scholarly journals Phenotypes of prediabetes: pathogenesis and consequences for prediction and prevention of type 2 diabetes and cardiovascular diseases

2020 ◽  
Vol 22 (6) ◽  
pp. 577-581
Author(s):  
Norbert Stefan
Keyword(s):  
Type 2 Diabetes ◽  
Treatment Strategies ◽  
Visceral Obesity ◽  
Preventive Strategies ◽  
Nonalcoholic Fatty Liver ◽  
Cardiometabolic Diseases ◽  
Prediction And Prevention ◽  
Increased Risk ◽  
The Impact

The prevalence of type 2 diabetes is increasing world-wide. Thus, it is necessary to better understand its pathogenesis, the risk of diabetes-associated complications and effective treatment strategies. Because type 2 diabetes is a very heterogenous disease, both, related to its pathogenesis and risk of complications, phenotyping strategies in diabetes may help to tailor the preventive strategies based on the individuals risk. As the the hyperglycemic state of prediabetes is already associated with an increased risk of cardiometabolic diseases it is necessary to investigate the impact of phenotypes for predictive and preventive outcomes already in this early state of hyperglycemia. In this review artice I discuss how important phenotypes of prediabetes, such as nonalcoholic fatty liver disease, visceral obesity, insulin secretion defect and insulin resistance can be used to improve the prediction and prevention of type 2 diabetes and cardiovascular disease.

scholarly journals CANCER OF THE ORGANS OF THE REPRODUCTIVE SYSTEM IN WOMEN WITH TYPE 2 DIABETES. EFFECTS OF ANTIDIABETIC THERAPY

2020 ◽  
Vol 73 (5) ◽  
pp. 967-971
Author(s):  
Tamara S. Vatseba
Keyword(s):  
Type 2 Diabetes ◽  
Combination Therapy ◽  
Postmenopausal Women ◽  
Reproductive System ◽  
Uterine Cancer ◽  
Antidiabetic Therapy ◽  
Increased Risk ◽  
Risk Of Cancer ◽  
The Impact

The aim: to investigate the prevalence of cancer of the reproductive system in women with type 2 diabetes, and to examine the impact of antidiabetic therapy on cancer risk of this localization. Materials and methods: The study included a retrospective analysis of medical records of women with T2D with first diagnosed cancer during 2012-2016. The bases for the study were specialized medical institutions in Ivano-Frankivsk region. The obtained results were processed using statistical programs “Microsoft Excel” and “Statistika-12”. Results: Breast, uterine, and ovarian cancer were detected in 202 postmenopausal women, 63.92% from the total number of cancer cases in women. An increased risk of breast [OR = 1.24; 95% CI (1.04 – 1.50) P = 0.019] and uterine cancer [OR = 1.32; 95% CI (1.02 – 1.69) P = 0.040] has been identified. Most often, before the detection of cancer, women received combination therapy with sulfonylurea and metformin (83 patients (57.64%)) with BMI 32.64 ± 3.69 kg/m2. The difference between risk of cancer on metformin monotherapy and on sulfonylurea monotherapy [OR = 2.17; 95% CI (0.88 – 5.36) P = 0.141] or on combination therapy [OR = 1.68; 95% CI (0.76 – 3.74) P = 0.276] was not found. Conclusions: Postmenopausal women have an increased risk of breast and uterine cancer and are recommended to be screened for these diseases

scholarly journals Obstructive Sleep Apnoea and Type 2 Diabetes

2014 ◽  
Vol 10 (01) ◽  
pp. 35 ◽  
Author(s):  
Abd A Tahrani ◽  
Asad Ali ◽  
◽  
Keyword(s):  
Type 2 Diabetes ◽  
Risk Factor ◽  
Medical Condition ◽  
Diabetes Type 2 ◽  
Sleep Apnoea ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Osa Treatment ◽  
The Impact

