Influence of HbA1c on short-term blood pressure variability in type 2 diabetic patients with diabetic nephropathy

Background.In Cuba, the Ma-Pi 2 macrobiotic diet has shown positive results in 6-month assays with type 2 diabetic patients. The objective of this study was to assess the influence of this diet at short and medium terms.Methods.Sixty-five type 2 diabetic volunteers were included for dietary intervention, institutionally based for 21 days and followed later at home, until completing 3 months. 54 of them stayed until assay end. Before intervention, and after both assay periods, they were submitted to anthropometric records, body composition analyses and measurements of serum biochemical indicators, glycemic profile in capillary blood, blood pressure, and medication consumption; food intake was evaluated by the 3-day dietary recall.Results.During the intervention, the energy intake was 200 kcal higher at instance of more complex carbohydrates and dietary fiber and despite less fat and protein. Blood pressure and serum biochemical indicators decreased significantly in both periods; the safety nutritional indicators (hemoglobin, serum total proteins, and albumin) showed no variations. The global cardiovascular risk decreased and insulin consumption dropped by 46% and 64%, in both periods, respectively.Conclusions.The Ma-Pi 2 macrobiotic diet was a successful therapy at short term and after 3-month home-based intervention, for type 2 diabetics.

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Impact of Glycemic and Blood Pressure Variability on Surrogate Measures of Cardiovascular Outcomes in Type 2 Diabetic Patients

Diabetes Care ◽

10.2337/dc11-0034 ◽

2011 ◽

Vol 34 (7) ◽

pp. 1605-1609 ◽

Cited By ~ 100

Author(s):

A. Di Flaviani ◽

F. Picconi ◽

P. Di Stefano ◽

I. Giordani ◽

I. Malandrucco ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Variability ◽

Cardiovascular Outcomes ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Surrogate Measures ◽

Type 2 Diabetic

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Short-term renoprotective effect of SGLT-2 inhibitor for renal function and albuminuria in type 2 diabetes

10.21203/rs.3.rs-23179/v1 ◽

2020 ◽

Author(s):

Mitsunobu Kubota ◽

Eri SHiroyama ◽

Kanako Tanaka ◽

Yoko Yoshii

Keyword(s):

Blood Pressure ◽

Body Weight ◽

Diabetic Patients ◽

Protective Effects ◽

Renal Protection ◽

Short Term ◽

Type 2 Diabetic Patients ◽

Before And After ◽

Type 2 Diabetic

Abstract Background Progression of diabetic nephropathy in type 2 diabetic patients is a factor that determines the prognosis of life. Empagliflozin and canagliflozin, two oral diabetic SGLT-2 inhibitors, have shown improved renal outcomes in type 2 diabetic patients with chronic kidney disease in a large clinical study. These results suggest that SGLT-2 inhibitors could be used not only for hypoglycemic effects, but also for renal protective effects in patients with type 2 diabetes. It is not fully understood in which contexts the use of SGLT-2 inhibitors is likely to exert its renal protective effects. The purpose of this study was to clarify the profiles of patients in whom SGLT-2 inhibitors are more likely to exert a renal protective effect in clinical practice. We examined renal function and urinary albumin changes in short-term use of SGLT-2 inhibitors by patient background. Methods We retrospectively analyzed the chart information of sixty-three type 2 diabetic patients (33 males, 30 females, average age 53.0 ± 13.0 years) who were given usual doses of a SGLT-2 inhibitor. We investigated changes in body weight, blood pressure, glucose metabolism index, lipid metabolism index, estimated glomerular filtration rate (eGFR) and albuminuria (urinary albumin-to-creatinine ratio, UACR) three months before and after administration of a SGLT-2 inhibitor. Results Three months after administration of an SGLT-2 inhibitor, there were improvements in glucose tolerance, weight loss, blood pressure, and lipid indices. In all cases, there was no significant change in eGFR, but UACR decreased significantly. UACR decreased regardless of Angiotensin II Receptor Blocker medication and significantly decreased in the nephropathy stage 2 and 3 groups. UACR decreased only in the group in which blood pressure, body weight, and HbA1c decreased before and after administration of the SGLT-2 inhibitor. Conclusions Our study shows that SGLT-2 inhibitors are independent of renin-angiotensin system (RAS) inhibitors, and in addition to direct renal protection, the comprehensive effects of SGLT-2 inhibitors, which lower body weight, blood pressure, and blood glucose, are also important for their renal protection effects.

