scholarly journals Risk stratification score for acute myocardial infarction and sudden cardiac death in type 2 diabetes mellitus

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
S Lee ◽  
J Zhou ◽  
CL Guo ◽  
WKK Wu ◽  
WT Wong ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiac Death ◽  
Adverse Outcomes ◽  
Risk Scores ◽  
Diabetic Patients ◽  
Type 2 Diabetic

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Acute myocardial infarction (AMI) and sudden cardiac death (SCD) are major cardiovascular adverse outcomes in patients with type 2 diabetic mellitus. Although there are many risk scores on composite outcomes of major cardiovascular adverse outcomes or cardiovascular mortality for diabetic patients, these existing scores did not account for the difference in pathogenesis and prognosis between acute coronary syndrome and lethal ventricular arrhythmias. Furthermore, recent studies reported that HbA1c and lipid levels, which were often accounted for in these risk scores, have J/U-shaped relationships with adverse outcomes. Purpose The present study aims to evaluate the application of incorporating non-linear J/U-shaped relationships between mean HbA1c and cholesterol levels into risk scores for predicting for AMI and non-AMI related SCD respectively, amongst type 2 diabetes mellitus patients. Methods This was a territory-wide cohort study of patients with type 2 diabetes mellitus above the age 40 and free from prior AMI and SCD, with or without prescriptions of anti-diabetic agents between January 1st, 2009 to December 31st, 2009 at government-funded hospitals and clinics in Hong Kong. Risk scores were developed for predicting incident AMI and non-AMI related SCD. The performance of conditional inference survival forest (CISF) model compared to that of random survival forests (RSF) model and multivariate Cox model. Results This study included 261308 patients (age = 66.0 ± 11.8 years old, male = 47.6%, follow-up duration = 3552 ± 1201 days, diabetes duration = 4.77 ± 2.29 years). Mean HbA1c and high-density lipoprotein-cholesterol (HDL-C) were significant predictors of AMI under multivariate Cox regression and were linearly associated with AMI. Mean HbA1c and total cholesterol were significant multivariate predictors with a J-shaped relationship with non-AMI related SCD. The AMI and SCD risk scores had an area-under-the-curve (AUC) of 0.666 (95% confidence interval (CI)= [0.662, 0.669]) and 0.677 (95% CI= [0.673, 0.682]), respectively. CISF significantly improves prediction performance of both outcomes compared to RSF and multivariate Cox models. Conclusions A holistic combination of demographic, clinical, and laboratory indices can be used for the risk stratification of type 2 diabetic patients against AMI and SCD.

Awareness of Complications in Diabetic Patients - Study in a Tertiary Care Centre in Kerala

2021 ◽  
Vol 8 (37) ◽  
pp. 3334-3338
Author(s):  
Satish Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Type 2 Diabetic Patients ◽  
Complications Of Diabetes ◽  
Type 2 Diabetic

BACKGROUND Type 2 diabetes mellitus is common in the Indian population and awareness regarding the disease and its complications is low among the patients with diabetes. There is lack of studies regarding awareness of complications of diabetes among type 2 diabetic patients. The purpose of this study was to assess the awareness of diabetic complications among type 2 diabetic patients. METHODS This is an institutional based observational study. The sample comprised of 150 adult patients with type 2 diabetes mellitus who underwent treatment in the Department of Medicine, Medical College Kottayam and the patient’s age ranged from 18 - 77 years. RESULTS Majority of patients were in the age group 38 to 57 and the sample comprised of 56 % males and 44 % female patients. Out of 150 patients involved in the study, 120 patients (80 %) were aware of the complications of diabetes mellitus. Among the male patients, 70 (83.33 %) and among females, 50 (75.75 %) were aware of the complications in diabetes. In the study sample, 92 (61.33 %) were aware of the foot problems, 120 patients (80 %) were aware of renal complications, 91 patients were aware regarding eye problems of diabetes, 38 (25.33 %) regarding development of hypertension, 62 (41.33 %) regarding heart attack, 42 (28 %) patients were aware regarding development of stroke and 78 patients (52 %) had awareness regarding occurrence of recurrent infections. CONCLUSIONS Awareness regarding diabetes and its complications is fairly good among the diabetic patients in Kerala. Awareness regarding all complications of diabetes was higher among males than females. Providing awareness to type 2 diabetic patients by various educational programs may be of further help to prevent complications and to decrease the mortality and morbidity in type 2 diabetes patients. KEYWORDS Awareness, Diabetes

scholarly journals Study on the prevalence of dyslipidemia in type 2 diabetes mellitus

