48 results on '"Guo, Lixin"'
Search Results
2. Acetyllevocarnitine Hydrochloride for the Treatment of Diabetic Peripheral Neuropathy: A Phase 3 Randomized Clinical Trial in China.
- Author
-
Guo, Lixin, Pan, Qi, Cheng, Zhifeng, Li, Zhiyong, Jiang, Hongwei, Zhang, Fang, Li, Yufeng, Qiu, Wei, Lu, Song, Tian, Junhang, Fu, Yanqin, Li, Fangqiong, and Li, Danqing
- Subjects
- *
DIABETIC neuropathies , *TYPE 2 diabetes , *CLINICAL trials , *MEDIAN nerve , *DIABETES complications , *URINARY tract infections - Abstract
Diabetic peripheral neuropathy (DPN) is a highly prevalent chronic complication in type 2 diabetes (T2D) for which no effective treatment is available. In this multicenter, randomized, double-blind, placebo-controlled phase 3 clinical trial in China, patients with T2D with DPN received acetyllevocarnitine hydrochloride (ALC; 1,500 mg/day; n = 231) or placebo (n = 227) for 24 weeks, during which antidiabetic therapy was maintained. A significantly greater reduction in modified Toronto clinical neuropathy score (mTCNS) as the primary end point occurred in the ALC group (−6.9 ± 5.3 points) compared with the placebo group (−4.7 ± 5.2 points; P < 0.001). Effect sizes (ALC 1.31 and placebo 0.85) represented a 0.65-fold improvement in ALC treatment efficacy. The mTCNS values for pain did not differ significantly between the two groups (P = 0.066), whereas the remaining 10 components of mTCNS showed significant improvement in the ALC group compared with the placebo group (P < 0.05 for all). Overall results of electrophysiological measurements were inconclusive, with significant improvement in individual measurements limited primarily to the ulnar and median nerves. Incidence of treatment-emergent adverse events was 51.2% in the ALC group, among which urinary tract infection (5.9%) and hyperlipidemia (7.9%) were most frequent. Article Highlights: The prevalence of diabetic peripheral neuropathy (DPN) in adults with diabetes is ∼50%, with clinical manifestations of burning, tingling, pain, and progressive numbness. Carnitine insufficiency is associated with increased risk of type 2 diabetes complications, and carnitine therapy reduces fasting plasma glucose and hemoglobin A1c concentrations. Adult patients with DPN were treated with acetyllevocarnitine hydrochloride (ALC) orally while receiving concomitant antidiabetic therapy, which resulted in improved modified Toronto clinical neuropathy scores. Dietary ALC supplementation provides at least some incremental improvement in DPN-related symptoms. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
3. Guideline for the Management of Diabetes Mellitus in the Elderly in China (2024 Edition).
- Author
-
Guo, Lixin and Xiao, Xinhua
- Subjects
DIAGNOSIS of diabetes ,TREATMENT of chronic kidney failure ,MENTAL illness risk factors ,HYPOGLYCEMIA treatment ,TUMOR risk factors ,TREATMENT of diabetes ,DIABETES complications ,DIABETES prevention ,DRUG therapy for hyperlipidemia ,INSULIN therapy ,HYPERGLYCEMIA treatment ,COGNITION disorder risk factors ,HEART failure risk factors ,ATHEROSCLEROSIS risk factors ,TREATMENT of diabetic neuropathies ,INFECTION risk factors ,MEDICAL protocols ,LIFESTYLES ,METFORMIN ,GLUCAGON-like peptide-1 agonists ,COMBINATION drug therapy ,RISK assessment ,OSTEOPENIA ,IMMUNIZATION ,TYPE 1 diabetes ,CHINESE medicine ,THIAZOLIDINEDIONES ,SKIN diseases ,PALLIATIVE treatment ,MEDICAL technology ,PROFESSIONAL associations ,CLINICAL medicine research ,EXERCISE therapy ,ENZYME inhibitors ,HYPERTENSION ,SMOKING ,REGULATION of body weight ,FRAIL elderly ,DISEASE management ,GOAL (Psychology) ,HYPOGLYCEMIC agents ,DECISION making ,CARDIOVASCULAR diseases risk factors ,EYE diseases ,POLYPHARMACY ,HOSPITALS ,HOME environment ,INSULIN pumps ,LACTIC acidosis ,ORAL diseases ,NURSING care facilities ,INJECTIONS ,AGING ,MEDICAL research ,GERIATRIC assessment ,SODIUM-glucose cotransporter 2 inhibitors ,POLYNEUROPATHIES ,SLEEP apnea syndromes ,EVIDENCE-based medicine ,HEALTH education ,INSULIN secretagogues ,MEDICAL screening ,PLATELET aggregation inhibitors ,AUTONOMIC nervous system diseases ,DIABETES ,COMMITTEES ,DIET therapy ,PREVENTIVE health services ,COMORBIDITY ,SARCOPENIA ,ACCIDENTAL falls ,HYPOTENSION ,SLEEP disorders ,PERIOPERATIVE care ,BLOOD sugar monitoring ,DISEASE risk factors ,DISEASE complications ,SYMPTOMS - Abstract
With the deepening of aging in China, the prevalence of diabetes in older people has increased noticeably, and standardized diabetes management is critical for improving clinical outcomes of diabetes in older people. In 2021, the National Center of Gerontology, Chinese Society of Geriatrics, and Diabetes Professional Committee of Chinese Aging Well Association organized experts to write the first guideline for diabetes diagnosis and treatment in older people in China, the Guideline for the Management of Diabetes Mellitus in the Elderly in China (2021 Edition). The guideline emphasizes that older patients with diabetes are a highly heterogeneous group requiring comprehensive assessment and stratified and individualized management strategies. The guideline proposes simple treatments and de‐intensified treatment strategies for older patients with diabetes. This edition of the guideline provides clinicians with practical and operable clinical guidance, thus greatly contributing to the comprehensive and full‐cycle standardized management of older patients with diabetes in China and promoting the extensive development of clinical and basic research on diabetes in older people and related fields. In the past 3 years, evidence‐based medicine for older patients with diabetes and related fields has further advanced, and new treatment concepts, drugs, and technologies have been developed. The guideline editorial committee promptly updated the first edition of the guideline and compiled the Guideline for the Management of Diabetes Mellitus in the Elderly in China (2024 Edition). More precise management paths for older patients with diabetes are proposed, for achieving continued standardization of the management of older Chinese patients with diabetes and improving their clinical outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
4. Safety and effectiveness of dulaglutide in Chinese adults with type 2 diabetes mellitus in a real‐world setting: A prospective, observational post‐marketing study.
- Author
-
Guo, Lixin, Li, Li, Yu, Qiurong, Wang, Na, Chen, Jun, Xi, Yue, Wang, Huan, Wang, Yihua, and Xu, Jiawei
- Subjects
- *
TYPE 2 diabetes , *GLUCAGON-like peptide-1 receptor , *GLUCAGON-like peptide-1 agonists , *TERMINATION of treatment - Abstract
Aim: To our knowledge, this is the first real‐world study to investigate the safety and effectiveness of a glucagon‐like peptide‐1 receptor agonist in Chinese patients with type 2 diabetes mellitus (T2DM). Materials and Methods: This prospective, observational, post‐marketing study conducted at 46 hospitals in China included adults with T2DM prescribed dulaglutide in routine clinical practice. The primary endpoint was the incidence of treatment‐emergent adverse events (TEAEs) and serious AEs in patients who received ≥1 dose of dulaglutide, for up to 24 weeks. Exploratory endpoints included changes in patient‐reported glycated haemoglobin (HbA1c) and body weight. Post hoc analyses and multivariate regression were also performed. Results: From 20 January 2020 to 24 November 2021, 3291 patients received dulaglutide and entered the safety analysis. TEAEs were reported in 1333 (40.5%) patients; the most commonly reported were nausea (n = 193, 5.9%), diarrhoea (n = 183, 5.6%) and decreased appetite (n = 179, 5.4%). serious AEs were reported in 160 (4.9%) patients. TEAEs led to treatment discontinuation in 212 (6.4%) patients. The mean absolute change in HbA1c from baseline to week 24 was −1.65% (p <.001). Greater reductions in HbA1c at week 24 were observed in patients with T2DM duration ≤5 years (p =.002), baseline HbA1c ≥8.5% (p <.001), and without atherosclerotic cardiovascular disease (p =.002). The mean absolute change in body weight from baseline at week 24 was −2.62 kg (p <.001). Conclusion: Dulaglutide showed a safety profile consistent with previous reports and significantly reduced HbA1c in a real‐world setting. These findings support the clinical use of dulaglutide and inform the individualized treatment of patients with T2DM in China. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
5. Evaluating the long-term cost-effectiveness of fixed-ratio combination insulin degludec/liraglutide (IDegLira) versus other treatment regimens in the chinese type 2 diabetes patients.
- Author
-
Wei, Ran, Wang, Weihao, Huang, Xiusheng, Qiao, Jingtao, Huang, Jinghe, Xing, Chang, Pan, Qi, and Guo, Lixin
- Subjects
TYPE 2 diabetes ,LIRAGLUTIDE ,PEOPLE with diabetes ,COST effectiveness ,RENMINBI - Abstract
Background and aims: To assess the cost-effectiveness of utilizing IDegLira in comparison to other treatment regimens (liraglutide and degludec) in managing type 2 diabetes, taking into account the Chinese healthcare system's perspective. Methods: The clinical data were obtained from the randomized controlled trials (RCTs) of the DUAL I and DUAL II evidence studies that took place in China. To estimate the lifetime quality-adjusted life-years (QALYs) and direct medical costs of patients receiving different treatment strategies from a long-term perspective, the IQVIA CORE Diabetes Model version 9.0 (IQVIA, Basel, Switzerland) was utilized. The costs were evaluated from the perspective of the China National Health System. Future costs and clinical benefits were discounted annually at 5%, and sensitivity analyses were conducted. Results: IDegLira was projected to reduce the incidence of diabetes-related complications and improve quality-adjusted life expectancy (QALE) versus liraglutide and degludec. A survival benefit was observed with IDegLira over Liraglutide (0.073 years). Lifetime costs were lower by Chinese yuan (CNY) 27,945 on IDegLira than on Liraglutide therapy. A similar survival benefit was observed with IDegLira over degludec (0.068 years). Lifetime costs were lower by CNY 1196 on IDegLira than on degludec therapy. Therefore, IDegLira was found to be cost-effective versus liraglutide and degludec with incremental cost-effectiveness ratios of Dominant per QALY gained, respectively, under the threshold of three times the gross domestic product (GDP) per capita in China. Conclusion: IDegLira is a cost-effective hypoglycemic treatment option that delivers positive clinical outcomes while also reducing costs for Chinese patients living with type 2 diabetes. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
6. Prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy in adults with diabetes in China.
- Author
-
Hou, Xuhong, Wang, Limin, Zhu, Dalong, Guo, Lixin, Weng, Jianping, Zhang, Mei, Zhou, Zhiguang, Zou, Dajin, Ji, Qiuhe, Guo, Xiaohui, Wu, Qiang, Chen, Siyu, Yu, Rong, Chen, Hongli, Huang, Zhengjing, Zhang, Xiao, Wu, Jiarui, Wu, Jing, Jia, Weiping, and for the China National Diabetic Chronic Complications (DiaChronic) Study Group
- Subjects
DIABETIC retinopathy ,LOW vision ,LDL cholesterol ,INCOME ,VISION disorders ,DIABETES - Abstract
The current epidemic status of diabetic retinopathy in China is unclear. A national prevalence survey of diabetic complications was conducted. 50,564 participants with gradable non-mydriatic fundus photographs were enrolled. The prevalence rates (95% confidence intervals) of diabetic retinopathy and vision-threatening diabetic retinopathy were 16.3% (15.3%–17.2%) and 3.2% (2.9%–3.5%), significantly higher in the northern than in the southern regions. The differences in prevalence between those who had not attained a given metabolic goal and those who had were more pronounced for Hemoglobin A1c than for blood pressure and low-density lipoprotein cholesterol. The participants with vision-threatening diabetic retinopathy had significantly higher proportions of visual impairment and blindness than those with non-vision-threatening diabetic retinopathy. The likelihoods of diabetic retinopathy and vision-threatening diabetic retinopathy were also associated with education levels, household income, and multiple dietary intakes. Here, we show multi-level factors associated with the presence and the severity of diabetic retinopathy. Current data on the national distribution of diabetic retinopathy (DR) is lacking. Here, the authors show the national distribution, associated multi-level factors, and visual impairment of DR and vision-threatening DR in Chinese adults with diabetes. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
7. A multicentre, prospective, non-interventional study evaluating the safety of dapagliflozin in patients with type 2 diabetes in routine clinical practice in China (DONATE).
