Role of probiotics for the treatment of peri-implant mucositis in patients with and without type-2 diabetes mellitus

2020 ◽  
Author(s):  
Fawaz Alqahtani ◽  
Maha Alshaikh ◽  
Abid Mehmood ◽  
Nasser Alqhtani ◽  
Fahad Alkhtani ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Patients ◽  
Treatment Procedure ◽  
Inflammatory Parameters ◽  
Probing Depth ◽  
Crestal Bone Loss ◽  
Group 2

The hypothesis was that probiotic therapy (PT) does not offer additional benefits to mechanical debridement (MD) for treatment of diabetic subjects with peri-implant mucositis (PM). This study compared the influence of PT as an adjunct to MD for the treatment of PM in type2 diabetic and non-diabetic patients over a 12-month follow-up period. Patients with and without type-2 diabetes were encompassed. Based upon treatment-procedure, PM patients were categorized into 2 groups: (a) Non-surgical + PT; and (b) Group-2: Non-surgical MD alone. Demographics and education statuses were recorded. Gingival (GI) and plaque (PI) indices, crestal bone loss (CBL) and probing depth (PD were measured at baseline and after 6- and 12-months. Significant differences were detected with P<0.01. The HbA1c was significantly higher in diabetic patients at all time durations than patients without type-2 diabetes (P<0.001). Baseline GI, PI, PD and CBL) were comparable in all groups. In patients with type-2-diabetes, there was no difference in PI, GI, PD and CBL at 6- and 12-months’ follow-up. In patients without type-2 diabetes, there was a significant reduction in PI (P<0.01), GI (P<0.01), and PD (P<0.01) at 6-months and 1-year follow-up than their values at baseline. In patients without type-2 diabetes, MD with or without adjunct PT reduces soft tissue inflammatory parameters in patients with PM.

Comparison of photobiomodulation and photodynamic therapy as adjuncts to mechanical debridement for the treatment of peri-implantitis

2021 ◽  
pp. 1-10
Author(s):  
Mansour H. Al-Askar ◽  
Fahad A. Abdullatif ◽  
Abdulmonem A. Alshihri ◽  
Asma Ahmed ◽  
Darshan Devang Divakar ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Null Hypothesis ◽  
Gingival Index ◽  
P Values ◽  
Inflammatory Parameters ◽  
Probing Depth ◽  
Crestal Bone Loss ◽  
Group 3 ◽  
Soft Tissue Inflammation

BACKGROUND AND OBJECTIVE: The aim of this study was to compare the efficacy of photobiomodulation therapy (PBMT) and photodynamic therapy (PDT) as adjuncts to mechanical debridement (MD) for the treatment of peri-implantitis. The present study is based on the null hypothesis that there is no difference in the peri-implant inflammatory parameters (modified plaque index [mPI], modified gingival index [mGI], probing depth [PD]) and crestal bone loss (CBL) following MD either with PBMT or PDT in patients with peri-implantitis. METHODS: Forty-nine patients with peri-implantitis were randomly categorized into three groups. In Groups 1 and 2, patients underwent MD with adjunct PBMT and PDT, respectively. In Group 3, patients underwent MD alone (controls). Peri-implant inflammatory parameters were measured at baseline and 3-months follow-up. P-values < 0.01 were considered statistically significant. RESULTS: At baseline, peri-implant clinicoradiographic parameters were comparable in all groups. Compared with baseline, there was a significant reduction in mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) in Groups 1 and 2 at 3-months follow-up. In Group 3, there was no difference in the scores of mPI, mGI and PD at follow-up. At 3-months follow-up, there was no difference in mPI, mGI and PD among patients in Groups 1 and 2. The mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) were significantly higher in Group 3 than Groups 1 and 2. The CBL was comparable in all groups at follow-up. CONCLUSION: PBMT and PDT seem to be useful adjuncts to MD for the treatment of peri-implant soft-tissue inflammation among patients with peri-implantitis.

scholarly journals Elabela levels in patients with type 2 diabetes: can it be a marker for diabetic nephropathy?

