scholarly journals The risk of cardiovascular death in type 2 diabetes

2017 ◽  
Vol 95 (1) ◽  
pp. 57-59
Author(s):  
N. V. Zeinalova ◽  
Yagub Ziyaddin Kurbanov ◽  
V. A. Mirzazade ◽  
R. A. Rzayeva ◽  
M. S. Novruzova
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Disorders ◽  
Density Lipoprotein ◽  
Cardiovascular Death ◽  
Control Group ◽  
Average Risk ◽  
Virtual Control ◽  
Framingham Risk ◽  
Patients With Diabetes

Aim. To evaluate effects of metabolic disorders on the risk of cardiovascular death in patients with type II diabetes based on Framingham risk score. We analyzed results of examination of 210 men and 210 women with type 2 diabetes who applied for medical care to the VM center of Endocrinology during 1997-2014. A virtual control group was formed matching real patients in terms of the number, sex, age, and height having ideal body mass index, total cholesterol and high-density lipoprotein cholesterol levels. The average risk of cardiovascular death in patients with type 2 diabetes was equal to 4,56±0,254% compared with 0,6±1,028% in the virtual control group. The differences was significant (p <0,001). The minimum risk for the patients of the two groups was estimated at 0,001% and 0,01% respectively. The maximum risk of cardiovascular death is 34,17% in patients with diabetes and 8,24% in controls. It is concluded that type 2 diabetes and related metabolic disorders significantly increase the risk of cardiovascular death.

scholarly journals Impact of Canagliflozin in Patients with Type 2 Diabetes after Hospitalization for Acute Heart Failure: A Cohort Study

2021 ◽  
Vol 10 (3) ◽  
pp. 505
Author(s):  
Ernesto Martín ◽  
José López-Aguilera ◽  
Rafael González-Manzanares ◽  
Manuel Anguita ◽  
Guillermo Gutiérrez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Cardiovascular Death ◽  
Sglt2 Inhibitors ◽  
Control Group ◽  
First Year ◽  
Cardiovascular Morbidity And Mortality ◽  
Patients With Diabetes

Background: Heart failure (HF) is one of the mayor contributors to cardiovascular morbidity and mortality in patients with diabetes. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated to reduce the risk of hospitalization for HF in patients with type 2 diabetes mellitus (T2D). We aimed to assess the risk for re-hospitalization in a cohort of patients hospitalized for HF according to whether or not they received canagliflozin at discharge, as well as changes in N-terminal pro–B-type natriuretic peptide (NT-ProBNP) concentration during follow-up. Methods: We conducted a retrospective longitudinal study at a tertiary centre including 102 consecutive T2D patients discharged for acute HF without contraindication for SGLT2 inhibitors. We compared adverse clinical events (HF rehospitalization and cardiovascular death) and NT-ProBNP changes according to canagliflozin prescription at discharge. Results: Among the 102 patients included, 45 patients (44.1%) were prescribed canagliflozin and the remaining 57 (55.9%) were not prescribed any SGLT2 inhibitors (control group). After a median follow-up of 22 months, 45 patients (44.1%) were hospitalized for HF. Most of the rehospitalizations occurred during the first year (37.3%). HF readmission at first year occurred in 10 patients (22.2%) in the canagliflozin group and 29 patients (49.1%) in the control group (hazard ratio (HR): 0.45; 95% confidence interval (CI): 0.21–0.96; p < 0.039). A composite outcome of hospitalization for HF or death from cardiovascular causes was lower in the canagliflozin group (37.8%) than in the control group (70.2%) (HR: 0.51; 95% CI: 0.27–0.95; p < 0.035). Analysis of NT-ProBNP concentration showed an interaction between canagliflozin therapy and follow-up time (p = 0.002). Conclusions: Canagliflozin therapy at discharge was associated with a lower risk of readmission for HF and a reduction in NT-ProBNP concentration in patients with diabetes after hospitalization for HF.

