妊娠期糖尿病对妊娠结局的影响

目的通过对116例妊娠期糖尿病(GDM)产妇的临床资料进行回顾性分析,评估GDM治疗对妊娠结局的影响。方法116例GDM产妇中92例经产前糖尿病筛查发现并确诊。24例于入院后发现。将116例GDM产妇分为两组,A组为经产前糖尿病筛查发现并确诊,血糖控制达理想水平者72例。B组为产前确诊但孕妇血糖控制不理想者20例及未经治疗者24例共44例。收集并比较分析两组孕产妇及围产儿并发症情况。结果92例产前确诊并治疗患病产妇中72例(78.3%)血糖控制达到理想水平,孕期血糖控制理想的GDM孕产妇妊娠高血压疾病、早产、剖宫产、新生儿低血糖、死胎的发生率均低于血糖控制不理想者及未治疗者的发生率(P<0.05)。结论孕期血糖控制可降低GDM孕产妇和围产儿并发症的发生率。     

妊娠期合并糖尿病对母婴的影响研究

目的探讨妊娠期糖尿病对母婴的影响。方法对我院收治的88例妊娠期糖尿病妇女和围产儿的结局进行分析。结果妊娠期糖尿病孕妇妊高征、早产酮症酸中毒、剖宫产、早产的发生率明显高于正常组(P<0.05),妊娠期糖尿病围产儿新生儿窒息、胎儿畸形、新生儿低血糖的发生率明显高于正常组(P<0.05)。结论加强妊娠期血糖检测和OGTT筛查,早期诊断及控制血糖,可以有效改善妊娠结局,降低母儿并发症发生率。     

妊娠期糖尿病对母婴的影响分析

目的探讨妊娠期糖尿病对母婴的影响。方法回顾性分析我院自2008年1月至2010年1月收治的妊娠期糖尿病妇女76例,与之正常妊娠期妇女进行比较,分析妊娠结局。结果妊娠期糖尿病孕妇发生并发症及新生儿发生并发症的机率明显高于正常孕妇组,有显著的统计学差异(P<0.05)。结论妊娠期糖尿病严重影响母婴健康,早期发现和确诊、控制血糖是有效预防GDM和发生并发症的有效手段,应及时发现妊娠期糖尿病并控制血糖,减少母儿并发症的发生。可减少并发症的发生,有效提高孕妇的生产率,保证母体和婴儿的健康。     

妊娠期糖尿病对母婴影响的分析

目的研究早期诊断妊娠期糖尿病(GDM),有效控制血糖,减少母婴并发病的发生。方法回顾分析2005年1月至2007年12月期间的GDM患者72例,糖耐量异常者125例及正常孕妇180例作为对照组的妊娠结局。结果GDM组孕产妇并发症的发生率、胎婴儿并发症的发生率、手术产率均较对照组显著升高,糖耐量异常仅次于GDM。结论妊娠期重视GDM筛查、诊断、监测、治疗,可改善GDM妊娠期的不良结局,减少母儿合并症的发生,提高产科质量。早期诊断GDM及控制血糖是减少母婴并发症的关键。     

26例羊水过少临床分析

目的降低围产儿的病死率,寻求羊水过少的正确处理方法。方法回顾分析羊水过少26例报道。结果26例产妇中,出现胎动明显减少,分娩方式以剖宫产为多数。结论羊水过少严重威胁胎儿、新生儿的生命,故产前确诊,合理处理是降低围产儿患病率和死亡率的关键。     

妊娠期糖尿病36例临床分析

目的探讨妊娠期糖尿病对孕妇的影响,以进一步为临床治疗提供指导。方法选择我院2007年1月至2009年1月在医院住院分娩的妊娠24～34周确诊的GDM孕妇36例,同期随机选择与GDM同期分娩的产科病历资料完整的非糖尿病产妇30例,观察比较2组孕产妇并发症的发生情况。结果GDM组的并发症的发生率明显高于正常对照组,差异有显著性,P<0.05。结论妊娠期糖尿病能够增加母婴分娩时的并发症的发生率,应引起广大妇产科医生的的重视。     

探讨孕妇产前检测的重要性

我国孕产妇保健事业发展很快,各地均先后建立健全了孕产妇系统保健与孕妇管理,其目标为降低孕产妇及围生几患病率并提高母儿生活质量.产前检查是保证孕妇及胎儿安全的有效手断.本文通过对产前保健概念及其重要性的阐述,探讨孕妇产前检测的重要性.     

