scholarly journals Complications of Acute and Chronic Hyperglycemia

2017 ◽  
Vol 13 (01) ◽  
pp. 17 ◽  
Author(s):  
M Loredana Marcovecchio ◽  
Keyword(s):  
Risk Factor ◽  
Plasma Glucose ◽  
Vascular Complications ◽  
Glucose Variability ◽  
Acute Hyperglycemia ◽  
Postprandial Plasma Glucose ◽  
Positive Effects ◽  
Chronic Hyperglycemia ◽  
Patients With Diabetes ◽  
The Impact

Hyperglycemia is due to a dysregulation in the complex mechanisms implicated in glucose homeostasis. Chronic hyperglycemia, as measured by hemoglobin A1c (HbA1c), is a key risk factor for the development of microvascular and macrovascular complications, which in turn negatively influence the prognosis of patients with diabetes. Several studies have shown that acute hyperglycemia can add to the effect of chronic hyperglycemia in inducing tissue damage. Acute hyperglycemia can manifest as high fasting plasma glucose (FPG) or high postprandial plasma glucose (PPG) and can activate the same metabolic and hemodynamic pathways as chronic hyperglycemia. Glucose variability, as expressed by the intraday glucose fluctuations from peaks to nadirs, is another important parameter, which has emerged as an HbA1c-independent risk factor for the development of vascular complications, mainly in the context of type 2 diabetes. Treatments able to decrease HbA1c have been associated with positive effects in terms of reducing risk for the development and progression of complications. Further studies are required to clarify the impact of strategies more specifically targeting components of acute hyperglycemia, to improve outcomes in patients with diabetes.

Association between Visit-to-Visit Fasting Plasma Glucose Variability and Osteoporotic Fractures in nondiabetic subjects

2021 ◽  
Author(s):  
Jung A Kim ◽  
Ji Sung Lee ◽  
Eyun Song ◽  
Eun Roh ◽  
Ji Hee Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Plasma Glucose ◽  
Vertebral Fractures ◽  
Fasting Plasma Glucose ◽  
Osteoporotic Fractures ◽  
Glucose Variability ◽  
Fasting Plasma ◽  
The Mean ◽  
The Impact

Abstract Context Although long-term glucose variability has been reported to be a risk factor associated with osteoporosis, there have been no previous studies between the relationship of glucose variability and fractures in people without diabetes. Objective We assessed visit-to-visit variations in fasting plasma glucose (FPG) as a prognostic factor in predicting osteoporotic fractures in individuals without diabetes. Design, Setting, and Subjects Using a nationwide cohort database, we examined the impact of FPG on the development of osteoporotic fractures in men and women (aged ≥50 years). Main Outcomes The primary outcomes were the number of total fractures and vertebral fractures. FPG variability was measured using standard deviation (FPG-SD), coefficient of variation (FPG-CV), and variation independent of the mean (FPG-VIM). Results Of the 92,929 participants, 5,262 (5.7%) developed osteoporotic fractures during the mean follow-up of 8.4 years. Individuals in the highest quartile of FPG-SD showed an 11% and 16% increase in risk of total and vertebral fractures, respectively, compared with those in the lowest quartile after adjustment for mean FPG and other risk factors. Analyses using FPG-CV and FPG-VIM demonstrated similar results. Subgroup analyses and sensitivity analyses to explore potential heterogeneity showed consistent results. Conclusions FPG variability may be a novel risk factor for osteoporotic fractures independent of risk factors in the general population without diabetes.

scholarly journals Glycemic control as an important tool in the prevention of cardiovascular aging in patients with diabetes mellitus

2021 ◽  
pp. 238-244
Author(s):  
O. A. Shatskaya ◽  
I. Z. Bondarenko ◽  
S. S. Kukharenko
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular System ◽  
Diabetes Management ◽  
Vascular Complications ◽  
The Body ◽  
Self Control ◽  
Risk Of Death ◽  
Chronic Hyperglycemia ◽  
Age Related ◽  
Patients With Diabetes

In recent decades, there has been a significant increase in the incidence and prevalence of diabetes mellitus. Diabetes mellitus is characterized by the development of vascular complications leading to early disability and a decrease in the life expectancy of patients. Aging of the body inevitably leads to the occurrence of age-related diseases, including the cardiovascular system, and increases the risk of death. Metabolic and structural and functional disorders of the cardiovascular system arising in diabetes mellitus have common pathophysiological mechanisms with aging of the body. Chronic hyperglycemia can accelerate the aging process and play a decisive role in the occurrence and prognosis of cardiovascular events in patients with diabetes mellitus. Achieving target glycemic values is an important step towards preventing vascular complications in patients with diabetes mellitus. Improved models of glucometers, equipped with a number of additional functions, allow for structured self-control of glycemia, analyze the data obtained and carry out timely correction of therapy, actively involve patients in the process of diabetes management, which will significantly increase the efficiency of disease management, reduce the risk of complications in patients and improve the quality of life.

