scholarly journals HbA1C Variability Is Strongly Associated with Development of Macroalbuminuria in Normal or Microalbuminuria in Patients with Type 2 Diabetes Mellitus: A Six-Year Follow-Up Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Wen-Chan Chiu ◽  
Yun-Ru Lai ◽  
Ben-Chung Cheng ◽  
Chih-Cheng Huang ◽  
Jung-Fu Chen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glycemic Variability ◽  
Rank Test ◽  
Follow Up Study ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Hba1c Variability

Background. Glycemic variability is associated with higher risk of microvascular complications in patients with type 2 diabetes. Aim. To test the hypothesis that glycemic variability can contribute to progression to macroalbuminuria in normal or microalbuminuria in patients with type 2 diabetes. Design. This prospective study enrolled 193 patients with type 2 diabetes at a tertiary medical center. Methods. For each patient, the intrapersonal glycemic variability (mean, SD, and coefficient of variation of HbA1c) was calculated using all measurements obtained three years before the study. Patients were divided into four groups stratified by both urine albumin/creatinine ratio and HbA1c-SD. The presence of macroalbuminuria was assessed with Kaplan–Meier plots and compared by log-rank test. Results. Of the 193 patients, 83 patients were in the macroalbuminuria state. Patients in the initial macroalbuminuria group after enrollment had the highest diabetes duration, mean, CV-HbA1c and HbA1c-SD, and uric acid level, and the lowest estimate glomerular filtration rate, followed by subsequent macroalbuminuria and without macroalbuminuria groups. Patients with microalbuminuria and high HbA1c-SD showed the highest progression rate to macroalbuminuria, after a six-year follow-up study by Kaplan–Meier Plots and compared by log-rank test. Conclusions. Higher HbA1C variability is more likely to progress to macroalbuminuria in those patients who are already in a microalbuminuria state. We recommend that clinicians should aggressively control blood glucose to an acceptable range and avoid blood glucose fluctuations by individualized treatment to prevent renal status progression.

scholarly journals Adherence to yoga and its resultant effects on blood glucose in Type 2 diabetes: A community-based follow-up study

2017 ◽  
Vol 10 (1) ◽  
pp. 29 ◽  
Author(s):  
Aarti Jagannathan ◽  
Praveen Angadi ◽  
Arun Thulasi ◽  
Vinod Kumar ◽  
K Umamaheshwar ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Community Based ◽  
Follow Up Study

scholarly journals Poor Control of Plasma Triglycerides Is Associated with Early Decline of Estimated Glomerular Filtration Rates in New-Onset Type 2 Diabetes in China: Results from a 3-Year Follow-Up Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Chuan Wang ◽  
Lingshu Wang ◽  
Kai Liang ◽  
Fei Yan ◽  
Xinguo Hou ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Kidney Function ◽  
Renal Outcome ◽  
Onset Type ◽  
Follow Up Study ◽  
New Onset

Objective. Diabetic kidney disease (DKD) is the most common cause of end-stage renal disease (ESRD). Even after strict control of obesity, hyperglycemia, and hypertension, some patients still progress rapidly. Previous studies suggested diabetic dyslipidemia might be one of the factors responsible for this high residual risk. This study aims to explore the impact of long-term lipid control on renal outcome in new-onset type 2 diabetes mellitus (T2DM). Methods. We conducted a 3-year follow-up study, involving 283 subjects with new-onset T2DM, and observed the effect of baseline and follow-up metabolic abnormalities, especially dyslipidemia, on the early damage of kidney function using multiple logistic regression analysis. Results. After 3 years follow-up, patients achieved a better control of body weight, hypertension, and blood glucose. The most reduced eGFR group shared the least reduced BMI and LDL-C, as well as the greatest increase in TG levels. Only TG in the follow-up, not any of the baseline data, nor obesity, blood glucose, BP, or LDL-C in the follow-up, was found to be significantly correlated with the most reduced eGFR. Compared with patients with constantly abnormal TG levels, the risks were even higher in the subjects who experienced a transition from normal TG to hypertriglyceridemia ( OR = 2.576 versus OR = 2.184 , after multiple adjustment), and by tight controlling of TG, patients started with abnormal baseline TG levels could reduce the risk of DKD progression to the same low levels as the TG-constantly-normal group. Conclusion. This study emphasized the importance of long-term TG control in East Asian patients with new-onset T2DM: TG control can delay the decline of kidney function in the early stage of DKD, and reversal of hypertriglyceridemia may undo the risks of the past. It is time to pay more attention to the control of TG in new-onset T2DM.

