scholarly journals Macrovascular Complications in Patients with Diabetes Mellitus: Incidence and Impact on Survival in Kazakhstan

2021 ◽  
Author(s):  
Antonio Sarría-Santamera ◽  
Binur Orazumbekova ◽  
Tilektes Maulenkul ◽  
Alessandro Salustri ◽  
Natalya Glushkova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Hospital Admission ◽  
Cumulative Incidence ◽  
Hospital Admissions ◽  
Macrovascular Complications ◽  
Diabetic Patients ◽  
Lower Survival ◽  
Patients With Diabetes ◽  
The Impact

Abstract Background and aim: Diabetic patients are at an increased risk for the development of macrovascular complications such as acute myocardial infarction (AMI), stroke and lower-limb amputations (LLA). This study aimed to explore a. the incidence of hospital admission for macrovascular complications (AMI, stroke, and LLA); b. to assess the impact of hospital admission on survival in a large population with diabetes mellitus living in Kazakhstan. Materials and methods: Retrospective observational study using a nationwide anonymized electronic database of 98.469 hospitalized diabetic patients from Kazakhstan between November 2013 and December 2019. The incidence of hospital admissions for AMI, stroke and LLA were obtained to calculate their all-time cumulative incidence, and survival rate at follow-up. Results: The all-time cumulative incidence of hospital admissions was 1.30% for AMI, 1.94% for stroke and 2.94% for LLA. The incidence of macrovascular complications was statistically significantly higher in males compared to females (p-value<0.05). 29.03% of diabetic patients with AMI, 25.16% with stroke and 29.80% with LLA died during the follow-up period. Individuals with AMI had 3.58 (95% CI 3.20; 4.01) times, with stroke 3.86 (95% CI 3.52; 4.24) times and with LLA 3.63 (95% CI 3.38; 3.88) times higher hazard of 6-year death compared to diabetic patients free of these complications. The stratified survival analysis by sex indicated the lower survival in women than in men, and the lower survival in older age groups. Conclusion: The results from this study shows that cumulative incidence of AMI and stroke among diabetic patients admitted in the hospitals in Kazakhstan between 2013-2019 years was similar to the estimates from other countries, but the incidence of LLA was significantly higher in Kazakhstan. Patients with diabetes mellitus (DM) in Kazakhstan are at high risk of excess mortality if they suffer from macro-vascular complications. More research is required to explore the reasons for the high incidence of those complications, in order to propose systematic solutions for lowering the incidence and improve survival.

Adjuvant Supplementation with L-Carnitine in Diabetic Population and its effects on Lipid Parameters

2021 ◽  
Vol 15 (8) ◽  
pp. 2017-2019
Author(s):  
Rao Salman Aziz ◽  
Usman Saeed ◽  
Nasim Aslam Ghumman ◽  
Muhammad Arshad ◽  
Asif Sohail ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Triglyceride Level ◽  
Clinical Care ◽  
Diabetic Patients ◽  
Healthy Population ◽  
Patients With Diabetes ◽  
Diabetic Population ◽  
Large Discount ◽  
The Impact ◽  
Lipid Parameters

Background: Diabetes is a complicated disease requires continuous clinical care, to govern blood sugar. Aim: To decides the impact of management of L carentin to diabetics at the lipid profile. Methods: This study turned into performed on 120 diabetic Patients had been decided on from endocrinology and diabetes, inside decided on standards. The Patients distributed into three Strata (1st Strata of healthy population and two Strata of patients with diabetes who were on metformin and glibenclamide, one Strata took a L carnitine in a dose of 1000 mg TDS and a Strata dealing with a placebo for a period of ninety days). Results: It is observed those who are on Lcarnitine, confirmed a large discount (p <0.05) with inside the triglyceride level, at the same time as no large adjustments had been located withinside the level of cholesterol and HDL and LDL. Conclusion: These study outcomes that management of L carentin improved profile of lipid in type-2diabetic Patients. Keyword: Dyslipidemia, Diabetes mellitus (DM), l-carnitine (LC).

