Hyperglycemia

高血糖症
  • 文章类型: Journal Article
    糖尿病是一种常见的慢性代谢紊乱,其特征在于长时间的葡萄糖水平升高。持续的高血糖会导致糖尿病并发症,如视网膜病变,肾病,和神经病,和心血管并发症,如缺血性心脏病,外周血管疾病,糖尿病性心肌病,中风,等。有许多研究表明,各种多酚影响葡萄糖稳态,并可以帮助减轻与糖尿病相关的并发症。
    这篇综述着重于各种膳食多酚在减轻糖尿病引起的心血管并发症中的可能作用。这篇综述还旨在概述ROS产生(由于糖尿病)之间的相互关系,炎症,糖化应激,和心血管并发症以及膳食多酚的抗高血糖作用。
    各种科学数据库,包括Scopus,WebofScience,谷歌学者,PubMed,科学直接,SpringerLink,和Wiley在线图书馆用于搜索符合纳入和排除标准的文章。
    本综述列出了基于各种临床前和临床研究的几种多酚,这些多酚具有抗高血糖潜力以及对心血管并发症的保护功能。
    一些临床前和临床研究表明,各种膳食多酚可能是减轻糖尿病相关心血管并发症的有希望的干预措施。
    UNASSIGNED: Diabetes mellitus is a common chronic metabolic disorder that is characterized by increased levels of glucose for prolonged periods of time. Incessant hyperglycemia leads to diabetic complications such as retinopathy, nephropathy, and neuropathy, and cardiovascular complications such as ischemic heart disease, peripheral vascular disease, diabetic cardiomyopathy, stroke, etc. There are many studies that suggest that various polyphenols affect glucose homeostasis and can help to attenuate the complications associated with diabetes.
    UNASSIGNED: This review focuses on the possible role of various dietary polyphenols in palliating diabetes-induced cardiovascular complications. This review also aims to give an overview of the interrelationship among ROS production (due to diabetes), inflammation, glycoxidative stress, and cardiovascular complications as well as the anti-hyperglycemic effects of dietary polyphenols.
    UNASSIGNED: Various scientific databases including Scopus, Web of Science, Google Scholar, PubMed, Science Direct, Springer Link, and Wiley Online Library were used for searching articles that complied with the inclusion and exclusion criteria.
    UNASSIGNED: This review lists several polyphenols based on various pre-clinical and clinical studies that have anti-hyperglycemic potential as well as a protective function against cardiovascular complications.
    UNASSIGNED: Several pre-clinical and clinical studies suggest that various dietary polyphenols can be a promising intervention for the attenuation of diabetes-associated cardiovascular complications.
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  • 文章类型: Journal Article
    通过O-GlcNAcylation对核和细胞质蛋白的动态和可逆修饰显着影响免疫系统的功能和功能障碍。O-GlcNAcylation在生理和病理条件下在所有免疫细胞功能的生化调节中起着至关重要的作用。在这一领域获得的三十年半的知识仅仅足以感知我们所知道的只是前奏。这篇综述试图指出O-GlcNAcylation在免疫系统关键信号转导途径和特定蛋白质功能中的已知调节作用。并向未知函数添加随后的问题。
    The dynamic and reversible modification of nuclear and cytoplasmic proteins by O-GlcNAcylation significantly impacts the function and dysfunction of the immune system. O-GlcNAcylation plays crucial roles under both physiological and pathological conditions in the biochemical regulation of all immune cell functions. Three and a half decades of knowledge acquired in this field is merely sufficient to perceive that what we know is just the prelude. This review attempts to mark out the known regulatory roles of O-GlcNAcylation in key signal transduction pathways and specific protein functions in the immune system and adumbrate ensuing questions toward the unknown functions.
