Microvascular Complications of Type 2 Diabetes Mellitus

2020 ◽  
Vol 18 (2) ◽  
pp. 117-124 ◽  
Author(s):  
Charles Faselis ◽  
Alexandra Katsimardou ◽  
Konstantinos Imprialos ◽  
Pavlos Deligkaris ◽  
Manolis Kallistratos ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Sexual Dysfunction ◽  
Microvascular Complications ◽  
Diagnostic Methods ◽  
Laboratory Evaluation

Background: Type 2 diabetes mellitus (T2DM) is a chronic, non communicable, multisystem disease that has reached epidemic proportions. Chronic exposure to hyperglycaemia affects the microvasculature, eventually leading to diabetic nephropathy, retinopathy and neuropathy with high impact on the quality of life and overall life expectancy. Sexual dysfunction is an often-overlooked microvascular complication of T2DM, with a complex pathogenesis originating from endothelial dysfunction. Objective: The purpose of this review is to present current definitions, epidemiological data and risk factors for diabetic retinopathy, nephropathy, neuropathy and sexual dysfunction. We also describe the clinical and laboratory evaluation that is mandatory for the diagnosis of these conditions. Method: A comprehensive review of the literature was performed to identify data from clinical studies for the prevalence, risk factors and diagnostic methods of microvascular complications of T2DM. Results: Diabetic nephropathy and retinopathy affect approximately 25% of patients with T2DM; diabetic neuropathy is encountered in almost 50% of the diabetic population, while the prevalence of erectile dysfunction ranges from 35-90% in diabetic men. The duration of T2DM along with glycemic, blood pressure and lipid control are common risk factors for the development of these complications. Criteria for the diagnosis of these conditions are well established, but exclusion of other causes is mandatory. Conclusion: Early detection of microvascular complications associated with T2DM is important, as early intervention leads to better outcomes. However, this requires awareness of their definition, prevalence and diagnostic modalities.

STUDY OF PREVALENCE AND CLINICAL PROFILE OF NEPHROPATHY AND RETINOPATHY IN TYPE 2 DIABETES PATIENTS AT TERTIARY CARE CENTER, UDAIPUR

2021 ◽  
pp. 6-8
Author(s):  
Yash Salil Patel
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Diabetic Nephropathy ◽  
Microvascular Complications ◽  
Tertiary Care ◽  
Positive Family History ◽  
Diabetic Patients

Microvascular complications of Type 2 Diabetes Mellitus (T2DM), (retinopathy and nephropathy) have a similar etiopathogenetic mechanism besides genetic predisposition. Even though these two complications frequently co-exist, their frequency varies. The association of these two signicant complications and their coexistence needs a relook. To study prevalence of retinopathy and nephropathy in Type 2 diabetes mel Aim: litus. Comparison of diabetic retinopathy and nephropathy in Type 2 diabetes mellitus and its correlation of diabetic retinopathy and nephropathy with duration of illness and various risk factors that affects development, progression and severity of diabetic retinopathy and nephropathy. 100 diabetic patients were taken up for study for a period of one year meeti Methodology: ng the criteria for the present study. Detailed history was taken from patient and meticulous examination was done of all patients with special emphasis on renal and ophthalmic symptoms. Clinical data and investigation prole was tabulated. Statistical analysis was done. Among 100 patients, 22 had diabetic retinopathy. Among patients with diab Results & Conclusion: etic retinopathy, 68.18% patients had positive family history. Among 100 patients, 32 had diabetic nephropathy, mean FBS was 207 mg%, PPBS was 317.8 mg% and mean HbA was 9.2%. Among patients with diabetic retinopathy, mean FBS was 211 mg%, PPBS was 324.9 1c mg%, HbA was 9.5%. From this study it is found that diabetic nephropathy starts earlier than retinopathy. In this study 1c hypertension was found to accelerate progression into nephropathy and retinopathy.

scholarly journals Association of 2184AG Polymorphism in the RAGE Gene with Diabetic Nephropathy in Chinese Patients with Type 2 Diabetes

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Wei Cai ◽  
Jian Li ◽  
Ji-Xiong Xu ◽  
Ying Liu ◽  
Wei Zhang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Microvascular Complications ◽  
Chinese Patients ◽  
Chinese Han ◽  
Genotype Frequencies ◽  
Diabetic Microvascular Complications

