scholarly journals Do Women with Diabetes Need More Intensive Action for Cardiovascular Reduction than Men with Diabetes?

2020 ◽  
Vol 20 (11) ◽  
Author(s):  
Jürgen Harreiter ◽  
Helena Fadl ◽  
Alexandra Kautzky-Willer ◽  
David Simmons
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Meta Analysis ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Risk Factor Management ◽  
High Risk Women ◽  
Background Population ◽  
Cvd Mortality

Abstract Purpose of Review This narrative review makes the case for greater efforts to reduce cardiovascular disease (CVD) risk in women with diabetes. Recent Findings In a recent meta-analysis including five CVOTs of diabetes medications with 46,606 subjects, women (vs men) with type 2 diabetes had a higher relative risk for stroke (RR 1.28; 95% CI 1.09, 1.50) and heart failure (1.30; 1.21, 1.40). Prior studies found higher “within-gender” RR for CVD mortality in women with diabetes although men have an absolute higher risk. Women with prior gestational diabetes mellitus (GDM) have a 2-fold higher CVD risk than the background population. Worse CVD and CVD risk factor management in women, as well as lower female therapy adherence, contribute further to these disparities. Summary The mechanism behind this excess risk includes biological, hormonal, socioeconomic, clinical, and behavioral factors that still require further investigation. The need for more intensive CVD reduction in women now includes more attention to screening for both incident diabetes and CVD risk factors among high-risk women.

scholarly journals MECHANISMS IN ENDOCRINOLOGY: Cardiovascular risk in women with type 2 diabetes mellitus and prediabetes: is it indeed higher than men?

2014 ◽  
Vol 171 (6) ◽  
pp. R245-R255 ◽  
Author(s):  
Panagiotis Anagnostis ◽  
Azeem Majeed ◽  
Desmond G Johnston ◽  
Ian F Godsland
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Absolute Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Mortality And Morbidity ◽  
Blood Pressure Targets ◽  
Definite Difference ◽  
Cvd Mortality

The relative risk for cardiovascular disease (CVD) events and mortality in diabetic women (in comparison with non-diabetic women) is believed to be greater than that in diabetic men. However, the absolute risk for CVD mortality and morbidity does not appear to be higher in women. In general, there is heterogeneity between studies, and whether there is any definite difference in the CVD risk between sexes at any level of glycaemia is not known. The same arguments also apply when comparing the CVD risk factors, such as lipid profiles and systemic inflammation indices, which seem to be worse in women than in men with diabetes mellitus (DM). The same questions emerge at any given glycaemic state: are women at worse risk and do they have a worse risk factor profile than men? These issues have yet to be resolved. Similar, though less extensive, data have been reported for prediabetes. Furthermore, women with DM are suboptimally treated compared with men regarding lipid and blood pressure targets. Large prospective studies representative of the general population are therefore needed to define the differences between sexes regarding CVD events and mortality at a given glucose level and after adjusting for any other confounders.

Determining the Cardiovascular Disease Risk Factor Knowledge and Related Factors Among Adults With Type 2 Diabetes Mellitus

2021 ◽  
pp. 105477382110464
Author(s):  
Emine Karaman ◽  
Aslı Kalkım ◽  
Banu Pınar Şarer Yürekli
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Related Factors

In this study was to determine knowledge of cardiovascular disease (CVD) risk factors and to explore related factors among adults with type 2 diabetes mellitus (DM) who have not been diagnosed with CVD. This descriptive study was conducted with 175 adults. Data were collected individual identification form and Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) scale. A negative correlation was found between age and CARRF-KL score. A significant difference was found between educational status and CARRF-KL score. The individuals described their health status as good, managed their condition with diet and exercise, received information from nurses, adults with DM in their family and those with no DM complications had significantly higher scores in CARRF-KL. The knowledge of an individual with DM about CVD risk factors should be assessed, CVD risks should be identified at an early stage, and individuals at risk should be subjected to screening.

