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1.
Nutrients ; 12(10)2020 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-33008059

RESUMEN

COVID-19 related restrictions aimed at curbing the spread of the coronavirus result in changes in daily routines and physical activity which can have a negative effect on eating and health habits. The aim of the study was to assess the impact of the COVID-19 pandemic on patients with diabetes and their nutrition and health behaviours. A survey conducted in July 2020 included 124 individuals with type 1 (n = 90) and 2 (n = 34) diabetes mellitus from Poland. To assess nutritional and health behaviours, an online questionnaire covering basic information, anthropometric data, and details regarding physical activity, eating, and hygiene habits was used. Almost 40% of all respondents with type 1 and 2 diabetes mellitus (DM) stated that their disease self-management had significantly improved. Over 60% of all participants declared that they had started eating more nutritious and regular meals during the COVID-19 pandemic. Enhanced hygiene, in particular, during the period, a statistically significant increase in hand sanitiser use was reported by respondents (18% vs. 82%, p < 0.001). The study demonstrated that the pandemic had a significant impact on the behaviour of patients with DM. Improved disease self-management and making healthy, informed food and hygiene choices were observed.


Asunto(s)
Infecciones por Coronavirus , Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Dieta , Conductas Relacionadas con la Salud , Pandemias , Neumonía Viral , Automanejo , Adolescente , Adulto , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 2/terapia , Ejercicio Físico , Conducta Alimentaria , Femenino , Desinfección de las Manos , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/epidemiología , Neumonía Viral/virología , Encuestas y Cuestionarios , Adulto Joven
2.
Saudi Med J ; 41(10): 1090-1097, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33026050

RESUMEN

OBJECTIVES: To elucidate the risk factors for hospital admission among COVID-19 patients with type 2 diabetes mellitus (T2DM). METHODS: This retrospective study was conducted at the Prince Sultan Military Medical City, Riyadh, Saudi Arabia between May 2020 and July 2020. Out of 7,260 COVID-19 patients, 920 were identified as T2DM. After the exclusion process, 806 patients with T2DM were included in this analysis. Patients' data were extracted from electronic medical records. A logistic regression model was performed to estimate the risk factors of hospital admission. Results: Of the total of 806 COVID-19 patients with T2DM, 48% were admitted in the hospital, 52% were placed under home isolation. Older age between 70-79 years (OR [odd ratio] 2.56; p=0.017), ≥80 years (OR 6.48; p=0.001) were significantly more likely to be hospitalized compared to less than 40 years. Similarly, patients with higher HbA1c level of ≥9% compared to less than 7%; (OR 1.58; p=0.047); patients with comorbidities such as, hypertension (OR 1.43; p=0.048), cardiovascular disease (OR 1.56; p=0.033), cerebrovascular disease (OR 2.38; p=0.016), chronic pulmonary disease (OR 1.51; p=0.018), malignancy (OR 2.45; p=0.025), chronic kidney disease (CKD) IIIa, IIIb, IV (OR 2.37; p=0.008), CKD V (OR 5.07; p=0.007) were significantly more likely to be hospitalized. Likewise, insulin-treated (OR 1.46; p=0.03) were more likely to require hospital admission compared to non-insulin treated patients. CONCLUSION: Among COVID-19 patients with diabetes, higher age, high HbA1c level, and presence of other comorbidities were found to be significant risk factors for the hospital admission.


Asunto(s)
Factores de Edad , Enfermedad Crónica/epidemiología , Infecciones por Coronavirus , Diabetes Mellitus Tipo 2 , Hemoglobina A Glucada/análisis , Hospitalización/estadística & datos numéricos , Pandemias , Neumonía Viral , Adulto , Anciano , Betacoronavirus/aislamiento & purificación , Comorbilidad , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/epidemiología , Registros Electrónicos de Salud/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Estudios Retrospectivos , Medición de Riesgo/métodos , Factores de Riesgo , Arabia Saudita/epidemiología
3.
Rev Assoc Med Bras (1992) ; 66(9): 1283-1288, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33027459

RESUMEN

The pharmacological therapy for type 2 diabetes mellitus has presented important advances in recent years, which has impacted the treatment of patients with established cardiovascular disease or with high cardiovascular risk. In this scenario, two drug classes have emerged and demonstrated clear clinical benefits: SGLT-2 inhibitors and GLP-1 agonists. The present review discusses the pharmacology, adverse effects, and clinical trials that have demonstrated the benefits of these medications in reducing cardiovascular risk.


Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Enfermedades Cardiovasculares/prevención & control , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Humanos , Factores de Riesgo , Inhibidores del Cotransportador de Sodio-Glucosa 2
4.
Rev Med Liege ; 75(10): 653-659, 2020 Oct.
Artículo en Francés | MEDLINE | ID: mdl-33030841

RESUMEN

Physical activity is a key step in the management of diabetes, both in type 1 and type 2 diabetes. In diabetic subjects, it is recommended to practice 150 minutes of weekly physical activity spread over at least three days, with a maximum of two consecutive days without exercise. However, more than 60 % of type 1 diabetic patients fail to meet this goal. This is largely explained by the fear of potential adverse effects, in particular the occurrence of hypoglycaemia during exercise, which represents a major obstacle to its safe practice. Therefore, specific therapeutic education should be considered in these subjects in order to promote regular physical activity.


