scholarly journals Telemedicine assists in the management of proatherogenic dyslipidemia and postprandial glucose variability in patients with type 2 diabetes mellitus: a cross-sectional study

2021 ◽  
Author(s):  
Po-Chung Cheng ◽  
Chia-Hung Kao

Objective. Coronary heart disease (CHD) is a prevalent complication of type 2 diabetes mellitus (T2DM). The proatherogenic low-density lipoprotein (LDL) cholesterol is an established risk factor of cardiovascular disease, and evidence also suggests that postprandial plasma glucose (PPG) levels closely delineate CHD mortality in diabetes. The investigators hypothesized that the addition of telehealth consultation to standard antidiabetic therapy may help to reduce postprandial glucose variability and plasma LDL cholesterol levels in patients with T2DM. Methods. This cross-sectional study enrolled patients with newly diagnosed T2DM who received standard antidiabetic therapy with or without additional telehealth consultation. Participants received blood tests for plasma lipid profile and glucose levels at diagnosis of diabetes and after one month of therapeutic intervention. Laboratory results were compared between treatment groups to determine the efficacy of complementary telehealth consultation. Results. Three hundred and seventy-five participants were enrolled. The standard treatment group had considerably greater levels of plasma LDL cholesterol than recipients of telehealth consultation (110 mg/dL vs. 93.1 mg/dL, P<0.001). Moreover, patients receiving standard treatment had greater levels of fasting plasma glucose (104 mg/dL vs. 98.5 mg/dL, P = 0.027), 2-hour PPG (169 mg/dL vs. 111 mg/dL, P<0.001), and postprandial glucose variability (65.4 mg/dL vs. 12.8 mg/dL, P<0.001) than participants under telehealth consultation. Conclusions. Telemedicine in addition to standard antidiabetic therapy helped to reduce plasma LDL cholesterol levels and postprandial glucose variability in patients with newly diagnosed T2DM. Therefore, telehealth consultation is a suitable complement to pharmacologic therapy for diabetic patients to assist in the management of proatherogenic dyslipidemia and postprandial glucose variability.

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Josep Franch-Nadal ◽  
Manel Mata-Cases ◽  
Irene Vinagre ◽  
Flor Patitucci ◽  
Eduard Hermosilla ◽  
...  

The objective of this cross-sectional study was to assess differences in the control and treatment of modifiable cardiovascular risk factors (CVRF: HbA1c, blood pressure [BP], LDL-cholesterol, body mass index, and smoking habit) according to gender and the presence of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) in Catalonia, Spain. The study included available data from electronic medical records for a total of 286,791 patients. After controlling for sex, age, diabetes duration, and treatment received, both men and women with prior CVD had worse cardiometabolic control than patients without previous CVD; women with prior CVD had worse overall control of CVRFs than men except for smoking; and women without prior CVD were only better than men at controlling smoking and BP, with no significant differences in glycemic control. Finally, although the proportion of women treated with lipid-lowering medications was similar to (with prior CVD) or even higher (without CVD) than men, LDL-cholesterol levels were remarkably uncontrolled in both women with and women without CVD. The results stress the need to implement measures to better prevent and treat CVRF in the subgroup of diabetic women, specifically with more intensive statin treatment in those with CVD.


BJGP Open ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. bjgpopen18X101636 ◽  
Author(s):  
Bjørn Gjelsvik ◽  
Anh Thi Tran ◽  
Tore J Berg ◽  
Åsne Bakke ◽  
Ibrahimu Mdala ◽  
...  

