scholarly journals Hypoglycemia and the risk of cognitive impairment and dementia in elderly and senile patients with type 2 diabetes

2020 ◽  
Vol 23 (1) ◽  
pp. 72-87
Author(s):  
Olga D. Ostroumova ◽  
Elena V. Surkova ◽  
Irina V. Goloborodova ◽  
Antonina V. Starodubova ◽  
Alexey I. Kochetkov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cognitive Impairment ◽  
Age Groups ◽  
Cognitive Status ◽  
Antidiabetic Drugs ◽  
Diabetic Patients ◽  
Glucose Lowering ◽  
Patients With Diabetes

Research results show that poor glycemic control and recurrent episodes of severe hypoglycaemia are associated with a decrease in cognitive function in elderly people with type 2 diabetes mellitus (T2DM). On the other hand, patients with diabetes mellitus associated with cognitive impairment/dementia are most at risk of developing hypoglycaemic conditions. It is obvious that the relationship between hypoglycaemia and dementia is very complex and has a mutually aggravating nature. Studies also show that individuals of older age groups with diabetes and cognitive impairment have a high risk of developing hypoglycaemic conditions, such as unwanted side effects from glucose-lowering therapy. In this case, of particular interest is the question that is being actively studied at the present time, which is concerning the effect of different groups of glucose-lowering antidiabetic drugs on the cognitive status and the rate of cognitive decline in diabetic patients with cognitive impairment. In this review, we attempted to summarise, systematise, and present data available in the literature concerning the effect of hypoglycaemia on the risk of cognitive impairment and dementia in elderly and senile patients with type-2 diabetes, as well as the degree of participation in this process of of various groups of sugar-lowering antidiabetic drugs.

Prevalence of Toenail Onychomycosis in Patients with Type 2 Diabetes Mellitus and Evaluation of Risk Factors

2011 ◽  
Vol 101 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Aynur Gulcan ◽  
Erim Gulcan ◽  
Sukru Oksuz ◽  
Idris Sahin ◽  
Demet Kaya
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Fasting Blood Glucose ◽  
Diabetic Patients ◽  
Essential Components ◽  
Patients With Diabetes ◽  
Epidemiologic Risk

Background: We sought to determine the frequency of toenail onychomycosis in diabetic patients, to identify the causative agents, and to evaluate the epidemiologic risk factors. Methods: Data regarding patients’ diabetic characteristics were recorded by the attending internal medicine clinician. Clinical examinations of patients’ toenails were performed by a dermatologist, and specimens were collected from the nails to establish the onycomycotic abnormality. All of the specimens were analyzed by direct microscopy and culture. Results: Of 321 patients with type 2 diabetes mellitus, clinical onychomycosis was diagnosed in 162; 41 of those diagnoses were confirmed mycologically. Of the isolated fungi, 23 were yeasts and 18 were dermatophytes. Significant correlations were found between the frequency of onychomycosis and retinopathy, neuropathy, obesity, family history, and duration of diabetes. However, no correlation was found with sex, age, educational level, occupation, area of residence, levels of hemoglobin A1c and fasting blood glucose, and nephropathy. The most frequently isolated agents from clinical specimens were yeasts. Conclusions: Long-term control of glycemia to prevent chronic complications and obesity and to promote education about the importance of foot and nail care should be essential components in preventing onychomycosis and its potential complications, such as secondary foot lesions, in patients with diabetes mellitus. (J Am Podiatr Med Assoc 101(1): 49–54, 2011)

scholarly journals Study on Thyroid Dysfunction in Patients with Type-2 Diabetes

2020 ◽  
Vol 7 (52) ◽  
pp. 3142-3147
Author(s):  
Senthil Chander ◽  
Kalpana Dev Venkatesan ◽  
Christina Mary Paul
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
General Medicine ◽  
Diabetic Patients ◽  
Endocrine Disorders ◽  
Cross Sectional ◽  
Patients With Diabetes

BACKGROUND Diabetes mellitus is one of the leading endocrine disorders worldwide. Thyroid dysfunction is a common endocrine disorder affecting the general population next to diabetes. The objective of this study was to determine the prevalence of thyroid dysfunction among patients with Type 2 diabetes. METHODS This analytical cross sectional study was conducted from June 2019 to Dec 2019. One hundred and fifty type–2 diabetes patients who attended the outpatient clinic of General Medicine Department, ACS Medical College and Hospital were included in the study. A detailed history and examination was done after getting informed consent. Blood samples were collected and sent to the laboratory for the evaluation of thyroid profile. RESULTS Thyroid dysfunction was found in 27 % of the patients with diabetes. Subclinical hypothyroidism was the most common thyroid dysfunction reported (14.7 %) followed by clinical hypothyroidism (10 %), subclinical hyperthyroidism (2 %) and clinical hyperthyroidism (0.6 %). CONCLUSIONS Thyroid dysfunction is common in patients with type-2 diabetes. A substantial proportion of the diabetic patients with thyroid dysfunction have subclinical hypothyroidism. Unidentified thyroid dysfunction could negatively impact diabetes and its complications. Therefore, early and routine screening of thyroid is recommended in all patients with diabetes to reduce the burden of the disease. KEYWORDS Type-2 Diabetes Mellitus, Thyroid Dysfunction, Hypothyroidism

