scholarly journals Inhaled corticosteroids and the risk of type 2 diabetes among Swedish COPD patients

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Björn Ställberg ◽  
Christer Janson ◽  
Karin Lisspers ◽  
Gunnar Johansson ◽  
Florian S. Gutzwiller ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Incidence Rate ◽  
Inhaled Corticosteroids ◽  
High Dose ◽  
Primary Care Settings ◽  
Copd Patients ◽  
Increased Risk ◽  
Yearly Incidence ◽  
Using Data

Abstract This study reports the association of ICS use and the risk of type 2 diabetes mellitus (T2DM) in Swedish patients with COPD using data from real-world, primary care settings. A total of 7078 patients with COPD were included in this analysis and the 5-year cumulative incidence rate per 100,000 person years was 1506.9. The yearly incidence rate per 100,000 person years ranged from 850 to 1919. Use of ICS especially at a high dose in patients with COPD was related to an increased risk of T2DM.

Aldosterone Induces Vasoconstriction in Individuals with Type 2 Diabetes: Effect of Acute Antioxidant Administration

2020 ◽  
Author(s):  
Stine Høyer Finsen ◽  
Mie Rytz Hansen ◽  
Pernille B Lærkegaard Hansen ◽  
Stefan P Mortensen
Keyword(s):  
Type 2 Diabetes ◽  
Blood Flow ◽  
Plasma Aldosterone ◽  
Control Group ◽  
High Dose ◽  
Healthy Controls ◽  
Leg Blood Flow ◽  
Arterial Blood ◽  
Increased Risk

Abstract Context Individuals with type 2 diabetes have an increased risk of endothelial dysfunction and cardiovascular disease. Plasma aldosterone could contribute by reactive oxygen species–dependent mechanisms by inducing a shift in the balance between a vasoconstrictor and vasodilator response to aldosterone. Objective We aimed to investigate the acute vascular effects of aldosterone in individuals with type 2 diabetes compared with healthy controls and if infusion of an antioxidant (n-acetylcysteine [NAC]) would alter the vascular response. Methods In a case–control design, 12 participants with type 2 diabetes and 14 healthy controls, recruited from the general community, were studied. Leg hemodynamics were measured before and during aldosterone infusion (0.2 and 5 ng min–1 [L leg volume]–1) for 10 minutes into the femoral artery with and without coinfusion of NAC (125 mg kg–1 hour–1 followed by 25 mg kg–1 hour–1). Leg blood flow and arterial blood pressure was measured, and femoral arterial and venous blood samples were collected. Results Compared with the control group, leg blood flow and vascular conductance decreased during infusion of aldosterone at the high dose in individuals with type 2 diabetes, whereas coinfusion of NAC attenuated this response. Plasma aldosterone increased in both groups during aldosterone infusion and there was no difference between groups at baseline or during the infusions. Conclusion These results suggests that type 2 diabetes is associated with a vasoconstrictor response to physiological levels of infused aldosterone and that the antioxidant NAC diminishes this response.

scholarly journals Exploring Differences in the Rate of Type 2 Diabetes Among American Cities: How Urbanization Continues to Challenge the Traditional Epidemiological View

Urban Science ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. 53
Author(s):  
Barry P. Young
Keyword(s):  
Type 2 Diabetes ◽  
Urban Areas ◽  
Disease Onset ◽  
The United States ◽  
Local Data ◽  
Medical Practitioners ◽  
Increased Risk ◽  
Control And Prevention ◽  
Using Data

As the world’s largest urban regions continue to expand, a concomitant rise in non-communicable diseases, particularly type 2 diabetes, poses an increasingly ominous challenge to experts in the field of public health. Given that the majority of the world’s population (54%) resides in urban areas, a figure likely to reach two-thirds by 2050, this issue presents serious implications for medical practitioners as well as policymakers seeking to manage long-term healthcare costs while sustaining historic increases in life expectancy. To explore how these trends are continuing to affect the United States, a multiple regression analysis was conducted using data provided by the Centers for Disease Control and Prevention (CDC) through their initiative, 500 Cities: Local Data for Better Health. The regression models revealed that larger cities reported significantly higher rates of type 2 diabetes even after controlling for variables that have been perennially linked to disease onset (e.g., levels of obesity, sedentary behavior). Implications are discussed, most notably the argument for moving beyond the ‘food desert’ paradigm when identifying and explaining which characteristics of larger cities place their residents at increased risk. This approach could help reveal opportunities for intervention that may not have garnered sufficient attention in the extant literature.

scholarly journals Ophthalmic complications in patients with nonvalvular atrial fibrillation and type 2 diabetes prescribed rivaroxaban or warfarin

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
O Costa ◽  
K Ho ◽  
JT Caranfa ◽  
B Vardar ◽  
K Abdelgawwad ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Propensity Score ◽  
Incidence Rate ◽  
Nonvalvular Atrial Fibrillation ◽  
Private Company ◽  
Increased Risk ◽  
Ophthalmic Complication

