scholarly journals Precision Diabetes Is Slowly Becoming a Reality

2019 ◽  
Vol 28 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Viswanathan Mohan ◽  
Venkatesan Radha
Keyword(s):  
Personalised Medicine ◽  
Neonatal Diabetes ◽  
Control Of Diabetes ◽  
Monogenic Forms Of Diabetes ◽  
Gene Defects ◽  
Clinical Tools ◽  
Near Future

The concept of precision medicine is becoming increasingly popular. The use of big data, genomics and other “omics” like metabolomics, proteomics and transcriptomics could make the dream of personalised medicine become a reality in the near future. As far as polygenic forms of diabetes like type 2 and type 1 diabetes are concerned, interesting leads are emerging, but precision diabetes is still in its infancy. However, with regard to monogenic forms of diabetes like maturity-onset diabetes of the young and neonatal diabetes mellitus, rapid strides have been made and precision diabetes has already become part of the clinical tools used at advanced diabetes centres. In patients with some monogenic form of diabetes, if the appropriate gene defects are identified, insulin injections can be stopped and be replaced by oral sulphonylurea drugs. In the coming years, rapid advances can be expected in the field of precision diabetes, thereby making the control of diabetes more effective and hopefully leading to prevention of its complications and improvement of the quality of life of people afflicted with diabetes.

Stressful Experiences,Workplace Stress, and Type 2 Diabetes:Management of Diabetes

2017 ◽  
Vol 10 (02) ◽  
Author(s):  
Purnima Awasthi
Keyword(s):  
Workplace Stress ◽  
Stressful Task ◽  
Control Of Diabetes ◽  
The Common ◽  
Stressful Experiences ◽  
Management Approaches ◽  
And Control

The present paper draws attention towards the common occurrence of daily life i.e., stress along with its relation and linkage with diabetes, which is no doubt reaching epidemic proportions. The paper throws light on the relation between stressful experiences and onset and control of diabetes. It focuses how stress might lead to diabetes and also increase the risk of type 1 and type 2 diabetes. Also in various situations managing diabetes in itself becomes a stressful task and adds up more to added risk. Finally various stress management approaches are discussed in order to ensure proper management of stress so that the quality of life of an individual is not hampered to the extremes and it becomes manageable to cope up or combat with the harmful consequences of stress, which further aggravates or increases the risk of diabetes.

scholarly journals Monogenic diabetes and pregnancy

2015 ◽  
Vol 8 (3) ◽  
pp. 114-120 ◽  
Author(s):  
Rinki Murphy
Keyword(s):  
Monogenic Diabetes ◽  
Nuclear Factor ◽  
Hepatocyte Nuclear Factor ◽  
Diabetes In Pregnancy ◽  
Specific Therapy ◽  
Monogenic Forms Of Diabetes ◽  
Gene Defects ◽  
Practical Implications

Monogenic diabetes is frequently mistakenly diagnosed as either type 1 or type 2 diabetes, yet accounts for approximately 1–2% of diabetes. Identifying monogenic forms of diabetes has practical implications for specific therapy, screening of family members and genetic counselling. The most common forms of monogenic diabetes are due to glucokinase ( GCK), hepatocyte nuclear factor ( HNF) -1A and HNF-4A, HNF-1B, m.3243A>G gene defects. Practical aspects of their recognition, diagnosis and management are outlined, particularly as they relate to pregnancy. This knowledge is important for all physicians managing diabetes in pregnancy, given this is a time when previously unrecognised monogenic diabetes may be uncovered with careful attention to atypical features of diabetes misclassified as type 1, type 2, or gestational diabetes.

851-P: Sleep and Quality of Life in Adolescents with Type 1 or Type 2 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 851-P
Author(s):  
MELISSA S. FAULKNER
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes

Type 1 Diabetes Mellitus - Risk Factor for Cardiovascular Disease Morbidity and Mortality

2020 ◽  
Vol 17 (1) ◽  
pp. 37-54
Author(s):  
Tatyana Chalakova ◽  
Yoto Yotov ◽  
Kaloyan Tzotchev ◽  
Sonya Galcheva ◽  
Boyan Balev ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Diabetic Control ◽  
Macrovascular Complications ◽  
Morbidity And Mortality ◽  
Diabetes Mellitus Risk

: Type 1 diabetes mellitus (T1DM) is a chronic disease that starts early in life and often leads to micro- and macrovascular complications. The incidence of the disease is lower than that of type 2 DM and varies in different countries and ethnic groups, and the etiological and pathogenetic factors are different from T2DM. The aim of this overview is to investigate the effect of T1DM on all-cause mortality and CVD morbidity and mortality. During the last decades, the treatment of T1DM has improved the prognosis of the patients. Still, the mortality rates are higher than those of the age- and sex-matched general population. With the prolonged survival, the macrovascular complications and cardiovascular diseases (CVD) appear as major health problems in the management of patients with T1DM. The studies on the CVD morbidity and mortality in this disease group are sparse, but they reveal that T1DM is associated with at least 30% higher mortality. In comparison to healthy people, CVDs are more common in T1DM patients and they occur earlier in life. : Furthermore, they are a major cause for death and impaired quality of life in T1DM patients. The correlation between diabetic control and the duration of T1DM is not always present or is insignificant. Nevertheless, the early detection of the preclinical stages of the diseases and the risk factors for their development is important; similarly, the efforts to improve glycemic and metabolic control are of paramount importance.