- Author
-
Guo, Lixin, Wang, Jing, Li, Li, Yuan, Lin, Chen, Sheng, Wang, Hui, Li, Tonghuan, Qi, Lin, and Yang, Hong
- Subjects
- *
TYPE 2 diabetes , *GENITALIA infections , *PATIENT safety , *URINARY tract infections , *DIABETIC acidosis , *BLOOD sugar , *POLYURIA - Abstract
Background: There are few large-scale studies evaluating the safety of the sodium-glucose cotransporter-2 inhibitor, dapagliflozin, in Chinese patients with type 2 diabetes. DONATE, a multicentre, single-arm, prospective, non-interventional study, is the first real-world study evaluating the safety of dapagliflozin in Chinese patients with type 2 diabetes in routine clinical practice. Methods: Between August 2017 and July 2020, patients with type 2 diabetes who had initiated dapagliflozin therapy and received ≥1 dose were prospectively recruited from 88 hospitals in China. Patients were subsequently followed up for 24 weeks; if patients discontinued dapagliflozin they were followed up for an additional 7 days after treatment discontinuation. The primary outcome was the proportion of patients with adverse events and serious adverse events, particularly key adverse events of special interest (AESI) including urinary tract infection, genital tract infection (typical symptoms with or without microbiological diagnosis) and hypoglycaemia (typical symptoms with or without blood glucose ≤3.9 mmol/L, or blood glucose ≤3.9 mmol/L without symptoms). Exploratory outcomes included the absolute change in metabolic parameters and the proportion of patients with other AESI including volume depletion, abnormal blood electrolytes, polyuria, renal impairment, diabetic ketoacidosis, hepatic impairment and haematuria. Results: A total of 3000 patients were enrolled, of whom 2990 (99.7%) were included in the safety analysis set. Mean (SD) age was 52.6 (12.0) years, and 65.8% of patients were male. Mean (SD) duration of type 2 diabetes at enrolment was 8.4 (7.1) years. Mean (SD) treatment duration of dapagliflozin was 209.1 (157.6) days. Adverse events were reported in 35.4% (n = 1059) of patients during the 24-week follow-up period. Overall, 9.0% (n = 268) were related to treatment and 6.2% (n = 186) were serious. Urinary tract infection, genital tract infection and hypoglycaemia were reported in 2.3% (n = 70), 1.3% (n = 39) and 1.1% (n = 32) of patients, respectively. The proportion of patients with other AESI was also low: polyuria (0.7%; n = 21), volume depletion (0.3%; n = 9), renal impairment (0.3%; n = 8), hepatic impairment (0.2%; n = 7), haematuria (0.2%; n = 6) and diabetic ketoacidosis (0.1%; n = 2). Conclusions: This study demonstrated that once-daily dapagliflozin was well tolerated in Chinese patients with type 2 diabetes and the overall safety profile of dapagliflozin in clinical practice in China was consistent with that reported in clinical trials. Trial registration: ClinicalTrials.gov, NCT03156985. Registered on 16 May, 2017. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
8. A new, alternative risk score for sarcopenia in Chinese patients with type 2 diabetes mellitus.
- Author
-
He, Qinghua, Wang, Xiuzhi, Yang, Caizhe, Zhuang, Xiaoming, Yue, Yanfen, Jing, Hongjiang, Hu, Jing, Sun, Mingxiao, and Guo, Lixin
- Subjects
DISEASE risk factors ,TYPE 2 diabetes ,SARCOPENIA ,CHINESE people ,RECEIVER operating characteristic curves - Abstract
Objective: To develop a new, alternative sarcopenia risk score to screen for sarcopenia in type 2 diabetes patients in China and to demonstrate its validity. Research design and methods: The data for this study came from a multicenter, cross-sectional study that had been designed to estimate the prevalence of sarcopenia among adults with type 2 diabetes and had been conducted in several hospitals in Beijing, China. A total of 1125 participants were randomly divided into two groups: an exploratory population and a validation population. A multivariable logistic regression model using the backward stepwise likelihood ratio method to estimate the probability of sarcopenia was fitted with candidate variables in the exploratory population. A new, alternative sarcopenia risk score was developed based on the multivariable model. The internal and external validations were performed in the exploratory and validation populations. The study was registered at Chinese Clinical Trial Registry (ChiCTR-EOC-15006901). Results: The new, alternative sarcopenia risk score included five variables: age, gender, BMI, total energy intake per day, and the proportion of calories supplied by protein. The score ranged from − 2 to 19. The area under the receiver operating characteristic (ROC) curve of the risk score for the prediction of sarcopenia in type 2 diabetes patients was 0.806 (95% CI 0.741–0.872) and 0.836 (95% CI 0.781–0.892) in the exploratory and validation populations, respectively. At the optimal cutoff value of 12, the sensitivity and specificity of the score for the prediction of sarcopenia were 70.9% and 81.0% in the exploratory population and 53.7% and 88.8% in the validation population, respectively. The Hosmer–Lemeshow goodness-of-fit test showed a good calibration with the risk score in external validation (χ
2 = 4.459, P = 0.813). Conclusions: The new, alternative sarcopenia risk score appears to be an effective screening tool for identification of sarcopenia in Chinese patients with type 2 diabetes in clinical practice. Clinical trial registration Chinese Clinical Trial Registry, ChiCTR-EOC-15006901. [ABSTRACT FROM AUTHOR]- Published
- 2023
- Full Text
- View/download PDF
9. A Regional Ionospheric Storm Forecasting Method Using a Deep Learning Algorithm: LSTM.
- Author
-
Ban, Panpan, Guo, Lixin, Zhao, Zhenwei, Sun, Shuji, Xu, Tong, Xu, Zhengwen, and Sun, Fengjuan
- Subjects
DEEP learning ,MACHINE learning ,STORMS ,CORONAL mass ejections ,MAGNETIC storms ,IONOSPHERIC techniques - Abstract
An ionospheric storm forecasting method was proposed using a deep learning algorithm, LSTM (long short‐term memory). We used the perturbation index to denote the level of an ionospheric storm, deduced from foF2 data, and helped to remove most of the local time and seasonal variations in the ionosphere. In constructing the model, a number of correlated factors were used as inputs, including the properties of coronal mass ejections, solar flare bursts, interplanetary conditions, and geomagnetic and ionospheric states, and the output was whether an ionospheric storm occurred locally in the next 24 hr. Data sets from 2007 to 2014 were used to train the model, and those from 2015 to 2016 were used for validation. The results showed that the model behaved well in most events. The mean precision rate, recall rate, accuracy, and F1 score of the model were 71.7%, 59.7%, 92.7%, and 65.0% in northern China and 78.9%, 56.3%, 96.3% and 65.0% in southern China, respectively. The LSTM forecasting model performed better than other models such as persistence, multiple‐layer perceptron and support vector machine models. Case studies also showed good performance during geomagnetic storms of different strengths. We believe that this model can be beneficial for functional ionospheric storm operation. Plain Language Summary: An ionospheric storm forecasting method was proposed using a deep learning algorithm, namely, LSTM (long short‐term memory). The model was trained using an ionospheric measurement data set in China. It was shown that the forecasting model performed better than the persistence, multiple‐layer perceptron and support vector machine models. Key Points: A deep learning method is used to build a forecasting model for ionospheric stormA normalized index perturbation index is used to denote if there occur an ionospheric storm or not, which is deduced from the ionospheric foF2 dataThe long short‐term memory model has a better performance than other models such as persistence, support vector machine and multiple‐layer perceptron model [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
10. Long-Term Cost-Effectiveness of Subcutaneous Once-Weekly Semaglutide Versus Polyethylene Glycol Loxenatide for Treatment of Type 2 Diabetes Mellitus in China.
- Author
-
Liu, Lei, Ruan, Zhen, Ung, Carolina Oi Lam, Zhang, Yawen, Shen, Yang, Han, Sheng, Jia, Ruxu, Qiao, Jingtao, Hu, Hao, and Guo, Lixin
- Subjects
TYPE 2 diabetes ,POLYETHYLENE glycol ,SEMAGLUTIDE ,COST effectiveness ,MEDICAL economics - Abstract
Objective: This study aimed to evaluate the long-term cost-effectiveness of once-weekly subcutaneous semaglutide versus polyethylene glycol loxenatide (PEG-loxenatide) in patients with type 2 diabetes uncontrolled on metformin, from a Chinese healthcare systems perspective. Methods: The study applied the Swedish Institute of Health Economics Diabetes Cohort Model to evaluate the long-term clinical and economic outcomes of once-weekly treatment of semaglutide at 0.5 mg and 1.0 mg, respectively, versus PEG-loxenatide 0.2 mg, over a 40-year time horizon. Baseline cohort characteristics were collected from the SUSTAIN China trial. A network meta-analysis was conducted to obtain comparative treatment effects of once-weekly semaglutide and PEG-loxenatide based on two phase 3a clinical trials. Drug costs were sourced from the national bidding price of China. Outcomes were discounted at 5.0% per annum. One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to assess the uncertainty of the base-case results. Results: When compared with PEG-loxenatide 0.2 mg, the projections of outcomes over the 40-year time horizon in patients with type 2 diabetes uncontrolled on metformin showed that treatment with once-weekly semaglutide 0.5 mg and 1.0 mg were associated with improved discounted life expectancy by 0.08 and 0.12 years, and improved discounted quality-adjusted life expectancy by 0.16 and 0.22 quality-adjusted life-years, respectively. Once-weekly semaglutide 0.5 mg and 1.0 mg were achieved at lifetime cost savings of 19,309 China Yuan (CNY) and 10,179 CNY, respectively. Sensitivity analyses verified the robustness of the results. Conclusion: From the perspective of Chinese healthcare systems, treatment with once-weekly subcutaneous semaglutide represents a dominant option versus PEG-loxenatide for patients with type 2 diabetes uncontrolled on metformin. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
11. Long-Term Cost-Effectiveness Analysis of Once-Weekly Semaglutide versus Dulaglutide in Patients with Type 2 Diabetes with Inadequate Glycemic Control in China.
- Author
-
Ruan, Zhen, Ung, Carolina Oi Lam, Shen, Yang, Zhang, Yawen, Wang, Weihao, Luo, Jingyi, Zou, Huimin, Xue, Yan, Wang, Yao, Hu, Hao, and Guo, Lixin
- Subjects
GLYCEMIC control ,TYPE 2 diabetes ,SEMAGLUTIDE ,COST effectiveness ,MEDICAL economics - Abstract
Introduction: The objective of the current study was to assess the long-term cost-effectiveness of once-weekly semaglutide 0.5 mg and 1.0 mg versus dulaglutide 1.5 mg for the treatment of patients with type 2 diabetes uncontrolled on metformin in the Chinese setting. Methods: The Swedish Institute of Health Economics Diabetes Cohort Model (IHE-DCM) was used to evaluate the long-term health and economic outcomes of once-weekly semaglutide and dulaglutide. Analysis was conducted from the perspective of the Chinese healthcare systems over a time horizon of 40 years. Data on baseline cohort characteristics and treatment effects were sourced from the SUSTAIN 7 clinical trial. Costs included treatment costs and costs of complications. Projected health and economic outcomes were discounted at a rate of 5% annually. The robustness of the results was evaluated through one-way sensitivity analyses and probabilistic sensitivity analyses. Results: Compared with dulaglutide 1.5 mg, once-weekly semaglutide 0.5 mg and 1.0 mg were associated with improvements in discounted life expectancy of 0.04 and 0.10 years, respectively, and improvements in discounted quality-adjusted life expectancy of 0.08 and 0.19 quality-adjusted life years (QALYs), respectively. Clinical benefits were achieved at reduced costs, with lifetime cost savings of 8355 Chinese Yuan (CNY) with once-weekly semaglutide 0.5 mg and 11,553 CNY with once-weekly semaglutide 1.0 mg. Sensitivity analyses verified the robustness of the research results. Conclusions: Once-weekly semaglutide was suggested to be dominant (more effective and less costly) versus dulaglutide 1.5 mg in patients with type 2 diabetes uncontrolled on metformin treatment in China. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
12. Efficacy and safety of a basal insulin + 2‐3 oral antihyperglycaemic drugs regimen versus a twice‐daily premixed insulin + metformin regimen after short‐term intensive insulin therapy in individuals with type 2 diabetes: The multicentre, open‐label, randomized controlled BEYOND‐V trial
- Author
-
Pan, Qi, Li, Yijun, Wan, Hailong, Wang, Junfen, Xu, Binhua, Wang, Guoping, Jiang, Chengxia, Liang, Li, Feng, Wei, Liu, Jingcheng, Wang, Ting, Zhang, Xia, Cui, Nan, Mu, Yiming, and Guo, Lixin
- Subjects
INSULIN therapy ,TYPE 2 diabetes ,DAPAGLIFLOZIN ,EMPAGLIFLOZIN ,ORAL medication ,INSULIN aspart ,INSULIN - Abstract
Aim: To compare the efficacy and safety of basal insulin glargine 100 units/ml (Gla) + 2‐3 oral antihyperglycaemic drugs (OADs) with twice‐daily premixed insulin aspart 70/30 (Asp30) + metformin (MET) after short‐term intensive insulin therapy in adults with type 2 diabetes in China. Materials and Methods: This open‐label trial enrolled insulin‐naïve adults with type 2 diabetes and an HbA1c of 7.5%‐11.0% (58‐97 mmol/mol) despite treatment with 2‐3 OADs. All participants stopped previous OADs except MET, then received short‐term intensive insulin therapy during the run‐in period, when those with a fasting plasma glucose of less than 7.0 mmol/L and 2‐hour postprandial glucose of less than 10.0 mmol/L were randomized to Gla + MET + a dipeptidyl peptidase‐4 inhibitor or twice‐daily Asp30 + MET. If HbA1c was more than 7.0% (>53 mmol/mol) at week 12, participants in the Gla group were added repaglinide or acarbose, at the physician's discretion, and participants in the Asp30 group continued to titrate insulin dose. The change in HbA1c from baseline to week 24 was assessed in the per protocol (PP) population (primary endpoint). Results: There were 384 enrollees (192 each to Gla and Asp30); 367 were included in the PP analysis. The threshold for non‐inferiority of Gla + OADs versus Asp30 + MET was met, with a least squares mean change from baseline in HbA1c of –1.72% and –1.70% (–42.2 and –42.1 mmol/mol), respectively (estimated difference –0.01%; 95% CI –0.20%, 0.17% [–0.1 mmol/mol; 95% CI –2.2, 1.9]). Achievement of HbA1c less than 7.0% (<53 mmol/mol) was comparable between the groups (60% vs. 57%). The proportion of participants with any (24% vs. 38%; P =.003), symptomatic (19% vs. 31%; P =.007) or confirmed hypoglycaemia (18% vs. 33%; P <.001) was lower in the Gla + OADs group. Conclusions: Compared with Asp30 + MET, Gla + 2‐3 OADs showed similar efficacy but a lower hypoglycaemia risk in Chinese individuals with type 2 diabetes who had undergone short‐term intensive insulin therapy. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
13. Study Design and Baseline Characteristics of Patients with T2DM in the Post-marketing Safety Study of Dulaglutide in China (TRUST-CHN).
