Cardiovascular events in patients with over 10 years history of type 2 diabetes mellitus

2019 ◽  
Vol 13 (1) ◽  
pp. 68-72
Author(s):  
Lotfollah Saed ◽  
Zana Deihim ◽  
Mohammad Khaled Naghshbandi ◽  
Mohsen Rajabnia ◽  
Seyyed Nima Naleini
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiovascular Events ◽  
History Of

The Cardiovascular Events in Metabolic Surgery Compared to the New Classes of Glucose-Lowering Agents in Patients with T2DM

2021 ◽  
Author(s):  
Najla Shamsi
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Metabolic Surgery ◽  
Cardiovascular Events ◽  
Controlled Trials ◽  
Glucose Lowering ◽  
Randomized Controlled ◽  
History Of

Type 2 Diabetes Mellitus is a prevalent chronic disease with several macrovascular and microvascular complications. Cardiovascular diseases including coronary artery disease and stroke are common macrovascular complication that reduces the quality of life and lead to early mortality. Additionally, they pose enormous socioeconomic burden on the societies and the governments. Therefore, any intervention that reduces the cardiovascular events in patients with diabetes will have positive impact of the patients and the society. Thus, this systematic review aimed to evaluate the cardiovascular events after metabolic surgery in comparison with the new classes of glucose lowering agents in patients with type 2 diabetes mellitus. The review included 11 randomized controlled trials to both GLP-1 RA and SGLT-2 i groups. It also included 7 metabolic surgery studies, 2 of these are randomized controlled trials and the other 5 are observational studies. These studies were the most relevant studies to the research question. The results revealed different baseline demographic and clinical characteristics between the medication trials and metabolic surgery studies. Moreover, it revealed significant reduction in cardiovascular events in metabolic surgery studies when compared to medication trials. It also showed significant HbA1c and weight reduction in the metabolic surgery group. The remission of diabetes was very high in the metabolic surgery group while none of medication trials accomplished diabetes recovery. However, both medication and surgery groups had adverse events. In conclusion, the review is consistent with previous literature. It suggests that metabolic surgery is more effective than medical therapy in reducing cardiovascular events. Although this conclusion should be interpreted with caution due to the differences in baseline characteristics between studies. In general, the review recommends younger adult diabetic patients with obesity and history of established cardiovascular diseases to undergo metabolic surgery. Whereas, older patients with history of cardiovascular disease should be advised to take one of the medications that has been proved to reduce cardiovascular events. Future studies that compare metabolic surgery and the new classes of the glucose lowering agents is recommended to confirm the findings in this review.

scholarly journals New clusters of type 2 diabetes mellitus and their outcomes: relation between pharmacological treatment and previous cardiovascular events

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Claudio Santos ◽  
Sonia Brito-Costa ◽  
Luis Margalho ◽  
Pedro Monteiro
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pharmacological Treatment ◽  
Cardiovascular Events ◽  
Glycated Haemoglobin ◽  
Research Unit ◽  
Clinical Research Unit ◽  
History Of

Abstract Background Type 2 Diabetes Mellitus (T2DM) is the most common form of diabetes in adults, with 90% to 95% of cases. This study aims to establish clusters and have knowledge about the relationship between previous cardiovascular events and pharmacological treatment for T2DM. Methods 191 participants (EG) with T2DM with the average of 70.3 years (SD = 8.3) and 36 with pre-diabetes (CG) with an average of 62 years (SD = 10.3) who participated in clinical trials at Clinical Research Unit in Cardiology of Coimbra Hospital and Universitary Centre without cognitive difficulties, were divided in 5 different clusters. These were established based on six different variables: body mass index (BMI), age of each individual, age at diagnosis of DMT2, glycated haemoglobin value (HbA1c), homeostatic model that estimates the function of β cells (HOMA2-B) and insulin resistance (HOMA2-IR). Results Cluster 1 presented pre-diabetic individuals (15.9%), while diabetic individuals were divided into clusters 2 (1.8%), 3 (17.6%), 4 (21.1%) and 5 (43.6%). Regarding the study of the prevalence of previous cardiovascular events, the majority of individuals present in the different clusters had history of acute myocardial infarction (AMI). As for the prevalence of pharmacological treatment for DMT2, it was found that metformin was the most used drug. It was observed a relationship between previous AMI and metformin administration in clusters 3 (P = 0.0027; P < 0.05) and 5 (P = 0.0059; P < 0.05). Conclusions It was possible to create different clusters in a sample of the Portuguese population and to observe the existence of dependency relationships between different previous cardiovascular events and pharmacological treatment.

Impact of Cardiovascular Screening Tests in Patients with Type 2 Diabetes Mellitus without Previous Histories of Cardiovascular Disease: 5-year Clinical Outcomes.

