Mortality after cancer among patients with diabetes mellitus: effect of diabetes duration and treatment: (questionable) classification of diabetic patients based on combination of specific glucose-lowering drugs. Reply to Holden SE, Bannister CA, Currie CJ [letter]

Metabolic diseases, especially diabetes mellitus, have become global health issues. The etiology of diabetes mellitus can be attributed to genetic and/or environmental factors. Current evidence suggests the association of gut microbiota with metabolic diseases. However, the effects of glucose-lowering agents on gut microbiota are poorly understood. Several studies revealed that these agents affect the composition and diversity of gut microbiota and consequently improve glucose metabolism and energy balance. Possible underlying mechanisms include affecting gene expression, lowering levels of inflammatory cytokines, and regulating the production of short-chain fatty acids. In addition, gut microbiota may alleviate adverse effects caused by glucose-lowering agents, and this can be especially beneficial in diabetic patients who experience severe gastrointestinal side effects and have to discontinue these agents. In conclusion, gut microbiota may provide a novel viewpoint for the treatment of patients with diabetes mellitus.

Download Full-text

Respiratory Dysfunction in Patients With Sepsis: Protective Effect of Diabetes Mellitus

American Journal of Critical Care ◽

10.4037/ajcc2011391 ◽

2011 ◽

Vol 20 (2) ◽

pp. e41-e47 ◽

Cited By ~ 11

Author(s):

Yong Yang ◽

Zakir-Hussain Abdul Salam ◽

Biauw Chi Ong ◽

Kok Soong Yang

Keyword(s):

Diabetes Mellitus ◽

Organ Dysfunction ◽

Asian Population ◽

Diabetic Patients ◽

Respiratory Dysfunction ◽

Discharge Data ◽

Patients With Diabetes ◽

Classification Of Diseases ◽

International Statistical Classification

Background Sepsis is a common complication in patients with diabetes mellitus. In a Western population, risk of respiratory dysfunction was lower in diabetic patients with sepsis. Objective To compare organ dysfunction, particularly respiratory dysfunction, between sepsis patients with and without diabetes mellitus in an Asian population. Method Hospital discharge data were collected for the period 2004 through 2008. Patients with sepsis, diabetes mellitus, and organ dysfunction were identified by using the International Statistical Classification of Diseases and Related Health Problems, 9th Revision, Australian Modification codes. Results Of the 383 238 patients hospitalized during the 5 years, 2943 of the 9221 who had sepsis also had diabetes (31.9%).The most common organ dysfunctions in patients with sepsis were renal (31.5%), cardiovascular (19.2%), and respiratory (10.9%). Among patients with sepsis, respiratory dysfunction was less likely in patients with diabetes (9.4%) than in those without (11.6%; P = .002), but renal dysfunction was more likely in patients with diabetes (46.5%) than in those without (24.4%; P < .001). However, only 27.6% of patients with diabetes had a respiratory source of sepsis compared with 33.4% in patients without diabetes (P < .001). Among patients with sepsis, diabetes mellitus was a significant and independent predictor of respiratory dysfunction (odds ratio, 0.80; 95% confidence interval, 0.66–0.98) after adjustments for age, sex, ethnicity, admission to intensive care, number of comorbid conditions, and other infection sources. Conclusion Among an Asian population, respiratory dysfunction in patients with sepsis is less likely to develop in those with diabetes than in those without diabetes.

Download Full-text

Clinical and psychological aspects of hypoglycemia in patients with diabetes mellitus

Diabetes Mellitus ◽

10.14341/2072-0351-5487 ◽

2010 ◽

Vol 13 (3) ◽

pp. 46-50 ◽

Cited By ~ 1

Author(s):

Olga Georgievna Mel'nikova ◽

Alexander Yur'evich Mayorov

Keyword(s):

Diabetes Mellitus ◽

Psychological Aspects ◽

Diabetic Patients ◽

Patients With Diabetes ◽

Specialized Care ◽

Detailed Characteristic ◽

Key Aspects ◽

Canadian Diabetes Association

This paper reviews key aspects of hypoglycemia in patients with diabetes mellitus. The description and classification of hyoglycemias are presented inconformity with criteria of American Diabetes Association, European Agency for Evaluation of Medicinal Products, Canadian Diabetes Association,and Russian Algorithm of specialized care for diabetic patients. The main factors responsible for the development of hypoglycemia and its clinicalpicture are considered. A detailed characteristic of abnormal sensitivity to hypoglycemia is given. Psychological aspects of the effects of hypoglycemiaon the quality of life and achievement of target parameters of glycemic control are analysed.

