scholarly journals Comparative evaluation of empagliflozin, canagliflozin and sitagliptin cardioprotective properties in rats with experimental type 2 diabetes mellitus

2021 ◽  
Vol 24 (2) ◽  
pp. 111-121
Author(s):  
A. V. Simanenkova ◽  
S. M. Minasian ◽  
T. L. Karonova ◽  
T. D. Vlasov ◽  
N. V. Timkina ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Blood Flow ◽  
Type 2 Diabetes Mellitus ◽  
Coronary Blood Flow ◽  
Control Group ◽  
Hemodynamic Parameters ◽  
Glucose Lowering ◽  
Ischemic Contracture

Background: Myocardial infarction (MI) is one of the leading causes of mortality in patients with type 2 diabetes mellitus (DM), therefore it is essential to give preference to a glucose-lowering drug having optimal cardioprotective properties. A comparative study of the various sodium-glucose co-transporter inhibitors representatives’ protective effects in experimental MI was not carried out within the framework of one study.Aim: To evaluate the influence of empagliflozin (EMPA) and canagliflozin (CANA), in comparison with sitagliptin (SITA), on hemodynamic parameters and myocardial damage area in rats with diabetes type 2 model in experimental MI.Materials and methods: Type 2 DM was modelled in Wistar rats by means of 4-week high-fat diet followed by nicotinamide 230 mg/kg and streptozotocin 60 mg/kg administration. 4 weeks after DM induction the following groups were made: «DM+SITA» — treatment with SITA 50 mg/kg, «DM+EMPA» — treatment with EMPA 2 mg/kg, «DM+CANA» — treatment with CANA 25 mg/kg per os once daily for 8 weeks. Animals in «DM» group remained untreated for the following 8 weeks. Rats in control group were fed with standard chow. 16 weeks after the experiment beginning transient global myocardial ischemia was modelled in all rats. Hemodynamic parameters and myocardium necrosis area were evaluated.Results: The necrosis area was larger in «DM» group, than in control one (p=0.018). Infarction size in «DM+SITA» did not differ from that in «DM» group (62.92(41.29;75.84) and 57.26(45.51;70.08)%, р=0.554). Necrosis area in «DM+EMPA» and «DM+CANA» groups was smaller than in «DM» group (37.90(20.76;54.66)%, 46.15(29.77;50.55) vs 57.26(45.51;70.08)%, р=0.008 and р=0.009, respectively). Necrosis size did not differ between «DM+EMPA» and «DM+CANA» groups (p=0.630). Ischemic contracture in «DM+CANA» group was less prominent than under the use of all other glucose-lowering drugs. We observed increase of coronary blood flow in «DM+EMPA» group, in comparison with «DM», «DM+CANA» and «DM+SITA» groups.Conclusions: SITA does not have cardioprotective effect in ischemia-reperfusion injury in diabetic rats. EMPA and CANA have similarly prominent infarct-limiting properties. EMPA is able to increase coronary blood flow, whereas cardioprotective action of CANA is associated with ischemic contracture diminishing.

scholarly journals Microcirculatory parameters in compensated and decompensated type 2 diabetes mellitus

2017 ◽  
Vol 89 (10) ◽  
pp. 28-35 ◽  
Author(s):  
O V Suchkova ◽  
Yu I Gurfinkel ◽  
M L Sasonko
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Blood Flow ◽  
Type 2 Diabetes Mellitus ◽  
Capillary Blood ◽  
Capillary Blood Flow ◽  
Control Group ◽  
Functional Changes ◽  
Group 2

