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1.
J Assoc Physicians India ; 69(1): 32-35, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34227773

RESUMEN

Background and Aim: The increasing incidence of nephrolithiasis in recent decades is coinciding with rising epidemic of obesity, metabolic syndrome, and type 2 diabetes. This temporal concordance suggests that a link might exist between these metabolic abnormalities and urinary stone disease. Therefore, the present study was aimed to investigate the association between presence of risk factors of nephrolithiasis and metabolic syndrome. Methods: In a hospital-based, case control study, hundred patients of metabolic syndrome diagnosed according to IDF criteria and hundred age and matched controls were studied for presence of risk factors of nephrolithiasis. Results: Patients with metabolic syndrome had significantly higher uricosuri a,hypercalciuria,oxaluria and hypocitraturia. The prevalence of risk factors of nephrolithiasis was also higher in patients with metabolic syndrome. The most prevalent was low urinary pH in 40% patients with mean pH of 5.8±1.6. Amongst other factors, 33% had hyperuricemia, 29% had hypercalciuria, 15% had oxaluria 13% had hypocitraturia and 10% had hyperuricosuria. Significant correlation was observed between risk factors of nephrolithiasis and components of metabolic syndrome. Conclusion: The present study provides an evidence of association between risk factors of nephrolithiasis and metabolic syndrome and suggests that nephrolithiasis may be a systemic disorder representing the interaction of multiple metabolic derangements. Determining common modifiable risk factors for the development of kidney stones might uncover new preventive strategies.


Asunto(s)
Diabetes Mellitus Tipo 2 , Cálculos Renales , Síndrome Metabólico , Estudios de Casos y Controles , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Humanos , Síndrome Metabólico/complicaciones , Síndrome Metabólico/epidemiología , Factores de Riesgo
2.
BMC Res Notes ; 14(1): 252, 2021 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-34193265

RESUMEN

OBJECTIVE: The purpose of this study is to compare the prevalence of latent TB infection (LTBI) among patients with type-2 diabetes mellitus (T2DM) to healthy controls without T2DM. To achieve this objective, we conducted a case-control study in a large hospital in Atlanta from 2016 to 2019. RESULTS: We enrolled 98 cases; 119 potential controls were screened, 84 of which had HbA1c ≥ 5.7% and one did not have QFT result, leaving 34 (28.6%) individuals enrolled as controls. LTBI prevalence was 9.2% among cases and 14.7% among controls (crude odds ratio 0.59, 95% CI 0.19-2.04). After adjusting for age and sex, the adjusted odds of LTBI among patients with T2DM was 0.45 (95% CI 0.13, 1.71) times the controls. We did not observe a statistically significant association between LTBI and T2DM. However, we reported a positive correlation between HbA1c level and nil count among individuals with LTBI (R2 = 0.55, p < 0.01). In addition, we reported a high prevalence of LTBI among adults with T2DM and family members without T2DM.


Asunto(s)
Diabetes Mellitus Tipo 2 , Tuberculosis Latente , Adulto , Estudios de Casos y Controles , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Hospitales , Humanos , Tuberculosis Latente/complicaciones , Tuberculosis Latente/epidemiología , Prevalencia , Factores de Riesgo , Prueba de Tuberculina
3.
BMC Endocr Disord ; 21(1): 144, 2021 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-34217276

RESUMEN

BACKGROUND: Although obesity, defined by body mass index (BMI), has been associated with a higher risk of hospitalisation and more severe course of illness in Covid-19 positive patients amongst the British population, it is unclear if this translates into increased mortality. Furthermore, given that BMI is an insensitive indicator of adiposity, the effect of adipose volume on Covid-19 outcomes is also unknown. METHODS: We used the UK Biobank repository, which contains clinical and anthropometric data and is linked to Public Health England Covid-19 healthcare records, to address our research question. We performed age- and sex- adjusted logistic regression and Chi-squared test to compute the odds for Covid-19-related mortality as a consequence of increasing BMI, and other more sensitive indices of adiposity such as waist:hip ratio (WHR) and percent body fat, as well as concomitant cardiometabolic illness. RESULTS: 13,502 participants were tested for Covid-19 (mean age 70 ± 8 years, 48.9% male). 1582 tested positive (mean age 68 ± 9 years, 52.8% male), of which 305 died (mean age 75 ± 6 years, 65.5% male). Increasing adiposity was associated with higher odds for Covid-19-related mortality. For every unit increase in BMI, WHR and body fat, the odds of death amongst Covid19-positive participants increased by 1.04 (95% CI 1.01-1.07), 10.71 (95% CI 1.57-73.06) and 1.03 (95% CI 1.01-1.05), respectively (all p < 0.05). Referenced to Covid-19 positive participants with a normal weight (BMI 18.5-25 kg/m2), Covid-19 positive participants with BMI > 35 kg/m2 had significantly higher odds of Covid-19-related death (OR 1.70, 95% CI 1.06-2.74, p < 0.05). Covid-19-positive participants with metabolic (diabetes, hypertension, dyslipidaemia) or cardiovascular morbidity (atrial fibrillation, angina) also had higher odds of death. CONCLUSIONS: Anthropometric indices that are more sensitive to adipose volume and its distribution than BMI, as well as concurrent cardiometabolic illness, are associated with higher odds of Covid-19-related mortality amongst the UK Biobank cohort that tested positive for the infection. These results suggest adipose volume may contribute to adverse Covid-19-related outcomes associated with obesity.


