Hyperglycemic memory in diabetic cardiomyopathy

Frontiers of Medicine ◽

10.1007/s11684-021-0881-2 ◽

2021 ◽

Author(s):

Jiabing Zhan ◽

Chen Chen ◽

Dao Wen Wang ◽

Huaping Li

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Blood Glucose ◽

Cardiovascular Diseases ◽

Glycemic Control ◽

Diabetic Cardiomyopathy ◽

Cardiovascular Complication ◽

Diabetes Therapy ◽

Patients With Diabetes ◽

Underlying Mechanisms

AbstractCardiovascular diseases account for approximately 80% of deaths among individuals with diabetes mellitus, with diabetic cardiomyopathy as the major diabetic cardiovascular complication. Hyperglycemia is a symptom that abnormally activates multiple downstream pathways and contributes to cardiac hypertrophy, fibrosis, apoptosis, and other pathophysiological changes. Although glycemic control has long been at the center of diabetes therapy, multicenter randomized clinical studies have revealed that intensive glycemic control fails to reduce heart failure-associated hospitalization and mortality in patients with diabetes. This finding indicates that hyperglycemic stress persists in the cardiovascular system of patients with diabetes even if blood glucose level is tightly controlled to the normal level. This process is now referred to as hyperglycemic memory (HGM) phenomenon. We briefly reviewed herein the current advances that have been achieved in research on the underlying mechanisms of HGM in diabetic cardiomyopathy.

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Relevance of self-control of blood glucose in the aspect of prevention of cardiovascular complications in patients with diabetes mellitus

Medical Council ◽

10.21518/2079-701x-2021-14-104-109 ◽

2021 ◽

pp. 104-109

Author(s):

D. I. Trukhan

Keyword(s):

Diabetes Mellitus ◽

Myocardial Infarction ◽

Blood Glucose ◽

Cardiovascular Diseases ◽

Glycemic Control ◽

Complications Of Diabetes ◽

Glucose Levels ◽

Risk Of Death ◽

Increased Risk ◽

Patients With Diabetes

There is a clear link between diabetes and cardiovascular disease. It is known that cardiovascular diseases in patients with diabetes mellitus occur 2–5 times more often than in people without diabetes. It is cardiovascular outcomes that are the main cause of death in patients with diabetes mellitus in both men and women. Diabetes mellitus has a high risk of coronary heart disease, myocardial infarction, arterial hypertension and acute cerebrovascular accident, and patients with diabetes mellitus may experience painless acute myocardial infarction associated with the presence of autonomic cardiac neuropathy. Various rhythm disturbances are much more common in diabetes mellitus, including paroxysmal forms of atrial fibrillation, which increase the risk of death by 1.8–2 times. The leading factor in the development of vascular complications of diabetes mellitus is hyperglycemia. In addition, early glycemic disorders - impaired glucose tolerance or impaired fasting glycemia - make a significant contribution to the increased risk of macrovascular complications. Improving glycemic control leads to a significant reduction in the risk of late macro- and microvascular complications of diabetes mellitus. Glycated hemoglobin is the gold standard for monitoring glycemic control, but it does not provide complete information on daily and intraday changes in glucose levels. Regular self-monitoring of glucose levels is important in the prevention of cardiovascular diseases in patients with diabetes mellitus. In addition, during the COVID-19 pandemic, all consensus documents and recommendations for the management of patients with diabetes indicate the need for regular monitoring of glucose levels. An important aspect of the technical impact on patients’ adherence to selfcontrol and diabetes therapy is the presence of a convenient communicative connection between the patient and the doctor, in particular, the possibility of contact remotely via a computer and a mobile phone. In conclusion, the possibilities of the new model of the line of blood glucose meters are considered.

