scholarly journals Metabolomics-Based Clinical Efficacy and Effect on the Endogenous Metabolites of Tangzhiqing Tablet, a Chinese Patent Medicine for Type 2 Diabetes Mellitus with Hypertriglyceridemia

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Jia Liu ◽  
Ziqiang Li ◽  
Hua Liu ◽  
Xianhua Wang ◽  
Chunxiao Lv ◽  
...  

Tangzhiqing tablet (TZQ) is derived from Tangzhiqing formula, which has been used to regulate glucose and lipid metabolism in China for hundreds of years. However, as a new Chinese patent medicine, its clinical indication is not clear. To explore the clinical indication and effect on the patients with type 2 diabetes mellitus (T2DM), a pilot clinical trial and metabolomics study were carried out. In the clinical study, T2DM patients were divided into three groups and treated with TZQ, placebo, or acarbose for 12 weeks, respectively. The metabolomic study based on UPLC Q-TOF MS was performed including patients with hypertriglyceridemia in TZQ and placebo groups and healthy volunteers. The clinical results showed that TZQ could reduce glycosylated hemoglobin (HbA1c) and fasting insulin. For patients with hypertriglyceridemia in TZQ group, the levels of HbA1c all decreased and were correlated with the baseline level of triglyceride. Metabonomics data showed a significant difference between patients and healthy volunteers, and 17 biomarkers were identified. After 12-week treatment with TZQ, 11 biomarkers decreased significantly (p<0.05), suggesting that TZQ could improve the metabolomic abnormalities in these participants. In conclusion, the clinical indication of TZQ was T2DM with hypertriglyceridemia, and its target was related to glycerophospholipid metabolism.

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Sihan Peng ◽  
Ziyan Xie ◽  
Xiyu Zhang ◽  
Chunguang Xie ◽  
Jian Kang ◽  
...  

Background. Yuquan Pill (YQP), a Chinese patent medicine for the treatment of diabetes, is widely used in the treatment of diabetes and its complications in China. However, the efficacy of YQP on type 2 diabetes mellitus (T2DM) has not been completely assessed. The aim of this study is to evaluate the efficacy and safety of YQP in the treatment of T2DM. Materials and Methods. We systematically searched 9 databases for specific keywords from inception to Oct 2021. We included randomized controlled trials (RCTs) involving YQP in the treatment of T2DM without language limitation. The study conformed to the Cochrane Handbook and Review Manager software was used for data analysis. The weighted mean differences (WMDs) and 95% confidence intervals (CIs) were used to measure treatment effects. Results. The final analysis included 10 publications. Analysis showed that the combination of YQP and conventional treatment was more effective than conventional treatment alone with regard to the levels of fasting blood glucose (WMD = −0.83; 95% CI [−1.01,−0.66]; p < 0.00001 ), two-hour postprandial glucose (WMD = −1.40; 95% CI [−1.49,−1.31]; p < 0.00001 ), glycosylated hemoglobin (WMD = −0.87; 95% CI [−1.26, −0.49]; p < 0.00001 ), total cholesterol (WMD = −0.50; 95% CI [−0.61, −0.39]; p < 0.00001 ), c-reactive protein (WMD = −0.58; 95%CI [−0.88, −0.28]; p = 0.0002 ), and overall effective rate (RR = 1.21; 95% CI [1.12, 1.31]; p < 0.00001 ). Conclusion. Evidence suggested that YQP might improve glucose and lipid metabolism and inflammation in patients with T2DM. Serious adverse events were not reported. The quality of the evidence analyzed was low and therefore our results should be interpreted with caution. More high-quality RCTs are now needed to verify these findings.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Yonghuan Bian ◽  
Changhao Liu ◽  
Zhaojiang Fu

