scholarly journals Prevalence of Hearing Loss in Type 2 Diabetes Mellitus and Its Association with Severity of Diabetic Neuropathy

2022 ◽  
Author(s):  
Abin M Abraham ◽  
Ashish Varghese ◽  
Jubbin Jagan Jacob
Keyword(s):  
Type 2 Diabetes ◽  
Hearing Loss ◽  
Diabetic Neuropathy ◽  
Hearing Threshold ◽  
Self Report ◽  
Increased Risk ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Purpose This study assessed the prevalence of hearing loss (HL) in patients with Type 2 Diabetes (T2DM) and its relationship with the presence and severity of diabetic neuropathy. Methods Patients between the ages of 30 to 60 years (both ages inclusive) with T2DM were recruited and divided into three groups. Group 1 included patients without neuropathy. Group 2 had patients with mild neuropathy. Group 3 had patients with moderate and severe neuropathy. After informed consent hearing threshold was assessed using pure tone audiometry (PTA). Results Of the 200 patients recruited, the prevalence of hearing loss was overall 81%. The prevalence was 66.7% in group 1, 80.9% in group 2 and 87.6% in group 3 (p=0.009). Among patients with moderate to severe neuropathy (group 3) 33.3% had clinically significant hearing loss (p=0.015). Age, gender, presence of neuropathy and severity of neuropathy were associated with increased risk of developing hearing loss. Severity of hearing loss worsened with increase in severity of neuropathy. Conclusions Age, gender and severity of neuropathy were associated with increased risk of developing hearing loss. Screening for hearing loss in patients with moderate to severe diabetic neuropathy using self-report questionnaires can help in timely diagnosis and treatment.

scholarly journals Comparing the effect of ladies’ finger water with fenugreek seeds water on the blood glucose level among subjects with type 2 diabetes mellitus-a randomized controlled trial

2021 ◽  
Vol 8 (1) ◽  
pp. 10
Author(s):  
Radhika R. ◽  
Navaneetha M. ◽  
Ravichandran K. ◽  
Hemavathi P.
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Fenugreek Seeds ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

<p><strong>Background: </strong>The primary aim of managing diabetes is to maintain blood glucose level to prevent diabetes induced complications. Studies showed that ladies finger and fenugreek seeds are blood sugar stabilizer. The objective of this randomized active controlled trial was to assess the effect of ladies finger water versus fenugreek seeds water on the blood glucose level among subject with type 2 diabetes.</p><p><strong>Methods: </strong>Total of 180 study participants were selected and equally assigned to three groups by computer generated randomization. Group 1-received ladies finger water and oral antidiabetic drug (OAD); group 2-received fenugreek seeds water and OAD; group 3-received only OAD for 15 days. Pre and post intervention fasting blood sugar (FBS) was assessed by accu-chek Performa glucometer. Wilcoxon signed rank test; one-way analysis of covariance followed by post hoc test with Bon-ferroni correction was done.</p><p><strong>Results: </strong>Analysis was done based on 168 subjects. There was a significant reduction in FBS level with the mean difference of group 1-21.0 mg/dl (p&lt;0.001), group 2-20.3 mg/dl (p&lt;0.001) and group 3-4.7 mg/dl (p=0.068). No significant difference found between group 1 and group 2 (p=1.00), but significant difference found between group 1 and group 3 (p=0.032); group 2 and group 3 (p=0.012). Both ladies finger water and fenugreek seeds water were superior in reduction of FBS than OAD.</p><p><strong>Conclusions: </strong>Ladies finger water or fenugreek seeds water can be used as adjunct along with OAD to control type 2 diabetes mellitus.</p><p><strong> </strong></p>

scholarly journals Lesions of paired eyes at the initial stages of non-proliferative diabetic retinopathy in patients with type 2 diabetes mellitus