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Dates fruits effects on blood glucose among patients with diabetes mellitus: A review and meta-analysis

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.4.4112 ◽

2021 ◽

Vol 37 (4) ◽

Author(s):

Hyder Osman Mirghani

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Glycemic Control ◽

Plasma Glucose ◽

Meta Analysis ◽

Postprandial Plasma Glucose ◽

Creative Commons ◽

Patients With Diabetes ◽

Glycemic Indices ◽

Open Access Article

Background & Objective: Dates fruit is known for its great nutritional value and two to three servings of dates fruit/day are beneficial for patients with diabetes. However, some may advice against this cheap and widely available fruit consumption. Besides, 12% of the population Worldwide are either suffering or are at risk of developing diabetes, but no previous meta-analysis has assessed this important issue. Thus, the study aimed to investigate the effects of date’s fruit on glycemia among patients with diabetes. Methods: A systematic literature search was conducted in PubMed, Medline, EBSCO, Cochrane, and Google Scholar databases for trials published in English from the first published article up to December 2020. The following keywords were used: “dates fruit and glycemic control”, “dates fruit and blood glucose”, “dates fruit and HbA1c” without limitations regarding the date of publication. Results: Out of the 942 references identified, only 10 cohorts from five full texts were included, a reduction of Fasting plasma glucose (FPG), odd ratio, -24.79, 95% CI=-34.75, -14.83 P =0.002. I2 for heterogeneity=79%, P <0.00001 and postprandial plasma glucose (PPPG), odd ratio -28.19, 95% CI=-60.66-4.29, P =<0.0001. I2 for heterogeneity=92%, P=0.09) was observed. While the effect on HbA1c was neutral, odd ratio, -.20, 95% CI=-.46 -.06, P=0.13. I2 for heterogeneity=0. %, P=0.55. Conclusion: Dates fruit was beneficial regarding glycemic control among patients with diabetes, physician may not need to restrict its use among patients with diabetes. The small number of the included studies and the heterogeneity observed in PPPG and FPG sub-analysis limited the current results. Further trials assessing the glycemic indices of various types of dates fruit are needed. doi: https://doi.org/10.12669/pjms.37.4.4112 How to cite this:Mirghani HO. Dates fruits effects on blood glucose among patients with diabetes mellitus: A review and meta-analysis. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.4112 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Diabetic heart: Metabolic reasons for the development of cardiomyopathy

Problems of Endocrinology ◽

10.14341/probl12056 ◽

1996 ◽

Vol 42 (6) ◽

pp. 20-26

Author(s):

E. I. Sokolov ◽

O. S. Zaichikova

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Coronary Arteries ◽

Diabetic Cardiomyopathy ◽

Myocardial Dysfunction ◽

Stroke Volume Index ◽

Left Ventricular ◽

Volume Index ◽

Dependent Diabetes Mellitus ◽

Patients With Diabetes

Cardiovascular disease is a common cause of death in patients with diabetes mellitus (DM). The likelihood of developing heart failure with this disease increases, even if you take into account the influence of factors such as age, blood pressure, plasma cholesterol, body weight and the condition of the coronary arteries. The term "diabetic cardiomyopathy" was proposed in 1972 by S. Rubier et al. They performed postmortem autopsy of patients with diabetes complicated by diabetic nephropathy and congestive heart failure without arterial hypertension and severe atherosclerosis of the coronary arteries. The hemodynamic parameters of a group of patients with diabetes without hypertension without significant atherosclerotic changes in the coronary arteries according to angiography were studied by T. Regan et al. In these patients, a decrease in stroke volume index and an increase in diastolic pressure in the left ventricle were detected. The observed changes, indicating a decrease in left ventricular myocardial extensibility, were interpreted as signs of subclinical cardiomyopathy. Based on the results of an echocardiographic examination of patients with insulin-dependent diabetes mellitus (IDDM) Ch. Dimitar proposed the following stages of development of diabetic cardiomyopathy: I - increased myocardial contractility; II - systolic and diastolic functions are not impaired; III - the beginning of the development of diastolic dysfunction, a decrease in the "compliance" of the left ventricular myocardium and dilatation of the left atrium; IV - progression of diastolic myocardial dysfunction (DDM) and the addition of systolic dysfunction.

