Cardiovascular Diseases ; epidemiology ; etiology ; China ; epidemiology ; Diabetes Complications ; complications ; epidemiology ; Diabetic Foot ; epidemiology ; etiology ; Diabetic Nephropathies ; epidemiology ; etiology ; Diabetic Neuropathies ; epidemiology ; etiology ; Diabetic Retinopathy ; epidemiology ; etiology ; Humans

OBJECTIVETo investigate the relationship of erectile dysfunction (ED) with blood vessel-, nerve- and androgen-related factors in young and middle-aged men with type 2 diabetes mellitus (T2DM) in order to provide some clinical evidence for early prevention and treatment of ED.

METHODSWe divided 53 male T2DM patients under 50 years into an ED group (IIEF-5 score < or = 21, n = 28) and a non-ED (NED) group (IIEF-5 score > or = 22, n = 25). We detected the levels of blood lipid, glucose, total testosterone (TT), sex hormone-binding globulin (SHBG), sulfate dehydroepiandrosterone (DHEA-S), calculated free testosterone (cFT), and examined the complications of macroangiopathy (MA), diabetic retinopathy (DR) and diabetic peripheral neuropathy (DPN), and compared the above indicators between the two groups.

RESULTSThere were no significant differences between the two groups in age, diabetes duration, body mass index, blood pressure, and blood lipid and glucose levels (P > 0.05). The incidence rate of DR was significantly higher in the ED than in the NED group (39.3% vs 4.0%, P < 0.05), but no statistically significant differences were found in the levels of TT, cFT, SHBG and DHEA-S and the incidence rates of MA and DPN between the two groups (P > 0.05).

CONCLUSIONThe incidence of ED is closely related to DR in young and middle-aged men with T2DM. Therefore particular attention should be paid to the erectile function of T2DM patients with DR as early as possible.

Adult ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Neuropathies ; complications ; Diabetic Retinopathy ; complications ; Erectile Dysfunction ; etiology ; Humans ; Male ; Middle Aged

Erectile dysfunction (ED) is a common complication of diabetes mellitus. Diabetes mellitus can cause oxidative stress, which plays a key role in the pathogenesis of diabetes-associated ED by acting on blood vessel endothelia, peripheral nerves and smooth muscles and inducing cell apoptosis. Recent progress in the researches on the correlation of oxidative stress with diabetic ED is briefly reviewed in this article.
Animals ; Diabetes Mellitus, Type 2 ; complications ; physiopathology ; Diabetic Neuropathies ; etiology ; physiopathology ; Erectile Dysfunction ; etiology ; physiopathology ; Humans ; Male ; Oxidative Stress ; Rats

Diabetes mellitus is a common problem, and female sexual dysfunction is one of its complications in diabetic women. Recent studies show that the major risk factors of sexual dysfunction in diabetic women are diabetes-induced vascular disease, neuropathy, endocrine abnormalities and psychological problems and so on. This article outlines the advances in the recent studies of female sexual dysfunction in diabetic women.
Diabetes Mellitus ; physiopathology ; psychology ; Diabetic Angiopathies ; physiopathology ; psychology ; Diabetic Neuropathies ; physiopathology ; psychology ; Female ; Humans ; Sexual Dysfunction, Physiological ; etiology ; Sexual Dysfunctions, Psychological ; etiology

Erectile dysfunction is a familiar complication of diabetes mellitus, which results from combined factors of impairment to the vascular structure of the penis, the pathological changes in neural system and neural transmitters, and endocrine disorders. There are numerous therapeutic options for the treatment of diabetic erectile dysfunction, including medicines like PDE5 inhibitors, insulin, androgen, surgical therapy and gene therapy.
Androgens ; physiology ; Diabetes Complications ; Diabetic Neuropathies ; complications ; Endothelin-1 ; physiology ; Erectile Dysfunction ; etiology ; therapy ; Humans ; Male ; Nitric Oxide ; physiology

BACKGROUNDVarious methods can be applied to build predictive models for the clinical data with binary outcome variable. This research aims to explore the process of constructing common predictive models, Logistic regression (LR), decision tree (DT) and multilayer perceptron (MLP), as well as focus on specific details when applying the methods mentioned above: what preconditions should be satisfied, how to set parameters of the model, how to screen variables and build accuracy models quickly and efficiently, and how to assess the generalization ability (that is, prediction performance) reliably by Monte Carlo method in the case of small sample size.

