scholarly journals A breakthrough-like effect of metformin reduces peripheral resistance to triiodothyronine in euthyroid, non-insulin-resistant, type 2 diabetic patients

2021 ◽  
Author(s):  
Melinda Kertész ◽  
Szilárd Kun ◽  
Eszter Sélley ◽  
Zsuzsanna Nagy ◽  
Tamás Kőszegi ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
In Vitro Study ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Akt Phosphorylation ◽  
Type 2 Diabetic

Background: Type 2 diabetes is characterized, beyond the insulin resistance, by polyhormonal resistance. Thyroid hormonal resistance has not yet been described in this population of patients. Metformin is used to decrease insulin resistance, and at present it is assumed to influence the effect of triiodothyronine, as well. Methods: In this open label, pilot, hypothesis generating, follow-up study 21 patients were included, all of them euthyroid with drug naïve, newly diagnosed type 2 diabetes. Before and after four weeks of metformin therapy fructosamine, homeostasis model assessment for insulin resistance (HOMA-IR), thyroid hormones, T3/T4 ratio, and TSH, as well as blood pressure and heart rate using ambulatory blood pressure monitor were measured. We also conducted an in vitro study to investigate the possible mechanisms of T3 resistance, assessing T3 induced Akt phosphorylation among normal (5 mM) and high (25 mM) glucose levels with or without metformin treatment in a human embryonal kidney cell line. Results: Metformin decreased the level of T3 (p<0.001), the ratio of T3/T4 (p=0.038), fructosamine (p=0.008) and HOMA-IR (p=0.022). All these changes were accompanied by an unchanged TSH, T4, triglyceride, plasma glucose, bodyweight, blood pressure and heart rate. In our in vitro study, T3 induced Akt phosphorylation decreased in cells grown in 25 mM glucose medium compared to those in 5 mM. Metformin could not reverse this effect. Conclusion: Metformin seems to improve T3 sensitivity in the cardiovascular system in euthyroid, type 2 diabetic patients, the mechanism of which may be supracellular.

scholarly journals Serum Levels of Progranulin Are Closely Associated with Microvascular Complication in Type 2 Diabetes

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Lin Xu ◽  
Bo Zhou ◽  
Huixia Li ◽  
Jiali Liu ◽  
Junhui Du ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
Linear Regression Analysis ◽  
Serum Levels ◽  
Diabetic Microangiopathy ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Objective. Progranulin (PGRN) was recently introduced as a novel marker of chronic inflammatory response in obesity and type 2 diabetes capable of directly affecting the insulin signaling pathway. This study aimed to investigate the correlation between PGRN and type 2 diabetics with microvascular complications.Methods. PGRN serum levels and glucose metabolism related substance were measured in 84 type 2 diabetic patients with or without microangiopathies and 12 health persons. Further analyses of serum PGRN in different stages of diabetic microangiopathies were conducted.Results. Serum levels of PGRN were markedly higher in type 2 diabetic patients with microangiopathies. PGRN serum levels increased with the progress of diabetic microangiopathies with significantly highest values detectable in clinical diabetic nephropathy (CDN) and proliferative diabetic retinopathy (PDR) groups. Serum PGRN concentrations in all individuals positively and markedly correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), triglyceride (TG), urinary albumin excretion rate (UAER), blood urea nitrogen (BUN), creatinine (CRE), white blood cell (WBC), disease duration, IL-6, and TNF-α, while correlating negatively and significantly with eGFR. Multiple linear regression analysis showed that only UAER and CRE were independently associated with serum PGRN.Conclusion. PGRN might be considered as a marker for diabetic microangiopathy and its severity.

scholarly journals Follow-up and treatment pattern during Ramadan and evaluation of the outcome of Ramadan fasting on clinical, biochemical and metabolic parameters in patients with type 2 diabetes mellitus: a realworld, multi-center, prospective observational study

2020 ◽  
Vol 11 (1) ◽  
pp. 30-38
Author(s):  
Nazmul Kabir Qureshi ◽  
Nazma Akter ◽  
Zafar Ahmed
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Prospective Observational Study ◽  
Treatment Pattern ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Ramadan Fasting ◽  
Type 2 Diabetic

