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Effect of intensive therapy of Multiple Factors Intervention on Vascular Complications in Type 2 Diabetes

Journal of Huazhong University of Science and Technology(Medical Sciences) 2003年第1期23卷 16-18页

作者：吴汉妮张淑玲沈迪 DepartmentofEndocrinology XieheHospitalTongjiMedicalCollegeHuazhongUniversityofScienceandTechnology

The effects of intensive versus regular therapy on incidence and progress of microalbuminuria in type 2 diabetes were compared. During a follow-up of 3 years, 96 cases of diabetes mellitus were randomized to intensive and regular therapy groups. HbA 1c goal was same in the two groups, but the goal of blood pressure (Bp) and lipid was more strict in the intensive therapy group than in the regular therapy group. There was statistically significant difference in the incidence and progression of vascular complications between the two groups. Logistic stepwise-regression analysis (odds ration, OR) showed that there was significant difference in the progression of nephropathy (OR 0.24, 95 % CI 0.12-0.76), retinopathy (OR 0.38, 95 % CI 0.16-0.88), peripheral neuropathy (OR 0.42, 95 % CI 0.22-0.86) and autonomic neuropathy (OR 0.29, 95 % CI 0.12-0.86) between the two groups (Pintensive blood glucose controlling could retard diabetic vascular complications. intensive therapy of multiple factors interventions (controlling Bp, regulating blood lipid, improving microcirculation) could decrease various risk factors for diabetic vascular complications.

关键词： type 2 diabetes vascular complications multiple factors intervention intensive therapy

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Individualized intensive insulin therapy of diabetes: Not only thegoal, but also the time

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World Journal of Diabetes 2024年第1期15卷 11-14页

作者： Yun Hu Hong-Jing Chen Jian-Hua Ma Department of Endocrinology The Affiliated Wuxi People's Hospital of Nanjing Medical UniversityWuxi People's HospitalWuxi Medical CenterNanjing Medical UniversityWuxi 214023Jiangsu ProvinceChina Department of Endocrinology Nanjing First HospitalNanjing 210000Jiangsu ProvinceChina

intensive insulin therapy has been extensively used to control blood glucose levels because of its ability to reduce the risk of chronic complications of *** to current guidelines,intensive glycemic control requires individu-alized glucose goals rather than as low as *** intensive therapy,rapid blood glucose reduction can aggravate microvascular and macrovascular complications,and prolonged overuse of insulin can lead to treatment-induced neuropathy and retinopathy,hypoglycemia,obesity,lipodystrophy,and insulin antibody ***,we need to develop individualized hypoglycemic plans for patients with diabetes,including the time required for blood glucose normalization and the duration of intensive insulin therapy,which deserves further study.

关键词： Diabetes intensive therapy Insulin Treatment-induced neuropathy

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Effects of intensive control of blood glucose and blood pressure on microvascular complications in patients with type Ⅱ diabetes mellitus

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International Journal of Ophthalmology(English edition) 2013年第2期6卷 141-145页

作者： Cai-Hong Zhu Shi-Sheng Zhang Yan Kong Yu-Fang Bi Ling Wang Qiong Zhang Department of Ophthalmology Ruijin Hospital School of Medicine Shanghai Jiaotong University New Vision Eye Clinic Ruijin Hospital School of Medicine Shanghai Jiaotong University Department of Hypertension Ruijin Hospital School of Medicine Shanghai Jiaotong University Department of Endocrinology Ruijin Hospital School of Medicine Shanghai Jiaotong University

AIM: To evaluate the effects of intensive control of blood glucose and blood pressure on microvascular complications in patients with type Ⅱ diabetes by comparing the therapeutic effects of intensive and standard treatment in patients with type Ⅱ diabetes. METHODS: A total of 107 patients with type Ⅱ diabetes were randomly assigned into intensive and standard treatment groups. Patients in the intensive treatment group received preterax (perindopril/ indapamide) to control blood pressure, and gliclazide (diamicron) MR to control blood glucose. Patients in the standard treatment group received routine medications or placebo. Urinary microalbumin (UMA), urinary creatinine (UCR), the UMA/ UCR ratio, and visual acuity were monitored according to the study design of the ADVANCE trial. Direct ophthalmoscopy and seven-field stereoscopic retinal photography were used to examine the fundi at baseline,and repeated after 5 years of treatment. RESULTS: The characteristics of patients in both groups were well balanced at baseline. After 5 years of treatment, visual acuity was found to be decreased in the standard group (P=0.04), but remained stable in the intensive group. The severity of diabetic retinopathy had not progressed in patients in the intensive group, but had deteriorated in the standard group (P=0.0006). The UMA/UCR ratio was not obviously changed in patients in the intensive group, whereas it was significantly increased in the standard group (P=0.00). CONCLUSION: intensive control of blood glucose and blood pressure can decrease the incidence or slow the progression of microvascular complications in patients with type Ⅱ diabetes, and maintain stable vision.

关键词： diabetes mellitus intensive therapy microvascular complications diabetic retinopathy

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