Asunto(s)
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Hipoglucemia , Deportes , Diabetes Mellitus Tipo 1/terapia , Ejercicio Físico , Humanos , Hipoglucemia/inducido químicamente , Hipoglucemia/prevención & control
5.
Khirurgiia (Mosk) ; (9): 75-79, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-33030005

RESUMEN

Surgical treatment of post-traumatic right-sided phrenic hernia is associated with certain technical difficulties due to topographic and anatomical features. Morbid obesity combined with diabetes mellitus type II is one of the main factors complicating any surgical thoracic or abdominal surgery and further rehabilitation. We report simultaneous surgery for complicated post-traumatic right-sided phrenic hernia in a patient with morbid obesity and diabetes mellitus type II. Surgical correction of giant phrenic hernia facilitated further effective treatment of morbid obesity and concomitant diabetes mellitus type II.


Asunto(s)
Diabetes Mellitus Tipo 2 , Herniorrafia , Obesidad Mórbida , Diabetes Mellitus Tipo 2/complicaciones , Hernia/complicaciones , Humanos , Obesidad Mórbida/complicaciones , Resultado del Tratamiento
6.
Med Hypotheses ; 143: 110197, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33017906

RESUMEN

Coronavirus disease 2019 (COVID-19) may have a metabolic origin given strong links with risk factors such as lipids and glucose and co-morbidities such as obesity and type 2 diabetes mellitus. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein mediates viral cellular entry via the ACE2 receptor. The cytoplasmic tail of this spike protein is heavily palmitoylated. Emerging studies suggest that SARS-CoV-2 alters lipid metabolism in the lung epithelial cells by modulating peroxisome proliferator-activated receptor alpha (PPARα), possibly contributing to lipotoxicity, inflammation and untoward respiratory effects. Disruption of this process may affect palmitoylation of SARS-CoV spike protein and thus infectivity and viral assembly. COVID-19 is also increasingly being recognized as a vascular disease, with several studies noting prominent systemic endothelial dysfunction. The pathogenesis of endothelial dysfunction may also be linked to COVID-19-mediated metabolic and inflammatory effects. Herein, exercise will be compared to fenofibrate as a possible therapeutic strategy to bolster resilience against (and help manage recovery from) COVID-19. This paper will explore the hypothesis that exercise may be a useful adjuvant in a setting of COVID-19 management/rehabilitation due to its effects on PPARα and vascular endothelial function.


Asunto(s)
Infecciones por Coronavirus/terapia , Terapia por Ejercicio/métodos , PPAR alfa/metabolismo , Neumonía Viral/terapia , Glicoproteína de la Espiga del Coronavirus/metabolismo , Betacoronavirus , Comorbilidad , Infecciones por Coronavirus/tratamiento farmacológico , Citoplasma/metabolismo , Diabetes Mellitus Tipo 2/complicaciones , Ejercicio Físico , Fenofibrato/química , Humanos , Inflamación , Metabolismo de los Lípidos , Lipoilación , Pulmón/metabolismo , Obesidad/complicaciones , Pandemias
7.
Medicine (Baltimore) ; 99(40): e22564, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33019468

RESUMEN

BACKGROUND: At present, the prevalence of type 2 diabetes mellitus (T2DM) has become a major public health issue throughout the world, especially in developing countries. Notably, traditional Chinese patent medicines (TCPMs) are of great significance in the treatment of T2DM combined with conventional Western medicine therapy. However, there is a lack of comparison among all the current common TCPMs for treating T2DM. Therefore, this study intends to explore the efficacy and safety of different TCPMs against T2DM through the Bayesian network meta-analysis (NMA). METHODS: We will conduct a comprehensive and systematic search for randomized controlled trials (RCTs) of TCPM for the treatment of T2DM in both Chinese and English databases published till August 2020. Two researchers will be responsible for screening eligible literature, extracting data, and assessing the risk of bias of included studies independently. Then, pairwise meta-analyses and Bayesian network meta-analyses will be conducted to assess all available evidence. In the end, data will be analyzed using STATA15.0 and WinBUGS1.4.3 software. CONCLUSION: This study will compare the efficacy and safety of different TCPMs against T2DM in detail. Our findings will provide a reliable evidence for selecting clinical treatment program and guideline development of T2DM.


