ABSTRACT: To evaluate the accuracy and safety of continuous glucose monitoring system (CGMS) in subjects with normal glucose tolerance (NGT), impaired glucose regulation (IGR) and newly-diagnosed type 2 diabetes mellitus (T2DM).
A total of 162 subjects (53 NGT, 53 IGR and 56 newly diagnosed T2DM) at 22 - 72 years old were recruited. Each subject received a continuous glucose monitoring (CGM) of CGMS SYSTEM GOLD(TM) (Medtronic Minimed, Northridge, CA) for 3 consecutive days and was instructed to self-calibrate the interstitial glucose levels with finger-stick blood glucose measurements (self-monitoring of blood glucose, SMBG) 7 times daily. Means of median absolute difference (median AD) and median absolute relative difference (median RAD) were calculated to assess the difference between CGM and SMBG values. The correlation between CGM and SMBG values were analyzed with the liner regression analysis. The data were analyzed by the ISO criteria for home glucose meters and Clarke error grid analysis.
All participants showed a good tolerance to the insertion of CGMS sensor and wearing the device. The mean duration of CGMS recording was (75.6 ± 8.3) h. A total of 4324 glucose meter values were paired with glucose measurements from CGMS. Overall, a good relationship (r = 0.943, P = 0.000) and no significant difference (P > 0.05) over a wide range (2.2 - 22.2 mmol/L) were found between CGM and SMBG values. The median AD was 0.5 (0.2 - 0.9) mmol/L and the median RAD 7.55% (3.33% - 14.09%) with 87.16% of sensor values meeting the ISO home glucose meter criteria. The Clarke error grid analysis showed that 99.58% of the readings from CGMS fell into the clinical acceptable zones including 87.5% values in zone A (clinical exact) and 12.1% values in zone B (benign error).
Both safe and well-tolerated, continuous glucose monitoring provides comparatively accurate blood glucose values to guide the diagnosis and treatment of diabetes.
Zhonghua yi xue za zhi 11/2010; 90(42):2967-70.
ABSTRACT: Diabetic nephropathy is a common complication of diabetes mellitus. This study aimed to explore whether mesenchymal stem cells (MSCs) transplantation could attenuate diabetic nephropathy in experimental diabetic rats.
Sprague-Dawley rats received a single intraperitoneal injection of streptozotocin (STZ) (60 mg/kg). Diabetic rats were randomized to four groups: diabetes control group (DC), ciclosporin A group (CsA), MSC group, and MSC + CsA group (MSCA). Bone marrow mesenchymal stem cells were cultured, identified and labeled by 5-bromo-2'-deoxyuridine (BrdU) in vitro. Then they were transplanted to diabetic rats via introcardiac infusion. Ciclosporin A was administered daily at 5 mg/kg. At 1, 2, 4, 8 weeks after transplantation, random blood glucose, urine albumin/creatinine ratio (Alb/Cr), endogenous creatinine clearance rate and renal mass index were tested. Renal morphology and labeled cells were examined.
Cultured MSCs expressed mesenchymal cell phenotype, and could be multidifferentiated to osteogenic and adipogenic cells. Labeled MSCs could be detected in the kidney of nephropathic rats, mainly in renal interstitium, but they did not propagate after engrafting in kidney. Over the course of the experiment, MSCA group showed a significant decrease in blood glucose compared with MSC group, CsA group and DC group (P < 0.05, respectively). The Alb/Cr in MSCA group and MSC group were significantly lower than CsA group and DC group (P < 0.05). And the Alb/Cr in MSCA group showed a significant decrease compared with MSC group (0.74 vs 0.84, P < 0.05). There was a significant difference in renal mass index between the MSCA group and DC group (5.66 vs 6.37, P < 0.05). No significant difference was found in creatinine clearance rate among 4 groups (P > 0.05). Treatment with MSC + CsA significantly ameliorated the morphology of diabetic kidney.
MSC could mildly ameliorate diabetic nephropathy by decreasing blood glucose, Alb/Cr ratio and renal mass index.
Chinese medical journal 11/2009; 122(21):2573-9. · 0.86 Impact Factor
ABSTRACT: To investigate the prevalence of metabolic syndrome (MS) and associated factors in the adults in Chengdu.
A cross-sectional survey was undertaken in 2242 residents over 20 years of age. The cluster sampling method was employed to recruit participants from Yulin and Longquan communities in Chengdu. The metabolic syndrome was defined by IDF 2005.
The prevalence of MS was 17.2%, with 15.0% and 18.6% for male and female, respectively. The age-adjusted rate of MS was 13.47%, with 17.71% and 11.09% for male and female, respectively. The difference in prevalence of MS between male and female was significant. The prevalence of central obesity, hypertension, hyperglycemia, high triglycerides, low HDL-C were 31.6%, 32.0%, 16.5%, 30.4%, and 31.2% respectively, which became 26.3%, 26.0%, 12.9%, 26.9%, and 30.5% respectively after age-adjustment. Gender differences appeared in all of the components of MS except for low HDL-C (P < 0.05). The multivariable stepwise analysis extracted age, history of hypertension, blood pressure, waist circumference, fasting glycaemia level and triglyceride as major risk factors for MS and blood HDL-C level as a protective factor of MS.
The prevalence of MS is considerably high in Chengdu. It will continue to rise thanks to the social economic development and population ageing. There is an urgent need to take actions to reduce the burden of MS.
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 11/2009; 40(6):1062-5, 1126.
ABSTRACT: To investigate the characteristics of glycemic excursions in people with normal glucose tolerance (NGT) in Chengdu.
A total of 50 non-obese people with normal glucose tolerance (NGT, 23-68 years old), normal blood pressures and lipid profiles participated in the study. The fluctuations of glucose levels in the participants were measured by a continuous glucose monitoring system (CGMS) for three days 72 h. The 48 h mean blood glucose (MBG), mean amplitude of glycemic excursions (MAGE), Largest amplitude of glycemic excursions (LAGE), Postprandial peak glucose (PPG), Postprandial glucose excursion (PPGE), Mean of postprandial glucose excursion (MPPGE), and absolute means of daily differences (MODD) were measured.
The number of glucose values detected by CGMS amounted to 861+/-7 with a mean absolute difference (MAD) of 11.3%+/-10.6%. The CGMS values were significantly correlated with the capillary glucose measurements (n=1076, r=0.761, P<0.005). The participants had a MBG of (5.9+/-1.2) mmol/L, a MAGE of (1.7+/-0.7) mmol/L, a LAGE of (4.4+/-1.9) mmol/L, a daily glycemic peak (PPG) of (8.7+/-1.7) mmol/L, a nadir level of (4.3+/-0.7) mmol/L, a MPPGE of (2.3+/-1.6) mmol/L, and a MODD of (0.75+/-0.79) mmol/L. The post-breakfast Postprandial glycemic excursions (PPGE) were lower than those of post-lunch and post-dinner (P=0.01 and P=0.05). The postprandial glucose excursions in the 60-70 year-old participants were the highest (P<0.022). In 95% (77%-100%) of the daytime, the glycose levels fluctuated between 4.1 and 8.8 mmol/L, and 78% of the participants (n=39) had hyperglycemia (BG>7.8 mmol/L) and 10% (n=5) had asymtomatic hypoglycemia (BG<2.8 mmol/L).
CGMS tests may be important for detecting asymptomatic hyperglycemia and hypoglycemia. The NGT people in Chengdu have exhibited abnormal blood glucose values in CGMS, revealing problems in people with normal range of blood glucose.
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 07/2009; 40(4):704-7.