256 Association of Glycemic Control Level with the Clinical Manifestation of Kidney Injury Among Patients with Diagnosed Diabetes

2020 ◽  
Vol 75 (4) ◽  
pp. 610
Keyword(s):  
Glycemic Control ◽  
Clinical Manifestation ◽  
Control Level ◽  
Kidney Injury ◽  
Diagnosed Diabetes

scholarly journals Pleiotropic Effects of Sodium-Glucose Cotransporter-2 Inhibitors: Renoprotective Mechanisms beyond Glycemic Control

2021 ◽  
Vol 22 (9) ◽  
pp. 4374
Author(s):  
Tomoaki Takata ◽  
Hajime Isomoto
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Kidney Injury ◽  
Sglt2 Inhibitors ◽  
Pleiotropic Effects ◽  
Future Research ◽  
Diabetic Patients ◽  
Sodium Glucose Cotransporter ◽  
Stage Renal Disease

Diabetes mellitus is a major cause of chronic kidney disease and end-stage renal disease. However, the management of chronic kidney disease, particularly diabetes, requires vast improvements. Recently, sodium-glucose cotransporter-2 (SGLT2) inhibitors, originally developed for the treatment of diabetes, have been shown to protect against kidney injury via glycemic control, as well as various other mechanisms, including blood pressure and hemodynamic regulation, protection from lipotoxicity, and uric acid control. As such, regulation of these mechanisms is recommended as an effective multidisciplinary approach for the treatment of diabetic patients with kidney disease. Thus, SGLT2 inhibitors are expected to become key drugs for treating diabetic kidney disease. This review summarizes the recent clinical evidence pertaining to SGLT2 inhibitors as well as the mechanisms underlying their renoprotective effects. Hence, the information contained herein will advance the current understanding regarding the pleiotropic effects of SGLT2 inhibitors, while promoting future research in the field.

scholarly journals Prevalence of previously diagnosed diabetes and glycemic control strategies in Mexican adults: ENSANUT-2016

PLoS ONE ◽  
2020 ◽  
Vol 15 (4) ◽  
pp. e0230752 ◽  
Author(s):  
Ismael Campos-Nonato ◽  
María Ramírez-Villalobos ◽  
Alejandra Flores-Coria ◽  
Andrys Valdez ◽  
Eric Monterrubio-Flores
Keyword(s):  
Glycemic Control ◽  
Control Strategies ◽  
Mexican Adults ◽  
Diagnosed Diabetes

scholarly journals Lack of Association between Past Helicobacter pylori Infection and Diabetes: A Two-Cohort Study

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1874
Author(s):  
Jeung Hui Pyo ◽  
Hyuk Lee ◽  
Sung Chul Choi ◽  
Soo Jin Cho ◽  
Yoon-Ho Choi ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Diabetic Nephropathy ◽  
Glycemic Control ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Poor Glycemic Control ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Models ◽  
H Pylori ◽  
Diagnosed Diabetes

Helicobacter pylori (H. pylori) may be involved in diabetes and other insulin-related processes. This study aimed to investigate the associations between H. pylori infection and the risks of type 2 diabetes, impaired glucose tolerance (IGT), diabetic nephropathy, and poor glycemic control. We retrospectively evaluated 16,091 subjects without diabetes at baseline who underwent repeated health examinations. Subjects were categorized according to whether they were seropositive and seronegative for H. pylori infection. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard models. The serological results were validated using an independent cohort (n = 42,351) based on a histological diagnosis of H. pylori infection. During 108,614 person-years of follow-up, 1338 subjects (8.3%) developed newly diagnosed diabetes, although the cumulative incidence of diabetes was not significantly related to serological H. pylori status. The multivariate Cox proportional-hazards regression models revealed that H. pylori seropositivity was not significantly associated with diabetes (HR: 1.01, 95% CI: 0.88–1.16; p = 0.854), IGT (HR: 0.98, 95% CI: 0.93–1.04; p = 0.566), diabetic nephropathy (HR: 0.99, 95% CI: 0.82–1.21; p = 0.952), or poor glycemic control (HR: 1.05, 95% CI: 0.90–1.22; p = 0.535). Similarly, histopathological findings of H. pylori infection were not significantly associated with diabetes (p = 0.311), diabetic nephropathy (p = 0.888), or poor glycemic control (p = 0.989). The findings from these large Korean cohorts indicate that there does not appear to be a role for past H. pylori infection in the development of diabetes, IGT, diabetic nephropathy, or poor glycemic control.

scholarly journals Glycemic control by the SGLT2 inhibitor empagliflozin decreases aortic stiffness, renal resistivity index and kidney injury

