scholarly journals Russian multicentre type 2 diabetes screening program in patients with cardiovascular disease

2016 ◽  
Vol 19 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Marina Vladimirovna Shestakova ◽  
Irina Evgenievna Chazova ◽  
Ekaterina Alekseevna Shestakova
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Glucose Tolerance ◽  
Screening Program ◽  
Density Lipoprotein ◽  
High Risk Group ◽  
Oral Glucose ◽  
Screening Programs

Aim.To evaluate the prevalence of undiagnosed type 2 diabetes mellitus (T2DM) among patients with cardiovascular disease.Materials and methods.T2DM screening programs among patients with cardiovascular disease were held from 2013 to 2014 in several Russian cities. In total, 1001 patients aged ≥40 years with hypertension and/or atherosclerotic disease and without prior diagnosis of T2DM were screened in outpatient cardiology clinics. T2DM diagnosis was based on fasting plasma glucose levels, glycated haemoglobin (HbA1c) and/or oral glucose tolerance test (OGTT) results. Blood pressure (BP), family history of T2DM, cardiovascular disease, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride levels were analysed.Results.Fasting glucose was measured in 1000 (99.8%) patients, HbA1c was measured in in 623 (62.2%) and OGTT was performed in 286 (2.6%). Fasting glucose detected 8% of newly diagnosed T2DM; among patients who underwentHbA1c measurement, the prevalence of T2DM was 10.91%, and among patients who underwent OGTT, the prevalence was 13.99%. Depending on the chosen test, the prevalence of undiagnosed pre-diabetes (impaired fasting glycaemia and impaired glucose tolerance) was in the range of 14.4%–36.4%. The majority of patients with T2DM diagnosed by OGTT did not have target blood pressure and lipid levels; 67.5% had elevated systolic BP, 47.5% had elevated diastolic BP, 90.9% had high LDL (≥1.8 mmol/l) and 52.9% had high triglyceride levels (≥1.7 mmol/l).Conclusion.A high prevalence of undiagnosed T2DM (from 8% to 13.99%, depending on the diagnostic criteria) and pre-diabetic state in patients with cardiovascular disease may require screening for T2DM in this high-risk group.

scholarly journals Skin autofluorescence predicts new cardiovascular disease and mortality in people with type 2 diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Henderikus E. Boersma ◽  
Robert P. van Waateringe ◽  
Melanie M. van der Klauw ◽  
Reindert Graaff ◽  
Andrew D. Paterson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Fasting Blood Glucose ◽  
Multivariable Analysis ◽  
Oral Glucose ◽  
Skin Autofluorescence ◽  
Z Score

Abstract Background Skin autofluorescence (SAF) is a non-invasive marker of tissue accumulation of advanced glycation endproducts (AGE). Recently, we demonstrated in the general population that elevated SAF levels predict the development of type 2 diabetes (T2D), cardiovascular disease (CVD) and mortality. We evaluated whether elevated SAF may predict the development of CVD and mortality in individuals with T2D. Methods We included 2349 people with T2D, available baseline SAF measurements (measured with the AGE reader) and follow-up data from the Lifelines Cohort Study. Of them, 2071 had no clinical CVD at baseline. 60% were already diagnosed with diabetes (median duration 5, IQR 2–9 years), while 40% were detected during the baseline examination by elevated fasting blood glucose ≥7.0 mmol/l) and/or HbA1c ≥6.5% (48 mmol/mol). Results Mean (±SD) age was 57 ± 12 yrs., BMI 30.2 ± 5.4 kg/m2. 11% of participants with known T2D were treated with diet, the others used oral glucose-lowering medication, with or without insulin; 6% was using insulin alone. Participants with known T2D had higher SAF than those with newly-detected T2D (SAF Z-score 0.56 ± 0.99 vs 0.34 ± 0.89 AU, p < 0.001), which reflects a longer duration of hyperglycaemia in the former group. Participants with existing CVD and T2D had the highest SAF Z-score: 0.78 ± 1.25 AU. During a median follow-up of 3.7 yrs., 195 (7.6%) developed an atherosclerotic CVD event, while 137 (5.4%) died. SAF was strongly associated with the combined outcome of a new CVD event or mortality (OR 2.59, 95% CI 2.10–3.20, p < 0.001), as well as incidence of CVD (OR 2.05, 95% CI 1.61–2.61, p < 0.001) and death (OR 2.98, 2.25–3.94, p < 0.001) as a single outcome. In multivariable analysis for the combined endpoint, SAF retained its significance when sex, systolic blood pressure, HbA1c, total cholesterol, eGFR, as well as antihypertensive and statin medication were included. In a similar multivariable model, SAF was independently associated with mortality as a single outcome, but not with incident CVD. Conclusions Measuring SAF can assist in prediction of incident cardiovascular disease and mortality in individuals with T2D. SAF showed a stronger association with future CVD events and mortality than cholesterol or blood pressure levels.