2021 ◽  
Vol 9 (1) ◽  
pp. 21-27
Author(s):  
S.O. Rykov ◽  
K.V. Korobov ◽  
S.Yu. Mogilevskyy
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Vascular Anomalies ◽  
Vascular Changes ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background. One of the early microvascular complications of type 2 diabetes mellitus (T2DM) is diabetic retino­pathy (DR). Its main cause is prolonged hyperglycemia, which triggers the development of microangiopathy. In this regard, the issue of damage to paired eyes and the spread of DR in the initial stages has not been fully clarified. The purpose: to study the peculiarities of lesions of paired eyes at the initial stages of non-proliferative diabetic retinopathy in patients with type 2 dia­betes mellitus. Materials and methods. We examined 91 patients with T2DM (182 eyes), who did not have retinopathy according to the International Diabetic Retinopathy Severity Scale of the American Academy of Ophthalmology (2002). Paired eyes were divided into three groups: group 1 included 132 paired eyes (66 patients) with 10 points according to the Early Treatment Diabetic Retinopathy Group Study (ETDRS); group 2 consisted of 25 eyes with 10 points on ETDRS, and group 3 — 25 paired eyes with retinal vascular anomalies (14–15 points on ETDRS). The patients were examined again after 1 year. According to the ETDRS, Airlie House classification, microaneurysms, microhemorrhages, intraretinal microvascular abnormalities, retinal vascular abnormalities, and retinal nonperfusion were detec­ted. Results. The majority (58.3 %) of paired eyes without initial changes (group 1) had no progression of DR within 1 year, 12.9 % had vascular anomalies (14–15 points on ETDRS), 13.6 % deve­loped mild, and 15.2 % — moderate non-proliferative DR. The highest progression of DR (88.0 % of eyes) was observed in eyes without diabetic vascular changes, which were paired to eyes with such changes (group 2) that was 2.1 times (p < 0.001) higher than the indicator of paired eyes without diabetic changes (group 1; 41.7 %). Most eyes that had mild vascular changes (group 3) progressed to moderate non-proliferative DR after 1 year, which was four times more often than in eyes that had no initial changes (60.0 versus 15.2 %; p < 0.001). DR in the eyes of group 3 with progression accounted for 43–47 points on EDTRS; the visual acuity of these eyes, both before and after 1 year, was significantly lower than in other groups, and the level of glycated hemoglobin in the blood of patients with such eyes was significantly higher. Conclusions. This study established the features of the progression of early stages of DR in patients with T2DM, and the significance of primary retinal vascular anomalies in the presence of which the progression of DR was faster.

Phenylthiocarbamide Taste Perception among Patients with Type 2 Diabetes Mellitus

2019 ◽  
pp. 1-5
Author(s):  
C. Igbeneghu ◽  
J. M. Olisekodiaka ◽  
J. A. Onuegbu ◽  
O. H. Oyeyode
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Taste Perception ◽  
Taste Sensitivity ◽  
Type 2 Dm ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim: To determine whether Phenylthiocarbamide (PTC) taste blindness is associated with type 2 Diabetes Mellitus (DM) and possible relationship between intake of treatment medications and PTC taste sensitivity. Methodology: The study participants consisted of 100 type 2 DM patients on treatment (group 1) and 100 newly diagnosed type 2 DM patients not on drugs treatment (group 2). Apparently healthy individuals (100) served as controls (group 3). Informed consent was obtained from each participant at the commencement of the study. Tasters and non-tasters were determined using phenylthiocarbamide (PTC) taste strips (0.0143 mg/strip). Results: In group 1, 66% were non-tasters; in group 2, 60% were non-tasters while 37% in group 3 were non-tasters. Phenylthiocarbamide taste perception varied significantly among the 3 groups studied (p < 0.001). Non-tasters of PTC in groups 1 and 2 were not significantly different (p = 0.38). Non-tasters of PTC in groups 1 and 2 (p < 0.001; OR 3.30 and p = 0.001; OR 2.55 respectively) were significantly higher than non-tasters in the control (group 3). Conclusion: This study shows that inability to taste PTC is associated with type 2 DM. However, intake of DM treatment medications does not appear to have any significant influence on PTC taste sensitivity.

