scholarly journals Pathomorphological changes of capillaries in the cerebral cortex in type 2 diabetes mellitus

2021 ◽  
Vol 14 (3) ◽  
pp. 354-362
Author(s):  
V. O. Tumanskyi ◽  
Yu. M. Avramenko
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cerebral Cortex ◽  
Electron Microscopic ◽  
Type 2 Dm ◽  
Conditional Control ◽  
Cortical Capillaries ◽  
Ischemic Encephalopathy

The aim of the study was to determine microscopic, immunohistochemical, electron microscopic, morphometric parameters of capillaries in the cerebral cortex in deceased patients with type 2 diabetes mellitus (DM) in comparison with the conditional control group and the group of deceased patients with dyscirculatory ischemic encephalopathy. Materials and methods. Microscopic, immunohistochemical, electron microscopic and morphometric studies of the cerebral cortex capillaries were performed in 3 groups: group I – 20 deceased patients with type 2 DM, group II conditional control (CC) – 20 deceased patients without clinical morphological signs of DM and cerebrovascular pathology, group III – 20 patients with dyscirculatory ischemic encephalopathy (DIEP). Results. It was found that in type 2 DM, the capillaries in the cerebral cortex lose pericytes due to their apoptosis: the number of pericytes in the cortical capillaries in type 2 DM was statistically significantly lower by 57.14 % compared to CC group and 50.00 % lower compared to DIEP group, the level of caspase-3 expression in the cortical microvessels in type 2 DM was significantly higher by 230.85 % compared with CC group and 81.67 % higher than in DIEP group. According to electron microscopy in type 2 DM, apoptosis of pericytes and single endothelial cells in the cerebral cortex capillaries was determined as well as significant expansion of basement membranes with the accumulation of electron-dense amorphous material and collagen fibrils. According to the results of morphometry, the outer diameter of the cortical capillaries in type 2 DM group was 4.90 % significantly larger, the inner diameter was 9.78 % smaller and the walls were 66.62 % thicker (compared with CC group) due to the accumulation of PAS-positive substances of blood serum and fibrosis, confirmed by 22.96 % greater area of type IV collagen expression in the microvessel walls. Conclusions. The pathomorphological changes of microvessels identified in deceased patients with type 2 diabetes mellitus are signs of diabetic cerebral microangiopathy.

scholarly journals Efektivitas Kurma (Phoenix dactylifera) dalam menurunkan kadar HbA1c pada pasien diabetes mellitus tipe 2: Laporan Kasus Berbasis Bukti

2020 ◽  
Vol 3 (1) ◽  
pp. 31-45
Author(s):  
Muhammad Sobri Maulana ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Hba1c Level ◽  
Phoenix Dactylifera ◽  
Herbal Remedies ◽  
Cochrane Library ◽  
Time Treatment ◽  
Type 2 Dm

Type 2 Diabetes Mellitus or Type 2 DM is a metabolic disease that can cause severe complications so that adequate management which one of the targets is lowering HbA1c level is needed. Up to this time, treatment for Type 2 DM including antihiperglycemic and injection. Herbal remedies as well as dates (Phoenix datcylifera) has been limited even though it has well-known antihyperglycemic effect. To investigate the effectivity of Dates (Phoenix dactylifera) in lowering HbA1c level among Type 2 Diabetes Mellitus patients. Literature searching was conducted on four online databases which are PubMed, Scopus, EBSCO, and Cochrane Library based on inclusion and exclusion criterias. Based on the results of critical studies, seven studies have shown that there is effectiveness in the administration of Dates (Phoenix dactylifera) in patients with type 2 diabetes mellitus on Lowering HbA1c levels and restricition of date diet needed for type 2 diabetes mellitus patients in 3 dates per day that are statistically significant for lowering HbA1c level with value of NNT is 1. Administration of Dates (Phoenix dactylifera) can be used as an adjuvant therapy on Type 2 Diabetes mellitus patients

scholarly journals Correlation Between Lipid Profile with Type 2 Diabetes Mellitus Progression

2020 ◽  
Vol 8 (2) ◽  
pp. 66-72
Author(s):  
Angiesta Pinakesty ◽  
Restu Noor Azizah
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Lipid Profile ◽  
Cholesterol Levels ◽  
Type 2 Dm ◽  
Hba1c Levels