Aim. To reveal the features of microcirculatory parameters in compensated and decompensated type 2 diabetes mellitus (T2DM). Subjects and methods. A total of 196 patients with T2DM were examined and divided into 2 groups: 1) 52 patients (40.4% of men) aged 52.8±8.7 years with compensated T2DM (glycated hemoglobin (HbA1с), 6.3±0.5%); 2) 68 patients (38.2% of men) aged 52.8±8.1 years with decompensated T2DM (HbA1с, 9.4±1.7%). Both patient groups had concomitant hypertension (its prevalence, degree, stage of hypertension were comparable). A control group consisted of 76 volunteers (40.8% of men) aged 52.2±8.7 years with normal carbohydrate metabolism and without signs of cardiovascular disease (HbA1с, 5.3±0.49%). Capillary blood flow in the finger nail-fold area was investigated in all the participants. A digital optical capillaroscope with image-processing software was used to obtain quantitative blood microcirculatory parameters. The diameters of arterial and venous capillary segments were measured, by calculating the remodeling rate. The degree of capillary tortuosity, network density, and polymorphism and the size of the perivascular zone (PZ) were estimated. Blood rheological properties and capillary blood flow velocity were also investigated. Results. The decompensated T2DM group compared to the compensated T2DM group was found to have a narrowing of the arterial capillary segment diameter (8.4±2.0 µm; p=0.009) and an increase in remodeling rates (1.47±0.22; p=0.000). The tendency of the PZ size to be larger in patients with decompensated T2DM compared to those with compensated T2DM (p=0.080) and the increase in this indicator compared to the control group (p=0.001) reflect the presence of edema syndrome in Group 2, as laboratory confirmed by a statistically significantly elevated sodium level (p=0.000; p=0.006). The enlarged venous capillary segment demonstrates involvement of the venous component in microcirculatory disorders in T2DM. The reduction in the density of the capillary network and the increase in capillary tortuosity and polymorphism, which were also observed in the patients of both groups versus the control group, are referred to as disorders that are characteristic of T2DM. Conclusion. In decompensated T2DM, capillary bed structural and functional changes are found as a narrowing of the arterial capillary segment, an increase in the rate of remodeling, and enlargement of the PZ. Digital capillaroscopy opens up new possibilities for assessing the magnitude of changes in the microcirculatory system in DM and can simultaneously evaluate the efficiency of treatment, by monitoring the status of the microvasculature.

scholarly journals Cerebral hemodynamics in patients with type 2 diabetes mellitus and chronic kidney disease

2021 ◽  
Vol 17 (6) ◽  
pp. 486-490
Author(s):  
A.Yu. Kholikov ◽  
Yu.M. Urmanova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Blood Flow ◽  
Type 2 Diabetes Mellitus ◽  
Cerebral Ischemia ◽  
Kidney Disease ◽  
Cerebral Hemodynamics ◽  
Control Group

Background. The main risk factors for cardiovascular diseases (CVD) are diabetes mellitus, anemia, microalbuminuria, proteinuria, azotemia, hyperlipidemia, obesity, smoking, lack of physical activity, and non-traditional factors are metabolic and hemodynamic disorders. The combined effect of diabetes mellitus and renal insufficiency increases the risk of CVD and confirms the worse survival prognosis of these patients compared to the general population. The study was aimed to study changes in the parameters of cerebral hemodynamics in patients with type 2 diabetes mellitus receiving programmed hemodialysis. Materials and me­thods. During the period from January 1, 2019 to June 1, 2021, 117 patients suffering from type 2 diabetes mellitus with chronic renal failure stage V on programmed hemodialysis were examined and observed. Of these, there were 58 women and 59 men. The average age of men was 67.0 ± 4.2 years, women — 64.0 ± 5.6 years. Twenty patients of the matched age formed the control group. The number of hemodialysis sessions in patients ranged from 2 to 162. All patients underwent examinations that included general clinical, biochemical, hormonal blood tests, Dopplerography of the main arteries of the head. Results. With the increasing degree of cerebral ischemia, the linear velocity of blood flow (LBFV) decreased in all the main arteries of the head: the common caro­tid artery, the internal carotid artery, the vertebral artery on both sides (p < 0.05). At the same time, the differences in the LBFV from healthy individuals were significant. The stenosis of the lumen of the main vessels of the head occurred mostly in patients of the third group with stage V diabetic nephropathy and grade III chronic cerebral ischemia, while they most often had multiple vascular stenosis. Conclusions. Dopplerography of the main arteries of the head is an informative method for determining the prognosis of cerebral ischemia in patients with type 2 diabetes mellitus and chronic kidney disease. Linear blood flow velocity was reduced in all groups of patients with type 2 diabetes mellitus and chronic kidney disease.

