scholarly journals Diabetic nephropathy: early markers for monitoring and prevention

2021 ◽  
Vol 9 (2) ◽  
pp. 565
Author(s):  
Vijayashree S. Gokhale ◽  
Kshithija R. Sajjan ◽  
Rupesh Parati ◽  
Keyuri Mehta
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Nephropathy ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Albumin Creatinine Ratio ◽  
Early Markers ◽  
Function Test ◽  
Type 2 Diabetic

Background: Type 2 diabetes, with its complications is perpetually on the rise more so in India .Diabetic Nephropathy progresses silently, and manifests at a stage where, patient can be offered only renal replacement. This study was undertaken to detect early markers of Diabetic Nephropathy. Aims and objective of the study was to study early nephropathy by UACR (urinary albumin/creatinine ratio), RFT (renal function test) and e-GFR in Type 2 diabetic patients of more than 2 years duration, with and without hypertension.Methods: A hospital based cross-sectional observational study, of 100 patients, 18-60 years of age, of type 2 Diabetes of 2 year duration and above, of which 50 were only diabetic and 50 had diabetes and hypertension. Patients who had an established renal disease were excluded from study.Results: Our study of 100 patients, 18-60 years of age, had 23 male and 77 female patients. Maximum patients were in age group 41-50 years, and 52% had diabetes of 2-4 years duration. Of the renal parameters studied, BUN was normal in 72% and S. Creatinine normal in 67%. UACR was normal in only 38%, and e-GFR was normal in 49%.Conclusions: In our study age and sex, duration of Diabetes and HbA1c did not have any bearing on renal parameters. UACR followed by e-GFR, were deranged early. UACR was more deranged in diabetics with hypertension. 

Evaluation of urinary TNF-α and KIM-1 biomarkers in T2DM in Upper Egypt

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Magdy EL Sharkawy ◽  
Samir K Abdul-Hamid ◽  
Tarek T Elmelegy ◽  
Mohammed F Adawy
Keyword(s):  
Diabetic Nephropathy ◽  
Early Stage ◽  
Clinical Syndrome ◽  
Diabetic Patients ◽  
University Hospitals ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Tnf Α ◽  
Type 2 Diabetic

Abstract Background Diabetes mellitus (DM) is the most frequent cause of chronic kidney failure in both developed and developing countries. Diabetic nephropathy, is a clinical syndrome characterized by albuminuria (>300 mg/day) with permanent and irreversible decrease in glomerular filtration rate (GFR). Aim of the Work To study the role of urinary TNF-α and urine KIM-1 in type 2 diabetic patients as predictors of DN comparative with albuminuria. Patients and Methods This is a cross-sectional study which include 90 type-2 diabetic patients and 30 controls selected from the outpatient clinic of Assiut University hospitals. All patients gave an informed consent and approval for the study was obtained from the IRB committee of the Assiut Medical Faculty. The recruited patients were divided into three groups: Normo-albuminuria Group (A) (n = 30): UACR less than 30 mg/gm, Microalbuminuria Group (B) (n = 30): UACR between 30-299 mg/gm and Macro-albuminuria Group (C) (n = 30): UACR equal or more than 300 mg/gm. Assess Urinary TNF-α and urine KIM-1 in comparision with albuminuria. Results Urinary KIM-1 and urinary TNF-α are statically significant with albuminuria in patients in the early stage of diabetic nephropathy (eGFR _60 mL/min/1.73 m2).Also there are statically significance between patients with macroalbuminuria than microalbuminuria. Conclusion The results of this study recommend the use of KIM-1 and TNF-α as good predictors of early detection of development of diabetic nephropathy.

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 CNDP1, NOS3, and MnSOD Polymorphisms as Risk Factors for Diabetic Nephropathy among Type 2 Diabetic Patients in Malaysia

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Mohd Jokha Yahya ◽  
Patimah Binti Ismail ◽  
Norshariza Binti Nordin ◽  
Abdah Binti Md Akim ◽  
Wan Shaariah Binti Md Yusuf ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Diabetic Nephropathy ◽  
Manganese Superoxide Dismutase ◽  
Multiplicative Model ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic ◽  
Mode Of Inheritance