2020 ◽  
Vol 20 (2) ◽  
pp. 833-840
Author(s):  
Erhan Onalan ◽  
Yusuf Doğan ◽  
Ebru Onalan ◽  
Nevzat Gozel ◽  
Ilay Buran ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Nephropathy ◽  
High Serum ◽  
Control Group ◽  
Diabetic Patients ◽  
Healthy Individuals ◽  
Urine Albumin ◽  
Healthy Control ◽  
Group 2

Backround: Elabela (ELA) is a hormone that is secreted at high levels in the kidneys of a healthy adult. This study aims to investigate whether serum ELA levels of patients with Type 2 Diabetes vary with the severity of renal damage. Methods: Our study included 50 healthy control subjects and 100 diabetic patients, who were categorized into groups based on urine albumin/creatinine ratios (ACR). Patients included in the study were assigned to four groups: Group 1 (healthy control), Group 2 (ACR<29mg/g), Group 3 (ACR=30-299 mg/g), and Group 4 (ACR>300 mg/g normal or high serum creatinine). Physical examination findings, demographic characteristics of the study group were recorded, and serum ELA levels and other laboratory parameters were assessed using appropriate methods. Results: The results of the study indicated that ELA levels determined in healthy individuals gradually decreased through stages of normal albuminuria, microalbuminuria, and macroalbuminuria. Moreover, ELA had a significant negative corre- lation with LDL-C (r=-0.201, p=0.014), glucose (r=-0.437, P<0.001), retinopathy (r=-0.222, P=0.006), serum BUN (r=- 0.161, P=0.049), and a positive correlation with eGFR (r=0.250, P=0.002). Conclusions: The fact that ELA levels are higher in healthy individuals compared to diabetic patients without microalbu- minuria, and higher in diabetic patients without microalbuminuria compared to patients with advanced albuminuria and kidney damage, suggests that the ELA level can be an important clinical prognostic variable and even a promising agent for the treatment of diabetic nephropathy patients. Keywords: Elabela, diabetes, diabetic kidney disease, albuminuria.

scholarly journals Risk of atrial fibrillation development of sodium-glucose co-transporter 2 inhibitor and thiazolidinedione treatment among patients with type 2 diabetes

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Y.R Kim ◽  
S.E Lee ◽  
K.A Kim
Keyword(s):  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Incidence Rates ◽  
Good Choice ◽  
Diabetic Patients ◽  
Funding Sources ◽  
Korean National Health Insurance ◽  
Outcome Event

Abstract Background Type 2 diabetes is an independent risk factor for the development of atrial fibrillation (AF). Recently, SGLT-2i has been shown to decrease the incidence of AF through several mechanisms including reduction of atrial dilatation via diuresis and lowering body weight. On the other hand, the use of TZD was found to protect diabetic patients from new-onset AF in observational studies. Thus, we aimed to compare the effect of SGLT-2i and TZD on the risk of AF development. Methods Using the Korean National Health Insurance Service database, we included patients with type 2 diabetes who were prescribed SGLT-2i or TZD at least once from January 2014 to December 2018. Patients were followed until the outcome event, death, or 31 December 2018. Sensitivity analysis was performed only including patients who prescribed study drugs ≥90 days. Results A total of 206,986 patients were included (88,227 patients in SGLT-2i group and 118,759 in TZD group). Baseline characteristics were mean age was 57 years and 57.4% were male; mean body mass index was 26.3kg/m2 and 68.3% had hypertension. During follow-up, the incidence rates of AF were 1.36% in SGLT-2i-treated patients and 0.87% TZD-treated patients, respectively (p=0.0002). The hazard ratio (HR) of AF was 0.846 (95% confidence interval [CI]: 0.0.775–0.923) in SGLT-2i-treated patients compared with TZD-treated patients. Conclusions In this study, the risk of AF development was significantly lower in patients treated with SGLT-2i versus TZD. SGLT2 would be a good choice for the patients with high risk of AF development among diabetes mellitus. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals A study of prevalence of microalbuminuria in recently detected type 2 diabetes and its relation to hypertension, dyslipidaemia and obesity

