Relationship of initial glucose level and all-cause death in patients with ischaemic stroke: the roles of diabetes mellitus and glycated hemoglobin level

BACKGROUND: Adequate glycemic control can significantly reduce the risk of developing cardiovascular events. However, until now, glycaemic targets in aged patients remain a subject of discussion, especially in the conditions of the combined development of Type 2 Diabetes Mellitus (T2DM) and ischemic heart disease (IHD).AIMS: To examine the structural and functional heart parameters in patients with IHD associated with T2DM and the rhythmoinotropic responses of their isolated myocardium depending on glycated hemoglobin level.MATERIALS AND METHODS: The study included 44 patients with a diagnosis of "chronic IHD associated with T2DM", of which 2 groups were formed. Patients with glycated hemoglobin level (HbA1c) <8% were included in the 1st group, and patients with HbA1c ≥8% were included in the 2nd group. The structural and functional heart parameters obtained with ultrasonography, and the rhythmoinotropic responses of myocardium in patients ex vivo were analyzed using the right atrial appendage fragments obtained during elective coronary artery bypass graft. The inotropic response of muscle strips at a basic stimulation frequency of 0,5 Hz to testing influences was assessed. An extrasystolic test and post-rest test were performed.RESULTS: It was found that extrasystolic contractions of isolated myocardial strips in patients of the 2nd group appeared at shorter extrasystolic intervals, which indicates a greater excitability of the myocardium in patients of this group. Postextrasystolic muscle contractions in patients of the 2nd group had significant potentiation. The amplitude of the muscle strips contractions in patients of both groups was potentiative after short rest periods. However, with an increase in the rest duration, potentiation of contractions was observed only in the group with a higher HbA1c level. According to the ultrasonography data, it was found that the values of the endsystolic and diastolic volumes, the interventricular septum thickness and the left ventricular (LV) myocardium mass were significantly lower in the patients of the 1st group compared with the corresponding indicators in the patients of the 2nd group. The early LV filling velocity (peak E) was significantly lower in the patients of the 1st group, which indicates a slower LV relaxation. At the same time, the rapid LV filling velocity did not have a significant intergroup difference, but this indicator exceeded the reference values in both groups.CONCLUSIONS: With a moderately increased glycemic level (9,2 [8,0; 10,3]%), the structural and functional heart parameters are preserved both at the level of the isolated myocardial tissue and at the level of the whole heart.

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The Effect of Gaseous Ozone Therapy in Conjunction with Periodontal Treatment on Glycated Hemoglobin Level in Subjects with Type 2 Diabetes Mellitus: An Unmasked Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17155467 ◽

2020 ◽

Vol 17 (15) ◽

pp. 5467 ◽

Cited By ~ 1

Author(s):

Biagio Rapone ◽

Elisabetta Ferrara ◽

Massimo Corsalini ◽

Ilaria Converti ◽

Felice Roberto Grassi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycated Hemoglobin ◽

Hemoglobin Level ◽

Periodontal Treatment ◽

Ozone Therapy ◽

Inflammatory Parameters ◽

Glycated Hemoglobin Level

Background: It is established that inflammation is involved in the pathogenesis of Type 2 Diabetes Mellitus (T2DM) by promoting insulin resistance and impaired beta cell function in the pancreas. Among the hypothesized independent risk factors implicated in the pathogenetic basis of disease, periodontal infection has been proposed to promote an amplification of the magnitude of the advanced glycation end product (AGE)-mediated upregulation of cytokine synthesis and secretion. These findings suggest an interrelationship between periodontal disease and type 2 diabetes, describing poor metabolic control in subjects with periodontitis as compared to nondiabetic subjects and more severe periodontitis in subjects with T2DM as compared to a healthy population, with a significant positive correlation between periodontal inflammatory parameters and glycated hemoglobin level. Results from clinical trials show that periodontal treatment is able to improve glycemic control in subjects with diabetes. Many therapeutic strategies have been developed to improve periodontal conditions in conjunction with conventional treatment, among which ozone (O3) is of specific concern. The principal aim of this trial was to compare the clinical effectiveness of an intensive periodontal intervention consisting of conventional periodontal treatment in conjunction with ozone gas therapy in reducing glycated hemoglobin level in type 2 diabetic patients and standard periodontal treatment. Methods: This study was a 12-month unmasked randomized trial and included 100 patients aged 40–74 years older, with type 2 diabetes mellitus diagnosed. All the patients received conventional periodontal treatment, or periodontal treatment in conjunction with ozone gas therapy in a randomly assigned order (1:1). The primary outcome was a clinical measure of glycated hemoglobin level at 3, 6, 9 and 12 months from randomization. Secondary outcomes were changes in periodontal inflammatory parameters. Results: At 12 months, the periodontal treatment in conjunction with ozone gas therapy did not show significant differences than standard therapy in decreasing glycated hemoglobin (HbA1C) level and the lack of significant differences in balance is evident. Conclusions: Although the change was not significant, periodontal treatment in conjunction with the gaseous ozone therapy tended to reduce the levels of glycated hemoglobin. The study shows a benefit with ozone therapy as compared to traditional periodontal treatment.

