Objective To explore the relationship between diabetic retinopathy (DR) and intima-media thickness in newly diagnosed type 2 diabetic patients. Methods A total of 1236 diabetic subjects who were diagnosed within 1 year, including 218 older patients, were enrolled in the study. Intima-media thickness of the right common carotid artery and femoral artery were determined using B mode ultrasonography. All subjects were ophthalmologically examined. Results The intima-media thickness values of the carotid artery and femoral artery[(0.83 ± 0.11)mm, (0. 80 ±0.11)mm] in elderly DR group were higher than those [(0. 78±0.12)mm, (0.75±0.13)mm] in elderly non-DR group(P＜0.05). The prevalences of DR in IMT≥0.8 mm group[20.6%: carotid artery, 18.6%: femoral artery] were higher than those in IMT＜ 0.8mm group [13.0%: carotid artery, 13.6%: femoral artery] (P＜0. 05). Logistic regression analysis also showed DR was associated with IMT. Conclusions DR is associated with IMT in newly diagnosed type 2 diabetic patients, and early changes of retinopathy are associated with increased IMT.

Objective To compare the prevalences of metabolic syndrome(MS)diagnosed with 4 diagnostic criteria by the World Health Organization(WHO,1999),the Inrernational Diabetes Federation(IDF,2005),the Third Report of the National Cholesterol Education Program Expert Panel on Detection,Evaluation and Treatment of High Blood Cholesterol in Adults(NCEP ATPⅢ,2001)and the Chinese Medical Association Diabetes Branch(CDS)respectively. Methods The interrelated parameters were measured in 1399 patients with newly-diagnosed type 2 diabetes mellitus.All the patients were divided into 2 groups:elderly group(259 cases)and non-elderly group(1140 cases),and the different prevalences diagnosed by 4 diagnostic criteria in 2 groups were compared. Results The MS prevalence was 68.0%,47.9%,46.7%and 54.8%in elderly group by WH0,CDS,IDF and NCEP ATPⅢ respectively.The consistent rate was 76.1% between WHO and CDS,and 70.3%between IDF and CDS,and 81.9% between NCEP ATPⅢ and CDS. Conclusions The WHO definition may be more suitable for MS diagnosis in elderly patients with newly-diagnosed type 2diabetes mellitus.

Objective To explore the correlation factors of hyperuricemia in elderly patients with type 2 diabetes mellitus(T2DM). Methods Two hundred and fifty-six inpatients with T2DM were divided into elderly(n=168)and non-elderly(n=88)groups. Another 37 elderly non-DM cases were as control. The parameters of serum uric acid and creatinine, urinary uric acid, pH and creatinine, clearance rates of uric acid and creatinine(Ccr)were determined and compared among 3 groups. Results The elderly T2DM group had higher level of serum uric acid than did non-elderly T2DM and control groups(all P