With the growing prevalence of obesity, the burden of type 2 diabetes is increasing. Obstructive sleep apnea (OSA) is a very common medical condition that is associated with increased risk for cardiovascular disease and mortality. Obesity is a common risk factor for OSA and type 2 diabetes and hence it is not surprising that OSA and type 2 diabetes are interlinked. OSA has been shown to be an independent risk factor for the development of incident pre-diabetes/type 2 diabetes. OSA is also associated with worse glycemic control and vascular disease in patients with type 2 diabetes. However, evidence for the benefits of OSA treatment in patients with type 2 diabetes is still lacking. The aim of this article is to provide an overview of OSA, the relationships between OSA and dysglycemia and the impact of OSA in patients with type 2 diabetes, highlighting recent advances in the field.

scholarly journals Obstructive Sleep Apnoea and Type 2 Diabetes

2010 ◽  
Vol 10 (1) ◽  
pp. 43 ◽  
Author(s):  
Abd A Tahrani ◽  
Asad Ali ◽  
◽  
Keyword(s):  
Type 2 Diabetes ◽  
Risk Factor ◽  
Obstructive Sleep Apnoea ◽  
Medical Condition ◽  
Diabetes Type 2 ◽  
Sleep Apnoea ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
The Impact

With the growing prevalence of obesity, the burden of type 2 diabetes is increasing. Obstructive sleep apnoea (OSA) is a very common medical condition that is associated with increased risk of cardiovascular disease and mortality. Obesity is a common risk factor for OSA and type 2 diabetes and hence it is not surprising that OSA and type 2 diabetes are interlinked. OSA has been shown to be an independent risk factor for the development of incident pre-diabetes/type 2 diabetes. OSA is also associated with worse glycaemic control and vascular disease in patients with type 2 diabetes. However, evidence for the benefits of OSA treatment in patients with type 2 diabetes is still lacking. The aim of this article is to provide an overview of OSA, the relationships between OSA and dysglycaemia and the impact of OSA in patients with type 2 diabetes, highlighting recent advances in the field.

scholarly journals Blood pressure variability and risk of heart failure in ACCORD and the VADT

2020 ◽  
Author(s):  
Daniel S. Nuyujukian ◽  
Juraj Koska ◽  
Gideon Bahn ◽  
Peter D. Reaven ◽  
Jin J. Zhou ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Blood Pressure Variability ◽  
Treatment Strategies ◽  
Risk Factor Management ◽  
Increased Risk ◽  
Blood Pressure Treatment

Objective: Although blood pressure variability is increasingly appreciated as a risk factor for cardiovascular disease, its relationship with heart failure is less clear. We examined the relationship between blood pressure variability and risk of heart failure (HF) in two cohorts of type 2 diabetes participating in trials of glucose and/or other risk factor management. <p> </p> <p>Research Design and Methods: Data were drawn from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial and the Veterans Affairs Diabetes Trial (VADT). Coefficient of variation (CV) and average real variability (ARV) were calculated for systolic (SBP) and diastolic blood pressure (DBP) along with maximum and cumulative mean SBP and DBP during both trials. </p> <p> </p> <p>Results: In ACCORD, CV and ARV of SBP and DBP were associated with increased risk of HF, even after adjusting for other risk factors and mean blood pressure (e.g., CV-SBP: HR=1.15, <i>p</i> = 0.01; CV-DBP: HR=1.18, <i>p</i> = 0.003). In the VADT, DBP variability was associated with increased risk of HF (ARV-DBP: HR=1.16, <i>p</i> = 0.001; CV-DBP: HR=1.09, <i>p</i> = 0.04). Further, in ACCORD, those with progressively lower baseline blood pressure demonstrated a stepwise increase in risk of HF with higher CV-SBP, ARV-SBP, and CV-DBP. Effects of blood pressure variability were related to dips, not elevations, in blood pressure.</p> <p> </p> <p>Conclusions: Blood pressure variability is associated with HF risk in individuals with type 2 diabetes, possibly a consequence of periods of ischemia during diastole. These results may have implications for optimizing blood pressure treatment strategies in those with type 2 diabetes.</p>

scholarly journals Youth-Onset Type 2 Diabetes Manifestations in other Specialties: Its Many Disguises