Gamma-oryzanol Ameliorates Insulin Resistance and Hyperlipidemia in Rats with Streptozotocin/nicotinamide-induced Type 2 Diabetes

2010 ◽  
Vol 80 (1) ◽  
pp. 45-53 ◽  
Author(s):  
Hsing-Hsien Cheng ◽  
Chien-Ya Ma ◽  
Tsui-Wei Chou ◽  
Ya-Yen Chen ◽  
Ming-Hoang Lai
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Lipid Metabolism ◽  
Rice Bran Oil ◽  
Area Under The Curve ◽  
Density Lipoprotein ◽  
Negative Influence ◽  
Control Group ◽  
Gamma Oryzanol

Gamma-oryzanol is a component of rice bran oil (RBO) with purported health benefits. This study evaluated the effects of gamma-oryzanol on insulin resistance and lipid metabolism in Wistar rats with type 2 diabetes (T2DM). The rats were divided into three groups and consumed one of the following diets for 5 weeks: 15 % soybean oil (control group); 15 % palm oil (PO); and 15 % PO with the addition of 5.25 g gamma-oryzanol (POO). The results showed that PO markedly increased plasma low-density-lipoprotein cholesterol, plasma triglycerides, and hepatic triglyceride levels, but did not reduce the area under the curve for glucose and insulin significantly, compared with the control group. Adding gamma-oryzanol to PO improved the negative influence of PO on lipid metabolism in T2DM rats. In addition, gamma-oryzanol tended to increase insulin sensitivity in T2DM rats compared to control and PO groups. Longer-term studies are needed to evaluate these effects further.

scholarly journals THE USE OF A VITAMIN-MINERAL COMPLEX IN THE COMBINED THERAPY OF PATIENTS WITH OBESITY AND TYPE 2 DIABETES MELLITUS: A CLINICAL TRIAL

2021 ◽  
Vol 22 (1) ◽  
pp. 60-71
Author(s):  
I.A. Lapik ◽  
◽  
K.M. Gapparova ◽  
A.V. Galchenko ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Combined Therapy ◽  
Clinical Manifestations ◽  
Micronutrient Deficiency ◽  
The Body ◽  
Control Group ◽  
Mineral Complex ◽  
Patients With Diabetes

Low caloric diet is used in the complex treatment of patients with diabetes mellitus and obesity. However, the reduced caloric food can inadvertently lead to decreased intake of micronutrients. The main goal of the research was to assess the necessity and effectiveness of the vitamin-mineral complex in the treatment of type 2 diabetes with obesity. Methods: 80 females suffering from type 2 diabetes and obesity, ranging from 40 to 65 years old participated in the study. The total patients were divided into two groups, each containing 40 patients. All patients were given a personalized diet and 1000mg of metformin every day. The experimental group, besides that, received vitamin-mineral complex. The biochemical analysis of the blood, composition of the body, and the complaint on micronutrient deficiency were taken before the experiment and after 14 days of the therapy. Results: Supplementation of the vitamin-mineral complex was associated with higher blood serum levels of vitamins B6, B12, B9, C, D, potassium, calcium, magnesium and zinc, and lower levels of glucose. Clinical manifestations, associated with micronutrient deficiency, were significantly decreased in patients who were given vitamin-mineral complex. All these changes were valid both in relation to the initial level in the study group and to the indicators after treatment in the control group. Conclusion: Micronutrient supplements may be a very important part of the combined therapy of patients with diabetes mellitus and obesity.

scholarly journals Parameters of cardiac hemodynamics in patients with diabetes mellitus with impairment of renal function

HYPERTENSION ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 5-10
Author(s):  
I.I. Topchiy ◽  
O.N. Kirienko ◽  
P.S. Semyonovykh ◽  
D.O. Kirienko ◽  
O.I. Tsygankov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Renal Function ◽  
Structural Parameters ◽  
Left Ventricular ◽  
Control Group ◽  
Group I ◽  
Patients With Diabetes

Currently, diabetes mellitus (DM) is a complex global problem, which is increasing every year. So, in 2019, diabetes mellitus was detected in 463 million adults (from 20 to 79 years old) in the world. And the main cause of death in patients with diabetes mellitus is cardiovascular complications. The study was aimed investigate the features of functional and structural changes in the heart in patients with type 2 diabetes mellitus and nephropathy. A total of 98 patients with type 2 diabetes mellitus were examined, out of which 78 patients had diabetic nephropathy (DN) of varying severity. The control group consisted of 20 healthy patients. After a clinical examination, depending on the state of renal function, all patients were divided into the following groups: group I — patients with type 2 diabetes mellitus without signs of nephropathy (n = 36), group II — patients with type 2 diabetes mellitus with normal glomerular filtration rate (GFR) and albuminuria (n = 33), group III — patients with type 2 diabetes mellitus with decreased GFR and albuminuria (n = 29). To study changes in hemodynamics and structural parameters of the heart, patients underwent transthoracic echocardiography on an ULTIMA PA ultrasound machine (Radmir, Ukraine) using a sectoral phased transducer with a frequency range of 2–3 MHz according to the standard technique based on the recommendations of the American Echocardiographic Society. To determine indexing indicators, the patients underwent anthropometric measurements. Patients with DN and albuminuria and decreased GFR showed an increase in the linear dimensions of the heart in comparison with controls and patients without signs of nephropathy. With DN, patients have a significant increase in left ventricular mass and a significant increase in the detection rate of left ventricular hypertrophy up to 91.3 % in patients with albuminuria and preserved renal function and up to 100 % with a decrease in GFR.

