scholarly journals The Correlation between Time in Range and Diabetic Microvascular Complications Utilizing Information Management Platform

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Xia Sheng ◽  
Guo-Hui Xiong ◽  
Peng-Fei Yu ◽  
Jian-Ping Liu
Keyword(s):  
Risk Factor ◽  
Blood Glucose ◽  
Diabetic Complications ◽  
Microvascular Complications ◽  
Target Range ◽  
Diabetic Patients ◽  
Management Platform ◽  
Time In Range ◽  
The Difference ◽  
Diabetic Microvascular Complications

Background. In recent years, the time of blood glucose within the target range is a new research hotspot in blood glucose management. TIR is expected to be a novel indicator for evaluating the efficacy of glycemic control and predicting diabetic complications. However, its relationship with diabetic complications has not been fully elucidated. Objective. To explore the relationship between time in range (TIR) and glycosylated hemoglobin (HbA1C) through the information big data management platform. Possible association between TIR and diabetic microvascular complications (retinopathy, nephropathy, and neuropathy) was investigated, attempting to provide theoretical basis for the clinical application of TIR and to explore the TIR control scope suitable for diabetic patients. Methods. A total of 5,644 type 2 diabetic patients hospitalized in the Department of Endocrinology, the Second Affiliated Hospital of Nanchang University, were selected from April 2017 to June 2020. Fingertip capillary blood glucose monitoring (FCGM) was monitored for a total of 455,664 times, and patients who are nondiabetic, pregnant, or with diabetic ketosis were excluded. Patients with 7 blood glucose points monitored for at least three consecutive days were selected as subjects in the study. 1,895 males and 1,513 females with diabetes were included, with an average age of (59.74 ± 13.40) years old and an average course of disease of 8.28 ± 7.11 years. The proportion of time in range (TIR) (70∼180 mg/dl) within the target range and the correlation between TIR and HbA1C were analyzed, as well as the relationship between TIR and the risk of diabetic complications. Results. (1) The average of TIR and HbA1C was 49.65 ± 23.36% and 8.92 ± 2.49%, respectively, and was linearly correlated. With the decrease of TIR, HbA1C increased significantly, and the difference was statistically significant ( P < 0.01 , R2 = 0.458). The correlation coefficient of mean TIR with mean HbA1C was −0.626. (2) There were 836 patients diagnosed with diabetic nephropathy (DN). The difference of TIR value between DN and non-DN was significant (T = 2.250, P < 0.05 ). Risk assessment showed the lower the TIR was, the higher the risk of DN was. TIR less than 40% was a risk factor for DN (OR = 1.249, 95% CI: 0.915–1.375). (3) There were 1,296 patients diagnosed with diabetic peripheral neuropathy (DPN). The difference of TIR value between DPN and non-DPN was significant (T = 3.844, P < 0.01 ). TIR value less than 70% was a risk factor for DPN (OR = 1.030, 95% CI: 0.769–1.379). (4) There were 2,077 patients diagnosed with diabetic retinopathy (DR). The difference of TIR value between DPN and non-DPN was significant (T = 3.608, P < 0.01 ). TIR value less than 50% was a risk factor for DR (OR = 1.092, 95% CI: 0.898–1.264). Summary. TIR may serve as a reference index for short-term blood glucose control, strongly reflecting the clinical blood glucose regulation and predicting the risk of diabetic microvascular complications.

scholarly journals To study levels of serum fibrinogen in type 2 diabetes mellitus and its association with diabetic microvascular complications

2017 ◽  
Vol 4 (1) ◽  
pp. 10
Author(s):  
Gurinder Mohan ◽  
Ranjeet Kaur ◽  
Aakash Aggarwal ◽  
Parminder Singh
Keyword(s):  
Diabetes Mellitus ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
High Serum ◽  
Diabetic Patients ◽  
Coagulation Disorder ◽  
Urine Albumin ◽  
Group A ◽  
Diabetic Microvascular Complications ◽  
Group B