Type 2 diabetes mellitus (T2DM) is associated with a high incidence of nephropathy. The aim of this study was to investigate the association of a genetic polymorphism of carnosinase (CNDP1-D18S880and -rs2346061), endothelial nitric oxide synthase (NOS3-rs1799983), and manganese superoxide dismutase (MnSOD-rs4880) genes with the development of diabetic nephropathy among Malaysian type 2 diabetic patients. A case-control association study was performed using 652 T2DM patients comprising 227 Malays (without nephropathy = 96 and nephropathy = 131), 203 Chinese (without nephropathy = 95 and nephropathy = 108), and 222 Indians (without nephropathy = 136 and nephropathy = 86). DNA sequencing was performed for theD18S880ofCNDP1, while the rest were tested using DNA Sequenom MassARRAY to identify the polymorphisms. DNA was extracted from the secondary blood samples taken from the T2DM patients. The alleles and genotypes were tested using four genetic models, and the best mode of inheritance was chosen based on the leastpvalue. Thers2346061ofCNDP1was significantly associated with diabetic nephropathy among the Indians only with OR = 1.94 and 95% CI = (1.76–3.20) and fitted best the multiplicative model, whileD18S880was associated among all the three major races with the Malays having the strongest association with OR = 2.46 and 95% CI = (1.48–4.10), Chinese with OR = 2.26 and 95% CI = (1.34–3.83), and Indians with OR = 1.77 and 95% CI = (1.18–2.65) in the genotypic multiplicative model. The best mode of inheritance for bothMnSODandNOS3was the additive model. ForMnSOD-rs4880, the Chinese had OR = 2.8 and 95% CI = (0.53–14.94), Indians had OR = 2.4 and 95% CI = (0.69–2.84), and Malays had OR = 2.16 and 95% CI = (0.54–8.65), while forNOS3-rs1799983, the Indians had the highest risk with OR = 3.16 and 95% CI = (0.52–17.56), followed by the Chinese with OR = 3.55 and 95% CI = (0.36–35.03) and the Malays with OR = 2.89 and 95% CI = (0.29–28.32). The four oxidative stress-related polymorphisms have significant effects on the development of nephropathy in type 2 diabetes patients. The genes may, therefore, be considered as risk factors for Malaysian subjects who are predisposed to T2DM nephropathy.

scholarly journals A cross-sectional observational study on drug utilisation pattern, prevalence and risk factors for the development of diabetic nephropathy among type 2 diabetic patients in a south indian tertiary care hospital

2020 ◽  
Vol 11 (1) ◽  
pp. 93-108
Author(s):  
Madhavi Mannam ◽  
Lavanya Nalluri ◽  
Dhanalakshmi Pinnika ◽  
Mounika Pothuraju ◽  
Ravindrababu Pingili ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Nephropathy ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
South Indian ◽  
Type 2 Diabetic