scholarly journals Quality of life of mild cognitive impairment patients with type 2 diabetes mellitus and hypertension

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2982-2989
Author(s):  
Sreejith K ◽  
Malarkodi Velraj
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Status ◽  
Practical Concern ◽  
Emotional Concern

Mild cognitive impairment (MCI) is a progressive neurodegenerative disease on which diabetes mellitus and hypertension play an important role as major risk factors. This study aims to assess the quality of life of MCI patients with type 2 diabetes and hypertension.  A cross sectional study was carried out in a tertiary care teaching hospital. Cognitive status of patients were assessed by Addenbrooke’s Cognitive Examination III (ACE-III) and Montreal Cognitive Assessment (MoCA). Mild Cognitive Impairment Questionnaire (MCQ) was used to score the quality of life. SPSS 21.0 was used to perform statistical analysis. Kruskal-Wallis test and Mann Whitney U test were used to analyze the relationship between quality of life and demographic parameters. Totally 1887 patients with type 2 DM and hypertension were screened to detect MCI patients. The prevalence of MCI in the population was found to 24.64%. Mean age of the population was 45.12 ± 10.54. Quality of life of patients was affected due to MCI with diabetes and hypertension in early ages. Patients employed in Govt or private sector (p=0.021) and disease duration less than 10 years (p=0.025) had significantly better quality of life. Two domains of MCQ, such as emotional concern and practical concern were assessed separately found that MCI patient’s practical concern scores did not differ significantly from emotional concern scores (p= 0.874). Quality of life was affected in MCI patients with diabetes and hypertension in early ages. Routine clinical examination should consider the quality of life as an important parameter during the patient visit and necessary modifications should be given to enhance the quality of life as well as patient satisfaction.

COMPARATIVE HEMATOLOGICAL STUDY OF TYPE 2 DIABETIC AND NON-DIABETIC PATIENTS IN ERODE DISTRICT, TAMIL NADU

2021 ◽  
pp. 29-30
Author(s):  
Murugesan Thinakaran ◽  
Thangadurai Chitra
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Tamil Nadu ◽  
Haematological Parameters ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Hematological Indices ◽  
Patients With Diabetes ◽  
Type 2 Diabetic

Background And Objectives: Previous studies have shown that hematological alterations are a common nding in patients with diabetes. To aim of our study was to explore the hematological indices in type 2 diabetic patients compared with non-diabetic individual. Establish the role of haematological parameters as an early prevention strategy. Materialand Method: Two hundred and forty-six subjects were recruited for this study, one hundred and fourteen with type 2 diabetes and One hundred and thirty-two non-diabetes, were evaluated for haematological parameters using hematologic analyzer. All the information's about the disease was collected with the knowledge of the patients form the concern hospital and laboratory. Results And Conclusions: Results were compared with the same measurements in 132 subjects without diabetes mellitus. The haematological prole associated with Type2 diabetic patients signicantly reduced Hb, RBCs, PCV and MCV than Non diabetes. Increased MCHC and WBCs were noted in Type2 diabetes. Our ndings suggest the need of screening for routine hematological tests in type 2 diabetes mellitus

scholarly journals Study Comparing the Liver Enzymes in Hypertensive and Normotensive Patients with Type 2 Diabetes

2021 ◽  
Vol 8 (7) ◽  
pp. 207-211
Author(s):  
Rishad Ahmed
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Liver Enzymes ◽  
Good Control ◽  
Diabetic Patients ◽  
Uncontrolled Diabetes ◽  
Elevated Liver Enzymes ◽  
Patients With Diabetes ◽  
Altered Liver

