scholarly journals Screening for Type 2 Diabetes – The ADDITION Netherlands Study

2009 ◽  
Vol 05 (0) ◽  
pp. 32 ◽  
Author(s):  
Guy EHM Rutten ◽  
Paul GH Janssen ◽  
◽  
Keyword(s):  
Type 2 Diabetes ◽  
General Practice ◽  
Cardiovascular Risk ◽  
Population Based ◽  
Diabetic Patients ◽  
Dutch Study ◽  
Patients With Diabetes ◽  
One Year ◽  
Event Rates

To investigate whether early treatment of screening-detected diabetic patients is beneficial, the Anglo–Danish–Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION) has been initiated. A total of 56,978 subjects 50–70 years of age without diabetes from 79 general practices in The Netherlands were invited to participate in a stepwise screening programme. Five hundred and eighty-six participants (1.0%) were diagnosed with type 2 diabetes. The score on the initial risk questionnaire was higher if glucose metabolism was more disturbed. The yield of screening varied widely between practices. A lower yield was not associated with an appropriate practice organisation regarding diabetes care, nor with a speciality of the GP in diabetes. Opportunistic screening in general practice seems preferable to population-based screening. Intensified multifactorial treatment of patients with screening-detected type 2 diabetes in general practice reduced the cardiovascular risk factor levels significantly after just one year without worsening healthrelated quality of life. After three years of follow-up, screened participants without diabetes but with an elevated risk score had comparable cardiovascular event rates to patients with diabetes. Screened individuals without diabetes are at risk of lacking optimal control of cardiovascular risk factors.

scholarly journals Prevalence of anemia in type II diabetes mellitus patients

2019 ◽  
Vol 7 (9) ◽  
pp. 3536
Author(s):  
Sreenivas Reddy ◽  
Molugu Divya Reddy
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
General Medicine ◽  
Type Ii Diabetes Mellitus ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
One Year ◽  
Prevalence Of Anemia

Background: Anemia is a common haematological finding in diabetic patients. The prevalence of anemia in the patients with diabetes is two or three times higher than in patients with comparable renal impairment and iron stores in the general population. As India is foreseen a diabetic capital of the world, it becomes imperative to recognize co-morbidities such as anemia at the earliest. The aim of this study was to determine the prevalence of anemia among patients with type 2 diabetes. Author conducted a prospective analysis of 100 diabetic patients visiting the outpatient clinic in our institution. Duration of study is One Year (November 2016 - December 2017). Study perform at Om Sai Hospitals, Balapur, Hyderabad, Telangana, India. A 100 patients suffering from type 2 Diabetes Mellitus, attending Outpatient Department of General Medicine, were included in the study.Methods: All the patients were subjected to detailed history, through clinical examination and investigation. Patients’ blood samples were analyzed for Glycated hemoglobin (HbA1C) values and hemoglobin (Hb) levels. The prevalence of anemia was then determined defining anemia by an Hb level <13.0 g/dL for men and <12.0 g/dL for women.Results: The prevalence of anemia in this study population was found to be 43%. The prevalence of anemia is significantly greater in diabetic females than in diabetic males and in poorly controlled diabetics than those with glycemic status under control.Conclusions: We conclude that anemia is a prevalent finding in patients with type 2 diabetes mellitus and represents significant unrecognised burden.

RISK-1: One-year Retrospective Study to Assess Cardiovascular Risk at the Onset of Type 2 Diabetes Mellitus in Slovenia

Metabolism ◽  
2021 ◽  
Vol 116 ◽  
pp. 154481
Author(s):  
Iris Marolt ◽  
Jana Komel ◽  
Elena Kuzmina ◽  
Anja Babič ◽  
Renata Kopriva ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiovascular Risk ◽  
Retrospective Study ◽  
One Year

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)

Abstract P057: Clusters of Cardiovascular Risk Factors Predict Incidence of Type 2 Diabetes in Men and Women: A Swedish Population-based Study