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Annayya R. Aroor ◽  
Nitin A. Das ◽  
Andrea J. Carpenter ◽  
Javad Habibi ◽  
Guanghong Jia ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Aortic Stiffness ◽  
Sglt2 Inhibitor ◽  
Kidney Injury ◽  
Resistivity Index

scholarly journals The Impact of Glyco-Metabolic Status in Patients Treated for Acute Coronary Syndrome

PRILOZI ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 37-50
Author(s):  
Marija Vavlukis ◽  
Biljana Zafirovska ◽  
Emilija Antova ◽  
Bekim Pocesta ◽  
Enes Shehu ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Glycemic Control ◽  
Morbidity And Mortality ◽  
Newly Diagnosed ◽  
Stress Hyperglycemia ◽  
Coronary Syndrome ◽  
Hospital Morbidity ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes ◽  
The Impact

Abstract Objective: The aim of the study was to assess the prevalence of newly diagnosed diabetes in patients with acute coronary syndrome and estimate the relationship between stress hyperglycemia, glyco-regulation and newly diagnosed diabetes with hospital morbidity and mortality. Methods: This was an observational study which included all patients hospitalized due to acute coronary syndrome (January 2015 until April 2017) at the University Clinic of Cardiology in Skopje, Macedonia. We analyzed demographic, clinical, biochemical variables and hospital morbidity and mortality. Five investigated groups were compared using a single biochemical parameter glycated hemoglobin (HgbA1c) depending on the presence of known diabetes before the acute event: 0-without DM (HgbA1c <5.6%), 1-newly diagnosed pre-diabetes (HgbA1c 5.6-6.5%), 2-newly diagnosed diabetes (HgbA1c ≥ 6.5%), 3-known well controlled diabetes (HgbA1c <7%) and 4-known un-controlled diabetes (HgbA1c ≥7%). Results: 860 patients were analyzed. Impaired glucose metabolism was confirmed in 35% of patients, 9% of which were with newly diagnosed diabetes. Stress hyperglycemia was reported in 27.3% (3.6% were without diabetes). The highest values of stress hyperglycemia were reported in newly diagnosed and known un-controlled diabetes. In-hospital morbidity and mortality were 15% and 5% accordingly and the rate was highest in patients with newly diagnosed and known, but un-controlled diabetes. HgbA1c, stress hyperglycemia, and poor glycemic control have emerged as significant independent predictors of hospital morbidity and mortality in patients with acute coronary syndrome. Conclusion: High prevalence of newly diagnosed diabetes was observed in patients with acute coronary syndrome. Stress hyperglycemia and failure to achieve glycemic control are independent predictors of hospital morbidity and mortality.

scholarly journals Impact of glycemic control on the incidence of acute kidney injury in critically ill patients: a comparison of two strategies using the RIFLE criteria

Clinics ◽  
2010 ◽  
Vol 65 (8) ◽  
Author(s):  
José Raimundo Araújo de Azevedo ◽  
Renato Palácio de Azevedo ◽  
Lara Carneiro de Lucena ◽  
Nathalia de Nazaré Rabelo da Costa ◽  
Widlane Sousa da Silva
Keyword(s):  
Acute Kidney Injury ◽  
Glycemic Control ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Rifle Criteria

scholarly journals Clinical characteristics and determinants of glycaemic control among type 2 diabetes mellitus (T2DM) patients in Fiji

2021 ◽  
Author(s):  
Pablo Romakin ◽  
Donald Wilson ◽  
Sabiha Khan ◽  
Masoud Mohaammadnezhad
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Glycaemic Control ◽  
Blood Sugar ◽  
Diabetes Management ◽  
Control Level ◽  
Poor Glycaemic Control

Abstract Background: Glycemic control is the centre in diabetes management. In patients with type 2 diabetes mellitus (T2DM), glycemic control is associated with clinical determinants. The aim of this study was to determine the proportion of poor glycemic control level and its clinical determinants among T2DM patients.Methods: This retrospective cross-sectional study was conducted on the medical records of T2DM patients attending diabetes clinics at the three selected health centres in Suva, Fiji. Patients who met the following criteria were included in the study: adult T2DM >18 years old registered during 2011 to 2016; on treatment for >1year; had >4 clinic visits and; had a recent HbA1c result in 2017. Logistic regression analysis was performed. A p value of <0.05 was considered as significant.Results: There were 200 female (59.2%) and 138 male (40.8%) T2DM patients included in this study with a mean age of 56.5 years (SD = + 9.9). Majority have poorly controlled random blood sugar (RBS), 67.1% and fasting blood sugar (FBS), 63.0%. Two-thirds (65.4%) had co-morbidities. The proportion of poor glycaemic control (HbA1c <7%) was 77.2% with mean HbA1c of 8.6% (+ 2.04). RBS, FBS, cholesterol, estimated glomerular filtration rate (eGFR) and diastolic blood pressure (DBP) were significant (p<0.05) determinants of poor glycaemic control.Conclusions: This study identified clinical determinants of T2DM patients that are highly associated with glycemic control. Health care workers managing T2DM patients should address these clinical determinants in order to achieve glycemic control.

