Relationship between Diabetes Mellitus and Degree of Coronary Artery Disease in Uraemic Patients Investigated with Coronary Angiography

2003 ◽  
Vol 26 (3) ◽  
pp. 196-199 ◽  
Author(s):  
F. Fabbian ◽  
P. Benussi ◽  
G. Cacici ◽  
L. Cavallini ◽  
C. Loschiavo ◽  
...  

Prevalence of cardiovascular disease is high in diabetic patients on renal replacement therapy (RRT); therefore we examined the role of diabetes mellitus on determining the degree of coronary artery stenosis. Twenty-five patients underwent coronary angiography, 12 were awaiting kidney transplantation and the examination was performed regardless of cardiac symptoms, 13 were affected by ischaemic heart disease (IHD). Diabetic and nondiabetic status together with the other risk factors for cardiovascular disease such as age, sex, length of time on RRT, smoking and elevated phosphorus levels history, clinical diagnosis of IHD, cerebrovascular and peripheral vascular disease, mean blood pressure, cholesterol, triglycerides, calcium, phosphate, albumin, haemoglobin, haematocrit and weekly dose of erythropoietin were derived from clinical records. All investigated parameters were matched in diabetic (group 1, n=10) and nondiabetic patients (group 2, n=15) and showed no differences. Clinical evidence of IHD was detected in 80% of patients in group 1 and 46% in group 2 and the percentage of patients on the renal transplant waiting list was not statistically different in the two groups (30 vs 60%). In 60% of patients in group 1 there were 3 or more stenotic lesions equal or greater than 75% of normal reference segment in the major coronary arteries, whilst in 53% in group 2 there were no haemodynamically significant narrowings. Narrowing percentage of the coronaries in group 1 and 2 were: right coronary artery 83±30 vs 32±41 (p <0.05), left anterior descending artery 80±25 vs 44±34 (p <0.05), left circumflex artery 46±37 vs 18±29 (p=0.05) respectively. Our study confirms that IHD is a clinical feature of uraemic diabetic patients and that diabetes is the main cardiovascular risk factor for determining the degree of coronary stenosis.

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Juliana de Fatima Pedroso ◽  
Zahra Lotfollahi ◽  
Ghadeer Albattarni ◽  
Maiara Arrruda Schulz ◽  
Andrea Monteiro ◽  
...  

Abstract The objective of the present study was to establish if individuals with Diabetes Mellitus (DM2) and periodontal diseases (gingivitis or periodontitis) presented an increase in the concentration of modified LDL (moLDL) and what is the influence of periodontal treatment on the decrease of moLDL particles with consequent improvement in the parameters of DM2. Twenty-four diabetic patients with periodontitis (Group 1) and twenty-four diabetic patients with gingivitis (Group 2) were followed up for a period of 12 months. Group 1 was treated with periodontal debridement, and Group 2 received supra-gingival scaling and prophylaxis. In both groups, periodontal clinical parameters: probing depth (PD), clinical attachment level (CAL), gingival resection (GR), bleeding on probing index (BOP) and plaque index; inflammatory serum markers (glycemia, A1c, total cholesterol, HDL-cholesterol (HDL-c), LDL-cholesterol (LDL-c), triglycerides and hs-CRP) and oxidized LDL (oxLDL) were measured at baseline, t = 6 and t = 12 months after treatment. Solutions of LDL were analyzed using the nonlinear optical Z-Scan and optical absorption techniques. The periodontal clinical parameters showed significant improvement (p < 0.05) in both Group after 12 months. For both groups, total cholesterol, HDL-c, LDL-c, triglycerides and A1c levels did not show significant reductions after periodontal therapy. hs-CRP levels in Group 1 presented a significant reduction after 12 months. The glycemic rate and the oxLDL concentrations did not show significant differences as a function of time. The optical measurements of LDL solutions revealed an improvement of the LDL-c quality in both groups. Periodontal debridement was able to improve periodontal parameters and the quality of LDL-c in diabetic patients but without changes in the oxLDL concentration in both groups. Considering the clinical relevance, the reduction of infectious and inflammatory sites present in the oral cavity through periodontal therapy may help with the control and prevention of hyperglycemia and precursors of cardiovascular diseases.


