This study was performed to investigate the effect of a telephone-delivered intervention on glycemic control and body mass index in Korean type 2 diabetic patients. 38 patients were randomly selected, with 20 assigned to a telephone group and 18 to a control group. The goal of the intervention was to keep blood glucose concentrations close to the normal range. The intervention was applied to the telephone group for 12 weeks. It consisted of continuous education and reinforcement of diet, exercise and medication adjustment, as well as frequent self-monitoring of blood glucose levels. Telephone intervention was performed twice per week for the first month, and then weekly for the second and third months. Subjects were requested to write self-management logs, including blood glucose, diet and an exercise diary. The diet diaries were analyzed by a dietitian, and subjects instructed about the results by telephone counseling or mail. All medication adjustments were communicated to the subjects' diabetes specialist. Glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG) and 2-hour postprandial glucose were measured before, and after, the intervention. Patients in the telephone group had a mean decrease of 1.2%, with those in the control group having a mean increase of 0.6%, in HbA1c. There were no significant differences in the body mass index (BMI) between the two groups. These findings indicated that a telephone-delivered intervention would improve HbA1c, but would not affect BMI.
Blood Glucose/*metabolism ; Body Mass Index ; Diabetes Mellitus, Type II/*blood/pathology/*therapy ; Human ; *Remote Consultation ; *Telephone

OBJECTIVETo investigate the effect of losartan, an angiotensin II type-1 receptor (AT1R) antagonist, on the levels of angiotensin II (Ang II) and AT1R in diabetic rat kidney.

METHODSMale Wistar rats were divided into 3 groups, group A (n=11) served as the control group, group B (n=11) included the diabetic rats (induced by intraperitoneal injection of streptozotocin) without any therapy, and group C (n=9) diabetic rats treated with losartan. After 18 weeks of treatment, the kidneys were taken from all the rats to measure the expression of AT1R mRNA by RT-PCR and detect the Ang II level. Blood was also drawn from the heart to measure Ang II level, and 24-hour urine was collected to measure albumin level (urine albumin excretion, UAE) with rat albumin enzyme immunoassay kit.

RESULTSThe blood and renal Ang II levels showed no significant difference between the 3 groups. The expression of renal AT1R mRNA in group B (0.62-/+0.17) was significantly lower than that in group A (1.13-/+0.82, P<0.01) and group C (1.13-/+0.62,P<0.01). UAE in group B (2.18-/+1.98 mg) was significantly higher than that in group A (0.41-/+0.47 mg/d, P<0.01) and C (0.65 -/+0.89 mg/d, P<0.01).

CONCLUSIONLosartan can increase the expression of AT1R mRNA in diabetic rat kidneys without altering the blood and renal Ang II levels.

Angiotensin II ; blood ; metabolism ; Angiotensin II Type 1 Receptor Blockers ; therapeutic use ; Animals ; Diabetes Mellitus, Experimental ; blood ; drug therapy ; genetics ; Immunoassay ; methods ; Kidney ; drug effects ; metabolism ; pathology ; Losartan ; therapeutic use ; Male ; RNA, Messenger ; biosynthesis ; genetics ; Rats ; Rats, Wistar ; Receptor, Angiotensin, Type 1 ; genetics ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVETo observe the effect of Jinmaitong capsule (JMT), a compound traditional Chinese medicine, on expressions of inducible nitric oxide synthase (iNOS) and nitro tyrosine (NT) protein in streptozocin-induced diabetic (STZ-DM) rats.

METHODIntraperitoneal injection of streptozocin in rats to establish a model. STZ-DM rats were randomly divided into the model control group (distilled water), the small-dose JMT group (JMT at dose of 0.45 g x kg(-1) x d(-1)), the medium-dose JMT group (JMT at dose of 0.88 g x kg(-1) x d(-1)), the large-dose JMT group (JMT at dose of 1.75 g x kg(-1) x d(-1)) and Vitamin C group (VC at dose of 0.05 g x kg(-1) x d(-1)). Ten normal rats with matching weight and age were selected as the normal control group (distilled water). After intragastric administration for 16 weeks, the expressions of iNOS and NT in sciatic nerve were detected by the immunohistochemistry method.