Background: Diabetes mellitus is a hypercoagulable state associated with atherosclerosis leading to development of vascular complications, including microvascular complications.Methods: In our study a total of 60 diabetic patients with duration of diabetes more than 5 years, attending the OPD/ indoor of SGRDIMSR, Amritsar, Punjaqqb, India were included. They were divided in two groups, group A of 30 patients including diabetics with any of the three microvascular complications (diabetic nephropathy, diabetic retinopathy and diabetic neuropathy) and group B of 30 patients including diabetics without any microvascular complication. Group C comprised of 30 age and sex matched non-diabetic subjects who served as controls. Subjects with liver cirrhosis, malignancy or coagulation disorder were excluded. After taking the consent, detailed history taking and detailed physical examination and relevant investigations were done. The serum fibrinogen (hemostasis marker), HBA1C and UACR (urine albumin creatinine ratio) along with routine investigations were measured.Results: It was observed that serum fibrinogen levels were significantly higher in diabetic patients (266.16±54.73 mg/dl) as compared to non-diabetic controls (174.66±18.32 mg/dl); p <0.001.Further, serum fibrinogen levels were found to be significantly higher in diabetic patients with microvascular complications (293.43±51.09 mg/dl) as compared to those without microvascular complications (238.90±44.12); p<0.001.Conclusions: Significantly high serum fibrinogen level was found in diabetic patients as compared to controls and was in positive correlation with development of microvascular complications.

scholarly journals Can hematological parameters in type 2 diabetes predict microvascular complication development?

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Erhan Onalan ◽  
Nevzat Gozel ◽  
Emir Donder
Keyword(s):  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
Hematological Parameters ◽  
Diabetic Patients ◽  
Healthy Controls ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
The Mean ◽  
The Difference

Objective: To examine potential associations between neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, mean platelet volume (MPV), HbA1c and microvascular complications in diabetic patients from a cost-effectiveness perspective. Methods: One hundred patients with type 2 diabetes attending our outpatient unit between May 2018 and October 2018 were included, and 100 healthy individuals served as the control group. A retrospective file search was performed to collect information on hemoglobin, mean platelet volume (MPV), glycosylated haemoglobin (HbA1c), hematocrit (Hct), neutrophil and lymphocyte count, neutrophil/lymphocyte ratio (NLR), platelets (Plt), platelet/lymphocyte ratio (PLR), and microvascular complications (neuropathy, retinopathy, nephropathy). Results: Demographic and laboratory data were retrospectively controlled between diabetes (n=100) and healthy control (n=100) groups. The mean age in diabetic patients and healthy controls was 56.34 and 36.68 years, respectively. The mean NLR in diabetics and healthy controls was 2.48 and 2.11, the difference in NLR being significant (p=0.002). MPV in diabetics and controls was 8.54 and 8.53, respectively, and the difference was not significant (p=0.93). PLR was also similar, i.e. 149.7 and 145.3 in diabetics and healthy controls (p=0.067). With respect to microvascular complications, retinopathy was found to be significantly associated with MPV and NLR (p=0.015, and p=0.051), and nephropathy showed a significant association with NLR (p=0.027) among diabetics. In contrast with the two other microvascular complications, no significant association between neuropathy and NLR could be detected, while PLR and neuropathy was significantly associated (p=0.003). Conclusion: Microvascular complications may be associated with certain hematologic parameters, as suggested by comparisons both between diabetics and healthy individuals and within the group of diabetic individuals. We believe that hematologic parameters such as hematocrit, MPV, NLR, and PLR, which can be obtained through a simple complete blood count, may be utilized as cost-effective predictors of diabetic microvascular complications. Further prospective studies with larger sample size are required to better delineate these associations. doi: https://doi.org/10.12669/pjms.35.6.1150 How to cite this:Onalan E, Gozel N, Donder E. Can hematological parameters in type 2 diabetes predict microvascular complication development? Pak J Med Sci. 2019;35(6):1511-1515. doi: https://doi.org/10.12669/pjms.35.6.1150 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Results of assessment of the efficacy of therapeutic and diagnostic aid to diabetic patients based on prospective studies

2010 ◽  
Vol 13 (3) ◽  
pp. 21-24
Author(s):  
Yury Ivanovich Suntsov ◽  
Oksana Vladimirovna Maslova ◽  
Igor Vladislavovich Kazakov
Keyword(s):  
Arterial Pressure ◽  
Diabetic Complications ◽  
Comparative Assessment ◽  
Diabetic Patients ◽  
Diagnostic Aid ◽  
Sensory Responsiveness ◽  
Cholesterol Levels ◽  
The Russian Federation ◽  
The Difference ◽  
Metabolic Indices

Aim. Comparative assessment of the prevalence of diabetic complications (DC) and the main metabolic indices in adult patients with DM1 and DM2 in the periodfrom 2003 to 2009. Materials and methods. The study based on the Diabet Tsentr mobile module was designed to perform screening (2003) and rescreening (2009) for DC in severalregions of the Russian Federation. Laboratory analyses included measurement of blood HbA1c, creatinine, urea, total cholesterol levels, and albumin in singlevoidurine samples. The patients underwent fundoscopy, evaluation of all forms of sensory responsiveness, measurement of arterial pressure, and ECG. The resultswere treated with the use of Statistica 6 software. They are presented as median, 25th and 75th percentiles (Me[25%;75%]). The difference between the groups wasregarded as statistically significant at p

scholarly journals TCF7L2 Gene Polymorphism as a Risk for Type 2 Diabetes Mellitus and Diabetic Microvascular Complications