scholarly journals Persistent impairment in working memory following severe hyperglycemia in newly diagnosed type 2 diabetes

2017 ◽  
Vol 2017 ◽  
Author(s):  
Joseph Cerasuolo ◽  
Anthony Izzo
Keyword(s):  
Working Memory ◽  
Neurological Injury ◽  
List Type ◽  
Newly Diagnosed ◽  
Neurocognitive Deficits ◽  
Proinflammatory Response ◽  
Acute Hyperglycemia ◽  
Chronic Hyperglycemia ◽  
The Impact ◽  
The Brain

Summary Acute hyperglycemia has been shown to cause cognitive impairments in animal models. There is growing appreciation of the numerous effects of hyperglycemia on neuronal function as well as blood–brain barrier function. In humans, hypoglycemia is well known to cause cognitive deficits acutely, but hyperglycemia has been less well studied. We present a case of selective neurocognitive deficits in the setting of acute hyperglycemia. A 60-year-old man was admitted to the hospital for an episode of acute hyperglycemia in the setting of newly diagnosed diabetes mellitus precipitated by steroid use. He was managed with insulin therapy and discharged home, and later, presented with complaints of memory impairment. Deficits included impairment in his declarative and working memory, to the point of significant impairment in his overall functioning. The patient had no structural lesions on MRI imaging of the brain or other systemic illnesses to explain his specific deficits. We suggest that his acute hyperglycemia may have caused neurological injury, and may be responsible for our patient’s memory complaints. Learning points: Acute hyperglycemia has been associated with poor outcomes in several different central nervous system injuries including cerebrovascular accident and hypoxic injury. Hyperglycemia is responsible for accumulation of reactive oxygen species in the brain, resulting in advanced glycosylated end products and a proinflammatory response that may lead to cellular injury. Further research is needed to define the impact of both acute and chronic hyperglycemia on cognitive impairment and memory.

scholarly journals Using GH-Method: Math-Physical Medicine to Conduct Segmentation Analysis to Investigate the Impact of Weather Temperatures on Glucose (Both FPG And PPG)

2020 ◽  
Vol 5 (3) ◽  
Keyword(s):  
Type 2 Diabetes ◽  
Big Data ◽  
Plasma Glucose ◽  
Physical Medicine ◽  
Postprandial Plasma Glucose ◽  
Segmentation Analysis ◽  
Metabolic Conditions ◽  
The Impact

This paper is based on big data collected from a period of 1,420daysfrom 6/1/2015 to 4/21/2019 with a total of 4,260 data, including highest ambient temperature (weather) of each day in degree Fahrenheit (°F), fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) in mg/dL. The dataset is provided by the author, who uses his own type 2 diabetes metabolic conditions control, as a case study via the “math-physical medicine” approach of a non-traditional methodology in medical research.

scholarly journals The Impact of Incretin-Based Medications on Lipid Metabolism

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Habib Yaribeygi ◽  
Mina Maleki ◽  
Alexandra E. Butler ◽  
Tannaz Jamialahmadi ◽  
Amirhossein Sahebkar
Keyword(s):  
Lipid Metabolism ◽  
Diabetes Complications ◽  
Clinical Evidence ◽  
Lipid Homeostasis ◽  
Beneficial Effects ◽  
Chronic Hyperglycemia ◽  
Current Review ◽  
Patients With Diabetes ◽  
Cellular Pathways ◽  
The Impact

Pathophysiological pathways that are induced by chronic hyperglycemia negatively impact lipid metabolism. Thus, diabetes is commonly accompanied by varying degrees of dyslipidemia which is itself a major risk factor for further macro- and microvascular diabetes complications such as atherosclerosis and nephropathy. Therefore, normalizing lipid metabolism is an attractive goal for therapy in patients with diabetes. Incretin-based medications are a novel group of antidiabetic agents with potent hypoglycemic effects. While the impact of incretins on glucose metabolism is clear, recent evidence indicates their positive modulatory roles on various aspects of lipid metabolism. Therefore, incretins may offer additional beneficial effects beyond that of glucose normalization. In the current review, how these antidiabetic medications can regulate lipid homeostasis and the possible cellular pathways involved are discussed, incorporating related clinical evidence about incretin effects on lipid homeostasis.