2019 ◽  
Vol 6 (3) ◽  
pp. 786
Author(s):  
Eda Dayakar ◽  
C. Sathya Sree ◽  
E. Sanjay
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Type 2 Diabetic

Background: Diabetes mellitus is a common health problem globally. Dyslipidaemia is a major risk factor to develop cardiovascular disease in diabetics. They present study was undertaken to find out the prevalence of dyslipidaemia in type 2 diabetic patients.Methods: The present study was a cross sectional study consisting of 46 (23 male and 23 female) known type 2 diabetes mellitus patients. Age, gender, duration of diabetes, body mass index (BMI) was recorder in all the diabetic patients.  Fasting blood glucose levels, total cholesterol, triglycerides, HDL, LDL, VLDL levels were measured using standard methods and recorded.Results: The average total cholesterol, triglycerides, LDL, HDL and VLDL were 200±42mg/dl, 169.62±89.79mg/dl, 132.45±36.38mg/dl,39.1±16.6mg/dl and 35.85±17.09mg/dl respectively. The incidence of occurrence of hypercholesterolemia was 58.6% and hypertriglyceridemia 36.9%. Increased levels of LDL were observed in 30 (65.2%) patients and reduced HDL was observed in 43 (93.4%) patients. The incidence rate of dyslipidaemia was higher in female diabetic patients when compared to male diabetic patients.Conclusions: Awareness on the dyslipidaemia and its risk factors should be provided to the type 2 diabetic patients as they are more prone to get cardiovascular disease and lipid profile also should be monitored regularly along with blood glucose levels.

scholarly journals Evaluation of thyroid dysfunction among type 2 diabetic patients

2014 ◽  
Vol 6 (3) ◽  
pp. 33-37
Author(s):  
Pranav Kumar Raghuwanshi ◽  
Devendra Pratap Singh Rajput ◽  
Bhupendra Kumar Ratre ◽  
Roopesh Jain ◽  
Narmada Patel ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Diabetic Patients ◽  
Subclinical Hyperthyroidism ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Background: Diabetes mellitus is a very common endocrinal disorders and incidence of thyroid dysfunction also rising in India and world over. Thyroid hormones directly control insulin secretion and insulin clearance. Diabetes also may affect the thyroid function to variable extent first at the level of hypothalamic control of TSH release and second at peripheral tissue by converting T4 to T3. Aims and Objectives: The present study was carried out aiming to evaluate thyroid dysfunction among type 2 diabetes mellitus patients. Material and Methods: Study included total 80 subjects. Thyroid dysfunction was evaluated by investigating the subjects for Total tri-iodo-thyronine (T3), Total thyroxine (T4) and thyroid stimulating hormone (TSH). Plasma glucose was estimated by- GOD-POD method and Thyroid profile was estimated by- CLIA (chemiluminescence immunoassay) system. Statistical analysis was performed using software statistical package for social sciences (SPSS) version 20, unpaired T test, Pearson’s correlation. Results: In type 2 diabetic patients the prevalence of hypothyroidism and subclinical hypothyroidism was found to be 4(10.00%) and 6(15.00%) respectively, while the prevalence of subclinical hyperthyroidism and hyperthyroidism was found to be 0(0.0%) and 1(2.5%) respectively. In non diabetic healthy subjects the prevalence of hypothyroidism and subclinical hypothyroidism was found to be 1(2.5%) and 3(7.5%) respectively while the prevalence of subclinical hyperthyroidism and hyperthyroidism was found to be 0(0.0%) and 0(0.0%) respectively. Conclusion: The prevalence of thyroid dysfunction was found to be higher in type 2 diabetes mellitus subjects as compared to non-diabetic subjects. DOI: http://dx.doi.org/10.3126/ajms.v6i3.10814Asian Journal of Medical Sciences Vol.6(3) 2015 33-37  

Carbamylation of LDL and its relationship with myeloperoxidase in Type 2 diabetes mellitus

2013 ◽  
Vol 126 (2) ◽  
pp. 175-181 ◽  
Author(s):  
Sammy W. M. Shiu ◽  
Su-Mei Xiao ◽  
Ying Wong ◽  
Wing-Sun Chow ◽  
Karen S. L. Lam ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Renal Impairment ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Independent Mechanism ◽  
Type 2 Diabetic