Combined Ayurveda and Yoga Practices for Newly Diagnosed Type 2 Diabetes Mellitus: A Controlled Trial

2017 ◽  
Vol 25 (1) ◽  
pp. 16-23
Author(s):  
Purnima Datey ◽  
Alex Hankey ◽  
H.R. Nagendra
Keyword(s):  
Type 2 Diabetes ◽  
Blood Sugar ◽  
Controlled Trial ◽  
Newly Diagnosed ◽  
Post Intervention ◽  
Group 3 ◽  
Group 2 ◽  
Male Prisoners ◽  
Group 1

Background: The increasing prevalence of type 2 diabetes in India is a cause for national concern, particularly the spiraling cost burden to the country. As one approach to stop its increase, Yoga medicine has been widely implemented, finding popularity with all social strata. Here, we report a study suggesting that treatment with fresh herbal juices and Yoga can improve the levels of blood glucose and hemoglobin A1c (HbA1c) in people with pre-diabetes. Methods: Study design: 3-arm controlled trial 3 months in duration. Participants: 157 male prisoners with newly diagnosed, high fasting blood sugar (FBS) and postprandial blood sugar (PPBS) levels. Group interventions: (1) Rasahara and Yoga, (2) Yoga, (3) no intervention. Assessments: FBS and PPBS levels were measured every 2 weeks; HbA1c and blood lipids were determined pre- and post-intervention. Results: Significant decreases occurred in the FBS (-21.13 ± 21.16 mg/dl) and PPBS levels (-15.02 ± 14.89 mg/dl) in group 1 (both p < 0.0001) and in the FBS level (20.62 ± 32.68 mg/dl) in group 2 (p = 0.0005), while the increases in group 3 attained significance only for the PPBS level (9.62 ± 21.83 mg/dl) (p = 0.0022). Observed changes in HbA1c were: group 1, -0.044 ± 0.059 mg/dl; group 2, +0.024 ± 0.456 mg/dl (not significant); and group 3, +0.365 ± 0.369 mg/dl (p < 0.0001). Conclusions: This study of Yoga for the treatment of diabetes shows that all male prisoners could benefit from the Yoga prison programs. Addition of Yoga programs to state and federal activities at all levels is now national policy in India. Follow-up studies should be carried out to obtain more robust results.

scholarly journals Renal status in elderly patients with type 2 diabetes

2019 ◽  
Vol 24 (1) ◽  
pp. 53-62 ◽  
Author(s):  
Kazunaga Takamatsu
Keyword(s):  
Type 2 Diabetes ◽  
Elderly Patients ◽  
The Elderly ◽  
Albumin Level ◽  
Diabetic Macroangiopathy ◽  
Patients With Diabetes ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background In Japan, there has been a remarkable increase in the incidence of type 2 diabetes in elderly patients. This study aimed to clarify the renal status in elderly patients with type 2 diabetes. Participants and methods There were 978 patients with type 2 diabetes who were classified into three groups: Group 1 (aged < 65 years of age), Group 2 (65–74 years of age), and Group 3 (≥ 75 years of age). Estimated glomerular filtration rate (eGFR) and urinary albumin level were measured. Moreover, the frequencies of each stage of chronic kidney disease for each group were determined, and differences among the three groups were analyzed. Results The mean eGFR in Group 3 was 63.2 ± 19.1 mL/min/1.73 m2, which was lower than those in Group 1 (83.3 ± 22.8 mL/min/1.73 m2) and Group 2 (72.0 ± 19.4 mL/min/1.73 m2). The percentage of low eGFR (< 60 mL/min/1.73 m2) with normo- and microalbuminuria in Group 3 was 31.9%, which was higher than the percentages observed in Group 1 (7.1%) or Group 2 (16.1%). Diabetic macroangiopathy was frequently observed in these patients. The frequency of low eGFR with proteinuria was 10.2%. In this group, diabetic micro- and macroangiopathies were frequently noted. Conclusion In elderly patients with type 2 diabetes, renal dysfunction is characterized by low eGFR with normo- and microalbuminuria. In this group, macroangiopathy was more common than microangiopathy. The elderly patients with diabetes with low eGFR with proteinuria frequently had micro- and macroangiopathies.

