scholarly journals Prevention and treatment of diabetic microangiopathy: A lecture

1995 ◽  
Vol 41 (6) ◽  
pp. 29-34
Author(s):  
A. K. Dreval
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Diabetic Microangiopathy ◽  
Diabetic Patients ◽  
Atherosclerotic Vascular Disease ◽  
Diabetic Macroangiopathy ◽  
Prevention And Treatment ◽  
Patients With Diabetes

One of the main complications leading to high disability and mortality in patients with diabetes mellitus is atherosclerotic vascular disease (diabetic macroangiopathy). At the same time, the frequency of atherosclerosis among patients with diabetes mellitus is significantly affected by the so-called risk factors for atherosclerosis. In particular, the incidence of atherosclerosis among the general population and among diabetics increases with increased levels of cholesterol (cholesterol) in the blood, blood pressure, smoking and obesity. However, in patients with diabetes mellitus, mortality, for example, from coronary heart disease increases by 3 times against any of the known risk factors. But even without risk factors, the frequency of atherosclerotic vascular damage in patients with diabetes is much higher than in non-diabetic patients, i.e. diabetes in itself is a risk factor for atherosclerosis.

scholarly journals When Uncontrolled Diabetes Mellitus and Severe COVID-19 Converge: The Perfect Storm for Mucormycosis

2021 ◽  
Vol 7 (4) ◽  
pp. 298
Author(s):  
Teny M. John ◽  
Ceena N. Jacob ◽  
Dimitrios P. Kontoyiannis
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Clinical Features ◽  
The Other ◽  
Diabetic Patients ◽  
Epidemiological Factors ◽  
Uncontrolled Diabetes ◽  
Diagnostic Certainty ◽  
Patients With Diabetes ◽  
Perfect Storm

Mucormycosis (MCR) has been increasingly described in patients with coronavirus disease 2019 (COVID-19) but the epidemiological factors, presentation, diagnostic certainty, and outcome of such patients are not well described. We review the published COVID-19-associated mucormycosis (CAMCR) cases (total 41) to identify risk factors, clinical features, and outcomes. CAMCR was typically seen in patients with diabetes mellitus (DM) (94%) especially the ones with poorly controlled DM (67%) and severe or critical COVID-19 (95%). Its presentation was typical of MCR seen in diabetic patients (mostly rhino-orbital and rhino-orbital-cerebral presentation). In sharp contrast to reported COVID-associated aspergillosis (CAPA) cases, nearly all CAMCR infections were proven (93%). Treating physicians should have a high suspicion for CAMCR in patients with uncontrolled diabetes mellitus and severe COVID-19 presenting with rhino-orbital or rhino-cerebral syndromes. CAMR is the convergence of two storms, one of DM and the other of COVID-19.

scholarly journals Lack of association between peroxisome proliferator-activated receptor-gamma-2 gene variants and the occurrence of coronary heart disease in patients with diabetes mellitus

2002 ◽  
pp. 545-551 ◽  
Author(s):  
M Bluher ◽  
T Klemm ◽  
T Gerike ◽  
H Krankenberg ◽  
G Schuler ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Multiple Logistic Regression Analysis ◽  
Peroxisome Proliferator ◽  
Haemoglobin A1c ◽  
Peroxisome Proliferator Activated Receptor ◽  
Patients With Diabetes ◽  
Reduced Risk

OBJECTIVE: Recent evidence indicates that peroxisome proliferator-activated receptor-gamma (PPARgamma) is expressed at high levels in foam cells of atherosclerotic lesions, that PPARgamma agonists may directly modulate vessel wall function and that mutations in the PPARgamma-2 gene are associated with a reduced risk of coronary artery disease. METHODS: We investigated whether known variants in the PPARgamma-2 gene are associated with the occurrence of coronary heart disease (CHD) in 365 patients with type 2 diabetes, prospectively characterised for the presence or absence of CHD. The Pro115Gln, Pro12Ala, Pro467Leu, Val290Met mutations and two polymorphisms C478T and C161T of the PPARgamma-2 gene were examined using PCR, denaturing gradient gel electrophoresis and direct sequencing. RESULTS: The distribution of the Pro12Ala, Ala12Ala, C161T and T161T variants was not significantly different between patients with and without CHD, independent of the gender. The Pro12Ala (P=0.011) and the Ala12Ala (P=0.006) variant were associated with a higher body mass index (BMI) compared with the Pro12Pro genotype. A multiple logistic regression analysis introducing the typical risk factors for CHD (age, sex, hypertension, smoking, BMI >26 kg/m2, elevated low density lipoprotein cholesterol and haemoglobin A1c >7%) identified age >60, male gender, hypertension and a higher BMI, but not the PPARgamma-2 variants, as significant risk factors for CHD in our study groups. CONCLUSION: The PPARgamma-2 genotype was not associated with an increased or reduced risk of the occurrence of CHD and can therefore not be regarded as an independent risk factor for CHD in patients with diabetes mellitus.