Insulin Resistance the Link between T2DM and CVD: Basic Mechanisms and Clinical Implications

2019 ◽  
Vol 17 (2) ◽  
pp. 153-163 ◽  
Author(s):  
Muhammad A. Abdul-Ghani ◽  
Amin Jayyousi ◽  
Ralph A. DeFronzo ◽  
Nidal Asaad ◽  
Jassim Al-Suwaidi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Molecular Mechanisms ◽  
Clinical Implications ◽  
Metabolic Abnormalities ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cardinal Feature

Insulin resistance (IR) is a cardinal feature of type 2 diabetes mellitus (T2DM). It also is associated with multiple metabolic abnormalities which are known cardiovascular disease (CVD) risk factors. Thus, IR not only contributes to the development of hyperglycemia in T2DM patients, but also to the elevated CVD risk. Improving insulin sensitivity is anticipated to both lower the plasma glucose concentration and decrease CVD risk in T2DM patients, independent of glucose control. We review the molecular mechanisms and metabolic consequences of IR in T2DM patients and discuss the importance of addressing IR in the management of T2DM.

scholarly journals Mortality rates and cardiovascular disease burden in type 2 diabetes by occupation, results from all Swedish employees in 2002–2015

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sofia Carlsson ◽  
Tomas Andersson ◽  
Mats Talbäck ◽  
Maria Feychting
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Mortality Rates ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Risk Of Death ◽  
Diabetes Mortality ◽  
Machine Operators ◽  
Cvd Mortality

Abstract Objective To identify occupations where employees with type 2 diabetes have a high risk of cardiovascular disease (CVD) and mortality, and their prevalence of CVD risk factors. This study can contribute in the creation of targeted interventions at the workplace. Research design and methods This nationwide registry-based study included all employees with type 2 diabetes born in Sweden in 1937–1979 (n = 180,620) and followed up in 2002–2015. We calculated age-standardized incidence (per 100,000 person-years) of all-cause and CVD mortality, ischemic heart disease (IHD) and stroke across the 30 most common occupations. Information on prognostic factors was retrieved from the National Diabetes Register. Results In males with type 2 diabetes, mortality rates were highest in manufacturing workers (1782) and machine operators (1329), and lowest in specialist managers (633). The risk of death at age 61–70 years was 21.8% in manufacturing workers and 8.5% in managers. In females with type 2 diabetes, mortality rates were highest in manufacturing workers (1150) and cleaners (876), and lowest in writers and artists (458); the risk of death at age 61–70 years was 12.4% in manufacturing workers and 4.3% in writers and artists. The same occupations also had relatively high incidences of CVD mortality, IHD and stroke. Occupational groups with poor prognosis had high prevalence of CVD risk factors including poor glycemic control, smoking and obesity. Conclusions Manufacturing workers, machine operators and cleaners with type 2 diabetes have two to three times higher mortality rates than managers, writers and artists with type 2 diabetes. Major health gains would be made if targeted workplace interventions could reduce CVD risk factors in these occupations.

scholarly journals Interaction between the dietary indices (DQI, DPI, HEI) and PPAR-γ gene variants on cardiovascular risk factors in a patient with type 2 diabetes mellitus

2020 ◽  
Author(s):  
Faezeh Abaj ◽  
Gity Sotoudeh ◽  
Elmira Karimi ◽  
Masoumeh Rafiee ◽  
Fariba Koohdani
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Density Lipoprotein ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Pro12ala Polymorphism ◽  
Ppar Γ ◽  
Dietary Indices

