OBJECTIVETo explore the regulation on 2-hour postprandial blood glucose (2h PBG) for patients with impaired glucose tolerance (IGT) in the intervention with electroacupuncture.

METHODSSixty cases of IGT were divided randomly into an electroacupuncture group and a blank control group, 30 cases in each one. In electroacupuncture group, electroacupuncture was applied to Shenshu (BL 23), Pishu (BL 20), Zusanli (ST 36) and Sanyinjiao (SP 6) in the intervention, lasting for 6 sessions. In blank control group, no any intervention was adopted. The levels of fasting blood-glucose (FBG), 2 h PBG with 75 g glucose and hemoglobin Alc (HbAlc) were observed before and after the intervention for the patients in electroacupuncture group, as well as in blank con trol group.

RESULTSThe total effective rate was 76.7% (23/30) in electroacupuncture group, which was superior to that of 16.7% (5/30) in blank control group (P < 0.01). 2h PBG [(7.08 +/- 0.74) mmol/L] and HbAlc [(5.74 +/- 0.35)%] were down-regulated significantly after the intervention with electroacupuncture of 6 sessions in electroacupuncture group. The therapeutic effects of it were superior remarkably to those [(8.93 +/- 1.87) mmol/L, (5.97 +/- 0.591)%] in blank control group, indicating statistical significant difference (P < 0.01, P < 0.05). But, there was no any impact for the patients with normal FBG.

CONCLUSIONElectroacupuncture may be the means to achieve the clinical effective intervention for the people with IGT and the approach in the prevention and treatment of diabetes at the early stage.

Adult ; Blood Glucose ; Electroacupuncture ; Female ; Glucose Intolerance ; metabolism ; therapy ; Glucose Tolerance Test ; Humans ; Male ; Middle Aged

OBJECTIVE: To observe the effect of acupuncture on vascular endothelial function in patients of polycystic ovary syndrome (PCOS) with impaired glucose tolerance (IGT) and normal glucose tolerance (NGT). METHODS: A total of 140 patients with PCOS were divided into an IGT group (70 cases, 11 dropped off) and a NGT group (70 cases, 9 cases dropped off). The patients in the two groups were treated with full-cycle acupuncture at Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6), Tianshu (ST 25), etc. once every other day, 3 times a week, for 3 months. Before and after treatment, TCM symptom score, insulin resistance index [including fasting plasma glucose (FPG), 2-hour blood glucose (2hPG), fasting serum insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR)] and vascular endothelial related factors [including asymmetric dimethylarginine (ADMD), endothelin-1 (ET-1), malondialdehyde (MDA), nitric oxide (NO)] were compared between the two groups; in addition, the obese subgroup and non-obese subgroup of the two groups were further compared. RESULTS: Compared before treatment, the TCM symptom scores, ADMD, ET-1 and MDA after treatment were decreased ( CONCLUSION Acupuncture could improve vascular endothelial function in PCOS patients, IGT patients have better efficacy than NGT patients, and obese patients have better efficacy than non-obese patients.
Acupuncture Therapy ; Blood Glucose ; Female ; Glucose ; Glucose Intolerance/therapy* ; Humans ; Insulin ; Insulin Resistance ; Polycystic Ovary Syndrome/therapy*

OBJECTIVETo observe clinical curative effect of cake-separated moxibustion on impaired glucose regulation (IGR) and explore its action mechanism.

METHODSSixty cases were randomly divided into a simple lifestyle intervention group (control group) and a cake-separated moxibustion combined with lifestyle intervention group (observation group), 30 cases in each one. The control group was treated with lifestyle intervention. Based on lifestyle intervention, cake-separated moxibustion at Pishu (BL 20), Weishu (BL 21) and Yishu (EX-B 3) was applied to the observation group. Fast plasma glucose (FPG), two hours plasma glucose after oral glucose tolerance test (OGTT2hPG), fasting insulin (FINS), homa insulin resistance index (HOMA-IR), blood lipid, body mass index (BMI) and waist circumference (WC) were observed in the two groups before and after treatment.

RESULTSAfter treatment, the OGTT2hPG and FPG were both decreased significantly (both P<0.05) in the two groups, compared between the two groups, the differences of FPG [(0.41 +/- 0.42) mmol/L vs (0.05 +/- 0.08)mmol/L] and OGTT2hPG [(0.85 +/- 0.53)mmol/L vs (0.17 +/- 0.19)mmol/L] were both statistically significant. There were no significant changes in FINS, HOMA-IR, blood lipid, BMI and WC in the control group before and after treatment (all P>0.05), but FINS, HOMA-IR levels, triglycerides (TG), total cholest-erol (TC), low density lipoprotein (LDL-C), BMI and WC in the observation group were decreased obviously after treatment (all P<0.05), which had statistical differences between the two groups (all P<0.05).

CONCLUSIONThe cake-separated moxibustion combined with lifestyle intervention can obviously control blood glucose levels, improve insulin resistance and blood lipid levels, decrease BMI and WC.