Asunto(s)
Diabetes Mellitus Tipo 2/terapia , Medicina China Tradicional/métodos , Medicamentos sin Prescripción/efectos adversos , Teorema de Bayes , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Humanos , Masculino , Metaanálisis en Red , Medicamentos sin Prescripción/uso terapéutico , Prevalencia , Ensayos Clínicos Controlados Aleatorios como Asunto , Seguridad , Resultado del Tratamiento
8.
Medicine (Baltimore) ; 99(41): e22347, 2020 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-33031271

RESUMEN

INTRODUCTION: Type 2 diabetic mellitus (T2DM) is a chronic disease. In 2013, the International Diabetes Federation showed that the total number of diabetic patients aged 20 to 79 years in China was 89 million, and it is expected to increase to 143 million by 2035. The incidence of T2DM and its complications in patients with blood glucose is gradually increasing, and there are low awareness rate, low diagnosis rate and high disability rate, which has become a global public health problem. Microcirculation Dysfunction in Type 2 diabetic mellitus (MDT2DM) plays an important role in the development of diabetic nephropathy, diabetic retinopathy, diabetic neuropathy and diabetic foot disease. It is 1 of the common etiological mechanisms of diabetic chronic complications. Patients with MDT2DM, serious complications, increase the quality of life of patients with social impact. Diabetic lower extremity microcirculation disease (dlemd) is the main cause of the occurrence, development and difficult healing of diabetic foot. Microvascular disease is microcirculation dysfunction. It has been proved that Shenqi compound prescription can treat T2DM macrovascular disease and microvascular dysfunction. However, due to the lack of evidence and no specific methods or suggestions, it is necessary to conduct a systematic evaluation of Shenqi compound prescription to provide effective evidence for further research. METHODS AND ANALYSIS: The following databases will be searched from their inception to August 2020: Electronic database includes PubMed, Embase, Cochrane Library, Web of Science, Nature, Science online, Chinese Biomedical Database WanFang, VIP medicine information, and China National Knowledge Infrastructure. PRIMARY OUTCOMES:: superoxide dismutase, malondialdehyde, C-reactiveprotein, HOMA-IR, advanced glycation end products , FPG, 2hBG, glycosylated hemoglobinA1c, fasting insulin ; ADDITIONAL OUTCOMES:: low density lipoprotein, high density lipoprotein, triglycerides, total serum cholesterol. Data will be extracted by 2 researchers independently, risk of bias of the meta-analysis will be evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions. All data analysis will be conducted by data statistics software Review Manager V.5.3. and Stata V.12.0. RESULTS: The results of this study will systematically evaluate the efficacy and safety of Shenqi compound prescription in treating patients with MDT2DM CONCLUSION:: The systematic review of this study will summarize the current published evidence of Shenqi compound prescription in the treatment of MDT2DM, and further guide its popularization and application. ETHICS AND DISSEMINATION: This study is a systematic review, the outcomes are based on the published evidence, so examination and agreement by the ethics committee are not required in this study. We intend to publish the study results in a journal or conference presentations. OPEN SCIENCE FRA MEWORK (OSF) REGISTRATION NUMBER: August 24, 2020.osf.io/es6z7. (https://osf.io/es6z7).


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Medicamentos Herbarios Chinos , Microcirculación/efectos de los fármacos , Proyectos de Investigación , Humanos , Metaanálisis como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Revisiones Sistemáticas como Asunto
9.
Medicine (Baltimore) ; 99(41): e22492, 2020 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-33031284

RESUMEN

RATIONALE: Metformin-associated lactic acidosis (MALA) is a rare adverse effect that has significant morbidity and mortality. MALA is a high anion gap (AG), nonosmolar acidosis. Associated osmolar-gap (OG) is rarely reported, so finding an OG may make the diagnosis of MALA challenging. PATIENT CONCERNS: Forty-five years' old type II diabetic patient on metformin presented to emergency with a two-day history of vomiting, watery diarrhea, and mild abdominal discomfort. On examinations, he looked dehydrated. Investigation revealed acute kidney injury (AKI) with a high lactic acid (LA) level of 24 mmol/L, pH of 6.8, AG of 40, and an OG of 20 mOsm/kg DIAGNOSES:: The presence of an OG made the diagnosis challenging; the history was negative for alcohol, osmolar substance, or illicit drug ingestion or use. The toxicology screen was negative. After ruling out plausible causes of AG and OG, MALA was deemed the likely reason for his presentation likely precipitated by dehydration and AKI. INTERVENTIONS: He underwent two sessions of hemodialysis, afterward managed with fluid hydration. OUTCOMES: On day 3, he was in the polyuric phase suggestive of acute tubular necrosis. His serum creatinine improved afterward with improved acidosis; after 8 days, he was discharged in stable condition. LESSONS: MALA is a rare side effect of metformin therapy. Acute kidney injury is a known precipitant of MALA. In our review, we highlight the association of MALA and the presence of an OG. We believe that treating physicians should be aware of this relationship to avoid delaying or overlooking such an important diagnosis.