scholarly journals Glycemic control and the risk of acute kidney injury in patients with type 2 diabetes and chronic kidney disease: parallel population-based cohort studies in U.S. and Swedish routine care

2020 ◽  
Author(s):  
Yang Xu ◽  
Aditya Surapaneni ◽  
Jim Alkas ◽  
Marie Evans ◽  
Jung-Im Shin ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Glycemic Control ◽  
Kidney Injury ◽  
Routine Care ◽  
Time Varying ◽  
Baseline Hba1c ◽  
Swedish Cohort ◽  
The U.S

<b>Objective: </b>Patients with diabetes and chronic kidney disease (CKD) have increased susceptibility to acute kidney injury (AKI), but mechanisms are unclear. We investigated the association of glycemic control with risk of AKI. <p><b>Research Design and Methods: </b>In two observational cohorts of U.S. (Geisinger Heath system, Pennsylvania) and Swedish (SCREAM project, Stockholm) adults with type-2 diabetes and confirmed CKD stages G3-G5 undergoing routine care, we evaluated associations between baseline and time-varying HbA1c with the incident AKI (defined as increase in creatinine ≥0.3 mg/dL over 48 hours, 1.5x creatinine over 7 days). </p> <p><b>Results: </b>In the U.S. cohort, there were 22877 patients (55% women) with median age 72 years and eGFR 52 ml/min/1.73 m<sup>2</sup>. In the Swedish cohort, there were 12157 patients (51% women) with median age 76 years and eGFR 51 ml/min/1.73 m<sup>2</sup>. During 3.1 and 2.3 years of follow-up, 7060 and 2619 AKI events were recorded in the U.S. and Swedish cohorts, respectively. The adjusted association between baseline HbA1c and AKI was similar in both cohorts. Compared to baseline HbA1c 6-6.9% (42-52 mmol/mol), the HR for AKI in patients with HbA1c>9% (75 mmol/mol) was 1.29 (95% CI 1.18-1.41) in Geisinger, and 1.33 (95% CI 1.13-1.57) in the Swedish cohort. Results were consistent in stratified analysis, when using death as competing risk, and when using time-varying HbA1c.</p> <p><b>Conclusions: </b>Higher HbA1c was associated with AKI in adults with type 2 diabetes and CKD, suggesting that improving glycemic control may reduce the risk of AKI.</p>

scholarly journals BIABHIG PATIENTS;

2007 ◽  
Vol 14 (01) ◽  
pp. 37-42
Author(s):  
MUHAMMAD AHMAD GHAZI, ◽  
YASIR AKRAM ◽  
MUHAMMAD ARSHAD CHEEMA
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Diabetic Foot ◽  
Surgical Complications ◽  
Surgical Debridement ◽  
Good Glycemic Control ◽  
Surgical Ward ◽  
Diagnosed Diabetes ◽  
Study Setting ◽  
Patient Department

Objective: Diabetics develop complications as a result ofinfection, microangiopathic and neuropathic changes. All these complication can be anticipated andprevented with good glycemic control and maintaining good podiatric care. This study was conducted todetermine the presentation and out come of diabetics in general surgical ward. Design: Observational crosssectional study Setting: Emergency and out patient department of South Surgical Ward, Mayo HospitalLahore. Period: Six months (1st June to 30th November 2004), Material and methods: 51 patients withdiabetes mellitus presenting, it included all the patients with diagnosed diabetes mellitus presenting withsurgical complications relating to their diabetes. All other patients who were normoglycemic or knowndiabetics without any surgical complications were excluded. Patients presenting with ulcerations on foot andlegs were classified on the basis of Wegners classification. Results: Out of 51 patients, 43.1%( 22) had adiagnosis of diabetic foot, 33.3%( 17) had an abscess and 23.5%( 12) had an abscess. According to theWagener's classification*. Class 2 was most common at presentation 34.8% and 23.5% of the patientspresenting with diabetic foot had to undergo an amputation thus suffering from a permanent disability.Conclusion: Good surgical debridement and proper use of antibiotics is required as well as good glycemiccontrol for early and safe recovery.

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