FIBROBLAST GROWTH FACTOR 21 FROM THE PERSPECTIVE OF A PROMISING MARKER OF METABOLIC DISORDERS AND PREMATURE AGING IN POLYMORBID CARDIOVASCULAR PATHOLOGY IN YOUNG AND MIDDLE-AGED PEOPLE

2020 ◽  
Vol 4 (2) ◽  
pp. 1002-1005
Author(s):  
G.A. Proshchai ◽  
◽  
S.V. Dudarenko ◽  
A.S. Partcerniak ◽  
E.Yu. Zagarskikh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Disorders ◽  
Premature Aging ◽  
Fibroblast Growth Factor 21 ◽  
Control Group ◽  
Middle Aged ◽  
Cardiovascular Pathology ◽  
Aged People ◽  
Carbohydrate And Lipid Metabolism

Objective: To evaluate the possibility of using fibroblast growth factor 21 (FGF 21) as a marker of metabolic disorders and premature aging in polymorbid cardiovascular pathology. Research methods: 199 men aged 35-55 years who were stratified into 3 groups were examined: group A - 117 patients with type 2 diabetes mellitus (type 2 diabetes), polymorbid cardiovascular disease (PCVD), obesity, androgen deficiency and anxiety-depressive disorders (ADD); group B - 55 patients with PCVD, obesity and ADD; group C - control group (n = 27). The examination of patients included a laboratory study of the level of FGF 21, indicators of carbohydrate and lipid metabolism, hormonal status, as well as daily monitoring of blood pressure and ECG. Results and conclusions. When compared with the control group, the level of FGF 21 was 3 times higher in the presence of type 2 diabetes. The most intense increase in FGF 21 levels was observed in groups of patients with several diseases. An increase in the level of FGF 21 in young and middle-aged people is probably due to a compensatory reaction to the existing androgen deficiency, disorders of carbohydrate and lipid metabolism. Strong correlations between FGF 21 and glucose, HDL cholesterol, total testosterone, ALT, and SBP during the day allow FGF 21 to be considered an early marker of cardiovascular disease and premature aging (PA) in young and middle-aged people

scholarly journals Treatment of Heart Failure with Sodium-Glucose Cotransporter 2 Inhibitors and Other Anti-diabetic Drugs

2019 ◽  
Vol 5 (1) ◽  
pp. 27-30 ◽  
Author(s):  
Thomas A Zelniker ◽  
Eugene Braunwald
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Renal Failure ◽  
Cardiovascular Death ◽  
Cardiovascular Outcomes ◽  
Sodium Glucose Cotransporter ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Glucagon Like Peptide 1

Patients with type 2 diabetes are at increased risk of developing heart failure, cardiovascular death and renal failure. The recent results of three large sodium-glucose cotransporter 2 inhibitor cardiovascular outcomes trials have demonstrated a reduction in heart failure hospitalisation and progressive renal failure. One trial also showed a fall in cardiovascular and total death. A broad spectrum of patients with diabetes benefit from these salutary effects in cardiac and renal function and so these trials have important implications for the management of patients with type 2 diabetes. Selected glucagon-like peptide 1 receptor agonists have also been shown to reduce adverse cardiovascular outcomes.

scholarly journals Beneficial effects of green banana biomass consumption in patients with pre-diabetes and type 2 diabetes: a randomised controlled trial

2019 ◽  
Vol 121 (12) ◽  
pp. 1365-1375 ◽  
Author(s):  
Edna S. Costa ◽  
Carolina N. França ◽  
Francisco A. H. Fonseca ◽  
Juliana T. Kato ◽  
Henrique T. Bianco ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Composition ◽  
Metabolic Disorders ◽  
Fasting Glucose ◽  
Controlled Trial ◽  
Density Lipoprotein ◽  
Model Assessment ◽  
Mass Percentage ◽  
Green Banana