2019 ◽  
Vol 74 (4) ◽  
pp. 339-347 ◽  
Author(s):  
Daniel Weghuber ◽  
Margarita Barrientos-Pérez ◽  
Margarita Kovarenko
Keyword(s):  
Type 2 Diabetes ◽  
Health Care Professionals ◽  
Acanthosis Nigricans ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Nonalcoholic Fatty Liver ◽  
Onset Type ◽  
Primary Health ◽  
Increased Risk

Background: Youth-onset type 2 diabetes (T2D) is increasing in many countries, creating large personal and societal burdens. While many primary health-care professionals (HCPs) are aware of the classic symptoms of T2D, there are several other manifestations that could indicate its presence. Summary: This narrative review summarizes information on these symptoms and indicators, focusing on those less well known. The classic symptoms and comorbidities include frequent urination, excessive thirst, metabolic syndrome, and obesity. In addition to these, the presence of dermatological (e.g., acanthosis nigricans, granuloma annulare, necrobiosis lipoidica diabeticorum, and scleredema), gynecological (e.g., polycystic ovary syndrome, oligomenorrhea, and vulvovaginitis), hepatological (e.g., nonalcoholic fatty liver disease), and psychiatric diseases (e.g., psychosis, depression, and autism) could indicate that a patient has T2D or is at increased risk of T2D. Other less well-known indicators include abnormal blood tests (e.g., oxidized lipids, inflammation markers, hepatokines, and adipokines), prescriptions for antipsychotic medications or statins, and disrupted sleep patterns. Key Message: Due to the diversity of T2D manifestations in young people, primary HCPs need to remain alert to its possible presence.

scholarly journals Interactions between genetic polymorphisms of glucose metabolizing genes and smoking and alcohol consumption in the risk of type 2 diabetes mellitus

2017 ◽  
Vol 42 (12) ◽  
pp. 1316-1321 ◽  
Author(s):  
Kaiping Gao ◽  
Yongcheng Ren ◽  
Jinjin Wang ◽  
Zichen Liu ◽  
Jianna Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lifestyle Factors ◽  
Environment Interaction ◽  
Nucleotide Polymorphisms ◽  
Gene Environment ◽  
Increased Risk ◽  
The Impact

The impact of gene-environment interaction on diabetes remains largely unknown. We aimed to investigate if interaction between glucose metabolizing genes and lifestyle factors is associated with type 2 diabetes mellitus (T2DM). Interactions between genotypes of 4 glucose metabolizing genes (MTNR1B, KCNQ1, KLF14, and GCKR) and lifestyle factors were estimated in 722 T2DM patients and 759 controls, using multiple logistic regression. No significant associations with T2DM were detected for the single nucleotide polymorphisms of MTNR1B, KLF14 and GCKR. However, rs151290 (KCNQ1) polymorphisms were found to be associated with risk of T2DM. Compared with AA, the odds ratios (ORs) of AC or CC genotypes for developing T2DM were 1.545 (P = 0.0489) and 1.603 (P = 0.0383), respectively. In stratified analyses, the associations were stronger in smokers with CC than smokers with AA (OR = 3.668, P = 0.013); drinkers with AC (OR = 5.518, P = 0.036), CC (OR = 8.691, P = 0.0095), and AC+CC (OR = 6.764, P = 0.016) than drinkers with AA. Compared with nondrinkers with AA, drinkers who carry AC and CC had 12.072-fold (P = 0.0007) and 8.147-fold (P = 0.0052) higher risk of developing T2DM. In conclusions, rs151290 (KCNQ1) polymorphisms are associated with increased risk of T2DM, alone and especially in interaction with smoking and alcohol.