Colorectal Liver Metastases - Does the Number of Lesions Determine the Sensibility of Resection?

Swiss Surgery ◽  
2000 ◽  
Vol 6 (1) ◽  
pp. 6-10
Author(s):  
Knoefel ◽  
Brunken ◽  
Neumann ◽  
Gundlach ◽  
Rogiers ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Chirurgische Entfernung

Die komplette chirurgische Entfernung von Lebermetastasen bietet Patienten nach kolorektalem Karzinom die einzige kurative Chance. Es gibt jedoch eine, anscheinend unbegrenzte, Anzahl an Parametern, die die Prognose dieser Patienten bestimmen und damit den Sinn dieser Therapie vorhersagen können. Zu den am häufigsten diskutierten und am einfachsten zu bestimmenden Parametern gehört die Anzahl der Metastasen. Ziel dieser Studie war es daher die Wertigkeit dieses Parameters in der Literatur zu reflektieren und unsere eigenen Patientendaten zu evaluieren. Insgesamt konnte von 302 Patienten ein komplettes Follow-up erhoben werden. Die gebildeten Patientengruppen wurden mit Hilfe einer Kaplan Meier Analyse und konsekutivem log rank Test untersucht. Die Literatur wurde bis Dezember 1998 revidiert. Die Anzahl der Metastasen bestätigte sich als ein prognostisches Kriterium. Lagen drei oder mehr Metastasen vor, so war nicht nur die Wahrscheinlichkeit einer R0 Resektion deutlich geringer (17.8% versus 67.2%) sondern auch das Überleben der Patienten nach einer R0 Resektion tendenziell unwahrscheinlicher. Das 5-Jahres Überleben betrug bei > 2 Metastasen 9% bei > 2 Metastasen 36%. Das 10-Jahres Überleben beträgt bislang bei > 2 Metastasen 0% bei > 2 Metastasen 18% (p < 0.07). Die Anzahl der Metastasen spielt in der Prognose der Patienten mit kolorektalen Lebermetastasen eine Rolle. Selbst bei mehr als vier Metastasen ist jedoch gelegentlich eine R0 Resektion möglich. In diesen Fällen kann der Patient auch langfristig von einer Operation profitieren. Das wichtigere Kriterium einer onkologisch sinnvollen Resektabilität ist die Frage ob technisch und funktionell eine R0 Resektion durchführbar ist. Ist das der Fall, so sollte auch einem Patienten mit mehreren Metastasen die einzige kurative Chance einer Resektion nicht vorenthalten bleiben.

Hormonal factors and type 2 diabetes risk in women: a 22 year follow-up study on more than 83 000 women from the E3N cohort study

2019 ◽  
Author(s):  
Sopio Tatulashvili ◽  
Gaelle Gusto ◽  
Beverley Balkau ◽  
Emmanuel Cosson ◽  
Fabrice Bonnet ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Diabetes Risk ◽  
Hormonal Factors ◽  
Follow Up Study

453-P: Metabolic Syndrome Severity Score, All-Cause Mortality, and Incident Vascular Events in Type 2 Diabetes: A 13-Year, Single-Centre, Follow-Up Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 453-P
Author(s):  
MONIA GAROFOLO ◽  
ELISA GUALDANI ◽  
DANIELA LUCCHESI ◽  
LAURA GIUSTI ◽  
VERONICA SANCHO-BORNEZ ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Severity Score ◽  
Single Centre ◽  
Vascular Events ◽  
Follow Up Study ◽  
All Cause Mortality

scholarly journals Glycemic variability and cardiovascular disease in patients with type 2 diabetes