Objective To explore different features and influencing factors of 75 g oral glucose tolerance test (OGTT) and glycated hemoglobin Ale (HbAlc) levels in subjects with newly diagnosed diabetes and prediabetes of natural history of type 2 diabetes. Methods All subjects were classified by OGTT into four groups: (1) normal glucose test (NGT), 31 subjects at age of (48. 4±15. 3) yrs (29-75 years old); (2) impaired fasting glucose (IFG), 33 subjects at age of (50. 8±9. 8) yrs (38-72years old) ; (3) impaired glucose tolerance test (IGT), 34 subjects at age of (54. 5±11.4) yrs (33-74years old), (4) T2DM, 117 subjects at age of (54.3 ± 14.1) yrs (29-75 years old). Glucose metabolism was evaluated by results of OGTT and HbAlc levels. The insulin secretion function and insulin resistance (IR) were evaluated by HOMA-β, △I30/△G330, area under curve of insulin (AUCINS)and HOMA-IR respectively. Results (1) Significant changes of HbAlc values among groups were as following order: T2DM(7. 41%)>IGT(5. 85%)>NGT(5.21%) (P<0. 01). HOMA-β value in T2DM, IGT and IFG decreased by 53. 1% (P<0. 01), 29.3% (P<0. 01) and 23.4% (P<0. 05)respectively as compared with NGT group. HOMA-IR value in diabetes group was 1.66-fold of NGT (P<0.01), 1. 29-fold of IFG (P<0.001) and 1.44-fold of IGT (P<0.05). (2) Only 3 h blood glucose concentration (BG) in 75 g OGTT was independently and positively correlated with HbAlc level (r=0. 71, P<0. 01). △I30/△G330 ratio was independently and negatively correlated with both 1 h and 2 h BG of OGTT (P<0.01). AUCins was positively correlated with only 3 h BG of OGTT (P<0.01). HOMA-β was independently and negatively correlated with all OGTT results except 2 h BG(P<0.01). HOMA-IR was an independently and negatively correlative factor of all OGTT results (P<0. 01 or P<0. 05). TG level was independently and positively correlated to only fasting BG (P<0. 05), and waist circumference value had an independent and positive relationship with only 1/2h BG (P<0. 01). Independently correlative factors of OGTT changes included △I30/△G330, AUCINS,HOMA-β, HOMA-IR and circumference values. Only 3 h BG was probably an independent contributor to HbAlc variation. Conclusions There are obvious HbAlc differences among T2DM,IGT and NGT patients. When HbAlc values are over 8%, no significant changes of glucose and insulin levels at 75 g glucose load test are found among subjects.

Objective To observe the incidence and awareness of dyslipidemia in newly diagnosed elderly type 2 diabetic patients,and to determine the efficacy and safety of simvastatin and Xuezhikang in the treatment of dyslipidemia.Methods Totally 255 newly diagnosed type 2 diabetic patients aged 60 to 75 years in CDCPS research were included and the incidence of dyslipidemia were retrospectively analyzed.Patients were divided into 3 groups:the group 1 was given simvastatin (20 mg/d); the group 2 was given Xuezhikang (0.6～ 1.2 g/d); the group 3 was given no lipid-lowering drugs.All the three groups were given lifestyle intervention and blood pressure and blood sugar control.All patients were followed up monthly and TG,TC,LDL-C,BUN,ALT and creatinine were examined at 7th,14th,and 20th months.Results The incidence of dyslipidemia and the rate of awareness in the study cohort was 62％ and 55.7％.Hypertriglyceridemia was the most common type of dyslipidemia (29％).Among 88 patients with dyslipidemia,25 (28.4％) patients had been treated with lipid-lowering drugs before our study,in whom,8(32％) patients had normal serum lipid levels and only 3 (12％)patients reached to the control standards.20 months after the treatment,the decrement scales of TG,TC and LDL-C were 1.8％,10.5 ％ and 20 ％ respectively in group 1;5.5 ％,15.0％ and 15.7％ respectively in group 2;2.7％,8.7％ and 4.5％ respectively in group 3.The long-term lifestyle intervention and blood pressure and blood sugar control reduced serum lipid to some degree.In the patients with dyslipidemia,lipid-lowering drugs had a better effect on serum lipid reduction than did the lifestyle intervention (P=0.0047,0.0433).There was no significant difference between simvastatin and Xuezhikang.The function changes of liver and kidney had no difference before and after drug intervention (P＞0.05).Conclusions Serum lipid should be monitored and early medicine intervention should be taken in newly diagnosed elderly type 2 diabetic patients.Medicine intervention has a better effect on serum lipid reduction than lifestyle intervention,and there are no significant differences in efficacy and safety between simvastatin and Xuezhikang.

