Dealing with complexity in type 2 diabetes

2019 ◽  
Vol 12 (6) ◽  
pp. 315-322
Author(s):  
Neel Basudev
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Diabetes Distress ◽  
Health Concerns ◽  
Metabolic Indices

The management of people with type 2 diabetes (or type 2 diabetes mellitus) can be complex and sits largely within the portfolio of primary care. Unfortunately, despite an ever-increasing therapeutic armoury, many people with type 2 diabetes fail to achieve optimal control of their blood glucose and other metabolic indices, putting them at higher risk of diabetes-related complications. The situation has sadly changed little over recent years. People with type 2 diabetes often have other long-term health concerns that need to be recognised and addressed alongside more traditional parameters such as blood glucose and blood pressure. In this article, we will consider the recognition and management of two of the more common conditions that co-exist in people with type 2 diabetes: Diabetes distress and renal disease. Although there is undoubtedly some overlap with type 1 diabetes, the discussion in this article solely relates to the management of type 2 diabetes.

scholarly journals Polymorphisms of Aldose Reductase (ALR2) Regulatory Gene are Risk Factors for Diabetic Retinopathy in Type-2 Diabetes Mellitus Patients in Bali, Indonesia

2018 ◽  
Vol 12 (1) ◽  
pp. 281-288 ◽  
Author(s):  
Desak Made Wihandani ◽  
Ketut Suastika ◽  
I Nyoman Agus Bagiada ◽  
Safarina G. Malik
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Aldose Reductase ◽  
Regulatory Gene ◽  
Fasting Blood Glucose ◽  
Regulatory Region

Aim: The study aimed to elucidate whether the polymorphisms of the aldose reductase regulatory gene were risk factors for Diabetic Retinopathy (DR) in type-2 diabetes mellitus (T2DM) patients in Bali. Methods: This is a case-control study including 35 cases of T2DM patients with DR paired with 35 cases with non-DR as controls. PCR analysis and DNA-sequencing were carried out to detect the C(-106)T and C(-12)G polymorphisms at the regulatory region of Aldose Reductase (ALR2) gene. Genotype and allele distributions were analyzed by Chi-squared test and independent t-and Mann-Whitney U tests were used to analyze other data. Results: Among all subjects in both groups, the baseline characteristics were homogenous except for systolic blood pressure, fasting blood glucose and 2-hours post-prandial blood glucose. This study found two polymorphisms, C(-104)T and C(-9)G, in the regulatory region of ALR2 gene. The result showed that the C(-104)T polymorphism was a risk factor for DR (OR=36; 95% CI = 4.43-292.85; p=0.001), but not the C(-9)G polymorphism (OR=1.28; 95% CI=0.48-3.38; p=0.621). Other findings in the study revealed that CC/CC haplotype is a protective factor for DR (OR=0.198; p=0.002), whereas CT/CC and CT/CG haplotypes as risk factors for DR with OR=15.58; p=0.002 and OR=2.29; p=0.005 respectively. Conclusion: It can be concluded that C(-104)T polymorphism in the regulatory region of Aldose Reductase (ALR2) gene was the risk factor for DR among T2DM patients in Bali, Indonesia. However, small sample size, systolic blood pressure, fasting blood glucose and 2-hours post-prandial blood glucose could affect our finding.

scholarly journals QTc interval and resting heart rate as long-term predictors of mortality in type 1 and type 2 diabetes mellitus: a 23-year follow-up

Diabetologia ◽  
2006 ◽  
Vol 50 (1) ◽  
pp. 186-194 ◽  
Author(s):  
C. Stettler ◽  
A. Bearth ◽  
S. Allemann ◽  
M. Zwahlen ◽  
L. Zanchin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Heart Rate ◽  
Type 2 Diabetes Mellitus ◽  
Qtc Interval ◽  
Resting Heart Rate

scholarly journals EFFECTS OF LONG-TERM ROUX-EN-Y GASTRIC BYPASS ON BODY WEIGHT AND CLINICAL METABOLIC COMORBIDITIES IN BARIATRIC SURGERY SERVICE OF A UNIVERSITY HOSPITAL

2016 ◽  
Vol 29 (suppl 1) ◽  
pp. 20-23 ◽  
Author(s):  
Cátia Ferreira da SILVA ◽  
Larissa COHEN ◽  
Luciana d'Abreu SARMENTO ◽  
Felipe Monnerat Marino ROSA ◽  
Eliane Lopes ROSADO ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
High Blood Pressure

