[The effects of liraglutide on body composition and muscle strength in adult obese patients with type 2 diabetes mellitus].
Zhonghua nei ke za zhi. 2021;(11):982-986
Objective: The aim of the present study was to observe the effects of liralutide on body composition and muscle function in adult obese patients with type 2 diabetes. Method: A total of 63 adult obese type 2 diabetic patients who were (52.6±9.7) years of age and with body mass index (BMI) of ≥28 kg/m2 were enrolled. The patients were randomly assigned into two groups. On the basis of maintaining the original hypoglycemic regimen, patients in the control group (n=24) were given dietary guidance only, and those in the treatment group (n=39) were injected with liraglutide. All patients were followed up for a period of 12 weeks. Blood glucose, glycosylated hemoglobin(HbA1c) and insulin levels, liver and kidney function, body composition assessed with electrical impedance methods, and grip strength measured by a grip meter for muscle function were detected at the baseline and the end of the study. Results: Compared with those in the control group, the reductions in HbA1c [(-1.54±2.10) % vs.(-0.53±0.84) %], body weight [(-3.46±4.2) kg vs.(-0.34±3.66) kg], body fat mass [(-1.97±2.98) kg vs.(-0.01±2.16) kg] and visceral fat area [(-0.01±2.16) cm2 vs.(0.34±6.39) cm2] were more pronouced in liraglutide treated group (all P<0.05). However, no changes could be observed in muscle mass and grip strength after liraglutide treatment. Conclusions: In addition to reducing blood glucose, body weight and fat mass, treatment with lilaluptide had no impact on muscle mass and muscle function. Therefore, liralutide is suitable for obese patients with type 2 diabetes, especially for weight management patients who are at risk of muscle loss.
A Low-Carbohydrate Diet Realizes Medication Withdrawal: A Possible Opportunity for Effective Glycemic Control.
Frontiers in endocrinology. 2021;12:779636
Plain language summary
Many studies have shown that diet restrictions can help glycemic control and reduce metabolic risks in patients with type 2 diabetes mellitus (T2DM). The aim of this study was to look at the efficacy of two diets, the LCD and the low-fat diet (LFD), on glycemic control and clinical treatment. The study was a prospective, open-label, double-arm, randomized controlled trial conducted from March 2019 to December 2020 in China. 134 T2DM participants took part and they were randomly assigned to the LCD group or the low -fat diet (LFD) group. The following were measured at the beginning and end of each intervention: weight, fasting blood glucose (FBG), postprandial 2-h blood glucose (PPG), glycosylated haemoglobin (HbA1c), antiglycemic medications, and medications for other diseases and emerging diseases. The effect of decreasing blood glucose control with the LCD is superior to that of the LFD for Chinese patients with T2DM. It also led to a lower medication effects score (MES). It can reduce body weight, BMI, and lipid-lowering agents. Strict diet control and monitoring are the keys to managing diabetes. Further larger scale studies are needed to obtain more evidence.
Objective: Multiple studies have confirmed that diet restrictions can effectively realize glycemic control and reduce metabolic risks in patients with type 2 diabetes mellitus (T2DM). In 2018, the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) stated that individuals can select a low-carbohydrate diet (LCD) according to their needs and preferences. Owing to the influence of Chinese traditional eating habits, only a small portion of patients in China have achieved their blood glucose goals. As a result, the Chinese government will incur huge expenditures. Method: This study recruited 134 T2DM participants and randomly assigned them to the LCD group (n = 67) or the low-fat diet (LFD) group (n = 67). All of the patients had a fixed amount of exercise and were guided by clinicians. After a period of dietary washout, all of the patients received corresponding dietary education according to group. The follow-up time was 6 months. The indicators for anthropometry, glycemic control, and medication application parameters were collected and compared between the two groups. Results: There were 121 participants who finally entered the study. The proportions of calories from three major nutrients the participants consumed met the requirements of LCD and LFD. Compared with baseline, the pre-postdifferences of body weight, BMI, and several other indicators were significant except for dosages of insulin used in the LCD group and MES in the LFD group. After the intervention, body weight, body weight index (BMI), fasting blood glucose (FBG), postprandial 2-h blood glucose (PPG), and glycosylated hemoglobin (HbA1c) levels in the LCD group decreased significantly (p < 0.05) compared with the LFD group. The number of patients using lipid-lowering agents was significant higher in the LCD group and lower in the LFD group. However, there was no significant difference between the two groups for antihypertensive, hormone-replacement, and other agents. Conclusions: The LCD diet can decrease body weight, glycemic levels, MES, and lipid-lowering agents more than the LFD diet, thus decreasing cost burden in Chinese patients with T2DM. Strict diet control and monitoring are the keys to managing diabetes.
The Focus and Target: Angiogenesis in Refractory Wound Healing.
The international journal of lower extremity wounds. 2018;(4):301-303
In recent years, wound repair, especially chronic and refractory wounds, is still a growing worldwide health problem that concerns the physical and mental health of patients and the productivity of society as a whole. In many developed countries and developing countries, such as China, rapid economic growth, negative lifestyle changes (such as increased dietary fat intake and reduced physical activity), and increasingly serious aging problems have led to more and more refractory wounds caused by chronic diseases, such as diabetes and microvascular diseases. There is a clear and orderly stage in the process of wound healing, and the malfunction of any step will lead to poor healing effect. There are many causes of refractory wounds, among which the poor vascular network is closely related. This review focuses on the role and improvement of the microvasculature in wound repair. In addition, the future developmental trend of wound regenerative therapy (active factors, [stem] cells, tissue-induced biomaterials, gene therapy, etc) is also considered.