scholarly journals 711 Effect of Roux-En-Y Gastric Bypass on HbA1c As Well As Number of Medications in Diabetic Patients

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Bhandari ◽  
M Rao ◽  
G Bussa ◽  
C Rao
Keyword(s):  
Diabetes Mellitus ◽  
Gastric Bypass ◽  
Glycosylated Haemoglobin ◽  
Morbidly Obese ◽  
Diabetic Patients ◽  
Obese Patients ◽  
The Mean ◽  
The Impact

Abstract Aim Roux en Y gastric bypass (RYGB) is known to ameliorate Type 2 Diabetes Mellitus (T2DM) in morbidly obese patients. We aimed to determine both the reduction in the glycosylated haemoglobin (HbA1c) and the number of anti-diabetic medications (including insulin) in diabetic patients undergoing RYGB over a five-year period. Method We reviewed data of diabetic patients (n = 530) who underwent RYGB from January 2012 – December 2017, including those with a minimum of a 2-year post-operative follow up (n = 47). Preoperatively, BMI, HbA1c and the number of anti-diabetic medications and the duration of T2DM since diagnosis were recorded. These measurements were repeated at the end of the two year follow up. Results At the time of enrolment in the bariatric programme, the median BMI was 42.5 (range, 31.7-61.5) kg/m2, mean duration of T2DM was 58 months and median HbA1c was 59 (37-118) mmol/mol. The mean number of anti-diabetic medications taken, including insulin, was 2. At the end of 2-year follow-up, the median BMI was 32 (range, 24-41) kg/m2 and HbA1c was 41(range, 33-91) mmol/mol. 15 patients (31.9%) still required anti-diabetic medication, 12 of whom had a diagnosis of T2DM for 3 years or more at time of enrolment. Conclusions RYGB is strongly associated with a resolution of T2DM in morbidly obese patients. In those who were not resolved, the number of anti-diabetic medications taken and HbA1c were reduced. The impact of the surgery is dependent on the duration of T2DM since diagnosis preoperatively.

scholarly journals The effect of diabetes mellitus on evolution and outcome of tuberculosis in a prospective study

2021 ◽  
Vol 64 (5) ◽  
pp. 16-20
Author(s):  
Alina Malic ◽  
◽  
Evelina Lesnic ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Prospective Study ◽  
Treatment Effectiveness ◽  
Similar Rate ◽  
Control Group ◽  
Diabetic Patients ◽  
A Prospective Study ◽  
Prospective Longitudinal ◽  
The Impact

Background: In the Republic of Moldova almost 5% of the cases with tuberculosis are diagnosed annually among diabetic patients. The aim of this study was to assess the impact of diabetes mellitus on the evolution and anti-tuberculosis treatment effectiveness in a prospective study. Material and methods: A prospective, longitudinal and case-control study, which included a total number of 252 patients diagnosed with pulmonary tuberculosis and distributed in a study group, consisting of 93 patients diagnosed with diabetes mellitus and a control group, consisting of 159 patients without glycemic disorders, was performed. Results: This study identified that one half of the group with diabetes was detected by active screening and one third received anti-tuberculous treatment before actual episode. A similar rate of diabetic and non-diabetic patients was microbiologically positive, as well confirmed with drug-resistance. The anti-tuberculous treatment effectiveness was lower in diabetic patients, the death rate and the low treatment outcome (lost to follow-up and failed) were higher than in non-diabetic patients. The main causes of unfavorable evolution were: glycemic disorders (hyperglycemia), diabetes complications and the history of the anti-tuberculous treatment in the anamnesis. Conclusions: The individualized approach and a tight follow-up should be performed regularly in all patients with glycemic disorders and tuberculosis for the improvement of the disease outcome.

scholarly journals Metformin Therapy and Survival in Multiple Myeloma Among US Veterans with Diabetes Mellitus