- Author
-
Guo, Lixin, Li, Li, Yu, Qiurong, Wang, Na, Chen, Jun, Wang, Zhiquan, and Ding, Yuchen
- Subjects
- *
GLUCAGON-like peptide 1 , *TYPE 2 diabetes , *CD26 antigen , *GLYCOSYLATED hemoglobin , *EXPERIMENTAL design - Abstract
Background: TRUST-CHN is a prospective, post-marketing safety study in patients with type 2 diabetes mellitus (T2DM) in China to evaluate the safety and effectiveness of dulaglutide in real-world clinical practice. We report here the study design and baseline characteristics of enrolled patients. Methods: The study design was described, and baseline data were analyzed, including demographic characteristics, T2DM duration, comorbidities, dulaglutide treatment patterns, and concomitant medications. Results: For the present analysis of this ongoing study, data were collected from January 2020 to November 2021. A total of 3313 patients were enrolled, of whom 3294 patients were included in the safety analysis. In total, 1047 patients had a prior history of dulaglutide use before being enrolled in the study. The mean (standard deviation [SD]) age of study subjects was 50.1 (13.2) years, 85.1% were aged < 65 years; 67.9% were male, and 35.9% had an education of university level or higher. Mean (SD) duration of T2DM was 6.4 (6.7) years. Baseline mean (SD) glycated hemoglobin was 8.8% (2.2%), and mean (SD) body mass index was 28.1 (4.1) kg/m2. A total of 2867 (87%) patients had at least one comorbidity, the most frequently reported of which were overweight/obesity (87.1%), hyperlipidemia (50.5%), hypertension (47.9%), diabetic neuropathy (18.9%), and coronary artery disease (15.7%). Almost all (99.7%) patients were treated with 1.5 mg dulaglutide; at baseline, 24.8% were treated with this medication as monotherapy and 75.2% in combination therapy with other medications, including metformin (42.3%), sodium glucose co-transporter2 inhibitor (26.7%), insulin (18.3%), α-glucosidase inhibitor (13.1%), sulfonylurea (5.3%), dipeptidyl peptidase 4 inhibitor (4.4%), glucagon-like peptide 1 receptor agonist (2.7%), and thiazolidinedione (2.4%). Conclusion: The present analysis revealed real-world baseline characteristics of patients with T2DM in China who use dulaglutide enrolled in TRUST-CHN. These data will enable further exploration of the characteristics of patients with T2DM in China and provide an insight on the current use of dulaglutide in clinical practice. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
14. Application of new international classification of adult‐onset diabetes in Chinese inpatients with diabetes mellitus.
- Author
-
Wang, Weihao, Pei, Xiaobei, Zhang, Lina, Chen, Zhi, Lin, Dong, Duan, Xiaoye, Fan, Jingwen, Pan, Qi, and Guo, Lixin
- Subjects
DIABETES ,ACETONEMIA ,DIABETIC angiopathies ,GLUTAMATE decarboxylase ,PERIPHERAL vascular diseases ,INSULIN resistance ,TYPE 2 diabetes - Abstract
Background: To determine whether the new international cluster‐based classification method can be applied to Chinese inpatients with diabetes mellitus (DM). Methods: Adult patients with DM hospitalized in our tertiary care centre from January 2017 to December 2018 were included in the study. K‐means cluster analysis was done in clusters based on glutamic acid decarboxylase antibodies, body mass index, glycosylated haemoglobin, homeostasis model‐assessed beta cell function, insulin resistance index, and age at diagnosis of DM. Chi‐square test was used to analyse inter‐subgroup differences in DM‐related complications and family history of DM. p < 0.05 was considered significant. Results: A total of 1152 inpatients with DM were included in the study. Five subgroups were obtained by cluster analysis with highest proportion of population in mild obesity‐related DM subgroup (34.55%), followed by mild age‐related DM (21.55%), severe insulin deficiency DM (20.51%), severe insulin resistance DM (19.02%), and severe autoimmune DM subgroup (4.36%). The prevalence of diabetic retinopathy, diabetic peripheral vascular disease, diabetic ketosis, coronary heart disease, hypertension, and family history of DM differed significantly among the subgroups (p < 0.05 for all). Conclusions: This cluster‐based classification could be applied to hospitalized adult patients with DM in China. It might help in strategizing for DM patients, and hence, improve management of DM in these patients. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
15. Changes in Direct Medical Cost and Medications for Managing Diabetes in Beijing, China, 2016 to 2018: Electronic Insurance Data Analysis.
- Author
-
Lixin Guo, Jie Zheng, Qi Pan, Qun Zhang, Yan Zhou, Weihao Wang, Lina Zhang, Tesfaye, Solomon, Jie Zhang, Guo, Lixin, Zheng, Jie, Pan, Qi, Zhang, Qun, Zhou, Yan, Wang, Weihao, Zhang, Lina, and Zhang, Jie
- Subjects
MEDICAL care costs ,DIRECT costing ,HEALTH insurance ,DRUG utilization ,DATA analysis - Abstract
Purpose: Although the cost and complexity of managing diabetes is increasing around the world, placing greater burden on patients and their families, the cost of drug regimens prescribed to Chinese patients has not been evaluated. This study was conducted to evaluate the temporal changes in the costs and drugs used for people with diabetes.Methods: Patients enrolled in Beijing Medical Insurance with outpatient medical records from 2016 through 2018 were included in this study. The outcomes of interest were: (1) the number of outpatient medications, (2) the number of comorbidities diagnosed, (3) the estimated annual cost of the outpatient drug regimen, (4) the drug therapy strategies used for diabetic patients, and (5) the most commonly prescribed classes of drugs.Results: Over the 3-year period, there was a significant decrease (9.0%, P <.001) in the average number of diabetes medications used. Both antiglycemic and non-antiglycemic drug use decreased by 3.6% and 12.9%, respectively. Similarly, for estimated annual costs of medication, an 18.4% (P <.05) decrease was observed, with a gradual decreased from ¥6,868 ($1,059) in 2016 to ¥5,605 ($865) in 2018.Conclusion: This is the first large-scale cost analysis of the medical management of diabetes since the implementation of medical insurance in China. Despite the increasing availability of newer, more expensive diabetes drugs, there was a significant reduction in the number of diabetes medications used, that may be due to a more rational approach to optimizing metabolic targets. [ABSTRACT FROM AUTHOR]- Published
- 2021
- Full Text
- View/download PDF
16. Secular trends and rural-urban differences in endocrine and metabolic disease mortality in China: an age-period-cohort modeling of National Data.
- Author
-
Li, Ying, Pan, Qi, Gao, Mengting, Guo, Lixin, Yan, Hong, and Li, Shiyue
- Subjects
RURAL-urban differences ,METABOLIC disorders ,ENDOCRINE diseases ,HEALTH planning ,ECONOMIC expansion - Abstract
Objectives: Annual mortality of endocrine and metabolic diseases (EMD) in a population reflects levels of economy-related lifestyles and medical care, both of which have changed substantially in China in the last hundred years. Linking these two factors with historical trends of EMD will enhance our understanding of the EMD epidemiology. Methods: Age-specific annual mortality rates of EMD from 1991 to 2016 were derived from the Health Statistics Yearbook of China and analyzed by rural and urban using age-period-cohort (APC) method. Intrinsic estimator was performed for parameter estimation. Results: The data fit APC models well. After controlling the influence of age, the estimated period effect increased rapidly from 1991 to 2001 before it leveled off. The risk for urban area increased faster than for rural area before 2006. Contrarily, the estimated cohort effects across 100 years from 1911 to 2016 showed an overall declining trend. For urban area, the cohort effect declined progressively since the 1911–1915 birth cohort with small fluctuations, while the same effect for rural area increased slowly from the 1911–1915 cohort to the 1951–1956 cohort before it declined, intercepting twice with that of urban one at cohort 1941–45 and another at 1996–2000. Conclusion: Increases in EMD mortality in China since 1991 can be explained primarily by the period effect, reflecting unhealthy lifestyles adapted along with rapid economic growth. The 100-year declines in cohort effect and the rural-urban differences could be largely attributed to the overall progress and rural-urban inequity in medical and healthcare. Future public health planning and decision-making must emphasize these two factors. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
17. Efficacy and Safety of Basal Insulin-Based Treatment Versus Twice-Daily Premixed Insulin After Short-Term Intensive Insulin Therapy in Patients with Type 2 Diabetes Mellitus in China: Study Protocol for a Randomized Controlled Trial (BEYOND V).
- Author
-
Liu, Jing, Jiang, Xia, Xu, Binhua, Wang, Guoping, Cui, Nan, Zhang, Xia, Liu, Jingcheng, Mu, Yiming, and Guo, Lixin
- Subjects
INSULIN therapy ,RESEARCH ,CLINICAL trials ,COMBINATION drug therapy ,INSULIN derivatives ,RESEARCH methodology ,HYPOGLYCEMIC agents ,PATIENT satisfaction ,BLOOD sugar ,MEDICAL cooperation ,EVALUATION research ,INSULIN ,TYPE 2 diabetes ,COMPARATIVE studies ,HYPOGLYCEMIA ,METFORMIN - Abstract
Introduction: Many Chinese patients who are uncontrolled by oral antidiabetic drugs (OADs) receive short-term intensive insulin therapy (IIT) in hospital to rapidly relieve glucose-associated toxicity and to preserve/improve β-cell function. However, evidence for optimizing insulin algorithms for maintenance treatment after IIT is lacking. This study will compare the efficacy and safety of basal insulin-based treatment versus twice-daily premixed insulin in type 2 diabetes mellitus (T2DM) patients after short-term in-hospital IIT.Methods: This 26-week randomized, multicenter, positive-controlled, open-label, parallel-group study will enroll approximately 400 male and female patients aged 18-70 years with poorly-controlled T2DM (HbA1c > 7.5%) despite treatment with metformin plus at least one other OAD for 8 or more weeks. During a run-in period of 7-10 days, patients will be treated in-hospital with IIT comprising insulin glargine (Lantus®) once daily and insulin glulisine (Apidra®) three times daily; both regimens will be titrated daily to achieve the glycemic goal. Eligible patients will then be randomized in a 1:1 ratio to insulin glargine plus OADs or twice-daily premixed insulin (NovoLog® Mix 70/30) for 24 weeks, with metformin maintained throughout the study in both treatment groups. The primary endpoint is HbA1c change from baseline to week 24. Secondary endpoints include assessment of fasting plasma glucose, total daily insulin dose, hypoglycemia incidence, body weight change, adverse events, and patient satisfaction.Discussion: Given the current lack of clinical data, this study will provide evidence supporting safe and effective glycemic control using basal insulin glargine-based therapy plus OADs compared with twice-daily premixed insulin in Chinese patients with T2DM after short-term IIT. This will assist physicians by providing a wider choice of treatments.Trial Registration: ClinicalTrials.gov identifier, NCT03359837 (registered on 2 December 2017). [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
- View/download PDF
18. Prevalence of thyroid dysfunction in older Chinese patients with type 2 diabetes—A multicenter cross-sectional observational study across China.
- Author
-
Zhu, Yu, Xu, Fengmei, Shen, Jie, Liu, Youshuo, Bi, Changhua, Liu, Jing, Li, Yufeng, Wang, Xueqin, Gao, Zhengnan, Liang, Linlang, Chen, Yanyan, Sun, Weiping, Guan, Qingbo, Zhang, Junqing, Luo, Zuojie, Guo, Lixin, Cai, Xiaopin, Li, Ling, Xiu, Lingling, and Yan, Li
- Subjects
TYPE 2 diabetes ,OLDER patients ,THYROTROPIN ,THERAPEUTICS ,THYROID hormones ,CROSS-sectional method ,DISEASE complications - Abstract
Type 2 diabetes [T2D] and thyroid dysfunction [TD] often co-occur, have overlapping pathologies, and their risk increases with age. Since 1995, universal salt iodization has been implemented in China to prevent disorders caused by iodine deficiency. However, after two decades of implementation of universal salt iodization, the prevalence of TD in elderly Chinese patients with T2D is not well described and may have been underestimated. We conducted a questionnaire-based survey across 24 endocrinology centers in China between December 2015 and July 2016. Demographic and clinical data from 1677 patients with T2D were obtained and analyzed to examine the prevalence of TD along with T2D in these patients. We assessed TD prevalence according to the four TD subtypes [subclinical hypothyroidism, clinical hypothyroidism, subclinical hyperthyroidism, and clinical hyperthyroidism], TD history, gender, and age. The diagnosis rates were calculated for TD and also for the TD subtype. The number of patients reaching treatment goals for T2D [hemoglobin A1c <7%] and TD [normal free thyroxine and thyroid-stimulating hormone [TSH]] and the incidences of complications and comorbidities were recorded. Among the enrolled patients with T2D [N = 1677], TD was diagnosed in 23.79% [399/1677] out of which 61% (245/399) were previously diagnosed and 38.59% (154/399) were newly diagnosed cases. Subclinical hypothyroidism, clinical hypothyroidism, subclinical hyperthyroidism, and clinical hyperthyroidism were reported in 4.89%, 9.3%, 1.13%, and 3.16% of the total population, respectively. Among patients previously diagnosed with TD, the incidence in women [166/795; 20.88%] was higher than in men [79/882; 8.96%]. The treatment goals for TD and T2D were attained in 39.6% [97/245] and 34.41% [577/1677] of the cases, respectively. Diabetic complications and comorbidities were reported in 99.7% of patients, with peripheral neuropathy being the most common [43.46%] followed by cataract [24.73%]. We had found that the incidences of dyslipidemia, elevated LDL levels, and osteoporosis were significantly higher in patients with TD than those without TD. TD is underdiagnosed in elderly Chinese patients with T2D. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
19. Direct medical costs for patients with type 2 diabetes in 16 tertiary hospitals in urban China: A multicenter prospective cohort study.
