BACKGROUND:Hyperglycemia has been detected in many critically ill patients in the department of emergency medicine.But its mechanism and prognosis have not been well elucidated.In this study,we measured the serum leve...BACKGROUND:Hyperglycemia has been detected in many critically ill patients in the department of emergency medicine.But its mechanism and prognosis have not been well elucidated.In this study,we measured the serum level of glycated hemoglobin A1C(HbA1c) in critically ill patients to evaluate the effects of hyperglycemia on the prognosis of the patients.METHODS:A total of 826 critically ill patients,who had been treated at the Department of Emergency Medicine of Chaoyang Hospital during October 2006 and November 2007,were divided into a diabetes mellitus group(n=184) and a non-diabetes mellitus group(642) according to whether they had diabetes mellitus.Fasting glucose and HbA1 c were measured in all patients.Those in the diabetes mellitus group were further assigned to a drug therapy subgroup and a non-drug therapy subgroup;the serum level of HbA1 c and its relationship with short-term outcome were evaluated.RESULTS:Fasting glucose increased in 78.8% of the patients(88.6%in the diabetes mellitus group,and 75.9%in the non-diabetes mellitus group,P<0.05),and HbA1 c was elevated in 45.5% of the patients(78.3% in the diabetes mellitus group,and 36.1%in the non-diabetes mellitus group,P<0.01).Fasting glucose,HbA1 c and 28-day mortality were improved more significantly(P<0.01) in the drug therapy subgroup than in the non-drug therapy subgroup.The 28-day mortality was more significantly different in patients with fasting blood glucose >8.33 mmol/L than in those with fasting blood glucose <8.33 mmol/L.CONCLUSIONS:Hyperglycemia of critically ill patients could not totally attribute to stress response,especially in those who have no history of diabetes mellitus.Prognosis of hyperglycemia may vary among critically ill patients.展开更多
Objective： To investigate the effects of health education based on integrative therapy of Chinese and Western medicine for type 2 diabetes mellitus（T2DM） from the aspects of knowledge, attitude and practice（KAP）,...Objective： To investigate the effects of health education based on integrative therapy of Chinese and Western medicine for type 2 diabetes mellitus（T2DM） from the aspects of knowledge, attitude and practice（KAP）, health-related quality of life（HRQo L）, body mass index（BMI） and glucose control. Methods： Patients were individually randomized into intervention group（receiving integrative education, n=120） and control group（receiving usual education, n=120）. The primary outcome was the changes in glycosylated hemoglobin A1c（HbA1c） levels after 3, 6, 9 and 12 months from baseline. Hierarchical linear models（HLMs） were used to assess within-group changes in outcomes over time and between-group differences in patterns of change. Secondary outcomes were KAP scores, HRQo L scores and BMI after 6 and 12 months, paired-sample t test was used to assess within-group changes in outcomes in 6 and 12 months, independent-sample t test was used to assess between-group differences in patterns of change. Results： HbA1c decreased statistically from baseline to 3 months, from 3 to 6 months, from 6 to 9 months and from 9 to 12 months in the intervention group（all P〈0.01）; and decreased significantly from baseline to 3 months, and from 3 to 6 months in the control group（P〈0.01）. There were significant between-group differences from baseline to 3 months（P=0.044）, from 6 to 9 months（P〈0.01） and from 9 to 12 months（P〈0.01）. Significant improvements in the intervention group along with significant between-group differences were found in KAP and HRQo L scores respectively（all P〈0.05）. The number in the intervention group of normal weight increased from 56 at baseline to 81（6 months）, 94（12 months）, the number in the control group were 63（baseline）, 69（6 months）, 70（12 months）, the χ~2 of hierarchical analysis of BMI were 6.93（P=0.075）, 10.31（P=0.016）, 15.53（P〈0.01）, respectively. Conclusion： Health education based on integrative therapy of Chinese and Western medicine is beneficial to the control of T2DM and should be recommended for T2DM.展开更多
文摘BACKGROUND:Hyperglycemia has been detected in many critically ill patients in the department of emergency medicine.But its mechanism and prognosis have not been well elucidated.In this study,we measured the serum level of glycated hemoglobin A1C(HbA1c) in critically ill patients to evaluate the effects of hyperglycemia on the prognosis of the patients.METHODS:A total of 826 critically ill patients,who had been treated at the Department of Emergency Medicine of Chaoyang Hospital during October 2006 and November 2007,were divided into a diabetes mellitus group(n=184) and a non-diabetes mellitus group(642) according to whether they had diabetes mellitus.Fasting glucose and HbA1 c were measured in all patients.Those in the diabetes mellitus group were further assigned to a drug therapy subgroup and a non-drug therapy subgroup;the serum level of HbA1 c and its relationship with short-term outcome were evaluated.RESULTS:Fasting glucose increased in 78.8% of the patients(88.6%in the diabetes mellitus group,and 75.9%in the non-diabetes mellitus group,P<0.05),and HbA1 c was elevated in 45.5% of the patients(78.3% in the diabetes mellitus group,and 36.1%in the non-diabetes mellitus group,P<0.01).Fasting glucose,HbA1 c and 28-day mortality were improved more significantly(P<0.01) in the drug therapy subgroup than in the non-drug therapy subgroup.The 28-day mortality was more significantly different in patients with fasting blood glucose >8.33 mmol/L than in those with fasting blood glucose <8.33 mmol/L.CONCLUSIONS:Hyperglycemia of critically ill patients could not totally attribute to stress response,especially in those who have no history of diabetes mellitus.Prognosis of hyperglycemia may vary among critically ill patients.
基金Supported by the National Natural Science Foundation of China(No.30873256)
文摘Objective： To investigate the effects of health education based on integrative therapy of Chinese and Western medicine for type 2 diabetes mellitus（T2DM） from the aspects of knowledge, attitude and practice（KAP）, health-related quality of life（HRQo L）, body mass index（BMI） and glucose control. Methods： Patients were individually randomized into intervention group（receiving integrative education, n=120） and control group（receiving usual education, n=120）. The primary outcome was the changes in glycosylated hemoglobin A1c（HbA1c） levels after 3, 6, 9 and 12 months from baseline. Hierarchical linear models（HLMs） were used to assess within-group changes in outcomes over time and between-group differences in patterns of change. Secondary outcomes were KAP scores, HRQo L scores and BMI after 6 and 12 months, paired-sample t test was used to assess within-group changes in outcomes in 6 and 12 months, independent-sample t test was used to assess between-group differences in patterns of change. Results： HbA1c decreased statistically from baseline to 3 months, from 3 to 6 months, from 6 to 9 months and from 9 to 12 months in the intervention group（all P〈0.01）; and decreased significantly from baseline to 3 months, and from 3 to 6 months in the control group（P〈0.01）. There were significant between-group differences from baseline to 3 months（P=0.044）, from 6 to 9 months（P〈0.01） and from 9 to 12 months（P〈0.01）. Significant improvements in the intervention group along with significant between-group differences were found in KAP and HRQo L scores respectively（all P〈0.05）. The number in the intervention group of normal weight increased from 56 at baseline to 81（6 months）, 94（12 months）, the number in the control group were 63（baseline）, 69（6 months）, 70（12 months）, the χ~2 of hierarchical analysis of BMI were 6.93（P=0.075）, 10.31（P=0.016）, 15.53（P〈0.01）, respectively. Conclusion： Health education based on integrative therapy of Chinese and Western medicine is beneficial to the control of T2DM and should be recommended for T2DM.