TIMING OF ACUTE PASSIVE HEATING ON GLUCOSE TOLERANCE AND BLOOD PRESSURE IN PEOPLE WITH TYPE 2 DIABETES: A RANDOMIZED, BALANCED CROSSOVER, CONTROL TRIAL

2021 ◽  
Author(s):  
Thomas Joseph James ◽  
Jo Corbett ◽  
Michael H. Cummings ◽  
Sharon Allard ◽  
John S. Young ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Microvascular Dysfunction ◽  
Oral Glucose ◽  
Passive Heating ◽  
Chronic Hyperglycemia

Type 2 diabetes mellitus (T2DM) is characterized by chronic hyperglycemia and progressive insulin resistance, leading to macro and microvascular dysfunction. Passive heating has potential to improve glucose homeostasis and act as an exercise mimetic. We assessed the effect of acute passive heating before or during an oral glucose tolerance test (OGTT) in people with T2DM. Twelve people with T2DM were randomly assigned to 3 conditions:1) 3 h OGTT (CON); 2) 1 h passive heating (40 °C water) 30 min before an OGTT (HOT-OGTT); and 3) 1 h passive heating (40 °C water) 30 min after commencing an OGTT (OGTT-HOT). Blood [glucose], insulin sensitivity, extracellular heat shock protein 70 (eHSP70), total energy expenditure (TEE), heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP) were recorded. Passive heating did not alter blood [glucose] (CON, 1,677 (386) a.u.; HOT-OGTT, 1,797 (340) a.u.; OGTT-HOT, 1,662 (364) a.u.; P = 0.28), insulin sensitivity (P = 0.15), or SBP (P = 0.18), but did increase [eHSP70] in both heating conditions (CON, 203.48 (110.81) pg·mL-1; HOT-OGTT, 402.47 (79.02) pg·mL-1; OGTT-HOT, 310.00 (60.53) pg·mL-1; P < 0.001), increased TEE (via fat oxidation) in the OGTT-HOT condition (CON, 263 (33) kcal; HOT-OGTT, 278 (40) kcal; OGTT-HOT, 304 (38) kcal; P = 0.001), increased HR in both heating conditions (P < 0.001) and reduced DBP in OGTT-HOT condition (P < 0.01). Passive heating in close proximity to a glucose challenge does not alter glucose tolerance but does increase [eHSP70] and TEE, and reduce blood pressure in people with T2DM.

Regulation of glucagon secretion by incretin-like hormone family in the patients at risk of developing type 2 diabetes mellitus

2014 ◽  
Vol 60 (1) ◽  
pp. 32-35
Author(s):  
E A Shestakova ◽  
A V Ilyin ◽  
A D Deev ◽  
M V Shestakova ◽  
I I Dedov
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Glucose Tolerance ◽  
Glucagon Secretion ◽  
Tolerance Test ◽  
Normal Glucose Tolerance ◽  
High Risk Group ◽  
Oral Glucose ◽  
Glucose Load

The study included 127 patients with type 2 diabetes (T2D) risk factors, who underwent oral glucose tolerance test (75 g glucose) with pancreatic and incretin hormones estimated in fasting state, at 30 and 120 minutes after glucose load. According to the test results the population was divided into 3 groups: group with normal glucose tolerance (NGT), group with high risk of diabetes developing (impaired glucose tolerance (IGT) and impaired fasting glycemia (IFG)) and newly-diagnosed T2D. The stimulated glucagon secretion was suppressed in NGT group, whereas in T2D patients there was an increase in glucagon levels at 30 min after the glucose load. Within high risk group the area under curve (AUC) of glucagon secretion was significantly elevated in IFG patients comparing to IGT (0,52 vs 0,07 ng·ml-1·min-1, р=0,0005). AUC of glucagon secretion was positively related only to fasting glucagon-like peptide 2 (GLP-2) level (r=0,61, р=0,0001), that suggests glucagonotropic properties for GLP-2. We conclude that glucagon stimulation by GLP-2 may play a role in decreased glucagon suppression in T2D patients and IFG state development.