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 The Association of Depression and the Cardiovascular Risk Factors of Blood Pressure, HbA1c, and Body Mass Index among Patients with Diabetes: Results from the Translating Research into Action for Diabetes Study

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Lindsay B. Kimbro ◽  
W. Neil Steers ◽  
Carol M. Mangione ◽  
O. Kenrik Duru ◽  
Susan L. Ettner
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Health ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
Patient Health ◽  
Hba1c Levels

Diabetic patients are nearly three times as likely to have depression as their nondiabetic counterparts. Patients with diabetes are already at risk for poor cardiovascular health. Using cross-sectional data from the translating research into action for diabetes (TRIAD) study, the authors tested the association of depression with cardiovascular risk factors in diabetic patients. Depression was measured using the patient health questionnaire (PHQ8). Patients who scored greater than 9 on the PHQ8 were classified as depressed and were compared with those who were not depressed(n=2,341). Depressed patients did not have significantly different blood pressure levels than those who were not depressed. However, those who were depressed had higher HbA1c levels than those who were not depressed(P<0.01)and higher BMIs than those who were not depressed(P<0.01). These results indicate that depressed diabetic patients are at greater risk of having poor control of cardiovascular risk factors and suggest that depression screening should be a standard practice among this patient group.

scholarly journals Risk factors for eye complications in patients with diabetes mellitus: development and progression

2000 ◽  
Vol 6 (2-3) ◽  
pp. 313-325
Author(s):  
M. El Shazly ◽  
M. Zeid ◽  
A. Osman
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Case Control Study ◽  
Case Control ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
Control Study

A multicentre case-control study was conducted to identify and quantify risk factors that may influence the development and progression of diabetic retinopathy. A total of 200 diabetic patients with nonproliferative retinopathy were compared with 400 diabetic patients without any eye complications with regard to the development of diabetic retinopathy. They were also compared with 200 diabetic patients with major eye complications to study the progression of diabetic eye complications. Results showed that the progression of diabetic eye complications was preventable since all the variables significantly affecting the process of progression, except type of diabetes, were avoidable

scholarly journals Chronic Kidney Disease and Associated Risk Factors Assessment among Diabetes Mellitus Patients at A Tertiary Hospital, Northwest Ethiopia

1970 ◽  
Vol 28 (6) ◽  
Author(s):  
Shewaneh Damtie ◽  
Belete Biadgo ◽  
Habtamu Wondifraw Baynes ◽  
Sintayehu Ambachew ◽  
Tadele Melak ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Systolic Blood Pressure ◽  
Older Age ◽  
Diabetic Patients ◽  
Study Participants

BACKGROUND: The prevalence of chronic kidney disease, particularly in diabetic patients, is increasing rapidly throughout the world. Nowadays, many individuals in developing nations are suffering from diabetes which is one of the primary risk factors of chronic kidney disease.METHODS: Institution based cross-sectional study was conducted at the University of Gondar Hospital from February to April 2016. A total of 229 study participants were selected using systematic random sampling technique. Urine sample was collected for albumin determination by dipstick. The Simplified Modification of Diet in Renal Disease study equation was used to estimate glomerular filtration rate. Binary logistic regression model was used to identify risk factors.RESULTS: Of the total 229 study participants, 50.2% were females and the mean age was 47±15.7 years. Among study participants, the prevalence of chronic kidney disease (CKD) was found to be 21.8% (95% CI: 16% - 27%). Of all study participants, 9(3.9%) had renal impairment (eGFR < 60 ml/min/ 1.73 m2) and 46 (20.1%) had albuminuria. Older age (AOR: 5.239, 95% CI: 2.255-12.175), systolic blood pressure ≥140mmHg (AOR: 3.633, 95% CI: 1.597-8.265), type 2 diabetes mellitus (AOR: 3.751, 95% CI: 1.507-9.336) and longer duration of diabetes (AOR: 3.380, 95% CI: 1.393-8.197) were independent risk factors of CKD.CONCLUSIONS: The study identified high prevalence (21.8%) of CKD among diabetic adults. CKD was significantly associated with older age, systolic blood pressure, type 2 DM and longer duration of DM. Thus, DM patients should be diagnosed for chronic kidney disease and then managed accordingly. 

