scholarly journals Experts’ opinion on the detection and management of prediabetes in Lebanon

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110294
Author(s):  
Emile Andari ◽  
Paola Atallah ◽  
Sami Azar ◽  
Akram Echtay ◽  
Selim Jambart ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preliminary Report ◽  
Early Stage ◽  
National Guidelines ◽  
Lifestyle Modifications ◽  
Multiple Tests ◽  
Lebanese Population ◽  
To Come ◽  
Near Future

Given that the complications of type 2 diabetes can start at an early stage, early detection and appropriate management of prediabetes are essential. We aimed to develop an expert opinion on prediabetes in Lebanon to pave the way for national guidelines tailored for the Lebanese population in the near future. A panel of seven diabetes experts conducted a thorough literature review and discussed their opinions and experiences before coming up with a set of preliminary recommendations for the detection and management of prediabetes in Lebanon. Lebanese physicians employ multiple tests for the diagnosis of prediabetes and no national cut-off values exist. The panel agreed that prediabetes screening should be focused on patients exceeding 45 years of age with otherwise no risk factors and on adults with risk factors. The panel reached that fasting plasma glucose (FPG) and HbA1c should be used for prediabetes diagnosis in Lebanon. FPG values of 100–125 mg/dL or HbA1c values of 5.7%–6.4% were agreed upon as indicative of prediabetes. For the management of prediabetes, a three-step approach constituting lifestyle modifications, pharmacological treatment and bariatric surgery is recommended. There should be more focus on research on prediabetes in Lebanon. This preliminary report will be further discussed with the Lebanese Society of Endocrinology, Diabetes and Lipids in 2021 in order to come up with the first Lebanese national guidelines for the detection and management of prediabetes in Lebanon.

scholarly journals Sex Differences in the Renal Function Decline of Patients with Type 2 Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Ayami Kajiwara ◽  
Ayana Kita ◽  
Junji Saruwatari ◽  
Hiroko Miyazaki ◽  
Yuki Kawata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Function ◽  
Sex Differences ◽  
Renal Dysfunction ◽  
Ldl Cholesterol ◽  
Early Stage ◽  
Interactive Effects ◽  
Renal Function Decline ◽  
Egfr Decline

Aims. We aimed to investigate the sex differences in the renal function decline among patients with type 2 diabetic mellitus (T2DM), focusing on the differences in the risk factors at early stage of renal dysfunction.Methods. A clinic-based retrospective longitudinal study (follow-up duration:8.1±1.4years) was conducted to assess the sex differences in the annual estimated glomerular filtration rate (eGFR) change in 344 (247 male and 97 female) Japanese T2DM patients. The sex differences in the risk factors of annual eGFR decline were subjected to linear regression analyses.Results. The mean annual eGFR change was-3.5±2.7%/year in females and-2.0±2.2%/year in males (P<0.001). Baseline retinopathy and proteinuria were significantly associated with a larger eGFR decline, irrespective of sex, while HbA1c and LDL-cholesterol levels were significantly associated with an eGFR decline in females only. Interactive effects were observed between sex and the HbA1c, LDL-cholesterol, retinopathy, or proteinuria levels on the annual eGFR decline.Conclusions. The increased susceptibility to poor metabolic control seemed to contribute to a higher risk of renal dysfunction in females with T2DM. Our study highlights the importance of aggressive therapeutic intervention to improve metabolic profiles at early stage, especially in females.

scholarly journals Efficacy of dapagliflozin versus sitagliptin on cardiometabolic risk factors in Japanese patients with type 2 diabetes: a prospective, randomized study (DIVERSITY-CVR)

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Ayako Fuchigami ◽  
Fumika Shigiyama ◽  
Toru Kitazawa ◽  
Yosuke Okada ◽  
Takamasa Ichijo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Body Weight ◽  
Primary Endpoint ◽  
Hba1c Level ◽  
Cardiometabolic Risk ◽  
Early Stage ◽  
Body Weight Loss ◽  
Cardiometabolic Risk Factors