2020 ◽  
Vol 11 (5) ◽  
pp. 38-43
Author(s):  
Shrikrishna V Acharya
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Nephropathy ◽  
Screening Tool ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Group 2 ◽  
Type 2 Diabetic ◽  
Group 1 ◽  
New Onset

Background: Microalbuminuria is one of the earliest markers of diabetic nephropathy, and if not recognized and treated early it may lead to diabetic nephropathy resulting in chronic renal failure. Aims and Objective: The aim of the current study was to find out the prevalence of microalbuminuria among newly detected Type 2 diabetic patients and also compare prevalence of microalbuminuria in patients with or without hypertension, dyslipidaemia and obesity. Materials and Methods: In this retrospective study, we analysed 90 patients with new onset type 2 diabetes mellitus. We divided the patients into two groups, group 1 with comorbidities like hypertension, dyslipidaemia and obesity (50 patients) and group 2 without comorbidities (40 patients). We analysed urinary microalbumin level in all patients and compared the prevalence of microalbuminuria between group 1 and group 2. Results: In our cohort of 90 patients, urinary microalbuminuria was found in 30 patients (33.3%). When we divided these nephropathy patients to group1 and group 2, we observed that group 1 with comorbidities had higher percentage of nephropathy patients i.e 24 out of 50(48%). Group 2 with 40 patients had only 6 patients with microalbiminuria ie 6 out of 40(15%). Incidence of microalbiminuria was higher in patients with hypertension, dyslipidaemia and obesity. Conclusions: We conclude that incidence of microalbiminuria is much more common in newly diagnosed type 2 diabetes. We also conclude that hypertension, obesity and hypercholesterolemia are risk factors for nephropathy and urinary microalbuminuria appears to be much more sensitive than serum creatinine as screening tool to detect diabetic nephropathy.

scholarly journals Profibrotic circulating proteins and risk of early progressive renal decline in Type 2 Diabetes patients with and without albuminuria

2020 ◽  
Author(s):  
Katsuhito Ihara ◽  
Jan Skupien ◽  
Hiroki Kobayashi ◽  
Zaipul I. Md Dom ◽  
Jonathan M. Wilson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Core Domain ◽  
Fibrotic Process ◽  
Baseline Levels ◽  
Design And Methods ◽  
Circulating Levels ◽  
Index Combination

<b>OBJECTIVE</b>: The role of fibrosis in early progressive renal decline in type 2 diabetes is unknown. Circulating WFDC2 (WAP four-disulfide core domain protein 2) and MMP-7 (Matrilysin) are postulated to be biomarkers of renal fibrosis. This study examined an association of circulating levels of these proteins with early progressive renal decline. <p><b>RESEARCH DESIGN AND METHODS</b>: Individuals with type 2 diabetes enrolled in the Joslin Kidney Study with eGFR ≥60 ml/min/1.73m<sup>2</sup> were followed for 6-12 years to ascertain fast early progressive renal decline defined as eGFR loss ≥5 ml/min/1.73m<sup>2</sup>/year. </p> <p><b>RESULTS</b>: A total of 1,181 individuals were studied: 681 without and 500 with albuminuria. Median eGFR and ACR at baseline were 97 ml/min/1.73m<sup>2</sup> and 24 mg/g, respectively. During follow-up, 152 individuals experienced fast early progressive renal decline: 6.9% in those with normoalbuminuria and 21% with albuminuria. In both subgroups risk of renal decline increased with increasing baseline levels of WFDC2 (p <0.0001) and MMP-7 (p <0.0001). After adjustment for relevant clinical characteristics and known biomarkers, an increase by one quartile in the Fibrosis Index (combination of levels of WFDC2 and MMP-7) was associated with higher risk of renal decline (OR 1.63; 95% CI 1.30-2.04). The association was similar and statistically significant among patients with and without albuminuria. </p> <p><b>CONCLUSIONS: </b>Elevation of circulating profibrotic proteins is associated with the development of early progressive renal decline in type 2 diabetes. This association is independent from albuminuria status and points to the importance of the fibrotic process in development of early renal decline. </p>

