scholarly journals Plasma phenylalanine and tyrosine and their interactions with diabetic nephropathy for risk of diabetic retinopathy in type 2 diabetes

2020 ◽  
Vol 8 (1) ◽  
pp. e000877
Author(s):  
Hui-Huan Luo ◽  
Juan Li ◽  
Xiao-Fei Feng ◽  
Xiao-Yu Sun ◽  
Jing Li ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Diabetic Nephropathy ◽  
Renal Dysfunction ◽  
Factor Model ◽  
Characteristic Curve ◽  
Additive Interaction ◽  
Predictive Values ◽  
Plasma Phenylalanine

ObjectiveTight control of hyperglycemia reduces risk of diabetic retinopathy (DR), but the residual risk remains high. This study aimed to explore relationships between plasma phenylalanine and tyrosine with DR in type 2 diabetes (T2D) and interactions between the two amino acids, and their secondary interaction with renal dysfunction.Research design and methodsWe extracted data of 1032 patients with T2D from tertiary hospital consecutively from May 2015 to August 2016. Binary logistic regression models with restricted cubic spline were used to check potential non-linear associations and to obtain ORs and 95% CIs of variables under study. Addictive interaction was estimated using relative excess risk due to interaction, attributable proportion due to interaction and synergy index. Area under the receiver operating characteristic curve was used to check increased predictive values.ResultsOf 1032 patients, 162 suffered from DR. Copresence of low phenylalanine and low tyrosine increased DR risk (OR 6.01, 95% CI 1.35 to 26.8), while either of them alone did not have a significant effect with significant additive interaction. Presence of diabetic nephropathy further increased the OR of copresence of low phenylalanine and low tyrosine for DR to 25.9 (95% CI 8.71 to 76.9) with a significant additive interaction. Inclusion of phenylalanine and tyrosine in a traditional risk factor model significantly increased area under the curve from 0.81 to 0.83 (95% CI 0.80 to 0.86).ConclusionPlasma low phenylalanine and low tyrosine worked independently and synergistically to increase the risk of DR in T2D. Presence of renal dysfunction further amplified the effect of copresence of low phenylalanine and low tyrosine on DR risk.

STUDY OF PREVALENCE AND CLINICAL PROFILE OF NEPHROPATHY AND RETINOPATHY IN TYPE 2 DIABETES PATIENTS AT TERTIARY CARE CENTER, UDAIPUR

2021 ◽  
pp. 6-8
Author(s):  
Yash Salil Patel
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Diabetic Nephropathy ◽  
Microvascular Complications ◽  
Tertiary Care ◽  
Positive Family History ◽  
Diabetic Patients

Microvascular complications of Type 2 Diabetes Mellitus (T2DM), (retinopathy and nephropathy) have a similar etiopathogenetic mechanism besides genetic predisposition. Even though these two complications frequently co-exist, their frequency varies. The association of these two signicant complications and their coexistence needs a relook. To study prevalence of retinopathy and nephropathy in Type 2 diabetes mel Aim: litus. Comparison of diabetic retinopathy and nephropathy in Type 2 diabetes mellitus and its correlation of diabetic retinopathy and nephropathy with duration of illness and various risk factors that affects development, progression and severity of diabetic retinopathy and nephropathy. 100 diabetic patients were taken up for study for a period of one year meeti Methodology: ng the criteria for the present study. Detailed history was taken from patient and meticulous examination was done of all patients with special emphasis on renal and ophthalmic symptoms. Clinical data and investigation prole was tabulated. Statistical analysis was done. Among 100 patients, 22 had diabetic retinopathy. Among patients with diab Results & Conclusion: etic retinopathy, 68.18% patients had positive family history. Among 100 patients, 32 had diabetic nephropathy, mean FBS was 207 mg%, PPBS was 317.8 mg% and mean HbA was 9.2%. Among patients with diabetic retinopathy, mean FBS was 211 mg%, PPBS was 324.9 1c mg%, HbA was 9.5%. From this study it is found that diabetic nephropathy starts earlier than retinopathy. In this study 1c hypertension was found to accelerate progression into nephropathy and retinopathy.

scholarly journals Validity of ICD-10-CM codes for determination of diabetes type for persons with youth-onset type 1 and type 2 diabetes

2019 ◽  
Vol 7 (1) ◽  
pp. e000547 ◽  
Author(s):  
Gloria C Chi ◽  
Xia Li ◽  
Sara Y Tartof ◽  
Jeff M Slezak ◽  
Corinna Koebnick ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Predictive Value ◽  
Gold Standard ◽  
Characteristic Curve ◽  
Diabetes Type ◽  
Predictive Values ◽  
Icd 10