Abstract Background Our study attempted to observe the value of periodontal curettage combined with root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes. Methods There involved 72 patients with type 2 diabetes mellitus complicated with moderate-to-severe chronic periodontitis who were diagnosed and treated in our hospital from January 2019 to December 2019. The patients enrolled were randomly divided into four groups using a computer-generated table: root planing and periodontal curettage combined group (n = 18), root planning group (n = 18), periodontal curettage group (n = 18) and cleansing group (n = 18). Blood glucose, plaque index (PI), gingival index (GI), probing depth (PD), attachment loss (AL), serum levels of inflammatory factors (Tumor Necrosis Factor Alpha [TNF- α] and hypersensitive C-reactive protein [hs-CRP]) were observed before and after treatment. The collecting dates were analyzed by the chi-square χ 2 test, repeated measurement analysis of variance, or t-test according to different data types and research objectives. Results Before treatment, there was no significant difference in PI, GI, PD and AL among the four groups (P> 0.05), while after 3-month treatment, the levels of PI, GI, PD and AL in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, with both root planing group and periodontal curettage group significantly lower than cleansing group (P< 0.05). The fasting blood glucose, 2-h postprandial blood glucose and glycosylated hemoglobin in the combined group, root planing group, periodontal curettage group and cleansing group were significantly lower than those before treatment (P < 0.05). Before treatment, there was no significant difference in TNF- α and hs-CRP among the four groups (P> 0.05), but the levels of TNF- α and hs-CRP in the four groups decreased significantly after 3-month treatment (P< 0.05). The levels of TNF- α and hs-CRP in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, and those in the root planing group and periodontal curettage group were significantly lower than those in the cleansing group (P< 0.05). Conclusion The combination therapy of periodontal curettage and root planing exerted beneficial effects on moderate-to-severe chronic periodontitis in patients with type 2 diabetes mellitus, which holds the potential to maintain the level of blood glucose and improve the quality of life of the patients.


2021 ◽  
Vol 71 (1) ◽  
pp. 24-29
Author(s):  
Rachma Putri Nariswari ◽  
Gwenny Ichsan Prabowo ◽  
Hermina Novida ◽  
Nurina Hasanatuludhhiyah

Introduction: Type 2 diabetes mellitus is caused by decreased tissue sensitivity to insulin. The prevalence of diabetes in the world has almost doubled since 1980, from 4.7% to 8.5% in adult population. Early diagnosis and treatment aimed at normalizing glycemic control are very important. The objective of this study was to evaluate and compare glycemic control of metformin and glimepiride in monotherapy of type 2 diabetes mellitus patients at Islamic Jemursari Hospital Surabaya. Method: This was a retrospective observational study using secondary data (medical record), include glycemic control (RPG) before and two months after receiving therapy of outpatients’ type 2 diabetes mellitus with metformin or glimepiride therapy in 2018. 96 samples were found that fit the inclusion criteria. The data were analyzed by Mann-Whitney test. Result: Most patients were female, aged 50-69 years old, and dosage of metformin therapy 1500 mg/day or glimepiride therapy 2 mg/day. There was no significant difference (p>0.05) of glycemic control (RPG) of metformin compared to glimepiride therapies in type 2 diabetes mellitus patients at Islamic Jemursari Hospital Surabaya in 2018. Conclusion: Metformin and glimepiride were not significantly different in glycemic control (RPG). There were patients with RPG >200 mg/dl after two months of metformin or glimepiride therapy.  


2018 ◽  
Vol 33 (4) ◽  
pp. 175-185 ◽  
Author(s):  
Gerard Marshall Raj ◽  
Jayanthi Mathaiyan ◽  
Mukta Wyawahare ◽  
Rekha Priyadarshini