BackgroundCoronary heart disease (CHD) and stroke are the major causes of death among people with diabetes.AimTo describe the prevalence and onset of CHD and stroke among patients with type 2 diabetes mellitus (T2DM) in primary care in Norway, and explore the quality of secondary prevention.Design & settingA cross-sectional study of data was undertaken from electronic medical records (EMRs) of 10 255 patients with T2DM in general practice. The study took place in five counties of Norway (Oslo, Akershus, Rogaland, Hordaland, and Nordland). Quality of care was assessed based on national guideline recommendations.MethodSummary statistics with adjustments and binary logistic regression models were used.ResultsIn total, 2260 patients (22.1%) had CHD and 759 (7.4%) had stroke. South Asians had significantly more CHD than ethnic Norwegians (29.5%, 95% confidence interval [CI] = 26.1 to 33.0 versus 21.5%, CI = 20.6 to 22.3) and other ethnic groups, and experienced onset of CHD or stroke at a mean of 7 years before Norwegians. In 47.9% of the patients, CHD was diagnosed before T2DM. Treatment target for low-density lipoprotein (LDL) cholesterol was reached for 30.0% and for systolic blood pressure (SBP) for 65.1% of the patients with CHD. Further, 20.9% of patients with CHD were present smokers, and only 5.0% of patients reached all four treatment targets (no smoking, HbA1c ≤7.0%, SBP <135 mmHg, LDL-cholesterol <1.8 mmol/l).ConclusionThe diagnosis of CHD preceded the diagnosis of T2DM in half of the patients. The prevalence of CHD was highest and onset earlier among ethnic South Asians. More intensive treatment of lipids, blood pressure, and smoking are needed in patients with T2DM and CHD.


2019 ◽  
Vol 6 (5) ◽  
pp. 1452
Author(s):  
Monica A. ◽  
Dhivya P.

Background: India is fast becoming the diabetes capital of the World. A direct atherogenic effect of triglyceride rich particles has been noted. This study assesses the lipid profile abnormalities in newly diagnosed type 2 diabetes mellitus. Since dyslipidemia is a risk factor for cardiovascular disease, such assessment will enable better recognition, prevention and management of cardiovascular mortality and morbidity.Methods: The study was conducted over a period of one year at a tertiary care hospital in South India. A cross-sectional study of 100 newly diagnosed type 2 diabetics in a rural South-Indian population was done. Results: In our study, 55 (55%) participants had high triglycerides and 45 (45%) had normal triglycerides.  Among the 55 participants with abnormal triglycerides, 34% had borderline high levels (150-199mg/dl), 18% had high levels (200-499 mg/dl) and 3% participants had very high triglycerides (≥500 mg/dl). 26% male and 29% female participants had above normal triglyceride levels. In our study, 25% had borderline high cholesterol levels and 5% had high total Cholesterol. 39% of participants had near optimal levels of LDL, 19% had borderline high levels of LDL, 7% had high levels of LDL and 4% had very high levels of LDL. Significantly higher levels of triglycerides and LDL were noted.Conclusions: Deranged lipid profiles are quite prevalent in type 2 diabetics with females having higher triglyceride levels. Recognition of such elevated triglyceride levels in even newly diagnosed type 2 diabetics will help in better prevention of associated cardiovascular disease.


2021 ◽  
Author(s):  
Yanli Li ◽  
Min Yi ◽  
Xiaoyi Deng ◽  
Wangen Li ◽  
Yimei Chen ◽  
...  

Abstract Background Diabetes mellitus (DM) and thyroid dysfunction (TD) are two closely associated disorders. The coexistence of TD could adversely influence metabolic control and even increase the long-term mortality in patients with DM. The objective of the present study was to investigate the thyroid status and the relationship between thyroid hormones, diabetic complications and metabolic parameters in patients with newly diagnosed type 2 DM (T2DM). Methods This is an observational cross-sectional study, conducting on 340 patients with newly diagnosed T2DM who were admitted to ward of endocrinology department and 120 matched nondiabetic subjects. Clinical characteristics were collected and laboratory measurements were conducted. Results Levels of free T3 (FT3), free T4 (FT4) and TSH were significantly lower in patients with T2DM as compared to nondiabetic subjects. The prevalence of TD was 21.2% in patients with diabetes, higher than that of controls (4.2%). The low T3 syndrome was the most frequent TD, shown in 14.7% of patients. The presence of diabetic complications (diabetic nephropathy (DN), diabetic ketosis), metabolic and demographic factors, including age, glycemic control and insulin resistance were factors associated with levels of thyroid hormones. FT3 level was inversely correlated with the level of urinary total protein (mg/24h) and the presence of DN. Multivariate analysis indicated low FT3 level as a strong independent risk factor (OR = 0.364, P < 0.001) for DN. Conclusions TD is not rarely seen in patients with newly diagnosed T2DM. Diabetic complications and diabetes-related metabolic and demographic factors are related to TD. Decreased FT3 is strongly correlated with the presence of DN.