Background: There are variable effects of Ramadan fasting on clinical and biochemical variables of diabetic people. Anti-diabetic agents are often adjusted during this time to reflect changes in lifestyle. The study was conducted to understand the diversity of follow-up, treatment pattern, clinical, and biochemical outcome of Ramadan fasting among type 2 diabetic patients who observed Ramadan fast. Methods: This real-world, multi-center, prospective, observational study was conducted at the diabetes outpatient department of National Healthcare Network (NHN) Uttara Center of Bangladesh Diabetic Somity (BADAS), Dhaka, Bangladesh and outpatient department of MARKS Hormone and Diabetes clinic, MARKS Medical College &Hospital in Dhaka, Bangladesh upon randomly selected type 2 diabetic patients, recruited 1 to 12 weeks prior to the Ramadan and followed up till 12 weeks post-Ramadan period. Finally, a total of 271 participants completed satisfactory follow up. Data was collected before, during, and after Ramadan using a set of questionnaires in a face to face interview. Results: The majority (80.1%) of participants received pre-Ramadan education, counseling, adjustment of medication and other direction to help them cope with Ramadan fasting. A significant reduction of weight, body mass index (BMI)) and blood pressure were reported after Ramadan fast (p<0.001). None of the studied participants experienced severe hyper/hypoglycemia or acute complications requiring hospitalization or an emergency room visit. Metformin was the commonest prescribed anti-diabetic medication. Premixed insulin was the commonest insulin regimen during study period. Three most commonly adjusted oral anti-diabetic drugs were gliclazide, glimepiride, metformin and insulin doses were also adjusted. Mean of fasting and prandial capillary blood glucose decreased from pre-Ramadan period to post-Ramadan period (P<0.05). HbA1c decreased during post-Ramadan period compared to pre-Ramadan visit (P=0.13). A significant reduction in the triglyceride level was observed during post-Ramadan follow up (P< 0.05). Conclusion: The study revealed that a safe fasting can be observed with proper pre-Ramadan work-up. Ramadan fasting resulted into significant reduction of weight, BMI, blood pressure, lipid profile and improved glycemic status in patients with type 2 diabetes. Birdem Med J 2021; 11(1): 30-38

Evaluation of the Prevalence of Sleep Disorder among Patients with Type 2 Diabetes Mellitus Referring to Ghaem Hospital from 2016 to 2017

2020 ◽  
Vol 16 ◽  
Author(s):  
Zahra Mazloum Khorasani ◽  
Vahid Roshan Ravan ◽  
Sepideh Hejazi
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Objectives: Diabetes is the most common metabolic disease in primary health care. The prevalence and severity of diabetes can be influenced through lifestyle modification. This study was aimed to identify the prevalence of sleep disorders as a modifiable lifestyle factor among diabetic patients. Materials and Methods: This cross‐sectional study was conducted on 190 patients with type 2 diabetes mellitus who referred to the Internal Medicine Clinic of the Ghaem Hospital, Mashhad, Iran from 2016 to 2017. A demographic questionnaire and the Pittsburgh Sleep Quality Assessment questionnaire (sleep disorder was defined as scores higher than 5) was filled for each subject. Blood tests including haemoglobin A1 C (Hb A1C), fasting blood sugar (FBS) and 2 hour post prandial glucose as well as the assessment of blood pressure, body mass index (BMI) were performed for all patients. Data were analysed using the statistical package for social sciences (SPSS) version 16. Results: Age of the patients (male to female ratio was 71/119s) was 56.31 ± 7.37 years. BMI more than 25 kg/m2 was observed in 145 (76.3%) of patients . Mean Pittsburgh Sleep Quality Assessment score was 7.48 ± 4.11. Fifty‐one (26.8%) patients were good sleepers and 139 (73.2%) were poor sleepers. There was a significant relationship between sleep disorder and age (p=0.019) and female gender (p=0.017) but no other variables including level of education, occupation, HbA1 C, FBS, 2 hour post prandial glucose, systolic and diastolic blood pressure. Discussion: Sleep disorders were common among type 2 diabetic patients especially women. It is recommended that sleep disorders should be screened in diabetic patients. Treatment and prevention of sleep disorders through sleep hygiene education including recommendation to have normal nocturnal sleep should be focused by practitioners in type 2 diabetic patients especially women. Appropriate measures should be taken to manage sleep disorders by weight control in this population.