P0751METFORMIN, A CLASSIC TREATMENT FOR TYPE 2 DIABETES WITH POSSIBLE RENOPROTECTIVE EFFECTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Adriana Acosta Barrios ◽  
Marian Goicoechea ◽  
Eduardo Verde ◽  
Ángela González-Rojas ◽  
Andres Delgado ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Kidney Disease ◽  
Experimental Studies ◽  
Diabetic Patients ◽  
Metformin Treatment ◽  
End Point ◽  
Progression Of Kidney Disease

Abstract Background and Aims Metformin is the antidiabetic of choice in patients with type 2 diabetes mellitus. Experimental studies and clinical observations have shown that metformin could have a beneficial effect on the progression of kidney disease through the activation of cAMP due to its anti-inflammatory, antifibrotic, and anti-oxidative action. The objective was to compare the progression of CKD in diabetic patients with or without metformin as antidiabetic in their treatment and the prevalence of cardiovascular events in both groups. Method Unicentric retrospective observational analysis. Inclusion criteria: outpatients seen in nephrology consultation during the year of 2012 with diabetes mellitus and stage 3 CKD. Renal, cardiovascular outcomes and mortality were analyzed between patients treated with / without metformin. Median follow-up of 76.5 months (41-84). Renal end-point: estimated glomerular filtration rate drop (MDRD-4) by 50% and / or start of dialysis program. Cardiovascular end-point: ischemic heart disease, stroke, arterial revascularization and / or amputation. Cardiovascular or any cause mortality. Results 148 patients (96M, 52W) with a mean age of 75±9 years and an eGFR of 40±9 ml / min / 1.73 m2 were included. In relation to hypoglycemic therapy: 45 received metformin, 61 insulin and 31 DPP4i. 80% received treatment with RAAS blockers. After the follow-up, the progression of the renal disease was greater in patients who did not receive metformin: eGFR fall of -7.0±16 vs -0.15±16 ml / min in those treated with metformin (p = 0.019). 25 patients in the group without metformin suffered a renal event vs. 5 in the metformin group (logRank: 4.186, p = 0.045). In the Cox analysis, metformin treatment decreases the progression of kidney disease in a model adjusted for baseline renal function and treatment with RAASB (HR 0.368, p = 0.043), losing its predictive power in a proteinuria-adjusted model. During the follow-up, 45 patients died (20 metformin, 25 non-metformin) and 45 patients suffered a cardiovascular event (15 metformin, 30 non-metformin), with no differences between the two groups. Conclusion Metformin treatment in patients with stage 3 CKD could slow the progression of CKD, this effect should be demonstrated in randomized studies with larger sample size.

scholarly journals Awaking Blood Pressure Surge and Progression to Microalbuminuria in Type 2 Normotensive Diabetic Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Michelangela Barbieri ◽  
Maria Rosaria Rizzo ◽  
Ilaria Fava ◽  
Celestino Sardu ◽  
Nicola Angelico ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cox Regression ◽  
Blood Pressure Monitoring ◽  
Adult Patients ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Pressure Surge