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Short-term renoprotective effect of SGLT-2 inhibitor for renal function and albuminuria in type 2 diabetes: a retrospective study

10.21203/rs.3.rs-35892/v1 ◽

2020 ◽

Author(s):

Mitsunobu Kubota ◽

Eri Shiroyama ◽

Kanako Tanaka ◽

Yoko Yoshii

Keyword(s):

Blood Pressure ◽

Body Weight ◽

Diabetic Patients ◽

Protective Effects ◽

Renal Protection ◽

Short Term ◽

Type 2 Diabetic Patients ◽

Before And After ◽

Type 2 Diabetic

Abstract Background Progression of diabetic nephropathy in type 2 diabetic patients is a factor that determines the prognosis of life. Empagliflozin and canagliflozin, two oral diabetic SGLT-2 inhibitors, have shown improved renal outcomes in type 2 diabetic patients with chronic kidney disease in a large clinical study. These results suggest that SGLT-2 inhibitors could be used not only for hypoglycemic effects, but also for renal protective effects in patients with type 2 diabetes. It is not fully understood in which contexts the use of SGLT-2 inhibitors is likely to exert its renal protective effects. The purpose of this study was to clarify the profiles of patients in whom SGLT-2 inhibitors are more likely to exert a renal protective effect in clinical practice. We examined renal function and urinary albumin changes in short-term use of SGLT-2 inhibitors by patient background. Methods We retrospectively analyzed the medical record information of sixty-three type 2 diabetic patients (33 males, 30 females, average age 53.0 ± 13.0 years) who were given usual doses of a SGLT-2 inhibitor. We investigated changes in body weight, blood pressure, glucose metabolism index, lipid metabolism index, estimated glomerular filtration rate (eGFR) and albuminuria (urinary albumin-to-creatinine ratio, UACR) three months before and after administration of a SGLT-2 inhibitor. Results Three months after administration of an SGLT-2 inhibitor, there were improvements in glucose tolerance, weight loss, blood pressure, and lipid indices. In all cases, there was no significant change in eGFR, but UACR decreased significantly. UACR decreased regardless of Angiotensin II Receptor Blocker medication and significantly decreased in nephropathy patients with microalbuminuria or overt albuminuria. UACR decreased only in the group in which blood pressure, body weight, and hemoglobin A1c decreased before and after administration of the SGLT-2 inhibitor. Conclusions Our study shows that the renoprotective effects of SGLT-2 inhibitors are more likely to be exerted in diabetic nephropathy patients who have advanced to at least microalbuminuria stage, and in addition to direct renal protection, the comprehensive effects of SGLT-2 inhibitors, which lower body weight, blood pressure, and blood glucose, are also important for their renal protection effects.

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Prevalence of Nephropathy with Evaluation of HbA1c Level and other Associated Risk Factors in Type 2 Diabetic Patients in a Tertiary Level Hospital

KYAMC Journal ◽

10.3329/kyamcj.v8i1.33868 ◽

2017 ◽

Vol 8 (1) ◽

pp. 21-26 ◽

Cited By ~ 1

Author(s):

Sayama Hoque ◽

MA Muttalib ◽

Md Imtiajul Islam ◽

Parvin Akter Khanam ◽

Nasrin Akter ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Logistic Regression ◽

Diabetic Nephropathy ◽

Blood Glucose ◽

Univariate Analysis ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

Background: Diabetes is the leading cause of chronic kidney disease which ultimately results end-stage renal disease (ESRD).Objectives: The purpose of the study was to explore the factors influencing or related to the development of the diabetic nephropathy with specific concern to the HbA1c (glycosylated hemoglobin) levels.Methods: Four hundred type 2 diabetic patients (male 166 and female 234) were studied and were evaluated for the presence of nephropathy through the review of their registered diabetic guide book. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used Student's ttest,?2-test and logistic regression analysis to determine and quantify the association of diabetic nephropathy with various risk factors specially HbA1c.Results: The prevalence of nephropathy was 24.0%; male 27.1%, female 21.8%. Increasing HbA1c categories above 7.0% were significantly associated with increased prevalence of nephropathy (15.8 vs 22.8 vs 30.7%; ?2 = 8.590, p = .013). Logistic regression models of univariate analysis showed that the risk of nephropathy was strongly increased at the HbA1c categories 8% (OR = 2.35; 95% CI: 1.30-4.25). Advanced age (OR = 3.8; 95% CI: 2.21-6.53), longer duration of diabetes (OR = 4.05; 95% CI: 2.31-7.10), lacking of physical exercise (OR = 1.93; 95% CI: 1.20-3.10), presence of hypertension (OR = 4.62; 95% CI: 2.42-8.83), fasting blood glucose (OR = 1.139; 95% CI: 1.054-1.231), blood glucose 2 hours after breakfast (OR = 1.088; 95% CI: 1.028-1.152), systolic blood pressure (OR = 1.049; 95% CI: 1.030-1.069) and diastolic blood pressure (OR = 1.061; 95% CI: 1.026-1.097) had significant association with nephropathy.Conclusion: HbA1c categories >7.0% is an important risk factor for the development of nephropathy.KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 21-26

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Effects of Vitamin E on Fasting and Postprandial Oxidative Stress, Inflammatory Markers, Glucose Status, Insulin Resistance, Blood Pressure and Pulse Rate in Type-2 Diabetic Patients: A Randomized Clinical Trial