scholarly journals New risk models for predicting diabetes and prediabetes in the first-degree relatives of patients with type 2 diabetes and a comparison with the FINDRIC

2021 ◽  
Author(s):  
Parisa Khodabandeh Shahraki ◽  
Awat Feizi ◽  
Sima Aminorroaya ◽  
Heshmatollah Ghanbari ◽  
Majid Abyar ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Glucose Tolerance ◽  
Lipid Profile ◽  
Risk Model ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Risk Models ◽  
Normal Glucose

Abstract Background We aimed to develop a risk model, monitoring the FDRs of patients with type 2 diabetes, who have normal glucose tolerance, to predict the onset of developing diabetes and prediabetes. In this study, 1765 FDRs of patients with type 2 diabetes mellitus, who had normal glucose tolerance, were subjected to statistical analysis. Diabetes risk factors including anthropometric indices, physical activity, fast plasma glucose, plasma glucose concentrations two-hour after oral glucose administration, glycosylated hemoglobin, blood pressure, and lipid profile at the baseline were considered as independent variables. Kaplan-Meier, log Rank test, univariate, and multivariable proportional hazard Cox regression were conducted. The optimal cut point for risk score was created according to receiver operating characteristic curve (ROC) analysis. Results The best diabetes predictability was achieved by a model in which waist to hip ratio (WHR), HbA1c, OGTT and the lipid profile were included. The best prediabetes risk model included HbA1c, systolic blood pressure, the lipid profile, and the oral glucose tolerance test (OGTT). These multivariable risk models were compared with FPG, HbA1c, and OGTT. The predictive efficiencies of models were higher than FPG and HbA1c; however the best predictive model of the current study showed comparable predictive efficiency to OGTT-AUC. Additionally, both diabetes models showed better performance than FINDRISC. Conclusion We recommend regular tests for FDRs of patients with type 2 diabetes to predict the risk of diabetes and prediabetes by using the OGTT-AUC. As a health check assessment tool, our diabetes models showed a more precise predictor compared to FINDRISC in our population.

scholarly journals Trends in the Degree of Control and Treatment of Cardiovascular Risk Factors in People With Type 2 Diabetes in a Primary Care Setting in Catalonia During 2007–2018

2022 ◽  
Vol 12 ◽  
Author(s):  
Manel Mata-Cases ◽  
Bogdan Vlacho ◽  
Jordi Real ◽  
Ramon Puig-Treserra ◽  
Magdalena Bundó ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Beta Blockers ◽  
Density Lipoprotein ◽  
Cross Sectional ◽  
Lipid Control

ObjectiveTo assess the trends in cardiovascular risk factor control and drug therapy from 2007 to 2018 in subjects with type 2 diabetes mellitus (T2DM).Materials and MethodsCross-sectional analysis using yearly clinical data and treatment obtained from the SIDIAP database. Patients aged ≥18 years with a diagnosis of T2DM seen in primary care in Catalonia, Spain. ResultsThe number of T2DM patients increased from 299,855 in 2007 to 394,266 in 2018. We also found an increasing prevalence of cardiovascular disease, heart failure, and chronic kidney disease (from 18.4 to 24.4%, from 4.5 to 7.3%, and from 20.2 to 31.3%, respectively). The achievement of glycemic targets (HbA1c&lt;7%) scarcely changed (54.9% to 55.9%). Major improvements were seen in blood pressure (≤140/90 mmHg: from 55% to 71.8%), and in lipid control (low-density lipoprotein cholesterol &lt;100 mg/dl: 33.4% to 48.4%), especially in people with established cardiovascular disease (48.8 to 69.7%). Simultaneous achievement of all three targets improved from 12.5% to 20.1% in the overall population and from 24.5% to 32.2% in those with cardiovascular disease but plateaued after 2013. There was an increase in the percentage of patients treated with any antidiabetic drug (70.1% to 81.0%), especially metformin (47.7% to 67.7%), and DPP4i (0 to 22.6%). The use of SGLT-2 and GLP-1ra increased over the years, but remained very low in 2018 (5.5% and 2.1% of subjects, respectively). There were also relevant increases in the use of statins (38.0% to 49.2%), renin-angiotensin system (RAS) drugs (52.5% to 57.2%), and beta-blockers (14.3% to 22.7%).ConclusionsDuring the 2007-2018 period, relevant improvements in blood pressure and lipid control occurred, especially in people with cardiovascular disease. Despite the increase in the use of antidiabetic and cardiovascular drugs, the proportion of patients in which the three objectives were simultaneously achieved is still insufficient and plateaued after 2013. The use of antidiabetic drugs with demonstrated cardio renal benefits (SGLT-2 and GLP-1ra) increased over the years, but their use remained quite low.