ObjectiveDiagnosis codes might be used for diabetes surveillance if they accurately distinguish diabetes type. We assessed the validity ofInternational Classification of Disease, 10th Revision, Clinical Modification(ICD-10-CM) codes to discriminate between type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) among health plan members with youth-onset (diagnosis age <20 years) diabetes.Research design and methods. Diabetes case identification and abstraction of diabetes type was done as part of the SEARCH for Diabetes in Youth Study. The gold standard for diabetes type is the physician-assigned diabetes type documented in patients’ medical records. Using all healthcare encounters with ICD-10-CM codes for diabetes, we summarized codes within each encounter and determined diabetes type using percent of encounters classified as T2DM. We chose 50% as the threshold from a receiver operating characteristic curve because this threshold yielded the largest Youden’s index. Persons with ≥50% T2DM-coded encounters were classified as having T2DM. Otherwise, persons were classified as having T1DM. We calculated sensitivity, specificity, positive and negative predictive values, and accuracy overall and by demographic characteristics.ResultsAccording to the gold standard, 1911 persons had T1DM and 652 persons had T2DM (mean age (SD): 19.1 (6.5) years). We obtained 90.6% (95% CI 88.4% to 92.9%) sensitivity, 96.3% (95% CI 95.4% to 97.1%) specificity, 89.3% (95% CI 86.9% to 91.6%) positive predictive value, 96.8% (95% CI 96.0% to 97.6%) negative predictive value, and 94.8% (95% CI 94.0% to 95.7%) accuracy for discriminating T2DM from T1DM.ConclusionsICD-10-CM codes can accurately classify diabetes type for persons with youth-onset diabetes, showing promise for rapid, cost-efficient diabetes surveillance.

scholarly journals Diabetic retinopathy as an independent predictor of subclinical cardiovascular disease: baseline results of the PRECISED study

2019 ◽  
Vol 7 (1) ◽  
pp. e000845 ◽  
Author(s):  
Rafael Simó ◽  
Jordi Bañeras ◽  
Cristina Hernández ◽  
José Rodríguez-Palomares ◽  
Filipa Valente ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Diabetic Retinopathy ◽  
Characteristic Curve ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Subclinical Cardiovascular Disease ◽  
Type 2 Diabetic ◽  
Subclinical Cvd

ObjectiveDetection of subclinical cardiovascular disease (CVD) has significant impact on the management of type 2 diabetes. We examined whether the assessment of diabetic retinopathy (DR) is useful for identifying patients at a higher risk of having silent CVD.Research design and methodsProspective case–control study comprising 200 type 2 diabetic subjects without history of clinical CVD and 60 age-matched non-diabetic subjects. The presence of subclinical CVD was examined using two parameters: (1) calcium coronary score (CACs); (2) composite of CACs >400 UA, carotid plaque ≥3 mm, carotid intima–media thickness ratio >1, or the presence of ECG changes suggestive of previous asymptomatic myocardial infarction. In addition, coronary angio-CT was performed. DR was assessed by slit-lamp biomicroscopy and retinography.ResultsType 2 diabetic subjects presented higher CACs than non-diabetic control subjects (p<0.01). Age, male gender, and the presence of DR were independently related to CACs >400 (area under the receiver operating characteristic curve (AUROC) 0.76). In addition, an inverse relationship was observed between the degree of DR and CACs <10 AU. The variables independently associated with the composite measurement of subclinical CVD were age, diabetes duration, the glomerular filtration rate, microalbuminuria, and the presence of DR (AUROC 0.71). In addition, a relationship (p<0.01) was observed between the presence and degree of DR and coronary stenosis.ConclusionsThe presence and degree of DR is independently associated with subclinical CVD in type 2 diabetic patients. Our results lead us to propose a rationalized screening for coronary artery disease in type 2 diabetes based on prioritizing patients with DR, particularly those with moderate–severe degree.

scholarly journals SUN-655 Helicobacter Pylori Infection Is Not Associated with Diabetes Among a Cohort of Diabetic Patients in Alexandria City, Egypt

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Mohamed Fahmy Amara
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Helicobacter Pylori ◽  
Diabetic Retinopathy ◽  
Diabetic Nephropathy ◽  
Helicobacter Pylori Infection ◽  
Diabetes Group ◽  
Significant Difference