- Author
-
Li, Xiang, Xu, Zhangrong, Ji, Linong, Guo, Lixin, Liu, Jing, Feng, Kun, Xu, Yushan, Zhu, Dalong, Jia, Weiping, Ran, XinWu, Chen, Limin, Zhao, Shi, Shi, Bingying, Zhu, Jun, Shan, Zhongyan, Zhou, Zhiguang, Zeng, Longyi, Weng, Jianping, Ren, Qian, and Zhou, Yan
- Subjects
MEDICAL care costs ,GLUCAGON-like peptide-1 receptor ,TYPE 2 diabetes ,GLUCAGON-like peptide-1 agonists ,DIRECT costing ,HEALTH care reform - Abstract
Aims/Introduction: To investigate the direct medical costs for patients with type 2 diabetes in China and to examine the influencing factors. Materials and Methods: In the present multicenter study, 1,070 patients with type 2 diabetes from 16 tertiary hospitals in 14 major cities of China were enrolled. Patient data and direct medical costs were collected during a follow‐up period of 6 months at intervals of 1 month. The log‐transformed direct medical costs were fitted by a generalized estimation equation to indicator variables for demographics, metabolic control, treatments, complications and comorbidities. Results: Data of 871 participants were included in the analysis. The mean annual total direct medical costs and outpatient medical costs were $1,990.20 and $1,687.20 respectively. The average costs per inpatient per admission were $2,127.10. The share of out‐of‐pocket for total medical costs, outpatient costs and cost per inpatient per admission were 45.4, 46.3 and 26.0% respectively. Independent determinants of total medical costs were diabetes duration, dyslipidemia and diabetic complications, such as neuropathy and nephropathy, as well as diabetes treatment, such as the use of glucagon‐like peptide‐1 receptor agonists. Costs showed prominent variation across centers. Conclusions: Diabetes is imposing a growing economic burden in patients with type 2 diabetes in China. Diabetes‐related complications and comorbidities have a great impact on the medical costs. As different health policies, economic development and regional health inequalities also have an important influence on the direct medical cost, healthcare reform needs to optimize resource allocation in health service delivery systems, and provide more equitable and affordable healthcare. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
20. A comparative study of ionospheric spread-F and scintillation at low- and mid-latitudes in China during the 24th solar cycle.
- Author
-
Wang, Ning, Guo, Lixin, Zhao, Zhenwei, Ding, Zonghua, Xu, Tong, and Sun, Shuji
- Subjects
- *
IONOSPHERE , *SCINTILLATION spectrometry , *SOLAR cycle , *IONOGRAMS , *IONOSONDES - Abstract
Highlights • FSF occurred more often after midnight. • RSF and scintillation appeared mainly during pre-midnight. • FSF occurrence rates mostly appeared during the summer months. • RSF and scintillation occurred mostly in the equinoctial months at low-latitudes. • Scintillation occurrence was usually associated with the appearance of RSF. Abstract The spread-F echo of ionograms and scintillation of satellite signal propagation along the Earth-space path are two typical phenomena induced by ionospheric irregularities. In this study, we obtained spread-F data from HF (high frequency) digital ionosonde and scintillation index (S4) data from L-band and UHF receivers at low- and mid-latitudes in China during the 24th solar cycle. These four sites were located at Haikou (HK) (20°N, 110.34°E), Kunming (KM) (25.64°N, 103.72°E), Qingdao (QD) (36.24°N, 120.42°E), and Manzhouli (MZL) (49.56°N, 117.52°E). We used these data to investigate spread-F and scintillation occurrence percentages and variations with local time, season, latitude and solar activity. A comparative study of spread-F and scintillation occurrence rates has been made. The main conclusions are as follows: (a) FSF occurred mostly during post-midnight, while RSF and scintillation appeared mainly during pre-midnight at HK and KM; (b) FSF occurrence rates were larger at QD and MZL than expected; (c) the FSF occurrence percentages were anti-correlated with solar activity at HK and KM; meanwhile RSF and scintillation occurrence rates increased with the increase of solar activity at this two sites; (d) the highest FSF occurrence rates mostly appeared during the summer months, while RSF and scintillation occurred mostly in the equinoctial months at HK and KM; (e) the scintillation occurrence was usually associated with the appearance of RSF, probably due to a different physical mechanism comparing with FSF. Some of these results verified the conclusions of previous papers, whereas some show slight difference. These results are important in understanding ionospheric irregularities variations characteristic at low- and mid-latitudes in China. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
21. Prediction of Chinese drivers' intentions to park illegally in emergency lanes: An application of the theory of planned behavior.
- Author
-
Zheng, Yubing, Ma, Yang, Guo, Lixin, Cheng, Jianchuan, and Zhang, Yunlong
- Subjects
ROAD safety measures ,TRAFFIC safety ,ACQUISITION of data ,MULTIVARIATE analysis ,LOGICAL prediction ,AUTOMOBILE driving laws ,ANALYSIS of variance ,BEHAVIOR ,EMERGENCY medical services ,INTENTION ,PSYCHOLOGY ,REGRESSION analysis ,THEORY ,CROSS-sectional method - Abstract
Objective: Illegal parking in emergency lanes (paved highway shoulders) is becoming a serious road safety issue in China. The aim of this study was to (1) examine the utility of the theory of planned behavior (TPB) extended with descriptive norms, past behavior, facilitating and deterring circumstances, sensation seeking, and invulnerability in predicting Chinese drivers' intentions toward illegal emergency lane parking; (2) investigate whether respondents' demographic characteristics would impact their views toward the behavior and predictive patterns of intentions; and (3) identify significant predictors of intentions.Methods: In this cross-sectional study, eligible respondents were all qualified Chinese drivers. A self-administered questionnaire was employed to collect data, including demographic information, descriptive norms, past behavior, facilitating and deterring circumstances, sensation-seeking, and scenario-based invulnerability combined with TPB constructs. Descriptive statistics, multivariate analyses of variance (MANOVAs), and a series of hierarchical multiple linear regression analyses were conducted in SPSS.Results: A total of 435 qualified drivers (234 males and 201 females) with a mean age of 35.2 years (SD =10.3) were included in analysis. The descriptive analysis showed that most participants reported weak intentions (M = 2.35) to park illegally in emergency lanes with negative attitude (M = 3.19), low perceived support (M = 2.91), and high control (M = 5.08) over the behavior. The model succeeded in explaining 64% of the variance in intentions for the whole sample, and principal TPB components accounted for 21% of variance in intentions after demographic variables were controlled for. MANOVAs revealed that significant differences of respondents' opinions toward illegal emergency lane parking were only found between better educated drivers (with college education background) and less-educated ones. Separate regression analyses revealed that the predictive pattern of better educated participants also differed significantly from that of less-educated ones.Conclusion: The study revealed that perceived behavioral control, past behavior, facilitating circumstance, and invulnerability emerged as consistently significant predictors of Chinese drivers' intentions to park illegally in emergency lanes. Findings of this study may have some practical implications in developing multifaceted interventions or education processes for illegal emergency lane parking in China. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
22. Uric acid, renal function and risk of hypoglycaemia in Chinese type 2 diabetes patients.
- Author
-
Ren, Yanfeng, Ji, Linong, Mu, Yiming, Hong, Tianpei, Ji, Qiuhe, Guo, Lixin, Huang, Qin, and Yang, Xilin
- Subjects
TYPE 2 diabetes complications ,GLOMERULAR filtration rate ,HYPOGLYCEMIA ,LONGITUDINAL method ,TYPE 2 diabetes ,PROGNOSIS ,URIC acid ,CROSS-sectional method ,DIAGNOSIS - Abstract
Background: This study aimed to explore independent associations between serum uric acid and hypoglycaemia, and whether mildly increased serum uric acid exacerbated the association between mild decline in estimated glomerular filtration rate (eGFR) and hypoglycaemia.Methods: A cross-sectional survey of 6713 inpatients with type 2 diabetes and eGFR ≥60 mL/min/1.73 m2 and admitted to 81 tertiary care hospitals in China was conducted. Self-reported asymptotic hypoglycaemia with plasma glucose ≤3.9 mmol/L, hypoglycaemia episodes with symptoms in 1 month or hypoglycaemia that needed assistance from other people in 3 months before hospitalization was used to define hypoglycaemia. Binary logistic regression was used to estimate odds ratios of serum uric acid for hypoglycaemia. Three measures, that is, relative excess risk due to interaction (RERI), attributable proportion due to interaction and synergy index (S) were used to estimate the effect of mildly decreased eGFR on the association of serum uric acid with hypoglycaemia.Results: Serum uric acid was associated with hypoglycaemia in an ordinal manner (P for trend <0.01) with an odds ratio of top quartile versus the lowest quartile up to 3.03 (95% confidence interval: 2.13-4.32). The odds ratio of serum uric acid levels ≥ versus <283 µmol/L (i.e. the median) was 1.98 (95% confidence interval:1.58-2.48). Serum uric acid levels ≥ versus <283 µmol/L greatly enhanced the association between mild decline in eGFR (eGFR < 90 mL/min/1.73 m2 ) and hypoglycaemia from 0.94 (0.36-2.43) to 3.90 (2.55-5.95), with a significant additive interaction (P < 0.05 for RERI, AP and S).Conclusions: Mildly increased serum uric acid was associated with increased risk of hypoglycaemia and enhanced the association between mildly decreased eGFR and hypoglycaemia in type 2 diabetes. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
23. Glargine insulin/gliclazide MR combination therapy is more effective than premixed insulin monotherapy in Chinese patients with type 2 diabetes inadequately controlled on oral antidiabetic drugs.
- Author
-
Zhou, Jian, Zheng, Fenping, Guo, Xiaohui, Yang, Huazhang, Zhang, Muxun, Tian, Haoming, Guo, Lixin, Li, Qiang, Mo, Yifei, and Jia, Weiping
- Subjects
HYPOGLYCEMIC agents ,GLICLAZIDE ,BLOOD sugar ,BLOOD sugar monitoring ,COMBINATION drug therapy ,COMPARATIVE studies ,GLYCOSYLATED hemoglobin ,RESEARCH methodology ,MEDICAL cooperation ,TYPE 2 diabetes ,PATIENT monitoring ,RESEARCH ,STATISTICAL sampling ,EVALUATION research ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,THERAPEUTICS - Abstract
Background: The aim of this study is to compare the efficacy and safety of once-daily insulin glargine plus gliclazide modified release combination therapy versus twice-daily premixed insulin monotherapy in Chinese type 2 diabetic patients insufficiently controlled by oral antidiabetic agents.Methods: In a 12-week, multicenter, randomized, parallel-group clinical trial, patients with poor glycaemic control (fasting plasma glucose ≥ 7.0 mmol/L and 7.5% < haemoglobin A1c ≤ 10%) on oral antidiabetic drugs were randomized to the treatment groups for combination therapy (n = 52) or monotherapy (n = 53). Continuous glucose monitoring was carried out over two 72-h periods, at the beginning and the end of the study, and the data were used to calculate the 24-h mean blood glucose, mean amplitude of glycaemic excursions, standard deviation of blood glucose, and the mean of daily differences.Results: The mean haemoglobin A1c decrease from baseline to study end was significant for both treatment groups (combination therapy: -1.23 ± 0.92%; insulin monotherapy: -1.02 ± 1.04%); moreover, the combination therapy group showed a significantly more robust haemoglobin A1c decrease (p = 0.0308). Both therapies significantly reduced the 24-h mean blood glucose (both, p < 0.001), but neither produced a significant effect on glycaemic variability, calculated as mean amplitude of glycaemic excursions, standard deviation of blood glucose, and mean of daily differences. In addition, the effects on rates of hypoglycaemic episodes were similar between the two therapies.Conclusions: Chinese patients with type 2 diabetes inadequately controlled with oral antidiabetic agents attained greater benefit from once-daily insulin glargine plus gliclazide modified release regimen than from a twice-daily premixed insulin regimen. [ABSTRACT FROM AUTHOR]- Published
- 2015
- Full Text
- View/download PDF
24. Association between microalbuminuria and cardiovascular disease in type 2 diabetes mellitus of the Beijing Han nationality.