Asunto(s)
Acidosis Láctica/sangre , Acidosis Láctica/inducido químicamente , Lesión Renal Aguda/complicaciones , Hipoglucemiantes/efectos adversos , Metformina/efectos adversos , Concentración Osmolar , Desequilibrio Ácido-Base , Acidosis Láctica/diagnóstico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Humanos , Ácido Láctico/sangre , Masculino , Persona de Mediana Edad
10.
Wiad Lek ; 73(8): 1671-1676, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33055332

RESUMEN

OBJECTIVE: The aim: To determine changes of FSG of neutrophilic granulocytes of peripheral blood (NGPB) of patients with CHC with concomitant DM-2. PATIENTS AND METHODS: Materials and methods: We've examined 180 patients with CHC: 160 with concomitant diabetes mellitus and 20 ones without it. The NGPB genome was studied using cytogenetic method. There were analyzed 100 interphase NGPB nuclei in the preparation, structural characteristics were evaluated according to indices: chromatization (IC), nucleolar (IN), pathologically altered nuclei (PAN), micronuclei (MNI). RESULTS: Results: Violations of FSG OF NGPBwere found according to all indices in patients with CHC, they were more pronounced in patients with concomitant DM-2. CONCLUSION: Conclusions: FSG NGPB is more disordered in CHC with concomitant DM-2. The reduction of IC in CHC with concomitant DM-2 is more pronounced in men. Reduction of IN in patients with CHC with and without DM-2 is a marker of violations of the second stage of realization of hereditary information. The tendency to change the components of the cytogenetic status of all examined patients due to the frequency of MNI was determined.


Asunto(s)
Diabetes Mellitus Tipo 2 , Hepatitis C Crónica , Biomarcadores , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/genética , Granulocitos , Humanos , Masculino
11.
Wiad Lek ; 73(8): 1690-1695, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33055335

RESUMEN

OBJECTIVE: The aim of the study was to observe the influence of dense bean extract on the intensity of apoptotic processes in the liver cells and pancreas of rats on a model of type 2 diabetes mellitus on obesity's background. PATIENTS AND METHODS: Materials and methods: The main method was to model type 2 diabetes mellitus on the background of obesity in organism of mature six-month-old male rats of the Wistar population (n = 21), weighing 150-170 g. The modelling was carried out by intraperitoneal low dose administration of streptozotocin (30 mg / kg, in citrate buffer pH = 4, 5) inside after three months period of keeping animals on a combined diet. Apoptosis in DNA samples of liver and pancreas cells was identified in duplicates using electrophoresis in a 1% agarose gel with using a 1kb DNA SibEnzyme apoptosis marker (from 10,000 to 250 nucleotides). RESULTS: Results: Only in two of the seven studied DNA samples of the pancreas of a group of rats, treated with a dense bean extract, were observed the traces of necrosis without detectable manifestations of the apoptotic process. It situates at the level of indicators of the animals' intact control group and indicates the distinct effect's presence which includes maintaining pancreas cells survival (in both endocrine and exocrine parts) if imbalance of carbohydrate and lipid metabolism take place in organism. CONCLUSION: Conclusion: Dense bean extract showed a more distinct effect than the comparison drug metformin in relation to the risk of premature loss of pancreatic cell function and the development of non-alcoholic fatty liver disease. A dense bean extract is promising for further pharmacological studies, with the aim of creating phytopreparations - «Glyphasonorm¼ tablets and «Glyfasolin¼ capsules for the correction of type 2 diabetes mellitus and its complications.


Asunto(s)
Diabetes Mellitus Experimental , Diabetes Mellitus Tipo 2 , Animales , Apoptosis , Diabetes Mellitus Experimental/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Masculino , Obesidad/complicaciones , Ratas , Ratas Wistar
12.
Zhonghua Yan Ke Za Zhi ; 56(10): 754-760, 2020 Oct 11.
Artículo en Chino | MEDLINE | ID: mdl-33059418