Background: Vitamin B12 deficiency may be related to peripheral neuropathy in people with type 2 diabetes mellitus (T2DM). Level of B12 in T2DM observed by many investigators showed variable results. Studies on vitamin B12 in T2DM are very limited in Bangladesh. Objectives: To observe serum vitamin B12 level in newly diagnosed T2DM patients. Methods: Observational cross-sectional study encompassing 50 newly diagnosed T2DM and 50 controls as per American Diabetes Association (ADA) criteria. Vitamin B12 and Hemoglobin A1c (HbA1c) were measured for all. Results: Both mean (492.46±28.82 vs. 346.48±19.65 pg/mL, mean±SEM; p=<0.001) and median (435.50 vs. 334.50 pg/mL) values of serum vitamin B12 were found to be higher in T2DM than those of controls. None of the diabetic subjects were found to be B12 deficient whereas 6 were borderline deficient; these frequencies were 7 and 11 respectively among the controls. Vitamin B12 level was statistically similar in patients with or without clinically evident peripheral neuropathy (mean±SEM; 523.48±39.39 vs. 441.84±38.76 pg/mL, p=0.172). B12 level showed positive correlation with fasting plasma glucose (FPG, r=0.285, p=0.061) and HbA1c (r=0.287, p= 0.043) in diabetes group but there was no correlation with body mass index (BMI). Conclusion: Vitamin B12 is found sufficient in newly diagnosed Bangladeshi T2DM patients.


2021 ◽  
Vol 1 (3) ◽  
pp. 303-313
Author(s):  
Muhammad Ihsan Fadillah ◽  
Ilmiawati Ilmiawati ◽  
Eka Fithra Elfi

Background. Cigarette smoke may cause harm not only to active smokers but also to those in their vicinity (passive smokers). Cigarettes contain nicotine, which triggers the release of catecholamines, affecting lipid metabolism. Exposure to cigarette smoke may increase serum LDL cholesterol levels in active and passive smokers. Objective. This study aimed to analyze the correlation between serum cotinine (a metabolite of nicotine) and LDL cholesterol levels in young adults. Methods. A cross-sectional study was performed, the analysis included 122 Andalas University students, aged 17.5 - 25.9 years. Demographic data, smoking degree, serum cotinine, and LDL cholesterol levels were collected. Bivariate analysis was carried out individually on each independent and confounding variables to the dependent variable, followed by multiple hierarchical regressions analysis. Results. Serum cotinine levels in this study was 10,5 ± 6.8 ng/ml (mean±SD), and serum LDL cholesterol levels were 65,5±18,5 mg/dl (mean±SD). There was no significant correlation between serum cotinine and LDL cholesterol levels in bivariate analysis. However, serum cotinine levels had a nonlinear correlation with serum LDL cholesterol levels in the regression model that included body mass index (BMI) as the confounding variable. The adjusted r2 value in this study is 0,066, the standardized β coefficient for the BMI is 0,197 (p = 0.028), for the serum cotinine levels is -0,830 (p = 0.007), and for the squared serum cotinine levels is 0,753 (p = 0.014).


Sign in / Sign up

Export Citation Format

Share Document