- Author
-
Guo, Lixin, Cheng, Yang, Wang, Xiaoxia, Pan, Qi, Li, Hui, Zhang, Lina, and Wang, Yao
- Subjects
- *
ALBUMINURIA , *CARDIOVASCULAR diseases risk factors , *TYPE 2 diabetes , *ATHEROSCLEROSIS , *C-reactive protein , *URIC acid - Abstract
The objective of this study is to investigate the correlation of urinary albumin excretion rate (UAER) with the incidence of coronary heart disease (CHD), pathological characteristics and severity of coronary atherosclerosis in patients with type 2 diabetes mellitus (T2DM), and explore the efficacy of using the urinary albumin excretion rate (UAER) to predict the risk of CHD in patients with T2DM. The study included 1,004 T2DM patients with normo- and micro-albuminuria who underwent coronary angiography for suspected coronary atherosclerosis. The severity of coronary atherosclerosis was defined using the Gensini's score system. The correlation of UAER with the incidence of CHD, pathological characteristic and the severity of coronary atherosclerosis in patients with T2DM was analyzed. The best numerical value of UAER in predicting the risk of CHD in patients with T2DM was calculated. The differences in sex, age, BMI, SBP, history of smoking, duration of diabetes mellitus, HbA1C, FPG, LDL-C, HDL-C, Cre, Uric acid, HOMA-IR between microalbuminuria(MAU) subgroup and normal albuminuria subgroup were statistically significant( P < 0.05). The differences in the incidence of CHD, the number of pathological coronary vessels, the Gensini's score and LVEF% between microalbuminuria group and normal albuminuria group were statistically significant ( P < 0.05). UAER increased significantly with an increase in the number of pathological coronary vessels. Logistic multiple regression analysis showed that UAER was independently correlated with the incidence of CHD (OR = 1.092, P = 0.000, 95% CI = 1.063-1.122). Spearman's correlation analysis showed that the Gensini's score was significantly positively correlated with UAER, sex, age, BMI, SBP, the history of smoking and drinking, the duration of diabetes mellitus, HbA1c, FPG, PPG, LDL-C, Cre, C-reactive protein (CRP), uric acid (UA). Based on the ROC curve, the 11.275 μg/min of UAER was the best numerical value to predict the risk of CHD in patients with T2DM. Area under the curve was 0.799, sensitivity was 65.1%, and specificity was 82.9%. Conclusion: Microalbuminuria in patients with T2DM is another risk factor for CHD. Microalbuminuria is significantly positively correlated with the severity of coronary atherosclerosis. An UAER value of 11.275 μg/min can be used to predict the risk of CHD in patients with T2DM. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
25. Morphological and molecular characterization of free-floating and attached green macroalgae Ulva spp. in the Yellow Sea of China.
- Author
-
Duan, Weijun, Guo, Lixin, Sun, Dong, Zhu, Shuifang, Chen, Xianfeng, Zhu, Wenrong, Xu, Tao, and Chen, Changfa
- Subjects
- *
ALGAL blooms , *PHYLOGENY , *MORPHOLOGY , *ULVA - Abstract
During the summer of 2008 and 2009, massive algal blooms repeatedly broke out in the Yellow Sea of China. These were undoubtedly caused by the accumulations of one or more species in the macroalgal genus Ulva. In previous reports, morphological observation indicated that the species involved in this phenomenon is Ulva prolifera but molecular analyses indicated that the species belongs to an Ulva linza-procera-prolifera (LPP) clade. Correct identification of the bloom species is required to understand and manage the blooms, but the taxonomic status of the bloom species remains unclear. In the current study, the taxonomic status of 22 selected specimens from the Yellow Sea was assessed by using both morphological and molecular (ITS and rbcL sequences) data. In addition, 5S rDNA analyses were performed for those samples clustering in the LPP clade, and phylogenetic tree and ribotype analyses were constructed for determining the possible origin of the bloom. Three free-floating and two attached Ulva species were distinguished and described: Ulva compressa Linnaeus and Ulva pertusa Kjellman were found in free-floating samples; U. linza Linnaeus was found on rocks; and U. prolifera O.F. Müller was found in both habitats. Diversity in free-floating Ulva of the Yellow Sea appears to be greater than previously thought. The dominant free-floating Ulva species, U. prolifera, was not closely related to local populations attached to rocks but was closely related to populations from Japan. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
26. Prevalence of very high cardiovascular disease risk in patients with type 2 diabetes mellitus: A population‐based cross‐sectional screening study.
- Author
-
Wang, Weihao, Qiao, Jingtao, Zhang, Lina, Zhang, Jie, Luo, Jingyi, Chen, Chen, Wang, Xiaoxia, Jia, Peng, Zhang, Jia, Pan, Qi, and Guo, Lixin
- Subjects
- *
TYPE 2 diabetes , *CARDIOVASCULAR diseases , *CORONARY artery disease , *LEFT ventricular hypertrophy , *CARDIOVASCULAR diseases risk factors , *CROSS-sectional method - Abstract
Aim Methods Results Conclusions The 2019 ESC/EASD guidelines categorize cardiovascular disease risk (CVD) in patients with diabetes mellitus (DM). Assessing CVD risk is necessary to identify individuals at very high risk of CVD, enabling tailored and precise intervention for this high‐risk population. This study aims to evaluate the severity of a very high risk for CVD stratification among patients with type 2 DM (T2DM) across different regions in China.We conducted a cross‐sectional screening study from 1 January 2020 to 30 December 2022. Disease duration, body mass index (BMI), targeted organ damage, such as atherosclerotic heart disease, proteinuria, impaired renal function, left ventricular hypertrophy, retinopathy and known CVD risk factors, were collected from diabetic patients by professionally trained physicians. The risk of CV in patients with DM was categorized into two groups: very high risk and others, according to the 2019 ESC/EASD guidelines.In total, 1 870 720 participants from 1669 hospitals in 30 provinces of China, excluding Tibet, Taiwan, Hong Kong and Macao, were enrolled from 2020 to 2022, among whom 67.50% of patients with T2DM were at very high risk for CVD. The proportions of very high‐risk T2DM were higher in Northeast China (75.82%), Central China (73.65%) and Southwest China (72.66%), while the lowest prevalence of very high‐risk T2DM was found in Southern China (60.15%). The multivariate binary logistic regression analyses suggested that the category of very high risk for CVD is associated with age [odds ratio (OR) = 1.04; 95% confidence interval (CI): 1.04‐1.04; p < .0001], BMI (OR = 1.07; 95% CI: 1.07‐1.07; p < .0001), duration of DM (OR = 1.05; 95% CI: 1.05‐1.05; p < .0001), hypertension (OR = 3.75; 95% CI: 3.72‐3.78; p < .0001), dyslipidaemia (OR = 5.22; 95% CI: 5.18‐5.27; p < .0001) and smoking (OR = 2.92; 95% CI: 2.89‐2.95; p < .0001).This study represented the largest observational study of CVD risk assessment in patients with T2DM in China. The CVD risk situation of patients with diabetes in China is critical, and comprehensive control and management of CVD risk factors, such as hypertension, BMI and dyslipidaemia, in patients with DM need to be strengthened in patients with T2DM in China. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
27. Standards of medical care for type 2 diabetes in China 2019.
- Author
-
Jia, Weiping, Weng, Jianping, Zhu, Dalong, Ji, Linong, Lu, Juming, Zhou, Zhiguang, Zou, Dajin, Guo, Lixin, Ji, Qiuhe, Chen, Li, Chen, Liming, Dou, Jingtao, Guo, Xiaohui, Kuang, Hongyu, Li, Ling, Li, Qifu, Li, Xiaoying, Liu, Jing, Ran, Xingwu, and Shi, Lixin
- Subjects
MEDICAL care standards ,TYPE 2 diabetes ,DIET therapy ,CEREBROVASCULAR disease ,MENTAL illness ,CHINESE medicine ,EXERCISE therapy ,BLOOD sugar monitors ,DIABETES complications ,MEDICAL quality control ,BLOOD sugar monitoring ,MEDICAL protocols ,DISEASE complications - Abstract
The prevalence of diabetes in China has increased rapidly from 0.67% in 1980 to 10.4% in 2013, with the aging of the population and westernization of lifestyle. Since its foundation in 1991, the Chinese Diabetes Society (CDS) has been dedicated to improving academic exchange and the academic level of diabetes research in China. From 2003 to 2014, four versions of Chinese diabetes care guidelines have been published. The guidelines have played an important role in standardizing clinical practice and improving the status quo of diabetes prevention and control in China. Since September 2016, the CDS has invited experts in cardiovascular diseases, psychiatric diseases, nutrition, and traditional Chinese medicine to work with endocrinologists from the CDS to review the new clinical research evidence related to diabetes over the previous 4 years. Over a year of careful revision, this has resulted in the present, new version of guidelines for prevention and care of type 2 diabetes in China. The main contents include epidemiology of type 2 diabetes in China; diagnosis and classification of diabetes; primary, secondary, and tertiary diabetes prevention; diabetes education and management support; blood glucose monitoring; integrated control targets for type 2 diabetes and treatments for hyperglycaemia; medical nutrition therapy; exercise therapy for type 2 diabetes; smoking cessation; pharmacologic therapy for hyperglycaemia; metabolic surgery for type 2 diabetes; prevention and treatment of cardiovascular and cerebrovascular diseases in patients with type 2 diabetes; hypoglycaemia; chronic diabetic complications; special types of diabetes; metabolic syndrome; and diabetes and traditional Chinese medicine. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
28. Chinese clinical guidelines for continuous glucose monitoring (2018 edition).
- Author
-
Bao, Yuqian, Chen, Li, Chen, Liming, Dou, Jingtao, Gao, Zhengnan, Gao, Leili, Guo, Lixin, Guo, Xiaohui, Ji, Linong, Ji, Qiuhe, Jia, Weiping, Kuang, Hongyu, Li, Qifu, Li, Qiang, Li, Xiaoying, Li, Yanbing, Li, Ling, Liu, Jing, Ma, Jianhua, and Ran, Xingwu
- Subjects
BLOOD sugar monitors ,GLUCOSE ,GUIDELINES ,BLOOD sugar analysis ,BLOOD sugar monitoring ,TYPE 1 diabetes ,PROGNOSIS ,TYPE 2 diabetes ,MEDICAL protocols - Abstract
Blood glucose monitoring is an important part of diabetes management. Continuous glucose monitoring (CGM) technology has become an effective complement to conventional blood glucose monitoring methods and has been widely applied in clinical practice. The indications for its use, the accuracy of the generated data, the interpretation of the CGM results, and the application of the results must be standardized. In December 2009, the Chinese Diabetes Society (CDS) drafted and published the first Chinese Clinical Guideline for Continuous Glucose Monitoring (2009 edition), providing a basis for the standardization of CGM in clinical application. Based on the updates of international guidelines and the increasing evidence of domestic studies, it is necessary to revise the latest CGM guidelines in China so that the recent clinical evidence can be effectively translated into clinical benefit for diabetic patients. To this end, the CDS revised the Chinese Clinical Guideline for Continuous Glucose Monitoring (2012 Edition) based on the most recent evidence from international and domestic studies. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
29. Treatment Patterns and Glycemic Control in Older Adults with Type 2 Diabetes Mellitus Receiving Only Oral Antidiabetes Drugs in China.
- Author
-
Zhang, Lihua, Ji, Linong, Guo, Lixin, Lu, Juming, Tian, Haoming, Zhu, Dalong, Xing, Xiaoping, Weng, Jian Ping, and Jia, Weiping
- Subjects
- *
GLYCEMIC control , *TYPE 2 diabetes treatment , *HYPOGLYCEMIC agents , *ORAL drug administration , *CHINESE people , *DISEASES , *AGE distribution , *BLOOD sugar , *COMBINATION drug therapy , *COMPARATIVE studies , *GLYCOSYLATED hemoglobin , *INSULIN , *RESEARCH methodology , *MEDICAL cooperation , *TYPE 2 diabetes , *RESEARCH , *EVALUATION research , *TREATMENT effectiveness , *SULFONYLUREAS , *CROSS-sectional method - Abstract
Background: Only a few studies have reported the use of oral antidiabetes drugs (OADs) for treating older adults with type 2 diabetes mellitus (T2DM) in China. This study assessed the status of OAD therapy and relevant factors associated with OAD treatment patterns and glycemic control among older patients.Patients and Methods: We conducted a noninterventional, observational, cross-sectional, multicenter study, which was initiated by the Chinese Diabetes Society, in which 9,872 outpatients with T2DM were recruited who received OADs only. Current antidiabetes treatment regimens and related clinical data were collected from patients' self-reporting and medical records. Participants were divided into two groups: ≥65 years and <65 years. All data were tabulated, and statistical analyses were performed using SPSS version 16 software (SPSS Inc., Chicago, IL).Results: Insulin secretagogues (52.6%): sulfonylureas (SU) (26.6%) and glinides (26.0%) were commonly used as monotherapy in those ≥65 years. The most popular OAD pattern was dual combination therapy (46.8%), with SU plus glucosidase inhibitors (25.1%) being most common in older participants. Age, diabetes duration, body mass index, achieving the glycemic control targets, and hypoglycemia were influencing factors to those ≥65 years in diverse treatment pattern models (P < 0.05). Older patients receiving OADs with triple or more combination treatment and complications were more likely to have substandard glycemic control (hemoglobin A1c level ≥7%).Conclusions: The pattern of OADs alone in older adults with T2DM was significantly different from those <65 years in China. A comprehensive OAD treatment pattern or insulin combination may be necessary for better glycemic control in older patients with multiple combinations of OADs or complications. [ABSTRACT FROM AUTHOR]- Published
- 2015
- Full Text
- View/download PDF
30. Retagliptin as add-on therapy to metformin in Chinese patients with type 2 diabetes inadequately controlled with metformin: A multicentre, randomized, double-blind, placebo-controlled, phase 3 trial.
