scholarly journals Prediction of atrial fibrillation and sudden cardiac death in type 2 diabetic patients on insulin: a territory-wide observational cohort study

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
S Lee ◽  
K Jeevaratnam ◽  
T Liu ◽  
D Chang ◽  
WKK Wu ◽  
...  
Keyword(s):  
Cox Regression ◽  
Density Lipoprotein ◽  
Adverse Outcomes ◽  
Lipoprotein Cholesterol ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cox Regression Analysis ◽  
Hba1c Variability ◽  
Type 2 Diabetic

Abstract Funding Acknowledgements Type of funding sources: None. Introduction With the global shift towards a more personalized approach in the management of diabetes, there is an increasing interest in exploring the application of new parameters, such as HbA1c and lipid variability, to better monitor disease progression and evaluate the prognosis. Given that metabolic abnormalities may exacerbate the risk of adverse outcomes in patients with type 2 diabetes mellitus, patients who are partially or fully dependent on insulin are more likely to have severe disease and may be at higher risks of arrhythmias.  Purpose  The aim of the present study aims was to assess the predictive value of HbA1c and lipid variability towards ventricular tachycardia (VT), ventricular fibrillation (VF), or SCD, as well as incident AF in type 2 diabetic patients receiving insulin therapy. Methods The territory-wide retrospective observational study consists of type 2 diabetic patients prescribed with insulin, who attended publicly funded clinics and hospitals in Hong Kong between January 1st, 2009 to December 31st, 2009. Variability in total cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglyceride, and HbA1c were assessed through their standard deviation (SD) and coefficient of variation (CV) for patients with at least three measurements of the respective indices. Univariate and multivariate Cox regression analysis was used to predict for the primary outcomes- incident SCD and AF. Results A total of 23329 patients (mean ± SD age: 64 ± 14 years old; 51% male; mean HbA1c 8.6 ± 1.3%) were included. In total, 2512 and 1846 patients experienced incident SCD and AF respectively over the course of follow-up. On multivariate analysis, higher HbA1c variability (SD: hazard ratio [HR]: 1.45, 95% confidence interval [CI] 1.21-1.75; p < 0.0001) and triglyceride variability (SD: HR: 1.36, 95%CI: 1.24-1.49; p < 0.0001) were associated with increased of SCD risk. By contrast, only the increase in LDL-C variability was predictive of AF (SD: HR 2.95, 95%CI 1.37-6.39; p= 0.006). Conclusions  Higher HbA1c variability and lipid variability were associated with increased of SCD risk while only higher LDL-C variability was predictive of incident AF.  Therefore, poor glucose control and variability in lipid parameters in diabetic patients are associated with SCD and incident AF.  These observations suggest the need to re-evaluate the extent of glycemic control required for outcome optimization.

scholarly journals Lipid Profile of Type 2 Diabetic and Hypertensive Patients in the Jamaican Population

2010 ◽  
Vol 2 (01) ◽  
pp. 025-030 ◽  
Author(s):  
Lorenzo Gordon ◽  
Dalip Ragoobirsingh ◽  
Errol Y St A Morrison ◽  
Eric Choo-Kang ◽  
Donovan McGrowder ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Diabetic Patients ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Type 2 Diabetic Patients ◽  
Type 2 Dm ◽  
Type 2 Diabetic