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  • 文章类型: Journal Article
    糖尿病(DM)是一种罕见的,鸟类代谢紊乱的记录很少。由于禽类生理和代谢的显着差异,从哺乳动物中的DM推断知识具有挑战性。1991年12月至2022年1月的文献综述确定了14种出版物,涵盖16种糖尿病鸟类,其中63%(10/16)属于以Ara为主要属的鹦鹉目。没有注意到性倾向,但男性通常出现在较年轻的年龄。常见的临床症状包括多尿94%(15/16),烦渴88%(14/16),体重下降75%(12/16),嗜睡63%(10/16),和多食性38%(6/16)。DM的诊断基于临床体征和持续性高血糖100%的存在(16/16),经常伴有93%的糖尿(13/14),对胰岛素治疗的反应80%(8/10),胰腺病理90%(9/10)。14例患者开始糖尿病的特异性治疗,但6个月或更长时间的血糖调节仅在6只鸟中实现。5只受管制的禽类接受注射长效胰岛素管理,1只接受口服格列吡嗪和饮食调整。然而,格列吡嗪在其他病例中效果不佳,可能归因于缺乏功能性β细胞。三只糖尿病鸟类进展到缓解。7例患者的平均生存时间为诊断后36天,治疗被证明是不成功的。一名患者失去随访,和2在诊断后立即实施安乐死。经常对胰腺进行组织学检查(90%,9/10)显示包括萎缩在内的异常,纤维化,和有或没有淋巴浆细胞性胰腺炎的内分泌胰岛空泡化。合并症,包括含铁血黄素沉着症和感染,很常见。这篇综述表明,如在狗和人类中观察到的,诊断为DM的鸟类主要受到I型糖尿病的影响。与哺乳动物相反,禽类DM通常与潜在疾病相关,在开始长期胰岛素治疗之前,完整的临床检查对于诊断和解决继发性疾病至关重要。
    Diabetes mellitus (DM) is an uncommon, poorly documented metabolic disorder of birds. Extrapolating knowledge from DM in mammals is challenging because of marked differences in avian physiology and metabolism. A literature review from December 1991 to January 2022 identified 14 publications covering 16 diabetic birds, 63% (10/16) of which belonged to the order Psittaciformes with Ara as the predominant genus. No sex predilection was noted, but males generally presented at a younger age. Commonly reported clinical signs included polyuria 94% (15/16), polydipsia 88% (14/16), weight loss 75% (12/16), lethargy 63% (10/16), and polyphagia 38% (6/16). Diagnosis of DM was based on the presence of clinical signs and persistent hyperglycemia 100% (16/16), often with glucosuria 93% (13/14), response to insulin therapy 80% (8/10), and pancreatic pathology 90% (9/10). Specific treatment for DM was initiated in 14 patients, but blood glucose regulation for 6 months or longer was only achieved in 6 birds. Five of the regulated birds were managed with injectable long-acting insulin and 1 with oral glipizide combined with dietary modifications. However, glipizide yielded poor results in other cases, likely attributable to a lack of functional beta cells. Three diabetic birds progressed to remission. Treatment proved unsuccessful for 7 patients with a mean survival time of 36 days from diagnosis. One patient was lost to follow-up, and 2 were euthanized immediately following diagnosis. Histological examination of the pancreas frequently (90%, 9/10) revealed abnormalities including atrophy, fibrosis, and vacuolization of the endocrine islets with or without lymphoplasmacytic pancreatitis. Comorbidities, including hemosiderosis and infection, were common. This review suggests that birds diagnosed with DM are primarily affected by a type I diabetes as observed in dogs and humans. In contrast to mammalian species, avian DM is often associated with underlying disease and a complete clinical workup is essential to diagnose and address secondary disease conditions prior to initiating long-term insulin therapy.
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  • 文章类型: Journal Article
    背景:妊娠高血糖症(HIP)是一种影响全球孕妇的重大医疗并发症,由于它可能对母婴造成负面后果,因此被认为是公共卫生负担。这项系统评价和荟萃分析的目的是检查患病率,危险因素,和埃塞俄比亚HIP的母婴结局。
    方法:为了收集本研究的相关信息,在几个主要数据库中搜索了已发表和未发表的研究,包括PubMed,Embase,Hinari,WebofScienceDirect,和谷歌学者,以及其他来源。JoannaBriggs研究所(JBI)工具用于评估这些研究结果的方法学质量。然后使用MicrosoftExcel软件中的模板提取和汇总数据,提取的数据使用Stata软件16.0版进行分析。如果在研究之间发现显著的异质性,我们进行了亚组分析以进一步检查数据.
