1.
[The Management of Blood Glucose Should be Emphasized in the Treatment of COVID-19].
Ma, WX, Ran, XW
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition. 2020;(2):146-150
Abstract
Based on the higher mortality and the higher proportion of critically ill adults in coronavirus disease 2019 (COVID-19) patients with diabetes, good inpatient glycemic control is particularly important in the comprehensive treatment of COVID-19. Individualized blood glucose target goals and treatment strategies should be made according to specific circumstances of COVID-19 inpatients with diabetes. For mild patients, a strict glycemic control target (fasting plasma glucose (FPG) 4.4-6.1 mmol/L, 2-hour postprandial plasma glucose (2 h PG) 6.1-7.8 mmol/L) are recommended; a target for the glycemic control of common type patients (FPG 6.1-7.8 mmol/L, 2 h PG 7.8-10.0 mmol/L) and subcutaneous insulin deliver therapy are recommended; a target nonfasting blood glucose range of 10.0 mmol or less per liter for severe-type COVID-19 patients, a relatively Less stringent blood glucose control target (FPG 7.8-10.0 mmol/L, 2 h PG 7.8-13.9 mmol/L) for critically ill patients and intravenous insulin infusion therapy are recommended. Due to the rapid changes in the condition of some patients, the risk of diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar status (HHS) maybe occur during the treatment. Blood glucose monitoring, dynamic evaluation and timely adjustment of strategies should be strengthened to ensure patient safety and promote early recovery of patients.
2.
[Efficacy and safety of vitamin D for type 2 diabetes mellitus: a systematic review].
Gao, W, Chen, DW, Liu, GJ, Ran, XW
Zhonghua yi xue za zhi. 2013;(18):1401-6
Abstract
OBJECTIVE To evaluate the efficacy and safety of vitamin D (VD) for patients with type 2 diabetes mellitus. METHODS Randomized controlled trials (RCT) were identified from CBM (1978.1-2012.9), CNKI (1979.1-2012.9), Pubmed (1950.1-2012.9), EMbase (1970.1-2012.9) and Cochrane library (issue 4, 2012). Publications of the RCT on the treatment of type 2 diabetes mellitus with VD were included and analyzed according to the criteria of Cochrane handbook. RESULTS Six RCT involving 328 patients were included. Meta-analysis indicated that VD caused a reduction in glycosylated hemoglobin A 1c (HbA 1c) (P = 0.05) but not in fasting plasma glucose (FPG), homeostasis model assessment index of insulin resistance (HOMA-IR) and failed to improve quantitative insulin sensitivity check index (QUICKI) and homeostasis model assessment index of β cell function (HOMA-β) (P > 0.05). As reported in a trial, the side effect of VD was hypercalcemia. CONCLUSION VD may have positive effects on patients with type 2 diabetes mellitus. However, the evidence is weak due to the general low methodological quality. Thus we have not made a reliable conclusion about the effects of VD for type 2 diabetes mellitus at the moment. Further larger, randomized, double-blind, placebo-controlled and multicenter trials are warranted.
3.
[Effects of sibutramine on blood glucose and lipids, body fat mass and insulin resistance in obese patients: a multi-center clinical trial].
Tong, NW, Ran, XW, Li, QF, Tang, BD, Li, R, Yang, FY, Liu, YP, Li, XJ
Zhonghua nei ke za zhi. 2005;(9):659-63
Abstract
OBJECTIVE To evaluate the effects of sibutramine on body weight, body fat mass, metabolism of plasma glucose and serum lipids, and insulin resistance (IR) in primary obesity patients. METHODS A double-blind, double-placebo, randomized controlled, multi-center clinical trial was conducted. 359 voluntary obese subjects, whose body mass index (BMI) > or = 27 kg/m(2), without hypertension and diabetes, were enrolled. They were randomly divided into group A, B and C respectively. Sibutramine tablets or capsules were administered 10-20 mg/day for 24 weeks to the test groups and placebo to a control group. CT scan was used to measure the intra or subcutaneous-abdominal fat areas (IAFA, SAFA) at L(4)-L(5) level. Dual energy X-ray absorptiometry (DEXA) was used to measure total body fat mass (TBFM). RESULTS 315 subjects continued to be followed for 24 weeks. After opening the blind, it was shown that group A received sibutramine tablet (n = 107), group B placebo (n = 104) and group C was capsule (n = 104). In group A and C body weight loss was 4.86 kg (6.42%) and 4.68 kg (6.38%), TBFM reduction was 4.07 kg (13.94%) and 4.09 kg (15.02%), SAFA decreased 7.30% and 7.45%, IAFA decreased 19.21% and 16. 98% respectively. Fasting plasma glucose decreased from 5.69 to 4.83 mmol/L and from 5.38 to 4.69 mmol/L in group A and C respectively. Fasting serum insulin decreased from 20.98 to 14.75 mU/L and from 21.11 to 14.68 mU/L, 2 h insulin decreased from 70.91 to 44.11 mU/L and from 73.13 to 41.93 mU/L in group A and C respectively. Serum triglyceride decreased from 1.98 to 1.73 mmol/L and 1.84 to 1.67 mmol/L, total cholesterol decreased from 5.08 to 4.75 mmol/L and from 5.06 to 4.46 mmol/L, high-density lipoprotein cholesterol increased from 1.13 to 1.28 mmol/L and 1.10 to 1.31 mmol/L in group A and C respectively, HOMA-IR index decreased from 5.32 to 3.32, and from 5.09 to 3.12 respectively in group A and C. Adverse drug reaction was 32.41%, 13.47% and 31.20% in group A, B and C. CONCLUSIONS Sibutramine tablet or capsule decreases comparably body weight and TBFM, especially IAFA regulates plasma glucose and serum lipid metabolism and also decreases IR. Sibutramine is well tolerated in most of the subjects.