Diabetic nephropathy is the leading cause of the end-stage renal disease (ESRD) worldwide, and it is estimated that ~ 20% of type 2 diabetic patients reach ESRD during their lifetime. The objective of the present study was to assess the drug utilization pattern, risk factors, and prevalence of diabetic nephropathy in patients with type 2 diabetes mellitus in a south Indian tertiary care hospital. A cross-sectional observational study was conducted on 613 subjects (254 with and 359 without diabetic nephropathy). Prevalence of diabetic nephropathy was measured, and risk factors for the development of diabetic nephropathy were determined by calculating odds ratios using graph-pad prism statistical software, and drug utilization pattern was assessed. Nephropathy was significantly higher in subjects who are married (98.8%, OR, 3.903; 95% CI, 1.125-13.54, P=0.0211),  poorly educated (61%, OR, 0.3670;95%CI, 0.2635-0.5112, P<0.0001), house wives (44.4%, OR, 0.5492; 95% CI, 0.3432 - 0.8789, P=0.0120), rural residents (51.2%, OR, 0.3943; 95% CI, 0.2820-0.5513, P<0.0001) and risk factors were hypertension (37.44%, OR, 4.131; 95% CI, 2.687-6.350, P<0.0001), other diseases (36.51%, OR, 4.963; 95% CI, 3.202 -7.692, P<0.0001), Endocrine diseases (9.53%, OR, 2.460; 95% CI, 1.433- 4.224, P=0.0009), history of CVD (7.90%, OR, 17.20; 95% CI, 7.049- 41.95, P<0.0001), HbA1c (36.1%, OR, 3.380; 95% CI, 2.157- 5.295, P<0.0001), low HDL (23%, OR, 0.5961; 95% CI, 0.3572 - 0.9947 , P=0.0470), high FBS levels (29.3%, OR, 6.111; 95%CI, 1.283 -29.10, P=0.0113), high triglyceride levels (39.8%, OR, 0.6077; 95%CI, 0.3878 -0.9523, P=0.0293), high serum creatinine (28.3%, OR, 154.3; 95% CI, 37.92- 627.7, P<0.0001), duration of T2DM(5-10years 39.8%, OR, 2.653;95% CI, 1.778 - 3.958, & > 10 years 37%, OR, 3.606 ; 95% CI, 2.362-5.504, P<0.0001), physical inactivity(64.9%, OR, 0.5188;95% CI, 0.3727-0.7220 , P<0.0001), soft drinks occasionally (31.9%, OR, 2.253; 95% CI, 1.531-3.315, P<0.0001), habit of taking tea /coffee twice without sugar(42.3%, OR, 1.845; 95% CI, 1.094 to 3.112, P=0.0208) were significant risk factors for development of nephropathy. Metformin (47.05%), a combination of Glimepiride and Metformin (30.71%), a combination of insulin isophane and insulin regular (29.41%), teneligliptin (10.45%), insulin regular (9.80%) were the anti-diabetic medications mostly given to the T2DM patients with nephropathy. The present study revealed that the risk factors for the development of diabetic nephropathy were multiple.

scholarly journals Dietary Diversity as a Risk Factor for Obesity in Algerian Patients with Type 2 Diabetes Mellitus

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1229
Author(s):  
Abdenour Bounihi ◽  
Hamza Saidi ◽  
Asma Bouazza ◽  
Hassiba Benbaibeche ◽  
Malha Azzouz ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Dietary Diversity ◽  
Diabetic Patients ◽  
Obese Patients ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Type 2 Diabetic

Although the incidence of “diabesity” (coexistence of type 2 diabetes and obesity) is alarmingly increasing in Algeria, the diet–diabesity link has not been well defined. This study aimed to explore the association between dietary diversity score (DDS) and obesity among Algerian type 2 diabetic patients. It was a cross-sectional observational study involving 390 type 2 diabetic patients. Anthropometric data were gathered, and dietary intake information was obtained through a 24-h dietary recall method, which was used to calculate DDS. Potential confounders such as age, sex, smoking, physical activity and energy intake were controlled for using multivariate logistic regression. A total of 160 patients (41.3%) were classified as obese. As expected, obese patients had a higher body mass index, waist circumference, hip circumference, body fat and fat mass index. Furthermore, obese patients more frequently met carbohydrate recommendations and had a higher intake of meat and protein. Female sex, hypertension, low physical activity and high meat and protein intake were positively associated with diabesity. Additionally, higher DDS was positively associated with diabesity after adjusting for confounders. Thus, a more diversified diet may be a risk factor for obesity among Algerian type 2 diabetic patients.

scholarly journals Prescription of Physical Activity by General Practitioners in Type 2 Diabetes: Practice and Barriers in French Guiana

2022 ◽  
Vol 12 ◽  
Author(s):  
Stephanie Dranebois ◽  
Marie Laure Lalanne-Mistrih ◽  
Mathieu Nacher ◽  
Liliane Thelusme ◽  
Sandra Deungoue ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
General Practitioners ◽  
French Guiana ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Balanced Diet ◽  
Type 2 Diabetic

BackgroundGeneral practitioners (GPs) are the major primary healthcare players in the management of type 2 diabetes. In addition to a well-balanced diet, physical activity (PA) appears as a necessary non-medicinal therapy in the management of diabetic patients. However, GPs emphasize several obstacles to its prescription. The aim of this study is to evaluate the practices, barriers, and factors favoring the prescription of PA in type 2 diabetic patients by GPs in French Guiana.MethodWe conducted a cross-sectional descriptive study using a questionnaire, designed to interview 152 French Guiana GPs and describe their practice in prescribing PA in type 2 diabetic patients.ResultsOur results revealed that the prescription of PA as a non-medicinal therapeutic choice in the management of type 2 diabetes was practiced by 74% of the French Guiana GPs. However, only 37% of GPs responded that they implemented the recommendations; indeed, only one-third knew about them. The majority of GPs were interested in PA training, but only 11% were actually trained in this practice. The lack of structure adapted to the practice of PA and the lack of awareness of the benefits of PA in metabolic pathology appeared as the main obstacles to PA prescription.ConclusionThis study highlights the importance of improving the training of GPs in the prescription of PA, the development of adapted PA structures, and collaboration between the different actors within the framework of the sport-health system in type 2 diabetes in French Guiana.