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The effects of diabetes mellitus type 1 on children’s audiovestibular system: a randomized case control study

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00069-x ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Reham Rafei El Shafei ◽

Sherif Guindi ◽

Amr El Refaie ◽

Erini Mikhail ◽

Remon Magdy Yousef

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Glycated Hemoglobin ◽

Diabetes Mellitus Type 1 ◽

Case Control ◽

Hemoglobin Level ◽

System A ◽

Glycated Hemoglobin Level

Abstract Background Children with diabetes mellitus type 1 have many deficits, including neuropathy, retinopathy, and nephropathy, all of which compromise their activity and daily functional status. Vestibular dysfunction is another possible complication of diabetes and may increase the risk of falls. Despite diabetes mellitus prevalence, few studies evaluated its effect on hearing, and even fewer examined the effect on the audiovestibular system. A randomized case control pilot study design was implemented to evaluate the effect of type 1 diabetes mellitus on the audiovestibular system of children. Results The study included 50 children divided into 2 groups; the study group included 25 children suffering from type 1 diabetes mellitus, and the control group included 25 patients who were known to be nondiabetics. Both groups underwent basic audiological and vestibular test battery. Only 16% showed different degrees of hearing loss. Regarding vestibular assessment, saccadic eye tracking showed the highest degree of abnormal results within the study group (80%). Correlation between saccade findings among cases and the risk factors of diabetes like duration, glycated hemoglobin level, diabetic ketoacidosis, and hypoglycemic coma attacks indicated statistically significant positive correlation between saccade latency and glycated hemoglobin level. Conclusion This study proposed that type 1 diabetes mellitus can affect the audiovestibular system of children even in the absence of symptoms. Accordingly, appropriate early rehabilitative management should be planned in an attempt to avoid further complications.

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Supplementation of coenzyme Q10 and α-tocopherol lowers glycated hemoglobin level and lipid peroxidation in pancreas of diabetic rats

Nutrition Research ◽

10.1016/j.nutres.2007.12.005 ◽

2008 ◽

Vol 28 (2) ◽

pp. 113-121 ◽

Cited By ~ 29

Author(s):

Cristina M. Sena ◽

Elsa Nunes ◽

Aline Gomes ◽

Maria S. Santos ◽

Teresa Proença ◽

...

Keyword(s):

Lipid Peroxidation ◽

Coenzyme Q10 ◽

Glycated Hemoglobin ◽

Diabetic Rats ◽

Hemoglobin Level ◽

Glycated Hemoglobin Level

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Glycemic Status, Lipid Profile and Proteinuria in Diabetic nephropathy

Journal of Nepal Medical Association ◽

10.31729/jnma.115 ◽

2010 ◽

Vol 49 (178) ◽

Cited By ~ 3

Author(s):

P Jha ◽

BKL Das ◽

S Shrestha ◽

S Majhi ◽

L Chandra ◽

...

Keyword(s):

Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Lipid Profile ◽

Glycated Hemoglobin ◽

Fasting Blood Glucose ◽

Diabetic Patients ◽

Age Group ◽

Arterial Blood ◽

Cardiovascular Morbidity And Mortality ◽

Glycated Hemoglobin Level

INTRODUCTION: Diabetic nephropathy is one of the major complications of Diabetes Mellitus characterized by persistent albuminuria, elevated arterial blood pressure, a relentless decline in glomerular filtration rate (GFR) and a high risk of cardiovascular morbidity and mortality. METHODS: In this study, urinary micro-albumin estimation was done in 177 diabetic patients. This study aims to ascertain association of glycemicstatus, lipid profile and proteinuria in Type 2 Diabetes Mellitus with nephropathy. RESULTS: Among 177 patients, 26 had frank proteinuria, 79 had micro-albuminuria and 72 were without proteinuria. Increased frequency ofproteinuria was seen in male than female. Micro-albuminuria and frank proteinuria was seen more in older age group. The multiple comparisons showed the significantly increased levels of urea, creatinine, fasting blood glucose in micro-albuminuria and overt proteinuria patients in comparison to without proteinuria. Glycated hemoglobin level was increased with the increasing age group particularly in overt proteinuric patients. CONCLUSIONS: The glycemic control, monitoring of lipid profile and early urinary protein estimation with better management may delay diabetic nephropathy or its further complications in diabetes mellitus. KEYWORDS: diabetes mellitus, diabetic nephropathy, frank proteinuria, glycated hemoglobin, micro-albuminuria.

