The Effect of Long-term Intensified Insulin Treatment on the Development of Microvascular Complications of Diabetes Mellitus

Diabetic neuropathy may be one of the most common and severe complications of diabetes mellitus. Oxidative stress plays a pivotal role in the development of microvascular complications of diabetes. The majority of related pathways like polyol and hexosamine, advanced glycation end products, poly-ADP-ribose polymerase, and protein kinase-C all originated from initial oxidative stress. In this review, the authors present the current oxidative stress hypothesis in diabetes mellitus and summarize the pathophysiological mechanisms of diabetic neuropathy associated with increased oxidative stress. The development of modern medicines to treat diabetic neuropathy needs intensive long-term comparative trials in the future. Orv. Hetil., 2016, 157(49), 1939–1946.

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Retinal vascular fractals predict long-term microvascular complications in type 1 diabetes mellitus: the Danish Cohort of Pediatric Diabetes 1987 (DCPD1987)

Diabetologia ◽

10.1007/s00125-014-3317-6 ◽

2014 ◽

Vol 57 (10) ◽

pp. 2215-2221 ◽

Cited By ~ 31

Author(s):

Rebecca Broe ◽

Malin L. Rasmussen ◽

Ulrik Frydkjaer-Olsen ◽

Birthe S. Olsen ◽

Henrik B. Mortensen ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Microvascular Complications ◽

Pediatric Diabetes ◽

Danish Cohort

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Diabetes Complications and their Relation to Glycemic Control among Patients Attending Diabetic Clinic at King Khalid National Guard Hospital in Jeddah, Saudi Arabia

Saudi Journal of Internal Medicine ◽

10.32790/sjim.2011.1.1.5 ◽

2011 ◽

Vol 1 (1) ◽

pp. 29-33 ◽

Cited By ~ 2

Author(s):

Abdullah M. Krawagh ◽

Abdullah M. Alzahrani ◽

Tariq A. Naser

Keyword(s):

Diabetes Mellitus ◽

Saudi Arabia ◽

Heart Disease ◽

Glycemic Control ◽

Ischemic Heart Disease ◽

National Guard ◽

Microvascular Complications ◽

Ischemic Heart ◽

Diabetic Clinic

This study addresses the prevalence of ischemic heart disease, hypertension and long-term complications of diabetes mellitus among patients attending the diabetic clinic and their relation to glycemic control. Methods: A study was conducted on a cross-section on all consecutive patients attending the diabetic clinic at King Khalid National Guard Hospital in Jeddah, Saudi Arabia, from January 2007 to January 2008. The degree of glycemic control was gauged using blood level of glycosylated hemoglobin (HbA1C) and classified into good (less 7%), fair (7.1-8%), poor (8.1-9%) and very poor (greater than 9%). All patients were screened for hypertension, ischemic heart disease and microvascular complications. Results: Two hundred and ten patients were recruited in the study. Glycemic control was good in 17 (8.1%), fair in 49 (23.2%), poor in 56 (26.6%) and very poor in 88 (41.9%). There was high prevalence of retinopathy (76; 36%), microalbuminuria (80; 37.9%), neuropathy (108; 51.2%) and ischemic heart disease (51; 24.2%), especially among patients with poor and very poor control. Although the presence of hypertension, frank nephropathy and peripheral vascular disease was also disturbingly high among diabetic patients, their frequency was the same among good, fair, poor and very poor glycemic control groups. Conclusion: The prevalence of long-term complications of diabetes mellitus was alarmingly high among Saudi nationals. Microvascular complications and ischemic heart disease were also noticed to be more common in diabetics with poor and very poor glycemic control. This emphasizes the need of national awareness program about the gravity of the problem.