scholarly journals Nitric oxide modulation of renal and cardiac hemodynamics in type 2 diabetes

2002 ◽  
pp. 687-694 ◽  
Author(s):  
M Dalla Vestra ◽  
D Sacerdoti ◽  
G Bombonato ◽  
P Fioretto ◽  
G Finucci ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Type 2 Diabetes ◽  
Cardiac Output ◽  
Diabetic Nephropathy ◽  
Renal Plasma Flow ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Control Subjects ◽  
Type 2 Diabetic

OBJECTIVE: To evaluate endothelial function in type 2 diabetic patients with and without diabetic nephropathy. METHODS: We studied the effects of systemic infusion of the nitric oxide (NO) synthase inhibitor NG-monomethyl-l-arginine (L-NMMA) on cardiovascular and renal hemodynamics in six type 2 diabetic patients with microalbuminuria (D2-MA), six type 2 diabetic patients with normoalbuminuria (D2-NA) and five control subjects. Both type 2 diabetic patients and control subjects had mild arterial hypertension. RESULTS: L-NMMA infusion decreased the cardiac index in all groups. A reduction in glomerular filtration rate (GFR) and an increase in filtration fraction were observed only in controls. Renal plasma flow decreased in controls and D2-NA patients and renal vascular resistance increased in all groups. CONCLUSIONS: The effect of L-NMMA on cardiac output was similar in controls and type 2 diabetic patients with and without diabetic nephropathy. In contrast, the effect on GFR was impaired in both diabetic groups, suggesting that glomerular NO homeostasis is altered in type 2 diabetes. Moreover the discrepancy, in diabetic patients, between cardiac and renal effects during L-NMMA infusion suggests that the modulation of glomerular hemodynamics is independent from NO-regulated cardiac output.

scholarly journals FVC, FEV1 and FEV1/FVC% in Type 2 Diabetes and Their Relationships with Duration of the Disease

1970 ◽  
Vol 4 (2) ◽  
pp. 81-87 ◽  
Author(s):  
Md Omar Ali ◽  
Shelina Begum ◽  
Noorzahan Begum ◽  
Taskina Ali ◽  
Sultana Ferdousi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Metabolic Diseases ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Duration Of Diabetes ◽  
Group A ◽  
Type 2 Diabetic

Background: Diabetes mellitus is a chronic debilitating disease affecting various organs including lungs. The magnitude of the complications of this disease is related to its duration. Objective: To observe FVC, FEV1 and FEV1/FVC% in type 2 diabetic patients and their relationship with duration of the disease. Methods: This cross-sectional study was carried out in the Department of Physiology, BSMMU, Dhaka, from July 2007 to June 2008 on 60 type 2 diabetic male patients of age 40-60 years (Group B). For comparison, 30 age and BMI matched apparently healthy non diabetic subjects (Group A) were also studied. Patients were selected from the out patient department of Bangladesh Institute of research on diabetes, endocrine and metabolic diseases. Based on duration of diabetes, diabetic patients were divided into B1 (5-10 years) and B2 (10-20 years). FVC, FEV1 and FEV1/FVC% of all the subjects were measured by a digital microspirometer. Data were analyzed by One way ANOVA test, Unpaired Student's 't' test and Pearson's correlation coefficient test as applicable. Results: Mean of the percentage of the predicted values of FVC and FEV1, were significantly (p<0.001) lower in both those of Gr. B1 and B2 than that in A and were also significantly (p<0.001) lower in Gr. B2 when compared with Gr. B1. Again, FEV1/FVC% was significantly (p<0.01) higher in Gr. B2 than those in Gr. B1 and A whereas this value was lower in Gr. B1 than those of group A but it was not statistically significant. However, FVC and FEV1 showed negative and FEV1/FVC% showed positive correlations with duration of diabetes. All these correlations were statistically non significant. Conclusion: From the result of this study it can be concluded that the ventilatory function of lung may be reduced in type 2 diabetes which may be related to the duration of the disease. Key words: FVC, FEV1, diabetes mellitus DOI: 10.3329/jbsp.v4i2.4178 J Bangladesh Soc Physiol. 2009 Dec;4(2): 81-87  

scholarly journals The study of dyslipidemia and its correlation with nephropathy in diabetes mellitus type 2 patients

