The TUDID Study – Background and Design of a Prospective Cohort

2020 ◽  
Author(s):  
Benjamin Assad Jaghutriz ◽  
Robert Wagner ◽  
Stephanie Kullmann ◽  
Louise Fritsche ◽  
Sabine S. Eckstein ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Laboratory Tests ◽  
Diabetes Complications ◽  
Treatment Options ◽  
University Hospital ◽  
Tailored Treatment ◽  
The Individual

AbstractPrevalence of both type 1 and type 2 diabetes mellitus is growing worldwide and one major cause for morbidity and mortality. However, not every patient develops diabetes-related complications, but causes for the individual susceptibility are still not fully understood. As a platform to address this, we initiated the TUDID (TUebingen DIabetes Database) study, a prospective, monocentric, observational study that includes adults with diabetes mellitus who are treated in the inpatient clinic of a University Hospital in southern Germany. Besides a thorough clinical examination and extensive laboratory tests (with integrated biobanking), major study focuses are the kidneys, the eyes, the vasculature as well as cognition and mood where standardized investigations for early stages for diabetes complications are performed. Analyses of the data generated by this precise characterization of diabetes-related complications will contribute to our understanding of the development and course of such complications, and thus facilitate the implementation of tailored treatment options that can reduce the risk and severity of diabetes-related complications.

scholarly journals Personalized Medicine in Diabetes

2011 ◽  
Vol 57 (2) ◽  
pp. 231-240 ◽  
Author(s):  
Noemi Malandrino ◽  
Robert J Smith
Keyword(s):  
Diabetes Complications ◽  
Treatment Strategies ◽  
Molecular Characteristics ◽  
Molecular Determinants ◽  
Treatment Of Diabetes ◽  
Monogenic Forms Of Diabetes ◽  
Personalized Approach

BACKGROUND Multiple genes that are associated with the risk of developing diabetes or the risk of diabetes complications have been identified by candidate gene analysis and genomewide scanning. These molecular markers, together with clinical data and findings from proteomics, metabolomics, pharmacogenetics, and other methods, lead to a consideration of the extent to which personalized approaches can be applied to the treatment of diabetes mellitus. CONTENT Known genes that cause monogenic subtypes of diabetes are reviewed, and several examples are discussed in which the genotype of an individual with diabetes can direct considerations of preferred choices for glycemic therapy. The extent of characterization of polygenic determinants of type 1 and type 2 diabetes is summarized, and the potential for using this information in personalized management of glycemia and complications in diabetes is discussed. The application and current limitations of proteomic and metabolomic methods in elucidating diabetes heterogeneity is reviewed. SUMMARY There is established heterogeneity in the determinants of diabetes and the risk of diabetes complications. Understanding the basis of this heterogeneity provides an opportunity for personalizing prevention and treatment strategies according to individual patient clinical and molecular characteristics. There is evidence-based support for benefits from a personalized approach to diabetes care in patients with certain monogenic forms of diabetes. It is anticipated that strategies for individualized treatment decisions in the more common forms of diabetes will emerge with expanding knowledge of polygenic factors and other molecular determinants of disease.

scholarly journals Thyroid Dysfunction among Greek Patients with Type 1 and Type 2 Diabetes Mellitus as a Disregarded Comorbidity

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Maria E. Barmpari ◽  
Maria Kokkorou ◽  
Anastasia Micheli ◽  
Irene Alexiou ◽  
Elefteria Spanou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Diabetes Complications ◽  
Clinical Course ◽  
Nodular Goiter ◽  
Biochemical Measurements ◽  
Diabetes Center

Introduction. The aim of this study was to determine the prevalence of thyroid dysfunction in Greek patients with type 1 (T1DM) and type 2 (T2DM) diabetes mellitus as well as its possible relations to glycaemic control and to diabetic complications. Methods. A total of 1015 patients, consecutively followed in the Outpatient Diabetes Center, were studied. Anthropometric and biochemical measurements, occurrence of diabetes complications, and classical comorbidities were assessed. Average HbA1c of the previous year was calculated. Wellbeing was determined, using a 10-point optimal scale. All the above parameters were compared between subjects with or without thyroid disease. Results. All patients were euthyroid at the time of the study, either on thyroid medications or not. Hypothyroidism occurrence did not differ between T2DM and T1DM patients (37.1% versus 43.5%, p>0.05). Nodular goiter was observed more frequently in T2DM patients (34.1% versus 18.8%, p<0.05). T2DM patients with hypothyroidism compared to those without hypothyroidism had higher HbA1c (7.27% versus 6.98%, p<0.01), TChol (184.97 mg/dl versus 168.17 mg/dl, p<0.001), and higher HDL-Chol (51.28 mg/dl versus 46.77 mg/dl, p<0.01). T2DM patients without hypothyroidism had a better wellness feeling (7.5 versus 5.3 points, p<0.01). Conclusions. Screening for thyroid disease among T2DM patients should be routinely considered, as it is found to be an additional commorbidity. If it remains undiagnosed, it could aggravate the clinical course of the disease.

scholarly journals Knowledge, Perceptions and Concerns of Diabetes-Associated Complications among Individuals Living with Type 1 and Type 2 Diabetes Mellitus

Healthcare ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 25
Author(s):  
Clara Sanz-Nogués ◽  
Mohamad Mustafa ◽  
Helen Burke ◽  
Timothy O’Brien ◽  
Cynthia Coleman
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Bone Fractures ◽  
University Hospital ◽  
Related Complication ◽  
Preventative Measures ◽  
Health Complications