Abstract Background This work aimed to evaluate the influence of single nucleotide polymorphisms (SNPs) in the SLC47A1 (922-158G>A; rs2289669) and SLC47A2 (−130G>A; rs12943590) genes on the relative change in HbA1c in type 2 diabetes mellitus (T2DM) patients of South India who are taking metformin as monotherapy. It also aims to study the effects of these SNPs on the dose requirement of metformin for glycemic control and the adverse effects of metformin. Methods Diabetes patients on metformin monotherapy were recruited based on the eligibility criteria (n=105). DNA was extracted and genotyping was performed with a real-time PCR system using TaqMan® SNP genotyping assay method. The HbA1c levels were measured using Bio-Rad D-10™ Hemoglobin Analyzer. Results After adjusting for multiple comparisons (Bonferroni correction) the difference found in the glycemic response between the “GG” genotype and “AG/AA” genotype groups of the SLC47A2 gene was not significant (p=0.027; which was greater than the critical value of 0.025). Patients with “GG” genotype showed a 5.5% decrease in HbA1c from baseline compared to those with the “AG/AA” genotype (0.1% increase). The SNP in the SLC47A1 gene also did not influence the glycemic response to metformin (p=0.079). The median dose requirements based on the genotypes of the rs12943590 variant (p=0.357) or rs2289669 variant (p=0.580) were not significantly different. Similarly, there was no significant difference in the occurrence of adverse effects across the genotypes in both the SLC47A1 (p=0.615) and SLC47A2 (p=0.309) genes. Conclusions The clinical response to metformin was not associated with the SNPs in the SLC47A1 and SLC47A2 genes coding for the multidrug and toxin extrusion protein (MATE) transporters. Furthermore, the studied SNPs had no influence on the dose requirement or adverse effects of metformin.


2021 ◽  
Vol 3 (3) ◽  
Author(s):  
Lamia Oulkadi ◽  
Bouchra Amine ◽  
Imane El binoune ◽  
Samira Rostom ◽  
Rachid Bahiri

Type 2 diabetes mellitus (T2DM) and osteoporosis are chronic diseases with increasing prevalence. The aim of this study was to determine the prevalence of osteoporosis and osteoporotic fracture in women with T2DM and to identify predictive factors of fracture occurrence. The prevalence of osteoporosis and fractures in postmenopausal women with T2DM was 23.1% and 16.9%, respectively. 46.2% of T2DM patients had normal bone mineral density (BMD) (P<0.01) and 58.5% of control subjects had osteopenia (P<0.01). Incidence of fracture in T2DM patients with osteopenia was significantly increased versus control subjects when stratified according the BMD (P=0.009). By stratifying T2DM patients according to fractures, factors that were significantly associated with occurrence included T2DM duration (P=0.038), use of insulin (P=0.017), and lower BMD (P=0.048). Our study suggests that there was a higher prevalence of fracture in T2DM patients compared to control subjects and a significant difference in BMD was found between the groups. We also showed that insulin use, low BMD, and long duration of T2DM are factors associated with an increased risk of bone fracture.


2015 ◽  
Vol 7 (1) ◽  
pp. 1-6
Author(s):  
Kyuzi Kamoi

Previous longitudinal studies have demonstrated that blood pressure measurements at home (HBP) in the wakening- up display stronger predictive power for death, and vascular complications in patients with type 2 diabetes mellitus (T2DM) than clinic blood pressure measurements (CBP). The leading cause of death was cancer. Patients with T2DM have associated with cancer, and high CBP is a risk factor for cancer. Therefore, this study investigated whether HBP or CBP is related to cancer event in patients with T2DM for 10 years. At baseline, 400 Japanese patients with T2DM were classified as hypertensive (HT) or normotensive (NT) based on HBP and CBP. Mean (± SD) duration was 95 ± 35 months. Primary and secondary endpoints were death and cancer, respectively. Differences in outcome between HT and NT were analyzed using survival curves from Kaplan-Meier analysis and log-rank testing. Associated risk factors were assessed using Cox proportional hazards. On basis of HBP, death and event of cancer were significantly higher in HT than in NT. The leading cause of death was cancer. On basis of CBP, there was no significant difference in the incidence of death and event of cancer between patients with HT and NT at baseline. Associated risk factor for cancer was T2DM. Home morning HT may be reflected more keenly state of cancer than clinic HT, which may be superior to clinic NT. When we meet with such patients, it is important that cancer may be one of many causes for morning HT in Japanese patients with T2DM.