Download Full-text

Heart Failure in Patients with Diabetes Mellitus

Cardiac Failure Review ◽

10.15420/cfr.2016:20:2 ◽

2017 ◽

Vol 03 (01) ◽

pp. 52 ◽

Cited By ~ 38

Author(s):

Giuseppe MC Rosano ◽

Cristiana Vitale ◽

Petar Seferovic ◽

◽

...

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Total Mortality ◽

Glycated Haemoglobin ◽

Diabetic Patients ◽

Glucose Lowering ◽

Increased Risk ◽

Patients With Heart Failure ◽

Patients With Diabetes ◽

Negative Effect

Diabetes and heart failure are closely related: patients with diabetes have an increased risk of developing heart failure and those with heart failure are at higher risk of developing diabetes. Furthermore, antidiabetic medications increase the risk of mortality and hospitalisation for heart failure in patients with and without pre-existing heart failure. When the two diseases are considered individually, heart failure has a much poorer prognosis than diabetes mellitus; therefore heart failure has to be a priority for treatment in patients presenting with the two conditions, and the diabetic patient with heart failure should be managed by the heart failure team. No specific randomised clinical trials have been conducted to test the effect of cardiovascular drugs in diabetic patients with heart failure, but a wealth of evidence suggests that all interventions effective at improving prognosis in patients with heart failure are equally beneficial in patients with and without diabetes. The negative effect of glucose-lowering agents in patients with heart failure or at increased risk of heart failure has become evident after the withdrawal of rosiglitazone, a thiazolidinedione, from the EU market due to evidence of increased risk of cardiovascular events and hospitalisations for heart failure. An important issue that remains unresolved is the optimal target level of glycated haemoglobin, as recent studies have demonstrated significant reductions in total mortality, morbidity and risk of heart failure despite achieving HbA1c levels similar to those observed in the UKPDS study conducted some decades ago. Meta-analyses showed that intensive glucose lowering is not associated with any significant reduction in cardiovascular risk but conversely results in a significant increase in heart failure risk. Different medications have different risk: benefit ratios in diabetic patients with heart failure; therefore, the heart failure team must judge the required intensity of glycaemic control, the type and dose of glucose lowering agents and any change in glucose-lowering therapy, according to the clinical conditions present.

Download Full-text

Mortality after cancer among patients with diabetes mellitus: effect of diabetes duration and treatment

Diabetologia ◽

10.1007/s00125-014-3186-z ◽

2014 ◽

Vol 57 (5) ◽

pp. 927-934 ◽

Cited By ~ 49

Author(s):

Kristina Ranc ◽

Marit E. Jørgensen ◽

Søren Friis ◽

Bendix Carstensen

Keyword(s):

Diabetes Mellitus ◽

Diabetes Duration ◽

Patients With Diabetes ◽

After Cancer

Download Full-text

Hypoglycemia and the risk of cognitive impairment and dementia in elderly and senile patients with type 2 diabetes

Diabetes Mellitus ◽

10.14341/dm10202 ◽

2020 ◽

Vol 23 (1) ◽

pp. 72-87

Author(s):

Olga D. Ostroumova ◽

Elena V. Surkova ◽

Irina V. Goloborodova ◽

Antonina V. Starodubova ◽

Alexey I. Kochetkov ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Cognitive Impairment ◽

Age Groups ◽

Cognitive Status ◽

Antidiabetic Drugs ◽

Diabetic Patients ◽

Glucose Lowering ◽

Patients With Diabetes

Research results show that poor glycemic control and recurrent episodes of severe hypoglycaemia are associated with a decrease in cognitive function in elderly people with type 2 diabetes mellitus (T2DM). On the other hand, patients with diabetes mellitus associated with cognitive impairment/dementia are most at risk of developing hypoglycaemic conditions. It is obvious that the relationship between hypoglycaemia and dementia is very complex and has a mutually aggravating nature. Studies also show that individuals of older age groups with diabetes and cognitive impairment have a high risk of developing hypoglycaemic conditions, such as unwanted side effects from glucose-lowering therapy. In this case, of particular interest is the question that is being actively studied at the present time, which is concerning the effect of different groups of glucose-lowering antidiabetic drugs on the cognitive status and the rate of cognitive decline in diabetic patients with cognitive impairment. In this review, we attempted to summarise, systematise, and present data available in the literature concerning the effect of hypoglycaemia on the risk of cognitive impairment and dementia in elderly and senile patients with type-2 diabetes, as well as the degree of participation in this process of of various groups of sugar-lowering antidiabetic drugs.