Introduction: Diabetes mellitus (DM) is a non-communicable disease that has increased from year to year. Type 2 diabetes mellitus is not caused by lack of insulin secretion, but is caused by the failure of the body's cells to respond to the hormone insulin (insulin resistance). Insulin resistance was found to be a major contributor to atherogenic dyslipidemia. Dyslipidemia in DM risks 2 to 4 times higher than non-DM. Although dyslipidemia has a great risk for people with type 2 diabetes mellitus, this conventional risk factor only explains a portion (25%) of excess cardiovascular risk in type 2 DM. Discussion: In uncontrolled type 2 DM patients, LDL oxidation occurs faster which results from an increase in chronic blood glucose levels. Glycemic control as a determinant of DM progressivity is determined through HbA1c examination. HbA1c levels are associated with blood triglyceride levels. Meanwhile, triglyceride levels are associated with total cholesterol and HDL cholesterol levels. HbA1c levels are also associated with LDL cholesterol levels. Conclusion: There is a relationship between lipid profile and the progression of type 2 diabetes mellitus.   Keywords: type 2 diabetes mellitus, dyslipidemia, HbA1c, glycemic control, lipid profile

scholarly journals COMPARATIVE STUDY OF SITAGLIPTINAND PIOGLITAZONE AS ADDONTHERAPY OVER PLASMA GLUCOSE LEVEL IN TYPE 2 DIABETES MELLITUS PATIENTS : AN OBSERVATIONAL COHORT STUDY

2020 ◽  
pp. 10-11
Author(s):  
Ravindra Kumar Das ◽  
Rahul Kumar Sinha ◽  
Debarshi Jana
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Plasma Glucose ◽  
Plasma Glucose Level ◽  
Observational Cohort Study ◽  
Type 2 Dm ◽  
Observational Cohort ◽  
Pioglitazone Group

Background: Type 2 diabetes mellitus (DM) is a progressive chronic disorder and sustained control of plasma glucose is essential to prevent complications. Pioglitazoneofthiazolidinedionesand sitagliptin of Dipeptidyl peptidase-4 inhibitors (DPP4I) have recently been used as add-on therapy to control type 2 DM. The aim of this study was to compare the plasma glucose and glycocelatedHb% level of both the group who had poor glycemic control with Metformin and sulfonylurea. MATERIAL AND METHODS: In this observational cohort study, 100 patients with uncontrolled type 2 DM on 2000 mg/day of Metformin and 4 mg/day of Glimepiride were enrolled. The patients were randomly allocated into two groups with fifty each. One group received two divided doses of pioglitazone (30 mg/day) and the other received two divided doses of sitagliptin (100 mg/day) as the third medication. Plasma glucose fasting and 2 hours after drug and meal along with HbA1c were assessed before and after three months of treatment. Results: Fasting plasma glucose level in the sitagliptin group was higher than the pioglitazone group; however, this difference was not statistically significant (130.30 ± 30.29 versus 124.58 ± 46.84, p=0.212). Significantdifferences were not observed in HbA1c (7.20±0.96 versus 7.43±0.99, p=0.563) and plasma glucose 2 hours after meal (194.56±66.22 versus 198.58±51.5, p=0.946) after treatment withsitagliptin and pioglitazone among the two groups. Mean weight in the sitagliptin group was lower compared to the pioglitazone group after treatment, however, this difference was not statistically significant (p=0.824). Conclusion: Both the molecule as third agent had similar efficacy in glycemic control. Sitagliptin is better choice to add-on therapy in obese overweight patients.

scholarly journals Type 2 Diabetes Mellitus And Vitamin C

2019 ◽  
Vol 09 (03) ◽  
pp. 232-236
Author(s):  
Shabzain Ishrat ◽  
Talea Hoor ◽  
Mohammed Sajid Abbas Jaffri
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Vitamin C ◽  
Good Control ◽  
Type 2 Dm ◽  
Vitamin C Supplementation ◽  
Antioxidant Supplements

Type 2 diabetes mellitus (DM) is a chronic disease which deteriorates the quality of life with time. Type 2 DM accounts for more than 90% cases of diabetes mellitus as compared to other types of this disease. There is significant oxidative stress in type 2 DM which plays an important role in the pathogenesis of disease. In order to combat this oxidative stress antioxidant supplements have to be added as add on therapy along with treatment of type 2 DM. Vitamin C is the safest antioxidant which plays significant role in diminishing the oxidative stress. The vitamin C supplementation have good control of FBS and HbA1c and therefore helps in achieving better glycemic control along with prevention of lipid abnormalities.