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Charlotte A Larsson ◽  
Bledar Daka ◽  
Margareta I Hellgren ◽  
Maria C Eriksson ◽  
Lennart Råstam ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Population Based ◽  
Population Based Study ◽  
Men And Women ◽  
Self Rated Health

Introduction: Clusters of metabolic variables and their effects on incidence of type 2 diabetes have been studied previously; however, little is known about the effects on diabetes from risk factor clusters including lifestyle and self-rated health. Hypothesis: We assessed the hypothesis that clusters of common cardiovascular risk factors, including lifestyle and self-rated health, can predict development of type 2 diabetes in men and women, respectively. Methods: In 2002-2005, 2816 men and women, 30-74 years, were randomly selected from two municipalities in southwestern Sweden and assessed with regard to cardiovascular/metabolic risk factors within the Skaraborg Project (76% participation). Participants performed an OGTT, had blood samples drawn, had anthropometric measurements and blood pressure taken, and answered validated questionnaires about e.g. leisure-time physical activity (with four answer alternatives from intensive to sedentary) and self-rated health (with five alternatives from excellent to very poor). Using the same protocol, 1332 participants from the baseline survey where re-examined in 2011-2014. After excluding those with diabetes at baseline, 1268 participants were included in this prospective population-based study. Results: Factor analysis (using varimax rotation) identified significant loadings (≥0.40) on the following three identical factors in men and women: the metabolic factor , comprising HOMA-ir, WHR, systolic blood pressure, and apolipoprotein B-to-A1 ratio; the vitality factor , comprising physical activity and self-rated health; and the addiction factor , comprising smoking and alcohol consumption. After a mean follow-up of 9.7±1.4 years, 76 cases of diabetes were identified; 46 in men and 30 in women. In a logistic regression analysis adjusted for all principal components, age, and educational level, the metabolic factor significantly predicted type 2 diabetes in both men (OR: 3.3, CI: 2.3-5.0) and women (OR: 3.5, CI: 2.2-5.6). Furthermore, a predictive effect of the vitality factor was also seen in women (OR: 1.8, CI: 1.2-2.9), but not in men (OR: 1.1, CI: 0.8-1.6), whereas the addiction factor had no effect in either men or women. Conclusions: This is to our knowledge the first time principle components of cardiovascular risk factors, including both metabolic and lifestyle variables, have been used to predict incidence of type 2 diabetes. The gender difference observed with regard to the combined impact of self-rated health and physical activity are novel and indicates a mechanism beside the metabolic syndrome that warrants further gender-specific exploration in future studies.

408Albuminuria as a predictor of incident ischemic stroke and myocardial infarction in patients with type 2 diabetes but without cardiovascular disease: A Danish cohort study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M V Fangel ◽  
P B Nielsen ◽  
J K Kristensen ◽  
T B Larsen ◽  
T F Overvad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
All Cause Mortality ◽  
Patients With Diabetes