2018 ◽  
Vol 7 (3) ◽  
pp. 24-32
Author(s):  
E. A. Archakov ◽  
R. E. Batalov ◽  
S. Yu. Usenkov ◽  
M. S. Khlynin ◽  
A. V. Smorgon ◽  
...  

Aim. To estimate the efficacy of catheter ablation in patients with type 2 diabetes mellitus (T2D) present with atrial fibrillation and sick sinus syndrome (SSS) undergoing permanent pacemaker implantation.Methods. 56 patients (34 females) with persistent AF and SSS were enrolled in the study. The mean age of patients was 67.7±10.7 years. Dual chamber cardiac pacemaker with remote monitoring function were implanted in all patients. All the patients were assigned to two groups: Group 1 comprised 31 patients aged 67.3±9.6 years, and Group 2 comprised 25 patients aged 72.6±9.9 years, including 22 (39.2%) diabetic patients. 2-3 days after pacemaker implantation, group 1 patients underwent intracardiac electrophysiology study and RFA of the pulmonary vein ostia, mitral isthmus and the left atrial posterior wall. Group 2 patients received antiarrhythmic drug therapy. Results. 3 patients (9%) in Group 1 had recurrent AF within the 6-month follow-up. The efficacy of the RFA for AF was 55% (n = 17) 1 year after the indexed hospitalization. 8 patients had short paroxysmal attacks which gradually lessened and stopped after. 5 patients (21%) in Group 2 did not have any AF paroxysms within the 1-year follow-up (Х2 = 5.52, р = 0.02). All these patients received amiodarone as antiarrhythmic drug therapy, whereas the others had paroxysmal attacks. Frequent attacks in 10 patients (40%) led to a change in antiarrhythmic drug use. Hospital readmission rates for AF were 16% and 52%, respectively (Х2 = 4.15, р = 0.04). The impact of atrial and ventricular stimulation on the development of recurrent AF was statistically insignificant (atrial stimulation – X2 = 0.01, cc = 1, p = 0.90; ventricular stimulation – X2 = 0.15, cc = 1, p = 0.69). None paroxysmal attacks were recorded in 10 diabetic patients (45%) after the RFA within the 1-year follow-up.Conclusion. Catheter ablation for persistent AF and SSS treated with permanent pacemakers is highly effective and safe method. In addition, it is superior to pharmacological approach. The presence of T2D likely did not significantly affect the efficacy of RFA for persistent form of AF. 


2020 ◽  
Vol 7 (48) ◽  
pp. 2847-2851
Author(s):  
Sreenivasulu Uppara ◽  
Bhagyamma Sollapurappa Narayanaswamy ◽  
Rama Kishore Akula Venkata ◽  
Thanuja Ramanna ◽  
Shyam Prasad B.R

BACKGROUND The multi-organ disorder, diabetes mellitus (DM) continues to be one of the commonest and challenging health-related problems in the 20th century, prevalent in about 9.3 % of the world's population in 2019 and likely to affect 10.2 % by 2030. Diabetes mellitus is a group of chronic metabolic disorders of multiple aetiology, characterized by chronic hyperglycaemia due to derangement in carbohydrate, fat and protein metabolism. Electrolytes are crucial in maintaining various metabolic functions and play a pivotal role in maintaining a healthy state's body. Diabetic patients are more prone to and frequently develop a constellation of electrolyte disorders due to hyperglycaemia, polydipsia and polyuria. METHODS Our study comprised a total of 70 subjects in the age group of 35 - 60 years with age and sex-matched controls. They were grouped into two groups; the first group, group-1 (healthy controls) and the second group was group-2 (patients of diabetes mellitus on oral hypoglycaemic agents with poor control). 5 ml of fasting venous blood was collected in a plain vacutainer tube in the morning after a zerocalorie overnight 08 hours fast. Post collection, the blood sample was used as serum or plasma or whole blood to estimate plasma glucose, blood urea, serum creatinine, serum sodium, serum potassium, serum chloride by kit methods using an auto analyser. RESULTS Among the various parameters tested, the mean value of fasting plasma glucose, blood urea, serum creatinine, serum potassium, serum chloride were higher in group-2 (diabetic patients) compared to group-1 (healthy controls) with a p-value of < 0.0001. The value of the mean of serum sodium was lower in group-2 (diabetes mellitus) compared to group-1 (healthy controls) with a p-value of < 0.0001. CONCLUSIONS We conclude that electrolyte abnormalities are present in diabetic patients and maybe a root cause for associated morbidity or mortality. These disturbances are generally seen in decompensated Diabetes Mellitus patients, elderly individuals and in the presence of renal impairment. KEYWORDS Diabetes Mellitus, Serum Electrolytes, Fasting Blood Glucose