Association Between Lipid Accumulation Product and Mild Cognitive Impairment in Patients with Type 2 Diabetes

2020 ◽  
Vol 77 (1) ◽  
pp. 367-374
Author(s):  
Zi-Wei Yu ◽  
Xin Li ◽  
Ying Wang ◽  
Yu-Hong Fu ◽  
Xin-Yuan Gao
Keyword(s):  
Type 2 Diabetes ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Lipid Accumulation ◽  
Glycosylated Hemoglobin ◽  
Visceral Obesity ◽  
Lipid Accumulation Product ◽  
Increased Risk ◽  
Normal Cognition

Background: Diabetes may increase the risk of conversion of mild cognitive impairment (MCI) to dementia. Lipid accumulation product (LAP), an index of visceral obesity, has been shown to be a powerful predictor of insulin resistance and type 2 diabetes (T2D). However, little attention has been paid to the relationship between LAP and MCI in T2D. Objective: We aimed to investigate the association between the LAP index and MCI in patients with T2D. Methods: In total, 220 hospitalized patients with T2D, including 113 MCI patients and 107 patients with normal cognition, were enrolled in this cross-sectional study. We collected demographic, anthropometric, and biochemical data on each subject. The LAP index was calculated according to the following formulas: [waist circumference (WC) (cm) – 65]×triglyceride (TG) (mmol/L) for males and [WC (cm) – 58] ×TG (mmol/L) for females. Results: Compared with patients with normal cognition, MCI patients were older and had a higher LAP index, WC, body mass index, and glycosylated hemoglobin A1c level, as well as a lower Montreal Cognitive Assessment score and education level (p < 0.05). After adjusting for confounding factors, LAP index was associated with MCI (OR = 1.047, 95% CI = 1.031–1.063, p < 0.01). The area under the ROC curve (AUC) for the LAP index was higher than that for WC and BMI. Conclusion: A high LAP index is associated with an increased risk of MCI in T2D patients. The LAP index appears to be a good indicator of risk of MCI in patients with T2D.

scholarly journals Association between Hemoglobin Levels and Diabetic Peripheral Neuropathy in Patients with Type 2 Diabetes: A Cross-Sectional Study Using Electronic Health Records

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Jun Yang ◽  
Pi-jun Yan ◽  
Qin Wan ◽  
Hua Li
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Patient Characteristics ◽  
Continuous Variable ◽  
Perception Threshold ◽  
Cross Sectional ◽  
Increased Risk ◽  
The Impact

Objective. To investigate the relationship between hemoglobin levels and diabetic peripheral neuropathy (DPN) in type 2 diabetes mellitus (T2DM). Methods. 1511 patients with T2DM were included in the study. DPN was diagnosed based on symptoms, signs, and laboratory tests. Hemoglobin was defined as both a continuous variable and a quartile category variable. We compared patient characteristics between the no diabetic peripheral neuropathy (NDPN) and DPN groups. Logistic regression was conducted to investigate the association of DPN with hemoglobin in all T2DM patients. Linear regression was also performed to investigate the impact of hemoglobin on the vibrating perception threshold (VPT). Results. Compared with the NDPN group, hemoglobin level in the DPN group was significantly lower (118.54 ± 16.91 versus 131.62 ± 18.32 g/L, P<0.01). The prevalence of DPN increased by 50.1% (95% CI: 42.2–57.0%; P<0.001) per standard deviation decrease in hemoglobin. Compared to the highest quartile of hemoglobin, the lower quartiles were associated with a significantly increased risk of DPN in the entire T2DM population (all P<0.01). A per unit decrease in hemoglobin leads to a 0.12 (95% CI: 0.07–0.168) unit increase in VPT after adjustment for possible confounders (P<0.001). Conclusions. Lower hemoglobin levels were associated with increased prevalence of DPN and higher VPT.

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