Asunto(s)
Adiposidad/fisiología , COVID-19/mortalidad , Enfermedades Cardiovasculares/epidemiología , Síndrome Metabólico/epidemiología , Obesidad/epidemiología , Anciano , Anciano de 80 o más Años , Bancos de Muestras Biológicas/estadística & datos numéricos , Índice de Masa Corporal , COVID-19/complicaciones , COVID-19/patología , Factores de Riesgo Cardiometabólico , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/mortalidad , Estudios de Cohortes , Bases de Datos Factuales , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/mortalidad , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/mortalidad , Persona de Mediana Edad , Morbilidad , Mortalidad , Obesidad/complicaciones , Obesidad/mortalidad , Factores de Riesgo , SARS-CoV-2/fisiología , Reino Unido/epidemiología
4.
Medicine (Baltimore) ; 100(27): e26418, 2021 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-34232174

RESUMEN

BACKGROUND: Previous studies have demonstrated that Helicobacter pylori is a critical factor in the development of gastrointestinal diseases. However, only limited studies have reported results on the relationship between H pylori infection and patients with type 2 diabetes mellitus (T2DM). Moreover, the conclusions from these past studies are variable. Because there are contradictory results on this issue, the present study aims to examine the clinical therapeutic impacts of H pylori eradication to treat patients experiencing T2DM. METHODS: The present protocol is drafted according to the provisions of the Preferred Reporting Items for Systematic Review and Meta-analyses Protocols guidelines. PubMed, Cochrane Central Register of Controlled Trials databases, EMBASE, Web of Science, China National Knowledge Infrastructure, and Chinese BioMedical Literature Database will be searched up to May 2021 to obtain randomized controlled trials evaluating the clinical therapeutic effects of H pylori eradication to treat patients experiencing T2DM. We will use 2 investigators independently to carry out study selection, data extraction, and employ the Cochrane Collaboration criteria to evaluate their risks of bias. Furthermore, we will apply Stata 16.0 software to perform data analysis. RESULTS: We intend to evaluate the clinical therapeutic impacts of H pylori eradication to treat patients suffering from T2DM. CONCLUSIONS: Our findings may support existing evidence on the clinical therapeutic impacts of H pylori eradication to treat patients with T2DM. ETHICS AND DISSEMINATION: Since all data will be extracted from the published literature, the study does not require an ethical approval. OSF REGISTRATION NUMBER: May 31, 2021.osf.io/qtexu. (https://osf.io/qtexu/).


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori/aislamiento & purificación , Diabetes Mellitus Tipo 2/complicaciones , Infecciones por Helicobacter/complicaciones , Humanos
5.
BMJ Case Rep ; 14(7)2021 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-34244196

RESUMEN

A 58-year-old female with known type 2 diabetes mellitus continued to take her usual medications, including metformin, an ACE inhibitor and a non-steroidal anti-inflammatory drug, while suffering from diarrhoea and vomiting. On presentation to the emergency department, she was found to have a profound lactic acidosis, cardiovascular instability and acute kidney injury. Despite a pH of 6.6, lactate of 14 mmol/L and a brief asystolic cardiac arrest, supportive treatment and the use of renal replacement therapy resulted in rapid improvement in her acid-base abnormalities and haemodynamic parameters. Metformin-associated lactic acidosis is a rare but life-threatening complication of diabetes management. Patient education and awareness amongst clinicians are paramount in the prevention and treatment of this condition.


Asunto(s)
Acidosis Láctica , Lesión Renal Aguda , Diabetes Mellitus Tipo 2 , Metformina , Acidosis Láctica/inducido químicamente , Acidosis Láctica/terapia , Lesión Renal Aguda/inducido químicamente , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Femenino , Humanos , Hipoglucemiantes/efectos adversos , Metformina/efectos adversos , Persona de Mediana Edad
6.
Curr Cardiol Rep ; 23(8): 104, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-34196800

RESUMEN

PURPOSE OF REVIEW: Obesity is associated with an increased risk for type 2 diabetes, and weight loss in adults with obesity and type 2 diabetes may be indicated to reduce health risk and improve diabetes control. It is important to understand the effectiveness of weight loss interventions for the prevention and treatment of type 2 diabetes. RECENT FINDINGS: Lifestyle interventions for weight loss show effectiveness for prevention of type 2 diabetes. Weight loss in patients with type 2 diabetes can decrease cardiometabolic risk and improve diabetes control. However, diabetes remission with lifestyle approaches is limited and to achieve this medical approaches such as bariatric surgery that result in greater magnitudes of weight loss may be necessary. Dissemination of lifestyle interventions for weight loss, along with other medical approaches such as bariatric surgery when indicated, are needed to reduce the health burden of type 2 diabetes in patients with obesity.