2021 ◽  
Vol 9 (1) ◽  
pp. 1-4
Author(s):  
Moogaambiga S ◽  
Kirubhakaran K ◽  
Devi PL ◽  
Santhosh P

Background: Cardiovascular disease is a major cause of morbidity and mortality in diabetics. However diabetic patients do not present with typical anginal symptoms or may be even asymptomatic and silent coronary artery disease (CAD) is prevalent in diabetics. Moreover silent CAD is not different from symptomatic CAD with respect to prognosis and adverse effects. Aim: The study was done to demonstrate the prevalence of silent myocardial ischemic changes in asymptomatic type 2 diabetes mellitus patients with normal resting ECG by doing a stress exercise test. Methodology: This descriptive study was done in 100 patients with type 2 diabetes more than 2 years who did not have any history of cardiovascular disease or symptoms. Detailed history was taken and investigations such as HbA1c, fasting and postprandial blood sugar, serum creatinine, urine examination were done. Resting ECG, Echocardiogram was found to be normal and they were subjected to a treadmill test. Results: Among the 100 participants 18 persons (18%) had positive ECG findings in treadmill test. A positive association was found between the duration of diabetes and prevalence of positive treadmill test. Conclusion: There is significant prevalence of silent CAD in diabetic patients and they tend to present with advanced disease at presentation and have poorer prognosis compared to non diabetic population. Hence it is necessary to screen early for silent CAD in diabetics to improve disease outcomes.


2013 ◽  
Vol 6 (1) ◽  
pp. 3-9
Author(s):  
Md. Sk. Mamun ◽  
AAS Majumder ◽  
M Ullah ◽  
S Alam

Background: Cardiovascular diseases are the leading cause of death and morbidity in diabetic patients and this group is two to four times as likely to develop cardiovascular disease than the nondiabetic group, women being specially involved in this situation. In women , diabetes appear to be a stronger risk factor for the development of coronary heart disease than in men regardless of age ,menopausal status and whether or not the patient is insulin or non-insulin dependent. Objective of this study was to compare the angiographic extent of coronary artery disease between diabetic men and diabetic women. Method: This observational study was undertaken on 100 diabetic patients ( 50 women and 50 men) admitted inNational Institute of Cardiovascular disease (NICVD) during the period of July, 2006 to April ,2007.Diabetic women with coronary artery disease constitute the study group-I and diabetic men with coronary artery disease matched for age (±5 years) and risk factors , the study group-II . Coronary angiography was done in all patients & findings were analyzed. Segmental distribution method for coronary artery lesions was used to describe the distribution of atherosclerotis in coronary artery. Results: The mean age of group I was 51.02 ±8.93 years and that of the group II was 50.99± 9.83 years. In this study it was found that Diabetic women with coronary artery disease (CAD) had a higher coronary artery score, CAS (11.02±5.034) as compared to the diabetic men with CAD ( 8.04±4.866) (p<0.001). Diabetic women had also higher number of diseased vessels ( 78.67% vs 67.34%; p<0.01) and higher number of vessel score 3 ( 58% vs 34%; p<0.001). As compared to the diabetic men, diabetic women had a higher total number of coronary artery lesions (183 vs 136; p<0.001), a higher number of lesions per patient (3.66/ patients vs 2.72/patients; p<0.001) and a higher number of diffuse vessels (13.56% vs 8.91%;p<0.05). Conclusion: Diabetic women with coronary artery disease have more severe disease on coronary angiography as compared to diabetic men with coronary artery disease. The diffuse coronary artery involvement was also significantly higher in diabetic women than men. Cardiovascular Journal Volume 6, No. 1, 2013, Page 3-9 DOI: http://dx.doi.org/10.3329/cardio.v6i1.16108


2015 ◽  
Vol 53 (3) ◽  
pp. 248-252 ◽  
Author(s):  
Vidya Kadashetti ◽  
Rajendra Baad ◽  
Neelima Malik ◽  
K.M. Shivakumar ◽  
Nupura Vibhute ◽  
...  