Objective To analyze the initial treatment strategies, blood glucose control and reaching standard status of newly diagnosed type 2 diabetes mellitus (T2DM) in the middle-aged and elderly. Methods The 771 patients diagnosed with T2DM newly or within one year, aged 50-70 years, selected from Chinese Diabetes Complication Prevention Study (CDCPS) were enrolled in this study. The correlations of initial treatment strategies with blood glucose control (target value of glycated hemoglobin was less than 7.0%) and reaching standard status were analyzed retrospectively. Based on the same lifestyle intervention, the therapy was further divided into group A (without medication), group B (single oral hypoglycemic agent), group C (combined oral hypoglycemic agents), group D (treatment including insulin). Results Although receiving the different treatments, the 771 patients had a similar mean glycated hemoglobin level, from 7.2% to 7.7%, among the four kinds of intervention before entering the study. The increased intensity and complexity after therapy adjustment along with the increased glycated hemoglobin level was observed at baseline. The corresponding relationships between medication and HbA1c were as follow: without medication-6.1%, single oral hypoglycemic agent-7.2%, combined oral hypoglycemic agents-7.7%, treatment including insulin-9.2%. After 20 months of follow-up, the mean fasting glucose and glycated hemoglobin were 6.6 mmol/L and 6.2%, separately. According to the target glycated hemoglobin level of less than 7.0%, all four-kinds of therapies had high achievement rates, which were all above 80% except that was 63.2% in group D. Sulphonylurea and biguanide as initial single oral hypoglycemic agent therapy had the similar effectiveness on glucose control and target glycated hemoglobin achievement. Conclusions According to the levels of glucose and glycated hemoglobin, multiple individual therapies should be enacted at the beginning of treatment. The strategy mainly based on sulphanylurea and biguanide is proved to be persistently effective in newly-diagnosed middle-aged and elderly diabetic patients in China.

Objective To analyze the impact of atorvastatin on blood lipids and arterial media thickness(IMT)in new-onset type 2 diabetes patients. Methods 333 patients,30-70 years old and diagnosed within one year as type 2 diabetes,were selected from the Chinese Diabetes Complication Prevention Study(CDCPS)to take part in this study. Changes of blood lipids and IMT of carotid, femoral and iliac artery pre and post the administration of atorvastatin were tested and followed for 24 months. Results Total cholesterol,triglycerides and low-density lipoprotein decreased significantly (P=0.000)and maintained at a low level. The carotid artery IMT decreased significantly(P=0.022) at the end of this study,but the femoral and iliac artery IMT did not show any obvious change. There were no serious adverse events noticed,during the study period. Conclusion Long-term use of atorvastatin seemed to be safe and effective in reducing blood lipids in patients with type 2 diabetes thus could delay the development of atherosclerosis.

Pancreatic duct stone is a sequel of chronic pancreatitis and may be found in the main ducts,side branches or parenchyma.These stones obstruct the pancreatic ducts and produce ductal hypertension,which leads to pain,the cardinal feature of CP.Surgical operation has been the preferred treatment of pancreatic duct stones in many domestic and external pancreatic medical centers.Lithotomy by longitudinal pancreatic duct incision and Roux-en-Y anastomosis of pancreatic duct to jejunum is the main and effective surgical procedure,while micro-surgery was also rational for the treatment of pancreatic duct stones.However,further studies with a larger sample size and longer follow-up duration are needed to improve the surgical technique and verify our initial results.

OBJECTIVETo analyze the impact of atorvastatin on blood lipids and arterial media thickness (IMT) in new-onset type 2 diabetes patients.

METHODS333 patients, 30-70 years old and diagnosed within one year as type 2 diabetes, were selected from the Chinese Diabetes Complication Prevention Study (CDCPS) to take part in this study. Changes of blood lipids and IMT of carotid, femoral and iliac artery pre and post the administration of atorvastatin were tested and followed for 24 months.

RESULTSTotal cholesterol, triglycerides and low-density lipoprotein decreased significantly (P = 0.000) and maintained at a low level. The carotid artery IMT decreased significantly (P = 0.022) at the end of this study, but the femoral and iliac artery IMT did not show any obvious change. There were no serious adverse events noticed, during the study period.

CONCLUSIONLong-term use of atorvastatin seemed to be safe and effective in reducing blood lipids in patients with type 2 diabetes thus could delay the development of atherosclerosis.

Adult ; Aged ; Atorvastatin Calcium ; Diabetes Mellitus, Type 2 ; drug therapy ; Female ; Follow-Up Studies ; Heptanoic Acids ; therapeutic use ; Humans ; Lipids ; blood ; Male ; Middle Aged ; Pyrroles ; therapeutic use ; Tunica Media ; pathology