胰岛素泵治疗妊娠期糖尿病临床观察及对妊娠结局的影响

目的探讨胰岛素泵治疗妊娠期糖尿病的临床疗效,及GDM对妊娠结局的影响。方法对我科收治的GDM孕妇进行治疗并对妊娠结局的影响进行分析。结果在GDM的治疗中,198例血糖、OGTT均控制在正常水平,有效率为92,9%,无低血糖及其他并发症发生。GDM孕妇妊高征、羊水过多、产后出血、早产的发生率明显高于正常组(P<0.05),新生儿窒息、新生儿低血糖的发生率明显高于正常组(P<0.05)。结论胰岛素泵是GDM患者安全有效的治疗手段。加强孕期保健,重视GDM的早期筛查,对减少母体和患儿并发症发生,提高孕妇优生优育有重要意义。     

88例妊娠期糖尿病患者围产期临床护理体会

目的总结妊娠期糖尿病患者围产期的护理效果,确保母婴安全,防止并发症发生。方法对我院收治的88例患者妊娠期糖尿病患者进行围产期心理护理、控制饮食、感染、新生儿护理等方面进行回顾性分析。结果通过精心的护理,有效降低母婴并发症的发生。结论围产期精心、有效的护理可以使患者顺利通过分娩期,作好新生儿护理和观察,预防感染,降低母婴并发症的发生和围产儿死亡率,确保母婴平安,提高优生优育。     

96例胎盘早剥临床分析

目的通过对胎盘早剥的临床分析,总结胎盘早剥的发病原因、预防、诊断、治疗及预后,提高诊疗水平。方法我院10年来治疗胎盘早剥96例,分析其发病原因、诊断、治疗、预后情况。结果发生产后出血、子宫胎盘卒中、凝血功能障碍、肾功能衰竭、围产儿死亡分别占41.67%、29.17%、6.25%、1.04%、18.75%,发生原因主要是血管病变,行子宫次全切除4例,全宫切除2例。结论胎盘早剥是妊娠晚期出血的重要原因之一,是妊娠期危及母儿生命的严重并发症,发病凶险,能否及时诊断和治疗,直接危及孕产妇、围产儿生命,防治至关重要。     

正规胰岛素强化治疗糖尿病疗效分析

目的分析探讨临床中正规胰岛素治疗糖尿病的疗效。方法回顾性分析2008年1月至2009年12月期间我院收治的36例糖尿病患者的临床资料,患者由于口服降糖药物疗效不佳,住院后所有患者均行皮下注射正规胰岛素每日3次强化进行治疗。结果 36例糖尿病患者中,所有患者经过2周左右的胰岛素皮下注射治疗,90%的患者餐前及餐后血糖都能控制在比较理想的范围内。结论皮下注射正规胰岛素强化治疗糖尿病疗效显著,值得临床推广应用。     

富GIF啤酒酵母制品对糖尿病大鼠空腹血糖和糖耐受量的影响

目的研究富GTF啤酒酵母制品对糖尿病大鼠空腹血糖和糖耐受量的影响。方法采用腹腔注射四氧嘧啶建立糖尿病大鼠模型,将模型大鼠随机分为3组,分别每天服用普通面包酵母0.1g、富GTF啤酒酵母干粉0.1g和富GTF啤酒酵母胶囊1粒,每天测空腹血糖。30d后进行糖耐受量试验,测0、0.5和2h各时间点血糖。结果富GTF啤酒酵母胶囊和富GTF啤酒酵母干粉不降低正常大鼠血糖。服药30d后,富GTF啤酒酵母胶囊组糖尿病大鼠空腹血糖下降52.45%,富GTF啤酒酵母干粉组血糖下降32.34%,而面包酵母干粉无降糖作用。各样品组糖耐受量2h后均下降,富GTF啤酒酵母胶囊组血糖下降迅速。结论富GTF啤酒酵母胶囊降血糖效果显著,优于富GTF啤酒酵母干粉,并能显著改善糖尿病大鼠糖耐受量。     

Blood glucose regulation with stochastic optimal control for insulin-dependent diabetic patients

Diabetes is a disease resulting from the impaired mechanism of insulin secretion from the pancreas, which prevents glucose from entering the cells and being utilized and leads to wide swings of blood sugar and many complications such as heart disease and stroke, kidney disease and amputations. In order to prevent these complications and achieve a better quality of life for diabetic patients, effective regulation of blood glucose is essential. This study aims to achieve a better blood glucose control profile by incorporating the time-dependent uncertainties in diabetic patient parameters into formulations of optimal control using a novel approach which originates from finance literature. The time-dependent uncertainties are represented using stochastic processes called Ito processes and the mathematical formulation for this problem is presented. The usefulness of this approach is shown using experimental data from a diabetic patient and stochastic and deterministic optimal control profiles are computed. The stochastic profile results in fewer variations in blood glucose from the reference value of 4.5 mmol/L as compared to the deterministic profile in the presence of parametric uncertainty. This method holds a lot of promise in reducing the wide swings of blood glucose observed in diabetic patients and preventing possible complications of diabetes.     