Background: We investigated the interaction between PPAR-γ Pro12Ala polymorphism and Healthy Eating Index (HEI), Dietary Quality Index-International (DQI-I) and Dietary Phytochemical Index (DPI) on Cardiovascular Disease (CVD) risk factors in patients with type 2 diabetes mellitus (T2DM). Methods: This cross-sectional study was conducted on 393 diabetic patients. PPAR-γ Pro12Ala was genotyped by PCR-RFLP method. Biochemical markers including total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), superoxide dismutase (SOD), C-reactive protein (CRP), total antioxidant capacity (TAC), pentraxin-3 (PTX3), isoprostaneF2α (PGF2α) were measured by standard protocol. FFQ was used for dietary indices (DQI, DPI, HEI) calculation. Results: There was no significant relationship between PPAR-γ Pro12Ala polymorphism and CVD risk factors. The rs1801282-DQI interactions were significant on WC (P= 0.01). Thus, C-allele carriers in the higher tertile of DQI had higher WC compared to GG homozygous. Further, an interaction was observed between PPAR rs1801282 polymorphism and DQI on serum IL-18 level (P = 0.03). Besides, a significant rs1801282-DPI interaction was shown on HDL concentration (P Interaction= 0.04), G allele carriers who were in the highest tertile of DPI, had lower HDL. Moreover, there were significant rs1801282-HEI interactions on ghrelin (P= 0.04) in the crude model and serum leptin (P = 0.02) in the adjusted model. Individuals with (CC, CG) genotypes in the higher tertile of HEI, had lower leptin and ghrelin concentration. Conclusions: Higher dietary indices (DQI, DPI, HEI) may affect the relationship between PPAR-γ Pro12Ala polymorphism and waist circumference and ghrelin, leptin, HDL-c, IL-18 concentration in patients with T2DM. To date, studies on this polymorphism have been shown that this gene can interact with diabetes and different nutritional factors. For the first time, this study provides information on the interaction of dietary indices (DQI, DPI, HEI) and PPAR-γ gene which is functionally effective in nutrient metabolism.

scholarly journals Reduced insulin clearance is linked to subclinical atherosclerosis in individuals at risk for type 2 diabetes mellitus

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Elko Randrianarisoa ◽  
Angela Lehn-Stefan ◽  
Anja Hieronimus ◽  
Robert Wagner ◽  
Jakob Maucher ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Subclinical Atherosclerosis ◽  
Insulin Clearance ◽  
Cvd Risk Factors ◽  
Cvd Risk

AbstractHyperglycemia and insulin resistance contribute to vascular damage and are regulated by different pathophysiological processes. The aim of the study was to systematically investigate the relative contributions of multiple fasting state- and oral glucose tolerance test (oGTT)-derived glycemic traits to carotid intima-media thickness (cIMT), a surrogate parameter of subclinical atherosclerosis, in individuals with increased risk for type 2 diabetes mellitus (T2D). 667 volunteers (417 women and 250 men, mean age 44.1 years), who were free of cardiovascular disease (CVD), were included in this cross-sectional study. Glucose tolerance, insulin sensitivity, insulin secretion and insulin clearance were assessed by frequently sampled 75 g oGTT. CIMT was measured by high-resolution ultrasound. Insulin clearance was associated with cIMT in univariate analysis (ßst = − 0.17, p < 0.0001) and in a stepwise regression analysis on 15 variables possibly affecting cIMT, age (r2 = 0.3923, p < 0.0001), insulin clearance (r2 = 0.4564, p < 0.0001), systolic blood pressure (r2 = 0.4733, p < 0.0001), body mass index (BMI) (r2 = 0.4804, p = 0.002), gender (r2 = 0.4831, p = 0.013), and fasting insulin clearance (r2 = 0.4857, p = 0.030) turned out to be significant determinants of cIMT. In a cross-validated model resulting from this analysis, insulin clearance was found to be an independent determinant of cIMT (ßst = − 0.16, p < 0.0001) even after adjusting for traditional CVD risk factors. Reduced insulin clearance may be an early marker of damage on the vasculature, independent of classical CVD risk factors. Reduced insulin clearance should be considered with regard to vascular insulin resistance.

scholarly journals Interaction Between the Dietary Indices (DQI, DPI, HEI) and PPAR-γ Gene Variants on Cardiovascular Risk Factors in a Patient With Type 2 Diabetes Mellitus

2020 ◽  
Author(s):  
Faezeh Abaj ◽  
Guity Soutudeh ◽  
Elmira Karimi ◽  
Masoumeh Rafiee ◽  
Fariba Koohdani
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Density Lipoprotein ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Pro12ala Polymorphism ◽  
Ppar Γ ◽  
Dietary Indices