scholarly journals Mean Platelet Volume and Platelet Distribution Width as Markers of Vascular Thrombosis in Type 2 Diabetes Mellitus

2016 ◽  
Vol 50 (3) ◽  
pp. 127-131 ◽  
Author(s):  
M Bhanukumar ◽  
Prasanna KH Ramaswamy ◽  
Naveen K Peddi ◽  
Vineetha B Menon
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Mean Platelet Volume ◽  
Platelet Distribution Width ◽  
Platelet Volume ◽  
Distribution Width ◽  
Vascular Thrombosis ◽  
Type 2 Dm

ABSTRACT Aims The objective of the study was to determine the mean platelet volume (MPV) and platelet distribution width (PDW) in subjects with type 2 diabetes mellitus (type 2 DM) compared to subjects without type 2 DM and their correlation with fasting blood glucose, glycosylated hemoglobin (HbA1c), and duration of type 2 DM respectively. Materials and methods A prospective analytical case—control study was conducted involving 50 subjects with type 2 DM and 50 subjects without type 2 DM. The mean and standard deviation were estimated for both the groups separately and independent Student's “t”-test was used for evaluating the significant difference. The statistical evaluation was carried out at 95% confidence level. Results Mean MPV and PDW in case group was significantly higher compared to control group (p < 0.005). Fasting blood glucose, HbA1c, and duration of type 2 DM did not significantly alter MPV or PDW. Conclusion The study concludes that MPV and PDW are significantly increased in patients with type 2 DM compared to patients without type 2 DM. Platelet volume indices are an important, simple, and cost-effective tool that should be used and explored extensively, especially in countries, such as India, for predicting the possibility of impending acute vascular events in patients with type 2 DM. Clinical significance This analytical method helps us to use MPV and PDW as early markers of vascular thrombosis. How to cite this article Bhanukumar M, Ramaswamy PKH, Peddi NK, Menon VB. Mean Platelet Volume and Platelet Distribution Width as Markers of Vascular Thrombosis in Type 2 Diabetes Mellitus. J Postgrad Med Edu Res 2016;50(3):127-131.

scholarly journals Relationship of Type 2 Diabetes Mellitus Duration with The Occurrence of Erectile Dysfunction at Puskesmas Denpasar Barat I

2021 ◽  
Vol 2 (1) ◽  
pp. 23-28
Author(s):  
Alexander Petra Sihite ◽  
I Gusti Ngurah Pramesemara ◽  
I Wayan Surudarma
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Erectile Dysfunction ◽  
Cross Sectional ◽  
Type 2 Dm ◽  
Number Of Patients ◽  
Relationship Of ◽  
The Relationship

Background: Type 2 diabetes mellitus is a metabolic disease that characterized by high blood sugar levels. This condition is often not noticed immediately and usually patient starting to realize it when complications have been occurred. A long-term complication of type 2 DM that occurred in men is erectile dysfunction (ED). ED is a condition when a person is unable to achieve or maintain an erection for sexual intercourse. One factor that influence the occurrence of ED and its severity in type 2 DM patients is the duration of the disease. Objective: The aim of this study was to determine the relationship of type 2 DM duration and the occurrence of ED. Methods: This study is an observational analytic cross-sectional study conducted at the Puskesmas (Public Health Center) Denpasar Barat I. The research data was obtained through medical record data and fill the International Index of Erectile Function (IIEF-5) questionnaire on 36 type 2 DM patients aged around 40-60 years. The statistical analysis used was Fisher's exact test. Results: The results showed that of the 36 samples, 19 (52.8%) samples had type 2 DM <24 months and 17 (47.2%) samples had type 2 DM >24 months. It was found that 5 (13.9%) samples did not experience ED while the rest experienced ED with different severity. There was a significant relationship between the type 2 DM duration and the occurrence of erectile dysfunction at Puskesmas Denpasar Barat I (p = 0.022). Conclusion: Study has found that type 2 DM patients with the longer duration (>24 months)  have a higher occurrence of ED and tended to be more severe compared to those with shorter duration (<24 months). Further studies should be performed with higher number of patients and more controlled risk factor so it will be more accurate in determining the relationship between the duration of type 2 DM and ED.