2021 ◽  
Vol 9 (1) ◽  
pp. e002032
Author(s):  
Marcela Martinez ◽  
Jimena Santamarina ◽  
Adrian Pavesi ◽  
Carla Musso ◽  
Guillermo E Umpierrez
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glycated Hemoglobin ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Cardiovascular Complications ◽  
Glucose Levels ◽  
Increased Risk ◽  
Patients With Diabetes

Glycated hemoglobin is currently the gold standard for assessment of long-term glycemic control and response to medical treatment in patients with diabetes. Glycated hemoglobin, however, does not address fluctuations in blood glucose. Glycemic variability (GV) refers to fluctuations in blood glucose levels. Recent clinical data indicate that GV is associated with increased risk of hypoglycemia, microvascular and macrovascular complications, and mortality in patients with diabetes, independently of glycated hemoglobin level. The use of continuous glucose monitoring devices has markedly improved the assessment of GV in clinical practice and facilitated the assessment of GV as well as hypoglycemia and hyperglycemia events in patients with diabetes. We review current concepts on the definition and assessment of GV and its association with cardiovascular complications in patients with type 2 diabetes.

scholarly journals A 4 year follow-up study of cognitive functioning in patients with type 2 diabetes mellitus

Diabetologia ◽  
2009 ◽  
Vol 53 (1) ◽  
pp. 58-65 ◽  
Author(s):  
E. van den Berg ◽  
◽  
Y. D. Reijmer ◽  
J. de Bresser ◽  
R. P. C. Kessels ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cognitive Functioning ◽  
Follow Up Study

scholarly journals Oxidative stress in patients with type 2 diabetes mellitus treated with metformin

2017 ◽  
Vol 27 (2) ◽  
pp. 25857
Author(s):  
Samuel Selbach Dries ◽  
Bárbara Da Silveira Soares ◽  
Ana Luiza Ziulkoski ◽  
Simone Gasparin Verza ◽  
Rafael Linden ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Superoxide Dismutase ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Side Effects ◽  
Diabetic Complications

*** Oxidative stress in patients with type 2 diabetes mellitus treated with metformin ***AIMS: To evaluate oxidative stress parameters in patients with type 2 diabetes mellitus treated with metformin, relating these values to its side effects, plasma levels, glycemic control, diabetic complications, lipid profile, and the influence of pharmacotherapeutic follow-up.METHODS: Patients with type 2 diabetes mellitus, on metformin and in pharmacotherapeutic follow-up for four months, were evaluated. The pharmacotherapeutic follow-up consisted in providing information and answering patients’ questions about medication and disease. In addition, administration times, dosages, and presence or absence of side effects related to the use of metformin were verified. Glycemic and lipid profile, oxidative stress (superoxide dismutase and malondialdehyde) and plasma metformin were evaluated. Pearson’s correlation and Spearman’s correlation were performed to evaluate the relationship between the variables at the beginning of the study. The independent t-test and Mann-Whitney U test were used to assess the difference between the groups with and without diabetic complications. The range of values between the beginning and  end of the study was evaluated using Student’s t-test or Wilcoxon U test. The significance level was set at 5%.RESULTS: The initial sample consisted of 49 patients aged 59±9 years with a body mass index of 29.8±5.1 kg/m2, who have had diabetes for a median time of 36 months (interquartile range of 1-240) and have been on metformin for a median time of 36 months (interquartile range of 1-180). Twenty-five patients left the study between the second and fourth meetings. Malondialdehyde levels differed between before and after pharmacotherapeutic follow-up, being positively correlated with blood glucose, glycohemoglobin, and triglyceride level, and negatively correlated with metformin and superoxide dismutase. Blood glucose, glycohemoglobin, and malondialdehyde levels increased, whereas metformin levels decreased in the group with diabetic complications, and there was a correlation between malondialdehyde and the number of diabetic complications per patient.CONCLUSIONS: In this sample of patients with type 2 diabetes mellitus treated with metformin, oxidative stress was more pronounced in those with poor glycemic control and diabetic complications.

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