Search

The effects of the selective estrogen-receptor modulator raloxifene on glycemic control and the lipid profile had not previously been identified in osteoporotic postmenopausal Asian women with diabetes. The purpose of this study was to clarify the effect of raloxifene on diabetes control and lipid metabolism in postmenopausal Japanese women with high levels of urinary NTx and type 2 diabetes. Thirty seven postmenopausal female patients (mean age: 67.3 yrs) with osteoporosis and type 2 diabetes underwent 1-year 60 mg/day treatment. All patients took the same amount of medicine for diabetes or hyperlipidemia treatment for 1 year. The lipid profile (T-cho, HDL-cho, T-G, LDL-cho), glycated hemoglobin (HbA1c), and urinary NTx were assessed. Raloxifene decreased the levels of urinary NTx from 58.5 +/- to 46.7 pmol/µmol. Cr (p=0.024). Concerning the lipid profiles, raloxifene led to a significant increase in the levels of HDL-cho from 52.2 +/- 2.5 to 61.8 +/- 4.3 mg/dl (p=0.001) and a decrease in the level of LDL-cho from 119.2 +/- 5.0 to 102.7 +/- 4.3 mg/dl (p=0.034). There was no significant change in triglycerides from 119.8 +/- 11.1 to 111.7 +/- 11.7 mg/dl (p=0.445). In addition, the mean levels of HbA1c were significantly decreased from 7.0 +/- 0.17 to 6.6 +/- 0.10% (p=0.037) after 1-year treatment. In conclusion, 1-year treatment of raloxifene favorably altered a bone biomarker of osteoblast by decreasing urinary NTx. Moreover, raloxifene favorably affected not only the lipid profile but also glycemic control in Japanese women with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Elevated urine albumin excretion (UAE) in type 2 diabetes increases the risk of renal and cardiovascular disease. The angiotensin II receptor blocker valsartan reduces UAE in type 2 diabetes subjects, but whether this effect is dose-dependent or not still remains unclear. In this study, we investigated the importance of valsartan dosing in reducing UAE. The study comprised 26 patients with hypertensive (blood pressure > 140/90mmHg) type 2 diabetes (12 men and 14 women; mean aged: 64.5 +/- 10.9 years) treated with 80 mg/day of valsartan for at least 3 months (administration period: 15.9 +/- 12.5 months). A dose of 160 mg of valsartan was administered instead of 80 mg for 6 months. Blood pressure, UAE, the glomular filtration ratio (calculated by MDRD formula), and HbA1c were determined. After 6 months of valsartan therapy, a significant decrease was observed in the blood pressure (systolic blood pressure: from 161 +/- 15 to 142 +/- 12 mmHg, diastolic blood pressure: from 88 +/- 14 to 75 +/- 12 mmHg (p<0.001)). Mean UAE was decreased from 115.1 +/- 181.6 to 85.6 +/- 130.2 mg/g. Cr (p value of log function = 0.025). In addition, a significant decrease was observed in UAE of the subgroup of patients displaying slightly low GFR levels (60∼90ml/min, n=7), from 182 +/- 242 to 129 +/- 173 mg/g.Cr (p value of log function = 0.048). Moreover, the decreasing UAE was not associated with reduced blood pressure. Neither glycemic controls nor lipid profiles were significantly changed. In conclusion, higher dose of valsartan was found to exhibit a significant protection against renal dysfunction, especially in type2 diabetes patients with only slight renal dysfunction. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate the effectiveness of reeducation in the insulin injection technique in glycemic controls. A pretest experimental study was performed with 87 insulin-treated diabetic outpatients (11 with type 1 and 76 with type 2 diabetes; 43 men and 44 women). All patients were treated with insulin for more than 3 years. After answering questions about the insulin injection technique (kind of insulin, timing, dose preparation, needle, suspension, bubble escape, disinfection, storage, injection site, injection time), the knowledge levels of patients were scored. Afterwards, correct answers and explanation sheest were given to all patients. In addition, physicians in charge gave a short lecture and advice for 10 minutes individually. Four months after reeducation, HbA1c and glycoalbumin were measured. For all patients, the mean HbA1c levels improved from 6.94 to 6.28% (p<0.05) and mean glycoalbumin levels improved from 22.76 to 19.73% (p<0.05). The 28 patients with a good understanding whose scores were more than 12 points showed a slight decrease in HbA1c from 6.78 to 6.39% (p=0.07). The 38 patients with a medium understanding (scores from 10 to 11 points) showed a significant decrease in HbA1c from 7.0 to 6.21% (p<0.05). In addition, the 21 patients with a poor understanding whose scores were below 9 points showed a significant decrease in HbA1c from 7.03 to 6.26% (p<0.01). In conclusion, reeducation in the insulin injection technique led to an improvement in glycemic control in insulin-treated diabetes patients, especially in those with a poor understanding of the insulin injection technique. More attention should be paid to these strategies in outpatients. [ABSTRACT FROM AUTHOR]