The purpose of this study was to investigate the knowledge, perceptions and concerns of individuals living with diabetes mellitus regarding the disorder and its associated long-term health complications. Individuals living with type 1 (N = 110) and type 2 (N = 100) diabetes were surveyed at the Diabetes Centre at University Hospital Galway (Ireland). A questionnaire was used to record respondent’s perceptions and concerns about living with diabetes and developing associated long-term health complications, especially diabetes-induced osteopathy. Participants’ responses revealed a variety of perspectives. Individuals with type 1 diabetes had a deeper understanding of the aetiology of diabetes and were more concerned about its complications than individuals with type 2 diabetes. The most recognized complications identified by the participants were retinopathy (92% type 1; 83% type 2), amputations (80% type 1; 70% type 2) and nephropathy (83% type 1; 63% type 2). Diabetes-related osteopathy was under-recognized, with 37% (type 1) and 23% (type 2) of respondents identifying bone fractures as a diabetes-related complication. Enhancing the patient awareness of this under-recognized diabetes-associated complication and ensuring that preventative measures are incorporated within health care programmes may offer methodologies to address this complication clinically.

scholarly journals Clinical and Biochemical Predictors of Endothelial Dysfunction in Egyptian Adolescents with Type 1 and those with Type 2 Diabetes

2021 ◽  
pp. 87-97
Author(s):  
EkramHamed Zakaria ◽  
MedhatAbdElmaged Ghazy ◽  
Wesam Salah Mohamed ◽  
Nesreen Ahmed Kotb
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Endothelial Dysfunction ◽  
Vascular Complications ◽  
University Hospital ◽  
Control Group ◽  
Model Assessment ◽  
Significant Difference

Aims: Since endothelial dysfunction precedes clinically significant diabetic vascular complications, circulating endothelial progenitor cells (EPCs) have generated interest as a biomarker of endothelial function and are considered a mirror for endogenous vasculo-regenerative capacity. So we aimed to assess EPCs count in adolescents with type 1 diabetes mellitus (T1DM) in comparison to those with type 2 diabetes mellitus (T2DM) and extend these findings to assess their relationship to other clinical and biochemical risks of endothelial dysfunction. Patients and Methods: Fifty Egyptian adolescents were included in this study, 20 with T1DM, 20 T2DM and 10 healthy control subjects. Patients are recruited from Diabetes and Endocrinology Unit, outpatient clinic of internal medicine department Tanta University Hospital, in the period from 2017 to 2019. EPCs count was determined by Flowcytometry, anthropometric measurements and laboratory investigations were done for fasting and 2-hours post-prandial blood glucose, serum lipid profile, HbA1c, urinary albumin creatinine ratio, fasting C peptide, and homoeostasis model assessment of insulin resistance (HOMA- IR). Results: In T1DM, EPCs count was significantly higher compared to T2DM(0.032) and control group(p0.001) and it was negatively correlated with age of patients and duration of diabetes but was positively correlated with HbA1c. While, the count was higher in T2DM compared to control with no statistically significant difference(p0.063) and negatively correlated with body mass index, waist circumference, blood pressure and HOMA-IR. Conclusion: Adolescents with T2DM have distressing clinical and biochemical findings and significantly lower count of (EPCs) than adolescents with T1DM. This puts them at potential higher risk for early development of endothelial dysfunction and less power of vascular repair that may potentiate early harboring of vascular complications.

scholarly journals Diabetes and bone health: latest evidence and clinical implications

2017 ◽  
Vol 9 (3) ◽  
pp. 67-74 ◽  
Author(s):  
Vikram Sundararaghavan ◽  
Matthew M. Mazur ◽  
Brad Evans ◽  
Jiayong Liu ◽  
Nabil A. Ebraheim
Keyword(s):  
Diabetes Mellitus ◽  
Bone Health ◽  
Treatment Options ◽  
Health It ◽  
Mineral Density ◽  
Insufficient Response ◽  
Distinguishing Features ◽  
Clinical Problems

As the prevalence of diabetes is increasing worldwide, research on some of the lesser-known effects, including impaired bone health, are gaining a lot of attention. The two most common forms of diabetes are type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). These two differ in their physiology, with T1DM stemming from an inability to produce insulin, and T2DM involving an insufficient response to the insulin that is produced. This review aims to highlight the most current information regarding diabetes as it relates to bone health. It looks at biochemical changes that characterize diabetic bone; notably increased adiposity, altered bone metabolism, and variations in bone mineral density (BMD). Then several hypotheses are analyzed, concerning how these changes may be detrimental to the highly orchestrated processes that are involved in bone formation and turnover, and ultimately result in the distinguishing features of diabetic bone. The review proceeds by explaining the effects of antidiabetes medications on bone health, then highlighting several ways that diabetes can play a part in other clinical treatment outcomes. With diabetes negatively affecting bone health and creating other clinical problems, and its treatment options potentiating these effects, physicians should consider the use of anti-osteoporotic drugs to supplement standard anti-diabetes medications in patients suffering with diabetic bone loss.

scholarly journals Chronic kidney disease in patients with diabetes mellitus

2021 ◽  
Vol 10 (5) ◽  
pp. R151-R159
Author(s):  
Espen Nordheim ◽  
Trond Geir Jenssen
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Treatment Options ◽  
Specific Treatment ◽  
Patients With Diabetes ◽  
Concomitant Condition

Chronic kidney disease is a common complication and concomitant condition of diabetes mellitus. The treatment of patients with diabetes and chronic kidney disease, including intensive control of blood sugar and blood pressure, has been very similar for type 1 and type 2 diabetes patients. New therapeutic targets have shown promising results and may lead to more specific treatment options for patients with type 1 and type 2 diabetes.

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