scholarly journals Ten-year Follow-up of Sitagliptin Treatment in Type 2 Diabetes Mellitus Patients

2021 ◽  
Author(s):  
Sachiko Hattori
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cell Function ◽  
Urinary Albumin ◽  
Control Group ◽  
Glucose Lowering ◽  
B Cell Function ◽  
History Of

Abstract Background: Early and effective intervention with a dipeptidyl peptidase 4 inhibitor (DPP4i) before the development of advanced atherosclerosis in type 2 diabetes mellitus (T2DM) patients without a history of cardiovascular disease (CVD) is reported to increase the chance of significant reductions in not only microvascular disease, but also CVD. Method: This study aimed to investigate whether sitagliptin is effective and tolerated for glycemic control and whether renoprotective effects and b-cell function are preserved for as long as ten years in Japanese patients with T2DM without a history of CVD. Results: The situation is equivalent to improving glycemic control as assessed by hemoglobin A1c both in a sitagliptin group (sitagliptin 50 mg as either monotherapy or combination therapy with other oral glucose-lowering drugs (n=17)) or a control group (placebo as either monotherapy or combination therapy with other glucose-lowering drugs (n=9)), while anti-inflammatory effects as assessed by high-sensitivity C-reactive peptide in the sitagliptin group were superior to those in the control group. In the sitagliptin group, the mean values of urinary albumin excretion measured as urinary albumin-to-creatinine ratio (ACR) were markedly decreased, but no changes in estimated glomerular filtration rate (eGFR) were seen throughout the study. Beta-cell function as evaluated by homeostatic model assessment of b-cell function (HOMA-β) values was reduced at baseline in both groups, improved significantly in the sitagliptin group, and continued unchanged in the control group during the study. Conclusion: This observation suggests that early intervention with sitagliptin in patients with T2DM may have long-lasting renoprotective and islet-protective effects. Trial registration: UMIN Clinical Registry (UMIN000038459). Registered 01November (Retrospectively registered), https://upload.umin.ac.jp/UMIN000038459

ESTIMATION OF SERUM FERRITIN LEVELS IN TYPE 2 DIABETIC PATIENTS AND ITS RELATION WITH HbA1C LEVEL.

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Shah Namrata Vinubhai ◽  
Pardeep Agarwal ◽  
Bushra Fiza ◽  
Ramkishan Jat
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Sugar ◽  
Serum Ferritin ◽  
Inflammatory Marker ◽  
Control Group ◽  
Diabetic Patients ◽  
Positive Correlation

Background: Serum ferritin is known as an index for body iron stores also as an inflammatory marker and it is influenced by several disease. We were looking for a correlation between HbA1c and S. Ferritin in type 2 DM. Methodology: The present study a total of 150 participants were enrolled of which 100 were confirmed cases of Type 2 Diabetes Mellitus and rest 50 age and sex matched healthy subjects constituted the control group. All were screened for HbA1c, Fasting blood sugar, Post prandial blood sugar and S.Ferritin. Results: A highly significant variation and positive correlation was observed with respect to S.Ferritin and HbA1c levels. Mean S.Ferritin was high in the subgroup with poor glycemic control. Conclusion: The fasting, post prandial sugar levels, HbA1c and S.Ferritin were significantly higher in the diabetic subjects. This study shows a positive correlation between HbA1c and S. Ferritin levels. So we can conclude that in diabetic patients S. Ferritin may serve as an independent marker of poor glycemic and metabolic control. Keywords: Serum ferritin, Type 2 Diabetes Mellitus, HbA1c.