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4502-4502
Author(s):  
Jesse Keller ◽  
Kristen M. Sanfilippo ◽  
Suhong Luo ◽  
Brian F. Gage ◽  
Kenneth R Carson
Keyword(s):  
Diabetes Mellitus ◽  
Multiple Myeloma ◽  
Secondary Analysis ◽  
Growth Factor Receptor ◽  
Diabetic Patients ◽  
Defined Daily Dose ◽  
Metformin Therapy ◽  
Immortal Time Bias ◽  
The Impact

Abstract Background: Metformin is an oral biguanide anti-diabetic medication used in patients with type 2 diabetes mellitus (DM). Recently, metformin use in diabetic patients with multiple myeloma (MM) has been associated with improved overall survival (OS) (Wu et al, 2014). Additionally, long-term metformin use has been associated with a decrease in the rate of progression of MGUS to MM (Chang et al. 2015). These anti-tumor effects are hypothesized to be mediated through insulin receptor/insulin-like growth factor receptor-1 signaling and moderation of cellular effects of hyperglycemia and hyperinsulinemia. To confirm the association between metformin use and improved survival in diabetic patients with MM, we evaluated a cohort of United States veterans with MM and diabetes. Methods: Patients diagnosed with MM in the Veterans Administration database from September 1, 1999 to December 31, 2009 were identified and followed through October 2014. Patients who did not receive MM directed therapy within 6 months of diagnosis were excluded, as were patients who died within 1 year of MM diagnosis. Furthermore, patients who did not have a pre-existing diagnosis of DM at the time of MM diagnosis were excluded. To standardize dose-response effects, a defined daily dose (DDD) calculation of 1 gram of metformin daily was used. Cox modeling was used to assess the association between mortality and metformin use. Additional variables considered included: age, body mass index, race, use of novel therapeutic agents, transplantation, year of diagnosis, creatinine ≥ 1.5, albumin ≤ 3 g/dL and bisphosphonate use. Metformin use was evaluated as a time varying covariate to control for immortal time bias. Patients were defined as metformin users if they were prescribed metformin during a period starting 3 months prior to MM diagnosis extending through completion of follow-up. To assess for the impact of steroid-induced DM (SID), a secondary analysis including these patients was completed. Results: A total of 3,069 MM patients were evaluable, of whom 549 had a diagnosis of DM prior to MM diagnosis. Among these patients, 268 patients (49%) had received metformin therapy. Diabetic metformin users were younger (mean 66.5 years vs 68 years, P=0.0044), and had fewer comorbidities including chronic kidney disease (9.7% vs 37.4%, P < 0.0001) and ischemic heart disease (39.2% vs 48.8%, P < 0.0001), compared with diabetic non-metformin users . Additionally, metformin users were more likely to have undergone autologous stem cell transplantation (18.3% versus 8.2%, P=0.0005). There was no difference in mortality for metformin users versus non-users (adjusted HR (aHR) 1.11, 95% CI [0.88-1.39]). Utilization of DDDs to stratify metformin users by dose exposure showed no difference in mortality between those with ≥ 365 DDDs (aHR 0.96, 95% CI[0.71-1.29]) or those with < 365 DDDs (aHR 1.28, 95% CI[0.97 -1.70]), as compared to non-users. Among patients with DM or SID diagnosed at any time during follow-up, no significant association with survival was seen among users versus non-users, for any use of metformin (aHR 1.08, 95%CI[0.87 - 1.33]) or when stratified by ≥ 365 DDDs (aHR 0.96 95%CI[0.71-1.29]) or < 365 DDDs (aHR 1.28, 95%CI[0.97-1.70]). Conclusion: In contrast to a prior study reporting improvements in OS, we found no significant association between metformin use and OS in this cohort of diabetic patients with MM. This is largest cohort study performed to date to assess the role of metformin in patients with MM. This study does not support the prescription of metformin as adjunct therapy in MM. Disclosures Sanfilippo: Amgen: Speakers Bureau.

