scholarly journals Therapy of acromegalic patients exacerbated by concomitant type 2 diabetes requires higher pegvisomant doses to normalise IGF1 levels

2014 ◽  
Vol 171 (1) ◽  
pp. 59-68 ◽  
Author(s):  
Michael Droste ◽  
Julia Domberg ◽  
Michael Buchfelder ◽  
Klaus Mann ◽  
Anja Schwanke ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glucose Metabolism ◽  
Insulin Therapy ◽  
Oral Treatment ◽  
Receptor Expression ◽  
Diabetic Patients ◽  
Glucose Metabolism Disorders ◽  
Patients With Diabetes ◽  
Worse Prognosis

ObjectiveAcromegaly is associated with an increased prevalence of glucose metabolism disorders. Clinically confirmed diabetes mellitus is observed in approximately one quarter of all patients with acromegaly and is known to have a worse prognosis in these patients.DesignOf 514 acromegalic patients treated with pegvisomant and recorded in the German Cohort of ACROSTUDY, 147 had concomitant diabetes mellitus. We analysed these patients in an observational study and compared patients with and without concomitant diabetes.ResultsUnder treatment with pegvisomant, patients with diabetes mellitus rarely achieved normalisation (64% in the diabetic cohort vs 75% in the non-diabetic cohort,P=0.04) for IGF1. Diabetic patients normalised for IGF1 required higher pegvisomant doses (18.9 vs 15.5 mg pegvisomant/day,P<0.01). Furthermore, those diabetic patients requiring insulin therapy showed a tendency towards requiring even higher pegvisomant doses to normalise IGF1 values than diabetic patients receiving only oral treatment (22.8 vs 17.2 mg pegvisomant/day,P=0.11).ConclusionsHence, notable interdependences between the acromegaly, the glucose metabolism of predisposed patients and their treatment with pegvisomant were observed. Our data support recent findings suggesting that intra-portal insulin levels determine the GH receptor expression in the liver underlined by the fact that patients with concomitant diabetes mellitus, in particular those receiving insulin therapy, require higher pegvisomant doses to normalise IGF1. It is therefore important to analyse various therapy modalities to find out whether they influence the associated diabetes mellitus and/or whether the presence of diabetes mellitus influences the treatment results of an acromegaly therapy.

Revascularization in patients with diabetes mellitus

2018 ◽  
pp. 337-350
Author(s):  
George Kassimis ◽  
Adrian Banning
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Developing Countries ◽  
Diabetic Patients ◽  
Industrialized Countries ◽  
Patients With Diabetes ◽  
The Usa ◽  
Artery Disease ◽  
Worse Prognosis

Coronary artery disease (CAD) is virtually ubiquitous in adults with diabetes mellitus (DM) and it confers a substantially worse prognosis than for non-diabetic patients. There are more than 150 million adults worldwide estimated to have DM, at least half of whom will die from cardiovascular causes. Maturity-onset or type 2 DM accounts for up to 95% of all cases of diabetes and its prevalence has increased by 40% in industrialized countries and almost tripled in developing countries. It has been estimated that the global prevalence of DM among adults will be 7.7% (439 million individuals) in 2025. In the USA, the costs related to DM have been estimated at $174 billion in 2007—$116 billion for direct and $58 billion for indirect medical costs such as disability and work loss—while they are expected to rise to $192 billion by 2020.

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)

DYSLIPIDEMIA – TYPE2 DIABETES AND NON DIABETES POPULATION IN AND AROUND ERODE DISTRICT, TAMILNADU

2021 ◽  
pp. 8-9
Author(s):  
Murugesan Thinakaran ◽  
Thangadurai Chitra
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Complications ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Lipid Status ◽  
Type2 Diabetes ◽  
Patients With Diabetes ◽  
Tertiary Hospitals ◽  
Low Hdl