Diabetes during Pregnancy: A Maternal Disease Complicating the Course of Pregnancy with Long-Term Deleterious Effects on the Offspring. A Clinical Review

In spite of the huge progress in the treatment of diabetes mellitus, we are still in the situation that both pregestational (PGDM) and gestational diabetes (GDM) impose an additional risk to the embryo, fetus, and course of pregnancy. PGDM may increase the rate of congenital malformations, especially cardiac, nervous system, musculoskeletal system, and limbs. PGDM may interfere with fetal growth, often causing macrosomia, but in the presence of severe maternal complications, especially nephropathy, it may inhibit fetal growth. PGDM may also induce a variety of perinatal complications such as stillbirth and perinatal death, cardiomyopathy, respiratory morbidity, and perinatal asphyxia. GDM that generally develops in the second half of pregnancy induces similar but generally less severe complications. Their severity is higher with earlier onset of GDM and inversely correlated with the degree of glycemic control. Early initiation of GDM might even cause some increase in the rate of congenital malformations. Both PGDM and GDM may cause various motor and behavioral neurodevelopmental problems, including an increased incidence of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Most complications are reduced in incidence and severity with the improvement in diabetic control. Mechanisms of diabetic-induced damage in pregnancy are related to maternal and fetal hyperglycemia, enhanced oxidative stress, epigenetic changes, and other, less defined, pathogenic mechanisms.     

Anti-Diabetic Effect of Portulaca oleracea L. Polysaccharideandits Mechanism in Diabetic Rats

Diabetes mellitus (DM) is a metabolic syndrome caused by multiple genetic and environmental factors. Traditional Chinese medicine preparations have shown a comprehensive and function-regulating characteristic. Purslane (Portulaca oleracea L.) is an annual succulent herb. Currently, there have been some related reports on the treatment of diabetes with purslane. The current study was designed to separate and purify the polysaccharide, a systematic study of its physical and chemical properties, antioxidant activity, and anti-diabetic mechanism, in order to provide a theoretical basis for the development of drugs of purslane. A crude water soluble polysaccharide extracted from purslane was named CPOP (crude Portulaca oleracea L. polysaccharide). Effects of CPOP on bodyweight, glucose tolerance test (GTT), fasting blood glucose (FBG), fasting serum insulin (FINS), insulin sensitivity index (ISI), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), methane dicarboxylic aldehyde (MDA), and superoxygen dehydrogenises (SOD) were investigated. The results indicate that the oral administration of CPOP could significantly increase the body weight and significantly improve the glucose tolerance in diabetic rats. Meanwhile, CPOP could significantly reduce the FBG level, and elevate the FINS level and ISI value in diabetic rats. In addition, CPOP could significantly reduce TNF-α and IL-6 levels in diabetic rats; CPOP could also reduce MDA and SOD activities in the liver tissue of diabetic rats. These results suggest that the anti-diabetic effect of CPOP may be associated with its antioxidant and anti-inflammatory effects.     

Serum vitamin A during pregnancy and effects on obstetrics and perinatal outcomes in HIV infected pregnant women

To evaluate serum vitamin levels and its association with obstetrics and perinatal results in HIV infected pregnant women. Observational and prospective study carried out at Division of Infectious-Contagious Diseases in Gynecology and Obstetrics of the University Hospital, Medicine School of Ribeir?o Preto, University of S?o Paulo, involving 57 pregnant women divided into 3 groups: Group 1, with 12 normal pregnant women, it was the control group; Group 2, with 20 HIV infected pregnant women, using ZDV; and Group 3, with 25 HIV infected pregnant women, using therapy I contend ZDV, 3TC and nelfinavir. The evaluation of the serum vitamin level was obtained three times during pregnancy at equidistant time intervals and in the immediate period after birth. We also evaluated the levels of this vitamin and the hemoglobin in the blood of the umbilical cord. We obtained maternal and newborn infant anthropometric data, as well as the counting of lymphocyte TCD4 and viral load of the HIV during the pregnancy. Reduced serum vitamin levels were observed in the Group 1(25%), the Group 2(29,4%) and the Group 3(28,6%). Association was not observed between serum levels of maternal retinol and the duration of the gestation in groups 2 and 3. In groups 1 and 3, an association was observed between the maternal concentration of retinol and the newborn hemoglobin (p=0.05). In distinct way to the Control group, association was not observed between the retinol levels of the umbilical cord and the weight of the newborn in gestations of Group 2, while a trend to this association was observed in gestations of Group 3 (p=0.06). We observed high prevalence of hipovitaminosis A in the population of this study, regardless of antiretroviral scheme used.     