Relationship Between Left Atrial Strain and Malnutrition Scores in Diabetic Patients

2021 ◽  
Author(s):  
Flora Özkalaycı ◽  
Ali Karagoz ◽  
Işıl Kutlutürk Karagöz ◽  
Süleyman Çağan Efe ◽  
Erdem Türkyılmaz ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Left Atrial ◽  
Public Health Problem ◽  
Adverse Outcomes ◽  
Diabetic Patients ◽  
Left Atrial Strain ◽  
Patients With Diabetes ◽  
Atrial Strain ◽  
The Impact ◽  
Conut Score

Objectives: Malnutrition is a serious public health problem that is associated with adverse outcomes in a broad range of disease including cardiovascular disease and diabetes mellitus. Malnutrition is demonstrated to be accompanying to several disease, yet there is a lack of evidence on the impact of malnutrition on cardiac functions in patients with diabetic patients with diabetic retinopathy. Herewith our primary goal was to evaluate the relation between any degree malnutrition with left atrial strain in relevant patient group. Patients and Methods: Patients with diabetes mellitus with retinopathy, who were referred to the outpatient cardiology clinic were assessed. Those who had sinus rhythm, had no findings of significant valvular heart disease and coronary artery disease underwent to 2-dimensional speckle tracking echocardiography and assessed for malnutrition in their prior examinations were included to the study. Hundred and seventy patients met the inclusion criteria. Malnutrition scores such as CONUT score, NRI, and PNI were used to evaluate nutrition condition of the patients. Results: Thirty percent of all diabetic patients were demonstrated to have malnutrition according to the CONUT score. Left atrial conduit strain was demonstrated to decrease [ß: -7.5 (CI 95%, -10.7, -4.3 p<0.001)], Left atrial reservoir strain was demonstrated to increase [ß: 2.48(CI 95%,0.83- 4.13 p<0.03)] and Left atrial contractile strain was demonstrated to decrease [ß: -4.21(CI 95%, -2.21, -6.01 p<0.001)] in the presence of any degree malnutrition. Conclusion: In this study we have demonstrated that malnutrition is an important entity in patients with diabetes mellitus and also has a significant impact on Left atrial strain.

P5644Hypoglycemic episodes increase the risk of ventricular arrhythmias and sudden cardiac arrest in patients with type 2 diabetes - a nationwide cohort study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y C Hsieh ◽  
Y C Liao ◽  
C H Li ◽  
J C Lin ◽  
C J Weng ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Sudden Cardiac Arrest ◽  
Control Group ◽  
Diabetic Patients ◽  
Hypoglycemic Episode ◽  
Kaplan Meier ◽  
Patients With Diabetes ◽  
Diagnosed Diabetes ◽  
The Impact

Abstract Background Hypoglycemic episode (HE) increases the risk of cardiovascular mortality. The impact of HE on the risk of sudden death remains unclear. We hypothesized that HE increases the risks of ventricular arrhythmia (VA) and sudden cardiac arrest (SCA), and that anti-diabetic agents (ADAs) causing hypoglycemia also increase the risks of VA and SCA. Methods Patients aged ≥20 years with newly diagnosed diabetes were identified from the Taiwan National Insurance Database. HE was defined as the presentation of hypoglycemic coma or specified/unspecified hypoglycemia. For control group, we included diabetic patients without HE, and they were frequency-matched to the HE group at a 4:1 ratio. The primary outcome was the occurrence of any event of VA (including ventricular tachycardia and fibrillation) and SCA during the defined follow-up periods. Multivariate Cox hazards regression model was used to evaluate the hazard ratio (HR) for VA or SCA. Results A total of 54,303 diabetic patients were screened with 1,037 of them in the HE group, and 4,148 in the control group. During a mean follow-up period of 3.3±2.5 years, 29 VA/SCA events had occurred. Compared to the control group, the HE group had a higher incidence of VA/SCA (adjusted HR: 2.42, p=0.04). Diabetic patients medicated with insulin for glycemic control increased the risk of VA/SCA compared to those without insulin (adjusted HR: 3.05, p=0.01). Kaplan-Meier survival curves Conclusions HEs in patients with diabetes increased the risks of VA and SCA compared to those without. Their use of insulin also independently increased the risk of VA/SCA.

