Effects of supine blood pressure on interpretation of standing up test in 500 patients with diabetes mellitus

Abstract Background Telemonitoring and web-based interventions are increasingly used in primary-care practices in many countries for more effective management of patients with diabetes mellitus (DM). A new approach in treating patients with diabetes mellitus in family practices, based on ICT use and nurse practitioners, has been introduced and evaluated in this study. Method Fifteen Slovene family practices enrolled 120 DM patients treated only with a diet regime and/or tablets into the study. 58 of them were included into the interventional group, and the other 62 DM patients into the control group, within one-year-long interventional, randomised controlled trial. Patients in the control group had conventional care for DM according to Slovenian professional guidelines, while the patients in the interventional group were using also the eDiabetes application. Patients were randomised through a balanced randomisation process. Results Significant reductions of glycated haemoglobin (HbA1c) values were found after 6 and 12 months among patients using this eDiabetes application (p<0.05). Among these patients, a significant correlation was also found between self-monitored blood pressure and the final HbA1c values. Diabetic patients’ involvement in web-based intervention had only transient impact on their functional health status. Conclusion This eDiabetes application was confirmed to be an innovative approach for better self-management of DM type 2 patients not using insulin. Both a significant reduction of HbA1c values and a significant correlation between the average self-measured blood pressure and the final HbA1c values in the interventional group were found. Nurse practitioners – as diabetes care coordinators – could contribute to better adherence in diabetes e-care.

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Reduced short-term complexity of heart rate and blood pressure dynamics in patients with diabetes mellitus type 1: multiscale entropy analysis

Physiological Measurement ◽

10.1088/0967-3334/29/7/010 ◽

2008 ◽

Vol 29 (7) ◽

pp. 817-828 ◽

Cited By ~ 50

Author(s):

Z Trunkvalterova ◽

M Javorka ◽

I Tonhajzerova ◽

J Javorkova ◽

Z Lazarova ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Heart Rate ◽

Diabetes Mellitus Type 1 ◽

Multiscale Entropy ◽

Entropy Analysis ◽

Short Term ◽

Patients With Diabetes ◽

Pressure Dynamics

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ASSESSMENT OF NEPHRIN AND PODOCIN LEVELS IN THE URINE OF PATIENTS WITH DIABETES MELLITUS

Nephrology (Saint-Petersburg) ◽

10.24884/1561-6274-2017-21-2-33-40 ◽

2017 ◽

Vol 21 (2) ◽

pp. 33-40

Author(s):

I. N. Bobkova ◽

A. A. Shchukina ◽

M. V. Shestakova

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Diabetic Nephropathy ◽

Serum Creatinine ◽

Arterial Hypertension ◽

Healthy Subjects ◽

Early Diagnostics ◽

Urinary Levels ◽

Patients With Diabetes ◽

Early Diabetic Nephropathy

THE AIM:to assess excretion value of podocytes injury biomarkers in urine and to clarify their significance for early diabetic nephropathy (DN) diagnostics in diabetes mellitus (DM) patients with different severity of albuminuria (AU)/proteinuria(PU).PATIENTS AND METHODS.74 DM pts were studied, including 30 with type1 DM (T1DM) and 44 pts with type2 DM (T2DM). They were divided into three groups: 41 pts with AU <30 mg/gCr (A1), 13 pts with AU 30-300 mg/gCr (A2), 20 pts with PU (A3). CKD S1 was revealed in 41pts, CKD S2 – in 25 pts, CKD S3 – in 8 pts. Arterial hypertension was observed in 52 pts of 74(70%), mainly in T2DM. 10 healthy subjects were studied as control. Urinary levels of nephrin and podocin (an important slit diaphragm proteins) were measured by ELISA.RESULTS.Nephrinuria (NU) >5,84ng/ml/g, which not detecting in controls, was revealed in 63% of A1 pts, in 77% – in A2, in 80% – in A3. Podocinuria (PdU)>1,73ng/ml/g was revealed in 78% of A1 pts, in 54% of A2 and in 83% – A3. NU in pts with PU was significantly higher than in AU<30 mg/g. PDU in groups with different AU/PU was equally high and has no differ between DM types. Direct correlation was obtained between NU and AU (R=0,947 p<0,05). NU and PdU in T1DM correlated directly with serum creatinine (R=0,489 p<0,05 and R=0,468 p<0,05) and indirectly with GFR (R=-0,461 p<0,05 and R=-0,36 р<0,05). In DM duration less than 5 years NU directly correlated with НbА1с level, in T2DM – indirectly with systolic blood pressure.CONCLUSON. Nephrin and podocin levels can be useful for early diagnostics and monitoring of DN.

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Increased Level of Systolic Blood Pressure in Hepatocellular Carcinoma Patients with Diabetes Mellitus

Diabetes Metabolic Syndrome and Obesity Targets and Therapy ◽

10.2147/dmso.s251943 ◽

2020 ◽

Vol Volume 13 ◽

pp. 1979-1988

Author(s):

Wei-Shuo Zhang ◽

Xiao-Ou Li ◽

Hui Zhang ◽

Chun Gao ◽

Long Fang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Hepatocellular Carcinoma ◽

Blood Pressure ◽

Systolic Blood Pressure ◽

Patients With Diabetes

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Diabetes Mellitus and Hypertension—A Case of Sugar and Salt?

International Journal of Molecular Sciences ◽

10.3390/ijms21155200 ◽

2020 ◽

Vol 21 (15) ◽

pp. 5200

Author(s):

Marcus Sondermann ◽

Michał Holecki ◽

Andrea Marita Kirsch ◽

Manuela Bastian ◽

Dagmar-Christiane Fischer ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Glucose Metabolism ◽

Volume Regulation ◽

Plasma Osmolality ◽

Sodium Retention ◽

Specific Mechanism ◽

Blood Concentrations ◽

Fluid Status ◽

Patients With Diabetes

The majority of patients with diabetes mellitus (DM) have hypertension (HTN). A specific mechanism for the development of HTN in DM has not been described. In the Zucker, Endothel, und Salz (sugar, endothelium, and salt) study (ZEuS), indices of glucose metabolism and of volume regulation are recorded. An analysis of these parameters shows that glucose concentrations interfere with plasma osmolality and that changes in glycemic control have a significant impact on fluid status and blood pressure. The results of this study are discussed against the background of the striking similarities between the regulation of sugar and salt blood concentrations, introducing the view that DM is probably a sodium-retention disorder that leads to a state of hypervolemia.

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