Rheumatoid Factor in Type 2 Male Diabetes Mellitus Patients in a Tertiary Care Hospital of Bangladesh

2018 ◽  
Vol 4 (2) ◽  
pp. 58-62
Author(s):  
Roksana Yeasmin ◽  
MA Muttalib ◽  
Kazi Nazneen Sultana ◽  
Nizamul Hoque Bhuiyan ◽  
Md Jamil Hasan Karami ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Uric Acid ◽  
Rheumatoid Factor ◽  
Serum Uric Acid ◽  
Control Group ◽  
Healthy Male ◽  
Male Patients

Background: Type 2 diabetes mellitus is a chronic disease characterized by relative or absolute deficiency of insulin, resulting in glucose intolerance.Objectives: The present study was planned to see the associations of serum uric acid with positive Rheumatoid factor in type 2 male diabetes mellitus patients. Methodology: This case control study was carried out at the department of Biochemistry at Ibrahim Medical College, Dhaka, Bangladesh. The duration of the study was from June 2015 to June 2016 for a period of one year. In this present study, male patients with type 2 diabetes mellitus were taken as case group and age and sex matched healthy male were taken as control group. Rheumatoid factor was measured from the blood of all case and control group respondents. Others blood para meters were also measured for the correlation with the diabetes mellitus patients.Results: In this present study, 110 male patients presented with type 2 diabetes mellitus were recruited as case and age and sex matched healthy male were recruited as control. More rheumatoid factor positive in type 2 DM male patients with the uric acid range between 6.5 to 9.5 mg/dL. The number of patients was 5 out of total 9 rheumatoid factor positive cases. In this study serum uric acid was significantly correlated with rheumatoid factor in type 2 male diabetic patients. Rheumatoid factor positive cases were taking insulin among 9 and it was statistically significantly associated (p<0.001). Conclusion: In this study serum uric acid is significantly associated with positive rheumatoid factor in type 2 male diabetic patients.Journal of Current and Advance Medical Research 2017;4(2):58-62

scholarly journals Fermented pork fat (Sa-um) and lifestyle risk factors as potential indicators for type 2 diabetes among the Mizo population, Northeast India

2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Freda Lalrohlui ◽  
Souvik Ghatak ◽  
John Zohmingthanga ◽  
Vanlal Hruaii ◽  
Nachimuthu Senthil Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cox Regression ◽  
Control Group ◽  
Diabetic Patients ◽  
Lifestyle Habits ◽  
Pork Fat

AbstractOver the last few decades, Mizoram has shown an increase in cases of type 2 diabetes mellitus; however, no in-depth scientific records are available to understand the occurrence of the disease. In this study, 500 patients and 500 healthy controls were recruited to understand the possible influence of their dietary and lifestyle habits in relation with type 2 diabetes mellitus. A multivariate analysis using Cox regression was carried out to find the influence of dietary and lifestyle factors, and an unpaired t test was performed to find the difference in the levels of biochemical tests. Out of 500 diabetic patients, 261 (52.3%) were males and 239 (47.7%) were females, and among the control group, 238 (47.7%) were males and 262 (52.3%) were females. Fermented pork fat, Sa-um (odds ratio (OR) 18.98), was observed to be a potential risk factor along with tuibur (OR 0.1243) for both males and females. Creatinine level was found to be differentially regulated between the male and female diabetic patients. This is the first report of fermented pork fat and tobacco (in a water form) to be the risk factors for diabetes. The unique traditional foods like Sa-um and local lifestyle habits like tuibur of the Mizo population may trigger the risk for the prevalence of the disease, and this may serve as a model to study other populations with similar traditional practices.