Adult ; Aged ; Female ; Glucose ; metabolism ; Glucose Intolerance ; metabolism ; physiopathology ; therapy ; Humans ; Insulin ; Male ; Middle Aged ; Moxibustion ; Waist Circumference

Gestational diabetes mellitus (GDM) is one of the most common medical complications during pregnancy. Both mother and baby are at increased risk of adverse pregnancy outcomes, as well as long-term metabolic effects such as diabetes. Diagnosing and treating GDM can reduce perinatal complications. The International Association of Diabetes and Pregnancy Study Groups (IADPSG) has proposed a new screening strategy for overt diabetes at the first prenatal visit and diagnostic criteria for GDM based on perinatal outcomes. However, controversies still exist and there is no international consensus about these issues. Regarding the management of GDM, individualized medical nutrition therapy is the cornerstone of treatment. If maternal glucose levels and/or fetal growth patterns show a sufficiently high risk of perinatal complications, insulin can be used to intensify treatment, and regimens should be tailored to meet glycemic targets. Postpartum screening for early detection of glucose intolerance and implementation of diabetes prevention programs are important for women with a history of GDM.
Consensus ; Diabetes, Gestational* ; Diagnosis* ; Female ; Fetal Development ; Glucose ; Glucose Intolerance ; Humans ; Insulin ; Mass Screening ; Mothers ; Nutrition Therapy ; Postpartum Period ; Pregnancy ; Pregnancy Outcome

Objective: To evaluate the intervention effects of peer support education mode for type 2 diabetes control in rural residents. Methods: A random cluster sampling method has been used, including 300 rural residents aged above 18 years old from three villages (184 in control group, 116 in intervention group), in order to proceed the physical check-up and health education programs. Unchanged rate, transfer rate of patients, rate of impaired glucose tolerance, turn normal rate and other biochemical indicators of patients and people with impaired glucose tolerance from control group and intervention group were analyzed, to evaluate the intervention effects of peer support education mode. Results: The glycemic control rate of intervention group for patients and people with impaired glucose tolerance (72.2% and 71.4%) were higher than control group (43.6% and 26.7%), but the unchanged rate of intervention group (13.9% and 0.0%) were lower than control group (42.3% and 73.3%). Patients with diabetes or glucose intolerance in the education group improved significantly in waist-to-hip ratio, uric acid, total cholesterol and HDL-C. Glycemic hemoglobin level also improved significantly in diabetes patients of the education group. Conclusion: Peer support for education intervention seemed beneficial for diabetic control. The combination of education and effect evaluation was important in the evaluation of diabetes prevention and control. Peer support education also benefited the blood glucose control in general population.
Adolescent ; Blood Glucose/analysis* ; Diabetes Mellitus, Type 2/therapy* ; Glucose Intolerance ; Health Education ; Humans ; Patient Education as Topic/methods* ; Peer Group ; Rural Population ; Self-Help Groups

OBJECTIVETo study the role of baseline risk factors in predicting the onset of diabetes among essential hypertensive patients with metabolic syndrome (MS) and to evaluate an ideal therapeutic regime that could reduce the risk factors and risk of onset of diabetes.

METHODSA randomized parallel clinical trial in essential hypertensive patients of grade 1 or 2 was conducted. Two of the three components (1) increased waist circumference and/or BMI; (2) increased triglycerides (TG) and/or decreased high-density lipoprotein cholesterol; (3) impaired glucose tolerance (IGT) were present define the MS. The three intervention therapy groups were: indapamide + fosinopril (I + F, n = 151); atenolol + nitrendipine (A + N, n = 160); atenolol + nitrendipine + metformin (A + N + M, n = 152). Each case was followed-up monthly and the dosage of medicine taken be adjusted according to their BP level. The plasma glucose during fasting and two hours after taking 75 g glucose orally was also measured every six months. The new onset of diabetes was diagnosed according to the criteria. OGTT, insulin release test, lipid analysis, body weight and waist circumference were measured again at the last follow-up.

RESULTS(1) The lowering of BP was similar among the three groups (P > 0.05). 23 new diabetes onsets occurred, being 10 in group I + F and 8 in group A + N and 5 in group A + N + M, respectively (P > 0.05); (2) Proportions of patients' risk factors decreased significantly in group A + N or A + N + M, e.g. the proportions of high TG in each group reduced by 14.7% and 9.3% respectively (P < 0.05), the central fat distribution reduced by 16.7% and 15.9% respectively (P < 0.05) and the IGT reduced by 6.6% and 29.6% respectively (P < 0.05). However no changes were found in group I + F; (3) After 1 year and 5 months' follow-up, the proportions of main risk factors (high TG, central fat distribution and IGT) in the three groups were 91%, 96%, 83% and 90%, 88%, 47%, respectively. The difference of IGT was significant between two groups (P < 0.01) and the proportions of having three risk factors were 70% and 31% in the two groups (P < 0.01); (4) I + F group was better than A + N group in reduction of TG and central fat distribution. And A + N + M group improved in all risk factors.