Asunto(s)
Cirugía Bariátrica , Diabetes Mellitus Tipo 2 , Adulto , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/terapia , Humanos , Estilo de Vida , Obesidad/complicaciones , Obesidad/terapia , Pérdida de Peso
7.
Acta Biomed ; 92(3): e2021100, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-34212935

RESUMEN

PURPOSE: Glycemic control is important in order to avoid LDLs increased susceptibility to oxidation in diabetic patients. This study assess the relationship between diabetes control with serum prooxidant-antioxidant balance (PAB), oxidized LDL cholesterol (oxLDLc), homocysteine and vitamin D levels in patients with type 2 diabetes. MATERIAL AND METHODS: This was a cross-sectional study on three groups including 80 subjects as well (WGC) and poor (PGC) glycemic control and 40 healthy subjects. Presence of nephropathy and retinopathy were determined using IDF criteria. HbA1c level was determined with columnar chromatography using BioSystems kit. Serum PAB, homocysteine, oxLDLc and vitamin D levels were measured by the standard tests. RESULTS: There was a significant association between PAB with PGC (P< 0.001), diabetic retinopathy (P< 0.01) and nephropathy (P< 0.01) in type 2 diabetic patients. Moreover, the results showed that vitamin D serum levels was significantly lower in PGC patients (P< 0.01), and diabetic patients with retinopathy (P< 0.01). Multiple linear regression analysis revealed that the vitamin D deficiency can predict the HbA1c variations by 77.7% (ß=- 0.775) in subjects with type 2 diabetes mellitus (P<0.001). CONCLUSIONS: There was a significant association between prooxidant-antioxidant balance and vitamin D serum levels with diabetic complications.


Asunto(s)
Diabetes Mellitus Tipo 2 , Deficiencia de Vitamina D , Estudios Transversales , Diabetes Mellitus Tipo 2/complicaciones , Control Glucémico , Humanos , Oxidantes , Deficiencia de Vitamina D/complicaciones
8.
Am J Case Rep ; 22: e931639, 2021 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-34262010

RESUMEN

BACKGROUND Immune checkpoint inhibitors (ICIs) are anticancer medications that enhance the antitumor immune response. The clinical benefit afforded by ICIs, however, can be accompanied by immune-related adverse events (IRAEs). One of the common endocrine IRAEs is hypophysitis, which often causes hypopituitarism with secondary adrenal insufficiency (AI). Secondary AI, including isolated adrenocorticotropic hormone (ACTH) deficiency (IAD), is often associated with hyponatremia. Here, we report an unusual case of ICI-related IAD associated with severe hyperkalemia. CASE REPORT A 78-year-old woman who had an ileal conduit, chronic kidney disease, type 2 diabetes mellitus, and hypertension and was taking an angiotensin II receptor blocker began treatment for advanced ureteral cancer with the anti-programmed cell death protein 1 inhibitor pembrolizumab. The therapy effectively controlled the cancer, but 4 1/2 months after starting it, the patient developed anorexia, general weakness, and muscle pain and was diagnosed with IAD associated with severe hyperkalemia and hyperchloremic metabolic acidosis. She recovered after prompt administration of corticosteroids and treatment with sodium bicarbonate, glucose/insulin, and cation exchange resins. CONCLUSIONS Hyperkalemia is a common symptom of primary AI but is less common in patients with central AI because a lack of ACTH does not cause aldosterone deficiency and mineralocorticoid action is preserved. The present case demonstrates the need for physicians to be aware of severe hyperkalemia as a life-threatening complication of secondary AI induced by ICIs, particularly in patients with predisposing factors, such as kidney dysfunction, diabetes mellitus, an ileal conduit, and renin-angiotensin-aldosterone system inhibitor use.


