Adding to the Armamentarium for the Treatment of Diabetes Mellitus

2006 ◽  
Vol 00 (02) ◽  
Author(s):  
Curtis Triplitt
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Microvascular Complications ◽  
Significant Morbidity ◽  
Common Chronic Disease ◽  
Prevention And Early Detection ◽  
Increased Risk ◽  
The Us ◽  
Treatment Of Diabetes

Current estimates are that more than 20 million people in the US have diabetes. Diabetes mellitus, especially type-2 diabetes mellitus (T2DM), is an increasingly common chronic disease with the potential for significant morbidity and mortality. People with diabetes are at an increased risk of both macrovascular complications, such as myocardial infarction and stroke, and microvascular complications, including retinopathy, neuropathy and nephropathy. The prevention and early detection of complications is paramount to improving outcomes, as diabetes and its complications are estimated to cost over US$100 billion per year in the US.

scholarly journals The Role of Combined SGLT1/SGLT2 Inhibition in Reducing the Incidence of Stroke and Myocardial Infarction in Patients with Type 2 Diabetes Mellitus

2021 ◽  
Author(s):  
Bertram Pitt ◽  
Gabriel Steg ◽  
Lawrence A. Leiter ◽  
Deepak L. Bhatt
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Relative Increase ◽  
Sodium Glucose Cotransporter ◽  
Increased Risk ◽  
Sglt2 Inhibition

Abstract Purpose In patients with type 2 diabetes mellitus (T2DM), both sodium-glucose cotransporter 2 inhibitors (SGLT2is) and glucagon-like peptide receptor agonists (GLP-1 RAs) have demonstrated significant improvements in cardiovascular and kidney outcomes independent of their glycemic benefits. This paper will briefly compare the effect of SGLT2is and GLP-1 RAs to that of the SGLT1/2 inhibitor sotagliflozin on the incidence of myocardial infarction (MI) and stroke in patients with T2DM and further postulate mechanisms to account for these findings. Methods and Results Thus far, the results from SCORED and SOLOIST (trials studying the SGLT1/2 inhibitor sotagliflozin) suggest that an increase in SGLT1 inhibition when added to SGLT2 inhibition may contribute to reductions in MI and stroke in patients with T2DM. This benefit is beyond what SGLT2is alone can accomplish and at least similar to GLP-1 RAs but with the added benefit of a reduction in hospitalizations and urgent visits for HF. Larger and longer studies are required to confirm the effectiveness of SGLT1/SGLT2 inhibition in reducing MI and stroke in patients with T2DM and elucidate the mechanisms associated with this finding. Conclusions The role of SGLT1/2 inhibition as an addition to GLP-1 RAs in patients with and without T2DM at increased risk for MI and stroke requires further study. Regardless, the finding that a relative increase in SGLT1/2 inhibition reduces the risk of MI and stroke as well as hospitalizations and urgent visits for heart failure could improve quality of life and reduce the healthcare burden associated with T2DM.

Epidemiology of type 2 diabetes mellitus

2011 ◽  
pp. 1748-1754
Author(s):  
Sarah Wild ◽  
Jackie Price
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Social Impact ◽  
Microvascular Complications ◽  
Macrovascular Disease ◽  
Organ Damage ◽  
Increased Risk ◽  
Prevalence Of Obesity ◽  
Obesity Hypertension

Diabetes mellitus represents a group of metabolic disorders characterized by hyperglycaemia, which may or may not be associated with symptoms. The chronic hyperglycaemia of diabetes results from defects in insulin secretion, insulin action, or both, and is associated with long-term organ damage, particularly in the eyes, kidneys, nerves, heart, and blood vessels. Patients with type 2 diabetes have a higher prevalence of obesity (particularly abdominal obesity), hypertension, and lipid disorders, as well as an increased risk of macrovascular disease in coronary, peripheral, and cerebral arterial circulations, than people without diabetes. Microvascular complications of diabetes include retinopathy, which can lead to loss of vision, nephropathy (leading to renal failure), neuropathy (with an increased risk of foot ulcers, amputations, and foot deformations), and autonomic neuropathy, causing cardiovascular, gastrointestinal, genitourinary, and sexual dysfunction. Diabetes may have a serious emotional and social impact on affected individuals and their families, and has major economic implications for society as a whole in both developed and developing countries.

scholarly journals Hormonal Contraception and Diabetes

2012 ◽  
Vol 5 ◽  
pp. CMWH.S9934
Author(s):  
L.F. Pallardo ◽  
A Cano ◽  
I Cristobal ◽  
M.A. Blanco ◽  
M Lozano ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Preconception Care ◽  
Microvascular Complications ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Contraceptive Methods ◽  
Type 2 Dm ◽  
Increased Risk

Women with gestational diabetes mellitus are at increased risk for developing diabetes mellitus (DM), mainly type 2 DM, as well as metabolic syndrome. The presence of subsequent pregnancies increases the risk. In addition, pregnancy in patients with type 1 and type 2 DM also elevates the risk of morbidity and mortality for both mothers and offspring. Thus, all women with pre-existing type 1 or type 2 DM should receive preconception care to optimize glycemic control (HbA1c ≤ 6%). In those cases with macrovascular or microvascular complications, family planning is even more important in order to avoid the risk of aggravation of such complications associated with a new pregnancy. The present review analyzes the metabolic and cardiovascular repercussions of hormone contraception in non-diabetic women as well as in type 1 and type 2 DM patients with and without macrovascular and microvascular complications. Finally, the recommendations pertaining to hormonal contraceptive methods for women with diabetes are summarized.

