scholarly journals Metabolic Risk Factors in Patients with Kidney Stones with and without Type 2 Diabetes

Author(s):  
Francisco Spivacow ◽  
Elisa Del Valle ◽  
Juan Boailchuk ◽  
Pablo Martínez Allo ◽  
Martin Pailler

Abstract Background: In the past few decades, the prevalence of kidney stones in Western countries has increased in parallel with the growing overweight/obesity and type 2 diabetes mellitus rates. An increased insulin resistance in these patients explains, in part, the rising prevalence of uric acid stones. The objective of this retrospective study is to evaluate the metabolic abnormalities in type 2 diabetic and non-diabetic patients with kidney stones. All patients were evaluated following an ambulatory protocol for kidney stones. Methods: A total of 104 diabetic patients (age: 57.8 ± 11 years) and 130 non-diabetic (age: 52.1 ± 6.7 years) patients with kidney stones were selected. Higher rates of body mass index, hypertension, urinary tract infection, gout and hyperuricemia were observed in diabetic patients as compared to the non-diabetics, while similar rates were found for their family history of kidney stones. Results: Urinary pH was lower in diabetic patients than in non-diabetic patients. Metabolic abnormalities were detected in 95.2% and 81.5% of diabetic and non-diabetic, respectively. Unduly acidic urine pH was the most frequent abnormality in diabetic patients while hyperuricosuria was the second more common abnormality. On the other hand, in non-diabetics patients idiopathic hypercalciuria was the most common metabolic abnormality followed by hyperuricosuria. Conclusions: The main risk factor for lithogenesis in type 2 diabetes is unduly acidic urine pH, followed by hyperuricosuria and idiopathic hypercalciuria.

2007 ◽  
Vol 33 (1) ◽  
pp. 37-43 ◽  
Author(s):  
S. Hadjadj ◽  
F. Duengler ◽  
F. Torremocha ◽  
G. Faure-Gerard ◽  
F. Bridoux ◽  
...  

2013 ◽  
Vol 20 (02) ◽  
pp. 237-243
Author(s):  
GHULAM HUSSAIN BALOCH ◽  
ABDUL QADIR DALL ◽  
ATIF SITWAT HAYAT ◽  
Syed Zulfiquar Ali Shah ◽  
Bikha Ram Devrajani

Objective: To determine the frequency and pattern of dental carries in patients with type 2 diabetes mellitus. Design: Crosssectional descriptive study. Patients and methods: Patients with history of type 2 diabetes mellitus for ≥ 02 years duration with ≥ 35 years ofage and of either gender with dental pain visit at medical and dental outpatient department (OPD) of Liaquat University Hospital Hyderabad.The detail history was taken and the blood samples were taken for haemoglobin A1c (HbA1c) to assess the glycemic status. The existenceof dental carries and its pattern was diagnosed through dental examination by consultant dentist had clinical experience ≥05 years. The datawas collected on pre-designed proforma, entered and analyzed in SPSS version 11.00. Results: A total of 137 type 2 diabetic patients wereselected for this study, out of these 82 were males and 55 females. The dental carries was found in 98 (71.5%) patients. Out of these ninetyeight, 53 (54.08%) were males and 45 (45.92%) were female. Upper molar teeth involvement was present in 46 patients and lower molarteeth were involved in 52 patients. Dentine carries was seen in 35 patients, enamel carries in 19, white spot carries in 20 patients, pulpitis in16 patients, and pulp capping in 8 patients. Involvement of individual teeth was also assessed, the upper molar involvement was present in32 patients, premolar involvement was present in 11, incisor involvement in 03 patients. The lower molars were involved in 28 patients,lower pre molar in 21 and lower incisors in 03 patients. Dental carries was present in 43 (43.9%) patients in patients whose duration ofdiabetes was between 5-10 years, whereas those patients having duration >10 years had 31.6% frequency of dental carries, whileregarding duration of <5 years only 24 (24.5%) patients had dental carries. Conclusions: The diabetic patients are more prone to acquiredental caries.


2021 ◽  
Vol 24 (1) ◽  
pp. 32-44
Author(s):  
T. A. Zelenina ◽  
V. V. Salukhov ◽  
A. B. Zemlianoi ◽  
S. G. Zheleznjak ◽  
O. A. Klitsenko