Objective: There were few clinical trials which indicate altered liver biochemical findings in diabetic patients, but through investigation to compare the liver enzymes in-between hypertensive and normotensive patients with type 2 diabetes was not evaluated. Thus main objective of current study was to compare the liver enzymes in hypertensive and normotensive patients with type 2 diabetes. Materials and Methods: This was a retrospective observational study conducted in a tertiary medical teaching hospital in Kolkata. Hospital OPD reports and patients clinical case records were used to fetch the required data in a predesigned clinical record pro forma. Result: Total 180 patients were participated in this observational retrospective trial where 33% patient were normotensive but having T2DM and 67% patients were hypertensive with T2DM. There were no statistically significant differences between the study variables among both the groups. However elevated level of GGT, ALT and AST were observed in T2DM normotensive patients as compare to T2DM hypertensive patients. abnormal liver functions were recorded in patients with uncontrolled diabetes as compared to patients with good control (p<0.05). Conclusion: The current study concluded that elevated liver enzymes like bilirubin, GGT, SGOT and SGPT were common among diabetes mellitus patients and comparable with patients with hypertensive as well as normotensive patients with diabetes mellitus. Keywords: Liver enzymes, T2DM, hypertension.

How can we avoid the danger of hypoglycemia, one of the most serious complications of therapy of type 2 diabetes mellitus? The role of DPP-4 inhibitors

2011 ◽  
Vol 57 (3) ◽  
pp. 48-52
Author(s):  
M G Pavlova ◽  
A V Zilov
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Studies ◽  
Large Scale ◽  
Age Groups ◽  
Consensus Algorithm ◽  
Diabetic Patients ◽  
Dipeptidyl Peptidase 4

Optimal or near-optimal compensation of diabetes mellitus is almost inevitably fraught with the risk of hypoglycemia. In patients with type 2 diabetes (DM2), especially in those of old-age groups, the development of hypoglycemia increases the risk of CV death, cardiac rhythm disturbances, dementia, and depressive states. Whether absolutely all diabetic patients should be treated so as to ensure blood glucose levels close the physiological values thus far remains a matter of controversy. The results of large-scale clinical studies carried out in the recent years suggest the necessity to revise the existing algorithms for the treatment of patients with DM2. Highly efficacious agents for the purpose should be chosen with reference to both their glucose-normalizing activity and "the safety profile" (i.e. reduced risk of hypoglycemia). A panel of experts for the Russian Association of Endocrinologists (RAE) developed and published «Consensus Algorithm on the initiation and intensification of therapy of type 2 diabetes mellitus». Its main provisions emphasize the necessity of treating diabetics on an individual basis and establish target levels of glycemia for each patient. Special attention should be given to the patients belonging to high risk groups, i.e. those with manifest macrovascular pathology, unable to recognize hypoglycemia, and having serious concomitant diseases. The following first line preparations are recommended to enhance the safety of DM2 therapy: metformin, dipeptidyl peptidase-4 (DPP-4) inhibitors and agonists of glucagon-like peptide-1 (GLP-1) receptors. The results of both national and international clinical studies of vildaglyptin give reason to recommend this DPP-4 inhibitor for a wider application to the treatment of patients with type 2 diabetes mellitus.

Glucose-lowering therapies in patients with type 2 diabetes and cardiovascular diseases

2019 ◽  
Vol 26 (2_suppl) ◽  
pp. 73-80 ◽  
Author(s):  
Francesco Prattichizzo ◽  
Lucia La Sala ◽  
Lars Rydén ◽  
Nikolaus Marx ◽  
Marc Ferrini ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Receptor Agonist ◽  
Glucose Lowering ◽  
Patients With Diabetes ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Type 2 diabetes mellitus is a major risk factor for developing cardiovascular disease, and many patients with diabetes have prevalent cardiovascular complications. Recent cardiovascular outcome clinical trials suggest that certain new glucose-lowering drugs are accompanied by additional cardioprotective properties. Indeed, selected glucagon-like peptide-1 receptor agonists have a proved cardiovascular benefit in terms of a reduced incidence of ischaemic events, while sodium/glucose co-transporter-2 inhibitors have also shown significant protection, with a striking effect on heart failure and renal endpoints. These findings have been integrated in recent guidelines which now recommend prescribing (when initial metformin monotherapy fails) a glucagon-like peptide-1 receptor agonist or a sodium/glucose co-transporter-2 inhibitor with clinical trial-confirmed benefit in patients with diabetes and atherosclerotic cardiovascular disease, and a sodium/glucose co-transporter-2 inhibitor in such patients with heart failure or chronic kidney disease at initial stages. Furthermore, the new 2019 European Society of Cardiology guidelines in collaboration with the European Association for the Study of Diabetes recommend a glucagon-like peptide-1 receptor agonist or a sodium/glucose co-transporter-2 inhibitor in treatment-naive patients with type 2 diabetes mellitus with pre-existing cardiovascular disease or at high cardiovascular risk. Future research will disentangle the mechanisms underpinning these beneficial effects and will also establish to what extent these results are generalisable to the whole diabetes population. In the meantime, available evidence should prompt a wide diffusion of these two classes of drugs among patients with diabetes and cardiovascular disease. Here, we briefly summarise recent findings emerging from cardiovascular outcome clinical trials, discuss their impact on treatment algorithms and propose new possible approaches to improve our knowledge further regarding the cardiovascular effect of glucose-lowering medications.