Asunto(s)
Diabetes Mellitus Tipo 2 , Hiperpotasemia , Neoplasias Ureterales , Derivación Urinaria , Insuficiencia Suprarrenal , Hormona Adrenocorticotrópica , Anciano , Anticuerpos Monoclonales Humanizados , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Femenino , Humanos , Hiperpotasemia/inducido químicamente
9.
BMC Endocr Disord ; 21(1): 144, 2021 Jul 03.
Artículo en Inglés | MEDLINE | ID: covidwho-1295459

RESUMEN

BACKGROUND: Although obesity, defined by body mass index (BMI), has been associated with a higher risk of hospitalisation and more severe course of illness in Covid-19 positive patients amongst the British population, it is unclear if this translates into increased mortality. Furthermore, given that BMI is an insensitive indicator of adiposity, the effect of adipose volume on Covid-19 outcomes is also unknown. METHODS: We used the UK Biobank repository, which contains clinical and anthropometric data and is linked to Public Health England Covid-19 healthcare records, to address our research question. We performed age- and sex- adjusted logistic regression and Chi-squared test to compute the odds for Covid-19-related mortality as a consequence of increasing BMI, and other more sensitive indices of adiposity such as waist:hip ratio (WHR) and percent body fat, as well as concomitant cardiometabolic illness. RESULTS: 13,502 participants were tested for Covid-19 (mean age 70 ± 8 years, 48.9% male). 1582 tested positive (mean age 68 ± 9 years, 52.8% male), of which 305 died (mean age 75 ± 6 years, 65.5% male). Increasing adiposity was associated with higher odds for Covid-19-related mortality. For every unit increase in BMI, WHR and body fat, the odds of death amongst Covid19-positive participants increased by 1.04 (95% CI 1.01-1.07), 10.71 (95% CI 1.57-73.06) and 1.03 (95% CI 1.01-1.05), respectively (all p < 0.05). Referenced to Covid-19 positive participants with a normal weight (BMI 18.5-25 kg/m2), Covid-19 positive participants with BMI > 35 kg/m2 had significantly higher odds of Covid-19-related death (OR 1.70, 95% CI 1.06-2.74, p < 0.05). Covid-19-positive participants with metabolic (diabetes, hypertension, dyslipidaemia) or cardiovascular morbidity (atrial fibrillation, angina) also had higher odds of death. CONCLUSIONS: Anthropometric indices that are more sensitive to adipose volume and its distribution than BMI, as well as concurrent cardiometabolic illness, are associated with higher odds of Covid-19-related mortality amongst the UK Biobank cohort that tested positive for the infection. These results suggest adipose volume may contribute to adverse Covid-19-related outcomes associated with obesity.


Asunto(s)
Adiposidad/fisiología , COVID-19/mortalidad , Enfermedades Cardiovasculares/epidemiología , Síndrome Metabólico/epidemiología , Obesidad/epidemiología , Anciano , Anciano de 80 o más Años , Bancos de Muestras Biológicas/estadística & datos numéricos , Índice de Masa Corporal , COVID-19/complicaciones , COVID-19/patología , Factores de Riesgo Cardiometabólico , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/mortalidad , Estudios de Cohortes , Bases de Datos Factuales , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/mortalidad , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/mortalidad , Persona de Mediana Edad , Morbilidad , Mortalidad , Obesidad/complicaciones , Obesidad/mortalidad , Factores de Riesgo , SARS-CoV-2/fisiología , Reino Unido/epidemiología
10.
Int J Mol Sci ; 22(13)2021 Jun 22.
Artículo en Inglés | MEDLINE | ID: mdl-34206340

RESUMEN

Intestinal organoids are used to analyze the differentiation of enteroendocrine cells (EECs) and to manipulate their density for treating type 2 diabetes. EEC differentiation is a continuous process tightly regulated in the gut by a complex regulatory network. However, the effect of chronic hyperglycemia, in the modulation of regulatory networks controlling identity and differentiation of EECs, has not been analyzed. This study aimed to investigate the effect of glucotoxicity on EEC differentiation in small intestinal organoid platforms. Mouse intestinal organoids were cultured in the presence/absence of high glucose concentrations (35 mM) for 48 h to mimic glucotoxicity. Chronic hyperglycemia impaired the expression of markers related to the differentiation of EEC progenitors (Ngn3) and L-cells (NeuroD1), and it also reduced the expression of Gcg and GLP-1 positive cell number. In addition, the expression of intestinal stem cell markers was reduced in organoids exposed to high glucose concentrations. Our data indicate that glucotoxicity impairs L-cell differentiation, which could be associated with decreased intestinal stem cell proliferative capacity. This study provides the identification of new targets involved in new molecular signaling mechanisms impaired by glucotoxicity that could be a useful tool for the treatment of type 2 diabetes.


Asunto(s)
Diferenciación Celular , Células Enteroendocrinas/metabolismo , Hiperglucemia/complicaciones , Intestino Delgado/metabolismo , Organoides , Animales , Diabetes Mellitus Tipo 2/complicaciones , Células Enteroendocrinas/efectos de los fármacos , Células Enteroendocrinas/fisiología , Glucosa/metabolismo , Glucosa/toxicidad , Intestino Delgado/efectos de los fármacos , Intestino Delgado/fisiopatología , Células L , Masculino , Ratones , Ratones Endogámicos C57BL , Transducción de Señal
11.
Int J Mol Sci ; 22(12)2021 Jun 16.
Artículo en Inglés | MEDLINE | ID: mdl-34208589