scholarly journals Effect of sodium intake on blood pressure and albuminuria in Type 2 diabetic patients: the role of insulin resistance

Diabetologia ◽  
2003 ◽  
Vol 47 (2) ◽  
pp. 300-303 ◽  
Author(s):  
M. Vedovato ◽  
G. Lepore ◽  
A. Coracina ◽  
A. R. Dodesini ◽  
E. Jori ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Sodium Intake ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

scholarly journals Transthyretin and Amyloid in the Islets of Langerhans in Type-2 Diabetes

2008 ◽  
Vol 2008 ◽  
pp. 1-7 ◽  
Author(s):  
Gunilla T. Westermark ◽  
Per Westermark
Keyword(s):  
Type 2 Diabetes ◽  
Islets Of Langerhans ◽  
Islet Cells ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Amyloid Fibril Protein ◽  
Type 2 Diabetic

Transthyretin (TTR) is a major amyloid fibril protein in certain systemic forms of amyloidosis. It is a plasma protein, mainly synthesized by the liver but expression occurs also at certain minor locations, including the endocrine cells in the islets of Langerhans. With the use of immunohistochemistry and in situ hybridization, we have studied the distribution of transthyretin-containing cells in islets of Langerhans in type-2 diabetic and nondiabetic individuals. TTR expression was particularly seen in alpha (glucagon) cells. Islets from type-2 diabetic patients had proportionally more transthyretin-reactive islet cells, including beta cells. A weak transthyretin immunoreaction in IAPP-derived amyloid occurred in some specimens. In seeding experiments in vitro, we found that TTR fibrils did not seed IAPP while IAPP fibrils seeded TTR. It is suggested that islet expression of transthyretin may be altered in type-2 diabetes.

scholarly journals Hypoadiponectinemia is associated with increased insulin resistance, dyslipidemia and presence of type 2 diabetes in non obese central Indian population

2018 ◽  
Vol 7 (1) ◽  
pp. 106
Author(s):  
Anil B. Choudhury ◽  
Shankar M. Pawar ◽  
Purnima Dey Sarkar ◽  
Keerti Gopi
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Waist Circumference ◽  
Adiponectin Level ◽  
Diabetic Group ◽  
Diabetic Patients ◽  
Inverse Association ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Background: Accumulating evidence suggests that adiponectin, a major adipocyte secretory protein, has insulin-sensitizing and anti-atherogenic properties and protects against later development of type 2 diabetes. We investigated the association of adiponectin with insulin resistance, blood lipids and type 2 diabetes in non obese central Indian population.Methods: Anthropometric and biochemical parameters were measured in 149 (81 male and 68 female) newly diagnosed non obese type 2 diabetic patients and 157 (85 male and 72 female) age and body mass index (BMI) matched controls.Results: Adiponectin level (p<0.0001) was significantly lower in the diabetic group than in non diabetic control. In an age, gender and BMI adjusted model, adiponectin level was significantly negatively correlated with waist circumference, waist to hip ratio, systolic blood pressure, fasting insulin, homeostasis model assessment-insulin resistance (HOMA-IR) (p= 0.0034), HbA1C, total cholesterol, LDL-cholesterol, and triglycerides (p<0.0001) and positively correlated with HDL-cholesterol (p =0.0014) in non obese type 2 diabetic group. However, there was no significant correlation between adiponectin and glucose in this study. In stepwise linear regression analysis, adjusted for potential confounder, significant inverse association was observed between serum adiponectin level and HOMA-IR (p = 0.0001). In multivariate logistic regression model, adjusted for age, gender, BMI, waist circumference, and waist-hip ratio, lower adiponectin was independently associated with the presence of type 2 diabetes (p<0.0001).Conclusions: Lower adiponectin levels in non obese type 2 diabetic patients were significantly related to the increased insulin resistance, dyslipidemia, and presence of type 2 diabetes, independently of overall and abdominal adiposity, thereby suggesting a direct link between adiponectin and carbohydrate and lipid metabolism in human.