Protein carbamylation has been considered only quantitatively important in uraemia and carbamylated LDL is pro-atherogenic. We have shown that carbamylated LDL is increased in Type 2 diabetic patients without renal impairment. Carbamylation is mediated by a urea-independent mechanism via myeloperoxidase.

scholarly journals Correlation of Pulmonary Function Tests with Anthropometry and Glycaemic Control in Type 2 Diabetes Mellitus-A Cross-sectional Study

2021 ◽  
Author(s):  
Aiswarya Roy Karintholil ◽  
Akshatha Rao Aroor ◽  
Joel Sabu ◽  
Joshua Chacko
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycaemic Control ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Duration Of Diabetes ◽  
Lung Functions ◽  
Type 2 Diabetic

Introduction: Diabetic patients are found to have reduced lung functions compared to their controls and their relationship with the duration of diabetes, glycaemic control, and Body Mass Index (BMI) is poorly characterised. Aim: To determine the correlation between the pulmonary function abnormalities with anthropometry, glycaemic control, and duration of diabetes in type 2 diabetic patients. Materials and Methods: A total of 80 type 2 diabetic patients were studied. BMI, Waist Circumference (WC), Waist-Hip Ratio (WHR), Fasting, postprandial blood sugar and glycosylated haemoglobin (HbA1c) were assessed from July to September 2018. Spirometry was done in accordance with the guidelines from the American Thoracic Society (ATS). Reduced pulmonary functions were defined as patients with restrictive (FEV1/FVC≥0.7 and FVC< 80% predicted) or obstructive (FEV1/FVC<0.7) impairment. Statistical analysis was done using ANOVA test and Karl Pearson Correlation coefficient. Results: The mean values of FEV1/FVC (0.8±0.08) and FVC% predicted (60.29±11.39) showed a restrictive pattern. FEF (25-75%) (r=0.241, p=0.031) and PEFR (r=0.245, p=0.029) positively correlated with duration of diabetes. BMI had a negative correlation with FVC% predicted (r=0.239, p=0.033). A negative correlation between FEV1% and Waist Circumference (WC) was observed (r=-0.232, p=0.038). HbA1c negatively correlated to FEV1/FVC (r=-0.227, p=0.043). Conclusion: Patients with type 2 Diabetes Mellitus (DM) were found to have an asymptomatic restrictive pulmonary impairment. Increased duration of diabetes, increased BMI, increased WC was associated with decreased lung functions in diabetics.

scholarly journals Diabetes control could through platelet-to-lymphocyte ratio in hemograms

2019 ◽  
Vol 65 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Burcin Atak ◽  
Gulali Aktas ◽  
Tuba T. Duman ◽  
Edip Erkus ◽  
M. Zahid Kocak ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Patients ◽  
Platelet To Lymphocyte Ratio ◽  
Type 2 Diabetic Patients ◽  
Lymphocyte Ratio ◽  
Inflammatory Index ◽  
Type 2 Diabetic

SUMMARY OBJECTIVE Association between type 2 diabetes mellitus and inflammation is well-established. We aimed to study platelet-to-lymphocyte ratio (PLR), a novel inflammatory index derived from hemogram, in diabetic patients in comparison to those in healthy volunteers. METHODS Medical data of type 2 diabetics that showed up in general outpatient medical clinics of our institution between February 2017 and August 2017 were recorded and analyzed. RESULTS Median PLR of type 2 diabetic patients was significantly higher than the PLR of healthy controls (p=0.001). Moreover, PLR was significantly and positively correlated with HbA1c (p<0.001, r=0.58), fasting plasma glucose (p<0.001, r=0.49), and c-reactive protein (p=0.003, r=0.30) levels. Type 2 diabetic subjects with proteinuria had significantly higher PLR levels than that of diabetic subjects without proteinuria. CONCLUSION As an inexpensive and easy to use index, PLR may be useful in predicting the development and control levels of type 2 diabetes mellitus. However, its correlation with HbA1c needs to be validated by larger prospective studies.