Visit-to-visit blood pressure variability in patients with type 2 diabetes with and without previous history of cardiovascular disease

2020 ◽  
Vol 38 (9) ◽  
pp. 1737-1744
Author(s):  
Maria Grazia Radaelli ◽  
Stefano Ciardullo ◽  
Silvia Perra ◽  
Rosa Cannistraci ◽  
Eleonora Bianconi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Blood Pressure Variability ◽  
Previous History ◽  
History Of

scholarly journals The Effect of Urtica Dioica Extract on Blood Lipids Profile in Patients with Type 2 Diabetes: A Randomized Double-blinded Clinical Trial

2021 ◽  
Author(s):  
Roya Khajeh Mehrizi ◽  
Hassan Mozaffari-Khosravi ◽  
Parisa Aboee
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Clinical Trial ◽  
Total Cholesterol ◽  
Density Lipoprotein ◽  
Urtica Dioica ◽  
Significant Difference ◽  
The Mean ◽  
Double Blinded

Background: Diabetes is an endocrine disorder that is strongly associated with cardiovascular disease. The use of alternative therapy has recently increased and medicinal plants are one of the alternative therapies for diabetic patients. This study aimed to evaluate the protective effect of Urtica dioica (Nettle) on lipid profile in patients with type 2 diabetes (T2D). Method: This parallel randomized double-blinded clinical trial was conducted on 60 men and women with T2D for an 8-week period. The participants were randomly assigned to received 100mg/kg/day extract of Urtica Dioica (UG) and the placebo group (PG). Blood triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDLc) and high density lipoprotein cholesterol (HDLc) were measured at baseline and end of the study. The data were analyzed using SPSS 16.0 and P < 0.05 was considered significant. Results: The mean difference of total cholesterol showed no significant difference in the UG compared to the PG which were -10.56±40.5 and -19.5± 35.9 (P = 0.14), respectively. The study also showed no significant difference between TG and LDLc in the UG compared to the PG (-39.8±171.5 vs. -23.37±72.3 (P = 0.68) and -3.16±33.4 vs. -11.2±35.6 (P = 0.15), respectively). The mean difference of HDLc in the UG and PG were -2.68±8.11 and 2.62±10.6 (P = 0.05), respectively, indicating a significant increase in the UG compared to the PG. Conclusion: The results demonstrated that consumption of 100mg/kg/day extract of UD for 8 weeks by increasing HDL concentration can decrease the risk of cardiovascular disease in patients with T2D.

scholarly journals Efficacy and Safety of Ertugliflozin in Patients With Type 2 Diabetes Mellitus and Established Cardiovascular Disease Treated With Metformin and Sulfonylurea

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A331-A331
Author(s):  
Matthew J Budoff ◽  
Timothy M E Davis ◽  
Alexandra G Palmer ◽  
Robert Frederich ◽  
David E Lawrence ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Glycemic Control ◽  
Sglt2 Inhibitor ◽  
Efficacy And Safety