Abstract Background Risk stratification in patients with type 2 diabetes continues to be an important priority in the management of diabetes-related morbidity and mortality. International guidelines generally recognize patients with diabetes and cardiovascular disease as high-risk patients. Risk stratification is, however, more uncertain in diabetes patients without cardiovascular disease. Micro- and macroalbuminuria have previously been identified as predictors of cardiovascular events and mortality in general cohorts of diabetes patients. However, less is known about the predictive value of albuminuria in patients with diabetes but without established cardiovascular disease. Purpose We aimed to examine the association between albuminuria level and the risk of ischemic stroke, myocardial infarction, and all-cause mortality in patients with type 2 diabetes and without a diagnosis of cardiovascular disease. Methods We linked Danish nationwide registries to identify patients with type 2 diabetes and without cardiovascular disease from May 2005 through June 2015. Based on two consecutive measurements of the urinary albumin excretion rate or albumin-to-creatinine ratio patients were stratified in categories of normoalbuminuria, microalbuminuria, and macroalbuminuria. Patients were followed for the outcomes ischemic stroke, myocardial infarction, and all-cause mortality until December 31, 2015. Five-year risk of outcomes were presented as cumulative incidence functions (with death as a competing event). Associations between albuminuria level and incidence of ischemic stroke, myocardial infarction, and all-cause mortality were evaluated with Cox proportional hazard regression adjusted for cardiovascular risk factors. Results The study population included 78,841 patients with type 2 diabetes (44.7% females, mean age 63.2). When comparing patients with microalbuminuria to patients with normoalbuminuria in an age- and sex-adjusted analysis, we found hazard ratios (HRs) of 1.45 (95% CI: 1.24–1.69), 1.45 (95% CI: 1.24–1.70), and 1.50 (95% CI: 1.39–1.61) for ischemic stroke, myocardial infarction, and all-cause mortality, respectively. Furthermore, macroalbuminuria was associated with HRs of 2.05 (95% CI: 1.70–2.48), 2.25 (95% CI: 1.86–2.71), and 2.03 (95% CI: 1.85–2.23) for ischemic stroke, myocardial infarction, and all-cause mortality, respectively. Similar results were found after adjusting for cardiovascular risk factors. Conclusions In this nationwide cohort study of patients with type 2 diabetes but without cardiovascular disease, patients with micro- and macroalbuminuria had a higher risk of incident ischemic stroke, myocardial infarction, and all-cause mortality. This finding supports that patients with micro- or macroalbuminuria should be screened regularly and followed closely in clinical practice. Moreover, these findings suggest that patients with type 2 diabetes and micro- or macroalbuminuria may benefit from intensive vascular risk reduction.

scholarly journals Extremely high-dose insulin requirement in a diabetic patient with COVID-19: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
François R. Jornayvaz ◽  
Benjamin Assouline ◽  
Jérôme Pugin ◽  
Karim Gariani
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Patient ◽  
Insulin Requirement ◽  
Diabetic Patients ◽  
High Dose ◽  
Intravenous Insulin ◽  
Patients With Diabetes ◽  
Mechanical Ventilation Support ◽  
High Insulin

Abstract Background Detailed description of hyperglycemia management in diabetic patients infected with SARS-CoV-2 remain limited, although patients with diabetes show higher complication and mortality rate than patients without diabetes. Transient non-severe increased insulin requirement in patients hospitalized for medical conditions such as sepsis or myocardial infarction is a well-known phenomenon. However, extremely high-dose insulin requirement remains a very rarely reported entity. Here, we report the case of an extreme and transitory insulin requirement episode in a type 2 diabetic patient presenting an acute respiratory distress syndrome caused by SARS-CoV-2. Case presentation A 57-year-old man resident in Geneva, Switzerland, previously known for type 2 diabetes for 3 years was admitted for an aggravation of his dyspnea. His type 2 diabetes was treated only with metformin and his latest Hb1Ac was 6.1%. Chest CT SCAN showed a bilateral multilobar ground-glass opacification. Twenty-four hours after his admission he presented a worsening of dyspnea and severe hypoxemia requiring a transfer to the intensive care unit rapidly followed by oro-tracheal intubation for mechanical ventilation support. A bronchoalveolar lavage was performed and test of SARS-CoV-2 by RT-qPCR assay was positive. At day 3, he presented a rapidly progressive insulin requirement at a rate of up to 50 units/hour intravenous insulin aspart. Despite the high insulin doses, he maintained an elevated plasma glucose level at 270 mg/dL on average. His extremely high-dose insulin requirement “resolved” at day 9, and the insulin infusion rate was rapidly reduced. Conclusions This case may reflect a specific and profound impact of SARS-CoV-2 on metabolic homeostasis, in particular in diabetic patients that appear more prone to complications of COVID-19 infection. Yet, the mechanisms behind this remain to be elucidated. The optimal management of hyperglycemia of diabetic patients infected with SARS-CoV-2 has yet not be defined, however insulin remain the mainstay of treatment approach. Report of extreme dysregulation of chronic conditions such as diabetes in patients with COVID-19 may help clinicians to better take care of patients during the pandemic of SARS-CoV-2. To the best of our knowledge this is the first description of extremely high-dose insulin requirement in patient with COVID-19.

scholarly journals Infective endocarditis according to type 2 diabetes mellitus status: an observational study in Spain, 2001–2015