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Evaluating Perioperative Glycemic Control of Non-cardiac Surgical Patients with Diabetes

Military Medicine ◽

10.1093/milmed/usaa467 ◽

2020 ◽

Author(s):

L Alan Todd ◽

Robert A Vigersky

Keyword(s):

Diabetes Mellitus ◽

Cardiac Surgery ◽

Blood Glucose ◽

Glycemic Control ◽

Medical Record ◽

Electronic Medical Record ◽

Perioperative Period ◽

Poor Glycemic Control ◽

Surgical Patients ◽

Patients With Diabetes

ABSTRACT Introduction Hyperglycemia during the perioperative period has generally been accepted as a contributor of poor outcomes in patients with diabetes mellitus undergoing surgery. Although an optimal glycemic range has not been clearly established in the literature, a consensus among national medical organizations generally recommends serum glucose levels to be maintained less than 180 mg/dL during the perioperative period. Materials and Methods The primary purpose of this evidence-based project was to identify the range of blood glucose values obtained from adult patients with diabetes mellitus undergoing non-cardiac surgery at a large military medical facility. The secondary purpose of this project was to assess the need for change in future practice. A retrospective review of the electronic medical record was conducted to identify adult surgical patients with diabetes scheduled for non-cardiac surgery. Preoperative and postoperative blood glucose values were obtained from the electronic medical record. The frequency of blood glucose values maintained within the recommended range of 140-180 mg/dL was recorded. Additional demographic data were collected to include age, height, weight, body mass index, length of surgery, and insulin/oral glycemic medications. Results Of the 9,449 surgeries performed between January 1, 2013, and December 31, 2013, there were 762 (8%) adult non-cardiac surgical patients identified with either a diagnosis of diabetes or a blood glucose value reported during the perioperative period. The recommended blood glucose range of 140-180 mg/dL was achieved in 31.3% (179 of 572) of patients before surgery and 28.6% (71 of 248) after surgery. A blood glucose value was not recorded before or after surgery in 24.9% (190 of 762) of patients identified as having pre-diabetes or diabetes. Conclusion Diabetes is a frequent finding in surgical patients. Monitoring blood glucose values during the perioperative period may allow for early treatment and prevent complications related to poor glycemic control. The results of this project revealed 2 potential areas of improvement in the care of non-cardiac surgical patients with diabetes: (1) improving compliance with obtaining blood glucose values before and after surgery and (2) reducing the incidence of postoperative hyperglycemia (>180 mg/dL) which potentially could prevent avoidable complications related to poor glycemic control.

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Reducing the risk of heart failure in diabetes mellitus: review of new therapeutics

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20201094 ◽

2020 ◽

Vol 9 (4) ◽

pp. 660

Author(s):

Shreeharsh Godbole ◽

Shreerang Godbole

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Glycemic Control ◽

Long Term Outcomes ◽

Increased Risk ◽

High Prevalence ◽

Patients With Diabetes ◽

Diabetic Population ◽

Glucose Transport Protein

Diabetes mellitus (DM) and heart failure (HF) are closely related: patients with diabetes have an increased risk of developing HF and those with HF are at higher risk of developing diabetes. When the two diseases are considered individually, HF has a much poorer prognosis than diabetes mellitus; therefore, treatment of HF is a priority in these group of patients. There are many drugs now available to achieve glycemic control in individuals with DM. However, as we enter an era of personalization in the management of DM, the next challenge will be the identification of therapeutic strategies that will not only achieve and maintain glycemic control, but that will also reverse existing complications. Given the high prevalence of HF in DM, there is a strong imperative to advance this field, with the view of identifying robust strategies that will not only improve long-term outcomes in subjects with DM and HF but also limit the likelihood of developing HF in the first place. Newer therapies like sodium- glucose transport protein- 2 inhibitors (SGLT-2 I) and sacubitril or valsartan have shown potential benefit for reducing the risk of heart failure in diabetic population. This review will summarize the new therapeutics to reduce the risk of HF in patients with DM.

