Hyperglycemic Hyperosmolar State

2017 ◽  
Author(s):  
Shamsuddin Akhtar
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Elective Surgery ◽  
Successful Management ◽  
Hyperglycemic Hyperosmolar State ◽  
Patients With Diabetes ◽  
Life Threatening ◽  
Control And Management ◽  
Underlying Pathophysiology ◽  
Surgical Condition

The incidence of diabetes mellitus has rapidly increased in recent years. Perioperative care of patients with diabetes presents challenges of glycemic control and management of associated cardiovascular disease. Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are life-threatening complications of diabetes that require emergent therapy. Although elective surgery in patients with DKA or HHS is contraindicated, there are times when an emergent surgical condition may require anesthesia in the presence of DKA or HHS. There are many different factors that may precipitate these disorders and an understanding of the underlying pathophysiology and treatment is important for successful management of anesthesia.

scholarly journals Association between plasma levels of heat shock protein 60 and cardiovascular disease in patients with diabetes mellitus

2006 ◽  
Vol 27 (13) ◽  
pp. 1565-1570 ◽  
Author(s):  
Alireza Shamaei-Tousi ◽  
Jeffrey W. Stephens ◽  
Ren Bin ◽  
Jacqueline A. Cooper ◽  
Andrew Steptoe ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Heat Shock ◽  
Heat Shock Protein ◽  
Plasma Levels ◽  
Heat Shock Protein 60 ◽  
Patients With Diabetes

Antidiabetic and Antidyslipidemic activity of Secang (Caesalpinia sappan L.) Wood extract on Diabetic Rat

2021 ◽  
pp. 2800-2806
Author(s):  
Diana Holidah ◽  
Ika Puspita Dewi ◽  
Fransiska Maria Christianty ◽  
Noer Sidqi Muhammadiy ◽  
Nur Huda
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Blood Glucose ◽  
Diabetic Rat ◽  
Level Increase ◽  
Patients With Diabetes ◽  
Potential Activity ◽  
Wood Extract ◽  
Antidyslipidemic Activity

Diabetes mellitus is a syndrome due to disorders of carbohydrate, lipid, and protein metabolism due to decreased insulin secretion or reduced insulin sensitivity. The number of people with diabetes mellitus is increasing every year. However, diabetes mellitus is a major cause of cardiovascular disease, blindness, kidney failure, and amputation due to gangrene. Patients with diabetes mellitus have a possibility of 2-3 times higher cardiovascular disease than non diabetic. Sappan wood containing brazilin that have antioxidant activity and had a potential activity to lower the incidence of type 2 diabetes mellitus. Objective of this research was to determine the activity of secang wood extract as an antidiabetic and antidyslipidemic on diabetic rat. Diabetic rat induced by alloxan and given extract once daily for 14 days. At 15th day, blood glucose level, lipid profile was determine, pancreas was harvested and processed to hystopathological examination. Secang wood extract decreased blood glucose, cholesterol, triglyceride, and LDL level, increase HDL level, and repair the histology of pancreas on diabetic rat after 14 days treatment. Based on the result, secang wood extract had antidiabetic and antidyslipidemic activity on diabetic rat.

scholarly journals Aspirin for primary prevention of cardiovascular outcomes in diabetes mellitus: An updated systematic review and meta-analysis

2019 ◽  
Vol 27 (19) ◽  
pp. 2034-2041 ◽  
Author(s):  
Safi U Khan ◽  
Zain Ul Abideen Asad ◽  
Muhammad U Khan ◽  
Swapna Talluri ◽  
Farman Ali ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Meta Analysis ◽  
Cardiovascular Outcomes ◽  
Randomized Controlled ◽  
Patients With Diabetes ◽  
Incident Cases ◽  
Risk Ratios ◽  
Prevention Of Cardiovascular Disease

