scholarly journals Glycation Markers in the Geriatrics Patients

2021 ◽  
Author(s):  
Aleksandra Kuzan ◽  
Emilia Królewicz ◽  
Irena Kustrzeba-Wójcicka ◽  
Karolina Lindner ◽  
Małgorzata Sobieszczańska
Keyword(s):  
Diabetes Mellitus ◽  
Geriatric Patients ◽  
Scavenger Receptor ◽  
Diagnostic Value ◽  
High Density Lipoproteins ◽  
Diabetic Patients ◽  
Therapeutic Benefits ◽  
Scavenger Receptor Class ◽  
Free Amine ◽  
Patients With Diabetes

Abstract Background: Medical care for geriatric patients is a great challenge, mainly due to overlapping various deficits relevant to physiologic ageing with numerous coexisting diseases, of which the most common are diabetes mellitus and atherosclerosis. In case of diabetes, glycation process is intensified, which accelerates atherosclerosis development and diabetic complications. Our goal was to investigate the relationship between the classical biochemical parameters of diabetes and atherosclerosis (fasting glucose, glycated hemoglobin (HbA1c), low and high density lipoproteins (LDL, HDL), triglycerides, etc.), as well as parameters which may indicate a nephropathy (creatinine, glomerular filtration rate – GFR), and the parameters strictly related to glycation. Methods: We analyzed the patients' serum concentration of fluorescent glycation products, concentration of soluble receptor for advanced glycation products (sRAGE), lipoprotein receptor-1 (LOX-1), galectin 3 (GAL3), scavenger receptor class A (SR-A) and scavenger receptor class B (SR-BI), as well as the level of lipid peroxidation and free amine content. Results: Among the identified correlations, the most interesting are the following : sRAGE with triglycerides (r = 0.47); sRAGE with SR-BI (r=0.47); SR-BI with LOX-1 (r=0.31), and SR-BI with HDL (r=-0.30). It has been shown that pentosidine and fluorescent AGEs as well as reactive free amine contents are significantly higher in elderly patients with ischemic heart disease. Fluorescent AGEs and pentosidine are also significantly higher in patients with arterial hypertension. The influence of diabetes therapy on parameters related to peroxidation and glycation was also analyzed. Malondialdehyde turned to be higher in patients with diabetes mellitus type 2 not treated with insulin or metformin than in those treated with both medications (p=0.052). GAL3 was found to be lower both in persons without diabetes and in diabetics treated with metformin (p=0.005). LOX1 was higher in diabetic patients not treated with metformin or insulin, and lowest in diabetics treated with both insulin and metformin, with the effect of metformin reducing LOX1 levels (p=0.039). Conclusions: Our results were the basis for a discussion about the diagnostic value in clinial practice of LOX-1 and GAL3 in geriatric patients with diabetes and also provide grounds for inferring the therapeutic benefits of insulin and metformin treatment.

scholarly journals Diabetes mellitus and nonalcoholic fatty liver disease: The verges of contingency

2017 ◽  
Vol 89 (2) ◽  
pp. 59-65 ◽  
Author(s):  
I G Bakulin ◽  
Yu G Sandler ◽  
E V Vinnitskayа ◽  
V A Keiyan ◽  
S V Rodionova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Multiple Logistic Regression Analysis ◽  
Diagnostic Value ◽  
Diabetic Patients ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Nonalcoholic Fatty Liver ◽  
Α2 Macroglobulin ◽  
Patients With Diabetes ◽  
Clinically Significant

Aim. To estimate the incidence of hepatic steatosis (HS) and liver fibrosis (LF) in patients with diabetes mellitus (DM), by applying the noninvasive techniques of liver fibroelastometry (LFE) and a battery of fibrotests (FTs); to determine their diagnostic value and to identify factors influencing the development of LF. Subjects and methods. A comprehensive examination was made in 82 diabetic patients (mean age, 56.7±12.7 years; p=0.033). The data were statistically evaluated using ROC curve analysis, correlation and single-factor analyses of variance, and multiple logistic regression analysis. Results. FTs and LFE revealed that the DM patients had liver cirrhosis (LC) (METAVIR F4) in 12 (14.6%) and 15 (18.2%) patients, respectively. Those showed clinically significant fibrosis (METAVIR fibrosis stages F2-3) in 19 (23.1%) and 23 (28%) patients, respectively. Varying degrees of HS were present in 79 (96.3%) patients. LFE and FTs demonstrated comparable results in detecting LC (the area under the receiver operating characteristics curve (AUROC), 0.83 and 0.81, respectively). The development of LF is influenced by factors, such as the degree of HS, obesity, the activity of an inflammatory process, and the level of alanine aminotransferase and α2-macroglobulin. Conclusion. Diabetic patients are at high risk for NAFLD to develop LF and LC. LFE and FTs showed a comparably high accuracy in the diagnosis of LC in patients with DM and these may be used for screening. With allowance made for the existing risk factors of LF and LC, it is necessary to identify groups of patients with DM for further examination and follow-up. Patients who are diagnosed with stage F4 should be examined carefully to evaluate concurrent diseases and to make liver biopsy.

