膳食调节为导向下血糖调控食品开发研究

随着经济的快速发展,人们对于健康饮食的重视程度越来越高,不规律的饮食习惯对人们的身体健康造成了非常严重的影响,而糖尿病也成为了继心脑血管疾病、肿瘤之后的第三大慢性疾病。本文对膳食调节和糖尿病进行了系统分析和综述,介绍了血糖调控食品的研究进展,探讨了未来血糖调控食品的开发方向,以为膳食调节为导向下血糖调控食品开发提供参考。     

Long-term health economic benefits of sensor-augmented pump therapy vs continuous subcutaneous insulin infusion alone in type 1 diabetes: a UK perspective

Aims/hypothesis:

Continuous subcutaneous insulin infusion (CSII) is an important treatment option for type 1 diabetes patients unable to achieve adequate glycemic control with multiple daily injections (MDI). Combining CSII with continuous glucose monitoring (CGM) in sensor-augmented pump therapy (SAP) with a low glucose-suspend (LGS) feature may further improve glycemic control and reduce the frequency of hypoglycemia. A cost-effectiveness analysis of SAP?+?LGS vs CSII plus self-monitoring of blood glucose (SMBG) was performed to determine the health economic benefits of SAP?+?LGS in type 1 diabetes patients using CSII in the UK.

Methods:

Cost-effectiveness analysis was performed using the CORE diabetes model. Treatment effects were sourced from the literature, where SAP?+?LGS was associated with a projected HbA_1c reduction of ?1.49% vs ?0.62% for CSII, and a reduced frequency of severe hypoglycemia. The time horizon was that of patient lifetimes; future costs and clinical outcomes were discounted at 3.5% and 1.5% per annum, respectively.

Results:

Projected outcomes showed that SAP?+?LGS was associated with higher mean quality-adjusted life expectancy (17.9 vs 14.9 quality-adjusted life years [QALYs], SAP?+?LGS vs CSII), and higher life expectancy (23.8 vs 21.9 years), but higher mean lifetime direct costs (GBP 125,559 vs GBP 88,991), leading to an incremental cost-effectiveness ratio (ICER) of GBP 12,233 per QALY gained for SAP?+?LGS vs CSII. Findings of the base-case analysis remained robust in sensitivity analyses.

Conclusions/interpretation:

For UK-based type 1 diabetes patients with poor glycemic control, the use of SAP?+?LGS is likely to be cost-effective compared with CSII plus SMBG.     

诺合龙联合二甲双胍治疗2型糖尿病的疗效分析

为观察诺合龙联合二甲双胍治疗2型糖尿病的临床疗效,对已确诊的34例初治的门诊2型糖尿病患者给予诺合龙和二甲双胍联合治疗6个月。结果为：比较用药前后患者空腹血糖、餐后血糖及糖化血红蛋白的改变,结果均存在统计学意义（P〈0．05）。诺合龙联合二甲双胍治疗2型糖尿病,疗效显著。     

Examining and interpreting responsiveness of the Diabetes Medication Satisfaction measure

Abstract

Objective: Treatment satisfaction (TS) is an important patient reported outcome (PRO) in diabetes as it is correlated with outcomes necessary for optimal treatment (e.g., compliance, self-management behaviour). The objective of this study was to examine the responsiveness of the DiabMedSat, a disease-specific PRO measure, assessing Overall, Burden, Efficacy and Symptom TS.

Methods: The DiabMedSat was included in an open label, observational study of the safety and efficacy of biphasic insulin aspart 30 (NovoMix 30) in routine practice with type 2 diabetes. Responsiveness analyses, examining both internal and external responsiveness, were conducted and minimally important differences (MID) assessed.

Results: In 18,817 patients, all TS scores significantly improved after 26 weeks of treatment (p<0.001). The effect sizes for these changes were above 0.5 indicating that the ability to detect change was moderate-to-large in size. Significant differences were found for all TS scores comparing patients who met their HbA_1c goal, who improved but did not meet goal and who did not improve (p<0.01), and for patients who experienced a minor hypoglycaemic event and those who did not (p<0.001). DiabMedSat scores were able to detect changes in patients’ own global rating of satisfaction (MID ranging from 5.3 to 11.7) and in physician-rated satisfaction with patients’ HbA_1c improvement (MID ranging from 5.3 to 10.2).

Conclusions: In the context of an observational study, the DiabMedSat has been shown to be highly responsive to change and can be considered as an acceptable PRO measure for TS in diabetes.     

糖尿病教育在糖尿病综合治疗中的作用研究

为探讨糖尿病教育对糖尿病患者血糖水平的影响,将已确诊糖尿病的164例门诊患者随机分为观察组和对照组。观察组在对照组药物治疗的基础上增加半年糖尿病教育。观察组82例患者糖尿病相关知识掌握程度良好,血糖控制较对照组有明显改善。糖尿病教育可明显改善糖尿病患者的血糖控制水平。     

心理治疗对2型糖尿病肾病治疗效果的影响

为探讨心理治疗对2型糖尿病肾病(T2DN)治疗效果的影响,选择2型糖尿病肾病患者94例,随机分为对照组和观察组,每组47例。对照组行常规治疗,观察组在对照组的基础上进行相应的心理治疗,6个月后分别检测并分析2组患者的空腹血糖(FPG)、糖化血红蛋白(HbA1C)及24 h尿白蛋白(24hUAlb)水平。结果为:观察组患者FPG、HbA1C及24 hUAlb水平均较对照组明显改善,2组之间比较均存在统计学差异(P<0.05)。心理治疗可提高2型糖尿病肾病的治疗效果。     

膳食纤维生理功能的研究进展

膳食纤维作为一类生物大分子物质,其独特的性质使其在生理代谢过程和预防疾病等方面发挥重要的作用,目前已成为研究热点。本文探讨膳食纤维的主要生理功能,为深入研究与开发利用新型膳食纤维产品而提供参考。     

果葡糖浆的制备方法概述

介绍果葡糖浆的制备方法,以葡萄糖为原料有碱法和葡萄糖异构酶法;以蔗糖为原料有酸法包括常压与加压、蔗糖水解酶法、阳离子树脂法;以菊粉为原料有酸法和酶法,本文还介绍了果葡糖浆的性能,用途等.