Abstract 2605: Hypoglycemia Does Not Increase Long-term Mortality Or Morbidity In Diabetic Patients With Myocardial Infarction. A Report From The Digami 2 Trial.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Linda G Mellbin ◽  
Klas Malmberg ◽  
Anders Waldenstrom ◽  
Hans Wedel ◽  
Lars Ryden
Keyword(s):  
Myocardial Infarction ◽  
Blood Glucose ◽  
Negative Impact ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Diabetic Patients ◽  
Type 2 Dm ◽  
Hazard Ratios

Aims Tight, insulin-based glucose control is recommended to diabetic patients (DM pat) with acute myocardial infarction (AMI). A potential draw-back would be if insulin induced hypoglycaemia (HG) had a negative impact of future prognosis. Methods 1253 pat (mean age 68 years; 67% males) with type 2 DM and suspect AMI were followed for a median of 2.1 years. 947 were randomised to insulin infusion during at least 24 hours while 306 were treated routinely. HG (blood glucose<3.0 mmol/L with or without symptoms) was recorded during hospitalisation. Unadjusted and adjusted (age, sex, smoking, previous MI and heart failure, renal function, duration of DM, coronary interventions, blood glucose at randomisation) Hazard Ratios (HR) and 95% Confidence Intervals (CI) for cardiovascular events (CVE = death, MI or stroke) during follow up were calculated. Results 153 pat (12.2%) experienced HG. During the first 24 hours 111 (11.7%) insulin-treated pat experienced HG (symptomatic 23.4%) compared with 3 (1.0%) pat on routine treatment (symptomatic 33.3%). As outlined in the figure HG was not an independent predictor of subsequent CVE. Conclusion Insulin induced HG was not a significant risk factor for subsequent CVE in AMI-pat with type 2 DM. Hypoglycaemic seem to identify patients at high risk for other reasons.

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.

scholarly journals Correlation of HbA1c levels with Triglyceride, LDL and HDL levels in Type 2 Diabetes Mellitus Patients

2021 ◽  
Vol 3 (2) ◽  
pp. 138-145
Author(s):  
Tri Prasetyorini ◽  
Cindy ◽  
Salbiah
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Significant Relationship ◽  
Metabolic Diseases ◽  
Blood Glucose Control ◽  
Design Data ◽  
Type 2 Dm ◽  
Hba1c Levels

Diabetes mellitus (DM) is a group of metabolic diseases with characteristics of increased blood glucose levels that occur due to abnormal insulin secretion, insulin action or both. It is necessary to monitor long-term glycemic status by measuring HbA1c levels to determine the quality of long-term blood glucose control. People with Type 2 DM are more at risk of suffering from cardiovascular disease characterized by dyslipidemia, with a characteristic description of high plasma triglyceride levels, elevated LDL levels and decreased HDL levels. The purpose of this study was to determine the relationship between HbA1c levels and levels of triglycerides, LDL and HDL. This study was an analytic observational study using a cross-sectional design. Data on each variable is secondary data obtained from patients with Type 2 DM at Jakarta Friendship Hospital for the period January-December 2018. The research sample used was 97 data of Type 2 DM patients. Chi-Square test showed an association between HbA1c levels and triglyceride levels with a value of p = 0.046 (< 0.05), there was a relationship between HbA1c levels and LDL levels with p = 0.742 (p > 0.05), and there was a relationship between HbA1c levels and HDL levels with p = 0.241 (p > 0.05). The conclusion obtained in this study is that there is a significant relationship between HbA1c levels and triglyceride levels and there was no significant relationship between HbA1c levels and LDL and HDL levels.

scholarly journals COMPREHENSIVE ASSESSMENT OF ENDOTHELIUM-DEPENDENT MEDIATORS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND DIABETES MELLITUS TYPE 2

2021 ◽  
Vol 76 (2) ◽  
pp. 14-18
Author(s):  
T. S. Zaikina ◽  
P. G. Kravchun ◽  
D. V. Minukhina ◽  
D. V. Minukhin ◽  
D. O. Yevtushenko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Carbohydrate Metabolism ◽  
Negative Impact ◽  
Enzyme Linked Immunosorbent Assay ◽  
Gradual Improvement ◽  
Type 2 Dm ◽  
Pai 1

The aim of study is to evaluate the levels of endothelium-dependent mediators: endothelial nitric-oxide synthase (NOS), plasminogen activator inhibitor-1 (PAI-1) and circulating soluble CD40 ligand (sCD40L) in patients with acute myocardial infarction (AMI) and concomitant type 2 diabetes mellitus (DM). The study included 255 patients with AMI, who were divided into two groups depending on the presence of concomitant type 2 DM: 1 group — 143 patients with concomitant type 2 DM; 2 group — 112 patients without concomitant disturbances of carbohydrate metabolism. Studied endothelial-dependent indicators were investigated using enzyme-linked immunosorbent assay. Statistical data were processed using the Mann–Whitney U-test, quantitative variables were described by the following parameters: median (Me), 25th and 75th percentiles (Q1; Q3). Analyzing the studied indicators on admission of patients to the hospital, a statistically significant decrease in NOS levels (p < 0,01), as well as an increase in PAI-1 (p < 0,01) and sCD40L (p < 0,01) in the cohort of patients with AMI and concomitant type 2 DM compared with patients without disturbances of carbohydrate metabolism. This indicates a more significant violation of endothelium-dependent vasodilation, thrombin fibrinolysis and activation of intravascular inflammation caused by comorbidity. Over the next 10 days, an increase in NOS levels, a decrease in PAI-1 and sCD40L levels were observed in patients of both groups, indicating a gradual improvement of the endothelial function. However, in patients with AMI and concomitant type 2 DM, the levels of the studied endothelium-dependent mediators continued to differ statistically even on the 10th day after acute occlusion of the coronary artery. In our opinion, this tendency is caused by the negative impact of metabolicdisorders associated with type 2 DM on the endothelium of the coronary arteries in patients with insulin resistance and, apparently, may increase the risk of complications of AMI.

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