scholarly journals Application of artificial intelligence in prediction of cardiovascular complications in patients with diabetes mellitus type 2: A protocol of systematic review

2021 ◽  
Author(s):  
Hengameh Ferdosian ◽  
◽  
Hadi Zamanian ◽  
Sayed Ali Emami ◽  
Elahe Sedighi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Microvascular Complications ◽  
Cardiovascular Complications ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Review Question

Review question / Objective: The aim of this systematic review is to evaluate AI-based models in identifying predictors of cardiovascular events and risk predtion in patients with diabetes mellitus type2. Condition being studied: T2DM patients have an increased risk of macrovascular and microvascular complications, lead to decreased quality of life and mortality. Considering the significance of cardiovascular complications in these patients, prediction of such events would be important. Different traditional statistical methods(such as regression) and new AI-besed algorithms are used to predict these complications in diabetic patients.

scholarly journals PREVALENCE OF THYROID DYSFUNCTION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Manoj Kumar Mali
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Thyroid Dysfunction ◽  
Microvascular Complications ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Increased Risk ◽  
Status Assessment

Background: Patients with type 2 diabetes mellitus are more prone to thyroid disorders. Hypothyroidism in them leads to an aggravation of microvascular complications. Diabetic patients with hypothyroidism also are at an increased risk of cardiovascular disease. Screening for thyroid dysfunction in diabetic patients will allow early treatment of hypothyroidism. Methods: All patients were evaluated for thyroid status; assessment of T3, T4 and TSH levels and Blood glucose levels and HbA1c. Results: 22.00% patients were present with subclinical hypothyroidism, 18.00% patients were present with hypothyroidism and 4.00% patients present with hyperthyroidism Conclusion: Screening for thyroid disease disease among patients with diabetes mellitus should be routinely performed for early detection and treatment of thyroid dysfunction to delay the complications of diabetes Keywords: Thyroid, Type-2DM, Complication

scholarly journals APOA1 (-75 G>A and 83 C>T) and APOB (2488 C>T) polymorphisms and its association with Myocardial Infarction, lipids and apolipoproteins in patients with Type 2 Diabetes Mellitus

2021 ◽  
Author(s):  
Fidel Casillas ◽  
Diana Martínez Fernández ◽  
Yeminia Valle ◽  
Maricela Aceves Ramírez ◽  
Brenda Parra-Reyna ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Healthy Subjects ◽  
Genotype Distribution ◽  
Dominant Model ◽  
Susceptibility Factor ◽  
Increased Risk ◽  
Ischemic Events

IntroductionThe increased risk of myocardial infarction (MI) in T2DM is well documented. Polymorphisms in APOA1 and APOB genes allow us to identify new genetic markers in Mexican population with T2DM and MI.Material and methodsWe studied 135 patients with DMT2 and MI (DI); another 85 non-infarcted diabetic individuals with DMT2 but without previous ischemic events (NID) and 242 Healthy subjects (HS), all three groups were selected with the aim to investigate the association between the polymorphisms and infarction when T2DM is present or absent.Results-75 G>A polymorphism: differences were found in genotype distribution between DI and NID individuals (OR: 2.01, CI:1.117-3.623, p= 0.019) with an increased risk for A in the dominant model (OR: 1.77, CI: 1.020-3.084, p= 0.042); also concentrations of ApoA-I for A/A were lower in comparison with G/A (p = 0.038) and LDL-C and HDL-C levels were lower in G/A respecting to G/G carriers. 83 C> T polymorphism of APOA1: for DI individuals: HDL-C was lower in T/T respecting to C/C and triglyceride levels were lower in C/T respect to C/C carriers.ConclusionsThe -75 G>A APOA1 polymorphism could be considered as a susceptibility factor for Myocardial Infarction in individuals with T2DM and 2488 C>T APOB polymorphism is associated with changes in HDL-C and LDL-C and triglycerides in the same group.roup.

scholarly journals NLRP3Inflammasome Polymorphism and Macrovascular Complications in Type 2 Diabetes Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Jasna Klen ◽  
Katja Goričar ◽  
Andrej Janež ◽  
Vita Dolžan
Keyword(s):  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Plasma Cholesterol ◽  
Microvascular Complications ◽  
Macrovascular Complications ◽  
Lipid Levels ◽  
Cholesterol Levels ◽  
Increased Risk

Background. It is generally accepted that poor glycemic control, arterial hypertension and/or hyperlipidemia, and the associated oxidative stress may contribute to the development of macro- and microvascular complications in type 2 diabetes (T2D). Such metabolic damage signals may activate inflammasome and trigger chronic inflammation. We investigated common polymorphisms in inflammasome coding genes and the risk for macro- and microvascular complications in T2D.Methods. In total 181 clinically well-characterised T2D patients were genotyped forNLRP3rs35829419 andCARD8rs2043211. Risk for diabetic complications was assessed using logistic regression.Results. Patients with median duration of T2D 11 (6–17) years had relatively well controlled blood glucose and lipid levels and blood pressure on the prescribed treatment regimen. Duration of T2D and plasma cholesterol levels were the most important clinical risk factors for macrovascular complications (P=0.007andP=0.031).NLRP3rs35829419 was associated with increased risk for macrovascular complications (P=0.004), with myocardial infarction in particular (P=0.052). No association was observed betweenCARD8polymorphism and any of T2D complications.Conclusions. Our preliminary data suggest the role ofNLRP3polymorphism in diabetic macrovascular complications, especially in myocardial infarction.

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