Abstract Introduction: Ertugliflozin (ERTU), a sodium-glucose cotransporter 2 (SGLT2) inhibitor, is approved as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus (T2DM). Aim: As a pre-specified sub-study of the Phase 3 VERTIS CV trial (NCT01986881), the efficacy and safety of ERTU were assessed in patients with T2DM and established atherosclerotic cardiovascular disease (ASCVD) inadequately controlled with metformin and sulfonylurea (SU). Methods: Patients with T2DM, established ASCVD, and HbA1c 7.0–10.5% on stable metformin (≥1500 mg/day) and SU doses as defined per protocol were randomized to once-daily ERTU (5 mg or 15 mg) or placebo. The primary sub-study objectives were to assess the effect of ERTU on HbA1c compared with placebo and to evaluate safety and tolerability during 18-week follow-up. Key secondary endpoints included proportion of patients achieving HbA1c &lt;7%, fasting plasma glucose (FPG), body weight, and systolic blood pressure. Changes from baseline at Week 18 for continuous efficacy endpoints were assessed using a constrained longitudinal data analysis model. Results: Of the 8246 patients enrolled in the VERTIS CV trial, 330 patients were eligible for this sub-study (ERTU 5 mg, n=100; ERTU 15 mg, n=113; placebo, n=117). Patients had a mean (SD) age of 63.2 (8.4) years, T2DM duration 11.4 (7.4) years, estimated glomerular filtration rate 83.5 (17.8) mL/min/1.73 m2, and HbA1c 8.3% (1.0) (67.4 [10.6] mmol/mol). At Week 18, ERTU 5 mg and 15 mg were each associated with a significantly greater least squares mean (95% CI) HbA1c reduction from baseline versus placebo; the placebo-adjusted differences for ERTU 5 mg and 15 mg were –0.7% (–0.9, –0.4) and –0.8% (–1.0, –0.5), respectively (P&lt;0.001). A higher proportion of patients in each ERTU group achieved HbA1c &lt;7% relative to placebo (P&lt;0.001). ERTU significantly reduced FPG and body weight (P&lt;0.001, for each dose versus placebo), but not systolic blood pressure. Adverse events were reported in 48.0%, 54.9%, and 47.0% of patients in the ERTU 5 mg, 15 mg, and placebo groups, respectively. Genital mycotic infections were experienced by significantly higher proportions of male patients who received ERTU 5 mg and 15 mg (4.2% and 4.8%, respectively) versus placebo (0.0%; P≤0.05) and by a numerically, but not significantly, higher proportion of female patients who received ERTU 15 mg (10.3%) compared with placebo (3.8%) (P=0.36). The incidences of symptomatic hypoglycemia were 11.0% (5 mg), 12.4% (15 mg), and 7.7% (placebo), and of severe hypoglycemia 2.0% (5 mg), 1.8% (15 mg), and 0.9% (placebo). Conclusion: Among patients with T2DM and ASCVD, ERTU (5 mg and 15 mg) added to metformin and SU for 18 weeks improved glycemic control (HbA1c and FPG) and reduced body weight, and was generally well tolerated with a safety profile consistent with the SGLT2 inhibitor class.

scholarly journals The association of six-minutes walking test (6MWT) with cardiovascular disease risk among older women with type 2 diabetes mellitus in a rural primary health care: a pilot observational study

2020 ◽  
Vol 3 (1) ◽  
pp. 34
Author(s):  
Rakhmat Ari Wibowo ◽  
Arum Tri Wahyuningsih ◽  
Rio Jati Kusuma ◽  
Wahyu Pamungkasih ◽  
Denny Agustiningsih
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Heart Rate ◽  
Older Women ◽  
Walking Test ◽  
Primary Health ◽  
Ascvd Risk

The recent systematic review found that cardiovascular events contributed to approximately half of all deaths among patients with type 2 diabetes mellitus (T2DM). Several studies suggested that the six-minutes walking test (6MWT) could be a valuable prognostic tool for predicting cardiovascular disease (CVD) events in particular diseases. However, less is known concerning the role of 6MWT in predicting CVD events among patients with T2DM. Thus, this pilot observational study aimed to test the feasibility of conducting the 6MWT and to examine the association of measures collected during 6MWT with ASCVD risk estimator parameters for predicting CVD events among T2DM patients. Fourteen older women with T2DM in a rural primary health care were enrolled in this cross-sectional study. Blood pressure measurement, heart rate measurement, and blood sampling for HDL, LDL, and total cholesterol measurements were carried out during rest. Both heart rate and distance were measured at the end of the following 6MWT. Feasibility data were collected. Recruitment rate and measurement completion rate were 85.7% and 40% respectively. No adverse events during the 6MWT were reported. Patient’s heart rate at the end of 6MWT was correlated with diastolic blood pressure (r=0.5 p=0.48). Multivariate analyses suggested that every one-meter increase in distance of 6MWT, there is a decrease in diastolic blood pressure of -0.9 mmHg (p=0.01; 95% CI= -1.6 to -0.2). In conclusion, 6MWT is a feasible simple test which could provide a valuable prediction of ASCVD risk among older women with T2DM. Thus, this test should be considered to be conducted as a part of routine examination. Cohort study with a larger sample could be suggested to establish the usefulness of the 6MWT in predicting CVD risk.

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