scholarly journals The relationship of depression and anxiety among diabetic patients with changes in the components of lipid profile

2019 ◽  
Author(s):  
Diaa Abdelfattah ◽  
Abdulrahman Alduraywish
Keyword(s):  
Diabetes Mellitus ◽  
Lipid Profile ◽  
Total Cholesterol Level ◽  
Anxiety Symptoms ◽  
High Density ◽  
High Density Lipoproteins ◽  
Diabetic Patients ◽  
Depression And Anxiety ◽  
Patients With Diabetes ◽  
Anxiety Levels

Abstract Introduction our study aimed to investigate the presence of depression and anxiety symptoms in diabetic patients and their association with various components of lipid profile.Methods 428 patients with diabetes mellitus joined our study. Their de- mographic and lipid profile measurements were collected. The screening questionnaire HADS was used to evaluate level of depression and anxiety. An age matched control group consisting of 50 individuals were taken and their lipid profiles and depression and anxiety levels were determined.Results it was found that 22.4% of the sample showed marked depressive symptoms and 28.5% showed marked anxiety symptoms. We found that: depression was associated strongly but not significantly (P=0.057) with lower high density lipoproteins, and associated significantly (P=0.036) with lower total cholesterol level. In addition, anxiety was associated significantly (0.000) with lower high density lipoproteins and was associated significantly (P=0.004) with higher triglycerides level. There was insignificant association between all components of lipid profile and either depression or anxiety levels in the control group.Conclusion Depressive and anxiety symptoms were common among diabetic patients. Depression was related to lower high density lipoproteins, and to lower total cholesterol level. Anxiety was strongly related to lower high density lipoproteins and to higher triglycerides level. This relationship was specific to patients with diabetes mellitus in our study .

Intramuscular Nerve and Neuromuscular Junction Alteration In Extraocular Muscles of Diabetic Mice

1985 ◽  
Vol 43 ◽  
pp. 682-683
Author(s):  
Bruce R. Pachter
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Nerves ◽  
Sudden Onset ◽  
Extraocular Muscles ◽  
Diabetic Patients ◽  
Oculomotor Palsy ◽  
Third Nerve Palsy ◽  
Patients With Diabetes ◽  
Intramuscular Nerve ◽  
Oculomotor Nerves

Diabetes mellitus is one of the commonest causes of neuropathy. Diabetic neuropathy is a heterogeneous group of neuropathic disorders to which patients with diabetes mellitus are susceptible; more than one kind of neuropathy can frequently occur in the same individual. Abnormalities are also known to occur in nearly every anatomic subdivision of the eye in diabetic patients. Oculomotor palsy appears to be common in diabetes mellitus for their occurrence in isolation to suggest diabetes. Nerves to the external ocular muscles are most commonly affected, particularly the oculomotor or third cranial nerve. The third nerve palsy of diabetes is characteristic, being of sudden onset, accompanied by orbital and retro-orbital pain, often associated with complete involvement of the external ocular muscles innervated by the nerve. While the human and experimental animal literature is replete with studies on the peripheral nerves in diabetes mellitus, there is but a paucity of reported studies dealing with the oculomotor nerves and their associated extraocular muscles (EOMs).

scholarly journals A preliminary study on diabetes self-management education and glycemic control among patients with diabetes mellitus

2019 ◽  
Vol 9 (9) ◽  
pp. 98 ◽  
Author(s):  
Kisokanth G. ◽  
Indrakumar J. ◽  
Prathapan S. ◽  
Joseph J. ◽  
Ilankoon I.M.P.S.
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Management Education ◽  
Self Management ◽  
Rank Test ◽  
Diabetic Patients ◽  
Effective Measure ◽  
Before And After ◽  
Patients With Diabetes ◽  
Preliminary Study

This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant (p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.

scholarly journals When Uncontrolled Diabetes Mellitus and Severe COVID-19 Converge: The Perfect Storm for Mucormycosis

2021 ◽  
Vol 7 (4) ◽  
pp. 298
Author(s):  
Teny M. John ◽  
Ceena N. Jacob ◽  
Dimitrios P. Kontoyiannis
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Clinical Features ◽  
The Other ◽  
Diabetic Patients ◽  
Epidemiological Factors ◽  
Uncontrolled Diabetes ◽  
Diagnostic Certainty ◽  
Patients With Diabetes ◽  
Perfect Storm