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Bayer AG Berlin, Germany INTRODUCTION Patients with type 2 diabetes (T2D) are at an increased risk of ophthalmic complications compared to those without. Ophthalmic complications in T2D patients with comorbid nonvalvular atrial fibrillation (NVAF) may include ophthalmic bleeding and/or diabetic retinopathy. PURPOSE We sought to evaluate ophthalmic complications in patients with NVAF and T2D prescribed rivaroxaban or warfarin for stroke prevention. METHODS Optum® de-identified electronic health record (EHR) data from 11/2010-3/2020 were utilized. Adults with NVAF and T2D, newly started on rivaroxaban or warfarin and with ≥12 months of prior EHR activity were included. Patients were excluded if they received any oral anticoagulation in the prior 12 months, had valvular disease or pre-existing diabetic retinopathy. Our primary outcome was the incidence rate of any ophthalmic complication including non-traumatic bleeding (choroidal, intraocular, retinal, vitreous) or diabetic retinopathy.  Ophthalmic bleeds typically associated with trauma (hyphema, orbital) were excluded from our outcomes.  Hazard ratios (HR) with 95% confidence intervals (CIs) were calculated using propensity score-overlap weighted Cox regression. RESULTS We included 26,537 rivaroxaban and 61,690 warfarin patients. The average age of patients was 69 ± 9 years, CHA2DS2VASc score was 4.1 ± 1.5 and HASBLED 1.5 ± 0.9. Thirty-two percent of patients had an a1c ≥7.0 and 16% an a1c≥8.0. Rivaroxaban was associated with a 15% (95%CI = 8-21%) relative hazard reduction of any ophthalmic complication (incidence rate = 1.25 vs. 1.46%/year) (Table), driven by reductions in both ophthalmic bleeding (HR = 0.80) and diabetic retinopathy (HR = 0.85). CONCLUSIONS Rivaroxaban was associated with a reduction in ophthalmic complications compared to warfarin. Table. Ophthalmic Complications Outcome Rivaroxaban, %/yearN = 26,537 Warfarin, %/yearN = 61,690 PS OLW HR (95%CI) Any Ophthalmic Complication 1.25 1.46 0.85 (0.79-0.92) Any Ophthalmic Bleed 0.15 0.19 0.80 (0.63-1.00) Choroidal Bleed 0.003 0.005 0.59 (0.11-3.17) Intraocular Bleed 0.01 0.01 0.75 (0.26-2.13) Retinal Bleed 0.08 0.09 0.93 (0.68-1.28) Vitreous Bleed 0.07 0.10 0.66 (0.47-0.92) Any Type of Diabetic Retinopathy 1.15 1.34 0.85 (0.79-0.93) Diabetic Retinopathy, non-proliferative 0.35 0.44 0.80 (0.69-0.93) Diabetic Retinopathy, proliferative 0.09 0.12 0.79 (0.59-1.05) Diabetic Retinopathy, unspecified 0.82 0.94 0.87 (0.79-0.97) CI = confidence interval; HR = hazard ratio; OLW = overlap weighted; PS = propensity score

11-LB: Nonsevere Hypoglycemia Predicts Increased Risk of Subsequent Severe Events in Patients with Type 2 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 11-LB
Author(s):  
SIMON R. HELLER ◽  
ELISE HACHMANN-NIELSEN ◽  
KAJSA KVIST
Keyword(s):  
Type 2 Diabetes ◽  
Increased Risk

Analysis of the Potential Association of Drug-Metabolizing Enzymes CYP2C9*3 and CYP2C19*3 Gene Variations With Type 2 Diabetes: A Case-Control Study

2020 ◽  
Vol 21 (14) ◽  
pp. 1152-1160
Author(s):  
Imadeldin Elfaki ◽  
Rashid Mir ◽  
Faisel Mohammed Abu-Duhier ◽  
Chandan Kumar Jha ◽  
Adel Ibrahim Ahmad Al-Alawy ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Antiplatelet Drug ◽  
Drug Metabolizing Enzymes ◽  
Genotype Distribution ◽  
Nucleotide Polymorphisms ◽  
Metabolizing Enzymes ◽  
Specific Pcr ◽  
Increased Risk ◽  
Different Populations