    结果:本系统综述和荟萃分析包括18项研究,涉及埃塞俄比亚50,816名孕妇的总样本量。在主要研究中,孕妇的HIP患病率差异很大,从0.4%到26.2%不等。埃塞俄比亚孕妇中HIP的合并患病率为6.9%(95%C2.2-11.6)。与没有糖尿病家族史的孕妇相比,有糖尿病家族史的孕妇发生HIP的几率高2.5倍(OR=2.49;95%CI=2.02,2.96)。然而,HIP与产妇肥胖(OR2.31,95%CI=0.85,3.78)或既往流产史(OR3.89;95%CI0.85,6.94)之间无显著关联.与HIP相关的常见胎儿结局为入住重症监护病房(46.2;95%CI27.4,65.1),巨大儿(27.3%;95%CI9.4%,45.1%),和早产(16.9;95%CI12.5,21.3)。此外,妊娠高血压疾病(28.0%;95%CI15.2,40.8)和手术分娩(51.4%;95%CI35.9,66.8)在埃塞俄比亚患有HIP的女性中更为常见.
    结论:尽管研究之间存在一些差异,荟萃分析显示,埃塞俄比亚100名孕妇中约有7名患有HIP.在埃塞俄比亚,发现糖尿病家族史是HIP的重要预测因素。此外,HIP与埃塞俄比亚母亲和婴儿的各种严重不良后果有关。这些发现强调了国家指南的必要性,以确保孕妇得到统一的HIP筛查。
    BACKGROUND: Hyperglycemia in pregnancy (HIP) is a significant medical complication affecting pregnant women globally and is considered a public health burden due to the negative outcomes it can cause for both mother and infant. The aim of this systematic review and meta-analysis was to examine the prevalence, risk factors, and feto-maternal outcomes of HIP in Ethiopia.
    METHODS: To gather relevant information for this study, both published and unpublished studies were searched for in several major databases, including PubMed, Embase, HINARI, Web of Science direct, and Google Scholar, as well as other sources. The Joanna Briggs Institute (JBI) tool was used to evaluate the methodological quality of the findings from these studies. Data was then extracted and summarized using a template in Microsoft Excel software, and the extracted data was analyzed using Stata software version 16.0. If significant heterogeneity was found between studies, subgroup analyses were conducted to further examine the data.
    RESULTS: Eighteen studies were included in this systematic review and meta-analysis, involving a total sample size of 50,816 pregnant women in Ethiopia. The prevalence of HIP among pregnant women varied considerably across the primary studies, ranging from 0.4 to 26.2%. The pooled prevalence of HIP among pregnant women in Ethiopia was found to be 6.9% (95% C 2.2-11.6). Pregnant women with a family history of diabetes had 2.5 times higher odds of developing HIP compared to those without a family history of diabetes (OR = 2.49; 95% CI = 2.02, 2.96). However, there was no significant association found between HIP and maternal obesity (OR 2.31, 95% CI = 0.85, 3.78) or previous history of abortion (OR 3.89; 95% CI 0.85, 6.94). The common fetal outcomes associated with HIP were admission to the intensive care unit (46.2; 95% CI 27.4, 65.1), macrosomia (27.3%; 95% CI 9.4%, 45.1%), and preterm birth (16.9; 95% CI 12.5, 21.3). Additionally, hypertensive disorders of pregnancy (28.0%; 95% CI 15.2, 40.8) and operative delivery (51.4%; 95% CI 35.9, 66.8) were more common among women with HIP in Ethiopia.
    CONCLUSIONS: Although there was some variation between studies, the meta-analysis revealed that approximately seven out of 100 pregnant women in Ethiopia had HIP. A family history of diabetes was found to be a significant predictor of HIP in Ethiopia. Additionally, HIP was associated with various serious adverse outcomes for both mothers and infants in Ethiopia. These findings highlight the need for national guidelines to ensure that pregnant women are uniformly screened for HIP.
