scholarly journals Association of Lower Extremity Vascular Disease, Coronary Artery, and Carotid Artery Atherosclerosis in Patients with Type 2 Diabetes Mellitus

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Zheng Yang ◽  
Bing Han ◽  
Hongguang Zhang ◽  
Guohui Ji ◽  
Liang Zhang ◽  
...  

The motive of this article is to present the case study of patients to investigate the association between the ultrasonographic findings of lower extremity vascular disease (LEAD) and plaque formation. Secondly, to examine the association between the formation of coronary artery and carotid artery atherosclerosis in patients with type 2 diabetes mellitus. 124 patients with type 2 diabetes (64 males and 60 females with the age group 25-78 years) are considered for the research studies who have registered themselves in the Department of Endocrinology and Metabolism from April 2017 to February 2019. All participants have reported their clinical information regarding diabetes, alcohol consumption, smoking status, and medication. The blood samples from subjects are collected for measurement of HbA1c, total cholesterol, triglycerides, HDL-c, and LDL-c levels. Two-dimensional ultrasound has been used to measure the inner diameter, peak flow velocity, blood flow, and spectral width of the femoral artery, pop artery, anterior iliac artery, posterior tibial artery, and dorsal artery and to calculate the artery stenosis degree. Independent factors of atherosclerosis are determined by multivariate logistic regression analysis. The results are evaluated within the control group and it is found that there is no significant impact of gender, age, and body mass index ( P > 0.05 ) on the lower extremity vascular diseases. Those with smoking, alcohol consumption, hypertension, and dyslipidemia have higher positive rate ( P < 0.05 ). The type 2 diabetes mellitus group has higher diastolic blood pressure and lower triglyceride ( P < 0.05 ). Diastolic blood pressure, HbA1C, total cholesterol, HDL-c, and LDL-C are not remarkably dissimilar between the type 2 diabetes mellitus group and the control group ( P > 0.05 ). Compared with the control group, the type 2 diabetes mellitus group has higher frequency of lower extremity vascular diseases in the dorsal artery than in the pop artery ( P < 0.05 ). The blood flow of type 2 diabetes mellitus group is found to be lower than that of the control group, especially in the dorsal artery ( P < 0.05 ). The blood flow velocity of the dorsal artery is accelerated ( P < 0.01 ). Among 117 patients of type 2 diabetes mellitus (94.35%) with a certain degree of injury, there are 72 cases of type I carotid stenosis (58.06%), 30 cases of type II carotid stenosis (24.19%), and 15 cases of type III carotid stenosis (12.10%). Out of 108 subjects in the control group, there are 84 cases of type 0 carotid stenosis (77.78%), 19 cases of type I carotid stenosis (17.59%), 5 cases of type II carotid stenosis (4.63%), and 0 case of type III carotid stenosis (0.00%). Compared with the control group, carotid stenosis is more common in patients with type 2 diabetes mellitus ( P < 0.05 ). Age, smoking, duration of diseases, systolic blood pressure, and degree of carotid stenosis are found to be associated with atherosclerosis. The findings suggest that the color Doppler ultrasonography can give early warning when applied in patients with carotid and lower extremity vascular diseases to delay the incidence of diabetic macroangiopathy and to control the development of cerebral infarction, thus providing an important basis for clinical diagnosis and treatment.

Author(s):  
Hadi Bazyar ◽  
Seyed Ahmad Hosseini ◽  
Sirous Saradar ◽  
Delsa Mombaini ◽  
Mohammad Allivand ◽  
...  

Abstract Background In patients with type 2 diabetes mellitus (T2DM) the inflammatory and metabolic responses to epigallocatechin-3-gallate (EGCG) are unknown. Objectives Evaluate the impacts of EGCG on metabolic factors and some biomarkers of stress oxidative in patients with T2DM. Methods In this randomized, double-blind, placebo-controlled trial, 50 patients with T2DM consumed either 2 tablets (300 mg) EGCG (n=25) or wheat flour as placebo (n=25) for 2 months. The total antioxidant capacity (TAC), interleukin-6 (IL-6), lipid profile, mean arterial pressure (MAP), atherogenic index of plasma (AIP) were evaluated before and after the intervention. Results The finding of present study exhibited a significant increase in the serum levels of TAC after the EGCG supplementation (p=0.001). Also, in compare with control group, the mean changes of TAC were significantly higher in supplement group (p=0.01). In intervention group, a significant decrease was observed in the mean levels of triglyceride, total cholesterol, diastolic blood pressure (DBP), AIP, and MAP (p<0.05). Taking EGCG resulted in the mean changes of total cholesterol, MAP and DBP were significantly lower in compare with control group (p<0.05). Conclusions This study recommended that EGCG supplementation may be improved blood pressure, lipid profile, AIP, and oxidative status in patients with T2DM.