Background and objects: Patients with diabetes mellitus are at high risk of cardiovascular events because of abnormal lipid status. Dyslipidemia is common in diabetes mellitus and is associated with cardiovascular complications. Early diagnosis and treatment is the main cornerstone in the prevention of its multiple complications. The aim of the study was to determine the prevalence of abnormal lipid prole levels. Materials and Method: The study population was made up of Eighty-ve (85) already diagnosed type 2 diabetic patients and Ninety-two (92) with an age range of 28 to 70 years, who come from routine health, follow up at various tertiary hospitals in Erode. The samples were analyzed using the chemical analyzer COBAS INTEGRA 400. Results and Conclusion: Dyslipidemia was found in 63.52% in type2 diabetes patients and 43.47% in non-diabetic patients. High TG, high LDL-C, high TC and low HDL-C exhibited an increasing trend in the proportion of patients with dyslipidemia. The following risk factors namely female sex, age above 50- years, BMI (overweight and obese), poor glycemic control, central obesity and physical inactivity were associated with diabetic dyslipidemia. This study presents some interesting and novel ndings which may be very important in the care and management of patients with type-2 diabetes.

Polymorphisms XbaI (rs693) and EcoRI (rs1042031) of the ApoB gene are associated with carotid plaques but not with carotid intima-media thickness in patients with diabetes mellitus type 2

VASA ◽  
2014 ◽  
Vol 43 (3) ◽  
pp. 171-180 ◽  
Author(s):  
Jovana Nikolajevic Starcevic ◽  
Marija Santl Letonja ◽  
Zala J. Praznikar ◽  
Jana Makuc ◽  
Andreja C. Vujkovac ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Diabetic Patients ◽  
Apob Gene ◽  
Apob Level ◽  
Patients With Diabetes ◽  
Unstable Plaques

Background: Apolipoprotein B is a key structural component of all the atherogenic lipoproteins (LDL, VLDL and IDL). Genetic variations of the ApoB gene may affect plasma ApoB and lipid levels, thus influencing atherogenesis. The present study was designed to investigate the association of polymorphisms XbaI (rs693) and EcoRI (rs1042031) of the ApoB gene with plasma ApoB level, lipid levels and the different ultrasound phenotypes of carotid atherosclerosis in patients with diabetes mellitus type 2. Patients and methods: 595 patients with diabetes (399 on statin therapy and 196 without) and 200 healthy controls were enrolled in the study. The carotid intima-media thickness (CIMT) and plaque characteristics (presence and structure) were assessed ultrasonographically. Biochemical analyses were performed using standard biochemical methods. Both XbaI (rs693) and EcoRI (rs1042031) genotypes were determined by real-time PCR. Results: Genotype distributions and allele frequencies of the XbaI and EcoRI polymorphisms were not statistically significantly different between diabetic patients and controls. No statistically significant difference in lipid parameters, ApoA1, ApoB, hs-CRP and fibrinogen as well as CIMT was observed in diabetic patients regarding XbaI and EcoRI polymorphisms, even after adjustment for statin treatment. The risk of having plaques on carotid arteries was higher in homozygous carriers of the mutant X + allele (OR = 1.74, p = 0.03) and lower in diabetics carrying mutant E- alleles (OR = 0.48, p = 0.02). Neither XbaI nor EcoRI polymorphism was associated with CIMT or presence of unstable plaques in diabetic patients. Plasma ApoB level was not independently associated with any of the ultrasonographic parameters of carotid atherosclerosis. Conclusions: Both XbaI and EcoRI polymorphisms were associated with presence of plaques on carotid arteries but not with CIMT or presence of unstable plaques. Plasma ApoB level was not independently associated with ultrasonographic phenotypes of carotid atherosclerosis in patients with diabetes mellitus.

scholarly journals Study on Thyroid Dysfunction in Patients with Type-2 Diabetes

2020 ◽  
Vol 7 (52) ◽  
pp. 3142-3147
Author(s):  
Senthil Chander ◽  
Kalpana Dev Venkatesan ◽  
Christina Mary Paul
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
General Medicine ◽  
Diabetic Patients ◽  
Endocrine Disorders ◽  
Cross Sectional ◽  
Patients With Diabetes