Abstract Background Few prospective studies have compared the cardiovascular benefits of sodium-glucose cotransporter-2 (SGLT2) inhibitors and dipeptidyl peptidase 4 (DPP-4) inhibitors. We aimed to clarify the efficacy of dapagliflozin versus sitagliptin for modulating cardiometabolic risk factors including high glycated hemoglobin (HbA1c) levels, hypoglycemia, and body weight. Methods This prospective, randomized, open-label, blinded-endpoint, parallel-group trial enrolled 340 Japanese patients with early-stage type 2 diabetes receiving metformin alone or no glucose-lowering agents, who were randomized to receive dapagliflozin or sitagliptin for 24 weeks. The primary endpoint was the proportion of patients who achieved the composite endpoint of HbA1c level maintenance < 7.0% (53 mmol/mol), avoidance of hypoglycemia (maintenance of sensor glucose ≥ 3.0 mmol/L or ≥ 54 mg/dL), and ≥ 3.0% body weight loss from baseline. Secondary endpoints included components of the primary endpoint, other metabolic indices, and glucose variability indices measured using flash glucose monitoring. Results Clinical characteristics of patients were age, 58.1 ± 12.2 years; known duration of diabetes, 5.8 ± 6.1 years; body weight, 74.7 ± 14.2 kg; body mass index, 27.9 ± 4.1 kg/m2; and HbA1c level, 7.8 ± 0.8% at baseline. The achievement ratio of primary endpoint was significantly higher in the dapagliflozin group than in the sitagliptin group (24.4% vs. 13.8%, P < 0.05). While the rates of HbA1c level maintenance < 7.0% (53 mmol/mol) and avoidance of hypoglycemia were comparable between the groups (49.4 vs. 50.0% and 88.7 vs. 92.3% for dapagliflozin vs. sitagliptin, respectively), body weight loss of ≥ 3.0% was significantly achieved in the dapagliflozin group (54.4 vs. 19.6%, P < 0.001). Moreover, dapagliflozin was superior to sitagliptin regarding several secondary endpoints that modulate cardiometabolic risk, namely reducing fasting plasma glucose, insulin, uric acid, increasing high-density lipoprotein cholesterol, and suppressing the increase in serum creatinine and the decrease in estimated glomerular filtration rate. On the other hand, sitagliptin was superior to dapagliflozin in suppressing glucose variability. Conclusions Compared to sitagliptin, dapagliflozin was significantly more effective at improving cardiometabolic risk factors, suggesting that SGLT2 inhibitors might be more suitable than DPP-4 inhibitors for preventing cardiovascular events in patients with early-stage but inadequately controlled type 2 diabetes. Trial registration Trial number, UMIN000028014; registered on June 30, 2017

scholarly journals Cognitive impairments in type 2 diabetes, risk factors and preventive strategies

2020 ◽  
Vol 31 (2) ◽  
Author(s):  
Garima Sharma ◽  
Arti Parihar ◽  
Tanay Talaiya ◽  
Kirti Dubey ◽  
Bhagyesh Porwal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Fruits And Vegetables ◽  
Early Stage ◽  
Cognitive Impairments ◽  
Diabetic Patients ◽  
Unhealthy Lifestyle

AbstractMild cognitive impairment (MCI) is a modifiable risk factor in progression of several diseases including dementia and type 2 diabetes. If cognitive impairments are not reversed at an early stage of appearance of symptoms, then the prolonged pathogenesis can lead to dementia and Alzheimer’s disease (AD). Therefore, it is necessary to detect the risk factors and mechanism of prevention of cognitive dysfunction at an early stage of disease. Poor lifestyle, age, hyperglycemia, hypercholesterolemia, and inflammation are some of the major risk factors that contribute to cognitive and memory impairments in diabetic patients. Mild cognitive impairment was seen in those individuals of type 2 diabetes, who are on an unhealthy diet. Physical inactivity, frequent alcohol consumptions, and use of packed food products that provides an excess of cheap calories are found associated with cognitive impairment and depression in diabetic patients. Omega fatty acids (FAs) and polyphenol-rich foods, especially flavonoids, can reduce the bad effects of an unhealthy lifestyle; therefore, the consumption of omega FAs and flavonoids may be beneficial in maintaining normal cognitive function. These functional foods may improve cognitive functions by targeting many enzymes and molecules in cells chiefly through their anti-inflammatory, antioxidant, or signaling actions. Here, we provide the current concepts on the risk factors of cognitive impairments in type 2 diabetes and the mechanism of prevention, using omega FAs and bioactive compounds obtained from fruits and vegetables. The knowledge derived from such studies may assist physicians in managing the health care of patients with cognitive difficulties.