Background:: Cytochrome P450s (CYPs) are drug-metabolizing enzymes catalyzing the metabolism of about 75% of drug in clinical use. CYP2C9 represents 20% CYP proteins in liver cells and is a crucial member of CYPs superfamily. CYP2C19 metabolizes very important drugs such as antiulcer drug omeprazole, the antiplatelet drug clopidogrel and anticonvulsant mephenytoin. Single nucleotide polymorphisms (SNPs) of CYP genes have been associated with unexpected drug reactions and diseases in different populations. Objective:: We examined the associations of CYP2C9*3 (rs1057910) and CYP2C19*3 (rs4986893) with T2D in Saudi population. Methods:: We used the allele-specific PCR (AS-PCR) and DNA sequencing in 111 cases and 104 controls for rs1057910, and in 119 cases and 110 controls for rs4986893. Results:: It is indicated that the genotype distribution of rs1057910 in cases and controls were not significantly different (P=0.0001). The genotypes of rs1057910 were not associated with type 2 diabetes (T2D) (P>0.05). Whereas the genotype distribution of rs4986893 in cases and controls was significantly different (P=0.049). The AA genotype of rs4986893 may be associated in increased risk to T2D with OR=17.25 (2.06-143.8), RR=6.14(0.96-39.20), P=0.008. Conclusion:: The CYP2C9*3 (rs1057910) may not be associated with T2D, while CYP2C19*3 (rs4986893) is probably associated with T2D. These findings need to be validated in follow-up studies with larger sample sizes and different populations.

The GSTM1 and GSTT1 Null Genotypes Increase the Risk for Type 2 Diabetes Mellitus and the Subsequent Development of Diabetic Complications: A Meta-analysis

2018 ◽  
Vol 15 (1) ◽  
pp. 31-43 ◽  
Author(s):  
Sayantan Nath ◽  
Sambuddha Das ◽  
Aditi Bhowmik ◽  
Sankar Kumar Ghosh ◽  
Yashmin Choudhury
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Meta Analysis ◽  
Subsequent Development ◽  
Asian Population ◽  
Gstm1 Null Genotype ◽  
Increased Risk

Background:Studies pertaining to association of GSTM1 and GSTT1 null genotypes with risk of T2DM and its complications were often inconclusive, thus spurring the present study.Methods:Meta-analysis of 25 studies for evaluating the role of GSTM1/GSTT1 null polymorphisms in determining the risk for T2DM and 17 studies for evaluating the role of GSTM1/GSTT1 null polymorphisms in development of T2DM related complications were conducted.Results:Our study revealed an association between GSTM1 and GSTT1 null polymorphism with T2DM (GSTM1; OR=1.37;95% CI =1.10-1.70 and GSTT1; OR=1.29;95% CI =1.04-1.61) with an amplified risk of 2.02 fold for combined GSTM1-GSTT1 null genotypes. Furthermore, the GSTT1 null (OR=1.56;95%CI=1.38-1.77) and combined GSTM1-GSTT1 null genotypes (OR=1.91;95%CI=1.25- 2.94) increased the risk for development of T2DM related complications, but not the GSTM1 null genotype. Stratified analyses based on ethnicity revealed GSTM1 and GSTT1 null genotypes increase the risk for T2DM in both Caucasians and Asians, with Asians showing much higher risk of T2DM complications than Caucasians for the same. </P><P> Discussion: GSTM1, GSTT1 and combined GSTM1-GSTT1 null polymorphism may be associated with increased risk for T2DM; while GSTT1 and combined GSTM1-GSTT1 null polymorphism may increase the risk of subsequent development of T2DM complications with Asian population carrying an amplified risk for the polymorphism.Conclusion:Thus GSTM1 and GSTT1 null genotypes increases the risk for Type 2 diabetes mellitus alone, in combination or with regards to ethnicity.

Epidemiology of Hypertension and Diabetes Mellitus in Latin America

2020 ◽  
Vol 16 ◽  
Author(s):  
Patricio Lopez-Jaramillo ◽  
Jose Lopez-Lopez ◽  
Daniel Cohen ◽  
Natalia Alarcon-Ariza ◽  
Margarita Mogollon-Zehr
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Latin America ◽  
Cardiovascular Diseases ◽  
Latin American ◽  
Premature Mortality ◽  
Increased Risk ◽  
And Control

: Hypertension and type 2 diabetes mellitus are two important risk factors that contribute to cardiovascular diseases worldwide. In Latin America hypertension prevalence varies from 30 to 50%. Moreover, the proportion of awareness, treatment and control of hypertension is very low. The prevalence of type 2 diabetes mellitus varies from 8 to 13% and near to 40% are unaware of their condition. In addition, the prevalence of prediabetes varies from 6 to 14% and this condition has been also associated with increased risk of cardiovascular diseases. The principal factors linked to a higher risk of hypertension in Latin America are increased adiposity, low muscle strength, unhealthy diet, low physical activity and low education. Besides being chronic conditions, leading causes of cardiovascular mortality, both hypertension and type 2 diabetes mellitus represent a substantial cost for the weak health systems of Latin American countries. Therefore, is necessary to implement and reinforce public health programs to improve awareness, treatment and control of hypertension and type 2 diabetes mellitus, in order to reach the mandate of the Unit Nations of decrease the premature mortality for CVD.

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