2012 ◽  
Vol 56 (5) ◽  
pp. 285-290 ◽  
Author(s):  
Serdal Korkmaz ◽  
Abdulkerim Yilmaz ◽  
Gürsel Yildiz ◽  
Fatih Kiliçli ◽  
Serhat Içağasioğlu

OBJECTIVE: The rate of reduction of nocturnal blood pressure (NBP) is lesser than normal in patients with type 2 diabetes mellitus (type 2 DM). Hyperhomocysteinemia (HHC) disrupts vascular structure and function, no matter the underlying causes. The risk of development of vascular disease is greater in diabetic patients with hyperhomocysteinemia than in patients with normal homocystein levels. The aim of the study was to investigate whether there are differences of homocystein levels in dipper and non-dippers patients with type 2 DM. SUBJECTS AND METHODS: We compared 50 patients (33 females, 17 males) with type 2 DM and 35 healthy individuals (18 females, 17 males ) in a control group. Ambulatory blood pressure monitoring (ABPM) was performed and homocysteine levels were measured in all patients. RESULTS: We found that the percentage of non-dipper pattern was 72% in patients with type 2 DM and 57% in control group. In diabetic and control individuals, homocystein levels were higher in non-dipper (respectively 13.4 ± 8.1 µmol/L and 11.8 ± 5 µmol/L) than in dipper subjects (respectively, 11.8 ± 5.8 µmol/L and 10.1 ± 4.2 µmol/L), but there was no significant difference between the two groups (respectively, p = 0.545, p = 0.294). CONCLUSION: In both groups, homocystein levels were higher in non-dipper than in dipper participants, but there was no significant difference between the groups. High homocystein levels and the non-dipper pattern increases cardiovascular risk. Therefore, the relationship between nocturnal blood pressure changes and homocystein levels should be investigated in a larger study.


2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Jia-Rong Gao ◽  
Xiu-Juan Qin ◽  
Zhao-Hui Fang ◽  
Li-Shan ◽  
Li-Ping Han ◽  
...  

Background. Type 2 diabetes mellitus (T2DM) has become a chronic disease, serious harm to human health. Complications of the blood pipe are the main cause of disability and death in diabetic patients, including vascular lesions that directly affects the prognosis of patients with diabetes and survival. This study was to determine the influence of high glucose and related mechanism of vascular lesion of type 2 diabetes mellitus pathogenesis. Methods. In vivo aorta abdominalis of GK rats was observed with blood pressure, heart rate, hematoxylin and eosin (H&E), Masson, and Verhoeff staining. In vitro cells were cultured with 30 mM glucose for 24 h. RT-QPCR was used to detect the mRNA expression of endothelial markers PTEN, PI3K, Akt, and VEGF. Immunofluorescence staining was used to detect the expression of PTEN, PI3K, Akt, and VEGF. PI3K and Akt phosphorylation levels were detected by Western blot analysis. Results. Heart rate, systolic blood pressure, diastolic blood pressure, and mean blood pressure in the GK control group were higher compared with the Wistar control group and no difference compared with the GK experimental model group. Fluorescence intensity of VEGF, Akt, and PI3K in the high-sugar stimulus group was stronger than the control group; PTEN in the high-sugar stimulus group was weakening than the control group. VEGF, Akt, and PI3K mRNA in the high-sugar stimulus group were higher than the control group; protein expressions of VEGF, Akt, and PI3K in the high-sugar stimulus group were higher than the control group. PTEN mRNA in the high-sugar stimulus group was lower than the control group. Protein expression of PTEN in the high-sugar stimulus group was lower than the control group. Conclusions. Angiogenesis is an important pathogenesis of T2DM vascular disease, and PTEN plays a negative regulatory role in the development of new blood vessels and can inhibit the PI3K/Akt signaling pathway.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xin Zhao ◽  
Xiaofeng Yu ◽  
Sixu Xin ◽  
Wei Zhang ◽  
Xiaomei Zhang ◽  
...  