2012 ◽  
Vol 56 (5) ◽  
pp. 285-290 ◽  
Author(s):  
Serdal Korkmaz ◽  
Abdulkerim Yilmaz ◽  
Gürsel Yildiz ◽  
Fatih Kiliçli ◽  
Serhat Içağasioğlu

OBJECTIVE: The rate of reduction of nocturnal blood pressure (NBP) is lesser than normal in patients with type 2 diabetes mellitus (type 2 DM). Hyperhomocysteinemia (HHC) disrupts vascular structure and function, no matter the underlying causes. The risk of development of vascular disease is greater in diabetic patients with hyperhomocysteinemia than in patients with normal homocystein levels. The aim of the study was to investigate whether there are differences of homocystein levels in dipper and non-dippers patients with type 2 DM. SUBJECTS AND METHODS: We compared 50 patients (33 females, 17 males) with type 2 DM and 35 healthy individuals (18 females, 17 males ) in a control group. Ambulatory blood pressure monitoring (ABPM) was performed and homocysteine levels were measured in all patients. RESULTS: We found that the percentage of non-dipper pattern was 72% in patients with type 2 DM and 57% in control group. In diabetic and control individuals, homocystein levels were higher in non-dipper (respectively 13.4 ± 8.1 µmol/L and 11.8 ± 5 µmol/L) than in dipper subjects (respectively, 11.8 ± 5.8 µmol/L and 10.1 ± 4.2 µmol/L), but there was no significant difference between the two groups (respectively, p = 0.545, p = 0.294). CONCLUSION: In both groups, homocystein levels were higher in non-dipper than in dipper participants, but there was no significant difference between the groups. High homocystein levels and the non-dipper pattern increases cardiovascular risk. Therefore, the relationship between nocturnal blood pressure changes and homocystein levels should be investigated in a larger study.


2020 ◽  
Vol 76 (1) ◽  
pp. 62-72
Author(s):  
Yuki Nishida ◽  
Shigeho Tanaka ◽  
Satoshi Nakae ◽  
Yosuke Yamada ◽  
Katsutaro Morino ◽  
...  

Introduction: Evaluation of total energy expenditure (TEE) and physical activity level (PAL) is important for treatment of patients with type 2 diabetes mellitus (T2DM). However, the validity of accelerometers (ACC) and physical activity questionnaires (PAQ) for estimating TEE and PAL remains unknown in elderly populations with T2DM. We evaluated the accuracy of TEE and PAL results estimated by an ACC (TEEACC and PALACC) and a PAQ (TEEPAQ and PALPAQ) in elderly patients with T2DM. Methods: Fifty-one elderly patients with T2DM (aged 61–79 years) participated in this study. TEEACC was calculated with PALACC using a triaxial ACC (Active style Pro HJA-750c) over 2 weeks and predicted basal metabolic rate (BMR) by Ganpule’s equation. TEEPAQ was estimated using predicted BMR and the PALPAQ from the ­Japan Public Health Center Study-Long questionnaire. We compared the results to TEEDLW measured with the doubly labeled water (DLW) method and PALDLW calculated with BMR using indirect calorimetry. Results: TEEDLW was 2,165 ± 365 kcal/day, and TEEACC was 2,014 ± 339 kcal/day; TEEACC was strongly correlated with TEEDLW (r = 0.87, p < 0.01) but significantly underestimated (–150 ± 183 kcal/day, p < 0.05). There was no significant difference in TEEPAQ and TEEDLW (–49 ± 284 kcal/day), while the range of difference seemed to be larger than TEEACC. PALDLW, PALACC, and PALPAQ were calculated to be 1.71 ± 0.17, 1.69 ± 0.16, and 1.78 ± 0.24, respectively. ­PALACC was strongly correlated with PALDLW (r = 0.71, p < 0.01), and there was no significant difference between the 2 values. PALPAQ was moderately correlated with PALDLW (r = 0.43, p < 0.01) but significantly overestimated. Predicted BMR was significantly lower than the BMR ­measured by indirect calorimetry (1,193 ± 186 vs. 1,262 ± 155 kcal/day, p < 0.01). Conclusions: The present ACC and questionnaire showed acceptable correlation of TEE and PAL compared with DLW method in elderly patients with T2DM. Systematic errors in estimating TEE may be improved by the better equation for predicting BMR.


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