ABSTRACT Background: Due to the high failure rate observed in the clinical treatment of morbid obesity an increase in bariatric surgery indications, as an alternative for the control of obesity and comorbidities, is noticeable. Aim: To evaluate the performance of type 2 diabetes mellitus, high blood pressure and dyslipidemia in patients submitted to Roux-en-Y gastric bypass in late follow-up. Methods: Retrospective analysis of 59 patients included in the bariatric surgery program. Anthropometric (height and body weight) and laboratory (LDLc, HDLc, VLDLc, triglyceride -TG - and glucose) data were collected on pre- and postoperative stages, through medical records. Results: Among the patients, 86% were female aged 43±11, of whom 52% had attended high school. The average postoperative time was 7±3 years. During the postoperative period, there were decreases of weight and body mass index, respectively (133±06 kg vs 91±04 kg p<0.05 e 49±74 kg/m2 vs 33±79 kg/m2, p<0.05). In comparison to the preoperative stage, lower concentrations of glucose (101.00±26.99 vs 89,11±15.19, p=0.014), total cholesterol rates (179.00±37,95 vs 167.48±28,50, p=0.016), LDLc (104.30±33.12 vs 91.46±24.58, p=0.016), VLDLc (25.40±11,12 vs 15.68±7.40, p<0.01), and TG (143.35±86.35 vs 82.45±37.39, p<0.01) and higher concentrations of HDLc (43.53±8.23 vs 57.90±15.60, p<0.01) were identified in the postoperative stage. 40% of hypertensive patients were still undergoing high blood pressure treatment during the postoperative stage. There was remission of type 2 diabetes mellitus and dyslipidemia on 81% and 94% of the cases, respectively. Conclusion: Roux-en-Y gastric bypass has proven itself to be an effective long term procedure, promoting weight loss, remission of DM2 and dyslipidemia.

scholarly journals Seasonal Variation in Blood Pressure in 162,135 Patients With Type 1 or Type 2 Diabetes Mellitus

2015 ◽  
Vol 18 (4) ◽  
pp. 270-278 ◽  
Author(s):  
Julia M. Hermann ◽  
Joachim Rosenbauer ◽  
Axel Dost ◽  
Claudia Steigleder-Schweiger ◽  
Wieland Kiess ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Seasonal Variation

scholarly journals ESSENTIAL HYPERTENSION

2007 ◽  
Vol 14 (04) ◽  
pp. 627-633
Author(s):  
IMRAN ASHRAF ◽  
Imran Khan ◽  
NOOR KAMIL ◽  
Abdul Mannan ◽  
Muhammad Shamaun Razi
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Essential Hypertension ◽  
Blood Glucose ◽  
Diabetic Patients ◽  
Newly Diagnosed ◽  
Once Daily

Background: Hypertension and type 2 diabetes mellitus also tend to coexist.The goal of antihypertensive therapy should consist of reducing cardiovascular morbidity and mortality associated withhypertension by a strategy focused on lowering blood pressure while minimizing the impact on other associatedcardiovascular risk factors like diabetes mellitus. Objectives: To observe and compare any change in serum glucosein patients with newly diagnosed essential hypertension with Atenolol and Amlodipine. Setting: Department ofPharmacology and Therapeutics, Basic Medical Science Institute (BMSI), Jinnah Post Graduate Medical Centre(JPMC), Karachi. Period: 12 weeks (90 days) Methods: Patients with newly diagnosed essential hypertension (N=70)were enrolled in this study and were divided into two groups, each comprised of 35 patients and were given tabletAtenolol 50/100mg once daily and tablet Amlodipine 5/10 mg once daily respectively for 90 days. Fasting Blood glucosewas measured on day of inclusion i.e. day 0, day 45 and day 90. At each fortnightly visit, blood pressure was recorded.Results: Atenolol raised mean blood glucose levels from baseline levels of 91.82±1.34 mg/dl to 99.73±1.33 mg/dl onday 90 (P<0.001) while Amlodipine had no significant effect on blood glucose level (P= N.S). Conclusion: Atenololmay not be a good choice for essential hypertensive patient with type 2 diabetes mellitus as it is found to impair the normal glucose metabolism. Long term clinical trials in diabetic patients are needed to confirm the observation of thepresent study.

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