scholarly journals Targeting risk factors: a feasible way for prevention of vascular complications in type 2 diabetes mellitus

2012 ◽  
Vol 15 (4) ◽  
pp. 103-108
Author(s):  
Irina Vladimirovna Kononenko ◽  
Olga Mikhailovna Smirnova

The article addresses challenges in the prevention of microvascular complications in type 2 diabetes mellitus (T2DM) and discusses necessity of multifactorial approach to management of these conditions. We present results of a large-scale ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation) trial that elucidates the combined influence of antihypertensive and of intensive glucose-lowering therapy on the risk of development of micro- and macrovascular complications of T2DM

Author(s):  
Krishan Kumar Meena ◽  
Praveen Sharma ◽  
Swati Srivastava ◽  
Uma Kumari Meena

Introduction: Diabetes mellitus (DM) is common metabolic disorder leading to various complications including micro-vascular complication. Diabetes and thyroid dysfunction can result in abnormalities of one another, as both are strongly implicated in cellular metabolism.  Aim of study was to establish any association between hypothyroidism and micro-vascular complications in patients of type 2 DM. Material and Methods: This Hospital based Cross sectional analytical Study was included 80 Euthyroid and 80 hypothyroid patients of type 2 DM. These patients were subjected to fundus examination (for retinopathy), urine for spot albumin and creatinine ratio and routine microscopy (for nephropathy), clinical examination and NCV (for neuropathy). Results: Age of patients ranged from 30 – 80 years. Most patients had duration of Diabetes > 5 years. Diabetic retinopathy was found in 15% Euthyroid and 37.5% Hypothyroid diabetics (p=0.002). Neuropathy was more in Hypothyroid (35%) as compared to Euthyroid (12.5%) patients (p=0.003). Prevalence of Nephropathy was also significantly more (p=0.011) in Hypothyroids (60%) as compared to Euthyroid (38.75%). Conclusion: Significant association was found between hypothyroidism and micro vascular complications in type 2 Diabetes mellitus. Screening of diabetics for thyroid functions is essential to reduce morbidity. Keywords: Diabetes, thyroid, retinopathy, neuropathy, nephropathy


2021 ◽  
Vol 22 (6) ◽  
pp. 3153
Author(s):  
Agnieszka Bielska ◽  
Magdalena Niemira ◽  
Adam Kretowski

Type 2 diabetes mellitus (T2DM) and its complications pose a serious threat to the life and health of patients around the world. The most dangerous complications of this disease are vascular complications. Microvascular complications of T2DM include retinopathy, nephropathy, and neuropathy. In turn, macrovascular complications include coronary artery disease, peripheral artery disease, and cerebrovascular disease. The currently used diagnostic methods do not ensure detection of the disease at an early stage, and they also do not predict the risk of developing specific complications. MicroRNAs (miRNAs) are small, endogenous, noncoding molecules that are involved in key processes, such as cell proliferation, differentiation, and apoptosis. Recent research has assigned them an important role as potential biomarkers for detecting complications related to diabetes. We suggest that utilizing miRNAs can be a routine approach for early diagnosis and prognosis of diseases and may enable the development of better therapeutic approaches. In this paper, we conduct a review of the latest reports demonstrating the usefulness of miRNAs as biomarkers in the vascular complications of T2DM.


Author(s):  
T Thippeswamy ◽  
Nirmal Nithin ◽  
Prathima Chikkegowda

Introduction: Numerous biochemical markers are being used in clinical practice for the prediction and prognostication of vascular complications among non diabetic individuals. Of late, fasting C-peptide levels is being investigated for its possible role in the prediction and protection of vascular complications of diabetes. It is also being explored for its protective role in prevention of vascular complications among patients with diabetes mellitus. Aim: The present study was undertaken with an objective to assess the strength of association of fasting C-peptide levels in the development of microvascular and macrovascular complications. Materials and Methods: An observational cross-sectional study involving 100 subjects with Type 2 Diabetes mellitus (T2DM) having an objective evidence of vascular complications were included into the study. The study period was 18 months from October 2017 to September 2019. After an overnight fasting of atleast 12 hours, C-peptide level estimation was done by Electro-Chemiluminescence Assay (ECLA) method. Results: The overall mean fasting C-peptide level among subjects with microvascular complications (0.73±0.55 ng/mL) was significantly decreased compared with subjects having macrovascular complications (2.44±0.72 ng/mL, with p-value being <0.001). Among microvascular complications, the mean fasting C-peptide level was least in subjects with diabetic retinopathy (0.64±0.35 ng/mL). Among patients with macrovascular complications, preserved C-peptide levels were observed in subjects with ischemic heart disease (2.35±0.75 ng/mL). Conclusion: Fasting serum C-peptide levels are significantly reduced among subjects with chronic T2DM having microvascular complications when compared to macrovascular complications. Also, with preserved serum levels, fasting C-peptide might have a protective role in the prevention of macrovascular complications among subjects with diabetes mellitus.