scholarly journals Effect of visceral obesity on main artery elasticity and vascular age in patients with hypertension, obesity, and type 2 diabetes

2021 ◽  
Vol 26 (4) ◽  
pp. 4466
Author(s):  
M. E. Statsenko ◽  
M. V. Derevyanchenko
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Events ◽  
Visceral Obesity ◽  
Main Artery ◽  
Group 4 ◽  
Vascular Age ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. To assess the effect of visceral obesity on main artery elasticity and vascular age in patients with hypertension (HTN), obesity, and type 2 diabetes (T2D).Material and methods. A total of 320 patients with stage II-III HTN aged 4570 years were divided into 4 groups: isolated HTN (group 1), HTN and obesity (group 2), HTN, obesity and T2D (group 3), HTN and T2D without obesity (group 4). We assessed the clinical status, parameters of visceral obesity, main artery elasticity, and vascular age. We used nonparametric statistics, Spearman correlation analysis.Results. At least 50% of all patients had visceral obesity, despite no BMI-estimated obesity in groups 1 and 4: 57,5 vs 100,0 vs 100,0 vs 50,0% in groups 1, 2, 3 and 4, respectively (p<0,0001).In the groups where hypertension was combined with obesity and T2D, the proportion of patients with leptin content above 32,7 ng/ml significantly increased to 80% (in total for groups 2 and 3) compared with 25,0% among HTN people without obesity (in total for groups 1 and 4). There was a significant increase in proportion of patients with a adiponectin decrease <14,6 ng/ml among patients with a combination of HTN and T2D ± obesity (45% in total for groups 3 and 4) in comparison with those with HTN and without T2D ± obesity (22,5% in total for groups 1 and 2).The visceral adiposity index (VAI) was significantly higher among patients with HTN, obesity and T2D compared with those with isolated HTN and HTN in combination with T2D only (2,96 [2,36; 3,98] vs 1,87 [1,40; 2,67] vs 2,22 [1,61; 3,26], respectively). A higher proportion of subjects with adipose tissue dysfunction was noted in groups 2 and 3 compared to groups 1 and 4 (75 vs 81,1 vs 41,5 vs 53,4%, respectively, p1-2<0,001, p1-3<0,001, p2-4=0,023, p3-4=0,002).The proportion of patients with a pulse wave velocity >10 m/s was consistently more common among patients of group 3 compared with patients in groups 1 and 2 (77,0 vs 57,9 and 55,3%, respectively, p1-3=0,004, p2-3=0,006).Vascular age was significantly lower in group 1 compared with groups 3 and 4 (64,0 [57,8; 71,0] vs 69,0 [62,0; 73,0] and 69,5 [66,0; 74,3] years, respectively), as well as in group 2 compared with group 4 (64,0 [56,5; 70,5] vs 69,5 [66,0; 74,3] years). The 5-year risk of cardiovascular events was significantly higher among patients with hypertension, obesity and T2D and those with HTN and T2D without obesity, compared with patients with isolated HTN, and with those with HTN and obesity (5,9 [3,9; 7,9] and 6,5 [4,7; 8,7] vs 4,4 [2,7; 6,8] and 3,6 [2,4; 5,8], respectively). Correlation analysis revealed the relationship between the visceral obesity parameters, main artery elasticity, vascular age and the 5-year risk of cardiovascular events, demonstrating the special aspects of HTN course in each of the studied groups.Conclusion. The paper showed peculiarities of the effect of visceral obesity on main artery elasticity and vascular age in patients with HTN in combination with obesity and T2D.