BACKGROUND: Diabetic autonomic neuropathy is the reason for early morbidity and mortality on diabetic patients. The pathology not only cardiac innervation but microvascular is presented.AIMS: We estimated the parameters of skin microvascular blood flow in accordance with cardiovascular autonomic neuropathy (CAN) staging in diabetic patients. We also assessed other risk factors of CAN in patients with diabetes.MATERIALS AND METHODS: We included 76 patients with type 2 diabetes in the study (24 patients with resent-onset diabetes and/or diabetes without microvascular complications, 26 with diabetic sensorimotor neuropathy (SMN) and 26 with SMN and previous history of diabetic foot amputation). The SMN was diagnosed on the basis of patients complaints, anamnesis and data of clinical neurological examinations. CAN was detected using several cardiovascular autonomic reflex tests (CART) as a gold standard of diagnosis: the tilt-table test, a deepbreathing and Valsalva Maneuver, handgrip test, cold-stress vasoconstriction. According to the Toronto Diabetic Neuropathy Expert Group Recommendation all patients was separated on the groups: CAN 0 (all CARTs were normal), CAN 1 (possible/early CAN — one abnormal CART was presented), CAN 2 (definite/confirmed CAN –at least two abnormal CARTs were found), CAN 3 (severe/advanced CAN — in the cases of orthostatic hypotension in addition to CARTs abnormalities). Microvascular blood flow of skin at the nail roller of fingers skin was valuated at rest as well as in functional cold test by the method of High-frequency Ultrasonic Dopplerography using the “Minimax Doppler K” device (LLC JV “Minimax”, St. Petersburg, Russia).RESULTS: CAN 1 was found in 8% diabetic patients without microvascular complications, 42 and 21% patients with SMN and diabetic foot amputations respectively. CAN 2 was diagnosed in 27% patients with SMN and 58% patients history of diabetic foot amputations. CAN 3 in 8% and 19% cases in patients with SMN and history of diabetic foot amputations respectively. The parameters of microvascular blood flow at rest were significantly decreased in patients with confirmed/severe CAN in comparison with early staging of CAN and patients without CAN (Vm=2.5±0.66 sm/sec vs. 4.4±0.54 sm/sec and 5.1±1.01 sm/sec respectively; p=0.0033). The abnormal result of cold test was detected in 94% patients with confirmed/ severe CAN and 26% patients with CAN 1.CONCLUSIONS: This investigation has demonstrated in a cohort with type 2 diabetes patients with/without SMN and with/ without history of previously foot amputations that decrease the Vm (the variable of microvascular blood flow assessed by High-frequency Ultrasonic Dopplerography) lower than 2.4 sm/sec is associated with 6.4 times increased likelihood of confirmed/severe CAN as well as positive cold test result. That the patients with positive cold test results were 28.6 times more likely have confirmed/severe CAN.


Author(s):  
Yasuhiro Oda ◽  
Masayuki Yamanouchi ◽  
Hiroki Mizuno ◽  
Rikako Hiramatsu ◽  
Tatsuya Suwabe ◽  
...  

Summary We report the renal histology of a 66-year-old man with hypertension, cardiovascular disease, and a 30-year history of type 2 diabetes mellitus with proliferative diabetic retinopathy, diabetic neuropathy, and diabetic foot status post toe amputation. Urinary protein excretion was 1.4 g/gCr, serum creatinine level 0.86 mg/dL, estimated glomerular filtration rate 69 mL/min/1.73 m2, and HbA1c 13–15%, despite using insulin. Light microscopy showed global glomerulosclerosis in 37% of the glomeruli, but the remaining glomeruli were intact. Significant polar vasculosis was present, while arteriolar sclerosis was mild. Electron microscopy revealed a thickened glomerular basement membrane, which is compatible with the early stage of diabetic glomerulopathy. The presented case was unique because glomerular changes seen typically in diabetes were not seen in the patient, despite the long-standing history of diabetes and diabetic comorbidities, while prominent polar vasculosis was found. Polar vascular formation helps preserve the glomeruli by allowing hyperosmotic blood bypass the glomeruli; this decreases intraglomerular pressure and minimizes glomerular endothelial damage. Learning points: A 66-year-old man with a 30-year history of type 2 diabetes mellitus with poor glycemic control underwent renal biopsy, which showed scarce glomerular changes typically seen in diabetic kidney disease and instead revealed significant polar vasculosis. Past studies demonstrated that the increased small vessels around the vascular hilus in diabetic patients originated from the afferent arterioles and drained into the peritubular capillaries. Polar vascular formation may preserve glomerular function by allowing the blood flow to bypass the glomeruli and decreasing the intraglomerular pressure, which minimizes endothelial damage of the glomerular tufts.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Polovina ◽  
I Milinkovic ◽  
G Krljanac ◽  
I Veljic ◽  
I Petrovic-Djordjevic ◽  
...  

