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Diabetes:高血糖与接受静脉溶栓治疗的糖尿病和非糖尿病急性缺血性卒中患者结局的关系

2019-07-10 xing.T MedSci原创

总之,aHG与用IVT治疗的糖尿病和非糖尿病AIS患者3个月不良临床结局相关。

有关入院时高血糖(aHG)与接受静脉溶栓(IVT)治疗的急性缺血性卒中(AIS)患者预后之间相关性的观察性研究现有数据是相互矛盾的,特别是在对糖尿病(DM)病史分层时。

近日,糖尿病领域权威杂志Diabetes上发表了一篇研究文章,研究人员使用来自SITS-ISTR研究的倾向评分匹配(PSM)数据评估了aHG(≥144mg/dl)与DM病史分层的结局之间的关联。该研究的主要安全性结局是症状性颅内出血(SICH); 三个月功能独立性(FI; mRS评分0-2)是主要的疗效结局。

伴有和不伴有aHG的患者在非糖尿病(n=12318)和糖尿病(n=6572)PSM亚组中的基线特征没有差异。在非DM组中,与没有aHG的患者相比,aHG患者的3个月FI(53.3% vs. 57.9%,p<0.001)率较低,3个月死亡率较高(19.2% vs. 16.0%,p<0.001),SICH发生率类似(1.7% vs. 1.8%,p=0.563)。同样,在DM组中,与没有aHG的患者相比,aHG患者3个月有利功能结局(mRS评分为0-1,34.1% vs. 39.3%,p<0.001)和FI(48.2% vs. 52.5%,p<0.001)发生率较低,3个月死亡率更高(23.7% vs. 19.9%,p<0.001),SICH率类似(2.2%  vs. 2.7%,p=0.224)。

总之,aHG与用IVT治疗的糖尿病和非糖尿病AIS患者3个月不良临床结局相关。 

原始出处:


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    2019-12-09 fusion
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Diabetes Care:晚期糖尿病状态和高血糖与轻度认知障碍和痴呆的关联

由此可见,糖尿病状态、血糖控制不佳和糖尿病病程较长与5年中位随访时认知结局较差有关。

AUTOPHAGY:二甲双胍可以减轻高血糖诱导的内皮损伤

目前为止,关于在糖尿病条件下内皮细胞(EC)中的巨自噬/自噬调节的研究非常有限。临床证据确定了二甲双胍的内皮保护作用,但其潜在机制尚不清楚。

JCEM:高血糖和服用二甲双胍与老年人B族维生素缺乏和认知功能障碍有关

由此可见,二甲双胍在老年人中的使用与较差的认知表现有关;可能涉及B族维生素缺乏症。强化食品可以优化B族维生素的状态,可能有助于维持糖尿病患者或糖尿病风险的老年人更好的认知健康。

Cell Metab:“糖有毒”!高血糖会导致每个β细胞每秒泄漏10万个ATP分子,胰岛细胞就是这样被活活饿死的

他们发现,2型糖尿病患者的高血糖水平,会导致生产胰岛素的β细胞变得“千疮百孔”,以至于单个β细胞在每秒钟的时间里,至少向周边组织环境中泄漏100000个ATP分子。

Cell Metab:糖真的有毒!高血糖环境下,胰腺细胞中致癌的KRAS突变暴增,或为导致胰腺癌的罪魁祸首之一

近日,中国台湾中央研究院的胡春美和李文华等研究发现,胰腺癌中极为常见的KRAS突变,竟与高血糖关系密切!高血糖引起的一系列代谢变化,让胰腺细胞缺乏合成修复DNA的原料dNTP,KRAS突变频率翻着倍的往上长。相关研究发表在Cell Metabolism上。

“困难户”降糖记

我在查房时,看见小伊一直在跟一名患者沟通。查房结束后,我问她怎么了,小伊感叹到:“又收了一个长病程的糖尿病患者。而且患者家属跟我抱怨,说这个药也吃了,那个药也吃了,可血糖还是降不下来。真是令人头疼!”

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