RESUMEN

Objective: To study the diabetic keratopathy in type 2 diabetes patients with retinopathy by in vivo laser confocal microscopy. Methods: This was a case-control study. Ninety type 2 diabetes patients were involved in this study from May 2015 to December 2019 in Qingdao Eye Hospital. According to the diabetic retinopathy clinical stage, these patients were divided into the non-proliferative diabetic retinopathy (NPDR) group (30 cases), early stage proliferative diabetic retinopathy (PDR) group (30 cases) and intermediate to late stage PDR group (30 cases). Thirty non-diabetic healthy volunteers were included in the control group. The central cornea was observed with an in vivo laser confocal microscope. The corneal nerve fiber density, nerve fiber length, nerve branch density, and nerve fiber tortuosity were compared between groups. The corneal Langerhans cells, epithelial cells, stromal cells and endothelial cells were also compared. Results: There were more nerve fibers and branches in the control group than the other three diabetic groups. The nerve fiber length in the control group, NPDR group, early stage PDR group and intermediate to late stage PDR group was (21.55±2.57), (14.73±1.56), (11.23±1.40) and (8.02±1.33) mm/mm2, respectively, and there were statistically significant differences between the groups (F=316.17, P=0.00). In the nerve fiber density, nerve branch density and curvature, there were statistically significant differences between the groups (F=345.72, 479.46, 167.00, all P=0.00). The basal cell density in the control group, NPDR group, and two PDR groups was (5 761±303), (5 336±367), (4 146±379) and (3 658±365) cells/mm2, respectively, and there were statistically significant differences between the groups (F=234.94, P=0.00). The anterior stromal cell density in the four groups was (836±30), (727±57), (544±59) and (360±47) cells/mm2, respectively, and there were statistically significant differences between the groups (F=535.08, P=0.00). The hexagonal endothelium cell rate in the four groups was 62.0%±5.5%, 51.1%±3.7%, 40.2%±4.0% and 27.8%±3.9%, respectively, and the Langerhans cell density was (1.5±0.6), (4.2±1.3), (6.8±2.1) and (10.9±2.1) cells/mm2, respectively; there were statistically significant differences between the groups (F=342.28, 179.78, all P=0.00). There was no statistically significant difference between the groups in the corneal endothelial cell density (F=1.58, P=0.20). Conclusions: In type 2 diabetes patients with diabetic retinopathy, the corneal nerve fiber and branch density can be significantly reduced, and the density of the hexagonal corneal endothelial cells, epithelial basal cells and anterior stromal cells can also decrease. Langerhans cells may be involved in the development diabetic keratopathy. (Chin J Ophthalmol, 2020, 56: 754-760).


Asunto(s)
Diabetes Mellitus Tipo 2 , Retinopatía Diabética , Estudios de Casos y Controles , Diabetes Mellitus Tipo 2/complicaciones , Retinopatía Diabética/diagnóstico por imagen , Células Endoteliales , Humanos , Microscopía Confocal
13.
J Dent Hyg ; 94(5): 6-13, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33008944

RESUMEN

Purpose: Depression is a rising global health concern manifesting bidirectional relationships between chronic disease conditions such as type 2 diabetes and oral health. The purpose of this study was to explore the knowledge, attitudes, and practices of oral health care professionals towards individuals with depression.Methods: A 24-item, validated Knowledge Attitudes and Practices (KAP) survey was used for this descriptive, cross-sectional study. Non-probability, convenience and snowball sampling was used to recruit oral health care professionals (dentists, dental hygienists and dental assistants) to participate in an electronic survey. Descriptive statistics were used to analyze the data.Results: A total of 288 oral health care professionals (n=288) met the inclusion criteria. Age of the provider was positively correlated with reviewing or assisting in reviewing patient's depression history during routine dental visits (r=.16, p=.007), and referring or assisting in referring a patient to a mental health specialist (r=.30, p<.001). Number of years of practice was positively associated with referring or assisting in the referral of a patient to a mental health specialist (r=.29, p=.001). Oral health care professionals who indicated having had mental health during their education were more likely to indicate reviewing a history of depression with the patient (rho=.17, p=.004).Conclusion: Age, lack of practice experience and education may influence oral health care professionals' attitudes and practices when providing care for patients with depression. Mental health and its relationship to oral and systemic health may be an appropriate addition to dental program curricula. Oral health care providers should consider modifying routine practices to include the special needs of patients with depression.


Asunto(s)
Diabetes Mellitus Tipo 2 , Salud Bucal , Estudios Transversales , Depresión/terapia , Conocimientos, Actitudes y Práctica en Salud , Humanos
14.
Tidsskr Nor Laegeforen ; 140(13)2020 09 29.
Artículo en Inglés, Noruego | MEDLINE | ID: mdl-32998491

RESUMEN

BACKGROUND: Cardiovascular diseases, cancer, type-2 diabetes and chronic obstructive pulmonary disease (COPD) were initially noted as the most common diseases among individuals who were hospitalised for COVID-19. However, the evidence base is weak. The objective of this study is to describe how selected diseases were distributed among adults with confirmed COVID-19 (COVID-19 positive tests) and among those hospitalised for COVID-19 compared to the general population. MATERIAL AND METHOD: We used data from the Norwegian Patient Registry, the Norwegian Registry for Primary Health Care and the Norwegian Surveillance System for Communicable Diseases for adults from the age of 20 and older for the period 1 March 2020-13 May 2020. RESULTS: Of all those who tested positive for COVID-19, 7 632 (94 %) were aged 20 years or older, and 1 025 (13.4 %) of these had been hospitalised. Among those hospitalised with COVID-19, there was a higher proportion of individuals with cardiovascular diseases (18.3 % versus 15.6 %), cancer (6.9 % versus 5.4 %), type-2 diabetes (8.6 % versus 5.2 %) and COPD (3.8 % versus 2.7 %) than in the general population as a whole after adjusting for age. The proportion of hospitalised patients with asthma, other chronic respiratory disease, cardiovascular disease, ongoing cancer treatment, complications related to hypertension, obesity and overweight, neurological disorders and cardiac and renal failure was also higher than in the general population. There were few differences between persons who had tested positive for COVID-19 and the general population in terms of underlying conditions. INTERPRETATION: Among those hospitalised for COVID-19, there was a higher proportion of patients with underlying illnesses than in the general population. This may indicate that these patients tend to have a more severe course of disease or that they are more likely to be hospitalised compared to healthy individuals. The results must be interpreted with caution, since the sample of COVID-19 individuals is non-random.


