):653-656
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
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complications
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drug therapy
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Drugs, Chinese Herbal
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therapeutic use
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Female
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Humans
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Middle Aged