scholarly journals Psychological Well Being In Type 2 Diabetes Mellitus Patients In Mulyorejo Public Health Center Surabaya

Jurnal NERS ◽  
2016 ◽  
Vol 11 (2) ◽  
pp. 147
Author(s):  
Rr Dian Tristiana
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetes Mellitus Type 2 ◽  
Transition Process ◽  
Well Being ◽  
Self Control ◽  
Psychological Well Being ◽  
Type 2 Dm

Introduction: Living with chronic diseases such as Diabetes mellitus type 2 will make patients experience change or imbalance include biological, psychological, social and spiritual. One of psychology aspects in patients with Diabetes mellitus type 2 is psychological well being (PWB). Emotional response of type 2 DM patients since the early diagnosis to begin undergoing the treatment will be different for each person. Type 2 DM patients need a good transition process to achieve well being state. The transition from a healthy to a diseased condition is needed for the successful self care management of type 2 DM patients. The purpose of this research was to explore the description of PWB in patients of type 2 Diabetes mellitus in six aspects of PWB and PWB facilitate and inhibitor factors in type 2 DM patients. Methods: This research used qualitative design research with case studies approach. The subject of research was seven participants who met the inclusion criteria. Data collection was done by structured interview and observation. Data analysis was done by thematic analysis. Result and Analysis: This study generated 14 themes. The result showed that the process of type 2 DM patients subjected to the process of transition from a healthy condition into ill condition. The transition process started with cyclic lose response which influence type 2 DM patient to self control and make a right decision-making to self care. Self-control would make type 2 DM patients able to adapt and engage with new experiences that become a new habit for type 2 DM patients and will facilitate type 2 DM patients in adapting to the internal and external environment and make type 2 DM patients have a positive hope in their life. Discuss and conclusion: finding in this study would hopefully be beneficial for professional health staff to make assessment about PWB in type 2 DM patients, nurse hopefully can assist patients in transition with the condition of type 2 DM. Need further research about the relation between self acceptance and self control, activation process till engagement to new habit in type 2 DM patients, perceived support to PWB in type 2 DM patient DM.Keywords: psychological well being, type 2 Diabetes mellitus, qualitative

scholarly journals Relationship between homocysteine and non-dipper pattern in patients with type 2 diabetes mellitus

2012 ◽  
Vol 56 (5) ◽  
pp. 285-290 ◽  
Author(s):  
Serdal Korkmaz ◽  
Abdulkerim Yilmaz ◽  
Gürsel Yildiz ◽  
Fatih Kiliçli ◽  
Serhat Içağasioğlu
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Control Group ◽  
Diabetic Patients ◽  
Nocturnal Blood Pressure ◽  
Type 2 Dm ◽  
Significant Difference

OBJECTIVE: The rate of reduction of nocturnal blood pressure (NBP) is lesser than normal in patients with type 2 diabetes mellitus (type 2 DM). Hyperhomocysteinemia (HHC) disrupts vascular structure and function, no matter the underlying causes. The risk of development of vascular disease is greater in diabetic patients with hyperhomocysteinemia than in patients with normal homocystein levels. The aim of the study was to investigate whether there are differences of homocystein levels in dipper and non-dippers patients with type 2 DM. SUBJECTS AND METHODS: We compared 50 patients (33 females, 17 males) with type 2 DM and 35 healthy individuals (18 females, 17 males ) in a control group. Ambulatory blood pressure monitoring (ABPM) was performed and homocysteine levels were measured in all patients. RESULTS: We found that the percentage of non-dipper pattern was 72% in patients with type 2 DM and 57% in control group. In diabetic and control individuals, homocystein levels were higher in non-dipper (respectively 13.4 ± 8.1 µmol/L and 11.8 ± 5 µmol/L) than in dipper subjects (respectively, 11.8 ± 5.8 µmol/L and 10.1 ± 4.2 µmol/L), but there was no significant difference between the two groups (respectively, p = 0.545, p = 0.294). CONCLUSION: In both groups, homocystein levels were higher in non-dipper than in dipper participants, but there was no significant difference between the groups. High homocystein levels and the non-dipper pattern increases cardiovascular risk. Therefore, the relationship between nocturnal blood pressure changes and homocystein levels should be investigated in a larger study.