METHODSAll the 274 patients (include 137 type 2 diabetes mellitus with diabetic peripheral neuropathy and 137 type 2 diabetes mellitus without diabetic peripheral neuropathy) from the Metabolic Disease Hospital in Tianjin participated in the study. There were 30 variables such as sex, age, glycosylated hemoglobin, etc. On account of small sample size, the classification and regression tree (CART) with the chi-squared automatic interaction detector tree (CHAID) were combined by means of the 100 times 5-7 fold stratified cross-validation to build DT. The MLP was constructed by Schwarz Bayes Criterion to choose the number of hidden layers and hidden layer units, alone with levenberg-marquardt (L-M) optimization algorithm, weight decay and preliminary training method. Subsequently, LR was applied by the best subset method with the Akaike Information Criterion (AIC) to make the best used of information and avoid overfitting. Eventually, a 10 to 100 times 3-10 fold stratified cross-validation method was used to compare the generalization ability of DT, MLP and LR in view of the areas under the receiver operating characteristic (ROC) curves (AUC).

RESULTSThe AUC of DT, MLP and LR were 0.8863, 0.8536 and 0.8802, respectively. As the larger the AUC of a specific prediction model is, the higher diagnostic ability presents, MLP performed optimally, and then followed by LR and DT in terms of 10-100 times 2-10 fold stratified cross-validation in our study. Neural network model is a preferred option for the data. However, the best subset of multiple LR would be a better choice in view of efficiency and accuracy.

CONCLUSIONWhen dealing with data from small size sample, multiple independent variables and a dichotomous outcome variable, more strategies and statistical techniques (such as AIC criteria, L-M optimization algorithm, the best subset, etc.) should be considered to build a forecast model and some available methods (such as cross-validation, AUC, etc.) could be used for evaluation.

Case-Control Studies ; Decision Trees ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Neuropathies ; diagnosis ; etiology ; Humans ; Logistic Models

BACKGROUNDPrevious studies suggested that zinc level was related to a certain diabetic microvascular complication. However, the relationship between zinc level and all the microvascular complications in type 2 diabetic patients remains unknown. The purpose of this study was to analyze the relationship between zinc level and each diabetic microvascular complication and identify the features related to low serum zinc level.

METHODSWe included the hospitalized patients with type 2 diabetes (T2D) at our department from May 30, 2013 to March 31, 2014. We initially compared the serum zinc levels between patients with specific microvascular complications and those without. We then analyzed the association between zinc level and each microvascular complication. Furthermore, we identified the unique features of patients with high and low serum zinc levels and analyzed the risk factors related to low zinc level.

RESULTSThe 412 patients included 271 with microvascular complications and 141 without any microvascular complications. Serum zinc level was significantly lower in patients with diabetic retinopathy (P < 0.001), diabetic nephropathy (DN, P < 0.001), or diabetic peripheral neuropathy (P = 0.002) compared with patients without that specific complication. Lower zinc level was an independent risk factor for DN (odds ratio = 0.869, 95% confidence interval = 0.765-0.987, P < 0.05). The subjects with lower serum zinc level had manifested a longer duration of diabetes, higher level of hemoglobin A1c, higher prevalence of hypertension and microvascular complications, and lower fasting and 2-h C-peptide levels.

CONCLUSIONSLower serum zinc level in T2D patients was related to higher prevalence of diabetic microvascular complications, and represented as an independent risk factor for DN. Patients with lower zinc level were more likely to have a longer duration of diabetes, poorer glucose control, and worse β-cell function.

Adult ; Aged ; Diabetes Mellitus, Type 2 ; blood ; complications ; Diabetic Nephropathies ; blood ; etiology ; Diabetic Neuropathies ; blood ; etiology ; Diabetic Retinopathy ; blood ; etiology ; Female ; Humans ; Male ; Middle Aged ; Risk Factors ; Zinc ; blood

BACKGROUNDWith economic growth and urbanization there have been significant changes in the life style and diet of urban residents in large cities of China, which is experiencing a rapid increase in the prevalence of diabetes. While high prevalence of diabetes has been reported, little is known of the long-term effects of diabetes in such a large population. The aim of this study was to estimate the morbidity rate of diabetic peripheral neuropathy (DPN) in a Chinese urban diabetic population with more than 10 years' disease duration, and evaluate the relevant risk factors. The clinical manifestation of DPN and pain status was also assessed.