2021 ◽  
Author(s):  
Noran Talaat Aboelkhair ◽  
Heba Elsayed Kasem ◽  
Amera Anwar Abdelmoaty ◽  
Rawhia Hassan Eledel
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Microvascular Complications ◽  
Diabetic Patients ◽  
Tcf7l2 Gene ◽  
Significant Difference ◽  
Patient Groups ◽  
Diabetic Microvascular Complications

Abstract Background: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic condition with various genetics and environmental influences that affects the capacity of the body to produce or use insulin resulting in hyperglycemia, which may lead to variable complications. It is one of the world’s rising health problems. There is emerging evidence that some genetic polymorphisms can impact the risk of evolving T2DM. We try to determine the relationship of (rs7903146) variant of the Transcription factor 7-like 2 (TCF7L2) gene with T2DM and its microvascular complications.Methods and Results: This case-control study included 180 subjects: 60 diabetic patients without complications, 60 diabetic patients with microvascular complications and 60 matched healthy controls. Genotypes of rs7903146 (C/T) SNP in the TCF7L2 gene were evaluated by real-time polymerase chain reaction via TaqMan allelic discrimination. Logistic regression was used to detect the most independent factor for development of diabetes and diabetic microvascular complications. Variant homozygous TT and heterozygous TC genotypes were significantly increased in diabetic without complications and diabetic with complications groups than controls (p=0.003, 0.001) respectively. The T allele was more represented in both patient groups than controls with no significant difference between patient groups. TT genotype as well as T allele was significantly associated with increased T2DM risk.Conclusion: The T allele of rs7903146 polymorphism of TCF7L2 confers susceptibility to development of T2DM. However, no significant association was found for diabetic complications.

The Correlation Between the Vitamin D Level and Glycemic Control Status Among Diabetic Patients - A Clinical Observational Study

2020 ◽  
Vol 7 ◽  
Author(s):  
Nasser Alqahtani ◽  
Eisa Ghazwani ◽  
Awad Alqahtani ◽  
Mohammed Helaly
Keyword(s):  
Vitamin D ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
High Hba1c ◽  
Sugar Levels ◽  
Diabetic Microvascular Complications

Background: Vitamin D deficiency is widespread and coexisted with diabetes. However, the relation between Vitamin D level and glycemic control is not yet fully understood. This study examines the correlation between vitamin D level and glycemia indicators and diabetic microvascular complications.Methods: The study is a cross-sectional study, had been done at the outpatient department in Najran university hospital, Saudi Arabia from May 2019 to February 2020. 220 patients recruited by simple random sampling.Results: 60% of diabetes (n-130) had been using oral anti-glycemic medications, though most of them had uncontrolled glycemic status and had got microvascular complications. It is notable that among diabetes having a low vitamin D level; 55.5% had high FBS, 45.6% had high RBS and 65% had high HBA1C. Besides,17% have retinopathy, 16.6% have nephropathy, 26.2% have peripheral neuropathy and 1.9% have a diabetic foot.Conclusion: The clinical and laboratory assessments are essential to control the glycemic state in diabetes. The study noted that an inverse relationship between the level of vitamin D with blood sugar levels and diabetic microvascular complications. To assure the feasibility of the prediction of vitamin D level in assessing the progress of diabetes further studies are needed.

scholarly journals Endothelial Progenitor Cells in Diabetic Microvascular Complications: Friends or Foes?

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Cai-Guo Yu ◽  
Ning Zhang ◽  
Sha-Sha Yuan ◽  
Yan Ma ◽  
Long-Yan Yang ◽  
...  
Keyword(s):  
Progenitor Cells ◽  
Endothelial Progenitor Cells ◽  
Microvascular Complications ◽  
Microvascular Disease ◽  
Diabetic Patients ◽  
Endothelial Progenitor ◽  
Vascular Abnormality ◽  
Diabetic Microvascular Complications ◽  
Angiopoietin 2 ◽  
And Function