Abstract Background. Diabetes mellitus is a massive, growing, silent epidemic that has the potential to cripple health services in all parts of the world. Currently, a diagnosis of diabetes is achieved by evaluating plasma glucose levels. Saliva offers some distinctive advantages. Whole saliva can be collected non-invasively and by individuals with limited training. The present study was aimed to estimate and correlate the plasma and salivary glucose levels in diabetic and non diabetic subjects, with special reference to age. Method. The study population consisted of three groups: Group 1 consisted of diabetics with BGL>200mg/dl and Group 2 consisted of diabetics with BGL 130-200mg/dl based on their random plasma glucose levels. Group 3 consisted of healthy population as controls with BGL <130 mg/dl. 2 ml of peripheral blood was collected for the estimation of random plasma glucose levels and unstimulated saliva was collected for the estimation of salivary glucose Results. The salivary glucose levels were significantly higher in group 1 and group 2 diabetics when compared with controls. The salivary glucose levels show a significant correlation with plasma glucose levels between study populations, suggesting that salivary glucose levels can be used as a monitoring tool for predicting glucose level in diabetic patients. Conclusion. The present study found that estimation of salivary glucose levels can be used as a noninvasive, painless technique for the measurement of diabetic status of a patient in a dental set up.


2019 ◽  
Vol 46 (1) ◽  
pp. 21-27
Author(s):  
A. Nikolov ◽  
A. Blazhev ◽  
M. Tzekova ◽  
K. Kostov ◽  
N. Popovski

Abstract Background and Aims: An important factor in the development of vascular wall lesions is the degradation of the elastic fiber major protein – elastin. Elastin peptides (EDP) derived from this degradation are present in the circulation and are a stimulus for the production of anti-elastin antibodies (AEAbs) IgM, IgG and IgA. The aim of this study was to investigate the possible association between AEAbs, lipid indices and the development of microvascular complications. Material and Methods: Sera of 93 patients with type 2 diabetes mellitus (T2DM) and arterial hypertension (AH) were investigated (mean age 61,4 ± 11,3 years, diabetes duration 9,88 ± 3,12 years; hypertension duration 9,28 ± 4,98). ELISA was used for determination of anti-elastin antibodies. These levels were compared to serum AEAbs in 42 age- and sex-matched controls. Diabetic patients were divided in two groups according to the presence – Group 1 (n = 67) or absence – Group 2 (n = 26) of microangiopathy. The lipid profile and lipid indices (log TG/HDL, LDL/HDL, TC/HDL and TG/HDL) were also studied. Results: Patients with T2DM and AH showed statistically significant higher levels of serum AEAbs IgA than healthy controls – 0,338 (0,133÷0,452) vs. 0,006 (0,052÷0,068) (KW = 19,54; P < 0.0001). Group 1 showed statistically significant higher levels of AEAbs IgA than patients without microangiopathy – 0,353 (0,173÷0,471) vs. 0,235 (0,098÷0,377) (KW = 3,36; p = 0.05) and healthy controls – 0,353 (0,173÷0,471) vs. 0,006 (0,052÷0,068) (KW = 20,37; p < 0,0001) (0.37 ± 0,03 vs. 0.06÷0.01) (p = 0.0001). Patients from Group 2 showed significantly higher levels of AEAbs IgA than controls 0,235 (0,098÷0,377) vs. 0,006 (0,052÷0,068) (KW = 8,54; P = 0.003). AEAbs IgA showed correlation with insulin dose (r = −0.35); (p = 0.01), SBP (r = 0.31); (p = 0.001), HbA1c (r = 0.21); (p = 0.04), BMI (r = 0.22); (p = 0.01). AEAbs IgA correlated with log TG/HDL (r = 0.28); (p = 0.001), LDL/HDL (r = 0.22); (p = 0.01) TC/HDL (r = 0.22); (p = 0.01) and with TG/HDL (r = 0.15); (p = 0.05). Conclusion: Our study proved a relationship between elevation of AEAb IgA, high lipid indices and the development of microvascular complications in patients with type 2 diabetes mellitus and arterial hypertension.