ABSTRACT Aims: Previous studies have shown that diabetes mellitus (DM) increases the risk of cardiovascular diseases in females to a greater extent than in males. In this cross-sectional study, we evaluated the lipid profiles of type 2 diabetic males and females. Materials and Methods: The study included 107 type 2 diabetic patients (41 males and 66 females), and 122 hypertensive type 2 diabetic patients (39 males and 83 females), aged 15 years and older. Total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), very low density lipoprotein-cholesterol (VLDL-C) and high density lipoprotein-cholesterol (HDL-C) concentrations were assayed for each group using standard biochemical methods. Results: The mean TC, TG, VLDL-C, HDL-C and LDL-C concentrations, TG/HDL and LDL/HDL ratios were higher in type 2 diabetic and hypertensive type 2 diabetic patients compared with non-diabetic, and hypertensive non-diabetic control subjects, although these were not significant (P > 0.05). Hypertensive type 2 diabetic females had significantly higher serum TC (7.42 ± 1.63 mmol/L) than hypertensive non-diabetic males (5.76±1.57 mmol/L; P < 0.05). All the other lipid and lipoprotein parameters except HDL-C were non-significantly higher in females with type 2 DM and those with hypertension and type 2 DM, compared with type 2 diabetic and hypertensive type 2 diabetic males, respectively (P > 0.05). Conclusion: This study demonstrated that dyslipidemia exists in our type 2 diabetic population with greater TC in hypertensive type 2 diabetic females compared with hypertensive type 2 diabetic males. This suggests that hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidemia compared with males.

scholarly journals Plasma lipoprotein(a) levels: a comparison between diabetic and non-diabetic patients with acute ischemic stroke

2004 ◽  
Vol 62 (2a) ◽  
pp. 233-236 ◽  
Author(s):  
Maurus Marques de Almeida Holanda ◽  
Rosália Gouveia Filizola ◽  
Maria José de Carvalho Costa ◽  
Rodrigo Vasconcelos C.L. de Andrade ◽  
José Alberto Gonçalves da Silva
Keyword(s):  
Ischemic Stroke ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Diabetic Patients ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

OBJECTIVE: The aim of this study was to evaluate lipoprotein(a) (Lp(a)), total cholesterol, high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), very low density lipoprotein cholesterol (VLDL ), triglycerides , apolipoprotein A (apo A) and B100 (apo B100), uric acid, glycaemic and insulin plasmatic concentrations in patients affected by acute stroke. In this group of patients, we have compared the variables between type 2 diabetic patients and non-diabetic patients. METHOD: We evaluate a total of 34 non-diabetic patients (22 males and 12 females; mean age 66.71 ± 10.83 years) and a group of 26 type 2 diabetic patients (15 males and 11 females; mean age 66.35 ± 9.92 years) in a cross-sectional study. RESULTS: Mean Lp(a) concentration did not significantly differ between type 2 diabetic patients and non-diabetic subjects (29.49 ± 23.09 vs 44.81 ± 44.34 mg/dl). The distribution of Lp(a)levels was highly skewed towards the higher levels in both groups, being over 30 mg/dl in 50%. Lp(a) concentration was positively correlated with abdominal adiposity, using waist-hip ratio(WHR)(p< 0.05). No association was found between Lp(a) and others risk factors like sex, age, other lipidic parameters and the presence of stroke. CONCLUSIONS: Our results showed that there were no significant differences between diabetic and non-diabetic patients' serum Lp(a) levels, which indicates that elevated Lp(a) levels were associated with ischemic stroke, irrespective of the presence of type 2 diabetes mellitus (type 2 DM).

scholarly journals Comparison of Two Creatinine-Based Equations for Predicting Decline in Renal Function in Type 2 Diabetic Patients with Nephropathy in a Korean Population

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Eun Young Lee ◽  
Young-Mi Lee ◽  
Kyu Hun Choi ◽  
Hyun Chul Lee ◽  
Byung-Wan Lee ◽  
...  
Keyword(s):  
Cox Regression ◽  
Diabetic Patients ◽  
Ckd Progression ◽  
Type 2 Diabetic Patients ◽  
Baseline Serum ◽  
Cox Regression Analysis ◽  
Disease Epidemiology ◽  
Increased Risk ◽  
Type 2 Diabetic