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  • 文章类型: Journal Article
    代谢综合征(MS)由相互关联的代谢因素的结果定义,这些因素直接增加了肥胖和其他代谢性疾病的患病率。目前,肥胖被认为是最相关的讨论话题之一,因为在发展中国家和不发达国家,肥胖的发病率已经达到了流行病。根据《世界肥胖地图集2023》报告,目前,世界人口的38%是肥胖或超重。肥胖的原因之一是能量摄入和能量消耗的不平衡,由于食用高热量快餐而导致的营养失衡起着关键作用。肥胖的不同危险因素之间的动态相互作用是高度复杂的;人们认识到高血糖和血脂异常对肥胖发病率的影响.快餐,主要由可溶性碳水化合物组成,非营养性人造甜味剂,饱和脂肪,和大量营养素的复合物(蛋白质-碳水化合物,淀粉-脂质,淀粉-脂质-蛋白质)提供高代谢卡路里。一些实验研究指出,乳制品蛋白质和肽可能调节肥胖危险因素的活性。为了准确证明结果,在体外条件下合成了来自乳乳蛋白的肽,并评估了它们对肥胖生物标志物的贡献。这篇叙述性综述文章介绍了有关牛奶中蛋白质和肽对快餐引起的肥胖的影响的综合信息。
    Metabolic syndrome (MS) is defined by the outcome of interconnected metabolic factors that directly increase the prevalence of obesity and other metabolic diseases. Currently, obesity is considered one of the most relevant topics of discussion because an epidemic heave of the incidence of obesity in both developing and underdeveloped countries has been reached. According to the World Obesity Atlas 2023 report, 38% of the world population are presently either obese or overweight. One of the causes of obesity is an imbalance of energy intake and energy expenditure, where nutritional imbalance due to consumption of high-calorie fast foods play a pivotal role. The dynamic interactions among different risk factors of obesity are highly complex; however, the underpinnings of hyperglycemia and dyslipidemia for obesity incidence are recognized. Fast foods, primarily composed of soluble carbohydrates, non-nutritive artificial sweeteners, saturated fats, and complexes of macronutrients (protein-carbohydrate, starch-lipid, starch-lipid-protein) provide high metabolic calories. Several experimental studies have pointed out that dairy proteins and peptides may modulate the activities of risk factors of obesity. To justify the results precisely, peptides from dairy milk proteins were synthesized under in vitro conditions and their contributions to biomarkers of obesity were assessed. Comprehensive information about the impact of proteins and peptides from dairy milks on fast food-induced obesity is presented in this narrative review article.
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  • 文章类型: Journal Article
    背景:氧化应激和炎症状况的激活与糖尿病(DM)发作和并发症的加速有关。尽管有各种抗DM药物,越来越多的趋势是发现廉价和有效的治疗方法,从植物中获得低副作用,作为药物开发的有希望的来源之一。
    目的:本研究旨在系统研究植物源性降糖药在糖尿病实验模型中的同时抗炎和抗氧化作用。
    方法:搜索词包括“糖尿病”,“草药”,“抗氧化剂”,“炎症生物标志物”,以及它们在PubMed中的等价物,Scopus,WebofScience,和Cochrane图书馆数据库截至2021年8月17日。
    结果:在整个数据库搜索过程中,记录了201项合格的实验研究。结果显示,最常评估的炎症和氧化应激生物标志物是肿瘤坏死因子(TNF)-α,白细胞介素(IL)6,IL-1β,IL-10,丙二醛(MDA),一氧化氮(NO)。抗氧化酶的活性,包括超氧化物歧化酶(SOD),谷胱甘肽(GSH),和过氧化氢酶(CAT)在本综述中进行了评估。在草药治疗中,foenum-graecumL.,积雪草(L.)Urb。,葡萄,和辣木.最常用于糖尿病并发症。由于处理的分散性,荟萃分析不适用。
    结论:我们的研究结果表明,在动物模型中应用不同的植物源性降糖治疗方法可以改善糖尿病及其并发症,以及调节伴随的炎症和氧化应激生物标志物。这些发现表明,基于植物的抗糖尿病药物和食品补充剂具有管理糖尿病及其并发症的潜力。
    BACKGROUND: The activation of oxidative stress and inflammatory conditions has been associated with acceleration in diabetes (DM) onset and complications. Despite various anti-DM medications, there is a growing trend to discover inexpensive and effective treatments with low adverse effects from plants as one of the promising sources for drug development.
    OBJECTIVE: This study aimed to systematically investigate the simultaneous anti-inflammatory and antioxidant effects of plant-derived hypoglycemic medicines in diabetic experimental models.
    METHODS: The search terms consisted of \"diabetes\", \"herbal medicine\", \"antioxidant\", \"Inflammatory biomarker\", and their equivalents among PubMed, Scopus, Web of Science, and Cochrane Library databases up to 17 August 2021.