RESULTThe expression levels of iNOS and NT protein in diabetic rats were higher than those in normal rats (P<0.05, P<0.01). Compared with the model group, the levels of iNOS and NT protein in JMT and VC groups were significantly decreased (P<0.05, P<0.01). Particularly, the medium-dose JMT group showed a better effect than the VC group (P<0.05, P<0.01).

CONCLUSIONJMT could down-regulate the expressions of iNOS and NT protein of sciatic nerve in diabetic rats.

Animals ; Blood Glucose ; Body Weight ; drug effects ; Capsules ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; pathology ; Diabetic Neuropathies ; drug therapy ; metabolism ; pathology ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Enzyme Activation ; drug effects ; Male ; Nitric Oxide Synthase Type II ; metabolism ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; drug effects ; metabolism ; pathology ; Tyrosine ; analogs & derivatives ; metabolism

BACKGROUNDDiabetic nephropathy is a major cause of renal failure in diabetes mellitus (DM). It has been known that renin-angiotensin system (RAS) blockers have a renal protective effect. This study aimed to investigate whether treatment with angiotensin II receptor blocker, olmesartan, could modify renal hemodynamic variables and vascular structural properties, then attenuate renal injury in streptozotocin (STZ)-induced DM rats.

METHODSDM was induced in male Wistar rats by intraperitoneal administration of STZ. The rats were then randomized to a DM group and an olmesartan treatment (OLM + DM) group. The normal group (non-DM) were administered only citrate buffer. At the end of the 14th week, blood glucose, kidney weight/body weight and urinary protein-to-creatinine ratio were determined. Further, the flow-pressure and pressure-glomerular filtration rate (GFR) relationships were determined for maximally vasodilated, perfused kidneys. From the relationship, 3 indices of vascular structural properties were estimated: slope of flow-pressure (minimal renal vascular resistance, reflecting overall luminal dimensions of preglomerular and postglomerular vasculature), slope of pressure-GFR (glomerular filtration capacity against pressure) and threshold pressure for beginning filtration at pressure-GFR (preglomerular to postglomerular vascular resistance ratio). Kidneys were then perfusion fixed for histological analysis. The renal histopathology was observed by light microscopy.

RESULTSThe body weight of DM rats was lower than that of non-DM rats. Blood glucose, kidney weight/body weight, urinary protein-to-creatinine ratio were significantly greater in DM rats than in non-DM rats. The parameters such as kidney weight/body weight, urinary protein-to-creatinine ratio in OLM + DM rats had dramatically decreased compared with those in DM rats. However, the treatment with olmesartan had no effect on blood glucose levels. The slope of flow-pressure relationship was greater in DM rats than that in non-DM rats (P < 0.05). But the slope of the pressure-GFR relationship was lower in DM rats than that in non-DM rats (P < 0.05) with the x-intercept of the line similar between the two groups. The slope of the flow-pressure relationship was decreased in DM rats group treated with olmesartan (P < 0.05). Moreover, olmesartan significantly increased the slope of the pressure-GFR relationship in DM rats (P < 0.05). The x-intercept of the pressure-GFR relationship reduced following olmesartan in DM rats.

CONCLUSIONSTreatment with olmesartan reduced urinary protein-to-creatinine ratio independent of blood glucose and increased average renal vessel lumen diameter in the perfused kidneys of STZ-induced DM rats, predominantly in preglomerular vessels, and then improved renal excretory capability. These findings were consistent with remodeling of the preglomerular vasculature in our hisological measurements.

Angiotensin II Type 1 Receptor Blockers ; therapeutic use ; Animals ; Blood Glucose ; drug effects ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; physiopathology ; Diabetic Nephropathies ; drug therapy ; prevention & control ; Hemodynamics ; drug effects ; Imidazoles ; Kidney ; drug effects ; metabolism ; pathology ; Male ; Organ Size ; drug effects ; Rats ; Rats, Wistar ; Tetrazoles