Evaluation of the Prevalence of Sleep Disorder among Patients with Type 2 Diabetes Mellitus Referring to Ghaem Hospital from 2016 to 2017

2020 ◽  
Vol 16 ◽  
Author(s):  
Zahra Mazloum Khorasani ◽  
Vahid Roshan Ravan ◽  
Sepideh Hejazi
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Objectives: Diabetes is the most common metabolic disease in primary health care. The prevalence and severity of diabetes can be influenced through lifestyle modification. This study was aimed to identify the prevalence of sleep disorders as a modifiable lifestyle factor among diabetic patients. Materials and Methods: This cross‐sectional study was conducted on 190 patients with type 2 diabetes mellitus who referred to the Internal Medicine Clinic of the Ghaem Hospital, Mashhad, Iran from 2016 to 2017. A demographic questionnaire and the Pittsburgh Sleep Quality Assessment questionnaire (sleep disorder was defined as scores higher than 5) was filled for each subject. Blood tests including haemoglobin A1 C (Hb A1C), fasting blood sugar (FBS) and 2 hour post prandial glucose as well as the assessment of blood pressure, body mass index (BMI) were performed for all patients. Data were analysed using the statistical package for social sciences (SPSS) version 16. Results: Age of the patients (male to female ratio was 71/119s) was 56.31 ± 7.37 years. BMI more than 25 kg/m2 was observed in 145 (76.3%) of patients . Mean Pittsburgh Sleep Quality Assessment score was 7.48 ± 4.11. Fifty‐one (26.8%) patients were good sleepers and 139 (73.2%) were poor sleepers. There was a significant relationship between sleep disorder and age (p=0.019) and female gender (p=0.017) but no other variables including level of education, occupation, HbA1 C, FBS, 2 hour post prandial glucose, systolic and diastolic blood pressure. Discussion: Sleep disorders were common among type 2 diabetic patients especially women. It is recommended that sleep disorders should be screened in diabetic patients. Treatment and prevention of sleep disorders through sleep hygiene education including recommendation to have normal nocturnal sleep should be focused by practitioners in type 2 diabetic patients especially women. Appropriate measures should be taken to manage sleep disorders by weight control in this population.

scholarly journals The TCF7L2 rs7903146 (C/T) polymorphism is associated with risk to type 2 diabetes mellitus in Southern-Brazil

2014 ◽  
Vol 58 (9) ◽  
pp. 918-925 ◽  
Author(s):  
Taís S. Assmann ◽  
Guilherme C. K. Duarte ◽  
Jakeline Rheinheimer ◽  
Lavínia A. Cruz ◽  
Luís H. Canani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Patients ◽  
Southern Brazil ◽  
Type 2 Diabetic Patients ◽  
Diabetes Group ◽  
Type 2 Diabetic ◽  
Tcf7l2 Rs7903146

Objective The aim of this study was to investigate the association between the rs7903146 (C/T) polymorphism in the TCF7L2 gene and type 2 diabetes mellitus, in a Southern-Brazilian population. Materials and methods The TCF7L2 rs7903146 polymorphism was genotyped in 953 type 2 diabetic patients and 535 non-diabetic subjects. All subjects were white. The polymorphism was genotyped by Real-Time PCR using TaqMan MGB probes (Life Technologies). Odds ratios (OR) and 95% confidence intervals (CI) were calculated for additive, recessive and dominant inheritance models. Results Genotype and allele frequencies of the rs7903146 polymorphism differed significantly between type 2 diabetic patients and non-diabetic subjects (P = 0.001 and P = 0.0001, respectively). The frequency of the minor allele was 38% in type 2 diabetes group and 31% in non-diabetic subjects, and this allele was significantly associated with type 2 diabetes risk (OR = 1.42, 95% CI 1.15 – 1.76 for the dominant model of inheritance). Moreover, the T/T genotype was associated with a higher risk for type 2 diabetes (OR = 1.83, 95% CI 1.3-2.5) than the presence of only one copy of the T allele (OR = 1.31, 95% CI 1.1-1.6). Both results were adjusted for age and gender. Conclusions Our results confirm the association between the TCF7L2 rs7903146 polymorphism and increase risk for type 2 diabetes in Southern-Brazil. Arq Bras Endocrinol Metab. 2014;58(9):918-25

scholarly journals Effects of empagliflozin versus placebo on cardiac sympathetic activity in acute myocardial infarction patients with type 2 diabetes mellitus: the EMBODY trial

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Wataru Shimizu ◽  
◽  
Yoshiaki Kubota ◽  
Yu Hoshika ◽  
Kosuke Mozawa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Acute Myocardial Infarction ◽  
Heart Rate ◽  
Type 2 Diabetes Mellitus ◽  
Cardiac Death ◽  
Sglt2 Inhibitor ◽  
Nerve Activity