scholarly journals Interrelationship Between 2019-nCov Receptor DPP4 and Diabetes Mellitus Targets Based on Protein Interaction Network

2021 ◽  
Author(s):  
Qian Gao ◽  
Wenjun Zhang ◽  
Tingting Li ◽  
Guojun Yang ◽  
Wei Zhu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Protein Interaction ◽  
Protein Interaction Network ◽  
Interaction Network ◽  
Final Analysis ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
New Perspective ◽  
Novel Coronavirus ◽  
The Impact

Abstract Objective: Exploring the relationship between diabetes mellitus targets and DPP4 of the receptor of novel coronavirus (2019-nCoV) through a protein interaction network to provide new perspective for clinical medication. Methods: Diabetes mellitus targets were obtained from GeneCards database. Targets with a relevance score exceeding 20 were included, and DPP4 protein was added manually. The initial protein interaction network was obtained through String. The targets directly related to DPP4 were selected as the final analysis targets. Importing them into String again to obtain the protein interaction network. Module identification, GO analysis and KEGG pathway analysis were carried out respectively. The impact of DPP4 on the whole network was analyzed by scoring the module where it located. Results: 43 DPP4-related proteins were finally selected from the diabetes mellitus targets and three functional modules were found by the cluster analysis. Module 1 was involved in insulin secretion and glucagon signaling pathway, module 2 and module 3 were involved in signaling receptor binding. The scoring results showed that LEP and apoB in module 1 were the highest, and the scores of INS, IL6 and ALB of cross module associated proteins of module 1 were the highest.Conclusions: DPP4 is widely associated with key proteins in diabetes mellitus. COVID-19 may affect DPP4 in patients with diabetes mellitus, leading to high mortality of diabetes mellitus combined with COVID-19. DPP4 inhibitors and IL-6 antagonists can be considered to reduce the effect of COVID-19 infection on diabetic patients.

scholarly journals Teleconsultation for pediatric patients with type 1 diabetes mellitus during the COVID-19 pandemic: experience of a university hospital in Brazil

2021 ◽  
Author(s):  
Yasmin Eugênia Santana ◽  
Thais Milioni Luciano ◽  
Ana Carolina Maia Teodózio ◽  
Amanda Maria Barradas Monteiro Santana ◽  
Letícia Rodrigues Ramos ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Admission Rate ◽  
University Hospital ◽  
Diabetic Patients ◽  
Hospital Admission Rate ◽  
Patients With Diabetes ◽  
Reference Hospital ◽  
Control And Prevention ◽  
The Impact

Abstract Introduction: The SARS-CoV-2 pandemic expanded rapidly around the world in 2020 and health services needed to be reconfigured to meet the new demand and ensure the care of patients with chronic diseases. For patients with diabetes mellitus, the teleconsultation stood out as a tool for clinical management in this period. Objective: Evaluate the impact of teleconsultation on glycemic control and prevention of acute complications related to diabetes mellitus in children and adolescents treated in a reference hospital during the COVID-19 pandemic in 2020. Method: Descriptive study of data from pediatric diabetic patients who received teleconsultation between April and September 2020. Results: During this period, 143 diabetic patients were evaluated, with a median of 3.4 teleconsultations per patient in the studied period; requiring adjustment of insulin doses in 84.6% of cases. The hospital admission rate was 8,4% due to diabetic decompensation. The metabolic control (HbA1c) became worsen in 46% of the sample and improved in 37%. Conclusion: The teleconsultation promoted health care for patients with diabetes mellitus during the COVID-19 pandemic, but was not able to guarantee adequate glycemic control.

scholarly journals The impact of diabetes mellitus on postoperative morbidity in laryngeal surgery