2020 ◽  
Author(s):  
Yoshibumi Antoku ◽  
Masao Takemoto ◽  
Takahiro Mito ◽  
Ryuta Shiiyama ◽  
Hiroko Otsuka-Morisaki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Outcomes ◽  
Cardiovascular Events ◽  
Screening Tests ◽  
Cardiovascular Screening ◽  
History Of

Abstract Background We previously reported that, among the asymptomatic patients with type 2 diabetes mellitus (T2DM) without history of cardiovascular disease (CVD), up to 19% of the patients with myocardial ischemia were detected by cardiovascular screening tests (CVSTs). We concluded that the CVSTs in patients with T2DM may be one of the most effective strategies to find CVD in those patients. Thus, the aim of the study was to assess the long-term clinical outcomes of CVSTs in patients with T2DM without previous histories of CVD. Methods Six hundred fifty-seven out-patients with T2DM who received CVSTs at least more than one time or not at all from April in 2014 to March in 2019 were defined as the S group or NS group, respectively. The data in 2104 and 2018 were collected from the medical records, and compared between the S and NS groups. Results This study revealed that, in the out-patients with T2DM in our hospital over those 5 years; 1) the frequency of receiving CVSTs was significantly increasing, 2) in accordance with that increase, the frequency of the internal use for CVD of statins, anti-platelets, and renin-angiotensin system inhibitors, which are well-known as medications for preventing CVD, was significantly increasing, 3) however, there was only a small increase in the internal use of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptors, which are well-known to suppress cardiovascular events in patients with T2DM, 4) LDL-cholesterol and triglycerides significantly improved more in the S group than the NS group, 5) highly sensitive C-protein, which is one of the strongest predictors of CVD, was significantly suppressed by CVSTs, 6) the progression of renal dysfunction was significantly more suppressed in the S group than the NS group, 7) in an inverse proportion to the CVST increase, the frequency of acute coronary syndrome, cerebral infarctions, 4-point major adverse cardiovascular events, and admissions due to heart failure were significantly decreasing, and 8) finally, the frequency of all-cause mortality was significantly suppressed during those 5 years. Conclusions Thus, it may be important to continue CVSTs in out-patients with T2DM without a previous history of CVD for several years.

scholarly journals Endocrinological and metabolic characteristics in patients who are non-obese and have polycystic ovary syndrome and different types of a family history of type 2 diabetes mellitus

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110166
Author(s):  
Yuan Wang ◽  
Hua Gao ◽  
Wen Di ◽  
Zhuowei Gu
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Family History ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
History Of ◽  
Second Degree

Objective We aimed to investigate whether patients with polycystic ovary syndrome (PCOS) and a family history (FH) of type 2 diabetes mellitus (T2DM) are at increased risk of endocrinological and metabolic abnormalities, and whether this risk differs between first-degree and second-degree relatives, and between maternal and paternal transmission. Methods A total of 680 patients with PCOS were enrolled in this retrospective, single-center study. Endocrine and glycolipid metabolism parameters were compared. Results The free androgen index (FAI), and levels of fasting blood glucose (FBG), fasting insulin (FINS), homeostatic model assessment-insulin resistance (HOMA-IR), total cholesterol (TC), and low-density lipoprotein cholesterol were significantly higher, whereas sex hormone binding globulin (SHBG) levels were significantly lower in patients with PCOS and a FH of T2DM. In patients with PCOS with a FH of T2DM in first-degree relatives, age and levels of FBG, FINS, and HOMA-IR were significantly higher than those who had a FH of T2DM in second-degree relatives. A maternal history of T2DM was associated with a higher body mass index, FAI, and TG levels, and lower SHBG levels. Conclusions Patients with PCOS and a FH of T2DM have more severe hyperandrogenism and metabolic disorders, especially in those with maternal transmission.

scholarly journals TYPE 2 DIABETES MELLITUS;

2013 ◽  
Vol 20 (02) ◽  
pp. 237-243
Author(s):  
GHULAM HUSSAIN BALOCH ◽  
ABDUL QADIR DALL ◽  
ATIF SITWAT HAYAT ◽  
Syed Zulfiquar Ali Shah ◽  
Bikha Ram Devrajani
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
University Hospital ◽  
Diabetic Patients ◽  
Haemoglobin A1c ◽  
Type 2 Diabetic Patients ◽  
History Of ◽  
Upper Molar

Objective: To determine the frequency and pattern of dental carries in patients with type 2 diabetes mellitus. Design: Crosssectional descriptive study. Patients and methods: Patients with history of type 2 diabetes mellitus for ≥ 02 years duration with ≥ 35 years ofage and of either gender with dental pain visit at medical and dental outpatient department (OPD) of Liaquat University Hospital Hyderabad.The detail history was taken and the blood samples were taken for haemoglobin A1c (HbA1c) to assess the glycemic status. The existenceof dental carries and its pattern was diagnosed through dental examination by consultant dentist had clinical experience ≥05 years. The datawas collected on pre-designed proforma, entered and analyzed in SPSS version 11.00. Results: A total of 137 type 2 diabetic patients wereselected for this study, out of these 82 were males and 55 females. The dental carries was found in 98 (71.5%) patients. Out of these ninetyeight, 53 (54.08%) were males and 45 (45.92%) were female. Upper molar teeth involvement was present in 46 patients and lower molarteeth were involved in 52 patients. Dentine carries was seen in 35 patients, enamel carries in 19, white spot carries in 20 patients, pulpitis in16 patients, and pulp capping in 8 patients. Involvement of individual teeth was also assessed, the upper molar involvement was present in32 patients, premolar involvement was present in 11, incisor involvement in 03 patients. The lower molars were involved in 28 patients,lower pre molar in 21 and lower incisors in 03 patients. Dental carries was present in 43 (43.9%) patients in patients whose duration ofdiabetes was between 5-10 years, whereas those patients having duration >10 years had 31.6% frequency of dental carries, whileregarding duration of <5 years only 24 (24.5%) patients had dental carries. Conclusions: The diabetic patients are more prone to acquiredental caries.

