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Objective To analyze the use of medical insurance expenses of diabetic patients with osteoarthritis (OA) in Beijing, and to explore the impact of OA on the economic burden of diabetes patients. Methods Diabetic patients aged>16 years with complete outpatient medical records from 2016 to 2018 in Beijing medical insurance were included, excluding those with less than 2 months of follow-up and no prescription records. Information was collected from the Beijing medical insurance database, including the international disease classification of diabetes and its complications and comorbidities, age, sex, disease course, drug (hypoglycemic and non-hypoglycemic drugs) treatment plan, and medical insurance costs. Multivariate regression model was used to control confounding factors, and Wilcoxon rank sum test, χ² test or Fisher exact test were used to compare the differences in various indicators between the patients with diabetes without OA and those with diabetes with OA. Results A total of 2 853 036 diabetic patients were included, of whom 673 251 patients (23.60%) had OA. Stratified by age, the proportion of diabetics with OA was higher in the 45-84 age group, 92.73%, 92.43% and 92.29% in 2016, 2017 and 2018, respectively. According to gender distribution, there were more females in diabetics with OA, 55.17%, 54.41% and 53.37% in 2016, 2017 and 2018, respectively. Compared with diabetics without OA, diabetics with OA had significantly more related to complications and comorbidities (P< 0.001). Compared with diabetics without OA, the total annual drug cost/drug number of diabetics with OA in 2018 was higher at (2 511±2 526) and (2 608±2 155) yuan/drug, respectively, of which the cost/drug number of hypoglycemic drugs and non-hypoglycemic drugs was higher. From 2016 to 2018, the types of drugs for diabetics with OA (especially the types of hypoglycemic drugs) showed an increasing trend year by year, while the total annual drug cost (including hypoglycemic drugs and non-hypoglycemic drugs) showed a decreasing trend, and the total annual drug cost/drug number of medications also showed a decreasing trend. Conclusions Diabetics with osteoarthritis have more diabetes complications and related comorbidities, and require more hypoglycemic drugs and medical expenses. Osteoarthritis significantly increases the medical expenses of diabetics. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between diabetic peripheral neuropathy (DPN) and cognitive impairment in elderly patients with Type 2 diabetes mellitus (T2DM). Methods The elderly T2DM patients (aged 60 to 75 years) hospitalized in the Department of Endocrinology, Beijing Hospital from December 2020 to November 2021 were enrolled in the group sequentially. The patients' medical history, general data and laboratory results were collected, the cognitive function was assessed by mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MOCA) scale, and the body function was evaluated by 4-meter walking speed and standing test on one foot with eyes closed. According to the presence or absence of DPN, patients were divided into DPN group and non-DPN group. Chi-square test, t test or Mann-Whitney U test were used to compare the differences of clinical features between the two groups, and logistic regression analysis was used to analyze the risk factors of cognitive impairment. Results Two hundred and six patients with T2DM were enrolled in the study, including 87 patients in the DPN group (42.2%) and 119 patients in the non-DPN group (57.8%). There were statistically significant differences in gender distribution, smoking history, the level of glycosylated hemoglobin A1c(HbA1c), 2 h postprandial C-peptide, 1, 25 (OH)2-vitamin D3, and standing time on one foot with eyes closed between non-DPN group and DPN group (P<0.05). There were statistically significant differences in MMSE score, MOCA score, memory score and attention score between non-DPN group and DPN group (P<0.05). According to MOCA score, patients were divided into normal cognitive function group (59 cases, 28.6%) and cognitive impairment group (147 cases, 71.4%). The education level, 2 h postprandial C-peptide level, standing time on one foot with eyes closed and 4-meter walking speed in the cognitive impairment group were lower than those in the normal cognitive function group, while the proportion of clinical DPN patients in the cognitive impairment group was higher than that in the normal cognitive function group [50.3% (74/147) and 22.0% (13/59), respectively], and the differences were statistically significant (P<0.05). Logistic regression analysis showed that in elderly patients with T2DM, DPN was a risk factor for cognitive impairment [OR (95%CI) was 3.622 (1.722 to 7.619)]. Educational background [OR (95%CI) was 0.458 (0.247 to 0.849)], 4-meter walking speed [OR (95%CI) was 0.339 (0.151 to 0.762)] and standing time on one foot with eyes closed [(OR (95%CI) was 0.830 (0.698 to 0.987)] were protective factors for cognitive impairment. Conclusions Peripheral neuropathy was associated with cognitive impairment in elderly patients with T2DM, and DPN was a risk factor for cognitive dysfunction. [ABSTRACT FROM AUTHOR]