Asunto(s)
Comorbilidad , Infecciones por Coronavirus/complicaciones , Neumonía Viral/complicaciones , Adulto , Asma , Betacoronavirus , Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Hospitalización , Humanos , Neoplasias , Noruega/epidemiología , Pandemias , Enfermedad Pulmonar Obstructiva Crónica , Adulto Joven
15.
Medicine (Baltimore) ; 99(41): e22660, 2020 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-33031329

RESUMEN

BACKGROUND: Dapagliflozin, a novel inhibitor of renal sodium-glucose cotransporter 2, allows an insulin-independent approach to improve type 2 diabetes hyperglycemia. This current research is a double blinded, randomized, and prospective trial to determine the effect of dapagliflozin on cardiovascular outcomes in type 2 diabetes. METHODS: This randomized controlled, double-blinded, single center trial is carried out according to the principles of Declaration of Helsinki. This present study was approved in institutional review committee of the Lianyungang Hospital affiliated to Xuzhou Medical University (LW-20200901001). All the patients received the informed consent. Diabetic patients were randomized equally to receive 28-week treatment with dapagliflozin or matching placebo. The major outcome of our current study was the change in the level of hemoglobin A1c (HbA1c) from the baseline to week 28. Secondary outcome measures contained the levels of fasting blood glucose, the mean change in seated systolic and diastolic blood pressure, body weight, and the mean change in calculated average daily insulin dose in patients treated with insulin at baseline, the other laboratory variables, and self-reported adverse events. The P < .05 was regarded as statistically significant. RESULTS: We assumed that the dapagliflozin administration in patients with type 2 diabetes would reduce HbA1c, body weight, systolic blood pressure, and achieve the goal of glycemic control, without adversely impacting cardiovascular risk. TRIAL REGISTRATION: This study protocol was registered in Research Registry (researchregistry5987).


Asunto(s)
Compuestos de Bencidrilo/uso terapéutico , Enfermedades Cardiovasculares/prevención & control , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Glucósidos/uso terapéutico , Inhibidores del Cotransportador de Sodio-Glucosa 2/uso terapéutico , Enfermedades Cardiovasculares/etiología , Diabetes Mellitus Tipo 2/complicaciones , Método Doble Ciego , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto
16.
BMC Endocr Disord ; 20(1): 155, 2020 Oct 16.
Artículo en Inglés | MEDLINE | ID: mdl-33066762

RESUMEN

BACKGROUND: Detailed description of hyperglycemia management in diabetic patients infected with SARS-CoV-2 remain limited, although patients with diabetes show higher complication and mortality rate than patients without diabetes. Transient non-severe increased insulin requirement in patients hospitalized for medical conditions such as sepsis or myocardial infarction is a well-known phenomenon. However, extremely high-dose insulin requirement remains a very rarely reported entity. Here, we report the case of an extreme and transitory insulin requirement episode in a type 2 diabetic patient presenting an acute respiratory distress syndrome caused by SARS-CoV-2. CASE PRESENTATION: A 57-year-old man resident in Geneva, Switzerland, previously known for type 2 diabetes for 3 years was admitted for an aggravation of his dyspnea. His type 2 diabetes was treated only with metformin and his latest Hb1Ac was 6.1%. Chest CT SCAN showed a bilateral multilobar ground-glass opacification. Twenty-four hours after his admission he presented a worsening of dyspnea and severe hypoxemia requiring a transfer to the intensive care unit rapidly followed by oro-tracheal intubation for mechanical ventilation support. A bronchoalveolar lavage was performed and test of SARS-CoV-2 by RT-qPCR assay was positive. At day 3, he presented a rapidly progressive insulin requirement at a rate of up to 50 units/hour intravenous insulin aspart. Despite the high insulin doses, he maintained an elevated plasma glucose level at 270 mg/dL on average. His extremely high-dose insulin requirement "resolved" at day 9, and the insulin infusion rate was rapidly reduced. CONCLUSIONS: This case may reflect a specific and profound impact of SARS-CoV-2 on metabolic homeostasis, in particular in diabetic patients that appear more prone to complications of COVID-19 infection. Yet, the mechanisms behind this remain to be elucidated. The optimal management of hyperglycemia of diabetic patients infected with SARS-CoV-2 has yet not be defined, however insulin remain the mainstay of treatment approach. Report of extreme dysregulation of chronic conditions such as diabetes in patients with COVID-19 may help clinicians to better take care of patients during the pandemic of SARS-CoV-2. To the best of our knowledge this is the first description of extremely high-dose insulin requirement in patient with COVID-19.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Neumonía Viral/complicaciones , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/patología , Diabetes Mellitus Tipo 2/virología , Relación Dosis-Respuesta a Droga , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/transmisión , Neumonía Viral/virología , Pronóstico
17.
Nat Commun ; 11(1): 4912, 2020 09 30.
Artículo en Inglés | MEDLINE | ID: mdl-32999275