Environmental (Lifestyle) Risk Factors for LADA

2019 ◽  
Vol 15 (3) ◽  
pp. 178-187 ◽  
Author(s):  
Sofia Carlsson
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Current Knowledge ◽  
Population Based ◽  
Lifestyle Modifications ◽  
Hybrid Form ◽  
Lifestyle Risk Factors ◽  
Lifestyle Risk

<P>Background: In order to prevent diabetes it is important to identify common, modifiable risk factors in the population. Such knowledge is extensive for type 2 diabetes but limited for autoimmune forms of diabetes. </P><P> Objective: This review aims at summarizing the limited literature on potential environmental (lifestyle) risk factors for LADA. Methods: A PubMed search identified 15 papers estimating the risk of LADA in relation to lifestyle. These were based on data from two population-based studies; one Swedish case-control study and one Norwegian cohort study. Results: Studies published to date indicate that the risk of LADA is associated with factors promoting insulin resistance and type 2 diabetes such as overweight, physical inactivity, smoking, low birth weight, sweetened beverage intake and moderate alcohol consumption (protective). Findings also indicate potential effects on autoimmunity exerted by intake of coffee (harmful) and fatty fish (protective). This supports the concept of LADA as being a hybrid form of diabetes with an etiology including factors associated with both insulin resistance and autoimmunity. Conclusion: LADA may in part be preventable through the same lifestyle modifications as type 2 diabetes including weight loss, physical activity and smoking cessation. However, current knowledge is hampered by the small number of studies and the fact that they exclusively are based on Scandinavian populations. There is a great need for additional studies exploring the role of lifestyle factors in the development of LADA.</P>

scholarly journals Timely Detection of Glaucoma in General Practice as a Means Prevent Late Diagnosis

2016 ◽  
pp. 143-145
Author(s):  
Nataliia Medvedovskaya ◽  
Zoreslava Povch
Keyword(s):  
Risk Factors ◽  
Early Stage ◽  
Low Vision ◽  
Family Doctor ◽  
Risk Groups ◽  
Sociological Research ◽  
Timely Diagnosis ◽  
Treatment And Prevention ◽  
The Family ◽  
Near Future

The objective: justification of need of the organization of introduction of measures for timely identification of an ophthalmic hypertension in practice of the family doctor for timely diagnosis of glaucoma, the prevention of development of her terminal stage became a research objective. Patients and methods. Outpatient and polyclinic units of five healthcare institutions of the city of Kiev in which primary help by the principles of the general medical practice – family medicine is given became scientific base of a research. Forms of account No. 12 «The report on the diseases registered at patients who live in the district of service of treatment and prevention facility» and questionnaires of a sociological research of risk factors of glaucoma (820 questionnaires) were primary material. Achievement of goals of a research demanded use of a complex of methods of a research, a basis for which was a systemic approach, namely: bibliosemantic, sociological, medico-statistical methods. Results. Of a research it has turned out that prevalence of glaucoma continues to increase enough in high gear (for 14,9% from 2010 to 2014) that proves relevance of a problem of the prevention of a blindness and a low vision because of glaucoma in Ukraine and in the near future. Owning knowledge of modern risk factors which has the proved influence on formation of an oftalmogipertenziya, and over time and glaucomas, physicians of primary contact can actively form risk groups on glaucoma that will allow to unify and to individualize at the same time preventively – improving, medical and diagnostic medical care in each case and to objectify assessment of her results in dynamics. Conclusion. Interaction in form of cooperation of the family doctor and ophthalmologist within the competences allows to perform effective long accounting of patients, preventing loss of visual functions by them for the account, first of all timely diagnosis of a disease (at an early stage), possible correction of the available risk factors of origin and progressing of glaucoma.