Abstract Background Protection from lethal ventricular arrhythmias leading to sudden cardiac death (SCD) is a crucial challenge after acute myocardial infarction (AMI). Cardiac sympathetic and parasympathetic activity can be noninvasively assessed using heart rate variability (HRV) and heart rate turbulence (HRT). The EMBODY trial was designed to determine whether the Sodium–glucose cotransporter 2 (SGLT2) inhibitor improves cardiac nerve activity. Methods This prospective, multicenter, randomized, double-blind, placebo-controlled trial included patients with AMI and type 2 diabetes mellitus (T2DM) in Japan; 105 patients were randomized (1:1) to receive once-daily 10-mg empagliflozin or placebo. The primary endpoints were changes in HRV, e.g., the standard deviation of all 5-min mean normal RR intervals (SDANN) and the low-frequency–to–high-frequency (LF/HF) ratio from baseline to 24 weeks. Secondary endpoints were changes in other sudden cardiac death (SCD) surrogate markers such as HRT. Results Overall, 96 patients were included (46, empagliflozin group; 50, placebo group). The changes in SDANN were + 11.6 and + 9.1 ms in the empagliflozin (P = 0.02) and placebo groups (P = 0.06), respectively. Change in LF/HF ratio was – 0.57 and – 0.17 in the empagliflozin (P = 0.01) and placebo groups (P = 0.43), respectively. Significant improvement was noted in HRT only in the empagliflozin group (P = 0.01). Whereas intergroup comparison on HRV and HRT showed no significant difference between the empagliflozin and placebo groups. Compared with the placebo group, the empagliflozin group showed significant decreases in body weight, systolic blood pressure, and uric acid. In the empagliflozin group, no adverse events were observed. Conclusions This is the first randomized clinical data to evaluate the effect of empagliflozin on cardiac sympathetic and parasympathetic activity in patients with T2DM and AMI. Early SGLT2 inhibitor administration in AMI patients with T2DM might be effective in improving cardiac nerve activity without any adverse events. Trial Registration: The EMBODY trial was registered by the UMIN in November 2017 (ID: 000030158). UMIN000030158; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034442.

scholarly journals Diurnal Variation of Serum 25 (OH) D3 , Calcium and Phosphorus in Type 2 Diabetes Mellitus

2019 ◽  
Vol 9 (1) ◽  
pp. 16-20
Author(s):  
Rupendra Shakya ◽  
Balram Neupane ◽  
Devi Prasad Bhandari
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diurnal Variation ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Calcium Phosphorus ◽  
Healthy Participants ◽  
Type 2 Diabetic

Diurnal variation, an outgrowth of chronobiology, is the inferential statistical mapping of structures in variables; in and around us, consisting of rhythms chaos and trends. Type-2 diabetes mellitus is a metabolic disorder with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action or both. The diurnal time structure of serum 25(OH) D3 and calcium may relate to the prevention and chronotherapeutic efficacy and management of type 2 diabetes mellitus. To our knowledge, the diurnal variation of serum 25(OH) D3 has not yet been reported in type 2 diabetic patients. The present study was planned to evaluate the diurnal variation of serum 25(OH) D3 , calcium and phosphorus levels in type 2 diabetic patients. Ten clinically healthy volunteers and ten diagnosed patients of type 2 diabetes mellitus of similar age groups were synchronized for one month with diurnal activity from about 06:00 to about 22:00 and nocturnal rest. All subjects took their meals three times daily without any change in their usual fluid intake. Blood sample were collected into plain and sterile vials under quality control procedures from each participant at every 6 hour. Serum 25(OH) D3 , serum Ca++, serum PO4 , FBS and PPBS levels were estimated. A marked diurnal variation in serum 25(OH) D3 was recorded in healthy subjects (P=0.030). Similarly, a circadian rhythm of borderline statistical significance was also recorded for vitamin D in diabetic patients (P=0.083) and in healthy participants for serum calcium (P=0.070), phosphorus (P=0.102), and the calcium-phosphorus ratio (P=0.091) by the Two way ANOVA analysis. In addition, the amplitude and acrophase differed from healthy participants in diabetic patients for studied variables with a change of MESOR for calcium-phosphorus ratio. Mapping the broader time structure of different physiological variables investigated herein may be helpful in understanding the treatment and prevention of diabetic mellitus. Key words: Serum 25(OH) D3 , Calcium, Phosphorous, Type 2 Diabetes mellitus

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