Background The safety and efficacy of aspirin for the primary prevention of cardiovascular disease in patients with diabetes mellitus remains controversial. Design A meta-analysis to investigate the effects of aspirin for the prevention of cardiovascular disease in diabetes mellitus. Methods Ten randomized controlled trials were selected using MEDLINE, EMBASE and CENTRAL databases until 27 September 2018. Risk ratios (RRs) with 95% confidence intervals (CIs) and risk differences (RDs) reported as incident events per 1000 person-years were calculated. Results In 33,679 patients, aspirin did not significantly reduce the risk of major adverse cardiovascular outcomes (RR 0.93, 95% CI 0.87–1.00, P = 0.06; RD −0.68 incident cases per 1000 person-years (95% CI −1.54, 0.17)), cardiovascular mortality (RR 0.95, 95% CI 0.83–1.09, P = 0.49; RD 0.11 incident cases per 1000 person-years (95% CI −0.80, 1.02)), myocardial infarction (RR 0.91, 95% CI 0.75–1.11, P = 0.36; RD −0.66 incident cases per 1000 person-years (95% CI −2.07, 0.75)), or stroke (RR 0.91, 95% C, 0.76–1.10, P = 0.33; RD −0.55 incident cases per 1000 person-years (95% CI −1.57, 0.47)). There was a significantly higher risk of total bleeding associated with aspirin (RR 1.29, 95% CI 1.07–1.55, P = 0.01; RD 1.49 incident cases per 1000 person-years (95% CI 0.36, 2.61)). Conclusion The use of aspirin for primary prevention of cardiovascular disease in patients with diabetes mellitus increases the risk of total bleeding without reducing the risk of major adverse cardiovascular outcomes.

scholarly journals Anti-Diabetic Drugs in Cardiovascular Disease

2021 ◽  
Vol 96 (2) ◽  
pp. 85-91
Author(s):  
Se-Eun Kim ◽  
Byung-Su Yoo
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Antidiabetic Drugs ◽  
Cardiovascular Safety ◽  
Safety And Efficacy ◽  
Cardiovascular Outcome Trials ◽  
Patients With Diabetes ◽  
Cardiovascular Stability ◽  
Selection Of

Diabetes is one of the important risk factors in cardiovascular disease associated with atherosclerosis, and cardiovascular disease is the leading cause of death in patients with diabetes mellitus. Recent randomized placebo-controlled cardiovascular outcome trials of all new antidiabetic drugs have linked SGLT-2 inhibitors and GLP1-agonists to not only increased cardiovascular stability but significant reduction of cardiovascular disease. These results have led to preferential selection of the most effective and beneficial antidiabetic drugs with the evidence of cardiovascular safety and efficacy. Herein, we address cardiovascular stability and the effectiveness of antidiabetic drugs, focusing on recently developed ones.

scholarly journals 459 Evaluation of LDL-C reductions by siRNA treatment with inclisiran in patients with diabetes mellitus, metabolic syndrome or neither

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
R. Scott Wright ◽  
David Kallend ◽  
Kausik K Ray ◽  
Lawrence Leiter ◽  
Wolfgang Koenig ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Controlled Trial ◽  
Atherosclerotic Cardiovascular Disease ◽  
Double Blind ◽  
Sirna Treatment ◽  
Patients With Diabetes

Abstract Aims Patients with diabetes (DM) and metabolic syndrome (MS) have elevated risks for atherosclerotic cardiovascular disease (ASCVD). Aggressive LDL-C lowering reduces risks. Inclisiran, a new siRNA, lowers LDL-C and was evaluated in patients with Type 2 diabetes (DM), metabolic syndrome (MS) without DM or neither (N) in the ORION-10 trial. Methods ORION-10 was a double-blind, randomized, placebo controlled trial evaluating inclisiran in 1561 patients with ASCVD on maximally tolerated therapy for lowering LDL-C. 781 inclisiran (INC) participants and 780 placebo (P) patients received 1.5 mL SQ tx at Days 1, 90, then every 6 months until Day 540. We evaluated the time adjusted change in LDL-C from baseline after Days 90–540 in DM (n = 702), MS (n = 455) and N participants (n = 404). Results There were no differences in baseline demographics and background therapies between INC and P. Statins were utilized in 89.8% INC and 88.7% of P. High intensity statins were utilized in 67.2% of INC and 68.8% of P; ezetimibe in 10.2% of NC and 9.5% of P participants. INC reduced LDL-C by − 54.4% (−58.3, −50.6 95% CI) in DM, (P < 0.001), −58.6% (−62.3, −54.8), P < 0.001 in-MS and −56.0% (−60.2, −51.7), in N subjects P < 0.001 (see Figure). Conclusions Inclisiran potently and durably reduces LDL-C across patients with DM, MS and those with neither, demonstrating potent efficacy and durability across glycaemic categories. Inclisiran may also represent a potent LDL-C lowering treatment for those with DM and MS.

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