    RESULTS: Throughout the search of databases, 201 eligible experimental studies were recorded. The results showed that the most commonly assessed inflammatory and oxidative stress biomarkers were tumor necrosis factor (TNF)-α, interleukin (IL) 6, IL-1β, IL-10, malondialdehyde (MDA), and nitric oxide (NO). The activity of antioxidant enzymes, including superoxide dismutase (SOD), glutathione (GSH), and catalase (CAT) were assessed in the present review. Among herbal treatments, Trigonella foenum-graecum L., Centella asiatica (L.) Urb., Vitis vinifera L., and Moringa oleifera Lam. were most commonly used for diabetic complications. Due to the dispersion of the treatments, meta-analysis was not applicable.
    CONCLUSIONS: Our findings showed that the application of different plant-derived hypoglycemic treatments in animal models improved diabetes and its complications, as well as modulated concomitant inflammatory and oxidative stress biomarkers. These findings suggest that plant-based antidiabetic medicines and food supplements have the potential to manage diabetes and its complications.
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  • 文章类型: Systematic Review
    糖尿病(DM),由于其长期高血糖,导致晚期糖基化终产物(AGEs)的积累,尤其是在血管壁上。皮肤自发荧光(SAF)是一种测量AGEs的非侵入性工具。DM患者有丰富的饮食来源AGEs,与高氧化应激和长期炎症相关。AGEs代表心血管(CV)危险因素,它们与CV事件相关联。我们的目的是通过检查2型DM(T2DM)患者中SAF与其他CV危险因素的相关性来评估SAF是否可以预测未来的CV事件(CVE)。此外,我们评估了SAF作为CVE预测工具的优势和局限性.遵循系统审查和元分析方法的首选报告项目,我们对CRD42024507397方案进行了系统评价,专注于AGEs,T2DM,SAF,CV风险。我们确定了2014年至2024年的7项研究,这些研究主要使用AGEReader诊断光学工具。涉及的患者总数为8934,平均年龄为63岁。所以,SAF是一个有价值的,评估T2DM患者CV风险的非侵入性标志物。它是与CVE独立相关的CV风险因素。SAF水平受长期高血糖的影响,生活方式,老化,和其他慢性疾病,如抑郁症,它可以用作CVE的预测工具。
    Diabetes mellitus (DM), due to its long-term hyperglycemia, leads to the accumulation of advanced glycation end-products (AGEs), especially in the vessel walls. Skin autofluorescence (SAF) is a non-invasive tool that measures AGEs. DM patients have a rich dietary source in AGEs, associated with high oxidative stress and long-term inflammation. AGEs represent a cardiovascular (CV) risk factor, and they are linked with CV events. Our objective was to assess whether SAF predicts future CV events (CVE) by examining its association with other CV risk factors in patients with type 2 DM (T2DM). Additionally, we assessed the strengths and limitations of SAF as a predictive tool for CVE. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, we conducted a systematic review with CRD42024507397 protocol, focused on AGEs, T2DM, SAF, and CV risk. We identified seven studies from 2014 to 2024 that predominantly used the AGE Reader Diagnostic Optic tool. The collective number of patients involved is 8934, with an average age of 63. So, SAF is a valuable, non-invasive marker for evaluating CV risk in T2DM patients. It stands out as a CV risk factor associated independently with CVE. SAF levels are influenced by prolonged hyperglycemia, lifestyle, aging, and other chronic diseases such as depression, and it can be used as a predictive tool for CVE.
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  • 文章类型: Meta-Analysis
    背景:对于COPD加重的治疗,除短效支气管扩张剂外,还推荐全身性皮质类固醇.尽管已经进行了几次系统审查,许多纳入研究是在2007年之前进行的,自2014年以来没有进行过重新评估.因此,我们进行了系统综述和荟萃分析,以评估COPD加重期患者全身使用糖皮质激素的疗效和安全性.
    方法:我们检索了相关的随机对照试验(RCT),并分析了治疗失败的原因。复发,肺功能,改善PaO2和PaCO2,呼吸困难,生活质量(QOL),住院时间和包括高血糖和死亡率在内的不良事件作为关注结局.