BACKGROUND Diabetes mellitus is one of the leading endocrine disorders worldwide. Thyroid dysfunction is a common endocrine disorder affecting the general population next to diabetes. The objective of this study was to determine the prevalence of thyroid dysfunction among patients with Type 2 diabetes. METHODS This analytical cross sectional study was conducted from June 2019 to Dec 2019. One hundred and fifty type–2 diabetes patients who attended the outpatient clinic of General Medicine Department, ACS Medical College and Hospital were included in the study. A detailed history and examination was done after getting informed consent. Blood samples were collected and sent to the laboratory for the evaluation of thyroid profile. RESULTS Thyroid dysfunction was found in 27 % of the patients with diabetes. Subclinical hypothyroidism was the most common thyroid dysfunction reported (14.7 %) followed by clinical hypothyroidism (10 %), subclinical hyperthyroidism (2 %) and clinical hyperthyroidism (0.6 %). CONCLUSIONS Thyroid dysfunction is common in patients with type-2 diabetes. A substantial proportion of the diabetic patients with thyroid dysfunction have subclinical hypothyroidism. Unidentified thyroid dysfunction could negatively impact diabetes and its complications. Therefore, early and routine screening of thyroid is recommended in all patients with diabetes to reduce the burden of the disease. KEYWORDS Type-2 Diabetes Mellitus, Thyroid Dysfunction, Hypothyroidism

scholarly journals Case Report: Severe Edema and Marked Weight Gain Induced by Marginal Thiamine Deficiency in a Patient With Alcohol Dependency and Type 2 Diabetes Mellitus

2021 ◽  
Vol 8 ◽  
Author(s):  
Hitomi Tanaka ◽  
Takatoshi Anno ◽  
Haruka Takenouchi ◽  
Hideyuki Iwamoto ◽  
Hideaki Kaneto ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Glucose Metabolism ◽  
Thiamine Deficiency ◽  
Diet Therapy ◽  
Peripheral Edema ◽  
Patients With Diabetes

Background: Patients with alcohol use disorder (AUD) may develop peripheral edema due to alcohol-related liver, renal, or heart disease. Thiamine deficiency is reported to occur in AUD and type 2 diabetes mellitus (T2DM). Thiamine deficiency may also cause peripheral edema. Thiamine is essential for optimal glucose metabolism through its role as an essential co-factor for key enzymes in intermediary metabolism. Since glucose metabolism worsens under diabetic conditions, it seems that a relative shortage of thiamine may occur more easily in patients with diabetes mellitus.Case Presentation: A 59-year-old Japanese man was admitted to the hospital with severe peripheral edema. His background history included alcohol liver disease (ALD), chronic renal failure (CRF), and T2DM. His body mass index (BMI) at admission was 37.7 kg/m2 and this represented a 30 kg increase in body weight over 2 months. Laboratory investigations showed anemia, liver and renal injury, hyperglycemia, and marginal hypothyroidism. The plasma thiamine diphosphate concentration was 20 ng/mL (reference range: 24–66 ng/mL). Diet therapy of 1,600 kcal/day and intravenous fursultiamine hydrochloride therapy (50 mg/once a day, seven days) was commenced in combination with intravenous diuretics. After one week, the plasma thiamine concentration was 853 ng/mL, and the patient's body weight had reduced by 18 kg.Conclusions: Patients with T2DM and AUD may develop severe peripheral edema in the context of marginal thiamine deficiency. Fursultiamine hydrochloride (50 mg/once a day, seven days) restored normal plasma thiamine concentrations and may have contributed to the rapid resolution of severe peripheral edema in this case. Empirical treatment with thiamine should be considered in patients with severe peripheral edema in the context of AUD and T2DM.

Haemostatic Abnormalities Persist Despite Glycaemic Improvement by Insulin Therapy in Lean Type 2 Diabetic Patients

1994 ◽  
Vol 71 (05) ◽  
pp. 692-697 ◽  
Author(s):  
Paul Knöbl ◽  
Guntram Schernthaner ◽  
Christoph Schnack ◽  
Peter Pietschmann ◽  
Sylvia Proidl ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Therapy ◽  
Factor Vii ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Control Subjects ◽  
Secondary Failure ◽  
Type 2 Diabetic ◽  
D Dimer