Abstract Abstract: Helicobacter Pylori infection is one of the most common bacterial infections in Egypt. A mounting body of evidence suggests the association of H Pylori infection with diabetes. H.Pylori is implicated in increasing insulin resistance and promoting chronic inflammation, resulting in the development of diabetes. This study aimed to estimate the prevalence of H.Pylori infection among a cohort of patients with diabetes in Alexandria city, Egypt and the possible role of this condition in the control of the glycemic profile. We also investigated the correlation between H.pylori infection and the presence of diabetes-related complications (diabetic nephropathy and retinopathy). The study was conducted on 300 subjects classified into three groups; Group (I): 100 patients with type 2 diabetes, Group (II): 100 subjects with type 1 diabetes, Group (III): 100 non-diabetic control subjects. Participants were subjected to detailed history taking and thorough clinical examination. Routine laboratory investigations were done, including HbA1c and fasting plasma glucose. Stool antigen test, on- site Helicobacter Pylori Ag Rapid Test-cassette was done. The mean duration of diabetes in type 2 diabetes was 8.18±5.87 years, while the mean duration in type 1 was 4.88± 3.02 years, which was statistically significante (p&lt; 0.05). The results of the presented study showed that there was no significant difference in the prevalence of Helicobacter Pylori infection between type 1 and type 2 patients with diabetes (31% Vs 38%, p=0.298), moreover; after adjustment for age, there was no significant difference in the prevalence of Helicobacter Pylori infection among either group with diabetes (Group 1 and group 2) compared to the control group, (p= 0.756 and 0.066) respectively. There was no statistically significant association between the presence of Helicobacter Pylori infection in both type 1 and type 2 diabetes, and an elevated HbA1c level above 6.5%.(p= 0.772 and p=0.524) respectively. The prevalence of diabetic nephropathy in patients with type 2 and type 1 diabetes was 5% and 3% respectively, which was non-statistically significant (p=0.721). While the prevalence of diabetic retinopathy was 11% among patients with type 2 compared to 1% among patients with type 1 diabetes, which was statistically significant (p=0.003). There was no statistically significant correlation between Helicobacter Pylori infection and the presence of diabetic nephropathy or diabetic retinopathy. Helicobacter Pylori infection was not associated with diabetes and did not affect the HbA1c level. Helicobacter Pylori infection was not correlated to the presence of either diabetic nephropathy or diabetic retinopathy among both patients with type 2 and type 1 diabetes. Nothing to Disclose: MA, MM, AH No Sources of Research Support

STUDY OF LIPOPROTEIN(A) IN TYPE 2 DIABETIC SUBJECTS AND ITS RELATIONSHIP TO DIABETIC MICROVASCULAR COMPLICATIONS AT MMCH, MADHUBANI, BIHAR

2021 ◽  
pp. 18-20
Author(s):  
Dilip Kumar Sah ◽  
Ajay Kumar Lal Das ◽  
Debarshi Jana
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Diabetic Nephropathy ◽  
Vascular Complications ◽  
Lipoprotein A ◽  
Duration Of Diabetes ◽  
The Relationship

AIM: To estimate the level of serum lipoprotein (a) [Lp (a)] in type 2 diabetes mellitus patients and to determine the relationship between Lp(a) in type 2 diabetes mellitus patients and micro-vascular complications. METHODS: A cross sectional study was performed that enrolled 144 subjects with type 2 diabetes mellitus above the age of 25 years attending outpatient Department of Medicine, Madhubani Medical College & Hospital, Madhubani, Bihar. Lp(a) levels were measured quantitatively in venous samples using Turbidimetric Immunoassay in all subjects. Each patient was evaluated for micro vascular complications, namely diabetic retinopathy, nephropathy and neuropathy. The relationship between Lp(a) levels and the micro vascular complications was assessed by univariate analysis. RESULTS: Mean age of cases was 53.93 ± 10.74 years with a male to female ratio of 1.3:1. Mean duration of diabetes was 9.53 ± 7.3 years. Abnormal Lp(a) levels (≥ 30 mg/dL) were observed in 38 (26.4%) diabetic subjects. Seventy-eight (54.16%) cases had diabetic nephropathy and signicantly higher Lp(a) levels were found among these cases [Median 28.2 mg/dL(Interquartile range; IQR 24.4-33.5) vs 19.3 mg/dL(IQR 14.7- 23.5); P< 0.05]. Retinopathy was present among 66 (45.13%) cases and peripheral neuropathy was detected among 54 (37.5%) cases. However, Lp(a) levels were not signicantly different among those with or without retinopathy and neuropathy. Positive correlation was found between higher Lp(a) levels and duration of diabetes (r = 0.165, P< 0.05) but not with HbA1c values (r = – 0.083). CONCLUSION: Abnormal Lp(a) levels were found among 26.4% of diabetic subjects. Patients with diabetic nephropathy had higher Lp(a) levels. No association was found between Lp(a) levels and diabetic retinopathy or neuropathy. Longer duration of diabetes correlated with higher Lp(a) levels.

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