- Author
-
Guo L, Tian F, Liu L, Chen M, Jiang C, Li S, Liu C, Zhang Y, Qin J, Yu D, Zong Y, and Dai W
- Subjects
- Humans, Double-Blind Method, Male, Female, Middle Aged, Blood Glucose drug effects, Blood Glucose metabolism, China, Aged, Treatment Outcome, Adult, Asian People, Dipeptidyl-Peptidase IV Inhibitors therapeutic use, East Asian People, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 blood, Metformin therapeutic use, Metformin administration & dosage, Hypoglycemic Agents therapeutic use, Hypoglycemic Agents administration & dosage, Glycated Hemoglobin analysis, Glycated Hemoglobin metabolism, Glycated Hemoglobin drug effects, Drug Therapy, Combination
- Abstract
Aim: To evaluate the efficacy and safety of retagliptin in Chinese patients with type 2 diabetes (T2D) inadequately controlled with metformin., Materials and Methods: This multicentre, phase 3 trial consisted of a 16-week, randomized, double-blind, placebo-controlled period, where patients with HbA1c levels between 7.5% and 11.0% were randomized to receive either once-daily (QD) retagliptin 100 mg (n = 87) or placebo (n = 87), both as an add-on to metformin. The primary endpoint was the change in HbA1c from baseline to week 16., Results: At week 16, the least squares mean change in HbA1c from baseline, compared with placebo, was -0.82% (95% CI, -1.05% to -0.58%) for the retagliptin 100 mg QD group (P < .0001) per treatment policy estimand. Significantly higher proportions of patients in the retagliptin 100 mg QD group achieved HbA1c levels of less than 6.5% (11.5%) and less than 7.0% (26.4%) compared with those receiving placebo (0% and 4.6%; P = .0016 and P < .0001, respectively) at week 16. Retagliptin 100 mg QD also lowered fasting plasma glucose and 2-hour postprandial plasma glucose levels. The incidence of adverse events (AEs) during the treatment period was similar between the two groups. However, slightly higher proportions of increased lipase and increased amylase in the retagliptin 100 mg QD group were observed. No patients discontinued treatment permanently because of AEs, and no episodes of severe hypoglycaemia were reported., Conclusions: Retagliptin 100 mg QD as an add-on therapy to metformin offers a new therapeutic option for treating Chinese patients with T2D inadequately controlled by metformin alone, and is generally well tolerated., (© 2024 John Wiley & Sons Ltd.)
- Published
- 2024
- Full Text
- View/download PDF
31. Real-world treatment satisfaction with dulaglutide, and its influencing factors, in a Chinese population with type 2 diabetes mellitus.
- Author
-
Guo L, Xi Y, Li L, Guo K, Wu J, Xu J, Wang Y, Wu G, and Si S
- Subjects
- Aged, Female, Humans, Male, Middle Aged, China epidemiology, East Asian People, Glycated Hemoglobin analysis, Glycated Hemoglobin metabolism, Recombinant Fusion Proteins therapeutic use, Diabetes Mellitus, Type 2 drug therapy, Glucagon-Like Peptides analogs & derivatives, Glucagon-Like Peptides therapeutic use, Glucagon-Like Peptides adverse effects, Hypoglycemic Agents therapeutic use, Immunoglobulin Fc Fragments therapeutic use, Patient Satisfaction
- Published
- 2024
- Full Text
- View/download PDF
32. A 5:2 Intermittent Fasting Meal Replacement Diet and Glycemic Control for Adults With Diabetes: The EARLY Randomized Clinical Trial.
- Author
-
Guo L, Xi Y, Jin W, Yuan H, Qin G, Chen S, Zhang L, Liu Y, Cheng X, Liu W, and Yu D
- Subjects
- Humans, Male, Female, Middle Aged, Adult, Glycated Hemoglobin analysis, Hypoglycemic Agents therapeutic use, China, Blood Glucose analysis, Blood Glucose drug effects, Intermittent Fasting, Diabetes Mellitus, Type 2 diet therapy, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 drug therapy, Fasting blood, Metformin therapeutic use, Glucosides therapeutic use, Benzhydryl Compounds therapeutic use, Glycemic Control methods
- Abstract
Importance: An intermittent fasting plan consisting of 2 nonconsecutive fasting days and 5 days of habitual intake per week and meal replacement diet (5:2 MR) could provide additional benefits to patients with type 2 diabetes., Objective: To evaluate the effect of the 5:2 MR on glycemic control among patients with early type 2 diabetes compared with metformin and empagliflozin., Design, Setting, and Participants: The EARLY (Exploration of Treatment of Newly Diagnosed Overweight/Obese Type 2 Diabetes Mellitus) study is a randomized, open-label, active parallel-controlled clinical trial conducted between November 13, 2020, and December 29, 2022, in 9 centers across China. A total of 509 eligible patients underwent screening, out of which 405 were randomly assigned to 3 groups and included in the intention-to-treat analysis., Interventions: Patients were randomly allocated in a 1:1:1 ratio to receive either metformin, empagliflozin, or 5:2 MR. The treatment was 16 weeks, with an 8-week follow-up., Main Outcomes and Measures: The primary end point was the change in hemoglobin A1c (HbA1c) level from baseline to 16 weeks. Secondary end points included changes in body weight, anthropometric measurements, and biochemical parameters., Results: Of the 405 randomized participants (265 men [65.4%]; mean [SD] age, 45.5 [11.0] years; mean [SD] body mass index, 29.5 [4.1]; and mean [SD] HbA1c level, 7.9% [0.6%]), 332 completed the 16-week treatment. From baseline to week 16, participants in the 5:2 MR group showed the greatest reduction in HbA1c (least-squares mean [LSM], -1.9% [SE, 0.2%]), significantly greater than patients receiving metformin (LSM, -1.6% [SE, 0.2%]; adjusted LSM difference, -0.3% [95% CI, -0.4% to -0.1%]) and empagliflozin (LSM, -1.5% [SE, 0.2%]; adjusted LSM difference, -0.4% [95% CI, -0.6% to -0.2%]). At week 16, the mean weight loss in the 5:2 MR group (LSM, -9.7 kg [SE, 2.2 kg]) was greater than that in the metformin group (LSM, -5.5 kg [SE, 2.3 kg]) and empagliflozin group (LSM, -5.8 kg [SE, 2.3 kg])., Conclusions and Relevance: This randomized clinical trial of Chinese adults with overweight or obesity and with early type 2 diabetes found that 5:2 MR could improve glycemic outcomes and weight loss in the short term compared with metformin or empagliflozin, making it a promising initial intervention and early management for type 2 diabetes., Trial Registration: Chinese Clinical Trial Registry Identifier: ChiCTR2000040656.
- Published
- 2024
- Full Text
- View/download PDF
33. Medications and medical expenditures for diabetic patients with osteoporosis in Beijing, China: A retrospective study.
- Author
-
Pan Q, Chen H, Fei S, Zhao P, Deng M, Xiao F, and Guo L
- Subjects
- Humans, Health Expenditures, Beijing, Retrospective Studies, China epidemiology, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 epidemiology, Osteoporosis drug therapy, Osteoporosis epidemiology
- Abstract
Aims: This study aimed to clarify the changes in treatment regimens and medical expenditures in diabetic patients with osteoporosis., Methods: We recruited 2,853,036 diabetic patients from the Beijing medical insurance database between 2016 and 2018. Among them, 406,221 patients also had osteoporosis. Clinical characteristics, treatment regimens, and medical costs were investigated in diabetic patients with and without osteoporosis., Results: Diabetes and osteoporosis were most prevalent in participants aged 45---84 years. Compared with diabetic patients without osteoporosis, those with osteoporosis were prone to developing comorbidities and diabetic complications. They often required multiple glucose-lowering drugs and had a higher rate of insulin use. Similarly, osteoporosis leads to an increased number of medications for non-hypoglycemia as well as higher healthcare costs. These medications and costs increased with the number of complications and comorbidities. Interestingly, from 2016 to 2018, although diabetic patients with osteoporosis took more drugs, medical costs were lower year by year., Conclusions: Osteoporosis might contribute to a worse condition in diabetic patients, and this population often requires more medications with higher medical costs., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)
- Published
- 2023
- Full Text
- View/download PDF
34. Direct medical cost and medications for patient of diabetes retinopathy in Beijing, China, 2016-2018.
- Author
-
Li H, Zhang L, Wang X, Wang W, Zhang J, Pan Q, and Guo L
- Subjects
- Humans, Hypoglycemic Agents, Beijing epidemiology, Insulin therapeutic use, China epidemiology, Retrospective Studies, Diabetic Retinopathy drug therapy, Diabetic Retinopathy epidemiology, Diabetes Mellitus, Type 2 drug therapy
- Abstract
Aims: Medications and costs of drug for diabetic retinopathy in outpatient in China have not been evaluated. The purpose of this study was to evaluate the hypoglycemic drugs and medical costs of diabetic retinopathy patients in the Beijing medical insurance system, analyze the characteristics of outpatient treatment, and investigate the changes in the quantity and cost of hypoglycemic drugs from 2016 to 2018., Methods: This is a retrospective observational study, including diabetic patients with outpatient records in Beijing medical insurance from 2016 to 2018. Data on oral hypoglycemic drugs, insulin and non-hypoglycemic drugs, complications, treatment strategies, and annual medical costs were recorded., Results: A total of 2,853,036 diabetic patients in Beijing medical insurance were enrolled in this study. 4.19 %-4.67 % of patients were diagnosed with retinopathy. Patients with retinopathy have more diabetic complications (1.65 ± 0.71 vs 0.18 ± 0.44. p < .0001), and use more drugs (5.11 ± 2.60 vs 3.85 ± 2.34, p < .0001), the annual total drug cost is also higher (¥ 13,836 ± 11,244 vs ¥ 10,030 ± 9375, p < .0001). The numbers of medication in retinopathy patients increased (5.11 ± 2.60 vs 4.95 ± 2.57, p < .0001), and the annual total drug cost (¥13,836 ± 11,244 vs ¥15,642 ± 13,344, p < .0001) decreased in 2018 compared with 2016., Conclusions: Patients with retinopathy were associated with more complications. Compared with patients without retinopathy, the number of medications and total medical costs were significantly increased. From 2016 to 2018, there was an increase in the number of medication treatments for patients with retinopathy, but a decrease in cost., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
35. Effect of foetal exposure to famine on the risk of nonalcoholic fatty liver disease in adulthood: A systematic review and meta-analysis.
- Author
-
Wei R, Wang W, Pan Q, and Guo L
- Subjects
- Humans, Male, Female, Famine, Risk Factors, China epidemiology, Life Style, Non-alcoholic Fatty Liver Disease epidemiology, Non-alcoholic Fatty Liver Disease etiology
- Abstract
Objective: The risk of metabolic disease in adulthood is not only attributed to an unhealthy lifestyle after birth but also to famine exposure during the foetal period. This systematic review and meta-analysis aimed to evaluate the effects of foetal exposure to famine as a risk factor for developing nonalcoholic fatty liver disease (NAFLD) in adulthood., Methods: Studies were retrieved from PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases to evaluate the effect of foetal exposure to famine on the risk of nonalcoholic fatty liver disease in adulthood., Results: Six studies involving 90,582 subjects were included in this meta-analysis. Foetal exposure to famine was associated with an increased risk of NAFLD(RR = 1.17, 95% CI: 1.08-1.27, P < 0.0001). Exposure to famine during the foetal period significantly increased the incidence of NAFLD in women (RR = 1.27, 95% CI: 1.16-1.40, P <0.00001), while similar results were not observed in the male subgroup (RR =0.99, 95% CI: 0.89-1.11, P = 0.88). Foetal exposure to famine was associated with the risk of mild NAFLD (RR = 1.17, 95% CI: 1.02-1.33, P = 0.02) and moderate to severe NAFLD (RR = 1.51, 95% CI: 1.16-1.98, P = 0.002)., Conclusions: Foetal exposure to famine is associated with an increased risk of NAFLD in adulthood. Women with NAFLD and moderate to severe NAFLD have a more robust association with foetal exposure to famine., Competing Interests: Conflict of interest The authors declare that the research was conducted without commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022. Published by Elsevier Ltd.)
- Published
- 2023
- Full Text
- View/download PDF
36. Medications and medical costs for diabetes patients with or without chronic respiratory disease in Beijing, China: A retrospective study.
- Author
-
Qiao J, Tan Z, Xu X, Zhou Y, Wang W, Luo J, Fan J, Pan Q, and Guo L
- Subjects
- Beijing, China epidemiology, Humans, Hypoglycemic Agents therapeutic use, Retrospective Studies, Diabetes Mellitus, Type 2 complications
- Abstract
Aims: The cost of drug regimens prescribed to Chinese patients has not been evaluated. This study aims to evaluate the medical costs and hypoglycemic agents for diabetes mellitus patients with or without chronic respiratory disease in Beijing, and to investigate the changes in the costs and number of antidiabetic medications used for diabetes patients with chronic respiratory disease from 2016 to 2018., Methods: This observational, retrospective study included diabetes patients with outpatient medication records from Beijing Medical Insurance between 2016 and 2018. The medications, including hypoglycemic and nonhypoglycemic drugs, insulin dosage, comorbidities, diabetes-related complications, treatment strategies, and annual medical costs, were recorded., Results: This study included 2,853,036 diabetes patients from 2016 to 2018. About 18.95%-20.53% of patients with chronic respiratory disease were predominantly distributed among those aged 45-84 years (88.7%-89.1%). Diabetes patients with chronic respiratory disease used more medications (4.48 ± 2.41 vs. 3.76 ± 2.33) and had higher total annual drug costs (¥12,286 ± 10,385 vs. ¥9700 ± 9202) to treat more comorbidities (2.52 ± 1.53 vs. 2.05 ± 1.85) than those without chronic respiratory disease ( p <.0001, respectively). From 2016 to 2018, diabetes patients with chronic respiratory disease had a 4.2% increase in medication, a 1.9% decrease in comorbidities, and a 5.4% decrease in total annual drug costs., Conclusions: In summary, diabetes patients with chronic respiratory disease had more comorbidities, required more hypoglycemic drugs, and had higher medical costs. During 2016-2018, diabetes patients with chronic respiratory disease used more medications and spent less money on medical care., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Qiao, Tan, Xu, Zhou, Wang, Luo, Fan, Pan and Guo.)