Download Full-text

Intramuscular Nerve and Neuromuscular Junction Alteration In Extraocular Muscles of Diabetic Mice

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100120102 ◽

1985 ◽

Vol 43 ◽

pp. 682-683

Author(s):

Bruce R. Pachter

Keyword(s):

Diabetes Mellitus ◽

Peripheral Nerves ◽

Sudden Onset ◽

Extraocular Muscles ◽

Diabetic Patients ◽

Oculomotor Palsy ◽

Third Nerve Palsy ◽

Patients With Diabetes ◽

Intramuscular Nerve ◽

Oculomotor Nerves

Diabetes mellitus is one of the commonest causes of neuropathy. Diabetic neuropathy is a heterogeneous group of neuropathic disorders to which patients with diabetes mellitus are susceptible; more than one kind of neuropathy can frequently occur in the same individual. Abnormalities are also known to occur in nearly every anatomic subdivision of the eye in diabetic patients. Oculomotor palsy appears to be common in diabetes mellitus for their occurrence in isolation to suggest diabetes. Nerves to the external ocular muscles are most commonly affected, particularly the oculomotor or third cranial nerve. The third nerve palsy of diabetes is characteristic, being of sudden onset, accompanied by orbital and retro-orbital pain, often associated with complete involvement of the external ocular muscles innervated by the nerve. While the human and experimental animal literature is replete with studies on the peripheral nerves in diabetes mellitus, there is but a paucity of reported studies dealing with the oculomotor nerves and their associated extraocular muscles (EOMs).

Download Full-text

A preliminary study on diabetes self-management education and glycemic control among patients with diabetes mellitus

Journal of Nursing Education and Practice ◽

10.5430/jnep.v9n9p98 ◽

2019 ◽

Vol 9 (9) ◽

pp. 98 ◽

Cited By ~ 1

Author(s):

Kisokanth G. ◽

Indrakumar J. ◽

Prathapan S. ◽

Joseph J. ◽

Ilankoon I.M.P.S.

Keyword(s):

Diabetes Mellitus ◽

Glycemic Control ◽

Management Education ◽

Self Management ◽

Rank Test ◽

Diabetic Patients ◽

Effective Measure ◽

Before And After ◽

Patients With Diabetes ◽

Preliminary Study

This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant (p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.

Download Full-text

When Uncontrolled Diabetes Mellitus and Severe COVID-19 Converge: The Perfect Storm for Mucormycosis

Journal of Fungi ◽

10.3390/jof7040298 ◽

2021 ◽

Vol 7 (4) ◽

pp. 298

Author(s):

Teny M. John ◽

Ceena N. Jacob ◽

Dimitrios P. Kontoyiannis

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Clinical Features ◽

The Other ◽

Diabetic Patients ◽

Epidemiological Factors ◽

Uncontrolled Diabetes ◽

Diagnostic Certainty ◽

Patients With Diabetes ◽

Perfect Storm

Mucormycosis (MCR) has been increasingly described in patients with coronavirus disease 2019 (COVID-19) but the epidemiological factors, presentation, diagnostic certainty, and outcome of such patients are not well described. We review the published COVID-19-associated mucormycosis (CAMCR) cases (total 41) to identify risk factors, clinical features, and outcomes. CAMCR was typically seen in patients with diabetes mellitus (DM) (94%) especially the ones with poorly controlled DM (67%) and severe or critical COVID-19 (95%). Its presentation was typical of MCR seen in diabetic patients (mostly rhino-orbital and rhino-orbital-cerebral presentation). In sharp contrast to reported COVID-associated aspergillosis (CAPA) cases, nearly all CAMCR infections were proven (93%). Treating physicians should have a high suspicion for CAMCR in patients with uncontrolled diabetes mellitus and severe COVID-19 presenting with rhino-orbital or rhino-cerebral syndromes. CAMR is the convergence of two storms, one of DM and the other of COVID-19.

Download Full-text