RESUMEN

There is mounting evidence that type 2 diabetes mellitus (T2DM) is related with increased risk for the development of cancer. Apart from shared common risk factors typical for both diseases, diabetes driven factors including hyperinsulinemia, insulin resistance, hyperglycemia and low grade chronic inflammation are of great importance. Recently, vitamin D deficiency was reported to be associated with the pathogenesis of numerous diseases, including T2DM and cancer. However, little is known whether vitamin D deficiency may be responsible for elevated cancer risk development in T2DM patients. Therefore, the aim of the current review is to identify the molecular mechanisms by which vitamin D deficiency may contribute to cancer development in T2DM patients. Vitamin D via alleviation of insulin resistance, hyperglycemia, oxidative stress and inflammation reduces diabetes driven cancer risk factors. Moreover, vitamin D strengthens the DNA repair process, and regulates apoptosis and autophagy of cancer cells as well as signaling pathways involved in tumorigenesis i.e., tumor growth factor ß (TGFß), insulin-like growth factor (IGF) and Wnt-ß-Cathenin. It should also be underlined that many types of cancer cells present alterations in vitamin D metabolism and action as a result of Vitamin D Receptor (VDR) and CYP27B1 expression dysregulation. Although, numerous studies revealed that adequate vitamin D concentration prevents or delays T2DM and cancer development, little is known how the vitamin affects cancer risk among T2DM patients. There is a pressing need for randomized clinical trials to clarify whether vitamin D deficiency may be a factor responsible for increased risk of cancer in T2DM patients, and whether the use of the vitamin by patients with diabetes and cancer may improve cancer prognosis and metabolic control of diabetes.


Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Neoplasias/etiología , Deficiencia de Vitamina D/complicaciones , Animales , Apoptosis/efectos de los fármacos , Autofagia/efectos de los fármacos , Biomarcadores , Ensayos Clínicos como Asunto , Diabetes Mellitus Tipo 2/metabolismo , Manejo de la Enfermedad , Susceptibilidad a Enfermedades , Humanos , Redes y Vías Metabólicas , Neoplasias/epidemiología , Neoplasias/prevención & control , Neoplasias/terapia , Pronóstico , Receptores de Calcitriol/metabolismo , Vitamina D/metabolismo , Vitamina D/farmacología , Deficiencia de Vitamina D/metabolismo
12.
J Coll Physicians Surg Pak ; 30(7): 765-769, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34271773

RESUMEN

OBJECTIVE: To compare superoxide dismutase 1 (SOD1) levels in diabetes mellitus patients with and without neuropathy. STUDY DESIGN: Cross-sectional comparative study. PLACE AND DURATION OF STUDY: Multidisciplinary Lab-1 of the Department of Biochemistry and Molecular Biology, Army Medical College, in cooperation with Pak-Emirates Military Hospital, Rawalpindi, Pakistan, from January 2020 to January 2021. METHODOLOGY: Eighty-four subjects were enrolled through non-probability purposive sampling technique. They were further divided into three groups. Patients with diabetic neuropathy were labelled as the group Ι, and patients with diabetes mellitus without neuropathy were included in group ΙΙ. While group ΙΙΙ was comprised of healthy individuals and taken as control. Biochemical parameters included fasting blood glucose levels and HbA1c. Superoxide dismutase-1 levels were measured by enzyme-linked immunosorbent assay (ELISA). Data were evaluated by SPSS version 22.0 and presented in percentage and mean ± standard deviation (SD). Independent sample t-test and one-way ANOVA followed by the post-hoc Tukey test were used for group comparison. RESULTS: Mean level of SOD1 was significantly higher in group Ι as compared to group ΙΙ and ΙΙΙ (p<0.001). Statistically significant difference was observed among groups Ι and ΙΙ (p=0.002), Ι and ΙΙΙ (p<0.001), and ΙΙ and ΙΙΙ (p=0.017). Mean levels of SOD1 were also significantly increased with poor glycemic control (p<0.001). CONCLUSION: SOD1 level was considerably high in patients with diabetes mellitus with neuropathy in comparison to diabetics without neuropathy and healthy individuals. Key Words: Diabetes mellitus, Diabetic neuropathy, ELISA, Superoxide dismutase 1(SOD1).


Asunto(s)
Diabetes Mellitus Tipo 2 , Superóxido Dismutasa , Estudios Transversales , Diabetes Mellitus Tipo 2/complicaciones , Humanos , Pakistán , Superóxido Dismutasa-1
13.
Vnitr Lek ; 67(4): 218-222, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34275307

RESUMEN

Arterial hypertension is one of the most frequent comorbidities of patients with type 2 diabetes, the rates are approximately three times higher among diabetics than in general population. The presence of both diseases increases the cardiovascular risk of the patients two to three times. Therefore, it is essential to control the blood pressure values vigorously down to 130/80 mmHg as recommended in guidelines of the Czech Hypertension Society. According to EHES Study data, the blood pressure control is not sufficient in Czech diabetic population. The target values are reached in only 29 % of diabetics. A well organized system of care, intensive antihypertensive treatment, self-monitoring of patients or appointment reminder system can be used to improve blood pressure control.


