scholarly journals Diabetic Retinopathy Is Strongly Predictive of Cardiovascular Autonomic Neuropathy in Type 2 Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Chih-Cheng Huang ◽  
Jong-Jer Lee ◽  
Tsu-Kung Lin ◽  
Nai-Wen Tsai ◽  
Chi-Ren Huang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Risk Factor ◽  
Autonomic Neuropathy ◽  
Valsalva Maneuver ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Cardiovascular Autonomic Neuropathy ◽  
Deep Breathing

A well-established, comprehensive, and simple test battery was used here to re-evaluate risk factors for cardiovascular autonomic neuropathy (CAN) in type 2 diabetes. One hundred and seventy-four patients with type 2 diabetes were evaluated through the methods of deep breathing and Valsalva maneuver for correlation with factors that might influence the presence and severity of CAN. The Composite Autonomic Scoring Scale (CASS) was used to grade the severity of autonomic impairment, and CAN was defined as a CASS score ≥2. Results showed that nephropathy, duration of diabetes, blood pressure, uric acid, and the presence of retinopathy and metabolic syndrome significantly correlated with the CASS score. Age may not be a risk factor for diabetic CAN. However, the effects of diabetes on CAN are more prominent in younger patients than in older ones. Diabetic retinopathy is the most significant risk factor predictive of the presence of CAN in patients with type 2 diabetes.

scholarly journals Type-2 Diabetes as a Risk Factor for Severe COVID-19 Infection

2021 ◽  
Vol 9 (6) ◽  
pp. 1211
Author(s):  
Mahnaz Norouzi ◽  
Shaghayegh Norouzi ◽  
Alistaire Ruggiero ◽  
Mohammad S. Khan ◽  
Stephen Myers ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Risk Factor ◽  
Inflammatory Responses ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Diabetic Patients ◽  
Angiotensin Converting Enzyme 2 ◽  
Immune System Dysfunction ◽  
Current Outbreak

The current outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), termed coronavirus disease 2019 (COVID-19), has generated a notable challenge for diabetic patients. Overall, people with diabetes have a higher risk of developing different infectious diseases and demonstrate increased mortality. Type 2 diabetes mellitus (T2DM) is a significant risk factor for COVID-19 progression and its severity, poor prognosis, and increased mortality. How diabetes contributes to COVID-19 severity is unclear; however, it may be correlated with the effects of hyperglycemia on systemic inflammatory responses and immune system dysfunction. Using the envelope spike glycoprotein SARS-CoV-2, COVID-19 binds to angiotensin-converting enzyme 2 (ACE2) receptors, a key protein expressed in metabolic organs and tissues such as pancreatic islets. Therefore, it has been suggested that diabetic patients are more susceptible to severe SARS-CoV-2 infections, as glucose metabolism impairments complicate the pathophysiology of COVID-19 disease in these patients. In this review, we provide insight into the COVID-19 disease complications relevant to diabetes and try to focus on the present data and growing concepts surrounding SARS-CoV-2 infections in T2DM patients.

TCF7L2 gene polymorphisms and type 2 diabetes: association with diabetic retinopathy and cardiovascular autonomic neuropathy

2012 ◽  
Vol 50 (5) ◽  
pp. 789-799 ◽  
Author(s):  
Cinzia Ciccacci ◽  
Davide Di Fusco ◽  
Laura Cacciotti ◽  
Roberto Morganti ◽  
Cinzia D’Amato ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Autonomic Neuropathy ◽  
Gene Polymorphisms ◽  
Cardiovascular Autonomic Neuropathy ◽  
Tcf7l2 Gene

scholarly journals Intensive Risk Factor Management and Cardiovascular Autonomic Neuropathy in Type 2 Diabetes: The ACCORD Trial

Diabetes Care ◽  
2020 ◽  
Vol 44 (1) ◽  
pp. 164-173
Author(s):  
Yaling Tang ◽  
Hetal Shah ◽  
Carlos Roberto Bueno Junior ◽  
Xiuqin Sun ◽  
Joanna Mitri ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Risk Factor ◽  
Autonomic Neuropathy ◽  
Cardiovascular Autonomic Neuropathy ◽  
Risk Factor Management

scholarly journals Time in Range, as a Novel Metric of Glycemic Control, Is Reversely Associated with Presence of Diabetic Cardiovascular Autonomic Neuropathy Independent of HbA1c in Chinese Type 2 Diabetes

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Qingyu Guo ◽  
Pu Zang ◽  
Shaoying Xu ◽  
Wenjing Song ◽  
Zhen Zhang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Logistic Regression ◽  
Autonomic Neuropathy ◽  
Valsalva Maneuver ◽  
Glycemic Variability ◽  
Cardiovascular Autonomic Neuropathy ◽  
Rate Variation ◽  
Time In Range ◽  
The Relationship