Mucormycosis (MCR) has been increasingly described in patients with coronavirus disease 2019 (COVID-19) but the epidemiological factors, presentation, diagnostic certainty, and outcome of such patients are not well described. We review the published COVID-19-associated mucormycosis (CAMCR) cases (total 41) to identify risk factors, clinical features, and outcomes. CAMCR was typically seen in patients with diabetes mellitus (DM) (94%) especially the ones with poorly controlled DM (67%) and severe or critical COVID-19 (95%). Its presentation was typical of MCR seen in diabetic patients (mostly rhino-orbital and rhino-orbital-cerebral presentation). In sharp contrast to reported COVID-associated aspergillosis (CAPA) cases, nearly all CAMCR infections were proven (93%). Treating physicians should have a high suspicion for CAMCR in patients with uncontrolled diabetes mellitus and severe COVID-19 presenting with rhino-orbital or rhino-cerebral syndromes. CAMR is the convergence of two storms, one of DM and the other of COVID-19.

scholarly journals Diabetes Mellitus—A Risk Factor for Unfavourable Outcome in COVID-19 Patients—The Experience of an Infectious Diseases Regional Hospital

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 788
Author(s):  
Egidia Miftode ◽  
Larisa Miftode ◽  
Ioana Coman ◽  
Cristian Prepeliuc ◽  
Maria Obreja ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Inflammatory Responses ◽  
Scientific Data ◽  
Risk Category ◽  
Diabetic Patients ◽  
Direct Effects ◽  
Unfavourable Outcome ◽  
Strong Connection ◽  
Risk Of Death ◽  
Patients With Diabetes

Early research into the implications concerning the evolution of the infection caused by the new coronavirus in people with glucose metabolism dysfunction, in this case diabetics, shows that severe forms of the disease predominate in this risk category. Moreover, it seems that even in patients with normal glycaemic status, COVID-19 may predispose to the development of hyperglycaemia which modulates immune mechanisms and inflammatory responses, with direct effects on morbidity and mortality. Thus, taking into account these scientific data, as well as the increased frequency of diabetes in the general population, we aimed to assess the risk of an unfavourable outcome of diabetic patients, which is in a strong connection with the presence and severity of pulmonary disease such as interstitial pneumonia/bronchopneumonia, as well as the effectiveness of Tocilizumab administration. The results of our study indicate a three-fold higher risk of death in patients with diabetes and COVID-19 (RR = 3.03; IC95%: 2.37–3.86; p = 0.001),compared to nondiabetic patients, and the risk of developing severe forms of acute respiratory failure was 1.5 times higher in the first studied category. In conclusion, we can say that the diabetic diagnosed with SARS-CoV-2 infection is more predisposed to immunological and organic dysfunctions that may ultimately result in death, and treatment with monoclonal anti-IL-6 antibodies was more effective in diabetic patients than non-diabetics (p < 0.05). The effectiveness of Tocilizumab was significant in both studied groups, but diabetic patients responded better to this therapy compared to non-diabetes-mellitus (DM) ones (76.7% vs. 35% p = 0.001).

scholarly journals Screening Strategy of Pancreatic Cancer in Patients with Diabetes Mellitus

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 572
Author(s):  
Suguru Mizuno ◽  
Yousuke Nakai ◽  
Kazunaga Ishigaki ◽  
Kei Saito ◽  
Hiroki Oyama ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Pancreatic Cancer ◽  
Epidemiological Studies ◽  
Screening Strategy ◽  
Diabetic Patients ◽  
Reverse Causality ◽  
Pilot Studies ◽  
Patients With Diabetes ◽  
High Risk Populations ◽  
New Onset

The incidence of pancreatic cancer (PCa) is increasing worldwide and has become one of the leading causes of cancer-related death. Screening for high risk populations is fundamental to overcome this intractable malignancy. Diabetes mellitus (DM) is classically known as a risk factor for PCa. Recently the reverse causality is in the spotlight, that is to say, DM is considered to be a manifestation of PCa. Numbers of epidemiological studies clarified that new-onset DM (≤2-year duration) was predominant in PCa patients and the relative risk for PCa inversely correlated with duration of DM. Among patients with new-onset DM, elder onset, weight loss, and rapid exacerbation of glycemic control were reported to be promising risk factors and signs, and the model was developed by combining these factors. Several pilot studies disclosed the possible utility of biomarkers to discriminate PCa-associated DM from type 2 DM. However, there is no reliable biomarkers to be used in the practice. We previously reported the application of a multivariate index for PCa based on the profile of plasma free amino acids (PFAAs) among diabetic patients. We are further investigating on the PFAA profile of PCa-associated DM, and it can be useful for developing the novel biomarker in the near future.

scholarly journals The Relationship between Frequently Used Glucose-Lowering Agents and Gut Microbiota in Type 2 Diabetes Mellitus