Objective To compare the effects of exenatide and insulin aspart 30 injection on carotid intima-media thickness (cIMT) in patients with type 2 diabetes mellitus (T2DM) with different baseline characteristics, and to explore the influencing factors of exenatide in improving atherosclerosis (AS). Methods A total of 59 patients with T2DM who were admitted to the Department of Endocrinology of Beijing Hospital from March 10, 2015 to June 20, 2017 were enrolled. The study was designed as a randomized, prospective, parallel positive drug control study. According to the baseline cIMT <1 mm and ≥1 mm, the patients were divided into the following groups: baseline non-atherosclerotic group and baseline atherosclerotic group; according to body mass index (BMI) <24 kg/m2 and ≥24 kg/m2, they were divided into normal weight group, overweight and obesity group; according to the baseline glycosylated hemoglobin A1c (HbA1c)<8.5% and HbA1c≥8.5%, they were divided into general hyperglycemia group and significant hyperglycemia group; according to the decrease of HbA1c<1.5% and HbA1c ≥1.5% at 52th week, the patients were assigned to the general hypoglycemic effect group and the good hypoglycemic effect group. The cIMT was measured. The results of each group were compared by group t test, nonparametric test and χ2 test. Results The prevalence rate of carotid atherosclerosis in patients with T2DM was 64.41% (38/59). After 52 weeks of treatment with exenatide, the cIMT of patients with baseline AS was significantly lower than that of patients without baseline AS (P=0.02). After 52 weeks of treatment with exenatide, the cIMT decreased in overweight and obese subjects, but slightly increased in normal weight subjects, and the difference was not statistically significant (P=0.21). After 52 weeks of treatment, the cIMT decreased in both the general hypoglycemic effect group and the good hypoglycemic effect group, but the difference was not statistically significant (P=0.17). After treatment with exenatide, there was no correlation between cIMT changes and blood glucose, low density lipoprotein cholesterol and BMI changes within 52 weeks (P=0.576, 0.188 and 0.352, respectively). Conclusions In patients with atherosclerosis at baseline, the improvement of cIMT was more significant and the benefit was greater after the administration of exenatide. cIMT levels were not affected by baseline body weight and hypoglycemic efficacy, and had no correlation with BMI and blood glucose changes after exenatide treatment. [ABSTRACT FROM AUTHOR]

Objective To investigate the prevalence of sarcopenia in middle aged and elderly patients with type 2 diabetes (T2DM) and clarify the associated risk factors. Methods From January 2016 to March 2018, 1 125 T2DM patients over 50 years old in endocrinology departments of nine hospitals in Beijing were enrolled in this study with system random sampling method. All patients, including 586 males and 539 females, were grouped into middle aged group (50-59 years), young elderly group (60-74 years) and elderly group (over 75 years) by age. Body composition was measured with bioimpedance analysis. Low muscle mass was defined as the appendicular skeletal muscle mass index below 7.18 kg/m² in men and 5.73 kg/m² in women. Low muscle strength was defined as grip strength below 29.5 kg in men and 21.2 kg in women. Sarcopenia was defined with low muscle mass coexisted with low grip strength. Chi-square test was used to compare the prevalence difference between groups. Multivariate Logistic regression was used for correlation analysis. Results (1) The detection rate of low muscle mass in all participants was 14.0% (157/1 125), which was significantly higher in male than that in female (18.3% vs 9.3%, χ²=18.867, P<0.05). (2) The detection rate of low grip strength in all participants was 36% (405/1 125), which was significantly higher in male than that in female (50.3% vs 20.4%, χ²=109.183, P<0.05). (3) The prevalence of sarcopenia in all participants was 8.5% (96/1 125), which was significantly higher in male than that in female (12.8% vs 3.9%, χ²=28.509, P<0.05). The prevalence of sarcopenia were 4.4%(21/475), 8.9%(49/548), 25.5%(26/102) in middle aged group, young elderly group and elderly group, respectively (χ²=47.984, P<0.05). The sarcopenic prevalence in male was obviously higher than that in female in young elderly and elderly group (χ² = 9.872-16.325, all P<0.05). (4) Logistic regression analysis showed that men, aging, low body mass index (BMI) and high glycated hemoglobin A1c (HbA1c) were risk factors associated with sarcopenia. The risk of sarcopenia increased obviously in patients older than 75 years (OR=4.992, 95%CI: 2.448-10.179) or whose HbA1c was over 10%(OR=3.563, 95%CI:1.526-8.322). Conclusions The risk of low muscle mass and low muscle strength increases in aged and elderly patients with T2DM. Low BMI, aging, high HbA1c were risk factors associated with sarcopenia in elderly patients with T2DM. [ABSTRACT FROM AUTHOR]