2010 ◽  
Vol 56 (5) ◽  
pp. 43-51
Author(s):  
I V Kononenko ◽  
O M Smirnova

The contribution of intensive control of glycemia to the reduction of the risk of microvascular complications of type 2 diabetes mellitus is known perfectly well whereas its influence on the development of macrovascular complications remains to be clarified and remains a subject of debates. Bearing in mind that hyperglycemia is a key pathogenetic factor triggering formation of diabetic complications, it is necessary to identify characteristics of carbohydrate metabolism to be taken into account when choosing therapeutic strategies and to determine their target values. Control of the HbA1c level remains the most accessible and informative tool for the assessment of the efficiency of long-term compensation of type 2 diabetes mellitus. However, this method is not altogether free from limitations that can hamper its clinical application. The fasting glycemia level does not completely reflect the quality of DM2 treatment. There is potential relationship between high postprandial plasma glucose levels and the development of vascular complications. Also, it has been shown that variability of glucose concentration may be an important risk factor of diabetic complications. Measurement of the full range of glycemic parameters including fasting plasma glucose level, HbA1c and postprandial glycemia gives an idea of the general picture of the course of the disease necessary for the choice of the treatment strategy.


2020 ◽  
Vol 7 (7) ◽  
pp. 1083
Author(s):  
Rajdeepak V. S. ◽  
Rekha G. ◽  
Jayashree S. C.

Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization and increased glucose production. The vascular complications of DM are subdivided into microvascular (retinopathy, neuropathy, nephropathy) and macrovascular complications (coronary artery disease, peripheral vascular disease, cerebrovascular disease). There is an observed disparity between various vascular complications of diabetes and the atherogenic factors.Methods: The patients with type 2 diabetes mellitus attending outpatient and inpatient departments in Dr. B. R. Ambedkar Medical College and hospital, from September 2014 to September 2016 were selected for this study. All patients were subjected to detailed history, physical examination and laboratory investigations with respect to complications of diabetes mellitus.Results: In this study, 76% of the patients had poor glycemic control with elevated HbA1c >7%. 38% of patients had normal BMI. 36% of patients were overweight and 26% were obese. 62% of patients were either overweight or obese. Hypercholesterolemia was seen in 26% of patients with poor glycemic control. Hyperhomocysteinemia was present in 38% of patients with microvascular complications and 33% of patients with macrovascular complications.Conclusions: Type 2 diabetes mellitus showed a strong correlation between glycemic status and incidence of diabetes complications. Hypercholesterolemia and hyperhomocysteinemia have added to the increased incidence of complications as additional factors in metabolic derangements as a consequence of poor glycemic control.


2019 ◽  
Vol 15 (1-2) ◽  
pp. 80-86
Author(s):  
O.P. Chernobrivtsev ◽  
S.V. Zyablitsev ◽  
T.I. Panova ◽  
Yu.O. Panchenko

Relevance. The problem of systematization and refinement of modern concepts of the pathogenesis of endothelial dysfunction (EDF) and its role in the development of microvascular complications of type 2 diabetes mellitus (T2DM) is relevant due to the lack of pathogenetic treatment nowadays, which would include endothelial dysfunction. Objective: to conduct an analytical review of the results of scientific research on the mechanisms of EDF in T2DM, with the aim of proposing an integrated modern concept of the pathogenesis of EDF. Materials and methods. Review of scientific publications in the international electronic scientific databases of PubMed, Embase and Scopus for keywords for the entire available period (1982-2019). Results. The article provides modern data on the modern concept of the pathogenesis of EDF and its role in the development of microvascular complications in T2DM. The pathogenesis of EDF in type 2 diabetes mellitus is based on the following key mechanisms: impaired synthesis of the endothelial fraction of nitric oxide (NO) due to inhibition of the activity of endothelial NO synthase (eNOS); decreased bioavailability of NO because of oxidative stress; activation of the formation of Endothelin-1 (ET1) and expression of endothelin receptors with a predominance of vasoconstriction; inflammation, which is supported by the synthesis of pro-inflammatory cytokines and causes the expression of inducible NO synthase (iNOS), which stimulates the synthesis of a significant amount of NO, which enters into free radical reactions with the formation of cytotoxic products. Conclusions. The pathogenesis of endothelial dysfunction is impaired nitric oxide synthesis. Endothelial dysfunction, as an integral mechanism, underlies in the core mechanisms the development of vascular complications in type 2 diabetes.


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 2393-PUB
Author(s):  
KENICHIRO TAKAHASHI ◽  
MINORI SHINODA ◽  
RIKA SAKAMOTO ◽  
JUN SUZUKI ◽  
TADASHI YAMAKAWA ◽  
...  

Author(s):  
Prawin Kumar ◽  
Niraj Kumar Singh ◽  
Kumari Apeksha ◽  
Vipin Ghosh ◽  
Raveendran Rajesh Kumar ◽  
...  

Abstract Introduction Diabetes mellitus is a metabolic disease associated with a rise in the level of blood glucose. Individuals with diabetes mellitus are more likely to develop hearing loss, tinnitus, and dizziness due to macro- and microvascular complications. The extent to which auditory and vestibular functions are impaired in individuals with type-2 diabetes mellitus is still under debate. Objective To systematically review studies focusing on auditory and vestibular functions in individuals with type-2 diabetes mellitus. Data Synthesis A search was conducted in the PubMed, MedlinePlus, Ingenta Connect and Google Scholar databases for articles published until June 2019. A total of 15,980 articles were primarily retrieved, 33 of which were shortlisted based on the inclusion criteria set by the investigators for the systematic review. Out of 33 full-length articles, 26 evaluated the functioning of the auditory system, while 7 evaluated the functioning of the vestibular system. Most studies related to auditory functioning reported a significant effect of type-2 diabetes mellitus on the peripheral auditory system, whereas studies on vestibular functioning reported no significant effect of diabetes mellitus on the functioning of the peripheral vestibular end-organ. Conclusion Overall, the results of various audiological and peripheral vestibular tests reveal distinctive peripheral and/or central auditory and vestibular end-organ impairments in individuals with type-2 diabetes mellitus.


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