Background. We investigated the predictive value of morning blood pressure surge (MBPS) on the development of microalbuminuria in normotensive adults with a recent diagnosis of type 2 diabetes.Methods. Prospective assessments of 24-hour ambulatory blood pressure monitoring and urinary albumin excretion were performed in 377 adult patients. Multivariate-adjusted Cox regression models were used to assess hazard ratios (HRs) between baseline and changes over follow-up in MBPS and the risk of microalbuminuria. The MBPS was calculated as follows: mean systolic BP during the 2 hours after awakening minus mean systolic BP during the 1 hour that included the lowest sleep BP.Results. After a mean follow-up of 6.5 years, microalbuminuria developed in 102 patients. An increase in MBPB during follow-up was associated with an increased risk of microalbuminuria. Compared to individuals in the lowest tertile (−0.67±1.10 mmHg), the HR and 95% CI for microalbuminuria in those in the highest tertile of change (24.86±6.92 mmHg) during follow-up were 17.41 (95% CI 6.26–48.42);pfor trend <0.001. Mean SD MBPS significantly increased in those who developed microalbuminuria from a mean [SD] of 10.6[1.4]to 36.8[7.1],p<0.001.Conclusion. An increase in MBPS is associated with the risk of microalbuminuria in normotensive adult patients with type 2 diabetes.

3269Impact of type 2 diabetes on incidence and phenotype of heart failure in patients with atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Polovina ◽  
I Milinkovic ◽  
G Krljanac ◽  
I Veljic ◽  
I Petrovic-Djordjevic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Diabetic Patients ◽  
History Of ◽  
New Onset

Abstract Background Type 2 diabetes (T2DM) portends adverse prognosis in patients with atrial fibrillation (AF). Whether T2DM independently increases the risk of incident heart failure (HF) in AF is uncertain. Also, HF phenotype developing in patients with vs. those without T2DM has not been characterised. Purpose In AF patients without a history of prior HF, we aimed to assess: 1) the impact of T2DM on the risk of new-onset HF; and 2) the association between T2DM and HF phenotype developing during the prospective follow-up. Methods We included diabetic and non-diabetic AF patients, without a history of HF. Baseline T2DM status was inferred from medical history, haemoglobin A1c levels and oral glucose tolerance test. Study outcome was the first hospital admission or emergency department treatment for new-onset HF during the prospective follow-up. The phenotype of new-onset HF was determined by echocardiographic exam performed following clinical stabilisation (at hospital discharge, or within a month after HF diagnosis). HF phenotype was defined as HFrEF (left ventricular ejection fraction [LVEF] <40%), HFmrEF (LVEF 40–49%) or HFpEF (LVEF≥50%). Cox regression analyses adjusted for age, sex, baseline LVEF, comorbidities, smoking status, alcohol intake, AF type (paroxysmal vs. non-paroxysmal) and T2DM treatment was used to analyse the association between T2DM and incident HF. Results Among 1,288 AF patients without prior HF (mean age: 62.1±12.7 years; 61% male), T2DM was present in 16.5%. Diabetic patients had higher mean baseline LVEF compared with nondiabetic patients (50.0±6.2% vs. 57.6±9.0%; P<0.001). During the median 5.5-year follow-up, new-onset HF occurred in 12.4% of patients (incidence rate, 2.9; 95% confidence interval [CI], 2.5–3.3 per 100 patient-years). Compared with non-diabetic patients, those with T2DM had a hazard ratio of 2.1 (95% CI, 1.6–2.8; P<0.001) for new-onset HF, independent of baseline LVEF or other factors. In addition, diabetic patients had a significantly greater decline in covariate-adjusted mean LVEF (−10.4%; 95% CI, −9.8% to −10.8%) at follow-up, compared with nondiabetic patients (−4.0%; 95% CI, −3.8% to −4.2%), P<0.001. The distribution of HF phenotypes at follow-up is presented in Figure. Among patients with T2DM, HFrEF (56.9%) was the most common phenotype of HF, whereas in patients without T2DM, HF mostly took the phenotype of HFpEF (75.0%). Conclusions T2DM is associated with an independent risk of new-onset HF in patients with AF and confers a greater decline in LVEF compared to individuals without T2DM. HFrEF was the most prevalent presenting phenotype of HF in AF patients with T2DM.

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