RESUMEN

Most signals detected by genome-wide association studies map to non-coding sequence and their tissue-specific effects influence transcriptional regulation. However, key tissues and cell-types required for functional inference are absent from large-scale resources. Here we explore the relationship between genetic variants influencing predisposition to type 2 diabetes (T2D) and related glycemic traits, and human pancreatic islet transcription using data from 420 donors. We find: (a) 7741 cis-eQTLs in islets with a replication rate across 44 GTEx tissues between 40% and 73%; (b) marked overlap between islet cis-eQTL signals and active regulatory sequences in islets, with reduced eQTL effect size observed in the stretch enhancers most strongly implicated in GWAS signal location; (c) enrichment of islet cis-eQTL signals with T2D risk variants identified in genome-wide association studies; and (d) colocalization between 47 islet cis-eQTLs and variants influencing T2D or glycemic traits, including DGKB and TCF7L2. Our findings illustrate the advantages of performing functional and regulatory studies in disease relevant tissues.


Asunto(s)
Glucemia/genética , Diabetes Mellitus Tipo 2/genética , Predisposición Genética a la Enfermedad , Islotes Pancreáticos/metabolismo , Sitios de Carácter Cuantitativo , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Glucemia/metabolismo , Línea Celular Tumoral , Estudios de Cohortes , Diabetes Mellitus Tipo 2/sangre , Diacilglicerol Quinasa/genética , Diacilglicerol Quinasa/metabolismo , Elementos de Facilitación Genéticos , Femenino , Regulación de la Expresión Génica , Estudio de Asociación del Genoma Completo , Humanos , Masculino , Ratones , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , RNA-Seq , Análisis de Secuencia de ADN , Proteína 2 Similar al Factor de Transcripción 7/genética , Proteína 2 Similar al Factor de Transcripción 7/metabolismo , Adulto Joven
18.
Medicine (Baltimore) ; 99(40): e22337, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33019410

RESUMEN

At present, glycated hemoglobin (HbA1c) and glycated albumin (GA) are used to evaluate glycemic control in diabetic patients, but they cannot reflect insulin deficiency and/or insulin resistance.We investigated the feasibility of using estimated average glucose to fasting plasma glucose ratio (eAG/fPG ratio) to estimate insulin resistance in young adult diabetes. A total of 387 patients with type 2 diabetes were included and were stratified into 2 groups based on median values of the glycemic index ratio: the GA/A1c ratio <2.09 (n = 91) and ≥2.09 (n = 296); the eAG/fPG ratio <1.69 (n = 155) and ≥1.69 (n = 232). HbA1c, GA, fructosamine, insulin, and C-peptide levels were measured. The ratio of GA to HbA1c was calculated, and the homeostasis model assessment of ß-cell function and insulin resistance were determined. The homeostasis model assessment of insulin resistance level was significantly associated with the eAG/fPG ratio, but not with the ratio of GA to HbA1c, GA, HbA1c, and fructosamine levels. The ratio of estimated average glucose to fasting plasma glucose level correlates with insulin resistance in young adult diabetes.


Asunto(s)
Glucemia/análisis , Diabetes Mellitus Tipo 2/sangre , Ayuno/metabolismo , Resistencia a la Insulina/fisiología , Adolescente , Adulto , Péptido C/sangre , Niño , Femenino , Fructosamina/sangre , Hemoglobina A Glucada/análisis , Índice Glucémico , Humanos , Insulina/sangre , Masculino , Albúmina Sérica/análisis , Adulto Joven
19.
Mediators Inflamm ; 2020: 6914878, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33061829