Objective: To analyze the differences of early atherosclerosis indices in type 2 diabetes mellitus (T2DM) patients with different degrees of obstructive sleep apnea-hypopnea syndrome (OSAHS) and explore the correlation between them, so as to provide a new clinical basis for the prevention and treatment of early atherosclerosis in patients with T2DM and OSAHS. Methods. A prospective study was conducted in 312 patients with T2DM and snoring who were hospitalized in the Department of Endocrinology, Peking University International Hospital from January 2017 to January 2020. According to the monitoring results, 312 patients were divided into 4 groups including the control group (208 cases), mild OSAHS group (18 cases), moderate OSAHS group (38 cases), and severe OSAHS group (48 cases). Multivariate logistic regression analysis was used to analyze the early atherosclerosis indices including brachial-ankle pulse wave velocity (PWV) and ankle-brachial index (ABI) in patients with T2DM coexistence with different degrees of OSAHS. Results. (1) As the degree of OSAHS increased, ABI decreased gradually and was lower than that in the control group, but PWV increased and was higher than that in the control group ( p < 0.05 , respectively). (2) The apnea-hypopnea index (AHI) positively correlated with PWV ( r = 0.36 , p < 0.05 ) and negatively correlated with ABI ( r = − 0.37 , p < 0.05 ). (3) Multivariate logistic regression showed that after adjusting for age, gender, duration, BMI, blood pressure, blood glucose, blood lipid, and other factors, OSAHS was a risk factor of lower extremity arterial disease (LEAD) in patients with T2DM. With the increase of degree of OSAHS, the risk of lower extremity atherosclerosis gradually increased. Conclusion. OSAHS is an independent risk factor of LEAD in patients with T2DM, and with the increase of AHI, the ABI and PWV have changed, which provides a new clinical basis for the prevention and the treatment of early atherosclerosis in patients with T2DM and OSAHS.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Leites de Souza Steffen ◽  
D Demétrio Faustino da Silva ◽  
C Schilling Mendonça ◽  
E Meyer

Abstract Background Motivational Interviewing (MI) has been effective in promoting positive changes in various health-related behaviors, including chronic disease management. The main goal of this study was evaluating the effectiveness of this care technology in individual nursing consultations for the control of type 2 Diabetes Mellitus (2DM) and Arterial Hypertension (AH) in primary healthcare. Methods Double-blind, controlled, parallel randomized clinical trial conducted in Porto Alegre, Rio Grande do Sul - Brazil, from June 2018 to July 2019. The study subjects suffered from 2DM with associated diagnosis of AH and were randomized individually to the Test/MI Group and Control Group. The Test Group was subjected to an MI-based nursing consultation intervention with a professional who had been trained for 20 hours, while the Control Group received conventional nursing consultation. The variables were collected in order to measure the main glycated hemoglobin and blood pressure outcomes, and for the secondary adherence outcome. Results After an average follow-up of 6 months, 175 patients completed the study. There was a significant difference between the groups with improvement in the Test/MI group for the outcomes Systolic Blood Pressure - SBP (p &lt; 0.01), Diastolic Blood Pressure - DBP (p &lt; 0.01), Total Adherence Score in Martín-Bayarre-Grau Questionnaire (p = 0.011) and their dimensions 'Treatment compliance' and 'Personal implication' (p = 0.033; p = 0.031). The blood pressure levels of the patients who received the Motivational Interviewing Intervention showed a significant mean reduction of 15.2 mmHg in SBP and 6.4 mmHg in DBP, compared to the control group. The Test group also showed a significant average intragroup reduction of 0.5% in HbA1c at the completion of the study (p &lt; 0.01). Conclusions It is concluded that the MI-based nursing consultation was effective in improving clinical control and adherence in diabetic and hypertensive patients in primary healthcare. Key messages MI-based nursing consultation is effective in reducing pressure and glycemic levels in primary healthcare. The MI improves adherence levels in diabetic and hypertensive patients.