2020 ◽  
Vol 12 (2) ◽  
pp. 51-57
Author(s):  
Omar Khashaba ◽  
Atef Alasfar ◽  
Enas Ahmed Elgendy ◽  
Bassant Mowafey

Background. The present study aimed to assess the clinical and radiographic effect of strontium ranelate and metal-substituted hydroxyapatite as bone graft materials on treating chronic periodontitis among diabetes mellitus patients. Methods. A randomized split-mouth study was conducted on 20 sites in 10 controlled type II diabetic patients suffering from chronic periodontitis. After phase I therapy, the sites were randomly allocated by a computer-generated table into two groups. Group 1: A mucoperiosteal flap was elevated in 10 sites, followed by the placement of strontium ranelate mixed with Gengigel. Group 2: A mucoperiosteal flap was elevated in 10 opposite sites, followed by the placement of metal-substituted hydroxyapatite mixed with Gengigel. Clinical parameters were assessed at baseline and 3- and 6-month intervals. Cone-beam computed tomography (CBCT) was used at baseline and after six months to assess bone gain. Results. The two treatment modalities resulted in a statistically significant reduction in clinical parameters at the 3- and 6-month intervals compared to the mean baseline value. Intergroup comparison showed a significant reduction in probing pocket depth and clinical attachment loss in group 1 compared to group 2. Comparison of the two sides by CBCT showed a significant increase in the alveolar bone height in the SR group than the metal-substituted hydroxyapatite group. Conclusion. Clinical and radiographic results showed a significant improvement in the two groups and provided evidence that strontium ranelate is promising in treating periodontal diseases.


1970 ◽  
Vol 5 (2) ◽  
pp. 75-78
Author(s):  
Mohammad Salman ◽  
Mohammad Ferdous Ur Rahman ◽  
Khawer Naveed Siddique ◽  
Md Mizanur Rahman Khan ◽  
Mohammed Shahed Anwar ◽  
...  

Diabetes mellitus (DM) increases the risk of cardiovascular events in patients with cardiovascular disease as well as in patients without any previous history of ischemic heart disease (IHD). This inordinate increase in the risk of coronary events in diabetic patients is attributed to multiple factors, including glycation and oxidation of proteins and increased prevalence of classic risk factors of coronary disease, such as hypertension, obesity, and dyslipidemia. Despite advances in the management of cardiovascular disease, a large proportion of diabetic subjects continue to have uncontrolled hyperglycemia, hypertension, and dyslipidemia. Patients with CAD and pre-diabetic states should undergo lifestyle modifications aimed at preventing DM. In patients with CAD and DM, routine use of aspirin and an angiotensin-converting en zyme inhibitor (ACE I) - unless contraindicated or not tolerated - and strict glycemic, blood pressure, and lipid control are strongly suggested. The results after revascularization in diabetic patients are usually worse compared with non-diabetic patients. Advances in PCI include the use of drug-eluting stents and adjunctive drug therapies, such as GpIIbIIIa antagonists. Glycemic control is an important determinant of outcome after revascularization in diabetic patients. In this review, some of these landmark studies are reviewed and some practical guidelines of management are suggested. Key words: Angiotensin-converting enzyme inhibitor; Coronary artery disease; diabetes mellitus; dyslipidemia. DOI: 10.3329/uhj.v5i2.4559 University Heart Journal Vol.5(2) July 2009 pp.75-78


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M M Ahmed ◽  
N M M Abdelfattah ◽  
A A Elsherbeny ◽  
S A Afifi

Abstract Introduction COPD is known to be a multisystemic inflammatory disease that goes beyond lung involvement. The association of decreased lung functions and diabetes mellitus has been studied for many years suggesting that the lung could be a target organ in diabetes mellitus. Objective assessment of pulmonary functions in COPD patients with normoglycemia and with diabetes mellitus, and patients with diabetes mellitus. Patients and Methods The study was conducted in Ain shams university hospitals After the inclusion criteria was met, patients were divided into 3 groups, each group was 20 patients,(group 1): diabetes mellitus patients,(group 2): COPD patients, and (group 3): COPD with diabetes mellitus patients. spirometry was performed and results were analyzed. Results In COPD with diabetes mellitus patients (group 3), the lung functions were the least. Diabetes mellitus was also an independent risk factor for reduced lung functions as was seen in nonsmoking diabetic patients (group 1). Conclusion Pulmonary functions are reduced in DM independent of smoking.


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