AbstractDiabetes mellitus is a global epidemic, characterised as a heterogeneous group of metabolic disorders associated with high risk of CVD. Green banana biomass, which is composed of resistant starches (RS) and cannot be hydrolysed by amylases, delays gastric emptying and modulates insulin sensitivity, thus contributing to improve metabolic disorders. The aim of the present study was to investigate the effects of consumption of RS from green banana biomass on body composition, fasting plasma glucose, glycated Hb (HbA1c) and homeostasis model assessment of insulin resistance in subjects with pre-diabetes or type 2 diabetes on top of treatment. Middle-aged subjects (n113) of both sexes with pre-diabetes (HbA1c: 5·7–6·4 %) or diabetes (HbA1c ≥ 6·5 %) were randomised to receive nutritional support plus green banana biomass (40 g) (RS: approximately 4·5 g, G1,n62) or diet alone (G2,n51) for 24 weeks. Body composition, biochemical analyses and dietary intake were evaluated at the beginning and end of the study. In the experimental group (G1), consumption of RS was associated with reduction in HbA1c (P= 0·0001), fasting glucose (P= 0·021), diastolic blood pressure (P= 0·010), body weight (P= 0·002), BMI (P= 0·006), waist and hip circumferences (P< 0·01), fat mass percentage (P= 0·001) and increase in lean mass percentage (P= 0·011). In controls (G2), reductions were observed in waist and hip circumferences (P< 0·01), HbA1c (P= 0·002) and high-density lipoprotein-cholesterol (P= 0·020). In pre-diabetes or diabetes, non-significant differences were observed in the percentage reduction in HbA1c and fasting glucose in exploratory analyses. Our results indicate that the consumption of bioactive starches is a good dietary strategy to improve metabolic control and body composition.

scholarly journals Postprandial Blood Pressure Decrease in Patients with Type 2 Diabetes and Mild or Severe Cardiac Autonomic Dysfunction

2019 ◽  
Vol 16 (5) ◽  
pp. 812
Author(s):  
Masahiko Hashizume ◽  
Saori Kinami ◽  
Keiichi Sakurai ◽  
Kazuhiro Izawa ◽  
Hideyuki Shiotani
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Systolic Blood Pressure ◽  
Autonomic Dysfunction ◽  
Control Group ◽  
Cardiac Autonomic Dysfunction ◽  
Patients With Diabetes ◽  
Severe Group ◽  
Meal Ingestion

Background Few reports have evaluated the relationship between changes in postprandial blood pressure and the severity of autonomic dysfunction in patients with type 2 diabetes. This was a cross-sectional study designed to investigate postprandial blood pressure changes in individuals without type 2 diabetes and patients with type 2 diabetes and mild or severe cardiac autonomic dysfunction. Methods Forty patients with type 2 diabetes mellitus and 20 individuals without type 2 diabetes participated in this study. Fifty-two participants underwent a meal tolerance test. Blood pressure (brachial systolic blood pressure (bSBP) and central systolic blood pressure (cSBP)), electrocardiogram recordings, and blood samples were assessed before and after meal ingestion. Patients with diabetes were divided into two groups based on their coefficient of variation of R–R intervals (CVRR): a normal or mildly dysfunctional group (mild group, CVRR ≥ 2%; n = 20) and a severely dysfunctional group (severe group, CVRR < 2%; n = 15). Results In the control group, bSBP and cSBP did not significantly change after meal ingestion, whereas both decreased significantly at 60 min after meal ingestion in the mild and severe groups. While blood pressure recovered at 120 min after meal ingestion in the mild group, a significant decrease in blood pressure persisted at 120 min after meal ingestion in the severe group. Conclusions Based on these results, adequate clinical attention should be paid to the risk of serious events related to postprandial decreases in blood pressure, particularly in patients with diabetes and severe cardiac autonomic dysfunction.

