scholarly journals Cardiovascular risk assessment in type 2 diabetes mellitus: comparison of the World Health Organization/International Society of Hypertension risk prediction charts versus UK Prospective Diabetes Study risk engine

2015 ◽  
pp. 583 ◽  
Author(s):  
Meththananda Herath ◽  
Thilak Weerarathna ◽  
Dilini Umesha
2011 ◽  
Vol 8 (1) ◽  
pp. 32-39 ◽  
Author(s):  
A V Kosygina

In recent decades, overweight and obesity have become a major problem for most countries. According to the World Health Organization (WHO), more than a billion people worldwide are overweight and more than 300 million are obese. These clinical and experimental studies highlight a clear relationship between obesity and several chronic diseases such as type 2 diabetes mellitus (T2DM), atherosclerosis, coronary heart disease, high risk of oncological diseases, disorders of the reproductive sphere, pathology of the musculoskeletal system, as well as deviations in mental status and processes of social adaptation. Therefore, considerable efforts of modern endocrinology focused on the study of etiopathogenetic aspects that underlie these diseases and identification of possible markers.


2021 ◽  
Vol 70 (3) ◽  
pp. 11-19
Author(s):  
Natalya V. Borovik ◽  
Еkaterina V. Musina ◽  
Alyona V. Tiselko ◽  
Svetlana V. Suslova ◽  
Olga B. Glavnova ◽  
...  

BACKGROUND: The increase in the incidence of type 2 diabetes mellitus worldwide and the improvement in the quality of diabetic and obstetric care lead to an increase in the number of pregnant women with type 2 diabetes mellitus. The incidence of obstetric and perinatal adverse outcomes in women with type 2 diabetes mellitus is often higher than in women with type 1 diabetes. In the world literature, there are few works on the effect of pregnancy planning on the course and outcome of pregnancy in women with type 2 diabetes mellitus. AIM: The aim of this study was to evaluate the role of pregnancy planning in patients with type 2 diabetes mellitus in improvement of pregnancy and birth outcomes. MATERIALS AND METHODS: We retro- and prospectively analyzed the course and outcome of pregnancy in 124 women with type 2 diabetes mellitus, who were observed in the Diabetes Mellitus and Pregnancy Center of the Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott for the period from 2010 to 2019. The study included 34 women with type 2 diabetes mellitus at the stage of pregnancy planning and 90 women during pregnancy. All patients underwent a general clinical examination, carbohydrate metabolism correction, training at the School of Diabetes Mellitus in the principles of rational nutrition, self-control of glycemia and insulin therapy. Diabetes compensation was assessed by the level of glycated hemoglobin, determined using a method certified in accordance with the National Glycogemoglobin Standartization Program and standardized in accordance with the reference values adopted in the Diabetes Control and Complications Trial, as well as by the level of glycemia (self-control at least four times a day). We also assessed the severity of vascular complications of type 2 diabetes mellitus before and during pregnancy, and identified and treated comorbidities. To assess the degree of obesity, the criteria of the World Health Organization and the pregravid body mass index calculated by the Quetelet formula were used. The severity of preeclampsia was assessed in accordance with federal clinical guidelines. Ultrasound examination of the fetus with Doppler blood flow in the vessels of the fetoplacental complex was performed using a Voluson E6 ultrasound system (GE Healthcare, USA). For the timely diagnosis of diabetic fetopathy and fetal cardiomyopathy, dynamic fetometry and echocardiography were conducted. In addition, cardiotocography was performed for antenatal assessment of the fetus from the 30th week of pregnancy. After delivery, a neonatologist assessed the condition of the newborn using the Apgar scale at the first and fifth minutes of life, and then the assessment was carried out in the early neonatal period. RESULTS: In the group of women who received pregravid training, the course and outcomes of pregnancy were significantly better: the frequency of preeclampsia was lower (14.7%) compared to the group of women with an unplanned pregnancy (40.0%); there was no severe preeclampsia compared to the same women (13.3%). The number of preterm births was significantly lower (14.7%) in the group of women with planned pregnancy compared to the group of women without pregravid preparation (37.8%). In addition, in the group of women planning pregnancy, there were no fetal congenital malformations, neonatal hypoglycemic conditions, hypertrophic cardiomyopathy; in the group of women with an unplanned pregnancy, these parameters being found to amount to 6.7%, 24.4% and 6.7%, respectively. There was no perinatal mortality in the group of women with a planned pregnancy; however, this parameter was shown to be 3.3% in the group of women with an unplanned pregnancy. CONCLUSIONS: Pregnancy planning in patients with type 2 diabetes mellitus can significantly improve the course of pregnancy and childbirth outcomes.


2021 ◽  
Vol 2 (6) ◽  
pp. 53-56
Author(s):  
Irina A. Novikova ◽  
◽  
Tatiana M. Panina ◽  

Type 2 diabetes mellitus is a violation of carbohydrate metabolism caused by insulin resistance and relative insulin insufficiency or a violation of insulin secretion with or without insulin resistance. The number of people with diabetes increased from 108 million in 1980 to 422 million in 2014. The World Health Organization (WHO) predicts that by 2030 this number will increase to 439 million, which is almost 10% of the adult population. A dentist is often the first to encounter manifestations of diabetes mellitus in the oral cavity, such as caries, candidiasis, dryness, inflammatory periodontal diseases, etc. Therefore, timely diagnosis and close interaction of doctors of different specialties is crucial for the treatment of this disease.


Cardiometabolic diseases, including obesity and Type-2 diabetes, are a growing concern and have become an epidemic worldwide. A World Health Organization (WHO) report, - ‘Global Prevalence of Type-2 diabetes’ estimates incidence of this disease, to be 9% among adults. An estimated 1.5 million death worldwide, were directly caused by diabetes. More than 80% of the Type-2 diabetes-related deaths occur in low-and middle-income countries. Worldwide in 2013, it was estimated that almost 400 million people suffer from diabetes, and this is supposed to reach a high of 600 million by 2035. According to the World Health Organization estimates, the impact of Type-2 diabetes-related health care expenditure, to prevent and manage diabetes and its clinical complications in the USA alone, was USD 360 billion in 2010 and will exceed 360 billion by 2030. WHO predicts losses in national income from Diabetes and Cardiovascular Disease (CVD) to be in equivalents of 557 billion in International Dollars (ID) in China, 303 billion in Russia, and 236 billion in India. Currently, there are 75 million diabetics in India and an equal number of pre-diabetics. The incidence of Type-2 diabetes in China also has reached epidemic proportions. Gulf Countries also have reported a high incidence of diabetes. One of the Global targets for diabetes management was to halt by 2025, the rise in the age-standardized adult prevalence of this disease, at its 2010 levels. However, according a recent publication in the Lancet (April 2016) by the NCD Risk Factor Collaboration, if the post-2000 trends continue in the increased incidence of type-2 diabetes, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2020 level worldwide is lower than 1% for men and women. Because of these observations, the best choice we have is, to go by the World Diabetes Federation recommendations, and manage the hyperglycemia efficiently. Besides, develop programs for early detection of altered glucose metabolism, and implement robust strategies for normalization of this altered state. In conclusion, through robust prevention programs, reduce the disease incidence, through better diagnostic tests, detect early risks that initiate or promote clinical complications, and by effective management of the risks, reduce or prevent acute events related to the end-organ failure.


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