    结果:我们确定了总共12项随机对照试验(N=1336)。全身性皮质类固醇可显着降低治疗失败(比值比;OR0.41,95%置信区间;CI0.25至0.67)和住院时间(平均差异;MD-1.57天,95%CI-2.36至-0.78)和改善的FEV1(MD0.18L,与安慰剂相比,COPD加重期的95%CI0.08至0.28)和呼吸困难(过渡性呼吸困难指数;MD1.90,95%CI0.26至3.54)。然而,全身性皮质类固醇与不良事件(OR1.83,95%CI1.25~2.69)和高血糖症(OR2.94,95%CI1.68~5.14)的发生率显著升高相关.
    结论:在中度和重度COPD和加重期重度阻塞性损害的患者中,全身性皮质类固醇引起更多的不良事件,包括高血糖,与安慰剂相比,但显着减少了治疗失败和住院时间,并改善了FEV1和呼吸困难。
    BACKGROUND: For the treatment of COPD exacerbations, systemic corticosteroids are recommended in addition to short-acting bronchodilators. Although there have been several systemic reviews, many of the included studies were conducted before 2007 and a re-evaluation has not been performed since 2014. Therefore, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety profile of systemic corticosteroids in patients with COPD during exacerbations.
    METHODS: We searched relevant randomized control trials (RCTs) and analyzed the treatment failure, relapse, lung function, improvement in PaO2 and PaCO2, dyspnea, quality of life (QOL), length of stay in hospital and adverse events including hyperglycemia and mortality as the outcomes of interest.
    RESULTS: We identified a total of 12 RCTs (N = 1336). Systemic corticosteroids significantly reduced the treatment failure (odds ratios; OR 0.41, 95% confidence intervals; CI 0.25 to 0.67) and hospital length of stay (mean difference; MD -1.57 days, 95% CI -2.36 to -0.78) and improved FEV1 (MD 0.18 L, 95% CI 0.08 to 0.28) and dyspnea (transitional dyspnea index; MD 1.90, 95% CI 0.26 to 3.54) in COPD exacerbations compared to placebo. However, systemic corticosteroids were associated with a significantly higher incidence of adverse events (OR 1.83, 95% CI 1.25 to 2.69) and hyperglycemia (OR 2.94, 95% CI 1.68 to 5.14).
    CONCLUSIONS: In patients with moderate and severe COPD and severe obstructive impairment during exacerbations, systemic corticosteroids cause more adverse events, including hyperglycemia, than placebo but significantly reduce the treatment failure and hospital length of stay and improve FEV1 and dyspnea.
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  • 文章类型: Journal Article
    目的:糖尿病神经病是糖尿病的一种使人衰弱的并发症,影响全世界数百万人。其特征在于由于长时间暴露于高血糖水平而导致的神经损伤。糖尿病性神经病可能会引起一系列症状,包括疼痛,麻木,肌肉无力,自主神经功能障碍,和足部溃疡,可能对那些受影响的人的生活质量造成重大损害。本文旨在对糖尿病神经病变的病理生理学进行全面概述。将讨论糖尿病神经病变的病因,包括风险因素,易感条件,以及高血糖之间复杂的相互作用的概述,代谢失调,和神经损伤。此外,我们将探索糖尿病神经病变的分子机制和途径,包括高血糖对神经功能的影响,葡萄糖代谢异常,晚期糖基化终产物(AGEs)的作用,以及炎症和免疫介导的过程。我们将概述受糖尿病神经病变影响的各种神经纤维,并探讨疼痛医学领域与糖尿病神经病变相关的常见症状和并发症。
    结果:这篇综述强调了在理解糖尿病神经病变的病理生理学方面的进展,并回顾了潜在的新治疗策略和未来研究的有希望的领域。总之,本文旨在阐明糖尿病神经病变的病理生理学,其深远的后果,以及不断发展的预防和管理策略。在了解糖尿病神经病变的机制和该领域正在进行的研究中,医疗保健专业人员可以更好地为糖尿病患者服务,最终改善福祉并减少并发症。
    OBJECTIVE: Diabetic neuropathy is a debilitating complication of diabetes mellitus that affects millions of individuals worldwide. It is characterized by nerve damage resulting from prolonged exposure to high blood glucose levels. Diabetic neuropathy may cause a range of symptoms, including pain, numbness, muscle weakness, autonomic dysfunction, and foot ulcers, potentially causing significant impairment to the quality of life for those affected. This review article aims to provide a comprehensive overview of the pathophysiology of diabetic neuropathy. The etiology of diabetic neuropathy will be discussed, including risk factors, predisposing conditions, and an overview of the complex interplay between hyperglycemia, metabolic dysregulation, and nerve damage. Additionally, we will explore the molecular mechanisms and pathways of diabetic neuropathy, including the impact of hyperglycemia on nerve function, abnormalities in glucose metabolism, the role of advanced glycation end products (AGEs), and inflammatory and immune-mediated processes. We will provide an overview of the various nerve fibers affected by diabetic neuropathy and explore the common symptoms and complications associated with diabetic neuropathy in the pain medicine field.