METHODSFive hundred and sixty-five diabetes patients were recruited into the study. Symptoms and examination helped diagnose neuropathy. The clinical manifestation of DPN was assessed with a visual analog pain score (VAS). Diabetic complication status was determined from medical records. Serum lipids and lipoproteins, glycosylated hemoglobin (HbA1c), and the urinary albumin excretion rate were measured.

RESULTSThe morbidity rate of DPN was 46.6%. HbA1c, hyperlipidemia, and retinopathy were significantly associated with neuropathy, and these risk factors were correlated with other diabetic micro and/or macrovascular complications. The average VAS pain score of the DPN patients was 4.12 ± 2.07. Severe and moderate pain was experienced by 11.4% and 40.5% respectively of DPN patients. About 3.7% of diabetic subjects had lower limb ulcer or amputation.

CONCLUSIONSThe morbidity rate of DPN for diabetic patients with > 10 years duration is very high compared to the range reported for other populations in the world. The risk factors for DPN include HbA1c, hyperlipidemia, and retinopathy. In long-standing diabetic patients, DPN was not associated with diabetic duration, and half of the DPN patients experienced considerable daily suffering.

Aged ; China ; Diabetic Neuropathies ; epidemiology ; metabolism ; physiopathology ; Female ; Glycated Hemoglobin A ; metabolism ; Humans ; Hyperlipidemias ; epidemiology ; metabolism ; physiopathology ; Male ; Middle Aged ; Pain ; etiology ; Risk Factors ; Urban Population

OBJECTIVETo investigate the relationship between blood glucose fluctuation and the pain sensation in patients with painful diabetic neuropathy.

METHODSThe severity of pain in 16 patients with painful diabetic neuropathy was assessed using visual analog scale (VAS), and according to the results, the patients were divided into mild to moderate pain group and severe pain group. The blood glucose of the patients were monitored continuously for 72 h using a continuous glucose monitoring system, and the MBG, SD, DMMG, MAGE, and AUCPG were obtained with the FBG and HbA1C tested.

RESULTSThe SD, DMMG, and MAGE of the severe pain group were all significantly higher than those of the mild to moderate pain group (P<0.05), and no significant difference was found in MBG, FBG or HbA1c between the two groups.

CONCLUSIONThe blood glucose fluctuation is associated with the severity of the pain degree, and effective control of the blood glucose fluctuation helps prevent and treat painful diabetic neuropathy.

Adult ; Blood Glucose ; metabolism ; Diabetic Neuropathies ; blood ; Female ; Humans ; Male ; Middle Aged ; Monitoring, Physiologic ; methods ; Pain ; blood ; etiology ; Pain Measurement ; Pain Threshold

OBJECTIVETo investigate the relationship between diabetes and somatostatin (SOM).

METHODSWe established a streptozocin-induced diabetic rats model and studied the changes of SOM mRNA in hippocampi of diabetic and normal rats by using in situ hybridication and computer image analysis. We studied the mechanism of chronic diabetes encephalopathy by observing the changes of somatostatin mRNA in the hippocampus of diabetic rats was studied.

RESULTThe number, light density and average area of positive cells in dentate gyrus area of hippocampus in diabetes model were reduced significantly as compared with normal rats (P < 0.01).

CONCLUSIONA decline in SOM mRNA expression may play a role in chronic diabetes encephalopathy because of SOM effect in brain.

Animals ; Brain Diseases ; etiology ; metabolism ; Dentate Gyrus ; metabolism ; Diabetes Mellitus, Experimental ; metabolism ; Diabetic Neuropathies ; metabolism ; Hippocampus ; metabolism ; Male ; RNA, Messenger ; biosynthesis ; Rats ; Rats, Sprague-Dawley ; Somatostatin ; biosynthesis ; genetics