scholarly journals THE ROLE OF VITAMIN D IN THE PATHOGENESIS OF CHRONIC NON-COMMUNICABLE DISEASES

2014 ◽  
Vol 17 (3) ◽  
pp. 27-30 ◽  
Author(s):  
L V Egshatyan ◽  
E N Dudinskaya ◽  
O N Tkacheva ◽  
D A Kashtanova
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Vitamin D ◽  
Β Cells ◽  
Pancreatic Β Cells ◽  
Autoimmune Destruction ◽  
Near Future ◽  
Reduced Risk

This review shows the role of vitamin D in the regulation of not only the level of calcium, but also in the pathogenesis of chronic systemic inflammation, disruption of insulin sensitivity of tissues. The sufficient levels of vitamin D in the blood can lead to reduced risk of developing type 2 diabetes, obesity, autoimmune destruction of pancreatic β-cells, certain cardiometa-bolic risk factors, and therefore cardiovascular disease. Perhaps preparations of vitamin D in the near future may become additional and necessary nutritional substances for correction of insulin resistance, cardiovascular disease, chronic inflammation and prevention of disorders of glucose metabolism.

scholarly journals South Asians and their increased cardiovascular risk: A review of risk factors and diet and lifestyle modification

2015 ◽  
Vol 1 (2) ◽  
pp. 74
Author(s):  
Rachel Nicoll ◽  
Michael Henein
Keyword(s):  
Risk Factors ◽  
Lifestyle Modification ◽  
South Asians ◽  
Density Lipoprotein ◽  
Plant Oils ◽  
Lifestyle Modifications ◽  
Cvd Risk ◽  
Diet And Lifestyle ◽  
Conventional Risk Factors

South Asians (SAs) have a significantly higher incidence and severity of type 2 diabetes and cardiovascular disease (CVD)<br />than Caucasians and can present with atypical ischaemic symptoms. This can present a challenge for health professionals<br />who may not be aware of the lowered thresholds recommended for SA body mass index, waist circumference and age.<br />Although SAs are likely to have all the hallmarks of metabolic syndrome: central obesity, insulin resistance, impaired glucose<br />tolerance, reduced high density lipoprotein, high triglycerides and hypertension, conventional risk factors alone do not fully<br />predict the increased CVD risk among this community. Furthermore, SAs themselves may not be aware of their increased<br />predisposition to disease nor of the dietary and lifestyle modifications which could reduce the risk and severity of their<br />condition. Even where some modification has been attempted, there may be cultural pressure to conform to a traditional<br />diet and the requirements for fasting and feasting. Principally, SAs should avoid large late meals, reduce sugary sweets and<br />drinks, alcohol and foods fried in plant oils which create damaging transfats, while increasing protein and non-fried vegetables<br />to help glycaemic control. Chewing paan, with or without added tobacco, is a particular risk factor for both CVD and cancer,<br />on a par with the dangers of smoking. Although not in the culture, exercise would also be of great benefit.

scholarly journals Study on prevalence of risk factors of diabetes among adult population in a rural area of West Bengal, India

2020 ◽  
Vol 7 (2) ◽  
pp. 701
Author(s):  
Dipanwita Sarkar ◽  
Rajesh Kumar Dalal ◽  
Shuvadeep Sarkar
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
High Risk ◽  
West Bengal ◽  
Early Stage ◽  
Adult Population ◽  
International Diabetes Federation ◽  
Anthropometric Measurement ◽  
Simple Method