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
You Lv ◽  
Xue Zhao ◽  
Weiying Guo ◽  
Ying Gao ◽  
Shuo Yang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gut Microbiota ◽  
Metabolic Diseases ◽  
Short Chain Fatty Acids ◽  
Current Evidence ◽  
Diabetic Patients ◽  
Glucose Lowering ◽  
Patients With Diabetes ◽  
Gastrointestinal Side Effects ◽  
Underlying Mechanisms

Metabolic diseases, especially diabetes mellitus, have become global health issues. The etiology of diabetes mellitus can be attributed to genetic and/or environmental factors. Current evidence suggests the association of gut microbiota with metabolic diseases. However, the effects of glucose-lowering agents on gut microbiota are poorly understood. Several studies revealed that these agents affect the composition and diversity of gut microbiota and consequently improve glucose metabolism and energy balance. Possible underlying mechanisms include affecting gene expression, lowering levels of inflammatory cytokines, and regulating the production of short-chain fatty acids. In addition, gut microbiota may alleviate adverse effects caused by glucose-lowering agents, and this can be especially beneficial in diabetic patients who experience severe gastrointestinal side effects and have to discontinue these agents. In conclusion, gut microbiota may provide a novel viewpoint for the treatment of patients with diabetes mellitus.

scholarly journals Association of proteinuria and incident atrial fibrillation in patients with diabetes mellitus: a population-based senior cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Juntae Kim ◽  
Pil-Sung Yang ◽  
Byoung-Eun Park ◽  
Tae Soo Kang ◽  
Seong-Hoon Lim ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Confidence Interval ◽  
Population Based ◽  
Hazard Ratio ◽  
Diabetic Patients ◽  
Dependent Manner ◽  
Dipstick Test ◽  
Patients With Diabetes ◽  
Urine Dipstick Test

AbstractDiabetes mellitus (DM) is considered an independent risk factor for atrial fibrillation (AF). The excess risk in relation to the presence of proteinuria has not been well elucidated. Our aim was to determine the association between the incidence of AF and proteinuria in diabetic population. A total of 240,499 individuals aged ≥ 60 years from the Korea National Health Insurance Service-Senior cohort from 2004 to 2014 were included. 4.2% of individuals with DM and 3.7% of controls were diagnosed with AF during a median follow-up period of 7.2 years. Amongst controls (participants without proteinuria and DM), DM only, proteinuria only, and DM with proteinuria groups, the crude incidences of AF were 0.58, 0.70, 0.96, 1.24 per 100 person-years respectively. Compared with controls, the weighted risk of AF was increased by 11% (hazard ratio = 1.11, 95% confidence interval = 1.02–1.20, P = .001), 48% (hazard ratio = 1.48, 95% confidence interval = 1.30–1.69, P < .001), and 66% (hazard ratio = 1.66, 95% confidence interval = 1.26–2.18, P < .001) in the DM only, proteinuria only, and DM with proteinuria groups, respectively (P for trend < .001). Degree of proteinuria in diabetic patients was associated with a significantly higher rate of incident AF in dose dependent manner. Thus, assessing proteinuria by a simple urine dipstick test could provide a useful adjunct to risk assessment for AF in elderly population with DM.

Prevalence of Toenail Onychomycosis in Patients with Type 2 Diabetes Mellitus and Evaluation of Risk Factors

2011 ◽  
Vol 101 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Aynur Gulcan ◽  
Erim Gulcan ◽  
Sukru Oksuz ◽  
Idris Sahin ◽  
Demet Kaya
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Fasting Blood Glucose ◽  
Diabetic Patients ◽  
Essential Components ◽  
Patients With Diabetes ◽  
Epidemiologic Risk

Background: We sought to determine the frequency of toenail onychomycosis in diabetic patients, to identify the causative agents, and to evaluate the epidemiologic risk factors. Methods: Data regarding patients’ diabetic characteristics were recorded by the attending internal medicine clinician. Clinical examinations of patients’ toenails were performed by a dermatologist, and specimens were collected from the nails to establish the onycomycotic abnormality. All of the specimens were analyzed by direct microscopy and culture. Results: Of 321 patients with type 2 diabetes mellitus, clinical onychomycosis was diagnosed in 162; 41 of those diagnoses were confirmed mycologically. Of the isolated fungi, 23 were yeasts and 18 were dermatophytes. Significant correlations were found between the frequency of onychomycosis and retinopathy, neuropathy, obesity, family history, and duration of diabetes. However, no correlation was found with sex, age, educational level, occupation, area of residence, levels of hemoglobin A1c and fasting blood glucose, and nephropathy. The most frequently isolated agents from clinical specimens were yeasts. Conclusions: Long-term control of glycemia to prevent chronic complications and obesity and to promote education about the importance of foot and nail care should be essential components in preventing onychomycosis and its potential complications, such as secondary foot lesions, in patients with diabetes mellitus. (J Am Podiatr Med Assoc 101(1): 49–54, 2011)

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