PLASMA LEVELS OF ASYMMETRIC DI METHYL ARGININE IN DIABETIC PATIENTS WITH NEUROPATHIC FOOT ULCERATION

Introduction: Genetic variants could aid in predicting antidiabetic drug response by associating them with markers of glucose control, such as glycated hemoglobin (HbA1c). However, pharmacogenetic implementation for antidiabetics is still under development, as the list of actionable markers is being populated and validated. This study explores potential associations between genetic variants and plasma levels of HbA1c in 100 patients under treatment with metformin. Methods: HbA1c was measured in a clinical chemistry analyzer (Roche), genotyping was performed in an Illumina-GSA array and data were analyzed using PLINK. Association and prediction models were developed using R and a 10-fold cross-validation approach. Results: We identified genetic variants on SLC47A1, SLC28A1, ABCG2, TBC1D4, and ARID5B that can explain up to 55% of the interindividual variability of HbA1c plasma levels in diabetic patients under treatment. Variants on SLC47A1, SLC28A1, and ABCG2 likely impact the pharmacokinetics (PK) of metformin, while the role of the two latter can be related to insulin resistance and regulation of adipogenesis. Conclusions: Our results confirm previous genetic associations and point to previously unassociated gene variants for metformin PK and glucose control.

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Rocker outsole shoe is not a threat to postural stability in patients with diabetic neuropathy

Prosthetics and Orthotics International ◽

10.1177/0309364614543549 ◽

2014 ◽

Vol 40 (2) ◽

pp. 224-230 ◽

Cited By ~ 5

Author(s):

Banafshe Ghomian ◽

Mojtaba Kamyab ◽

Hassan Jafari ◽

Mohammadebrahim Khamseh ◽

Aoife Healy

Keyword(s):

Diabetic Neuropathy ◽

Response Latency ◽

Postural Stability ◽

Response Strength ◽

Diabetic Patients ◽

Foot Ulceration ◽

Objective Evidence ◽

Significant Difference ◽

Quasi Experimental ◽

Force Displacement

Background: Rocker outsole shoes are commonly prescribed to patients with diabetic neuropathy to offload a particular area of the foot sole, thereby decreasing the risk of foot ulceration. Contrary to this, some evidence has reported a postural destabilising effect of these shoes in healthy adults. Objective: To explore the postural stability of patients with diabetic neuropathy who wear a rocker outsole shoe. Study design: Quasi-experimental. Method: In total, 17 patients with diabetic neuropathy (aged 49.29 ± 7.48 years; 7 female, 10 males) participated in this study. A Motor Control Test measuring centre of force displacement, response strength scale and response latency in medium and large perturbations was conducted using the EquiTest system to evaluate postural stability while wearing a baseline shoe (without a rocker outsole) or a rocker outsole shoe (with a toe-only rocker sole). Results: No significant difference was observed between the shoe conditions in centre of force displacement and response latency of the participants (p > 0.05). The results indicated a significant increase in the response strength scale of participants by the rocker outsole, for medium forward and backward and large forward perturbations ( p = 0.014, p = 0.001 and p = 0.027, respectively). Conclusion: When the immediate effect is a concern, the rocker outsole shoe did not negatively affect postural stability in patients with diabetic neuropathy. Clinical relevance This article will provide objective evidence about the effect of rocker outsole on postural balance in diabetic patients. In prescription of rocker outsole to prevent plantar ulceration of diabetic foot, immediate postural destabilising is not a concern.

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Comparison of Quantitative Sensory-Threshold Measures for Their Association With Foot Ulceration in Diabetic Patients

Diabetes Care ◽

10.2337/diacare.13.10.1057 ◽

1990 ◽

Vol 13 (10) ◽

pp. 1057-1061 ◽

Cited By ~ 101

Author(s):

J. M. Sosenko ◽

M. Kato ◽

R. Soto ◽

D. E. Bild

Keyword(s):

Diabetic Patients ◽

Sensory Threshold ◽

Foot Ulceration

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Insulin Resistance Is Associated with Increased Circulating Level of Thrombin-Activatable Fibrinolysis Inhibitor in Type 2 Diabetic Patients

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.87.2.8214 ◽

2002 ◽

Vol 87 (2) ◽

pp. 660-665 ◽

Cited By ~ 38

Author(s):

Yasuko Hori ◽

Esteban C. Gabazza ◽

Yukata Yano ◽

Akira Katsuki ◽

Koji Suzuki ◽

...

Keyword(s):

Insulin Resistance ◽

Plasma Levels ◽

Common Finding ◽

Diabetic Patients ◽

Thrombin Activatable Fibrinolysis Inhibitor ◽

Type 2 Diabetic Patients ◽

Visceral Fat Area ◽

Type 2 Dm ◽

Fibrinolysis Inhibitor

Hypofibrinolysis is a common finding in patients with diabetes mellitus (DM) and obesity and a risk factor for the development of cardiovascular disease. Recently, a new potent inhibitor of fibrinolysis, the thrombin-activatable fibrinolysis inhibitor (TAFI) has been isolated and characterized from human plasma. The present study was undertaken to assess the activity and circulating level of TAFI and its relation to fibrinolytic function and obesity in patients with type 2 DM. Fifty-seven patients with type 2 DM (38 men, 19 women) were enrolled in this study. DM patients were categorized in age-matched obese [body mass index (BMI) ≥ 25] and nonobese (BMI < 25) groups. The plasma concentration and activity of TAFI were significantly (P < 0.05) higher in DM patients than in healthy controls. The plasma levels and activity of TAFI were significantly (P < 0.05) elevated in obese DM patients compared with nonobese DM and nonobese healthy subjects. RT-PCR demonstrated the expression of TAFI in human adipose tissue and in human endothelial cells. The plasma levels of TAFI were independently and significantly correlated with glucose intolerance (HbA1c), with obesity (BMI, visceral fat area), and with an indicator of insulin resistance (glucose infusion rate). This study showed that increased circulating level of TAFI may be an important causative factor of hypofibrinolysis in patients with type 2 diabetes, obesity and insulin resistance.

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