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Chronic Microvascular Complications in Prediabetic States—An Overview

Journal of Clinical Medicine ◽

10.3390/jcm9103289 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3289

Author(s):

Angelika Baranowska-Jurkun ◽

Wojciech Matuszewski ◽

Elżbieta Bandurska-Stankiewicz

Keyword(s):

Risk Factor ◽

Glucose Metabolism ◽

Microvascular Complications ◽

Current Data ◽

Chronic Complications ◽

Prediabetic State ◽

Complications Of Diabetes ◽

Glucose Levels ◽

Abnormal Glucose Metabolism

A prediabetic state is a major risk factor for the development of diabetes, and, because of an identical pathophysiological background of both conditions, their prevalence increases parallelly and equally fast. Long-term hyperglycemia is the main cause inducing chronic complications of diabetes, yet the range of glucose levels at which they start has not been yet unequivocally determined. The current data show that chronic microvascular complications of diabetes can be observed in patients with abnormal glucose metabolism in whom glycaemia is higher than optimal but below diagnostic criteria for diabetes. Prediabetes is a heterogenous nosological unit in which particular types are differently characterized and show different correlations with particular kinds of complications. Analysis of the latest research results shows the need to continue studies in a larger population and can imply the need to verify the currently employed criteria of diagnosing diabetes and chronic complications of diabetes in people with prediabetes.

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Long-term efficacy and safety of vildagliptin add-on therapy in type 2 diabetes mellitus with insulin treatment

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2016.11.010 ◽

2017 ◽

Vol 123 ◽

pp. 9-17 ◽

Cited By ~ 9

Author(s):

Ippei Kanazawa ◽

Ken-ichiro Tanaka ◽

Masakazu Notsu ◽

Sayuri Tanaka ◽

Nobuaki Kiyohara ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Insulin Treatment ◽

Efficacy And Safety ◽

Term Efficacy

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Earlier intensified insulin treatment of Type 1 diabetes and its association with long-term macrovascular and renal complications

Diabetic Medicine ◽

10.1111/dme.12897 ◽

2015 ◽

Vol 33 (4) ◽

pp. 463-470 ◽

Cited By ~ 2

Author(s):

B. Rathsman ◽

M. Donner ◽

C. Ursing ◽

T. Nyström

Keyword(s):

Type 1 Diabetes ◽

Insulin Treatment ◽

Renal Complications ◽

Intensified Insulin Treatment

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Prehospital Treatment of Severe Hypoglycaemia: A Comparison of Intramuscular Glucagon and Intravenous Glucose

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00030132 ◽

1998 ◽

Vol 13 (2-4) ◽

pp. 44-50 ◽

Cited By ~ 12

Author(s):

Søren Carstens ◽

Michael Sprehn

Keyword(s):

Recovery Time ◽

Insulin Treatment ◽

Severe Hypoglycaemia ◽

Demographic Data ◽

Intravenous Glucose ◽

Prehospital Treatment ◽

Patient Interviews ◽

Patient Will ◽

Intensified Insulin Treatment

AbstractIntroduction:By introducing an intensified insulin treatment regime to patients with insulin-dependant diabetes mellitus (IDDM), the frequency of long-term complications that the patient will experience has been shown to decrease. The price is an increase in the frequency of severe and mild hypoglycaemic events. Therefore, constant monitoring of these patients is necessary.Hypothesis:This study compares the time until full recovery of IDDM patients with severe hypoglycaemia after treatment with either intravenous glucose or intramuscular glucagon.Methods:14 patients with IDDM with severe hypoglycaemia requiring treatment by the medical staff was randomised to treatment either with 50 ml of 50% glucose intravenously or intramuscular 1 mg glucagon. The time to recovery was recorded. Plasma glucose was measured at fixed intervals to achieve a glycaemia profile. Demographic data were acquired through patient interviews following recovery.Results:Recovery time between the two groups was significantly different statistically. Recovery time ranged for 1 to 3 minutes for those receiving glucose intravenously and 8 to 21 minutes for those receiving intramuscular glucagon. Characteristic glycaemia profiles were identified and differences were present between the two groups with a greater fluctuating pattern for the glucose group compared to the steadily increasing pattern seen after glucagon treatment. Alcohol was believed to be involved in 8 out of the 14 cases, and thereby, is the major confounding factor in this study.Conclusion:Intramuscularly administered glucagon is a safe and reliable alternative to intravenous glucose infusion. The fluctuating glyceamia pattern seen after glucose treatment indicates a low risk for secondary hypoglycaemia. However, further studies are necessary to support this assertion.

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