Euglycemic Diabetic Ketoacidosis Associated With Sodium–Glucose Cotransporter Type 2 Inhibitors in Patients With Type 2 Diabetes Mellitus Receiving Oral Therapy

2017 ◽  
Vol 32 (2) ◽  
pp. 240-243 ◽  
Author(s):  
Ryan B. Dull ◽  
Mikayla L. Spangler ◽  
Emily L. Knezevich ◽  
Britney M. Lau
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Case Reports ◽  
Serious Adverse Events ◽  
Type 2 Dm ◽  
Sodium Glucose Cotransporter ◽  
Increased Risk

Introduction and Objective: Postmarketing reports and warnings of serious adverse events such as diabetic ketoacidosis (DKA) have raised concern regarding the safety of sodium–glucose cotransporter 2 inhibitors (SGLT2i). This report describes 2 cases of symptomatic SGLT2i-associated euglycemic DKA (euDKA) leading to hospitalization in patients with type 2 diabetes mellitus (DM) previously well controlled on oral medications. Case Reports: Subject 1 is a 55-year-old female admitted with euDKA precipitated by infection and managed with intravenous insulin. This case was notable for a delayed diagnosis of euDKA and lack of clinical improvement despite withholding dapagliflozin. Subject 2 is a 62-year-old male admitted with euDKA precipitated by infection. His clinical condition improved rapidly and euDKA responded to withdrawal of empagliflozin alone. Discussion: Applying the Naranjo adverse medication reaction probability scale to each case (subject 1 score = 3 points; subject 2 score = 4 points) suggests these are possible adverse reactions to SGLT2i. Data from randomized controlled trials suggest DKA events in adults with type 2 DM receiving SGLT2i are rare and similar to placebo. However, data from a large cohort suggest these events occur more frequently and are associated with a 2-fold increased risk of DKA. Conclusion: This class of medications may be associated with a higher real-world risk of DKA in adults with type 2 DM than previously reported. Patients prescribed these medications should receive vigilant assessment for features of traditional DKA as well as euDKA.

The Effect of Metformin on Oncological Outcomes in Patients With Cervical Cancer With Type 2 Diabetes Mellitus

2016 ◽  
Vol 27 (1) ◽  
pp. 131-137 ◽  
Author(s):  
Jitti Hanprasertpong ◽  
Ingporn Jiamset ◽  
Alan Geater ◽  
Thanarpan Peerawong ◽  
Wikanda Hemman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cervical Cancer ◽  
Type 2 Diabetes Mellitus ◽  
Prognostic Factors ◽  
Stage Iii ◽  
Oncological Outcomes ◽  
Type 2 Dm

ObjectiveThe aim of this study was to evaluate any association between metformin use and oncological outcomes of cervical cancer in patients with type 2 diabetes mellitus (DM).MethodsWe retrospectively identified 248 patients with cervical cancer with type 2 DM who received primary treatment between 2004 and 2015. The clinicopathological characteristics and oncological outcomes were collected and analyzed. The patients were then separated into metformin use (n = 118) or non–metformin use (n = 130) groups.ResultsWith a median follow-up of 2.85 years, patients who were given metformin had lower recurrence rate than patients who did not receive metformin (P = 0.011). The 5-year disease-free survival (DFS) and overall survival (OS) were 81.55% and 93.27% in the metformin use group, and 65.06% and 86.82% for the non–metformin use group, respectively. In multivariate analysis, non–metformin use (hazard ratio [HR], 1.89; P = 0.037), baseline hypertension (HR, 2.52; P = 0.005), and stage (HR for stage II vs I, 3.48; HR for stage III vs I, 6.45; P = 0.01) were independent adverse prognostic factors for DFS, whereas the statistically significant independent prognostic factors for OS were age (HR for age >65 vs ≤50, 3.86; P = 0.044) and stage (HR for stage III-IVA vs I-II, 3.45; P = 0.007).ConclusionsOur findings demonstrate that metformin use is associated with improved DFS, but not in OS in patients with cervical cancer with type 2 DM. Further large-scale and long-term follow-up studies are warranted to confirm the antitumor effects of metformin.

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