Objective. The objective of this study is to investigate the relationship between time in range (TIR), a new metric of continuous glucose monitoring (CGM) and cardiovascular autonomic neuropathy (CAN) in individuals with type 2 diabetes mellitus (T2DM). Methods. A total of 349 individuals with T2DM were enrolled in this study. Evaluating by the standard cardiac autonomic reflex tests (CARTs), there were 228 diabetic individuals without cardiovascular autonomic neuropathy (without confirmed CAN) including absent CAN (n=83 cases) and early CAN (n=145 cases) and 121 diabetic individuals complicated with cardiovascular autonomic neuropathy (CAN) including definite CAN (n=109 cases) and severe CAN (n=12 cases). All patients underwent 3-day CGM. TIR is defined as the time percent during a 24-hour period when the glucose is in the range of 3.9-10 mmol/L. The Spearman analysis was used to analyze the correlation between TIR and CART parameters, total CAN score. The logistic regression was applied to analyze the relationship between TIR and CAN by adjusting for the age, duration of diabetes, sex, lipid situation, serum creatinine, body mass index, blood pressure, HbA1c (%), and other glycemic variability (GV) metrics. Results. The total presence of CAN was 34.67% (definite CAN 31.23% and severe CAN 3.44%). Patients with more severe CAN had lower TIR (P<0.001). With increasing quartiles of TIR, the presence of CAN by severity declined (P<0.05). TIR is inversely correlated with total score of CAN (P<0.001) and positively associated with heart rate variation during the lying to standing, Valsalva maneuver, and deep breathing (P<0.05). The logistic regression found a robust association between TIR and CAN independent of HbA1c and GV metrics. Conclusion. TIR is associated with the presence of CAN independent of HbA1c and GV metrics in Chinese type 2 diabetes.

scholarly journals Elevation of PTPN1 promoter methylation is a significant risk factor of type 2 diabetes in the Chinese population

2017 ◽  
Vol 14 (4) ◽  
pp. 2976-2982 ◽  
Author(s):  
Qing Huang ◽  
Liyuan Han ◽  
Yanfen Liu ◽  
Changyi Wang ◽  
Donghui Duan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Risk Factor ◽  
Promoter Methylation ◽  
Chinese Population ◽  
Significant Risk ◽  
Significant Risk Factor

Cardiovascular Autonomic Reflex Tests and 7 Heart Rate Variability Indices for Early Diagnosis of Cardiovascular Autonomic Neuropathy in Type 2 Diabetes Individuals

2021 ◽  
Vol 17 ◽  
Author(s):  
Yeelen Ballesteros Atala ◽  
Mozânia Reis De Matos ◽  
Denise Engelbrecht Zantut-Wittmann ◽  
Alejandro Rosell Castillo ◽  
Daniele P Santos-Bezerra ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Autonomic Neuropathy ◽  
Valsalva Maneuver ◽  
Cross Sectional Study ◽  
Cardiovascular Autonomic Neuropathy ◽  
Cross Sectional ◽  
Autonomic Reflex

Background: Cardiovascular autonomic neuropathy (CAN) is a common complication of type 2 Diabetes mellitus (T2D), and prevalence varies according to the methodology used. CAN should be diagnosed in the subclinical stage when an intensive treatment of T2D could avoid the progression to irreversible phases. Objective: Determine the prevalence of early involvement (EI) of CAN in T2D individuals comparing two methodologies. Methods: This was a cross-sectional study that included 183 T2D individuals who were monitored in a Tertiary centre. The diagnosis of CAN was based on the results of four cardiovascular autonomic reflex tests (CARTs: expiration-inspiration index, Valsalva maneuver, orthostatic test, and changes in blood pressure after standing) and of seven heart rate variability (7HRV) indices (CARTs plus the spectral analysis). The findings were validated in an independent cohort comprised of 562 T2D individuals followed in a Primary care setting. Results: With the use of 7HRV, 30.6% and 77.8% of individuals in the Tertiary and in the Primary centers, respectively, were classified as without CAN; 25.1% and 15.3% as EI and 44.3% and 6.9% as definitive CAN, respectively. The use of CARTs decreased the proportion of individuals without CAN in both centers (7.1% and 47%) and increased the frequency of EI (30.6% and 36.6%) and definitive CAN (62.3% and 16.4%), respectively. The concordance between both evaluated methodologies was weak. Conclusion: Higher proportions of T2D individuals were diagnosed with EI and with definitive CAN with the use of CARTs.

scholarly journals Urinary Tract Infection due to Extended-spectrum Beta-lactamase Producing Organisms is a Risk Factor for Bacteraemia Among Patients with Type 2 Diabetes Mellitus

2019 ◽  
Vol 31 (1) ◽  
pp. 9-12
Author(s):  
Muhammad Abdur Rahim ◽  
Shahana Zaman ◽  
Ishrat Jahan ◽  
Samira Humaira Habib ◽  
Tabassum Samad ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Urinary Tract Infection ◽  
Risk Factor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Type 2 Diabetic