scholarly journals The ePedsQLTM in Type 1 and Type 2 Diabetes: Feasibility, reliability, and validity of the Pediatric Quality of Life InventoryTM Internet administration

Diabetes Care ◽  
2008 ◽  
Vol 31 (4) ◽  
pp. 672-677 ◽  
Author(s):  
J. W. Varni ◽  
C. A. Limbers ◽  
T. M. Burwinkle ◽  
W. P. Bryant ◽  
D. P. Wilson
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Reliability And Validity

scholarly journals Clinical Practice of Hepatorenal Syndrome: A Brief Review on Diagnosis and Management

2021 ◽  
Vol 3 (2) ◽  
pp. 1-7
Author(s):  
. Rendy ◽  
. Febyan ◽  
Krisnhaliani Wetarini
Keyword(s):  
Clinical Practice ◽  
Hepatorenal Syndrome ◽  
Organ Transplant ◽  
Kidney Injury ◽  
Therapeutic Measures ◽  
Clinical Conditions ◽  
Underlying Pathophysiology

The hepatorenal syndrome is one of various potential causes of acute kidney injury in patients with decompensated liver disease. Hepatorenal syndrome is diagnosed based on reducing kidney function without any evidence of intrinsic kidney disease, including proteinuria, hematuria, or abnormal kidney ultrasonography. Clinically, hepatorenal syndrome is divided into two types named type 1 and type 2. The most favorable therapy for HRS cases is liver transplantation; however, only a few undergo this procedure due to the high mortality. Other modalities for hepatorenal syndrome therapy are pharmacology and non-pharmacology approaches. The purpose of management HRS is to optimize and stabilize the patient until an organ transplant available. This review aims to discuss the underlying pathophysiology and demonstrate the diagnostic approach of hepatorenal syndrome to determine the most appropriate therapeutic measures in clinical practice. The clinicians must be aware of management principles of hepatorenal syndrome to improve the quality of care for patients and optimize the clinical conditions.

scholarly journals Patterns of care of subjects with type 1 and type 2 diabetes according to their cardiovascular risk

2021 ◽  
Vol 24 (1) ◽  
pp. 30
Author(s):  
Pintaudi, B.
Keyword(s):  
Risk Factors ◽  
Quality Of Care ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Quality Indicators ◽  
High Cardiovascular Risk ◽  
Very High

AIM OF THE STUDY To explore the distribution by cardiovascular risk groups according to the classification promoted by the ESC (European Society of Cardiology) of subjects with type 1 (T1D) and type 2 (T2D) diabetes cared for by Italian diabetologists and to describe the quality indicators of care, with particular regard to cardiovascular risk factors. DESIGN AND METHODS The study is based on data extracted from electronic medical records of patients treated at the 258 diabetes centers participating in the Annals AMD initiative and active in the year 2018. Patients with T1D or T2D were stratified by cardiovascular risk, in accordance with the recent ESC guidelines. General descriptive indicators and measures of intermediate outcomes, intensity/appropriateness of pharmacological treatment for diabetes and cardiovascular risk factors, presence of other complications and overall quality of care were evaluated. RESULTS Overall, 29,368 adults with T1D and 473,740 subjects with T2D were evaluated. Among subjects with T1D: 64.7% were at very high cardiovascular risk, 28.5% at high risk and the remaining 6.8% at moderate risk. Among subjects with T1D at very high-risk: 54.7% had retinopathy, 29.0% had albuminuria, 7.3% had a history of major cardiovascular event, 47.3% had organ damage, 48.9% had three or more risk factors, and 70.6% had a diabetes duration of over 20 years. Among subjects with T2D: 78.5% were at very high cardiovascular risk, 20.9% at high risk and the remaining 0.6% at moderate risk. Among those with T2D at very high risk: 39.0% had organ damage, 89.1% had three or more risk factors, 18.7% had a previous major cardiovascular event, 26,4% had retinopathy, 39.5% had albuminuria. With regard to the glucose-lowering drugs: the use of DPPIV-i increased markedly as cardiovascular risk increased; the use of secretagogues also increased and, although within low percentages, also the use of GLP1-RA tended to increase. The use of SGLT2-i is also still limited, and only slightly higher in subjects with very high cardiovascular risk. In both types of diabetes, the overall quality of care, as summarized by the Q score values, tended to be lower as the level of cardiovascular riskincreased. CONCLUSIONS The analysis of a large population such as that of the AMD Annals database allowed to highlight the characteristics and quality indicators of care of subjects with T1D and T2D in relation to cardiovascular risk classes. A large proportion of subjects appear to be at high or very high risk. Glucose-lowering drug therapies seem not to be adequately used with respect to the potential advantages in terms of reduction of cardiovascular risk of some drug categories (GLP1-RA and SGLT2-i) and, conversely, with respect to the potential risks related to the use of other pharmacological classes (sulfonylureas). Several actions are necessary to optimize care and improve the quality of care for both subjects with T1D and T2D. KEY WORDS type 1 diabetes; type 2 diabetes; cardiovascular risk; quality indicators of care.

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