scholarly journals Assessing cardiovascular status using biomarkers and anthropometry among patients with Type-2 Diabetes in a resource limited setting

2021 ◽  
Vol 1 (1) ◽  
pp. 36-48
Author(s):  
Bako Hauwa
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Diabetic Patients ◽  
Hip Circumference ◽  
Type 2 Diabetic Patients ◽  
Anthropometric Indices ◽  
Resource Limited ◽  
Hs Crp ◽  
Type 2 Diabetic

Background: Diabetes places extra-burden on those affected with the condition particularly in resource constraint settings. Inaccessibility to affordable diagnostic procedures poses a major challenge to the assessment of cardiovascular status in patients with type-2 diabetes in resource limited settings. The study was aimed at evaluating some easily accessible biochemical markers and anthropometric indices implicated in cardiovascular disease amongst T2DM patients. Methods: One hundred and sixty (160) type-2 diabetic patients grouped into type-2 diabetes only as group 1, type-2 diabetic patients diagnosed with hypertension as group 2, and eighty (80) age and sex-matched controls as group 3, were enrolled in a cross-sectional pattern. Biochemical parameters were assayed using standard laboratory methods. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 20.0 with statistical significance considered at p≤0.05. Results: The values obtained for diabetic groups were: Glycated Hemoglobin (HbA1c) 9.07±1.99, 10.15±4.98, Total Homocysteine (tHcy) 14.85±52.10, 28.35±100.35, high sensitivity C-reactive protein (hs-CRP) 6.72±6.78, 10.00±11.15, Waist Circumference, 92.58±1.55, 93.65±18.91, Hip Circumference, 96.87±9.01, 98.96±20.33, Systolic Blood Pressure, 113.50±12.94, 135.50±22.72, Diastolic Blood Pressure, 70.75±8.57, 75.38±12.62, Body Mass Index, 25.40±4.70, 26.93±6.50 (among patients) and HbA1c 5.81±0.86, tHcy 0.75±1.44, hs-CRP 5.30±6.19, Waist Circumference 83.15±10.69, Hip Circumference 93.50±22.05, Systolic Blood Pressure, 113.50±10.20, Diastolic Blood Pressure, 77.00±7.19, Body Mass Index, 24.84±4.93 (among controls). Conclusion: The assessment of some cardio metabolic markers and anthropometric indices may provide easy and accessible tools for prediction and assessment of cardiovascular disease in patients with T2DM especially in resource poor settings.

Metabolic differences in healthy first-degree female relatives of type 2 diabetic patients

2013 ◽  
Vol 154 (44) ◽  
pp. 1747-1753
Author(s):  
Györgyi Kovács ◽  
Barbara Buday ◽  
Attila Fék ◽  
Botond Literáti-Nagy ◽  
József Pauer ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Hepatic Insulin Resistance ◽  
High Density Lipoproteins ◽  
Oral Glucose ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Prediabetic State ◽  
Type 2 Diabetic

Introduction: Today the prevalence of type 2 diabetes reached an epidemic level. It is known that type 2 diabetes could only be prevented before the manifestation, during the “prediabetic” state, urging the development of diagnostic tests to recognize the group at risk in time. Aim: The authors explored metabolic differences between healthy, normal glucose tolerant, normal insulin resistant females having first degree relatives with and without type 2 diabetes. Method: Healthy, normal insulin sensitive females without (n = 26) and with (n = 18) type 2 diabetic relatives were investigated. Results: Healthy females with first degree diabetic relatives had lower low density lipoproteins and higher high density lipoproteins as well as higher glucose and insulin levels at the 120 min of oral glucose test as compared to those without first degree diabetic relatives. Conclusions: These results suggest that the appearance of insulin resistance is preceded by hepatic insulin resistance and impaired lipid metabolism in the symptom-free prediabetic period of genetically suceptible females. Orv. Hetil., 154 (44), 1747–1753.

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