SummaryDiabetes mellitus is associated with disturbances of the haemostatic system, which might contribute to the development of diabetic vascular disease. We investigated the effect of metabolic improvement by insulin therapy on the haemostatic system in 61 patients with type 2 diabetes mellitus and secondaxy sulfunyluiea failure compared with 45 healthy control subjects matched for age, sex and BMI. Median age was 65, median diabetes duration 10 years. Median HbA1c (10%) and fructosamine (4.0 mM) levels were elevated before induction of therapy and decreased significantly within 6 months of insulin treatment to 7.5% and 3.0 mM, respectively (p <0.0001). Compared with control subjects, median plasma levels of fibrinogen (317 vs 286 mg/dl), coagulation factor VII activity (1.1 vs 0.89 U/1), von Willebrand factor (1.6 vs 1.3 U/1), D-dimer (105 vs 86 jug/1), protein C:Ag (1.24 vs 0.95 U/1), total protein S:Ag (1.15 vs 0.91 U/1), and antithrombin III activity (1.17 vs 1.08 U/1) were significantly elevated. Levels of free protein S were not different from control values. No significant decline of coagulation parameters could be recorded during insulin therapy. Patients with diabetic vasculopathy had higher levels of D-dimer than those without (133 vs 76 μg/1 before, 109 vs 88 μg/1 during therapy), whereas the other haemostatic parameters were not different. Our data indicate a significant activation of the coagulation system in diabetic patients with secondary failure to sulfonylurea drugs, with signs of a prethrombotic state and endothelial cell disturbance. Induction of insulin therapy results in a significant improvement of glycaemic and lipid metabolism, but the persisting enhanced activity state of the haemostatic system might contribute to the increased cardiovascular mortality of type 2 diabetic patients.

An Evaluation of Hemoglobin Concentration in Patients with Diabetes Mellitus Type 2

2019 ◽  
Vol 9 (02) ◽  
Author(s):  
Karem Kdaer Karem ◽  
Saba Ibrahim Salih ◽  
Wafaa Kadhim Jassim
Keyword(s):  
Diabetes Mellitus ◽  
Diabetes Mellitus Type 2 ◽  
Hemoglobin Concentration ◽  
The Body ◽  
Diabetes Mellitus Type ◽  
Diabetic Patients ◽  
Other Information ◽  
Patients With Diabetes ◽  
Age Range

The second type of diabetes Mellitus is the most common type of diabetes, its represent about 90-95% of diabetes cases. In this disease, the response of the body to insulin does not occur properly in a condition known as insulin resistance. The diabetes may accompany with anemia because the hormone erythropoietin (EPO) which is produced by the kidneys is regulates red blood cell production and the Kidney has been damaged at several levels as a complication of diabetes, the complication range from diabetic nephropathy to chronic kidney disease. This study was conducted at the AL-Kafeel Hospital, Kerbala from October 2016 to December2016. The study included 60 adult patients with age range from 43-67 years and having diabetes mellitus type 2. Fasting blood sugar and Hb tests were made and accompanied with other information like age and duration of diabetes mellitus. The results show that 43% of diabetic patients had anemia and there is a strong negative connection between Hb levels and the duration of getting diabetes (p0.01). We conclude from this study that anemia is may developed in Type 2DM patients and the diabetic patients should be taken care of toprevent the development of diseases and other complications.

COMPARATIVE HEMATOLOGICAL STUDY OF TYPE 2 DIABETIC AND NON-DIABETIC PATIENTS IN ERODE DISTRICT, TAMIL NADU

2021 ◽  
pp. 29-30
Author(s):  
Murugesan Thinakaran ◽  
Thangadurai Chitra
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Tamil Nadu ◽  
Haematological Parameters ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Hematological Indices ◽  
Patients With Diabetes ◽  
Type 2 Diabetic

Background And Objectives: Previous studies have shown that hematological alterations are a common nding in patients with diabetes. To aim of our study was to explore the hematological indices in type 2 diabetic patients compared with non-diabetic individual. Establish the role of haematological parameters as an early prevention strategy. Materialand Method: Two hundred and forty-six subjects were recruited for this study, one hundred and fourteen with type 2 diabetes and One hundred and thirty-two non-diabetes, were evaluated for haematological parameters using hematologic analyzer. All the information's about the disease was collected with the knowledge of the patients form the concern hospital and laboratory. Results And Conclusions: Results were compared with the same measurements in 132 subjects without diabetes mellitus. The haematological prole associated with Type2 diabetic patients signicantly reduced Hb, RBCs, PCV and MCV than Non diabetes. Increased MCHC and WBCs were noted in Type2 diabetes. Our ndings suggest the need of screening for routine hematological tests in type 2 diabetes mellitus

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