Impaired Glucose-Stimulated Proinsulin Secretion Is an Early Marker of β-Cell Impairment Before Prediabetes Stage

2019 ◽  
Vol 104 (10) ◽  
pp. 4341-4346 ◽  
Author(s):  
Ying Yang ◽  
Min Wang ◽  
Jingzhi Tong ◽  
Zuoliang Dong ◽  
Min Deng ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Plasma Glucose ◽  
Cell Function ◽  
Normal Glucose Tolerance ◽  
Β Cell ◽  
Family History Of Diabetes ◽  
Postprandial Plasma Glucose ◽  
Patients With Diabetes ◽  
Β Cell Function ◽  
Early Biomarker

Abstract Context Evidence indicates that there is substantial impairment/loss of β-cell function/mass even before prediabetes. Elevated plasma proinsulin is a sign of β-cell dysfunction in patients with diabetes/prediabetes. However, the dynamic changes of glucose stimulated proinsulin secretion (GSPS) among nondiabetic individuals remain obscure. Objective To examine GSPS and glucose-stimulated insulin secretion (GSIS) among individuals with normal glucose tolerance (NGT) and impaired glucose tolerance (IGT) and to evaluate whether impaired GSPS is an early biomarker of β-cell impairment in individuals with NGT who have subthreshold postprandial plasma glucose (PPG). Design and Participants We evaluated GSPS and GSIS in 116 Chinese adults without diabetes (mean age ± SD, 33.31 ± 9.10 years; mean BMI, 25.24 ± 4.20 kg/m2) with fasting plasma glucose (FPG) < 5.6 mmol/L. Based on 2hPPG, the participants were divided into three groups: NGT1 (2hPPG < 6.67 mmol/L), NGT2 (6.67 ≤ 2hPPG < 7.78 mmol/L), and IGT (7.78 ≤ 2hPPG<11.1 mmol/L). We analyzed the association of GSIS and GSPS with commonly used indexes of β-cell function, insulin resistance and family history of diabetes. Results Although not diagnosed with prediabetes, the individuals with NGT2 have clinical characteristics and high diabetes risk factors similar to those of the IGT group. However, unlike individuals with IGT, NGT2 participants did not exhibit a delayed GSIS. Instead, GSPS was impaired in NGT2 groups but not in NGT1 group. Conclusions This study suggests that impaired GSPS, but not impaired GSIS, may serve as an early biomarker to identify a subpopulation of NGT with a high risk of diabetes.

scholarly journals Ceylon cinnamon does not affect postprandial plasma glucose or insulin in subjects with impaired glucose tolerance

2011 ◽  
Vol 107 (12) ◽  
pp. 1845-1849 ◽  
Author(s):  
Jennie Wickenberg ◽  
Sandra Lindstedt ◽  
Kerstin Berntorp ◽  
Jan Nilsson ◽  
Joanna Hlebowicz
Keyword(s):  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Plasma Glucose ◽  
Venous Blood ◽  
Insulin Response ◽  
Postprandial Glucose ◽  
Oral Glucose ◽  
Postprandial Plasma Glucose ◽  
Positive Effects ◽  
Federal Institute

Previous studies on healthy subjects have shown that the intake of 6 g Cinnamomum cassia reduces postprandial glucose and that the intake of 3 g C. cassia reduces insulin response, without affecting postprandial glucose concentrations. Coumarin, which may damage the liver, is present in C. cassia, but not in Cinnamomum zeylanicum. The aim of the present study was to study the effect of C. zeylanicum on postprandial concentrations of plasma glucose, insulin, glycaemic index (GI) and insulinaemic index (GII) in subjects with impaired glucose tolerance (IGT). A total of ten subjects with IGT were assessed in a crossover trial. A standard 75 g oral glucose tolerance test (OGTT) was administered together with placebo or C. zeylanicum capsules. Finger-prick capillary blood samples were taken for glucose measurements and venous blood for insulin measurements, before and at 15, 30, 45, 60, 90, 120, 150 and 180 min after the start of the OGTT. The ingestion of 6 g C. zeylanicum had no significant effect on glucose level, insulin response, GI or GII. Ingestion of C. zeylanicum does not affect postprandial plasma glucose or insulin levels in human subjects. The Federal Institute for Risk Assessment in Europe has suggested the replacement of C. cassia by C. zeylanicum or the use of aqueous extracts of C. cassia to lower coumarin exposure. However, the positive effects seen with C. cassia in subjects with poor glycaemic control would then be lost.

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