Abstract Background Type 2 diabetes (T2DM) portends adverse prognosis in patients with atrial fibrillation (AF). Whether T2DM independently increases the risk of incident heart failure (HF) in AF is uncertain. Also, HF phenotype developing in patients with vs. those without T2DM has not been characterised. Purpose In AF patients without a history of prior HF, we aimed to assess: 1) the impact of T2DM on the risk of new-onset HF; and 2) the association between T2DM and HF phenotype developing during the prospective follow-up. Methods We included diabetic and non-diabetic AF patients, without a history of HF. Baseline T2DM status was inferred from medical history, haemoglobin A1c levels and oral glucose tolerance test. Study outcome was the first hospital admission or emergency department treatment for new-onset HF during the prospective follow-up. The phenotype of new-onset HF was determined by echocardiographic exam performed following clinical stabilisation (at hospital discharge, or within a month after HF diagnosis). HF phenotype was defined as HFrEF (left ventricular ejection fraction [LVEF] <40%), HFmrEF (LVEF 40–49%) or HFpEF (LVEF≥50%). Cox regression analyses adjusted for age, sex, baseline LVEF, comorbidities, smoking status, alcohol intake, AF type (paroxysmal vs. non-paroxysmal) and T2DM treatment was used to analyse the association between T2DM and incident HF. Results Among 1,288 AF patients without prior HF (mean age: 62.1±12.7 years; 61% male), T2DM was present in 16.5%. Diabetic patients had higher mean baseline LVEF compared with nondiabetic patients (50.0±6.2% vs. 57.6±9.0%; P<0.001). During the median 5.5-year follow-up, new-onset HF occurred in 12.4% of patients (incidence rate, 2.9; 95% confidence interval [CI], 2.5–3.3 per 100 patient-years). Compared with non-diabetic patients, those with T2DM had a hazard ratio of 2.1 (95% CI, 1.6–2.8; P<0.001) for new-onset HF, independent of baseline LVEF or other factors. In addition, diabetic patients had a significantly greater decline in covariate-adjusted mean LVEF (−10.4%; 95% CI, −9.8% to −10.8%) at follow-up, compared with nondiabetic patients (−4.0%; 95% CI, −3.8% to −4.2%), P<0.001. The distribution of HF phenotypes at follow-up is presented in Figure. Among patients with T2DM, HFrEF (56.9%) was the most common phenotype of HF, whereas in patients without T2DM, HF mostly took the phenotype of HFpEF (75.0%). Conclusions T2DM is associated with an independent risk of new-onset HF in patients with AF and confers a greater decline in LVEF compared to individuals without T2DM. HFrEF was the most prevalent presenting phenotype of HF in AF patients with T2DM.


2014 ◽  
Vol 05 (03) ◽  
pp. 250-253 ◽  
Author(s):  
Salma Bensbaa ◽  
Loubna Agerd ◽  
Saïd Boujraf ◽  
Chadya Araab ◽  
Rachid Aalouane ◽  
...  

ABSTRACT Background: The global prevalence of diabetes is increasing worldwide. In Morocco, diabetes and depression are major public health problems, requiring improvement in their care. Diabetes and depression are associated with morbidity and early mortality. This association contributes to raising the risk of the complications that occur, while causing higher suffering to patients, as also an increased cost toward healthcare. Aim: This study aims to assess the prevalence of depression in patients with type 2 diabetes (T2D), and identify the main risk factors for depression in this category of diabetic patients. Patients and Methods: Type 2 diabetic patients and older than 18 years of age were recruited. The exclusion criteria included being type 1 diabetic, pregnant woman, hospitalized patients, a history of neurological disorders, such as, stroke, infectious episidodes, and history of psychiatric disorders. The individual patient data was collected through individual and confidential interviews lasting 30 minutes, at the end of the diabetology consultation, by the same diabetologist, trained to use the psychometric scales that were needed. The Moroccan–Arabic version of the Beck diagnostic scale of depression was used. Patients assessed with depressive disorders were reviewed in a specialized psychiatric consultation. The statistical analysis was achieved by using SPSS package (version 17). We retained a threshold P value of 0.05. Settings and Design: A cross-sectional study was conducted that included adults with type 2 diabetes. The depression diagnosis was performed using the Arabic version of the Beck Depression scale. Statistical Analysis: We included 142 patients with type 2 diabetes, with an average age of 56.26 years. The prevalence of depression was 33.1%. The risk factors recognized for depression were, lack of social security, hypertension, and a history of type 2 diabetes of more than five years. Results and Conclusions: In this study, we have focused on the frequent association of ‘Type 2 diabetes and depression’ and the risk of mutual aggravation of both pathologies that might require multidisciplinary healthcare, as well as, improvement in the risk factors of depression through improved access to healthcare, with the extension of social security. The stability of the healthcare personnel involved in the treatment of both chronic diseases, including diabetes and hypertension screening, should also be considered for better management of psychiatric complications.


2011 ◽  
Vol 57 (5) ◽  
pp. 719-728 ◽  
Author(s):  
Chad R Borges ◽  
Paul E Oran ◽  
Sai Buddi ◽  
Jason W Jarvis ◽  
Matthew R Schaab ◽  
...  

