Context
Up to 40% polycystic ovary syndrome (PCOS) patients have prediabetes, an optimal pharmacotherapy regimen for diabetes prevention in PCOS is yet to be established.
Objective
To evaluate clinical efficacy of exenatide (EX), metformin (MET) or combination (COM) for prediabetes in PCOS.
Design
Randomized, open-label, parallel-group controlled trial.
Setting
Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine.
Patients
PCOS with prediabetes (fasting plasma glucose 5.6-6.9 mmol/L and/or 2-h post glucose 7.8-11.0 mmol/L on OGTT). 150 out of 183 eligible enrollees completed the study.
Intervention
EX (10-20 μg daily), MET (1500-2000 mg daily), or COM (EX plus MET) for 12 weeks.
Main Outcome Measures
Sustained remission rate of prediabetes (primary endpoint, a normal OGTT after 12 weeks of treatment followed by 12 weeks of washout on no drug treatment) along with anthropometric, hormonal, metabolic, and pancreatic β-cell function parameters (secondary endpoints) and potential mechanisms were assessed.
Results
IGT was found the dominant prediabetes phenotype. Overall sustained prediabetes remission rate was 50.7%. Remission rate of COM group (64%, 32/50) or EX group (56%, 28/50) was significantly higher than that of MET group (32%, 16/50) (p = 0.003 and 0.027, respectively). EX was associated with superior suppression of 2-hour glucose increment in OGTT. A two-step hyperglycemic clamp study further revealed that EX had led to higher postprandial insulin secretion as compared to MET, potentially explaining the higher remission rate.
Conclusions
As compared to MET monotherapy, EX or COM achieved higher rate of remission of prediabetes among PCOS patients by improving postprandial insulin secretion.
Minor spatial fluctuations on the pA scale in passive current density of type 304 stainless steel in dilute aqueous chloride solution are shown to relate directly to the subsequent initiation of pitting corrosion.
Flash sintering is a novel field‐assisted sintering technology for ceramics that allows a dramatic reduction in processing time and temperature. Since 2010, when flash sintering was first reported, it has been a focus of research interest in the field of materials science. Recent study results have confirmed that the sintering temperature decreases with the strength of the applied electric field; for some ceramics, the sintering temperature can be lowered even to room temperature. This represents an innovative breakthrough for ceramic sintering at ultra‐low temperatures. However, once the electric field strength in flash sintering is increased, new questions and challenges arise, such as whether or not partial discharge occurs in the green body if under electro‐thermal coupling stress, how to quantitatively analyse the impact of discharge on sintering, and, moreover, whether the sintering mechanism under a strong electric field is consistent with that under a weak electric field. These research questions require knowledge of partial discharge detection, dielectric theory, and other topics that are beyond the scope of materials science. To address this need, this review summarises the work carried out in flash sintering with a strong electric field from the perspective of high voltage and insulation technology. First, the flash sintering process and mechanism are briefly introduced. Then, the published literature on flash sintering with a strong electric field for various ceramic materials is summarised in depth. In addition, experimental phenomena that are observed in flash sintering with a strong electric field, such as flash and blackening, are discussed. Finally, some suggestions for future work are presented. It is anticipated that the knowledge gap between different areas of study can be filled by this review.
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