2017 ◽  
Vol 4 (5) ◽  
pp. 1231
Author(s):  
Rakesh K. Sisodia ◽  
Archana Gupta ◽  
Neelima Singh
Keyword(s):  
Diabetic Nephropathy ◽  
P Value ◽  
Diabetic Patients ◽  
Creatinine Ratio ◽  
Type 2 Diabetic Patients ◽  
Albumin Creatinine Ratio ◽  
Urine Albumin ◽  
Lipid Abnormalities ◽  
Type 2 Diabetic

Background: Diabetic nephropathy is one of the most severe diabetic microangiopathies. The aim of this study was to evaluate the lipid abnormalities associated with different stages of proteinuria in type 2 diabetic patients.Methods: In this study 100 type 2 diabetic patients were subjected to detailed history, clinical examination, Serum lipid profile, urine albumin creatinine ratio and routine biochemical investigations.Results: Out of 100 patients were included in study, 41 patients were normoabluminuric, 37 patients were microalbuminuric and 22 patients were overt proteinuric. Most common dyslipidemia found in study is increased triglyceride (43%) followed by increased LDL (28). On comparing normoalbuminuric to overt proteinuric, a positive correlation found in increased triglyceride (P value < 0.001) and increases LDL (P value <0.001).Conclusions: Concluded that raised Triglyceride and LDL are associated with Diabetic Nephropathy.

scholarly journals Serum Free Triiodothyronine Is Inversely Associated With Diabetic Peripheral Neuropathy but Not With Carotid Atherosclerotic Lesions in Type 2 Diabetic Patients With Euthyroid Function

2021 ◽  
Author(s):  
Mei-Fang Li ◽  
Jiang-Feng Ke ◽  
Shuai Li ◽  
Jun-Wei Wang ◽  
Zhi-Hui Zhu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Diabetic Patients ◽  
Free Triiodothyronine ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Serum Free ◽  
Atherosclerotic Lesions ◽  
Type 2 Diabetic

Abstract Background: The associations between serum free triiodothyronine (FT3) and diabetic peripheral neuropatprohy (DPN) / carotid atherosclerotic lesions in type 2 diabetic patients with normal thyroid function is still unclear. The purpose of our study was to explore the relationships of FT3 with DPN and carotid atherosclerotic lesions in Chinese type 2 diabetes inpatients with euthyroid function.Methods: A total of 2477 type 2 diabetes inpatients with euthyroid function were recruited in this cross-sectional study, and they were stratified into quartiles by FT3 levels. Peripheral neuropathy was assessed by neurological symptoms and signs as well as nerve conduction velocity tests. Carotid atherosclerotic lesions, including carotid intima-media thickness, plaque and stenosis, were evaluated by Doppler ultrasound. Results: After adjusting for potential confounders, there was a significant decrease in the prevalence of DPN in the patients with type 2 diabetes across the FT3 quartiles (23.5%, 20.9%, 18.9%, and 11.2%, respectively, p < 0.001). Logistical regression analysis further revealed that FT3 quartiles were significantly and inversely associated with DPN. Compared with the subjects in the highest FT3 quartile, the adjusted odds ratios (95% confidence interval) of DPN in the first to third FT3 quartile were successively 2.338 (1.407-3.884), 1.903 (1.134-3.194) and 1.598 (0.960-1.125). The patients with DPN had significantly higher prevalence of carotid plaques (55.8%) and carotid stenosis (1.3%) than non-DPN patients (44.8%; 0.5%). However, no statistical association was observed between FT3 quartiles and carotid atherosclerotic lesions.Conclusions: Lower FT3 within the normal range was independently associated with DPN, but not with carotid atherosclerotic lesions in Chinese type 2 diabetes inpatients with euthyroid function.

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