2006 ◽  
Vol 53 (1) ◽  
pp. 51-55 ◽  
Author(s):  
M. Jovanovic ◽  
J. Perovic ◽  
A. Grubor
Keyword(s):  
Diabetes Mellitus ◽  
Total Laryngectomy ◽  
Postoperative Morbidity ◽  
Diabetic Patients ◽  
Blood Transfusions ◽  
Wound Infections ◽  
Clinical Factor ◽  
Laryngeal Surgery ◽  
Patients With Diabetes ◽  
The Impact

The main aim of this study was to analyze risk factors of postoperative morbidity after extended laryngeal surgery comparing patients with diabetes mellitus and non-diabetic patients. In retrospective study 69 patients (63 male and 6 female), who underwent partial laryngo-pharyngectomy and total laryngectomy between 2003 and 2004, were evaluated. 13 % of the total group of examined patients had concurrent diabetes, while 87% were nondiabetic patients. We performed partial laryngopharyngectomy in 39 out of 69 patients (56.5%) and total laryngectomy in 30 patients (43.5%). Secondary wound infections (88.9%) and pharyngocutaneus fistula (44.5%) had a significantly higher rate in diabetic patients (p<0.001). Among diabetics the cases with intraoperative or postoperative blood transfusions were more frequent - 44.4%(p<0.001). Diabetic patients with laryngectomy procedures had more frequently prolonged postoperative anemia (55.5%, p<0.001) and electrolitic disbalance (66.6%, p<0.001). Our results have confirmed that diabetes mellitus is an important independent general clinical factor, which increases postoperative morbidity and hospitalization time in laryngeal surgery. Our data indicate the need to make a very serious plan and clinical assessment for laryngeal surgical therapy in diabetic patients.

scholarly journals Efficacy of Lipid-Lowering Therapy During Cardiac Rehabilitation in Patients With Diabetes Mellitus and Coronary Heart Disease

2021 ◽  
Author(s):  
Thomas Wittlinger ◽  
Bernhard Schwaab ◽  
Heinz Voeller ◽  
Christa Bongarth ◽  
Viktoria Heinze ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ldl Cholesterol ◽  
Lipid Lowering ◽  
Diabetic Patients ◽  
Lipid Lowering Therapy ◽  
Cholesterol Levels ◽  
Patients With Diabetes

Abstract BackgroundCardiac rehabilitation (CR) in patients with coronary heart disease (CHD) aims to increase adherence to a healthy lifestyle and to secondary preventive medication. CR is able to improve quality of life and prognosis in CHD patients. This is particularly relevant for CHD patients with diabetes mellitus.DesignA prospective, multicenter registry study with patients from six rehabilitation centers in Germany.MethodsDuring CR, 1100 patients with a minimum age of 18 years and CHD documented by coronary angiography were included in a LLT registry.ResultsIn 369 patients (33.9 %), diabetes mellitus was diagnosed. Diabetic patients were older (65.5 ± 9.0 vs. 62.2 ± 10.9 years, p < 0.001) than nondiabetic patients and more likely to be obese (BMI: 30.2 ± 5.2 kg/m2 vs. 27.8 ± 4.2 kg/m2, p < 0.001). Analysis indicated that diabetic patients were more likely to show LDL cholesterol levels below 55 mg/dL than patients without diabetes at the start of CR (Odds Ratio (OR) 1.9; 95 % CI 1.3 to 2.9) until 3 months of follow-up (OR 1.9; 95 % CI 1.2 to 2.9). During 12 months of follow-up, overall and LDL cholesterol levels decreased within the first 3 months and remained at the lower level thereafter (p < 0.001), irrespective of prevalent diabetes. At the end of the follow-up, LDL cholesterol did not differ significantly between patients with or without diabetes mellitus (p = 0.413).ConclusionWithin 3 months after CR, total and LDL cholesterol were significantly reduced, irrespective of prevalent diabetes mellitus. In addition, CHD patients with diabetes responded faster to LTT than nondiabetic patients, suggesting that diabetic patients benefit more from LLT treatment during CR.

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