Galen Medical Journal ◽

10.31661/gmj.v4i3.333 ◽

2015 ◽

Vol 4 (3) ◽

pp. 67-74

Author(s):

Najmeh Hejazi ◽

Mohammad Hossein Dabbaghmanesh ◽

Zohreh Mazloom ◽

Arash Dashtabi

Keyword(s):

Oxidative Stress ◽

Blood Pressure ◽

Vitamin E ◽

Pulse Rate ◽

Diabetic Patients ◽

Short Term ◽

Type 2 Diabetic Patients ◽

Significant Difference ◽

Type 2 Diabetic

Background: Atherosclerosis is one of the prevalent complications in diabetic patients. Increased free radical levels in diabetes activate stress-sensitive signaling pathway, resulting in this outcome. This study examines the effect of short-term supplementation of vitamin E on different biochemical markers in type 2 diabetic patients to prevent from atherosclerosis. Materials and Methods: In this single-blind placebo controlled trial, 30 type 2 diabetic patients were randomly divided into two groups of study to receive vitamin E (400IU) or identical placebo capsules daily for 6 weeks. Serum level of lipoproteins, glucose, insulin, malondialdehyde (MDA), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs CRP), pulse rate and blood pressure were measured in fasting and postprandial (after a fatty meal) states before and after six weeks of supplementation. Results: There was not any significant difference in fasting and postprandial lipid profile (Triglyceride, HDL-, LDL- and total Cholesterol), glucose, insulin and HOMA-IR after six weeks of intervention between the two groups. However, results of our study showed a significant decrease in fasting and postprandial MDA levels and postprandial pulse rate and a significant increase in fasting IL-6 in vitamin E group compared to the controls after supplementation. There were no significant differences between the groups in other markers. Conclusion: This study suggests that short term supplementation of vitamin E can reduce oxidative stress in fasting and postprandial states in type 2 diabetic patients and may prevent diabetic complications; in addition, increment of IL-6 after supplementation may play a role in attenuating Type 2 diabetes by anti-inflammatory effects.[GMJ. 2015;4(3):67-74]

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Short-term Renoprotective Effect of SGLT-2 Inhibitor for Renal Function and Albuminuria in Type 2 Diabetes: A Retrospective Study

10.21203/rs.3.rs-24057/v1 ◽

2020 ◽

Author(s):

Mitsunobu Kubota ◽

Eri Shiroyama ◽

Kanako Tanaka ◽

Yoko Yoshii

Keyword(s):

Blood Pressure ◽

Body Weight ◽

Diabetic Patients ◽

Protective Effects ◽

Renal Protection ◽

Short Term ◽

Type 2 Diabetic Patients ◽

Before And After ◽

Type 2 Diabetic

Abstract Background Progression of diabetic nephropathy in type 2 diabetic patients is a factor that determines the prognosis of life. Empagliflozin and canagliflozin, two oral diabetic SGLT-2 inhibitors, have shown improved renal outcomes in type 2 diabetic patients with chronic kidney disease in a large clinical study. These results suggest that SGLT-2 inhibitors could be used not only for hypoglycemic effects, but also for renal protective effects in patients with type 2 diabetes. It is not fully understood in which contexts the use of SGLT-2 inhibitors is likely to exert its renal protective effects. The purpose of this study was to clarify the profiles of patients in whom SGLT-2 inhibitors are more likely to exert a renal protective effect in clinical practice. We examined renal function and urinary albumin changes in short-term use of SGLT-2 inhibitors by patient background. Methods We retrospectively analyzed the medical record information of sixty-three type 2 diabetic patients (33 males, 30 females, average age 53.0 ± 13.0 years) who were given usual doses of a SGLT-2 inhibitor. We investigated changes in body weight, blood pressure, glucose metabolism index, lipid metabolism index, estimated glomerular filtration rate (eGFR) and albuminuria (urinary albumin-to-creatinine ratio, UACR) three months before and after administration of a SGLT-2 inhibitor. Results Three months after administration of an SGLT-2 inhibitor, there were improvements in glucose tolerance, weight loss, blood pressure, and lipid indices. In all cases, there was no significant change in eGFR, but UACR decreased significantly. UACR decreased regardless of Angiotensin II Receptor Blocker medication and significantly decreased in nephropathy patients with microalbuminuria or overt albuminuria. UACR decreased only in the group in which blood pressure, body weight, and HbA1c decreased before and after administration of the SGLT-2 inhibitor. Conclusions Our study shows that the renoprotective effects of SGLT-2 inhibitors are more likely to be exerted in diabetic nephropathy patients who have advanced to at least microalbuminuria stage, and in addition to direct renal protection, the comprehensive effects of SGLT-2 inhibitors, which lower body weight, blood pressure, and blood glucose, are also important for their renal protection effects.

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