Despite being featured as metabolic disorder, diabetic patients are largely affected by hyperglycemia-induced vascular abnormality. Accumulated evidence has confirmed the beneficial effect of endothelial progenitor cells (EPCs) in coronary heart disease. However, antivascular endothelial growth factor (anti-VEGF) treatment is the main therapy for diabetic retinopathy and nephropathy, indicating the uncertain role of EPCs in the pathogenesis of diabetic microvascular disease. In this review, we first illustrate how hyperglycemia induces metabolic and epigenetic changes in EPCs, which exerts deleterious impact on their number and function. We then discuss how abnormal angiogenesis develops in eyes and kidneys under diabetes condition, focusing on “VEGF uncoupling with nitric oxide” and “competitive angiopoietin 1/angiopoietin 2” mechanisms that are shared in both organs. Next, we dissect the nature of EPCs in diabetic microvascular complications. After we overview the current EPCs-related strategies, we point out new EPCs-associated options for future exploration. Ultimately, we hope that this review would uncover the mysterious nature of EPCs in diabetic microvascular disease for therapeutics.

scholarly journals Comparative Intraocular Pressure Study among Diabetic and Non-Diabetic Patients

2021 ◽  
pp. 229-233
Author(s):  
Asadullah Jatoi ◽  
Noman Ahmed Shaikh ◽  
Mona Liza Mahesar
Keyword(s):  
Intraocular Pressure ◽  
Microvascular Complications ◽  
Cross Sectional Study ◽  
Rank Test ◽  
Diabetic Patients ◽  
Health Issues ◽  
Cross Sectional ◽  
Clinical Investigations ◽  
Spearman Correlation Test ◽  
The Difference

Background: Diabetes mellitus is one of the major health issues in the world. Its microvascular complications contribute to ocular complications including increased intraocular pressure (IOP) which is a risk factor of glaucoma. Identification of factors responsible for glaucoma is a mainstay in the early detection and prevention of blindness. Aim and Objectives: The objective of the study was to compare IOP among diabetic and non-diabetic patients and to assess the correlation between age and IOP. Materials and Methods: The cross-sectional study was performed on 104 participants. Patients were divided into two groups based on diabetes (case, n = 52) and non-diabetes (control, n = 52). The detailed history and routine clinical investigations were performed. Three consecutive readings of IOP of the left and right eye were recorded separately using Goldmann applanation tonometer. Wilcox sign-rank test and Spearman-correlation test was used to find the difference between the IOP and correlation between age and IOP, respectively. Results: A significantly higher IOP was observed in diabetic patients than non-diabetic patients. (0.0001). There was no sex difference in IOP was observed in diabetic and non-diabetic patients. Age of the patient was not correlated with IOP (r = –0.02197219, P = 0.824). Conclusion: Diabetic patients are prone to higher IOP; therefore, diabetic patients should be regularly assessed for IOP for diagnosis glaucoma.

scholarly journals Sclerodactyly and Diabetic Complications among Egyptian Adolescent Type 1 Diabetic Patient

2019 ◽  
Vol 7 (23) ◽  
pp. 4004-4009
Author(s):  
Soha M. El Dayem ◽  
Abo El Magd El Bohy ◽  
Ahmed A. Battah
Keyword(s):  
Diabetic Complications ◽  
Clinical Laboratory ◽  
Microvascular Complications ◽  
Glycosylated Hemoglobin ◽  
Vascular Complications ◽  
Diabetic Patients ◽  
Skin Thickness ◽  
Laboratory Assessment ◽  
Limited Joint Mobility

BACKGROUND: One of the common complications of diabetic patients is sclerodactyly which is considered as a part of limited joint mobility. AIM: To assess sclerodactyly in adolescent type 1 diabetics and to detect its relation to other diabetic complications. METHODS: Sixty-three diabetics and 60 controls were studied. Clinical, laboratory assessment, ultrasonography of the skin, carotid artery intima-media thickness (cIMT) & renal colour duplex were done for all participants. RESULTS: Sclerodactyly was positive in 12 (19%) of diabetics. Patients with sclerodactyly had a significantly thickened skin compared to patients without sclerodactyly and controls, P = 0.0001. Male diabetics had significantly thickened skin (p = 0.0001). Diabetic patients with sclerodactyly had significant higher systolic blood pressure (p = 0.03), cholesterol (p = 0.05) and triglyceride (p = 0.004) and lower HDL-c (p = 0.04). Skin thickness had a significant positive correlation with age of diabetic patients (p = 0.02), waist/height ratio (p = 0.04), glycosylated hemoglobin (p = 0.03), albumin/creatinine ratio (p = 0.03), and cIMT (p = 0.03). CONCLUSION: Ultrasound easily diagnoses sclerodactyly. Diabetic patients had a high prevalence of sclerodactyly with increased macrovascular and microvascular complications. Sclerodactyly may be a marker for diabetic vascular complications. Frequent follow up of diabetic patients for early detection of sclerodactyly in uncontrolled diabetic patients is recommended. It could be an alarming sign for microalbuminuria, hypertension, hyperlipidaemia and atherosclerosis.

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