Six-month outcomes in dental patients identified with hyperglycaemia: a randomized clinical trial.
Journal of clinical periodontology. 2015;(3):228-35
AIM: To assess an approach to improving behavioural and glycaemic outcomes in dental patients who present with diabetes risk factors and previously unrecognized hyperglycaemia. METHODS We randomized 101 individuals identified with potential diabetes or pre-diabetes into two interventions. In the basic/control intervention, participants were informed about their diabetes risk factors and blood test result, and advised to see a physician. In the enhanced/test intervention, patients received a detailed explanation of findings and their implications, a written report for the physician, and were contacted at 2 and 4 months to inquire whether medical follow-up had occurred. At a 6-month re-evaluation, outcome measures included visit to physician, positive lifestyle changes and reduction in HbA1c. RESULTS Seventy-three subjects returned for the 6-month visit. The two intervention groups did not significantly differ in any of the outcome variables. Eighty-four percent of subjects reported having visited a physician post-randomization, and 49% reported at least one positive lifestyle change as a result of our intervention. In subjects identified with potential diabetes (baseline HbA1c ≥ 6.5%), HbA1c was reduced 1.46 ± 0.28% compared to baseline (p < 0.01). CONCLUSION Diabetes risk assessment and education by dental professionals of affected individuals unaware of their status may contribute to improved patient outcomes.
[Role of exercise in asthma management in children].
Nan fang yi ke da xue xue bao = Journal of Southern Medical University. 2014;(1):75-8
OBJECTIVE To study the role of exercise in asthma management in children and formulate exercise prescriptions for asthmatic children. METHODS A total of 112 asthmatic children aged 7-14 years were randomized into control group (n=56, with medications only) and exercise group (n=56, with medications and exercise prescription) for a trial lasting for 4 months. An asthma diary was used for all children to record the morning and evening peak expiratory flow (PEF), daytime and nighttime asthma symptom score, use of short-acting beta agonists, participation in physical activity, and exercise-induced asthma symptoms. RESULTS Of the 112 children, 5 dropped out before the trial completion. From the 13th week, PEF variation in exercise group was significantly lowered compared to that in the control group (P<0.05). Upon the completion of the trial, the daytime and nighttime symptoms score and emergency medication score were all significantly lower in the exercise group than in the control group (P<0.05). No severe adverse events occurred in the children during the trial. CONCLUSION Exercise for no less than 20 min, 3 days a week for 4 months is safe and beneficial for asthma control in children.
Findings of multiple neuritis on FDG PET/CT imaging.
Clinical nuclear medicine. 2013;(1):67-9
A 56-year-old woman with weight loss, facial pain, and weakness underwent FDG PET/CT to detect a tumor of unknown origin. The images did not detect any lesion typical of malignancy. However, elevated FDG activity in several cranial and peripheral nerves was noted and suggestive of multiple neuritis. Following therapy for neuritis, the patient's symptoms improved.
The Timed Up and Go test: predicting falls in ALS.
Amyotrophic lateral sclerosis : official publication of the World Federation of Neurology Research Group on Motor Neuron Diseases. 2007;(5):292-5
There are few functionally meaningful clinical measures used to guide management of patients with ALS. Falls are common, can be debilitating, and result in increased health care costs. We assessed the performance and ability to predict falls of the Timed Up and Go (TUG) test, which quantifies walking ability, in a prospective longitudinal study. Thirty-one patients underwent six monthly TUG, ALSFRS-R, forced vital capacity, muscle testing (MMT) and quality of life assessments. Linear and generalized linear mixed effects models assessed the associations among variables and ability to predict falls. The increase in TUG time was linear over six months, and TUG time was negatively associated with ALSFRS-R (p< or =0.001) and MMT scores (p< or =0.001). The TUG test was the only variable that was associated with the chance of falling (p = 0.024); patients with TUG times of 14 s had a 10% chance of falling during the study. In conclusion, TUG performance declined linearly in this longitudinal study, was correlated with standard outcome measures, and predicted falls. The TUG test can guide management of patients with ALS; a time of 14 s can be used to prompt the recommendation for mobility aids to prevent falls.
Resistance exercise decreases skeletal muscle tumor necrosis factor alpha in frail elderly humans.
FASEB journal : official publication of the Federation of American Societies for Experimental Biology. 2001;(2):475-82
Skeletal muscle protein and function decline with advancing age but the underlying pathophysiology is poorly understood. To test the hypothesis that the catabolic cytokine tumor necrosis factor alpha (TNF-alpha) contributes to this process, we studied the effects of aging and resistance exercise on TNF-alpha expression in human muscle. Using in situ hybridization, TNF-alpha message was localized to myocytes in sections of skeletal muscle from elderly humans. Both TNF-alpha mRNA and protein levels were elevated in skeletal muscle from frail elderly (81+/-1 year) as compared to healthy young (23+/-1 year) men and women. To determine whether resistance exercise affects TNF-alpha expression, frail elderly men and women were randomly assigned to a training group or to a nonexercising control group. Muscle biopsies were performed before and after 3 months. Muscle TNF-alpha mRNA and protein levels decreased in the exercise group but did not change in the control group. Muscle protein synthesis rate in the exercise group was inversely related to levels of TNF-alpha protein. These data suggest that TNF-alpha contributes to age-associated muscle wasting and that resistance exercise may attenuate this process by suppressing skeletal muscle TNF-alpha expression.