- Published
- 2022
- Full Text
- View/download PDF
37. Application of novel subgroups of Chinese inpatients with diabetes based on machine learning paradigm.
- Author
-
Wang W, Chen Z, Wang S, Chen F, Deng M, Pan Q, and Guo L
- Subjects
- China epidemiology, Humans, Machine Learning, Diabetes Mellitus diagnosis, Inpatients
- Abstract
Background and Aims: Six variables were used to determine five diabetes subgroups in European, Chinese and US populations in previous studies. This study aims to make new classification method of diabetes easier to use in clinical settings., Methods: Clinical data of 1152 hospitalized diabetic patients were collected and built a highly accurate model based on machine learning paradigm., Results: We visualized the confusion matrix of the classification model. The diagnose accuracy of five clusters (MOD, MARD, SIRD, SIDD and SAID) were 95%, 100%, 99%, 96% and 100%. An online tool (uqzhichen.uqcloud.net) was set up according to the cluster data based on machine learning paradigm. Six variables (age when diagnosed, HbA1c, BMI, HOMA2-β, HOMA2-IR and GADA) were needed to input in this diagnose system and then a highly accurate subgroup result was showed., Conclusions: This is a stable and accurate online diagnose system to identify five new subgroups of diabetes based on machine learning paradigm., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2022. Published by Elsevier Ltd.)
- Published
- 2022
- Full Text
- View/download PDF
38. Comment on Liu et al. Incidence of Type 1 Diabetes May Be Underestimated in the Chinese Population: Evidence From 21.7 Million People Between 2007 and 2017. Diabetes Care 2021;44:2503-2509.
- Author
-
Weng J, Zhou Z, and Guo L
- Subjects
- Asian People, China epidemiology, Humans, Incidence, Diabetes Mellitus, Type 1 epidemiology, Diabetes Mellitus, Type 2 epidemiology
- Published
- 2022
- Full Text
- View/download PDF
39. Changes in Direct Medical Cost and Medications for Managing Diabetes in Beijing, China, 2016 to 2018: Electronic Insurance Data Analysis.
- Author
-
Guo L, Zheng J, Pan Q, Zhang Q, Zhou Y, Wang W, Zhang L, Tesfaye S, and Zhang J
- Subjects
- Beijing, China, Cost of Illness, Cost-Benefit Analysis, Costs and Cost Analysis, Diabetes Mellitus epidemiology, Drug Costs, Electronic Health Records, Female, Humans, Hypoglycemic Agents economics, Insurance economics, Male, Primary Health Care, Retrospective Studies, Delivery of Health Care economics, Diabetes Mellitus drug therapy, Diabetes Mellitus economics, Health Expenditures statistics & numerical data, Hypoglycemic Agents therapeutic use, Insurance statistics & numerical data
- Abstract
Purpose: Although the cost and complexity of managing diabetes is increasing around the world, placing greater burden on patients and their families, the cost of drug regimens prescribed to Chinese patients has not been evaluated. This study was conducted to evaluate the temporal changes in the costs and drugs used for people with diabetes., Methods: Patients enrolled in Beijing Medical Insurance with outpatient medical records from 2016 through 2018 were included in this study. The outcomes of interest were: (1) the number of outpatient medications, (2) the number of comorbidities diagnosed, (3) the estimated annual cost of the outpatient drug regimen, (4) the drug therapy strategies used for diabetic patients, and (5) the most commonly prescribed classes of drugs., Results: Over the 3-year period, there was a significant decrease (9.0%, P <.001) in the average number of diabetes medications used. Both antiglycemic and non-antiglycemic drug use decreased by 3.6% and 12.9%, respectively. Similarly, for estimated annual costs of medication, an 18.4% ( P <.05) decrease was observed, with a gradual decreased from ¥6,868 ($1,059) in 2016 to ¥5,605 ($865) in 2018., Conclusion: This is the first large-scale cost analysis of the medical management of diabetes since the implementation of medical insurance in China. Despite the increasing availability of newer, more expensive diabetes drugs, there was a significant reduction in the number of diabetes medications used, that may be due to a more rational approach to optimizing metabolic targets., (© 2021 Annals of Family Medicine, Inc.)
- Published
- 2021
- Full Text
- View/download PDF
40. Glucose-lowering pharmacotherapies in Chinese adults with type 2 diabetes and cardiovascular disease or chronic kidney disease. An expert consensus reported by the Chinese Diabetes Society and the Chinese Society of Endocrinology.
- Author
-
Hong T, Su Q, Li X, Shan Z, Chen L, Peng Y, Chen L, Yan L, Bao Y, Lyu Z, Shi L, Wang W, Guo L, Ning G, Mu Y, and Zhu D
- Subjects
- Adult, China, Consensus, Humans, Societies, Medical, Sodium-Glucose Transporter 2 Inhibitors therapeutic use, Cardiovascular Diseases complications, Cardiovascular Diseases drug therapy, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Hypoglycemic Agents therapeutic use, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic drug therapy
- Abstract
Patients with type 2 diabetes mellitus (T2DM) are at risk of developing atherosclerotic cardiovascular disease (ASCVD) and chronic kidney disease (CKD), which are important causes of disabling and death in patients with T2DM. For the prevention and management of ASCVD or CKD, cardiovascular risk factors should be systematically evaluated, and ASCVD and CKD should be screened in patients with T2DM. In this consensus, we recommended that metformin should be used as the first-line therapy for patients with T2DM and ASCVD or very high cardiovascular risk, heart failure (HF) or CKD, and should be retained in the treatment regimen unless contraindicated or not tolerated. In patients with T2DM and established ASCVD or very high cardiovascular risk, addition of a glucagon-like peptide 1 receptor agonist (GLP-1RA) or sodium-glucose cotransporter type 2 (SGLT2) inhibitor with proven cardiovascular benefits should be considered independent of individualised glycated haemoglobin (HbA
1C ) targets. In patients with T2DM and HF, an SGLT2 inhibitor should be preferably added regardless of HbA1C levels. In patients with T2DM and CKD, SGLT2 inhibitors should be preferred for the combination therapy independent of individualised HbA1C targets, and GLP-1RAs with proven renal benefits would be alternative if SGLT2 inhibitors are contraindicated. Moreover, the prevention of hypoglycaemia and management of multiple risk factors by comprehensive regimen, including lifestyle intervention, antihypertensive therapies, lipid-lowering treatment and antiplatelet therapies, should be kept in mind in treating patients with T2DM and ASCVD, HF or CKD., (© 2020 John Wiley & Sons Ltd.)- Published
- 2021
- Full Text
- View/download PDF
41. Efficacy and safety of generic exenatide injection in Chinese patients with type 2 diabetes: a multicenter, randomized, controlled, non-inferiority trial.
- Author
-
Yang J, Xiao W, Guo L, Li Q, Zhong L, Yang J, Yang J, Gao Y, Tian Q, and Hong T
- Subjects
- Adult, Blood Glucose drug effects, Blood Glucose metabolism, China, Diabetes Mellitus, Type 2 blood, Drug Therapy, Combination, Drugs, Generic administration & dosage, Drugs, Generic adverse effects, Equivalence Trials as Topic, Female, Glycated Hemoglobin analysis, Humans, Hypoglycemia chemically induced, Hypoglycemic Agents administration & dosage, Hypoglycemic Agents adverse effects, Injections, Insulin metabolism, Male, Metformin administration & dosage, Metformin adverse effects, Middle Aged, Secretagogues administration & dosage, Secretagogues adverse effects, Treatment Outcome, Diabetes Mellitus, Type 2 drug therapy, Exenatide administration & dosage, Exenatide adverse effects
- Abstract
Aims: This study aimed to compare the efficacy and safety of generic exenatide with branded exenatide Byetta
® in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled on monotherapy or combination therapy of metformin and insulin secretagogues., Methods: A multicenter, randomized, controlled, non-inferiority trial was performed. A total of 240 patients with T2DM and glycated hemoglobin (HbA1c) ≥ 7% (53 mmol/mol) to ≤ 9.0% (75 mmol/mol) on monotherapy or combination therapy of metformin and insulin secretagogues for at least 3 months were randomized into generic exenatide or branded exenatide groups with a 1:1 ratio for 16 weeks of treatment. The primary endpoint was the change in HbA1c levels from baseline at week 16, with a non-inferiority margin of - 0.35% (- 3.83 mmol/mol) (lower bound of one-sided 95% confidence interval (CI) > - 0.35% (- 3.83 mmol/mol)). Secondary endpoints included the proportion of participants achieving HbA1c < 7% (53 mmol/mol), the changes in fasting plasma glucose (FPG), 2-h postprandial glucose (2hPG) following a standard meal, 7-point self-monitoring blood glucose (SMBG) profiles, body weight change from baseline at week 16 and the change in HbA1c levels from baseline at week 8. Safety issues were also evaluated., Results: After 16 weeks of treatment, HbA1c levels decreased significantly from baseline in the two groups, with a reduction of - 1.10% ± 1.31% (- 12.0 mmol/mol ± 14.3 mmol/mol) in the generic exenatide group and - 1.08% ± 1.11% (- 11.8 mmol/mol ± 12.1 mmol/mol) in the branded exenatide group (both P < 0.001). The least-squares mean difference of HbA1c reduction between the two groups was - 0.03% (- 0.33 mmol/mol), with a lower one-sided 95% CI limit of - 0.27% (- 2.95 mmol/mol), which was higher than the prespecified non-inferiority margin of - 0.35% (- 3.83 mmol/mol). Moreover, there were no significant differences in the proportion of participants achieving HbA1c < 7% (53 mmol/mol) and the changes in FPG, 2hPG, 7-point SMBG profiles and body weight at week 16 and the change in HbA1c levels from baseline at week 8 (all P > 0.05) between the two groups. The incidence of adverse events, including the incidence of hypoglycemia (18.3% and 17.5%, respectively), was similar for the generic and branded exenatide groups (P > 0.05)., Conclusions: In patients with T2DM inadequately controlled on monotherapy or combination therapy of metformin and insulin secretagogues, add-on treatment with generic exenatide demonstrated non-inferiority to branded exenatide in terms of improvements in HbA1c after 16 weeks of treatment. Furthermore, the two drugs were also similar for other efficacy endpoints and safety profile. Trial registration Chinese Clinical Trial Registry: ChiCTR-IPR-15006558, Date registered May 27, 2015.- Published
- 2020
- Full Text
- View/download PDF
42. Study Protocol for a Prospective, Multicenter, Randomized, Open-Label, Parallel-Group Clinical Trial Comparing the Efficacy and Safety of a Needle-Free Insulin Injector and a Conventional Insulin Pen in Controlling Blood Glucose Concentrations in Chinese Patients with Type 2 Diabetes Mellitus (The FREE Study).
- Author
-
Ji L, Chen L, Wang Y, Ma Z, Ran X, Sun Z, Xu X, Wang G, Guo L, and Shan Z
- Subjects
- Adolescent, Adult, Aged, China epidemiology, Diabetes Mellitus, Type 2 epidemiology, Female, Humans, Hypoglycemic Agents administration & dosage, Male, Middle Aged, Patient Safety, Prospective Studies, Surveys and Questionnaires, Treatment Outcome, Young Adult, Asian People psychology, Diabetes Mellitus, Type 2 drug therapy, Hypoglycemic Agents therapeutic use, Insulin administration & dosage, Insulin Infusion Systems, Needles, Patient Satisfaction statistics & numerical data
- Abstract
Introduction: China has the largest number of diabetic patients in the world. In the past 2 decades, the prevalence of diabetes in China has increased dramatically, and the current status of diabetes control in the diabetic population is not satisfactory. Although insulin is currently recognized in diabetes treatment guidelines as the therapeutic option for patients not adequately controlled by diet/exercise and oral agents, the proportion of patients with type 2 diabetes using insulin is still very low, and the time when insulin therapy is initiated is relatively late. In using insulin injections, concerns about the complexity of the treatment regimen, a fear of needles, and other psychological barriers can affect insulin treatment, impacting on patient compliance and potentially resulting in a poor treatment response. Another type of insulin injection device that has become available recently, the needle-free injector, is now being used in clinical practice because of its unique features and patients' injection experiences. The aims of this study are to investigate the efficacy and safety of the needle-free injector-based insulin treatment in blood glucose control in patients with type 2 diabetes, as compared with a conventional needle-based insulin treatment, and to evaluate patient satisfaction with the different insulin delivery methods., Methods and Planned Outcomes: A prospective, multicenter, randomized, open-label, parallel-group clinical trial was designed and implemented in China. A total of 420 patients with type 2 diabetes from ten research centers will be enrolled in the study. The primary efficacy endpoint is the change in the glycosylated hemoglobin (HbA1c) level from baseline to after 16 weeks of treatment after randomization. Secondary efficacy endpoints include measurements of blood glucose concentrations, the rate of achieving the target HbA1c level of less than 7%, patients' quality-of-life (as determined by the SF-36 questionnaire), the insulin dose administered, compliance with insulin therapy, and patients' satisfaction with their injection device., Ethics and Dissemination: The study was approved by the Independent Ethics Committee (IEC) of Peking University Peoples Hospital and was conducted in accordance with the moral, ethical, and scientific principles of the declaration of Helsinki and the provisions of good clinical practice (GCP) in China. Written informed consent will be obtained from all participants before any study-related procedures are implemented. It is hoped that the study will provide evidence for the clinical application of the needle-free injector by providing data on its efficacy and safety, as compared with a conventional insulin pen, in the Chinese type 2 diabetes population. When available, the results will be published in an international peer-reviewed journal., Trial Registration: ClinicalTrials.gov Identifier, NCT03243903. Registration date, August 9, 2017., Funding: Beijing QS Medical Technology Co., Ltd.