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Association between severity of obstructive sleep apnea and glycated hemoglobin level in Japanese individuals with and without diabetes

Endocrine Journal ◽

10.1507/endocrj.ej17-0356 ◽

2018 ◽

Vol 65 (1) ◽

pp. 121-127 ◽

Cited By ~ 6

Author(s):

Hideaki Kurosawa ◽

Yoshifumi Saisho ◽

Koichi Fukunaga ◽

Mizuha Haraguchi ◽

Wakako Yamasawa ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Glycated Hemoglobin ◽

Hemoglobin Level ◽

Obstructive Sleep ◽

Glycated Hemoglobin Level

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INTERRELATION OF HEMORHEOLOGICAL PARAMETERS WITH GLUCOSE AND GLYCATED HEMOGLOBIN IN PATIENTS WITH DIABETES MELLITUS TYPE2

Тромбоз, гемостаз и реология ◽

10.25555/thr.2018.2.0836 ◽

2018 ◽

Author(s):

А.В. Муравьев ◽

И.А. Тихомирова ◽

С.В. Булаева ◽

Ю.В. Малышева ◽

А.В. Замышляев

Keyword(s):

Diabetes Mellitus ◽

Glycated Hemoglobin ◽

Healthy Individuals ◽

Glucose Content ◽

Metabolic Hormones ◽

Metabolism Regulation ◽

Patients With Diabetes ◽

Glycated Hemoglobin Level ◽

Blood Transport

Введение. Нарушения реологических свойств крови при сахарном диабете 2 типа (СД-2) может приводить к снижению микрососудистой перфузии. Основной механизм, вероятно, связан с ухудшением микрореологии эритроцитов, в том числе из-за высокого содержания глюкозы и гликозилирования белков мембран клеток. Цель исследования: провести анализ связи гемореологических характеристик цельной крови и эритроцитов с содержанием глюкозы и гликированного гемоглобина и выявить влияние ряда метаболических гормонов на микрореологию эритроцитов у больных СД-2. Материалы и методы. У 30 больных СД-2 регистрировали параметры гемореологического профиля. Наряду с измерениями вязкости, деформируемости эритроцитов (ДЭ) и их агрегации (АЭ) определяли содержание глюкозы, гликированного гемоглобина и белков плазмы (альбуминов, глобулинов, фибриногена). В in vitro исследованиях регистрировали микрореологические характеристики эритроцитов после их инкубации с глюкозой и рядом метаболических гормонов (инсулином, глюкагоном, адреналином). Результаты. Наиболее существенные отличия гемореологических профилей у больных СД-2 от данных здоровых лиц были в их микрореологической части. Значения глюкозы и гликированного гемоглобина более выражено коррелировали с показателями гемореологического профиля у больных СД-2, чем у здоровых лиц: коэффициент корреляции между АЭ и концентраций глюкозы у больных СД-2 составил 0,660, в контрольной группе — 0,480. Под влиянием инсулина ДЭ достоверно повышалась, а АЭ, напротив, снижалась (p < 0,05). При инкубации эритроцитов с глюкагоном у больных СД-2 и у здоровых лиц АЭ была снижена на сходную величину. Адреналин в трех концентрациях умеренно повышал ДЭ (p < 0,05), а наблюдавшийся прирост АЭ был наибольшим при низкой концентрации гормона (0,01 мкМ). Заключение. Анализ параметров гемореологического профиля у больных СД-2 свидетельствует о нарушениях текучести крови и снижении ее транспортных возможностей. Также было показано, что гормоны, участвующие в регуляции метаболизма, оказывают прямое воздействие на микрореологию эритроцитов. Introduction. Disorders of blood rheological properties in diabetes mellitus type 2 (DM-2) can lead to reduction of microvascular perfusion. The main mechanism is probably associated with impairment of erythrocytes microrheology and also due to high glucose content and glycosylation of cell membrane proteins. Aim: to analyze the relationship between hemorheological characteristics of whole blood and erythrocytes with glucose content and glycated hemoglobin level, and to reveal the infl uence of metabolic hormones on erythrocytes microrheology in patients with DM-2. Materials and methods. In 30 patients with DM-2 we determined hemorheological parameters, blood viscosity, erythrocytes deformability (ED), erythrocytes aggregation (EA), glucose and glycated hemoglobin content, plasma proteins (albumins, globulins, fibrinogen) levels. In in vitro studies we recorded the microrheological characteristics of erythrocytes after their incubation with glucose and with some metabolic hormones (insulin, glucagon, adrenaline). Results. Microrheological parameters in patients with DM-2 diff ered signifi cantly from the parameters in healthy individuals. Glucose and glycated hemoglobin values more evidently correlated with hemorheological parameters in patients with DM-2 than in healthy individuals: the correlation coeffi cient between EA and glucose concentration in patients with DM-2 was 0.660, in healthy individuals — 0.480. Under insulin stimulus ED signifi cantly increased and AE, on contrary, decreased (p < 0.05). During erythrocytes incubation with glucagon EA similar reduced in patients with DM-2 and in healthy individuals. Adrenaline in three concentrations moderately increased ED (p < 0.05), and the observed EA increasing was greatest at low hormone concentration (0.01 μM). Conclusion. Analysis of hemorheological parameters in patients with DM-2 showed disorders of blood fl uidity and decreasing of blood transport capacity. It was also shown that hormones involved in metabolism regulation had a direct effect on erythrocytes microrheology.

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