Aim.To compare two creatinine-based estimated glomerular filtration rate (eGFR) equations, the chronic kidney disease epidemiology collaboration (CKD-EPI) and the modification of diet in renal disease (MDRD), for predicting the risk of CKD progression in type 2 diabetic patients with nephropathy.Methods.A total of 707 type 2 diabetic patients with 24 hr urinary albumin excretion of more than 30 mg/day were retrospectively recruited and traced until doubling of baseline serum creatinine (SCr) levels was noted.Results.During the follow-up period (median, 2.4 years), the CKD-EPI equation reclassified 10.9% of all MDRD-estimated subjects: 9.1% to an earlier stage of CKD and 1.8% to a later stage of CKD. Overall, the prevalence of CKD (eGFR < 60 mL/min/1.73 m2) was lowered from 54% to 51.6% by applying the CKD-EPI equation. On Cox-regression analysis, both equations exhibited significant associations with an increased risk for doubling of SCr. However, only the CKD-EPI equation maintained a significant hazard ratio for doubling of SCr in earlier-stage CKD (eGFR ≥ 45 mL/min/1.73 m2), when compared to stage 1 CKD (eGFR ≥ 90 mL/min/1.73 m2).Conclusion.In regard to CKD progression, these results suggest that the CKD-EPI equation might more accurately stratify earlier-stage CKD among type 2 diabetic patients with nephropathy than the MDRD study equation.

scholarly journals Lipid Profile Pattern in Type 2 Diabetes Mellitus Patients

2020 ◽  
Vol 14 (2) ◽  
pp. 177-179
Author(s):  
Most Sarmin Sultana ◽  
Yasmin Akhter ◽  
Mimi Parvin ◽  
Md Mahbub Ul Alam ◽  
Lubna Naznin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Lipid Profile ◽  
Density Lipoprotein ◽  
Armed Forces ◽  
Lipoprotein Cholesterol ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Dm ◽  
Type 2 Diabetic

Introduction: Dyslipidemia has been noted to play an integral role in the pathogenesis and progression of micro and macrovascular complications in Diabetes Mellitus (DM) patients. Lipid profile is the indicators of dyslipidemia. Objectives: To evaluate the prevalence and pattern of dyslipidemia in type 2 DM patients. Materials and Methods: This cross sectional study was conducted at Armed Forces Institute of Pathology (AFIP) from November 2014 to October 2015. The study included 300 type 2 diabetic patients belonging to the age group 30-59 years. Personal data and history of co-existing medical conditions were collected by data collection sheet and analyzed. Results: Among 300 study subjects with type 2 DM the prevalence of dyslipidemia was 94% among them 19% had single dyslipidemia and 75% had multiple dyslipidemia. In this study, high level of total cholesterol (TC), triglycerides(TG) and Low Density Lipoprotein-Cholesterol (LDL-C) were found in 47.3%, 76.7% and 41.3% patients respectively. High Density Lipoprotein- Cholesterol (HDL-C) levels were found to be low in 60% patients. Conclusion: The study revealed that dyslipidemia is very common in type 2 diabetic patients and the most common abnormality observed was increased serum TG level followed by decreased HDL-C level. So, patients with type 2 DM should be followed up with serum lipid profile regularly. Journal of Armed Forces Medical College Bangladesh Vol.14 (2) 2018: 177-179

Association of plasma ghrelin levels with diabetic nephropathy

2018 ◽  
Vol 42 (1-2) ◽  
pp. 39-44
Author(s):  
Somayeh Rahimi ◽  
Faranak Kazerouni ◽  
Mehdi Hedayati ◽  
Mehr Ali Rahimi ◽  
Ali Rahimipour ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Density Lipoprotein ◽  
Inverse Correlation ◽  
Ghrelin Level ◽  
Lipoprotein Cholesterol ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Plasma Ghrelin Level ◽  
Type 2 Diabetic