scholarly journals Study of neutrophil lymphocyte ratio in patients with type 2 diabetes mellitus and its correlation with glycemic control

2019 ◽  
Vol 6 (5) ◽  
pp. 1637
Author(s):  
Devamsh G. N. ◽  
Parvathi M. ◽  
Madhumathi R. ◽  
Leela Raghavan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Neutrophil lymphocyte ratio (NLR) is an indicator of subclinical inflammation. Subclinical inflammation may be associated with increased cardiovascular risk. Raised NLR is associated with metabolic syndrome and is found to be a predictor of cardiovascular disorders. There are only few studies assessing the correlation between NLR and glycemic control. The aim of the present study is to investigate the relationship between NLR and glycemic control in type 2 diabetes patients.Methods: This observational study was conducted in Department of Medicine, Bangalore medical college. 100 patients diagnosed to have type 2 diabetes mellitus were assessed. They were divided into three groups based upon HbA1c levels: Group 1, HbA1c ≤7%; group 2, HbA1c 7-9%, and group 3, HbA1c>9%. Complete blood count and other relevant investigations were performed. SPSS software was used for statistical analysis. T test was used for continuous variables and chi square test for categorical variables. ANOVA test was used to compare three groups. A p value of <0.05 was considered statistically significant.Results: Out of 100 patients, the white blood cell count (WBC count) was higher in group 3 as compared to group 1 and group 2(p 0.008). Similarly, the absolute neutrophil count was higher in group 3 as compared to group 1 and group 2(p.017). The neutrophil lymphocyte ratio (NLR) was significantly higher in group 3 as compared with group 1 and group 2(p.009). NLR had a positive correlation with HbA1c and was found to be an independent predictor of poor glycemic control in patients with type 2 diabetes mellitusConclusions: Our study found a significant positive correlation between NLR and glycemic control. Increased NLR is associated with elevated HbA1c and poor glycemic control. Type 2 diabetes mellitus patients with raised NLR should be evaluated for cardiovascular, renal and ocular complications of diabetes.

Effect of microalbuminuria on macular thickness in patients with type-2 diabetes mellitus

2018 ◽  
Vol 30 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Cemile Ucgul Atilgan ◽  
Kadir Gokhan Atilgan ◽  
Pinar Kosekahya ◽  
Mehtap Caglayan ◽  
Selam Yekta Sendul ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Macular Thickness ◽  
Serum Urea ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Purpose: To investigate the effect of microalbuminuria on macular thickness in patients with type-2 diabetes mellitus with no or mild diabetic retinopathy and to investigate the relationship between macular thickness and metabolic parameters. Materials and methods: Fifty eight eyes of 58 patients without diabetic retinopathy (group 1) in microalbuminuria stage, 42 eyes of 42 patients with mild diabetic retinopathy (group 2) in microalbuminuria stage, and 50 eyes of 50 patients without diabetic retinopathy and microalbuminuria (group 3) were included in this study. After detailed ophthalmologic examination, all patients underwent spectral domain-optical coherence tomography measurements. Macular thickness was noted from nine different areas (fovea, four parafoveal, and four perifoveal areas) and compared between groups. The correlations between macular thickness and age, duration of diabetes mellitus, microalbuminuria, serum urea, creatinine, glycosylated hemoglobin (HbAIc), albumin, sodium (Na), and urinary Na were evaluated. Results: The mean age was 53.29 ± 6.49 in group 1, 55.86 ± 6.97 in group 2, and 52.98 ± 5.66 years in group 3 (p = 0.06). The macular thickness values of superior, inferior, and nasal parafoveal areas were significantly different between groups (p = 0.001, p = 0.006, and p = 0.03, respectively). Bonferroni post test revealed that this difference originated from the difference between group 2 and 3 (p < 0.05 for all values). There were significant negative correlations between the macular thickness values of parafoveal areas and serum urea, HbA1c, albumin, microalbuminuria levels (p < 0.05 for all values). Conclusion: In this study, a significantly decreased parafoveal macular thickness was measured in patients with mild diabetic retinopathy and microalbuminuria compared to patients without diabetic retinopathy and microalbuminuria.