Effect of Long-Term Dietary Arginyl-Fructose (AF) on Hyperglycemia and HbA1c in Diabetic db/db Mice

We have previously reported that Amadori compounds exert anti-diabetic effects by lowering sucrose-induced hyperglycemia in normal Sprague-Dawley rats. In the present study we extended our recent findings to evaluate whether α-glucosidase inhibitor arginyl-fructose (AF) lowers blood glucose level in diabetic db/db mice, a genetic model for type 2 diabetes. The db/db mice were randomly assigned to high-carbohydrate diets (66.1% corn starch) with and without AF (4% in the diet) for 6 weeks. Changes in body weight, blood glucose level, and food intake were measured daily for 42 days. Dietary supplementation of AF resulted in a significant decrease of blood glucose level (p < 0.001) and body weight (p < 0.001). The level of HbA1c, a better indicator of plasma glucose concentration over prolonged periods of time, was also significantly decreased for 6-week period (p < 0.001). Dietary treatment of acarbose^® (0.04% in diet), a positive control, also significantly alleviated the level of blood glucose, HbA1c, and body weight. These results indicate that AF Maillard reaction product improves postprandial hyperglycemia by suppressing glucose absorption as well as decreasing HbA1c level.     

甘精胰岛素联合速效胰岛素类似物治疗鼻饲重症糖尿病研究

目的评估甘精胰岛素治疗鼻饲重症糖尿病患者的疗效和安全性。方法将2007年7月至2008年5月我院住院的80例鼻饲重症糖尿病患者分为2组,A组给予甘精胰岛素和速效胰岛素类似物控制血糖;B组采用胰岛素泵持续泵入速效胰岛素类似控制血糖,比较甘精胰岛素的疗效及安全性。结果治疗后与治疗前比较,2组患者的空腹血糖、餐后血糖均明显下降,2组的血糖下降程度、低血糖发生次数无明显差异。结论甘精胰岛素可以安全、有效的治疗鼻饲重症糖尿病患者。     

The Obscure Effect of Tribulus terrestris Saponins Plus Inulin on Liver Morphology,Liver Fatty Acids,Plasma Glucose,and Lipid Profile in SD Rats with and without Induced Type 2 Diabetes Mellitus

Diabetes is a predictor of nonalcoholic fatty liver disease (NAFLD). There are data suggesting that Tribulus terrestris (TT) saponins act as antidiabetic agents and protect against NAFLD. The effect of saponins may be increased by fermentable fibers such as inulin. The aim of the present study was to investigate the influence of TT saponins and TT saponins plus inulin on the plasma lipid profile and liver fatty acids of rats with induced diabetes mellitus type 2 (T2DM). The study was performed on 36 male Sprague–Dawley rats divided into two main groups: control and diabetic. Animals of the diabetic (DM) group were fed a high-fat diet and injected with streptozotocin (low doses). Animals of the control group (nDM) were on a regular diet and were injected with buffer. After the injections, the animals were split into subgroups: three non-diabetic (nDM): (i) control (c-C); (ii) saponin-treated rats (C-Sap); (iii) rats treated with saponins + inulin (C-Sap + IN), and three diabetic subgroups (DM): (iv) control (c-DM); (v) saponin-treated rats (DM-Sap); (vi) rats treated with saponins + inulin (DM-Sap + IN). Liver fatty acids were extracted and analyzed by gas chromatography, and plasma glucose and lipids were measured. The study showed significant changes in liver morphology, liver fatty acids, plasma lipid profile, and plasma glucose. In summary, supplementation with TT saponins or saponins with inulin for one month decreased the level of steatosis in rats with induced type 2 diabetes. Moreover, there were favorable effects on the plasma lipid profile in the rats. However, additional supplementation with inulin had a negative effect on liver morphology (with a microvesicular type of steatosis) in the non-diabetes group. Moreover, supplementation with inulin had a negative effect on plasma glucose in both diabetic and non-diabetic rats. These data show that a diet enriched with fermentable fibers reveals different effects in different organisms, and not all sources and forms of fiber are beneficial to health.