Asunto(s)
Diabetes Mellitus Tipo 2 , Hipertensión , Antihipertensivos/uso terapéutico , Presión Sanguínea , Monitoreo Ambulatorio de la Presión Arterial , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Humanos , Hipertensión/tratamiento farmacológico
14.
Vnitr Lek ; 67(E-4): 3-8, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34275312

RESUMEN

INTRODUCTION: The toe brachial index (TBI) is recommended for the detection of lower extremity arterial disease (LEAD) in case of reduced efficacy of the ankle brachial index (ABI), which most often occurs in diabetics. In this case, TBI is expected to give more accurate results. There are not many studies dealing with the use of TBI specifically in diabetics and the results are different. OBJECTIVE: The purpose of this work is to present the interim results of the study, whose main objective is to assess the validity of TBI in diabetics and to determine whether this method provides improvements over the ABI. METHODS: In the first phase of the study, 42 limbs were examined in 21 patients with type 2 diabetes. ABI was measured using the automatic oscillometric method (ABI OSC) and the manual method using the pencil doppler (ABI DPP). TBI was determined using an automatic plethysmographic method. The reference examination of the arteries of the lower limbs was performed using duplex ultrasonography (DUS). A paired t-test was used to compare the individual TBI and ABI methods. Cut-off points ABI < 0.9; TBI < 0.7; and DUS stenosis > 50 % were used to evaluate validity parameters. RESULTS: The individual ABI and TBI methods gave different results (p < 0.05). In eight limbs of the total number, LEAD was demonstrated using DUS. The best validity parameters were demonstrated by the TBI - sensitivity 0.88; specificity 0.88; positive predictive value 0.64; negative predictive value 0.97, positive likelihood ratio 7.44; negative likelihood ratio 0.14. The ABI method of calculation, that uses lower systolic blood pressure determined from two measurement sites on the ankle as a numerator, had a higher validity parameters. The ABI OSC did not correctly detect a single limb with stenosis > 50 % in this cohort. CONCLUSION: According to the interim results of this work, the TBI was more suitable for the detection of LEAD in diabetics in comparison with ABI.


Asunto(s)
Diabetes Mellitus Tipo 2 , Angiopatías Diabéticas , Enfermedad Arterial Periférica , Índice Tobillo Braquial , Diabetes Mellitus Tipo 2/complicaciones , Angiopatías Diabéticas/diagnóstico por imagen , Humanos , Extremidad Inferior , Enfermedad Arterial Periférica/diagnóstico por imagen , Valor Predictivo de las Pruebas
15.
Mymensingh Med J ; 30(3): 651-656, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34226451

RESUMEN

The present cross-sectional analytical study was carried out to observe blood pressure and serum total cholesterol in patients with type-2 diabetes mellitus. This observational study was carried out in the department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from January 2016 to December 2016. For this purpose, 200 subjects of both sexes and age ranged from 30-60 years were selected; among them 100 were type-2 diabetic person and 100 were apparently healthy. Blood pressure and serum total cholesterol was significantly higher (p<0.0001) in both male and female of the study group in comparison to healthy control group. From this study, it may conclude that type-2 persons are considered to have significant positive relation for formation of hypertension, hypercholesterolemia and metabolic abnormalities that have high morbidity and mortality. So, prevention of type-2 diabetes mellitus by taking necessary steps like regular physical exercise, intake of healthy diet and behavior therapy may help in prevention of type-2 diabetes mellitus related complication.


Asunto(s)
Diabetes Mellitus Tipo 2 , Hipercolesterolemia , Hipertensión , Adulto , Bangladesh/epidemiología , Estudios Transversales , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Humanos , Hipercolesterolemia/complicaciones , Hipercolesterolemia/epidemiología , Hipertensión/complicaciones , Hipertensión/epidemiología , Masculino , Persona de Mediana Edad
16.
Medicina (Kaunas) ; 57(7)2021 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-34209501