EVALUATION OF SERUM INTERLEUKIN-10 LEVELS AS A BIOMARKER OF GLYCEMIC ALTERATION IN CHRONIC PERIODONTITIS AND TYPE 2 DIABETES MELLITUS: BIO-CHEMICAL STUDY

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Aditi Yadav ◽  
Pradeep Shukla ◽  
Varun Dahiya ◽  
Gaurav Malhotra ◽  
Prerna Kataria ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Chronic Periodontitis ◽  
Glycosylated Hemoglobin ◽  
Interleukin 10 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim: Chronic periodontal disease (CPD) and type 2 diabetes mellitus (T2DM) share common pathogenic pathways. This study was aimed to estimate levels the of serum interleukin (IL?10), an anti?inflammatory cytokine also associated with T2DM and evaluate its association with hyperglycemia. Materials and Methods: This investigation involved seventy five participants (55 males, 20 females, 30-55 age group) divided into three groups comprising 25 participants each: Group 1 (healthy controls), Group 2 (CPD patients) and Group 3 (T2DM patients with CPD) . Plaque index, gingival index, probing pocket depths (PPD), clinical attachment loss, bleeding on probing, random blood sugar, glycosylated hemoglobin (HbA1c), and serum IL?10 was measured. Results: Interleukin?10 was detected in all three groups. Statistically significant (P < 0.05) differences were observed in most of the variables in all groups. IL?10 correlated significantly with PPD in Group 1 and with HbA1c in Group 3. IL?10 levels were lowest in Group 2. Conclusion: Low IL?10 levels associated with high HbA1c. Pathogenic mechanisms of CPD seem to regulate IL?10. Serum IL?10 levels may be one of the predictors of hyperglycemia. Key words: Chronic periodontitis, diabetes mellitus, glycosylated, hemoglobin A, interleukin?10, type 2 diabetes mellitus

scholarly journals Mediterranean Diet and Red Yeast Rice Supplementation for the Management of Hyperlipidemia in Statin-Intolerant Patients with or without Type 2 Diabetes

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Sartore Giovanni ◽  
Burlina Silvia ◽  
Ragazzi Eugenio ◽  
Ferraresso Stefania ◽  
Valentini Romina ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Ldl Cholesterol ◽  
Diabetic Patients ◽  
Red Yeast Rice ◽  
Type 2 Diabetic Patients ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Lipid profile could be modified by Mediterranean diet (MD) and by red yeast rice (RYR). We assessed the lipid-lowering effects of MD alone or in combination with RYR on dyslipidemic statin-intolerant subjects, with or without type 2 diabetes, for 24 weeks. We evaluated the low-density lipoprotein (LDL) cholesterol level, total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, triglyceride, liver enzyme, and creatinine phosphokinase (CPK) levels. We studied 171 patients: 46 type 2 diabetic patients treated with MD alone (Group 1), 44 type 2 diabetic patients treated with MD associated with RYR (Group 2), 38 dyslipidemic patients treated with MD alone (Group 3), and 43 dyslipidemic patients treated with MD plus RYR (Group 4). The mean percentage changes in LDL cholesterol from the baseline were-7.34±3.14% (P<0.05) for Group 1;-21.02±1.63% (P<0.001) for Group 2;-12.47±1.75% (P<0.001) for Group 3; and-22±2.19% (P<0.001) for Group 4 with significant intergroup difference (Group 1 versus Group 2,P<0.001; Group 3 versus Group 4,P>0.05). No significant increase in AST, ALT, and CPK levels was observed in all groups. Our results indicate that MD alone is effective in reducing LDL cholesterol levels in statin-intolerant patients with a presumably low cardiovascular risk, but associating MD with the administration of RYR improves patients’ LDL cholesterol levels more, and in patients with type 2 diabetes.

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