AbstractBackground:Ghrelin is a 28-amino acid peptide hormone which is produced in various tissues such as the kidney. It is proposed that this hormone exerts a broad spectrum of biological functions throughout the body. Ghrelin carries out endocrine and/or paracrine functions in the kidney, which seems to be one of the target tissues of this hormone. Results regarding circulating ghrelin levels in chronic kidney disease (CKD) and diabetic nephropathy (DN) patients are conflicting. We aimed to investigate the plasma ghrelin levels in type 2 diabetic patients with and without nephropathy.Methods:A total of 45 patients with DN and 45 patients with diabetes without diabetic nephropathy (NDN) were recruited for this study. Plasma ghrelin levels were determined using the enzyme-linked immunosorbent assay (ELISA) method. The association of plasma ghrelin with concentrations of fasting glucose (FBS), creatinine (Cr), blood urea nitrogen (BUN), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), triglycerides (TG) and anthropometric parameters was analyzed.Results:Plasma ghrelin concentration in the DN group was 1.16 (1.01–1.38) ng/mL and in the NDN group was 1.16 (0.92–1.41) ng/mL, so there were no significant differences between the two groups (p=0.467). In the NDN group, ghrelin showed an inverse correlation with TG (r=−0.467, p=0.001) and a direct correlation with HDL (r=0.562, p=0.000) but in the DN group these correlations were not found.Conclusions:Our findings implicated no relationship between the plasma ghrelin level and renal dysfunction in type 2 diabetic patients. Therefore, plasma ghrelin level may not be a probable indicator of kidney insufficiency in patients with type 2 diabetes mellitus (T2DM). Furthermore, we also found a positive correlation between ghrelin and HDL and an inverse correlation with TG levels.

Effects of Basal Insulin on Lipid Profile Compared to Other Classes of Antihyperglycemic Agents in Type 2 Diabetic Patients

2020 ◽  
Vol 105 (7) ◽  
pp. 2464-2474
Author(s):  
Mauro Rigato ◽  
Angelo Avogaro ◽  
Saula Vigili de Kreutzenberg ◽  
Gian Paolo Fadini
Keyword(s):  
Lipid Profile ◽  
Basal Insulin ◽  
Standard Therapy ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Antihyperglycemic Agents ◽  
Type 2 Diabetic

Abstract Objective The lipid profile represents a driver of cardiovascular risk in type 2 diabetes. The effect of chronic insulin therapy on cholesterol levels is unclear. We aim to evaluate the effect of basal insulin on lipid profile compared to other classes of antihyperglycemic agents in type 2 diabetic patients. Design We performed a meta-analysis of randomized controlled trials reporting changes of lipid parameters in type 2 diabetic patients randomly assigned to basal insulin or other classes of anti-hyperglycemic agents. Results The levels of total (TC) and low-density lipoprotein cholesterol (LDL-C) appeared to be significantly reduced by therapies with glucagon-like peptide-1 receptor agonists (GLP-1RA) in comparison to basal insulin (mean difference [MD] –3.80; 95% CI [–6.30 to –1.30] mg/dL, P &lt; .001 and –4.17; 95% CI [–6.04 to –2.30] mg/dL, P &lt; .0001), whereas no difference was detected between basal insulin and dipeptidyl peptidase-4 inhibitors (DPP4-I) or standard therapy (sulfonylurea ± metformin). Thiazolidinediones (TZD) produced a significant improvement in high-density lipoprotein cholesterol (HDL-C) (MD 3.55; 95% CI: 0.55 to 6.56 mg/dL, P = .02) but were associated with an increase in TC and LDL-C (MD 16.20; 95% CI: 9.09 to 23.31 mg/dL, P &lt; .001 and 5.19: 95% CI: –3.00 to 13.39 mg/dL, P = .21). Basal insulin was superior to standard therapy in triglyceride reduction (MD 3.8; 95% CI: 0.99 to 6.63 mg/dL, P = .008). Conclusions GLP-1RA were superior to basal insulin in the control of TC and LDL-C. Basal insulin effectively reduced serum triglycerides. TZD led to improvement in HDL-C. DPP4-I and standard therapy did not have any significant effect on lipid levels.

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