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
José M. de Miguel-Yanes ◽  
Rodrigo Jiménez-García ◽  
Valentín Hernández-Barrera ◽  
Javier de Miguel-Díez ◽  
Manuel Méndez-Bailón ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Infective Endocarditis ◽  
Population Based ◽  
Incidence Rates ◽  
Discharge Data ◽  
Admission Rates ◽  
Diabetes Status ◽  
Patients With Diabetes ◽  
Diabetes Mellitus Status

Abstract Background The main aims of this study were to describe trends and outcomes during admission for infective endocarditis (IE) in people ≥ 40 years old with or without type 2 diabetes distributed in five time-periods (2001–2003; 2004–2006; 2007–2009; 2010–2012 and 2013–2015), using Spanish national hospital discharge data. Methods We estimated admission rates by diabetes status. We analyzed comorbidity, therapeutic procedures, and outcomes. We built Poisson regression models to compare the adjusted time-trends in admission rates. Type 2 diabetes cases were matched with controls using propensity score matching (PSM). We tested in-hospital mortality (IHM) in logistic regression analyses. Results We identified 16,626 hospitalizations in patients aged ≥ 40 years for IE in Spain, 2001–2015. The incidence of IE increased significantly from 6.0/100,000 per year to 13.1/100,000 per year (p < 0.001) in the population with type 2 diabetes, and from 3.9/100,000 per year to 5.5/100,000 per year (p < 0.001) in the population without diabetes, over the study period. The adjusted incidence of IE was 2.2-times higher among patients with diabetes than among those without diabetes (IRR = 2.2; 95% CI 2.1–2.3). People with type 2 diabetes less often underwent heart valve surgery than people without diabetes (13.9% vs. 17.3%; p < 0.001). Although IHM decreased significantly in both groups over time, it represented 20.8% of IE cases among diabetes patients and 19.9% among PSM matched controls (p = 0.337). Type 2 diabetes was not associated with a higher IHM in people admitted to the hospital for IE (OR = 1.1; 95% CI 0.9–1.2). Conclusion Incidence rates of IE in Spain, among those with and without T2DM, have increased during the period 2001–2015 with significantly higher incidence rates in the T2DM population. In our population based study and after PSM we found that T2DM was not a predictor of IHM in IE.

scholarly journals Plasma C1q/TNF-Related Protein-9 Levels Are Associated with Atherosclerosis in Patients with Type 2 Diabetes without Renal Dysfunction

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Mariko Asada ◽  
Tomoaki Morioka ◽  
Yuko Yamazaki ◽  
Yoshinori Kakutani ◽  
Reina Kawarabayashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diabetic Patients ◽  
Protective Effects ◽  
Related Protein ◽  
Carotid Imt

Aim. C1q/tumor necrosis factor-related protein-9 (CTRP9), a paralog of adiponectin, is expressed in adipose tissue. CTRP9 exerts protective effects against obesity and atherosclerosis in rodents. We investigated the association between plasma CTRP9 levels and atherosclerosis in patients with type 2 diabetes. Methods. We included 419 patients with type 2 diabetes, 161 of whom had chronic kidney disease (CKD). Fasting plasma CTRP9 and total adiponectin levels were measured with enzyme-linked immunosorbent assay. The intima-media thickness (IMT) of the common carotid artery was measured with ultrasonography. Results. Plasma CTRP9 levels were higher in the CKD group than in the non-CKD group. Plasma CTRP9 levels were positively correlated with carotid IMT in the non-CKD group. Multivariate analyses revealed that plasma CTRP9 levels were positively associated with carotid IMT in the non-CKD group, independent of age, sex, body mass index, adiponectin, and other cardiovascular risk factors. However, plasma CTRP9 levels were not associated with carotid IMT in the CKD group. Conclusion. Plasma CTRP9 levels are associated with atherosclerosis in diabetic patients without CKD, independently of obesity, adiponectin, and traditional cardiovascular risk factors. This study indicates a potential role of CTRP9 in atherosclerosis progression in human type 2 diabetes.

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