    RESULTS: This review highlights advances in understanding the pathophysiology of diabetic neuropathy as well as reviews potential novel therapeutic strategies and promising areas for future research. In conclusion, this review article aims to shed light on the pathophysiology of diabetic neuropathy, its far-reaching consequences, and the evolving strategies for prevention and management. In understanding the mechanisms of diabetic neuropathy and the ongoing research in this area, healthcare professionals can better serve patients with diabetes, ultimately improving well-being and reducing complications.
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  • 文章类型: Journal Article
    目的:综合现有证据,以更好地了解干预措施预防或延缓当前或先前妊娠期糖尿病(GDM)妇女产后高血糖和2型糖尿病(T2DM)的有效性。
    方法:我们搜索了截至2020年12月的五个数据库,以获取报告(既往)GDM女性在药物或生活方式干预后产后血糖结局的主要同行评审文章。结果是T2DM的相对风险或血糖的连续测量,改变或跟进。至少需要两项研究评估相同的干预-结果组合来进行荟萃分析。其他研究被叙述。元回归用于评估关联是否因其他变量而异。我们使用关键评估技能计划清单评估偏见的风险。PROSPERO记录CRD42018102380。
    结果:我们在综述中纳入了31项研究,总样本量为8624名参与者,和26项荟萃分析研究。三分之二的研究在1年或更短时间内对参与者进行了随访。药物干预与T2DM风险降低相关(0.80[95%CI0.64-1.00],n=6项研究),生活方式干预也是如此,尽管效果较小(0.88[95%CI0.76-1.01],n=12项研究)。饮食和身体活动干预与空腹血糖的小幅降低有关。特别是在更长的干预措施中,但其他持续性结局的影响不一致.
    结论:尽管可能是偶然的,降低GDM后高血糖的干预措施可能是有效的。未来的研究应该提高对干预措施如何影响血糖控制以及如何优化干预措施的认识。
    OBJECTIVE: To synthesize the available evidence to better understand the effectiveness of interventions to prevent or delay hyperglycaemia and Type 2 diabetes mellitus (T2DM) postnatally in women with current or previous gestational diabetes mellitus (GDM).
    METHODS: We searched five databases up to December 2020 for primary peer-reviewed articles reporting postpartum glycaemic outcomes in women with (previous) GDM following pharmacological or lifestyle intervention. Outcomes were relative risk of T2DM or continuous measures of glycaemia, change or at follow-up. A minimum of two studies evaluating the same intervention-outcome combination were needed to conduct meta-analyses, otherwise studies were described narratively. Meta-regression was used to evaluate whether associations varied by additional variables. We assessed risk of bias using the Critical Appraisal Skills Programme checklist. PROSPERO record CRD42018102380.
    RESULTS: We included 31 studies in the review with a total sample size of 8624 participants, and 26 studies in meta-analyses. Two-thirds of studies followed up participants at 1 year or less. Pharmacological interventions were associated with reduced risk of T2DM (0.80 [95% CI 0.64-1.00], n = 6 studies), as were lifestyle interventions albeit with a smaller effect size (0.88 [95% CI 0.76-1.01], n = 12 studies). Dietary and physical activity interventions were associated with a small reduction in fasting plasma glucose, particularly in longer interventions, but inconsistent effects were seen for other continuous outcomes.
    CONCLUSIONS: Although possibly due to chance, interventions to reduce hyperglycaemia after GDM may be effective. Future research should improve understanding of how interventions affect glucose control and how to optimise interventions for this population.
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