Effects of epigallocatechin-3-gallate of Camellia sinensis leaves on blood pressure, lipid profile, atherogenic index of plasma and some inflammatory and antioxidant markers in type 2 diabetes mellitus patients: a clinical trial

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Hadi Bazyar ◽  
Seyed Ahmad Hosseini ◽  
Sirous Saradar ◽  
Delsa Mombaini ◽  
Mohammad Allivand ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lipid Profile ◽  
Atherogenic Index ◽  
Control Group ◽  
Atherogenic Index Of Plasma ◽  
The Mean

Abstract Background In patients with type 2 diabetes mellitus (T2DM) the inflammatory and metabolic responses to epigallocatechin-3-gallate (EGCG) are unknown. Objectives Evaluate the impacts of EGCG on metabolic factors and some biomarkers of stress oxidative in patients with T2DM. Methods In this randomized, double-blind, placebo-controlled trial, 50 patients with T2DM consumed either 2 tablets (300 mg) EGCG (n=25) or wheat flour as placebo (n=25) for 2 months. The total antioxidant capacity (TAC), interleukin-6 (IL-6), lipid profile, mean arterial pressure (MAP), atherogenic index of plasma (AIP) were evaluated before and after the intervention. Results The finding of present study exhibited a significant increase in the serum levels of TAC after the EGCG supplementation (p=0.001). Also, in compare with control group, the mean changes of TAC were significantly higher in supplement group (p=0.01). In intervention group, a significant decrease was observed in the mean levels of triglyceride, total cholesterol, diastolic blood pressure (DBP), AIP, and MAP (p<0.05). Taking EGCG resulted in the mean changes of total cholesterol, MAP and DBP were significantly lower in compare with control group (p<0.05). Conclusions This study recommended that EGCG supplementation may be improved blood pressure, lipid profile, AIP, and oxidative status in patients with T2DM.

scholarly journals Shared decision making and patient-centeredness for patients with poorly controlled type 2 diabetes mellitus in primary care—results of the cluster-randomised controlled DEBATE trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Anja Wollny ◽  
Christin Löffler ◽  
Eva Drewelow ◽  
Attila Altiner ◽  
Christian Helbig ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Decision Making ◽  
Type 2 Diabetes Mellitus ◽  
Shared Decision Making ◽  
Intervention Group ◽  
Control Group ◽  
Shared Decision ◽  
Patient Centeredness

Abstract Background We investigate whether an educational intervention of GPs increases patient-centeredness and perceived shared decision making in the treatment of patients with poorly controlled type 2 diabetes mellitus? Methods We performed a cluster-randomized controlled trial in German primary care. Patients with type 2 diabetes mellitus defined as HbA1c levels ≥ 8.0% (64 mmol/mol) at the time of recruitment (n = 833) from general practitioners (n = 108) were included. Outcome measures included subjective shared decision making (SDM-Q-9; scale from 0 to 45 (high)) and patient-centeredness (PACIC-D; scale from 1 to 5 (high)) as secondary outcomes. Data collection was performed before intervention (baseline, T0), at 6 months (T1), at 12 months (T2), at 18 months (T3), and at 24 months (T4) after baseline. Results Subjective shared decision making decreased in both groups during the course of the study (intervention group: -3.17 between T0 and T4 (95% CI: -4.66, -1.69; p < 0.0001) control group: -2.80 (95% CI: -4.30, -1.30; p = 0.0003)). There were no significant differences between the two groups (-0.37; 95% CI: -2.20, 1.45; p = 0.6847). The intervention's impact on patient-centeredness was minor. Values increased in both groups, but the increase was not statistically significant, nor was the difference between the groups. Conclusions The intervention did not increase patient perceived subjective shared decision making and patient-centeredness in the intervention group as compared to the control group. Effects in both groups might be partially attributed to the Hawthorne-effect. Future trials should focus on patient-based intervention elements to investigate effects on shared decision making and patient-centeredness. Trial registration The trial was registered on March 10th, 2011 at ISRCTN registry under the reference ISRCTN70713571.

