RESUMEN
Objective: To investigate the effect of infrared combined with methylcobalamin on the vibratory sensory threshold and lower limb nerve conduction velocity of patients with diabetic foot. Methods: One hundred and six patients with diabetic foot in our hospital from February 2018 to December 2020 were enrolled and divided into the study and control groups. The patients in the control group were given methylcobalamin, and the patients in the research group were treated with infrared light on the basis of the control group. The therapeutic effect, vibration sensory threshold, lower limb nerve conduction velocity, and related biochemical index levels before and after treatment in the two groups were counted. Result: The total effective rate of the study group (94.34%) was significantly higher than that of the control group (81.13%). The left/right lower limb vibration sensation threshold decreased in both groups after treatment, and the study group was lower than that of the control group (P < 0.05). The conduction velocity of the left/right common peroneal nerve and tibial nerve increased in both groups after treatment, and the study group was larger than that of the control group (P < 0.05). The bFGF, VEGF, and APN increased in both groups after treatment. VEGF and APN increased and IL-6 and TNF-α decreased in both groups after treatment, and the study group was better than the control group (P < 0.05). Conclusion: Infrared and methylcobalamin combined treatment of diabetic foot can effectively improve lower extremity nerve conduction velocity and vibration sensory threshold, regulate serum bFGF and VEGF levels, reduce the degree of inflammatory response, and help improve the overall treatment effect.
Asunto(s)
Diabetes Mellitus , Pie Diabético , Neuropatías Diabéticas , Pie Diabético/tratamiento farmacológico , Neuropatías Diabéticas/tratamiento farmacológico , Humanos , Extremidad Inferior , Conducción Nerviosa/fisiología , Umbral Sensorial , Factor A de Crecimiento Endotelial Vascular , Vitamina B 12/análogos & derivadosRESUMEN
Improving glucose sensitivity remains an unmet medical need in treating type 2 diabetes (T2D). Dorzagliatin is a dual-acting, orally bioavailable glucokinase activator that enhances glucokinase activity in a glucose-dependent manner, improves glucose-stimulated insulin secretion and demonstrates effects on glycemic control in patients with T2D. We report the findings of a randomized, double-blind, placebo-controlled phase 3 clinical trial to evaluate the efficacy and safety of dorzagliatin in patients with T2D. Eligible drug-naïve patients with T2D (n = 463) were randomly assigned to the dorzagliatin or placebo group at a ratio of 2:1 for 24 weeks of double-blind treatment, followed by 28 weeks of open-label treatment with dorzagliatin for all patients. The primary efficacy endpoint was the change in glycated hemoglobin from baseline to week 24. Safety was assessed throughout the trial. At week 24, the least-squares mean change in glycated hemoglobin from baseline (95% confidence interval) was -1.07% (-1.19%, -0.95%) in the dorzagliatin group and -0.50% (-0.68%, -0.32%) in the placebo group (estimated treatment difference, -0.57%; 95% confidence interval: -0.79%, -0.36%; P < 0.001). The incidence of adverse events was similar between the two groups. There were no severe hypoglycemia events or drug-related serious adverse events in the dorzagliatin group. In summary, dorzagliatin improved glycemic control in drug-naïve patients with T2D and showed a good tolerability and safety profile.
Asunto(s)
Diabetes Mellitus Tipo 2 , Glucemia , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Método Doble Ciego , Quimioterapia Combinada , Glucoquinasa , Glucosa , Hemoglobina Glucada/análisis , Hemoglobina Glucada/uso terapéutico , Humanos , Hipoglucemiantes , Pirazoles , Resultado del TratamientoRESUMEN
BACKGROUND: Angiogenic growth factors play an important role in wound healing. However, their associations with diabetic foot ulcers (DFUs) in humans have rarely been investigated. We examined the relationships between circulating concentrations of vascular endothelial growth factor (VEGF)-A and placenta growth factor (PlGF), and DFU risk. METHODS: We recruited 447 participants, including 169 DFU patients, 182 diabetes patients without DFUs, and 96 diabetes-free individuals. Plasma VEGF-A and PlGF concentrations were measured using commercial enzyme immunoassay kits. RESULTS: Concentrations of VEGF-A and PlGF in DFU patients were higher than those in diabetes-free controls (Pâ¯<â¯0.05), but lower than those in the diabetic controls (Pâ¯<â¯0.05). Increased concentrations of VEGF-A and PlGF were associated with a reduced risk of DFUs. The odds ratios (95% confidence intervals) were 0.93 (0.88, 0.97) for every 10â¯pg/ml increase in VEGF-A concentrations, and 0.96 (0.94, 0.99) for every 5â¯pg/ml increase in PlGF concentrations. VEGF-A concentrations were positively related to BMI, glycated hemoglobin (HbA1c), hypertension, and neuropathy, and PlGF was positively correlated to age, HbA1c, and hypertension, among DFU patients. CONCLUSION: VEGF-A and PlGF play important roles in the development of DFU but need to be confirmed in prospective studies.