RESUMEN

Background: COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has threatened every civilian as a global pandemic. The immune system poses the critical interactive chain between the human body and the virus. Here, we make efforts to examine whether comorbidity with type 2 diabetes (T2D) affects the immunological response in COVID-19 patients. Methods: We conducted a retrospective pilot study investigating immunological characteristics of confirmed cases of COVID-19 with or without comorbid T2D. Two subcohorts of sex- and age-matched participants were eligible for data analysis, of which 33 participants were with T2D and the remaining 37 were nondiabetic (NDM). Cellular immunity was assessed by flow cytometric determination of surface markers including CD3, CD4, CD8, CD19, CD16, and CD56 in peripheral blood. Levels of C reactive protein, immunoglobulin (IgG, IgM, IgA, and IgE), and complements (C3, C4) were detected by rate nephelometry immunoassay. And Th1/Th2 cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ) were detected by Cytometric Bead Array. Results: Neutrophil counts were found to be significantly higher in the T2D group than in the NDM group and had a significant relevance with clinical severity. Lymphocyte frequencies showed no significant differences in the two groups. However, the proportions and absolute counts of T, Tc, Th, and NK cells decreased in both groups to different degrees. An abnormal increase in neutrophil count and a decrease in lymphocyte subpopulations may represent risk factors of COVID-19 severity. The level of IgG, IgM, IgA, C3, and C4 showed no significant difference between the two groups, while the IgE levels were higher in the T2D group than in the NDM group (p < 0.05). Th1 cytokines including IFN-γ, TNF-α, and IL-6, as well as CRP, appeared significantly higher in the T2D group. Conclusions: The COVID-19 patients comorbid with T2D demonstrated distinguishable immunological parameters, which represented clinical relevancies with the predisposed disease severity in T2D.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/inmunología , Diabetes Mellitus Tipo 2/inmunología , Neumonía Viral/inmunología , Adulto , Anciano , Anciano de 80 o más Años , China/epidemiología , Estudios de Cohortes , Comorbilidad , Proteínas del Sistema Complemento/metabolismo , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Citocinas/sangre , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Humanos , Inmunidad Celular , Inmunoglobulinas/sangre , Mediadores de Inflamación/sangre , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Pandemias , Proyectos Piloto , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Estudios Retrospectivos , Células TH1/inmunología , Células Th2/inmunología
20.
Zhonghua Yi Xue Za Zhi ; 100(38): 2990-2996, 2020 Oct 20.
Artículo en Chino | MEDLINE | ID: mdl-33086449

RESUMEN

Objective: To investigate the appropriate cut-off point of time in range (TIR) for evaluating glucose control in type 2 diabetes mellitus (T2DM) patients, and analyze the prevalence of abnormal carotid intima-media thickness (CIMT) and diabetic retinopathy (DR) in different TIR categories. Methods: A total of 2 161 subjects with T2DM (1 183 males) were enrolled from hospitalized patients at the Department of Endocrinology and Metabolism of the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University from January 2005 to February 2012. The age of the enrolled participants was (60.4±11.9) years. Each patient underwent continuous glucose monitoring (CGM) for three consecutive days, then TIR (3.9-10.0 mmol/L), time above range (TAR) and time below range (TBR) were calculated. Fundus photography and carotid artery Doppler ultrasound were performed to diagnose DR and abnormal CIMT (defined as CIMT≥1.0 mm), respectively. Multivariate logistic regression models were used to examine the independent association of different TIR groups with CIMT and DR. Results: All subjects were divided into 4 groups according to TIR:≤40%, 41%-70%, 71%-85% and>85%. Significant linear trends in age, diabetes duration, body mass index (BMI), total cholesterol, glycated hemoglobin A1c (HbA1c), TAR and mean glucose (MG) existed among the 4 groups (all P(trend)<0.05). However, there was only a weak correlation between TIR and TBR (<3.9 mmol/L) (r=0.087, P<0.001), and no significant association was observed between TBR (<3 mmol/L) and the TIR categories (P(trend)=0.378). The overall prevalence of abnormal CIMT and DR was 12.1% and 23.8%, respectively. The prevalence of abnormal CIMT in the 4 groups with ascending levels of TIR was 16.9% (59/349), 12.9% (96/746), 11.2% (57/510) and 9.0% (50/556) (P(trend)<0.001), respectively. And the prevalence of DR was 30.7% (107/349), 29.4% (219/746), 20.8% (106/510) and 14.9% (83/556), respectively (P(trend)<0.001). In the binary logistic regression model by adjusting confounding factors, compared with TIR≤ 40%, the risk of abnormal CIMT was reduced by 33.8% (OR=0.662, 95%CI: 0.456-0.963, P=0.031), 40.8% (OR=0.592, 95%CI: 0.390-0.899, P=0.014), and 45.0% (OR=0.550, 95%CI: 0.358-0.846, P=0.006) in the other three groups, respectively. And the risk of DR was reduced by 2.9% (OR=0.971, 95%CI: 0.725-1.301, P=0.844), 33.4%(OR=0.666, 95%CI: 0.479-0.924, P=0.015) and 53.3% (OR=0.467, 95%CI: 0.331-0.657, P<0.001), respectively. Conclusion: Using 40%, 70% and 85% as cut-off point of TIR helps stratify the risk of diabetic complications, and assess the glucose control (Poor: TIR≤40%; Unsatisfactory: TIR≤70%; Satisfactory: TIR>70%; Optimal: TIR>85%) in patients with T2DM.


Asunto(s)
Glucemia , Diabetes Mellitus Tipo 2 , Automonitorización de la Glucosa Sanguínea , Grosor Intima-Media Carotídeo , China , Humanos , Masculino
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