scholarly journals Anthropometric and Metabolic Characteristics of Patients with Type 2 Diabetes Mellitus and Hypochromia

2014 ◽  
Vol 21 (4) ◽  
pp. 285-290
Author(s):  
Marius Cristian Neamţu ◽  
Ştefania Crăiţoiu ◽  
Rucsandra Dănciulescu Miulescu ◽  
Denisa Margină
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Common Finding ◽  
Study Patient ◽  
Control Group ◽  
Diabetic Patients ◽  
Metabolic Characteristics ◽  
Patients With Diabetes

AbstractBackground and Aims. Previous studies have shown that hypochromia is a common finding in patients with chronic diseases. The aim of our study was to estimate the anthropometric and metabolic characteristics of patients with type 2 diabetes mellitus (T2DM) and hypochromia. Material and Methods. 30 patients with T2DM were recruited for this study. Patient demographics, relevant concomitant illnesses and medical history were recorded. Anthropometric, biochemical parameters (fasting plasma glucose - FPG, glycated hemoglobin -HbA1c, glomerular filtration rate - GFR) and morphology of blood smear were assessed. Patients diagnosed with diabetes and hypochromia constituted the study group and patients with type T2DM but without hypochromia constituted the control group. Results. The study showed no statistically significant differences on anthropometric and metabolic characteristics of patients with diabetes and hypochromia, compared with controls. Conclusions. We observed a high prevalence of hypochromia in diabetic patients (46.66%). Our findings suggest the need of screening for routine hematological tests in patients with T2DM.

scholarly journals Intensification of glucose-lowering treatment in patients with diabetes mellitus type 2 on insulin therapy: Perspectives of dapagliflozin

2016 ◽  
Vol 19 (1) ◽  
pp. 72-79
Author(s):  
Olga Yuryevna Sukhareva ◽  
Marina Vladimirovna Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy ◽  
Diabetes Mellitus Type 2 ◽  
Glucose Lowering ◽  
Patients With Diabetes ◽  
Difficult Issue

Intensification of antihyperglycaemic treatment in patients with poorly controlled type 2 diabetes mellitus who were on insulin therapy remains a difficult issue. Results from clinical trials with the sodium-glucose linked transporter (SGLT-2) inhibitor dapagliflozin as add-on therapy in patients with type 2 diabetes mellitus using insulin are summarised and discussed in the article.

scholarly journals Study of anaemia in type 2 diabetes mellitus

2018 ◽  
Vol 6 (5) ◽  
pp. 1529 ◽  
Author(s):  
Deepali Kaushik ◽  
Raman Parashar ◽  
Praveen K. Malik
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pearson Correlation ◽  
Diabetic Patients ◽  
Variable Contribution ◽  
Patients With Diabetes ◽  
Unpaired Student ◽  
The Difference

Background: Anaemia is increasingly recognized entity in the patients with diabetes mellitus and constitutes an additional burden in patients. The prevalence of anaemia in the patients with diabetes is two or three times higher than in patients with comparable renal impairment and iron stores in the general population. As India is foreseen a diabetic capital of the world, it becomes imperative to recognize co-morbidities such as anaemia at the earliest. Hence this study is being conducted with the aim to determine the prevalence and various causes of anaemia in diabetics.Methods: After obtaining informed written consent, all diabetics patients were subjected to detailed history, through clinical examination and investigation with CBC, Renal function test including creatinine clearance. The difference of mean between anaemic and non anaemic diabetic patients was evaluated by unpaired student t test. Finally, correlation between the level of haemoglobin and index of renal damage (albumin-creatinine ratio) was accessed by Pearson correlation. Statistical software of SPSS 10 ver. and EXCEL (office 9) was used to analyse the data.Results: In the present study, nearly two third patients of type 2 diabetes mellitus were anaemic. The maximum number of anaemic patients with type 2 diabetes mellitus had microcytic hypochromic type of anaemia.Conclusions: It is therefore concluded that anaemia is a prevalent finding in patients with type 2 diabetes mellitus and represents significant unrecognised burden. The anaemia may be attributed to variable contribution of iron deficiency state and chronic inflammation as result of the disease itself.

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