Abstract Diabetes mellitus (DM) is a complex, multisystem disease, affecting large populations worldwide. Type 2 diabetes mellitus (T2DM) is a complex polygenic disease that causes hyperglycemia and accounts for 90-95% of all diabetes mellitus cases. We conducted a randomized, controlled single-blind study to observe how dietary care with restriction of carbohydrate absorption affects glucose and lipid metabolism in elderly patients with T2DM. Participants in the control group (Group C) received usual care and in the experimental group (Group E) white common bean extract (WCBE) was given before meals. The trial was divided into two periods: intensive and maintenance intervention periods. Glucose and lipid metabolic parameters of both groups were monitored over the study period. Glycosylated hemoglobin (HbA1c) in Group E was lower than in Group C at the end of the 2- and 4-month, and significantly decline from baseline. The area under curve of oral glucose tolerance test (OGTT) glucose after 2- and 4-month intervention than baseline in Group E and were all significantly lower than in Group C after the intervention. Both High-density lipoprotein (HDL) and Low-density lipoprotein (LDL) also improved in group E (P < 0.05). In the clinical management of elderly patients with T2DM, this individualized model of care without restricting carbohydrate intake can effectively improve patients' glucose metabolism. The effect of this care model is similar to that of a low-carbohydrate diet care model. Therefore, this regimen could be a novel antidiabetic approach for patients with T2DM who are unwilling to restrict their carbohydrate intake.

RESUMO Objetivo Investigar as características clínicas de prematuros com diferentes gravidades de displasia broncopulmonar (DBP) e divulgar os fatores de alto risco para a DBP. Métodos Coleta de dados clínicos de 91 prematuros internados em UTIN com diagnóstico de DBP, categorizados em grupos de acordo com a gravidade da doença: 41 casos leves, 24 casos moderados e 26 casos graves. Foram feitas a comparação e a análise de fatores de risco perinatais, tratamento, complicações e prognóstico de lactentes com diferentes graus de gravidade. Resultados O grupo grave teve uma proporção maior de bebês com doença cardíaca congênita (DCC) do que o grupo moderado (p < 0,05) e com pneumonia e ventilação mecânica (VM) ≥ 7 dias do que o grupo leve (p < 0,05). O grupo grave também apresentou maior incidência de reintubação do que os grupos leve e moderado (p < 0,05). Os grupos apresentaram diferentes (p < 0,05) taxas de incidência de persistência do canal arterial hemodinamicamente significativa (PCAhs). A análise de ridit sugeriu que os bebês prematuros (BPs) com PCAhs, infecções pulmonares microbianas múltiplas ou pneumonia por Klebsiella pneumoniae tinham doenças mais graves. Conclusão DCC, PCAhs, VM ≥ 7 dias, reintubação, pneumonia, principalmente infecções pulmonares microbianas múltiplas, e pneumonia por Klebsiella pneumoniae estão correlacionadas com a gravidade da DBP e podem ser usadas como preditoras de progressão da DBP.

ABSTRACT Objective To investigate the clinical characteristics of preterm infants with different severities of bronchopulmonary dysplasia (BPD) and disclose the high-risk factors of exacerbating BPD. Methods Collection of clinical data of 91 preterm infants admitted to the NICU and diagnosed with BPD, categorized in groups according to the disease severity: 41 mild cases,, 24 moderate cases, and 26 severe cases. Comparison and analysis of perinatal risk factors, treatment, complications and prognosis of the infants with different severity degrees. Results The severe group had a higher proportion of infants with congenital heart disease (CHD) higher than the moderate group (P < 0.05), and a higher ratio of pneumonia and mechanical ventilation (MV) ≥ seven days than the mild group (P < 0.05). The severe group also presented higher reintubation incidence than both the mild and moderate groups (P < 0.05). The groups presented different (P < 0.05) incidence rates of hemodynamically significant patent ductus arteriosus (hsPDA) . Ridit analysis suggested that the premature infants (PIs) with hsPDA, multiple microbial pulmonary infections, or Klebsiella pneumoniae pneumonia had more severe illness. Conclusion CHD, hsPDA, MV ≥ seven days, reintubation, pneumonia, especially multiple microbial pulmonary infections, and Klebsiella pneumoniae pneumonia are correlated with the severity of BPD and can be used as BPD progression predictor.