BACKGROUND In 2008, the US Food and Drug Administration (FDA) issued a Guidance for Industry statement formally recognizing (during drug development) the conjoined nature of type 2 diabetes (T2D) and cardiovascular disease (CVD), which has precipitated an urgent need for panels of markers (and means of analysis) that are able to differentiate subtypes of CVD in the context of T2D. Here, we explore the possibility of creating such panels using the working hypothesis that proteins, in addition to carrying time-cumulative marks of hyperglycemia (e.g., protein glycation in the form of Hb A1c), may carry analogous information with regard to systemic oxidative stress and aberrant enzymatic signaling related to underlying pathobiologies involved in T2D and/or CVD. METHODS We used mass spectrometric immunoassay to quantify, in targeted fashion, relative differences in the glycation, oxidation, and truncation of 11 specific proteins. RESULTS Protein oxidation and truncation (owing to modified enzymatic activity) are able to distinguish between subsets of diabetic patients with or without a history of myocardial infarction and/or congestive heart failure where markers of glycation alone cannot. CONCLUSION Markers based on protein modifications aligned with the known pathobiologies of T2D represent a reservoir of potential cardiovascular markers that are needed to develop the next generation of antidiabetes medications.


2005 ◽  
Vol 185 (3) ◽  
pp. 439-444 ◽  
Author(s):  
Chidum Ezenwaka ◽  
Risha Kalloo ◽  
Mathias Uhlig ◽  
Robert Schwenk ◽  
Juergen Eckel

The E23K variant of the Kir6.2 gene has been shown to be associated with type 2 diabetes mellitus in Caucasian subjects. Because offspring of type 2 diabetic patients have a genetically increased risk of developing diabetes, we sought to identify the E23K variant of the Kir6.2 gene in offspring of Caribbean patients with type 2 diabetes and assess the contribution of this variant to impaired glucose tolerance in these subjects. Forty-six offspring of patients with type 2 diabetes and 39 apparently healthy subjects whose immediate parents were not diabetic (‘control’) were studied after an overnight fast. Anthropometric indices were measured and blood samples were collected. Fasting and 2 h plasma glucose, insulin and lipids were subsequently determined. Insulin resistance was calculated using the homeostatic model assessment technique. The offspring and control subjects had similar frequencies of the E23K polymorphism (52.6 vs 45.5%, P>0.05) and the frequency of the E23K variant did not differ significantly between gender and ethnic distributions, irrespectively of a family history of diabetes (P>0.05). There were no significant differences in biochemical risk factors for developing diabetes in offspring carriers of the E23K variant compared with offspring non-carriers of the mutation. Offspring with the E23K mutation had even significantly higher 2 h insulin concentrations when compared with control subjects. It is concluded that the presence of the Kir6.2 E23K genotype in Caribbean subjects with an immediate positive family history of diabetes does not confer significantly higher levels of biochemical risk factors for the development of type 2 diabetes.


Author(s):  
Ugonma, Winnie Dozie ◽  
Nnenna, Vivian Okonkwo ◽  
Okwuchi, Blessed Nworuh ◽  
Somtochukwu, Mercy Orji ◽  
Chidozie Joakin Nwaokoro ◽  
...  

Background: Hypertension is among the important causes of non-communicable disease burden worldwide. It has raised public health concerns in both developed and developing nations. It mostly occurs in patients with diabetes and the prevalence depends on duration, type and age of the patient. The study aimed at determining the risk factors of hypertension among type 2 diabetic patients in Imo State, Nigeria. Methods: A hospital-based descriptive survey design involving 50 patients attending hospital was used. Structured questionnaire complemented with interview schedule was used to collect data from the respondents. Data were analyzed using frequency and mean score. Hypotheses were tested using Chi-square at 5% significance level. Results: The result showed that the majority (70.0%) of the patients was hypertensive, 54.0% of the patients used dietary control and drugs in the treatment of the diseases. Furthermore, it was found that 54.0% ate salty foods always, 58.0% of the patients added extra table salt in their meals, 54.0% ate canned foods and 82.0% took sugary drinks always. It was also found that 66.0% ate always from restaurants and 58.0% ate more of starchy foods. The result further showed that 74.0% of the patients avoided physical exercise and 70.0% indicated that doing stress works made them get anxious. Eighty percent of the patients had hypertension in their family history and the 74.0% indicated it was their brother/sister. The X2 result showed a significantly association between family history of hypertension and type 2 diabetes X2(121, N = 50) = 187, p = 0.000. It was also found that dietary pattern was significantly associated with risk of type 2 diabetes X2(121, N = 50) = 187, p = 0.000. Conclusion: Dietary pattern and family history of hypertension were significantly associated with type 2 diabetes. It was recommended that sensitization campaigns be organized to educate women on the effect of diets on diabetes. Also, family history of hypertension should be ascertained from patients to ensure early detection and treatment of diabetes.


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