Abstract Background: We investigated the interaction between PPAR-γ Pro12Ala polymorphism and Healthy Eating Index (HEI), Dietary Quality Index-International (DQI-I) and Dietary Phytochemical Index (DPI) on Cardiovascular Disease (CVD) risk factors in patients with type 2 diabetes mellitus (T2DM).Methods: This cross-sectional study was conducted on 393 diabetic patients. PPAR-γ Pro12Ala was genotyped by PCR-RFLP method. Biochemical markers including total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), superoxide dismutase (SOD), C-reactive protein (CRP), total antioxidant capacity (TAC), pentraxin-3 (PTX3), isoprostaneF2α (PGF2α) were measured by standard protocol. FFQ was used for dietary indices (DQI, DPI, HEI) calculation.Results: There was no significant relationship between PPAR-γ Pro12Ala polymorphism and CVD risk factors. The rs1801282-DQI interactions were significant on WC (P= 0.01). Thus, C-allele carriers in the higher tertile of DQI had higher WC compared to GG homozygous. Further, an interaction was observed between PPAR rs1801282 polymorphism and DQI on serum IL-18 level (P = 0.03). Besides, a significant rs1801282-DPI interaction was shown on HDL concentration (P Interaction= 0.04), G allele carriers who were in the highest tertile of DPI, had lower HDL. Moreover, there were significant rs1801282-HEI interactions on ghrelin (P= 0.04) in the crude model and serum leptin (P = 0.02) in the adjusted model. Individuals with (CC, CG) genotypes in the higher tertile of HEI, had lower leptin and ghrelin concentration.Conclusions: Higher dietary indices (DQI, DPI, HEI) may affect the relationship between PPAR-γ Pro12Ala polymorphism and waist circumference and ghrelin, leptin, HDL-c, IL-18 concentration in patients with T2DM.

scholarly journals Changes in Cardiac Metabolism in Prediabetes

Biomolecules ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1680
Author(s):  
Vera H. W. de Wit-Verheggen ◽  
Tineke van de Weijer
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiac Function ◽  
Cardiac Metabolism ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Prediabetic State ◽  
Exact Etiology ◽  
The Relationship

In type 2 diabetes mellitus (T2DM), there is an increased prevalence of cardiovascular disease (CVD), even when corrected for atherosclerosis and other CVD risk factors. Diastolic dysfunction is one of the early changes in cardiac function that precedes the onset of cardiac failure, and it occurs already in the prediabetic state. It is clear that these changes are closely linked to alterations in cardiac metabolism; however, the exact etiology is unknown. In this narrative review, we provide an overview of the early cardiac changes in fatty acid and glucose metabolism in prediabetes and its consequences on cardiac function. A better understanding of the relationship between metabolism, mitochondrial function, and cardiac function will lead to insights into the etiology of the declined cardiac function in prediabetes.

scholarly journals Effects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 10 (4) ◽  
pp. 634-646 ◽  
Author(s):  
Ehsan Ghaedi ◽  
Mohammad Mohammadi ◽  
Hamed Mohammadi ◽  
Nahid Ramezani-Jolfaie ◽  
Janmohamad Malekzadeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Lipid Profile ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Paleolithic Diet ◽  
Cvd Risk ◽  
Randomized Controlled

ABSTRACTThere is some evidence supporting the beneficial effects of a Paleolithic diet (PD) on cardiovascular disease (CVD) risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on CVD risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = −1.68 kg; 95% CI: −2.86, −0.49 kg], waist circumference (WMD = −2.72 cm; 95% CI: −4.04, −1.40 cm), BMI (in kg/m2) (WMD = −1.54; 95% CI: −2.22, −0.87), body fat percentage (WMD = −1.31%; 95% CI: −2.06%, −0.57%), systolic (WMD = −4.75 mm Hg; 95% CI: −7.54, −1.96 mm Hg) and diastolic (WMD = −3.23 mm Hg; 95% CI: −4.77, −1.69 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = −0.23 mmol/L; 95% CI: −0.42, −0.04 mmol/L), triglycerides (WMD = −0.30 mmol/L; 95% CI: −0.55, −0.06 mmol/L), LDL cholesterol (WMD = −0.13 mmol/L; 95% CI: −0.26, −0.01 mmol/L), and C-reactive protein (CRP) (WMD = −0.48 mg/L; 95% CI: −0.79, −0.16 mg/L) and also significantly increased HDL cholesterol (WMD = 0.06 mmol/L; 95% CI: 0.01, 0.11 mmol/L). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, systolic blood pressure, and circulating CRP concentrations were sensitive to removing some studies and to the correlation coefficients, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on CVD risk factors, the evidence is not conclusive and more well-designed trials are still needed.

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