Background: India is currently in the grip of an explosive epidemic of type 2 diabetes. The International Diabetes Federation (IDF) estimates that by 2030, 8.4% of the adult population will have diabetes in India, which already is the world’s diabetes capital. Indian diabetic risk score (IDRS) is a cost effective and simple method for mass screening at community level. The objective of the study was to find out the prevalence of risk factors of diabetes among rural adults of Amdanga, West Bengal and to study the socio-demographic correlates of higher risk.Methods: A community-based, cross-sectional study was carried out in Amdanga, North 24 Parganas district of West Bengal from 1st August 2019 to 30 th September 2019 among 104 adult population on risk status for type 2 diabetes mellitus using IDRS. Interview was conducted using pre-designed semi-structured questionnaire followed by anthropometric measurement. The data were analyzed by SPSS 16.0 version.Results: Out of 104 study subjects, 9.6% study subjects were not at risk of having diabetes, 45.2% were at moderate risk and 45.2% were at high risk of having diabetes. Marital status, hypertension, outside food intake, exercise and strenuous activity were significantly associated with the risk of diabetes.Conclusions: Majority of the adult population were at moderate and high risk of developing type 2 diabetes, hence screening is of utmost importance so that interventions can be initiated at an early stage and change of lifestyle should be initiated as soon as possible to delay the occurrence of type 2 diabetes.

scholarly journals A study on the prevalence of risk factors and presence of diabetic foot ulcers in T2DM patients in K. R. Hospital, Mysuru

2017 ◽  
Vol 4 (9) ◽  
pp. 2983 ◽  
Author(s):  
Chandrashekar S. ◽  
Suraj Muralidhar
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Early Stage ◽  
Ankle Brachial Index ◽  
Outpatient Basis ◽  
Diabetic Foot Ulcers ◽  
Foot Care ◽  
Minimum Data ◽  
Care Behavior

Background: India is one of the top ten diabetes mellitus (DM) countries. Thus, the aim of this study was to survey the prevalence of DFU risk factors and DFU prevalence among type 2 diabetes mellitus (T2DM) patients.Methods: An epidemiological study was conducted on an outpatient basis in K. R. hospital, Mysuru. All T2DM participants were ≥ 18 years were included. Demographic and foot care behavior were assessed using minimum data sheet (MDS). Meanwhile, presence of risk factors was evaluated for neuropathy and presence of angiopathy was evaluated with ankle brachial index (ABI) by using a hand-held doppler both dorsal and posterior tibial.Results: At the end of study, 249 T2DM participants were enrolled. The prevalence of DFU risk factors was 55.4% (95% CI: 53.7% - 57.0%), and prevalence of DFU was 12% (95% CI: 10.3% - 13.6%).Conclusions: Even though the prevalence of DFU is high, identification associated factors for presence of risk and DFU has not been integrated into national guideline. Thus, preventive strategies should be introduced at early stage to prevent presence of risk and DFU. 

Physical health and attendance at primary care in people with schizophrenia

2008 ◽  
Vol 25 (2) ◽  
pp. 57-60 ◽  
Author(s):  
Caragh Behan ◽  
Nicola McGlade ◽  
Farhan Haq ◽  
Anthony Kinsella ◽  
Michael Gill ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Primary Care ◽  
Physical Health ◽  
Physical Illness ◽  
National Guidelines ◽  
Endocrine Disease ◽  
Increased Risk

AbstractObjectives: People with schizophrenia are at increased risk of cardiovascular and endocrine disease. National guidelines recommend the physical health of people with schizophrenia be monitored by primary care, but little is known about whether such people attend primary care. We sought to examine the prevalence of cardiovascular and endocrine disease in a stable population with schizophrenia, and factors associated with attending primary care.Method: A cross sectional survey of people with a diagnosis of schizophrenia/schizoaffective disorder was taken from a larger cohort participating in the Resource for Psychoses and Genomics in Ireland (RPGI) study. Participants were interviewed using standardised clinical assessments, and underwent anthropometric measurements, and further information was collected by medical record review and contacting the general practitioner (GP).Results: Thirteen percent (n = 14) had established cardiovascular disease and 4.3% (n = 4) had type 2 diabetes. Risk factors for cardiovascular disease and type 2 diabetes were higher than the general population. Sixty-eight point five percent (n = 63) had attended their GP at least once in the previous year. Only 35% self reported a physical illness. Females (p = 0.03), those with both self-reported presence of physical illness (p = 0.007), and diagnosed physical illness (p = 0.001) were more likely to attend their GP. Other psychosocial, psychological and illness related variables did not predict attendance at primary care.Conclusion: While established patients attend their GP, they had significant unidentified risk factors for cardiovascular disease and type 2 diabetes. It is likely that non-attendees at secondary care would fare worse yet.

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