CONCLUSIONSIGT alone or combined with increased TG plus abdominal obesity are the most important risk factors in predicting a new onset of diabetes among essential hypertensive patients with MS. Metformin in combination with atenolol plus nitrendipine can significantly prevent the onset of diabetes as well as improve patients' metabolic abnormality.

Adult ; Diabetes Mellitus, Type 2 ; prevention & control ; Drug Therapy, Combination ; Female ; Glucose Intolerance ; Humans ; Hypertension ; complications ; drug therapy ; Male ; Metabolic Syndrome ; complications ; drug therapy ; Middle Aged ; Risk Factors

Adult ; Diabetes Mellitus, Type 1/therapy* ; Diabetes Mellitus, Type 2/diagnosis* ; Genetic Predisposition to Disease ; Glucose Intolerance ; Humans ; Islets of Langerhans ; Latent Autoimmune Diabetes in Adults/therapy*

Leptin, an adipocyte-secreted hormone, regulates energy homeostasis as well as reproductive, neuroendocrine, immune and metabolic functions. Subjects with decreased amounts of fat in their adipose tissue, i.e., lipoatrophy, have low leptin levels. In the context of open-label, uncontrolled studies leptin administration, in physiological replacement doses, has been shown to have metabolically salutary effects in the rare patients with the syndrome of congenital lipodystrophy accompanied by leptin deficiency. Much more patients with lipodystrophy suffer from lipodystrophy and the metabolic syndrome associated with the use of highly active antiretroviral therapy. In this so called highly active antiretroviral therapy (HAART)-associated lipodystrophy and metabolic syndrome, patients demonstrate fat maldistribution with dyslipidemia, insulin resistance, and other metabolic complications. Leptin administration has been shown to decrease central fat mass and to improve fasting insulin/glucose levels and insulin sensitivity in human immunodeficiency virus-infected hypoleptinemic patients with HAART induced lipodystrophy and the metabolic syndrome. By contrast, the results of leptin treatment in leptin replete or hyperleptinemic obese individuals with glucose intolerance and diabetes mellitus have been minimal or null, presumably due to leptin tolerance or resistance that impairs leptin action. In this review, we present the emerging clinical applications and potential therapeutic uses of leptin in humans with lipodystrophy and the metabolic syndrome.
Adipose Tissue ; Antiretroviral Therapy, Highly Active ; Diabetes Mellitus ; Dyslipidemias ; Fasting ; Glucose Intolerance ; HIV ; Homeostasis ; Humans ; Insulin Resistance ; Leptin ; Lipodystrophy ; Therapeutic Uses

Prediabetes is an abnormal condition between normal glucose metabolism and diabetes mellitus. Impaired glucose tolerance (IGT) is an indicator of high-risk state of prediabetes. Positive interventions of IGT, including life style changes and pharmacological intervention, can effectively postpone and reduce the development of prediabetes into type 2 diabetes mellitus, suggesting that IGT is a key point of diabetes prevention. Currently, pharmacological intervention for prediabetes is still at early stage. In this review, we summarizes recent clinical and preclinical studies on pharmacological intervention for prediabetes, and studies in the development of animal models with IGT and the application of new techniques. We also discuss the prospects of drugs for diabetes prevention, especially with the traditional Chinese medicine.
Animals ; Diabetes Mellitus, Type 2 ; prevention & control ; Disease Models, Animal ; Drugs, Chinese Herbal ; therapeutic use ; Glucose Intolerance ; Humans ; Prediabetic State ; drug therapy

OBJECTIVETo explore the effect of Renshen Jianxin Capsule (RJC) on insulin resistance in patients with coronary heart disease (CHD) and glucose tolerance impairment (GTI).

METHODSEighty patients with CHD-GTI of qi-deficiency blood-stasis syndrome were randomly assigned to 2 groups equally, the treated group was treated by RJC and the control group by metformin, based on the conventional Western medical treatment with nitric esters for 20 weeks. Changes before and after treatment in clinical symptoms and levels of blood glucose insulin, and insulin sensitivity index (ISI) were observed.

RESULTSThe scores of clinical symptoms of Chinese medicine decreased in both groups, which showed statistical significances compared with those before treatment (P<0.01, P<0.05). On alleviating the angina pectoris, the markedly effective rate of the treated group is 47.5%, the total effective rate was 80.0%, and the difference between the two groups showed statistical significance (P<0.05). FBG, INS and ISI were improved significantly in both groups after treatment (P<0.05, P<0.01); while the three indices showed in significant difference between the two groups after treatment (P> 0.05).

CONCLUSIONRJC was effective in improving insulin resistant, which may be one of the mechanisms of its therapeutic effect on CHD.

Aged ; Coronary Disease ; blood ; drug therapy ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Glucose Intolerance ; Humans ; Insulin ; blood ; Insulin Resistance ; Male ; Middle Aged ; Panax ; Phytotherapy ; Risk Factors