scholarly journals Assessing the Prevalence and Predicting Factors of an Abnormal Gated Myocardial Perfusion SPECT in Asymptomatic Patients with Type 2 Diabetes

2021 ◽  
Author(s):  
Elinaz Hosseinzadeh ◽  
Mohammadali Ghodsirad ◽  
Toktam Alirezaei ◽  
Maryam Arefnia ◽  
Mahasti Amoui ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Male Gender ◽  
Silent Myocardial Ischemia ◽  
Duration Of Diabetes ◽  
Predicting Factors ◽  
Asymptomatic Patients ◽  
History Of

Abstract IntroductionConsidering the significant prevalence of silent myocardial ischemia and its related morbidity and mortality in asymptomatic type two diabetic patients, it is not well known whether early screening with MPI is cost-effective. However, predicting factors are not elucidated. Materials and MethodsThis was a cross-sectional study including 63 asymptomatic patients with type 2 diabetes mellitus (T2DM), with normal ECG and ejection fraction. Patients with any history of documented valvular, congestive or ischemic heart disease, renal or hepatic failure were excluded. At first all patients were interviewed and checked for risk factors and then patients underwent a two-day rest/stress 99mTc-MIBI gated MPI SPECT. Data was assessed by QPS/QGS and 4DM software and evaluated by a nuclear medicine specialist with summed stress score (SSS) of more than 4 defined as CAD. ResultsThere were 42 females (67%) and 21 males (33%), with a mean age of 61.33 ± 6.98 years and 7.97 ± 4.86 years history of T2DM. CAD was detected in 26 (41.3%) patients and was significantly associated with male gender, smoking, requiring insulin therapy and EF (P-value = 0.019, 0.046, 0.05, 0.033, respectively). A significant association was found between the duration of diabetes, especially when >15y, and the probability of having CAD.. Multivariable logistic regression revealed that smoking; male gender and diabetes duration were the strongest independent predictors of abnormal MPI results.ConclusionWe found a high (46%) prevalence of abnormal stress MPI SPECT in patients with type 2 diabetes mellitus, despite being asymptomatic. Asymptomatic patients with a history of smoking, long duration of diabetes, being under insulin treatment and male gender might benefit from MPI for early detection of silent ischemia.

scholarly journals Significant polar vasculosis in a patient with a 30-year history of type 2 diabetes

2019 ◽  
Vol 2019 ◽  
Author(s):  
Yasuhiro Oda ◽  
Masayuki Yamanouchi ◽  
Hiroki Mizuno ◽  
Rikako Hiramatsu ◽  
Tatsuya Suwabe ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Endothelial Damage ◽  
Diabetic Patients ◽  
List Type ◽  
History Of ◽  
Intraglomerular Pressure ◽  
Vascular Formation

Summary We report the renal histology of a 66-year-old man with hypertension, cardiovascular disease, and a 30-year history of type 2 diabetes mellitus with proliferative diabetic retinopathy, diabetic neuropathy, and diabetic foot status post toe amputation. Urinary protein excretion was 1.4 g/gCr, serum creatinine level 0.86 mg/dL, estimated glomerular filtration rate 69 mL/min/1.73 m2, and HbA1c 13–15%, despite using insulin. Light microscopy showed global glomerulosclerosis in 37% of the glomeruli, but the remaining glomeruli were intact. Significant polar vasculosis was present, while arteriolar sclerosis was mild. Electron microscopy revealed a thickened glomerular basement membrane, which is compatible with the early stage of diabetic glomerulopathy. The presented case was unique because glomerular changes seen typically in diabetes were not seen in the patient, despite the long-standing history of diabetes and diabetic comorbidities, while prominent polar vasculosis was found. Polar vascular formation helps preserve the glomeruli by allowing hyperosmotic blood bypass the glomeruli; this decreases intraglomerular pressure and minimizes glomerular endothelial damage. Learning points: A 66-year-old man with a 30-year history of type 2 diabetes mellitus with poor glycemic control underwent renal biopsy, which showed scarce glomerular changes typically seen in diabetic kidney disease and instead revealed significant polar vasculosis. Past studies demonstrated that the increased small vessels around the vascular hilus in diabetic patients originated from the afferent arterioles and drained into the peritubular capillaries. Polar vascular formation may preserve glomerular function by allowing the blood flow to bypass the glomeruli and decreasing the intraglomerular pressure, which minimizes endothelial damage of the glomerular tufts.

Sign in / Sign up

Export Citation Format

Share Document