Preoperative Assessment of the Patient with Diabetes Mellitus

2019 ◽  
Author(s):  
Sean A. Josephs ◽  
Gretchen A. Lemmink
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Diabetic Ketoacidosis ◽  
Preoperative Assessment ◽  
Major Surgery ◽  
Key Words Diabetes Mellitus ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Hyperglycemic Hyperosmolar State ◽  
Patients With Diabetes

Diabetes mellitus is a major cause of morbidity and mortality.  Nearly 30 million Americans have diabetes, more than 25% of which are undiagnosed. Patients with diabetes have multiple problems that should be addressed prior to surgery. They often have uncontrolled glucose levels that should be treated preoperatively. Current studies suggest that outcomes may be improved if perioperative glycemic control is optimized. Patients with diabetes develop end-organ dysfunction that can complicate perioperative management. Preoperative assessment of cardiac, neurologic, vascular, and renal function is necessary for all patients with diabetes that undergo major surgery. Optimization of cardiac disease in particular can reduce major adverse cardiac events for patients with risk factors such as diabetes. Diabetic patients can occasionally present for major surgery with hyperglycemic emergencies such as diabetic ketoacidosis and hyperglycemic hyperosmolar state. These conditions require urgent treatment to prevent mortality regardless of the need for surgery. This article reviews the preoperative assessment and management of these issues. This review contains 1 figure, 4 tables, and 37 references. Key Words: diabetes mellitus (DM), end-organ damage, hyperglycemia, polyuria, polydipsia, polyphagia, perioperative glycemic management, diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS), perioperative cardiac risk factors

scholarly journals The risk factors of developing diabetic foot ulcers incidence with diabetic patients in Mukalla/Yemen

2020 ◽  
Author(s):  
مريم باراس ◽  
Eidha A. Bin Hameed
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Glucose ◽  
Bacterial Infection ◽  
Diabetic Foot ◽  
Age Groups ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Patients With Diabetes

Background: Diabetes is on the rise worldwide and is already considered as an epidemic by some experts. So, there is a need to raise awareness on the important factors that can help prevent bacterial infection in wounds of patients with diabetes. Objective: To study the risk factors of developing diabetic foot ulcer (DFU) in patients with diabetes. The study is the first in Yemen to investigate the prevalence of bacterial infection in wounds of diabetic patients. Materials and Methods: This is a case-control study carried out from November 2018 to May 2019. Twenty diabetic patients with foot ulcer and twenty without foot ulcer were examined. Risk factors and clinical profile of patients were studied by using a standardized questionnaire that included gender, age groups, past history of diabetes, duration of the disease, type of diabetes, DFU, type of ulcer, smoking, glucose level, and control of blood glucose level. Results: The risk factors that affected significantly the occurrence of DFU were gender (0.038), age groups (0.010), and duration of diabetes mellitus (DM) while hyperglycemic control, smoking, and family history were not. There was no significant difference (0.977) in mean fasting blood glucose (MBG) between the DM and DFU patients. Conclusions: Male diabetic patients aged more than 55 years and suffering from DM for more than 10 years were most likely to have DFU. Key words: diabetic foot ulcer, diabetes mellitus, risk factors, Yemen 

scholarly journals Diabetic Dermopathy (Shin Spots) and Diabetic Retinopathy - Are They Associated?

2020 ◽  
Vol 7 (48) ◽  
pp. 2806-2810
Author(s):  
Niya Babu ◽  
Nima Teresa Andrew ◽  
Mercy Paul ◽  
Chakkalackal Varkey Anthrayose ◽  
Anchitha Meenu Rajeev ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Developed Countries ◽  
Diabetic Microangiopathy ◽  
Diabetic Patients ◽  
Keywords Diabetic Retinopathy ◽  
Duration Of Diabetes ◽  
Patients With Diabetes ◽  
The Mean ◽  
The Developed Countries

BACKGROUND Diabetes mellitus (DM) is a major cause of avoidable blindness in the developing and the developed countries. Diabetic patients have 25 times more chance of becoming blind than the non-diabetics.1 According to the WHO, the number of people in India affected with Diabetes Mellitus in the year 2000 was 31.7 million which is estimated to rise to 79.4 million by 2030, which would be higher than any other country in the world. 75 percent of all Type 2 diabetics and almost all Type 1 diabetics are expected to develop diabetic retinopathy (DR) over a period of time.2 Diabetic dermopathy or shin spots are the commonest dermatological manifestation in patients with Diabetes Mellitus. It is also known as pigmented pretibial patches, spotted leg syndrome or diabetic dermangiopathy.3 Both diabetic retinopathy and dermopathy are manifestations of diabetic microangiopathy. We wanted to study the association between diabetic retinopathy and diabetic dermopathy. METHODS 182 patients (between 40 - 70 years of age) having diabetes mellitus for at least five years were included in the study and were examined for retinal changes and skin changes. The study period was six months. RESULTS Of the 182 diabetic patients included in this study, 106 (58.2 %) had diabetic retinopathy. Shin spots were seen in 158 cases (86.8 %). 100 (94.3 %) cases with diabetic retinopathy had shin spots. The mean duration of diabetes mellitus in patients with diabetic retinopathy was 11.85 years and it was 8.16 years in those without diabetic retinopathy. The mean duration of diabetes mellitus in patients with shin spots was 14.88 years and it was 10.70 years in those without shin spots. CONCLUSIONS There is significant association between diabetic retinopathy and diabetic dermopathy. KEYWORDS Diabetic Retinopathy, Shin Spots, Diabetic Dermopathy

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