Evaluation of Epicardial Adipose Tissue in Patients of Type 2 Diabetes Mellitus by Echocardiography and its Correlation with Intimal Medial Thickness of Carotid Artery

2017 ◽  
Vol 125 (09) ◽  
pp. 598-602 ◽  
Author(s):  
Zihang Wang ◽  
Yuhong Zhang ◽  
Weiwei Liu ◽  
Benli Su
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Adipose Tissue ◽  
Carotid Artery ◽  
Epicardial Adipose Tissue ◽  
Control Group ◽  
Intimal Medial Thickness ◽  
Type 2 Diabetic

AbstractThe present study aimed to evaluate the diagnostic value of echocardiography in measuring the thickness of epicardial adipose tissue (EAT) of the patients of type 2 diabetes mellitus (T2DM) and its correlation with the intimal-medial thickness of the carotid artery (cIMT) to investigate the relationship between EAT and cIMT. 68 patients of T2DM were enrolled and were divided into 2 groups: group of T2DM with duration≤10 years (35 cases) and group of T2DM with duration>10 years (33 cases). And 30 healthy subjects were enrolled as the control group. The thickness of EAT and cIMT were measured by echocardiography and high-frequency ultrasonography. The thickness of EAT and IMT of the carotid artery of 2 type 2 diabetic groups (duration≤10 years and>10 years) were significantly higher than that of the control group (all p<0.05), and the thickness of EAT and cIMT of the group of T2DM with duration>10 years were significantly higher than that of the group of T2DM with duration≤10 years (p<0.05). In univariate analysis, the thickness of EAT was positively and significantly associated with age (r=0.412, p<0.05), BMI (r=0.566, p<0.05), waist circumference (r=0.475, p<0.05), LDL (r=0.425, p<0.05), TG (r=0.496, p<0.05), duration of diabetes (r=0.384, p<0.05) and cIMT (r=0.456, p<0.05). In multiple stepwise regression analyses, age, BMI and IMT of carotid artery were appeared to be significantly associated with EAT (p<0.05 for all). In conclusion, routine screening of EAT and cIMT by ultrasonography in type 2 diabetic patients helps us to predict cardiovascular risks and prevent further development of cardiovascular complications.

The Cardiovascular Events in Metabolic Surgery Compared to the New Classes of Glucose-Lowering Agents in Patients with T2DM

2021 ◽  
Author(s):  
Najla Shamsi
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Metabolic Surgery ◽  
Cardiovascular Events ◽  
Controlled Trials ◽  
Glucose Lowering ◽  
Randomized Controlled ◽  
History Of

Type 2 Diabetes Mellitus is a prevalent chronic disease with several macrovascular and microvascular complications. Cardiovascular diseases including coronary artery disease and stroke are common macrovascular complication that reduces the quality of life and lead to early mortality. Additionally, they pose enormous socioeconomic burden on the societies and the governments. Therefore, any intervention that reduces the cardiovascular events in patients with diabetes will have positive impact of the patients and the society. Thus, this systematic review aimed to evaluate the cardiovascular events after metabolic surgery in comparison with the new classes of glucose lowering agents in patients with type 2 diabetes mellitus. The review included 11 randomized controlled trials to both GLP-1 RA and SGLT-2 i groups. It also included 7 metabolic surgery studies, 2 of these are randomized controlled trials and the other 5 are observational studies. These studies were the most relevant studies to the research question. The results revealed different baseline demographic and clinical characteristics between the medication trials and metabolic surgery studies. Moreover, it revealed significant reduction in cardiovascular events in metabolic surgery studies when compared to medication trials. It also showed significant HbA1c and weight reduction in the metabolic surgery group. The remission of diabetes was very high in the metabolic surgery group while none of medication trials accomplished diabetes recovery. However, both medication and surgery groups had adverse events. In conclusion, the review is consistent with previous literature. It suggests that metabolic surgery is more effective than medical therapy in reducing cardiovascular events. Although this conclusion should be interpreted with caution due to the differences in baseline characteristics between studies. In general, the review recommends younger adult diabetic patients with obesity and history of established cardiovascular diseases to undergo metabolic surgery. Whereas, older patients with history of cardiovascular disease should be advised to take one of the medications that has been proved to reduce cardiovascular events. Future studies that compare metabolic surgery and the new classes of the glucose lowering agents is recommended to confirm the findings in this review.

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