Antidiabetic properties of purified polysaccharide fromHedysarum polybotrys

2010 ◽  
Vol 88 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Fangdi Hu ◽  
Xiaodong Li ◽  
Lianggong Zhao ◽  
Shilan Feng ◽  
Chunming Wang
Keyword(s):  
Nitric Oxide ◽  
Type 2 Diabetes ◽  
Fatty Acid ◽  
Density Lipoprotein ◽  
Control Group ◽  
Hepatic Glycogen ◽  
Oral Glucose ◽  
Synthetase Activity ◽  
Molecular Weight Range

Hedysarum polybotrys polysaccharide (HPS) is the principal active fraction responsible for the antidiabetic properties of this species. The aim of this study was to determine the antidiabetic properties of 4 purified fractions of different molecular weight range HPSs (HPS1, HPS2, HPS3, HPS4). HPS3 was selected for examination of its hypoglycemic mechanism because of its significant hypoglycemic effect in alloxan-induced diabetic mice. The changes in blood glucose levels and oral glucose tolerance tests (OGTT) showed that hypoglycemia was more pronounced in HPS3-treated groups than in the diabetes mellitus model (DM) control group. The interleukin-6, tumor necrosis factor-α, leptin, and free fatty acid levels were significantly lower in the HPS3-treated groups and HPS3 + metformin (HPS3+MET) group than in the DM control group, while plasma insulin, hepatic glycogen, superoxide dismutase, and nitric oxide synthetase activity were significantly higher. Treatment with HPS3 or HPS3+MET also significantly lowered malonaldehyde levels compared with the DM control group, while it elevated the nitric oxide and total antioxidant capacity. HPS3 altered the plasma lipid levels by lowering cholesterol and triglyceride concentrations, while elevating the plasma high-density lipoprotein cholesterol level. Therefore, these results suggest that HPS3 may partly ameliorate hyperglycemia and hyperlipidemia associated with type 2 diabetes through increased insulin secretion, inhibition of lipid peroxidation, promotion of sensitivity to insulin, suppression of gluconeogenesis and reduction in the biosynthesis fatty acid, cholesterol and cell cytokines related to insulin resistance, and it could be a useful adjunct therapy to a proven first-line therapy for type 2 diabetes using metformin.

Pharmacist-Led Group Medical Appointments for the Management of Type 2 Diabetes with Comorbid Depression in Older Adults

2011 ◽  
Vol 45 (11) ◽  
pp. 1346-1355 ◽  
Author(s):  
Tracey H Taveira ◽  
Andrea G Dooley ◽  
Lisa B Cohen ◽  
Sameed Ahmed M Khatana ◽  
Wen-Chih Wu
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Standard Care ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Depression Symptoms ◽  
Multidisciplinary Education ◽  
Patients With Diabetes

Background:: Depression is associated with poor glycemic control, increased number of microvascular and macrovascular complications, functional impairment, mortality, and 4.5 times higher total health care costs in patients with diabetes. Shared medical appointments (SMAs) may be an effective method to attain national guideline recommendations for glycemic control in diabetes for patients with depression through peer support, counseling, problem solving, and improved access to care. Objective: To test the efficacy as assessed by attainment of a hemoglobin A1c (A1C) <7% of pharmacistted group SMA visits, Veterans Affairs Multidisciplinary Education in Diabetes and Intervention for Cardiac Risk Reduction in Depression (VA-MEDIC-D), in patients with type 2 diabetes mellitus. Methods: This was a randomized controlled trial of VA-MEDIC-D added to standard care versus standard care alone in depressed patients with diabetes with A1C >6.5%. VA-MEDIC-D consisted of 4 once-weekly, 2-hour sessions followed by 5 monthly 90-minute group sessions. Each SMA session consisted of multidisciplinary education and pharmacist-led behavioral and pharmacologic interventions for diabetes, lipids, smoking, and blood pressure. No pharmacologic interventions for depression were provided. The change in the proportion of participants who achieved an A1C <7% at 6 months was compared. Results: Compared to standard care (n = 44), a lower proportion of patients in VA-MEDIC-D (n = 44) had systolic blood pressure (SBP) <130 mm Hg at baseline, but were similar in other cardiovascular risk factors and psychiatric comorbidity. The change in the proportion of participants achieving an A1C <7% was greater in the VA-MEDIC-D arm than in the standard care arm (29.6% vs 11.9%), with odds ratio 3.6 (95% CI 1.1 to 12.3). VA-MEDIC-D participants also achieved significant reductions in SBP, low-density lipoprotein cholesterol, and non–high-density lipoprotein (HDL) cholesterol from baseline, whereas significant reductions were attained only in non–HDL cholesterol with standard care. There was no significant change in depressive symptoms for either arm. Conclusions: Pharmacist-led group SMA visits are efficacious in attainment of glycemic control in patients with diabetes and depression without change in depression symptoms.

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