RESUMEN

Background and objectives: Obstructive sleep apnea (OSA) is closely associated with insulin resistance (IR) and is an independent risk factor for incident type 2 diabetes mellitus (T2DM). Most studies evaluate the correlation between OSA and IR in only obese or T2DM patients. Therefore, we tried to investigate the effect of OSA on metabolic syndrome and IR in the general healthy male population. Materials and Methods: 184 subjects who visited a preventive health examination program were recruited for this study. All subjects received overnight polysomnography by a portable device (Watch-PAT 200). We examined several metabolic parameters and a homeostasis model of assessment for insulin resistance index (HOMA-IR). The subjects were divided into three groups by AHI (Apnea-hyponea index): normal group (AHI < 5), mild OSA group (5 ≤ AHI < 15), and moderate-severe OSA group (AHI ≥ 15). They were also divided into two groups according to minimum oxygen saturation: low group, Min-SpO2 < 88%; and high group, Min-SpO2 ≥ 88%. Results: Parameters of metabolic syndrome, including waist circumference, systolic and diastolic blood pressure, triglyceride, and high-density lipoprotein cholesterol showed significant differences among the AHI groups. Furthermore, HOMA-IR showed significant differences among the AHI groups. Those parameters, including metabolic syndrome and HOMA-IR, also showed differences between Min-SpO2 groups. Conclusions: In summary, this study helps confirm that AHI is associated with HOMA-IR in the general male population. Furthermore, the severity of AHI correlated with the parameters of metabolic syndrome. Therefore, AHI might be an indicator for evaluating both T2DM and metabolic syndrome, even in the general male population.


Asunto(s)
Diabetes Mellitus Tipo 2 , Resistencia a la Insulina , Síndrome Metabólico , Glucemia , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Humanos , Hipoxia/epidemiología , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/epidemiología
17.
BMJ Case Rep ; 14(5)2021 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-34059533

RESUMEN

A 65-year-old patient with background of alcohol excess and previous gunshot wounds was admitted with significant weight loss, leg cramps, dizziness and lethargy for the last 3 months. He was diagnosed with type 2 diabetes mellitus in July 2020 and was started on Metformin and Gliclazide by his in July; he was later commenced on alogliptin and empaglaflozin by diabetes specialist nurse in early August. He also had generalised muscle wasting, dorsal guttering in both hands and was cachectic when he presented to hospital. His haemoglobin A1c (HbA1c) was 124 mmol/mol in July 2020 and was 63 mmol/mol in September 2020. The patient had negative autoimmune and TB screen. CT abdomen/pelvis and CT lumbosacral spine that showed mild diverticular disease and bilateral L5 spondylolysis with L5-S1 spondylotic changes. Electrophysiological studies confirmed sensory motor peripheral neuropathy. Patient was diagnosed with diabetic neuropathic cachexia secondary to poorly controlled diabetes and was commenced on 30 units two times per day of NovoMix 30 insulin; this was adjusted to 24 units two times per day in endocrine clinic 3 months later, after gaining 10 kg in weight. Good glycaemic control is key to the management of such cases and, therefore, we recommend early referral to diabetes specialist input for consideration of insulin therapy.


Asunto(s)
Diabetes Mellitus Tipo 2 , Neuropatías Diabéticas , Heridas por Arma de Fuego , Anciano , Caquexia/etiología , Diabetes Mellitus Tipo 2/complicaciones , Neuropatías Diabéticas/complicaciones , Hemoglobina A Glucada , Humanos , Masculino
18.
BMC Gastroenterol ; 21(1): 263, 2021 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-34118892

RESUMEN

BACKGROUND: Insulin is highly recommended for diabetes management in persons with liver cirrhosis. However, few studies have evaluated its long-term effects in these persons. We conducted this study to compare the risks of mortality, liver-related complications, and cardiovascular events in persons with type 2 diabetes mellitus (T2DM) and compensated liver cirrhosis. METHODS: From January 1, 2000, to December 31, 2012, we selected 2047 insulin users and 4094 propensity score-matched nonusers from Taiwan's National Health Insurance Research Database. Cox proportional hazard models were used to assess the risks of outcomes. RESULTS: The mean follow-up time was 5.84 years. The death rate during the follow-up period was 5.28 and 4.07 per 100 person-years for insulin users and nonusers, respectively. In insulin users, the hazard ratios and 95% confidence intervals (CIs) of all-cause mortality, hepatocellular carcinoma, decompensated cirrhosis, hepatic failure, major cardiovascular events, and hypoglycemia were 1.31 (1.18-1.45), 1.18 (1.05-1.34), 1.53 (1.35-1.72), 1.26 (1.42-1.86), 1.41 (1.23-1.62), and 3.33 (2.45-4.53), respectively. CONCLUSIONS: This retrospective cohort study indicated that among persons with T2DM and compensated liver cirrhosis, insulin users were associated with higher risks of death, liver-related complications, cardiovascular events, and hypoglycemia compared with insulin nonusers.