Jurnal NERS ◽  
2017 ◽  
Vol 12 (2) ◽  
pp. 247
Author(s):  
Yuly Peristiowati

Introduction : This study aimed to evaluate the role of catechins isolates from GMB4 clone green to in the dynamics of endothelial progenitor cells (EPC) in type 2 diabetes mellitus (DM). Methods: 25 Wistar rats, were divided into 5 groups, including control group, type 2 diabetes mellitus group, treated daily administration of extracts of catechins isolate from GMB4 clones green tea at 20; 40; and 60 mg /kgBB doses for 6 weeks. EPCs analysis was performed by flow cytometry,levels of NO was performed using a spectrophotometer, serum levels of SDF-1a was performed with ELISA technique. Analysis of the expression of SDF-1 and CXCR-4 was performed using immunohistochemistry techniques. Results : The CD34+ and CD133+ count is lower in the DM group compared to the control group (P < 0.05). Of the three doses of catechins, only the highest dose were able to significantly increase CD34+ count compared to rats in the diabetes mellitus group (P < 0.05), Serum NO level is significantly higher in the DM the control group (P < 0.05). All three doses of catechins were able to significantly increase the expression of SDF-1a and CXCR4 in the aorta compared to the DM group or the control group (P < 0.05). Discussion :  It can be concluded that high dose cathecin isolate from GMB-4 clone green tea (60 mg/kgBB) may trigger the proliferation and maturation of EPCs in rats with type 2 DM in environment with high level of NO, involving the interacton between SDF-1a and CXCR4 in the aorta. 


2020 ◽  
pp. 1-3
Author(s):  
Anand Jadhao ◽  
Saumya Naik ◽  
Megha Bhonde ◽  
Saurabh Mishra

In type 2 diabetes mellitus (DM-2), cardiovascular diseases are the important cause of mortality and morbidity. Regular monitoring of the diabetic condition is essential for the proper management of diabetes & effective controlling of diabetes-related complications. As the recording of IAD (Interarm blood pressure difference) is a simple procedure and it is also related to the vascular complication, it can be a vital indicator of the severity of diabetes. So, it is very important to study IAD concerning Complicated and Non-Complicated DM-2 which will be helpful for planning a better clinical management. In this cross-sectional study, we compare Interarm blood pressure difference in three groups i.e. Control, Non-Complicated DM-2 and Complicated DM-2 groups. There is a significant increase in systolic IAD in DM-2 group as compared to the control group, but no significant difference found between Non-Complicated and Complicated DM-2 groups.


2021 ◽  
Vol 67 (3) ◽  
pp. 76-84
Author(s):  
Kalthum Asaaf Maulood

Type 2 diabetes mellitus (T2DM) is a global problem. Recent studies confirmed the association of genes and different single nucleotide polymorphisms with T2DM occurrence and progress. This study was aimed to estimate the vitamin D receptor (VDR) gene polymorphism in Type 2 Diabetes Mellitus patients in Erbil city. The results showed that the Body mass index (BMI), Systolic blood pressure and Diastolic blood pressure were significantly higher in the diabetic group compared to the control group (P<0.05). In addition, the percent of Glycated hemoglobin (HbA1c), Fasting blood glucose (FBG), and Homeostatic model assessment for insulin resistance (HOMA-IR) were significantly higher in the diabetic group compared to the control group (P<0.05). Among different parameters of lipid profile, only Low-density lipoprotein (LDL) was significantly higher in the diabetic group compared to the control group. It was found that FBG value was significantly higher in patients with GA and AA genotypes of BsmI compared with healthy controls. Patients with the GA genotype of BsmI had a higher value of triglyceride compared to healthy individuals. Patients with all ApaI genotypes had higher FBS values than controls. There were not observed any signi?cant associations among the BsmI and ApaI polymorphisms and the risk of T2DM. In conclusion, no evidence was found for the association between two VDR polymorphisms and T2DM patients in Erbil city.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Huimin Yan ◽  
Antonio Prista ◽  
Sushant M. Ranadive ◽  
Albertino Damasceno ◽  
Paula Caupers ◽  
...  

Background. Exercise training intervention is underused in the management of type 2 diabetes mellitus in East Africa. Methods. 41 physically-active males with type 2 diabetes mellitus living in Mozambique were recruited and randomly assigned to 12 weeks of supervised exercise of low intensity exercise (LEX), vigorous intensity exercise (VEX), or to a control group (CON). Since there were no differences for any outcome variables between the exercise groups, VEX and LEX were combined into one exercise group (EX). Results. Age and baseline body weight were similar between EX and CON. Plasma glucose at 120 min following glucose load (Glu 120) was significantly reduced in the EX group after training (Glu 120 : 17.3 mmol/L to 15.0 mmol/L, P<0.05), whereas Glu 120 remained unchanged in the CON (Glu 120 : 16.6 mmol/L to 18.7 mmol/L). After controlling for baseline blood pressure (BP), posttraining systolic BP and diastolic BP were lower in the EX group than in the CON group (EX: 129/77 mm Hg, CON: 152/83 mm Hg, P<0.05). Conclusion. Adding exercise to already active African men with type 2 diabetes improved glucose control and BP levels without concomitant changes in weight.


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