Introduction: Urinary tract infection (UTI) is common among patients with diabetes mellitus and the aetiological agents are often extended-spectrum beta-lactamase (ESBL) producing bacteria. Diabetic patients with UTI are sometimes complicated by bacteraemia. This study was designed to evaluate whether UTI due to ESBL-positive organisms is a risk factor for bacteraemia among patients with type 2 diabetes mellitus. Methods: This was a cross-sectional analytical study, done in BIRDEM General Hospital, Dhaka, Bangladesh from January to April 2016. Adult (e”18 years) type 2 diabetic subjects of either sex with culture proven UTI were included in this study. All study participants were subjected to undergo blood cultures as well. ESBL-positivity of the infective organisms for UTI was evaluated as possible risk factor for bacteraemia. Results: Total patients were 145 including 119 (82%) females. Eshcerichia coli (112, 77.2%) was the most common aetiological agents followed by Klebsiella pneumoniae (28, 19.3%). In 54 (37.2%) patients UTI was due to ESBL-positive organisms. Ten (6.9%) patients were complicated by bacteraemia [7 (7/ 54, 13%) among patients with UTI due to ESBL-positive organisms and 3 (3/91, 3.3%) among patients with UTI due to non-ESBL organisms]. UTI due to ESBL-positive organisms appeared as a significant risk factor for bacteraemia (OR 4.37, 95% CI 1.08-17.38, p 0.03). Conclusion: Nearly two-fifths of UTI cases were due to ESBL-positive organisms in this study. ESBLpositivity of the causative organisms was a significant risk factor for bacteraemia among type 2 diabetic subjects. Bangladesh J Medicine Jan 2020; 31(1) : 9-12

scholarly journals Past Obesity as well as Present Body Weight Status Is a Risk Factor for Diabetic Nephropathy

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Shu Meguro ◽  
Yusuke Kabeya ◽  
Karin Tanaka ◽  
Toshihide Kawai ◽  
Masuomi Tomita ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Risk Factor ◽  
Diabetic Nephropathy ◽  
Weight Status ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The Past ◽  
Body Weight Status

Aims. We analyzed the prevalence of nephropathy according to past body weight status in Japanese subjects with type 2 diabetes because the influence of past obesity on diabetic complications is not certain.Methods. We examined the prevalence of nephropathy in 2927 subjects with type 2 diabetes mellitus according to current BMI and maximum BMI in the past. We defined “current obesity” as BMI on hospitalization of 25 or more, “previous obesity” as BMI on hospitalization of less than 25 and self-reported maximum BMI in the past of 25 or more, and “continuously lean” as maximum BMI of less than 25.Results. The prevalence of nephropathy was significantly higher in subjects with current obesity (40.6%) or previous obesity (35.6%) than in those who were continuously lean (24.3%) (P<0.017). In logistic regression analysis, previous obesity, as well as current obesity, was a significant risk factor for nephropathy, independent of sex, age, disease duration, hypertension, dyslipidemia, HbA1c, and diabetic retinopathy.Conclusions. Obesity in the past, as well as the present body weight status, was a risk factor for diabetic nephropathy.

scholarly journals Cardiovascular Autonomic Neuropathy Is an Independent Risk Factor for Left Ventricular Diastolic Dysfunction in Patients with Type 2 Diabetes

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Jiewen Jin ◽  
Weimin Wang ◽  
Liangying Zhu ◽  
Tianwei Gu ◽  
Qing Niu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Risk Factor ◽  
Diastolic Dysfunction ◽  
Autonomic Neuropathy ◽  
Independent Risk Factor ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Cardiovascular Autonomic Neuropathy ◽  
Ventricular Diastolic Dysfunction

Aim. This study aimed to evaluate the association between cardiovascular autonomic neuropathy (CAN) and left ventricular diastolic dysfunction (LVDD) in type 2 diabetes patients. Methods. 315 type 2 diabetes patients from inpatients of Drum Tower Hospital were included and classified into no CAN (NCAN), possible CAN (PCAN), and definite CAN (DCAN) based on cardiovascular autonomic reflex tests. The left ventricular diastolic function was assessed by tissue Doppler imaging echocardiography. Results. The distribution of NCAN, PCAN, and DCAN was 11.4%, 51.1%, and 37.5%, respectively. The proportion of LVDD increased among the groups of NCAN, PCAN, and DCAN (39.4%, 45.3%, and 68.0%, P=0.001). Patients with DCAN had higher filling pressure (E/e′ ratio) (10.9±2.7 versus 9.4±2.8, P=0.013) and impaired diastolic performance (e′) (6.8±1.7 versus 8.6±2.4, P=0.004) compared with NCAN. CAN was found to be an independent risk factor for LVDD from the multivariate regression analysis (OR = 1.628, P=0.009, 95% CI 1.131–2.344). Conclusions. Our results indicated that CAN was an independent risk marker for the presence of LVDD in patients with diabetes. Early diagnosis and treatment of CAN are advocated for preventing LVDD in type 2 diabetes.

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