Asunto(s)
Diabetes Mellitus Tipo 2 , Neoplasias Hepáticas , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/epidemiología , Humanos , Hipoglucemiantes/efectos adversos , Insulina/uso terapéutico , Cirrosis Hepática/complicaciones , Cirrosis Hepática/epidemiología , Modelos de Riesgos Proporcionales , Estudios Retrospectivos
19.
Medicine (Baltimore) ; 100(25): e26508, 2021 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-34160471

RESUMEN

ABSTRACT: This study was conducted to examine whether Korean veterans from the US-Vietnam War who had a diagnosis of type II diabetes mellitus (T2DM) as well as past history of exposure to agent orange (AO) are vulnerable to hyperglycemia when receiving intra-articular corticosteroid injection (IACI) for pain relief.The current study included a total of 49 patients (n = 49) who received an injection of triamcinolone 20 or 40 mg to the shoulder under sonographic guidance or did that of dexamethasone 10 mg or triamcinolone 40 mg combined with dexamethasone 20 mg to the spine under fluoroscopic guidance. Their 7-day fasting blood glucose (FBG) levels were measured and then averaged, serving as baseline levels. This is followed by measurement of FBG levels for 14 days of IACI. Respective measurements were compared with baseline levels. The patients were also evaluated for whether there are increases in FBG levels depending on insulin therapy as well as HbA1c ≥ 7% or HbA1c < 7%.Overall, there were significant increases in FBG levels by 64.7 ±â€Š42.5 mg/dL at 1 day of IACI from baseline (P < .05). HbA1c ≥ 7% and HbA1c < 7% showed increases in FBG levels by 106.1 ±â€Š49.0 mg/dL and 46.5 ±â€Š3.8 mg/dL, respectively, at 1 day of IACI from baseline (P < .05). In the presence and absence of insulin therapy, there were significant increases in them by 122.6 ±â€Š48.7 mg/dL and 48.0 ±â€Š20.4 mg/dL, respectively, at 1 day of IACI from baseline (P < .05). But there were decreases in them to baseline levels at 2 days of IACI.Clinicians should consider the possibility of hyperglycemia when using corticosteroids for relief of musculoskeletal pain in Korean veterans from the US-Vietnam War who had a history of exposure to AO.


Asunto(s)
Agente Naranja/efectos adversos , Artralgia/tratamiento farmacológico , Diabetes Mellitus Tipo 2/complicaciones , Glucocorticoides/efectos adversos , Hiperglucemia/epidemiología , Trastornos por Estrés Postraumático/epidemiología , Anciano , Glucemia/análisis , Dexametasona/administración & dosificación , Dexametasona/efectos adversos , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Estudios de Seguimiento , Glucocorticoides/administración & dosificación , Humanos , Hiperglucemia/sangre , Hiperglucemia/diagnóstico , Hiperglucemia/etiología , Inyecciones Intraarticulares , Insulina/administración & dosificación , Masculino , República de Corea/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Trastornos por Estrés Postraumático/psicología , Triamcinolona/administración & dosificación , Triamcinolona/efectos adversos , Veteranos/psicología , Veteranos/estadística & datos numéricos , Guerra de Vietnam , Exposición a la Guerra/efectos adversos
20.
Pan Afr Med J ; 38: 292, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34178211

RESUMEN

Introduction: there is an association between hypogonadism and obesity, chronic hyperglycaemia, and ageing in men with type 2 diabetes mellitus (T2DM). T2DM is known to be associated with low testosterone. There is a paucity of data on the risk factors of hypogonadism in Nigerian men with T2DM. The objective of this study was to determine the clinical and biochemical correlates of hypogonadism and clinical predictors of low total testosterone levels in men with T2DM. Methods: this was a cross-sectional study consisting of 358 men with T2DM and 179 non-diabetic men (controls). Structured Androgen Deficiency in the Ageing Male questionnaire was administered. Clinical and biochemical parameters were measured. Free testosterone was calculated from albumin, SHBG and total testosterone using Vermeulen´s method. Hypogonadism was defined as fasting TT as < 8 nmol/L with or without symptoms or TT of 8-12 nmol/L with symptoms of androgen deficiency. Low testosterone was defined as serum total testosterone levels ≤ 12 nmol/L. Results: the mean (±SD) total testosterone of men with T2DM and controls were 8.79±3.35 nmol/L and 15.41±3.79 nmol/L respectively (p < 0.001). The risk of hypogonadism was associated with central obesity (Odds ratio [OR] 2.24, 95% confidence interval [CI] 0.38-13.07), systolic hypertension (OR 3.93, 95% CI 0.67-23.10), hyperglycaemia (OR 2.48, 95% CI 0.37-16.46) and hypercholesterolaemia (OR 2.50, 95% CI 0.43-14.61). In a multivariable regression analysis, there was a significant negative correlation between total testosterone and triglycerides (r -1.85, 95% CI -3.58 - 0.12, P = 0.04) and HDL cholesterol (r -1.25, 95% CI -5.95-3.45, P = 0.02). Conclusion: this study shows that in men with T2DM, triglycerides and HDL cholesterol are independent correlates of hypogonadism but not central adiposity, systolic blood pressure and glycaemia. Further large prospective studies are recommended.


Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Hipogonadismo/etiología , Obesidad/complicaciones , Testosterona/sangre , Adulto , Envejecimiento , Glucemia/metabolismo , HDL-Colesterol/sangre , Estudios Transversales , Humanos , Hipogonadismo/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Encuestas y Cuestionarios , Triglicéridos/sangre
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