- Published
- 2019
- Full Text
- View/download PDF
43. The relationship between human adenovirus 36 and obesity in Chinese Han population.
- Author
-
Zhou Y, Pan Q, Wang X, Zhang L, Xiao F, and Guo L
- Subjects
- Adenovirus Infections, Human complications, Adenovirus Infections, Human virology, Adult, China epidemiology, Female, Humans, Male, Middle Aged, Obesity complications, Obesity virology, Odds Ratio, Seroepidemiologic Studies, Sex Factors, Weight Gain, Adenovirus Infections, Human epidemiology, Adenoviruses, Human isolation & purification, Obesity epidemiology
- Abstract
The study aimed to explore the prevalence of human adenovirus-36 (HAdV-36) infection and the association of HAdV-36 with obesity in Chinese Han population. A qualitative determination using ELISA was performed to determine by duplication of the antibodies to HAdV-36 in the serum samples. Logistic regression analysis was used to analyze the association between HAdV-36 seropositivity and obesity. The overall HAdV-36 seroprevalence was 49.8% amongst 824 participants. The prevalence of HAdV-36 seropositive was 42.9 and 51.4% in the obese and non-obese participants, respectively, which was not statistically significant ( P =0.05). There were significant differences in the anthropometric and biochemical parameters observed between the two groups except for height ( P =0.067) and total cholesterol (TC) ( P <0.29). After the adjustment for age and gender, HAdV-36 seropositivity was a protective factor for obesity (odds ratio (OR) = 0.69, 95% confidence intervals (95% CI) = 0.48-0.97, P =0.03). In the male population, the adjusted OR for AD-36 antibody-positive status was statistically decreased for obese adults (OR = 0.59; 95% CI = 0.39-0.91; P =0.02). However, the similar result was not obtained in the female population (OR = 0.90; 95% CI = 0.48-1.67; P =0.73). We found a high prevalence of HAdV-36 infection in China and significant association between HAdV-36 infection and obesity or weight gain after the adjustment for age and gender. The HAdV-36 infection may be related to the weight loss in Chinese Han population, especially in the male group, which needs to be further confirmed., (© 2018 The Author(s).)
- Published
- 2018
- Full Text
- View/download PDF
44. Saxagliptin add-on therapy in Chinese patients with type 2 diabetes inadequately controlled by insulin with or without metformin: Results from the SUPER study, a randomized, double-blind, placebo-controlled trial.
- Author
-
Chen Y, Liu X, Li Q, Ma J, Lv X, Guo L, Wang C, Shi Y, Li Y, Johnsson E, Wang M, Zhao J, and Ji L
- Subjects
- Adamantane administration & dosage, Adamantane adverse effects, Adult, Aged, Asian People, Blood Glucose metabolism, China, Diabetes Mellitus, Type 2 blood, Dipeptides adverse effects, Double-Blind Method, Drug Therapy, Combination adverse effects, Female, Glycated Hemoglobin drug effects, Humans, Insulin adverse effects, Male, Metformin adverse effects, Middle Aged, Placebos, Adamantane analogs & derivatives, Blood Glucose drug effects, Diabetes Mellitus, Type 2 drug therapy, Dipeptides administration & dosage, Insulin administration & dosage, Metformin administration & dosage
- Abstract
This prospective, multicentre, phase III study (NCT02104804) evaluated the efficacy and safety of saxagliptin add-on therapy in Chinese patients with type 2 diabetes inadequately controlled by insulin ± metformin. Patients with glycated haemoglobin (HbA1c) 7.5% to 10.5% and fasting plasma glucose (FPG) <15 mmol/L (270 mg/dL) on stable insulin therapy (20-150 U/d) were randomized (1:1) to saxagliptin 5 mg once daily (N = 232) or placebo (N = 230) for 24 weeks, stratified by metformin use. The primary efficacy measure was change in HbA1c. Saxagliptin treatment resulted in a greater adjusted mean change in HbA1c from baseline to week 24 than placebo (-0.58%; P < .001), irrespective of metformin use, and a greater mean change in FPG (0.9 mmol/L [-15.9 mg/dL]; P < .001). More patients achieved HbA1c <7% with saxagliptin (11.4%) than with placebo (3.5%, P = .002). Adverse events and incidence of hypoglycaemia were similar in both groups. Overall, add-on saxagliptin 5 mg once daily significantly improved glycaemic control without increasing hypoglycaemia risk and was well tolerated in Chinese patients with type 2 diabetes inadequately controlled by insulin (± metformin)., (© 2017 John Wiley & Sons Ltd.)
- Published
- 2018
- Full Text
- View/download PDF
45. A Multicenter Evaluation of the Performance and Usability of a Novel Glucose Monitoring System in Chinese Adults With Diabetes.
- Author
-
Ji L, Guo X, Guo L, Ren Q, Yu N, and Zhang J
- Subjects
- Adult, Aged, Asian People, China, Female, Humans, Male, Middle Aged, Monitoring, Physiologic, Sensitivity and Specificity, Young Adult, Blood Glucose analysis, Blood Glucose Self-Monitoring instrumentation, Diabetes Mellitus blood
- Abstract
Objective: Flash glucose monitoring is a new glucose sensing technique that measures interstitial glucose levels for up to 14 days and does not require any calibration. The aim of this study is to evaluate the performance of the new system in Chinese patients with diabetes., Methods: A multicenter, prospective, masked study was performed in a total of 45 subjects with diabetes. Subjects wore 2 sensors at the same time, for up to 14 days. The accuracy was evaluated against capillary blood glucose (BG) and venous Yellow Springs Instrument (YSI; Yellow Springs, OH) measurements. During all 14 days, subjects were asked to perform at least 8 capillary BG tests per day. Each subject attended 3 days of 8-hour clinic sessions to measure YSI and sensor readings every 15 minutes., Results: Forty subjects had evaluable glucose readings, with 6687 of 6696 (99.9%) sensor and capillary BG pairs within consensus error grid zones A and B, including 5824 (87.0%) in zone A. The 6969 sensor and venous YSI pairs resulted in 6965 (99.9%) pairs within zones A and B, including 5755 (82.6%) in zone A. The sensor pairs with BG and YSI result in mean absolute relative difference (MARD) of 10.0% and 10.7%, respectively. Overall between-sensor coefficient of variation (CV) was 8.0%, and the mean lag time was 3.1 (95% confidence interval 2.54 to 4.29) minutes., Conclusions: The system works well for people with diabetes in China, and it is easy to wear and use.
- Published
- 2017
- Full Text
- View/download PDF
46. Interactive effect of serum uric acid and total bilirubin for cardiovascular disease in Chinese patients with type 2 diabetes.
- Author
-
Ren Y, Jin N, Hong T, Mu Y, Guo L, Ji Q, Li Q, Yang X, and Ji L
- Subjects
- Aged, Asian People, Bilirubin blood, Cardiovascular Diseases complications, China, Cross-Sectional Studies, Diabetes Mellitus, Type 2 complications, Female, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Risk Factors, Stroke complications, Stroke diagnosis, Uric Acid blood, Cardiovascular Diseases diagnosis, Diabetes Mellitus, Type 2 diagnosis
- Abstract
Serum uric acid (SUA) at high levels and bilirubin at low levels were potent antioxidant but it was uncertain that whether SUA and total bilirubin (TBIL) had additive interaction for the risk of CVD in type 2 diabetes mellitus (T2DM). We conducted a cross-sectional survey of 6713 inpatients with T2DM and admitted to 81 tertiary care hospitals. CVD was defined as having either prior coronary heart disease or stroke or peripheral arterial disease. Binary logistic regression was used to estimate odds ratios of SUA and TBIL for CVD. The effect size of additive interaction was estimated by three measures, i.e., relative excess risk due to interaction, attributable proportion due to interaction and synergy index. Among 6713 patients with T2DM, 561 (8.36%) suffered from CVD. Using ≥283 umol/L (median) to define high SUA and <11.5 umol/L (n = 2290 or 34.11%) to define low TBIL, copresence of both factors (n = 621 or 9.25%) was associated with 5.18-fold (95% CI, 4.00-6.72) risk of CVD with significant additive interactions in multivariable analysis as compared to absence of both risk factors. The copresence of both high SUA and low TBIL was associated with a large increased risk of CVD in high-risk Chinese patients with type 2 diabetes.
- Published
- 2016
- Full Text
- View/download PDF
47. China type 2 diabetes treatment status survey of treatment pattern of oral drugs users
- Author
-
Ji L, Lu J, Weng J, Jia W, Tian H, Zhu D, Xing X, and Guo L
- Subjects
- Administration, Oral, China, Cross-Sectional Studies, Dipeptidyl-Peptidase IV Inhibitors therapeutic use, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Male, Metformin therapeutic use, Middle Aged, Prognosis, Retrospective Studies, Sulfonylurea Compounds therapeutic use, Thiazolidinediones therapeutic use, Diabetes Mellitus, Type 2 drug therapy, Hypoglycemic Agents therapeutic use
- Abstract
Background: The aim of the present study was to investigate the current status of oral anti-diabetic drug (OAD) therapy in patients with type 2 diabetes and influencing factors in a real-world setting in China., Methods: A total of 9872 outpatients with type 2 diabetes, who had received OADs (monotherapy or combination therapy) for at least 3 months were recruited in this study. Current antidiabetic treatment regimen and related clinical data were collected from medical records and analyzed., Results: The most common OADs in use were insulin secretagogues (70.2%) such as sulfonylureas (SUs; 42.7%) or glinides (27.5%), followed by metformin (53.7%), α-glucosidase inhibitors (35.9%), thiazolidinediones (17.2%), and dipeptidyl peptidase-4 (DPP-4) inhibitors (0.8%). Dual-drug combination therapy was more common (45.4%) than monotherapy (35.8%) and combination therapy with at least three drugs (17.0%). Patients on SU or glinide monotherapy were more likely to alter their treatment frequently (odds ratio [OR], 1.7; 95% CI, 1.38-2.08; P < 0.001)., Conclusions: The status of OAD use in China is varied with a majority of the patients altering their treatment regimen citing poor effectiveness. These observations from a real-world setting may serve as guidance for improving diabetes management in China., (© 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.)
- Published
- 2015
- Full Text
- View/download PDF
48. Prevalence and associated factors of obstructive sleep apnea in hospitalized patients with type 2 diabetes in Beijing, China 2.
- Author
-
Zhang R, Guo X, Guo L, Lu J, Zhou X, and Ji L
- Subjects
- Adult, Aged, Aged, 80 and over, Body Mass Index, China epidemiology, Diabetes Complications etiology, Diabetes Mellitus, Type 2 complications, Female, Humans, Male, Middle Aged, Prevalence, Risk Factors, Sleep Apnea, Obstructive etiology, Young Adult, Diabetes Complications epidemiology, Diabetes Mellitus, Type 2 physiopathology, Sleep Apnea, Obstructive epidemiology
- Abstract
Background: The aim of the present study was to assess the prevalence and risk factors associated with obstructive sleep apnea (OSA) in hospitalized patients with type 2 diabetes mellitus (T2DM) in China., Methods: Patients with T2DM who were hospitalized in four facilities in Beijing were invited to participate in the study. In all, 337 patients were enrolled consecutively, and 210 (62.3%) completed the study. Data from 472 patients in a non-consecutive expanding study were analyzed for the association study. A portable monitoring device was used to detect the presence of OSA. The apnea-hypopnea index (AHI) and the lowest level of oxygen saturation during the night were recorded to evaluate the severity of OSA. Logistic regression analysis was used to estimate the odds ratio (OR) for OSA for risk factors., Results: The prevalence of OSA was 66.7%. The prevalence of moderate to severe OSA (AHI ≥15/h) was 20.0%. The multi-adjusted OR (95% confidence interval) estimating OSA corresponding to a 1-year increase in age was 1.06 (1.04, 1.08), whereas that to a 1-kg/m(2) increase in body mass index (BMI) was 1.18 (1.11, 1.26). The lowest oxygen saturation was associated with proliferative diabetic retinopathy (PDR) and cerebral infarction; the multivariate adjusted OR (95% CI) corresponding to a 1% increase in lowest oxygen saturation were 0.95 (0.92, 0.99) and 0.97 (0.94, 0.99), respectively., Conclusion: A high prevalence of OSA was observed in this sample of patients with T2DM in China. Age and BMI were associated with the presence of OSA. The lowest oxygen saturation was independently associated with the presence of PDR and cerebral infarction., (© 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.)
- Published
- 2015
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.