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Impact of insulin therapy on the mortality of acute heart failure patients with diabetes mellitus

Cardiovascular Diabetology ◽

10.1186/s12933-021-01370-y ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Se Yong Jang ◽

Jieun Jang ◽

Dong Heon Yang ◽

Hyun-Jai Cho ◽

Soo Lim ◽

...

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Glycemic Control ◽

Insulin Therapy ◽

Acute Heart Failure ◽

Mortality Risk ◽

Left Ventricular ◽

Hypoglycemic Agents ◽

Left Ventricular Ejection ◽

Patients With Diabetes

Abstract Background Patients with diabetes mellitus (DM) have a higher prevalence of heart failure (HF) than those without it. Approximately 40 % of HF patients have DM and they tend to have poorer outcomes than those without DM. This study evaluated the impact of insulin therapy on mortality among acute HF patients. Methods A total of 1740 patients from the Korean Acute Heart Failure registry with DM were included in this study. The risk of all-cause mortality according to insulin therapy was assessed using the Cox proportional hazard models with inverse probability of treatment weighting to balance the clinical characteristics (pretreatment covariates) between the groups. Results DM patients had been treated with either oral hypoglycemic agents (OHAs) alone (n = 620), insulin alone (n = 682), or insulin combined with OHAs (n = 438). The insulin alone group was associated with an increased mortality risk compared with the OHA alone group (HR = 1.41, 95 % CI 1.21–1.66]). Insulin therapy combined with OHAs also showed an increased mortality risk (HR = 1.29, 95 % CI 1.14–1.46) compared with the OHA alone group. Insulin therapy was consistently associated with increased mortality risk, regardless of the left ventricular ejection fraction (LVEF) or HF etiology. A significant increase in mortality was observed in patients with good glycemic control (HbA1c < 7.0 %) receiving insulin, whereas there was no significant association in patients with poor glycemic control (HbA1c ≥ 7.0%). Conclusions Insulin therapy was found to be associated with increased mortality compared to OHAs. The insulin therapy was harmful especially in patients with low HbA1c levels which may suggest the necessity of specific management strategies and blood sugar targets when using insulin in patients with HF.

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Self-monitoring of blood glucose and perceived obstacles in Turkish patients with diabetes mellitus

Endocrine Abstracts ◽

10.1530/endoabs.35.p483 ◽

2014 ◽

Author(s):

Ozlem Turhan Iyidir ◽

Mustafa Unubol ◽

Bulent Ogun Hatipoglu ◽

Ceyla Konca Degertekin

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Self Monitoring ◽

Patients With Diabetes ◽

Turkish Patients

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Neuropathy in the gut. Gut motility disorders in patients with diabetes mellitus

Orvosi Hetilap ◽

10.1556/oh.2012.29360 ◽

2012 ◽

Vol 153 (16) ◽

pp. 607-614

Author(s):

Tibor Wittmann

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Treatment Modalities ◽

Clinical Aspects ◽

Gut Motility ◽

Motility Disorders ◽

The Everyday ◽

Patients With Diabetes ◽

Leading Symptom ◽

Different Parts

The extent and severity of motility disorders remains heterogeneous in the different parts of the gut, and in most cases failures in gut motility do not correspond with the severity of the symptoms. If diarrhea or fecal incontinence is the leading symptom, or the blood glucose level varies frequently and considerably despite the treatment efforts, the motility of the stomach and bowels is seriously disturbed. The clinical aspects, detailed pathogenesis, diagnostic approach and treatment modalities of gastrointestinal motility disorders in diabetes mellitus are reviewed to help and improve the everyday medical practice. Orv. Hetil., 2012, 153, 607–614.

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