Objective. The interaction between advanced glycation end products and their cellular receptor (RAGE) has an important role in the pathogenesis of diabetic microvascular complications. The aim of this study was to investigate the relationship between the 2184A/G polymorphism in the RAGE gene and diabetic nephropathy in Chinese Han patients with type 2 diabetes mellitus. Methods. A total of 868 patients with type 2 diabetes mellitus (486 without and 382 with diabetic nephropathy) were enrolled in this study. The genotype and allele frequencies of the 2184A/G polymorphism were detected using the polymerase chain reaction-restriction fragment-length polymorphism method. Results. The G allele and AG + GG genotype frequencies in patients with diabetic nephropathy were significantly lower than those in patients without diabetic nephropathy (P=0.001 and P=0.005, resp.). After adjustments for possible confounders, multivariate logistic regression analyses showed that the 2184A/G polymorphism was independently associated with diabetic nephropathy (OR = 0.46, 95% CI: 0.22–0.92, P=0.028). Conclusions. Our study indicated that the 2184A/G polymorphism in the RAGE gene was significantly associated with diabetic nephropathy in Chinese Han patients with type 2 diabetes.

Diabetic nephropathy and risk factors for peripheral artery disease in Chinese with type 2 diabetes mellitus

Metabolism ◽  
2009 ◽  
Vol 58 (4) ◽  
pp. 504-509 ◽  
Author(s):  
Ming-Chia Hsieh ◽  
Kai-Jen Tien ◽  
Daw-Shyong Perng ◽  
Jeng-Yueh Hsiao ◽  
Shun-Jen Chang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Artery Disease

scholarly journals Assessment of Knowledge, Attitude and Practices of Medical Officers in Primary Health Centres Regarding Type 2 Diabetes Mellitus

2019 ◽  
Vol 20 (2) ◽  
pp. 63-67
Author(s):  
Jayaprakash S Appajigol ◽  
Manjunath Somappa Somannavar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Microvascular Complications ◽  
Diagnostic Methods ◽  
Primary Health ◽  
Primary Health Centres ◽  
Health Centres ◽  
Knowledge And Attitude

Background: Health education is an integral part of Type 2 diabetes mellitus (T2DM) management, as it can be prevented and controlled by the implication of appropriate interventions. The aim of the study was to assess the knowledge, attitude, and practice (KAP) of medical officers (MOs) in primary health centres (PHC) regarding T2DM. Materials and methods: The 104 medical officers (MOs) with an experience of £2 years of medical practice were included in the study. A self-completion questionnaire, designed to be completed within 10-15 minutes, was developed to analyse the KAP of the MOs regarding T2DM. Results: Among the 104 MOs, 14 had knowledge about the prevalence of T2DM in India. Among the risk factors, obesity (71), physical inactivity (31), family history (43), and hypertension (15) were identified by the MOs. The microvascular complications, including retinopathy (77), nephropathy (63), and neuropathy (49) were stated by the physicians. However, the physicians were less aware about the macrovascular complications. As few as 23 physicians included HbA1c test as one of the diagnostic methods, 43 physicians included HbA1c to monitor the glycemic levels. More than half (55) of the physicians prescribed appropriate medications for the treatment of T2DM. Conclusions: The MOs had considerable knowledge and attitude about T2DM, however due to lack of facilities at the PHCs, the practice of MOs in the management of T2DM is poor. Education programmes to expand the understanding of the MOs regarding T2DM and initiatives to advance the facilities at PHCs are essential to manage T2DM in India. Keywords: Type 2 Diabetes Mellitus J MEDICINE JUL 2019; 20 (2) : 63-67

The role of vitamin D deficiency and elevated inflammatory biomarkers as risk factors for the progression of diabetic nephropathy in patients with type 2 diabetes mellitus

2021 ◽  
Vol 19 (1) ◽  
pp. 1183-1192
Author(s):  
Ahmad El Askary ◽  
Amal F. Gharib ◽  
Mazen Almehmadi ◽  
Maha Mahfouz Bakhuraysah ◽  
Abdulaziz Ali Al Hajjiahmed ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Vitamin D Deficiency ◽  
Diabetic Patients ◽  
Tnf Α

Abstract Diabetic nephropathy (DN) is the leading cause of end-stage renal disease worldwide. Albuminuria is the most sensitive marker for the early recognition of DN. Therefore, we aimed to study the risk factors of albuminuria as a marker of DN among diabetic patients. The study included 41 patients with type 2 diabetes mellitus (T2DM), 50 type 2 diabetic nephropathy (T2DN) patients with macroalbuminuria, 43 T2DN patients with microalbuminuria and 38 healthy controls. Logistic regression was used to detect the most significant risk factors for albuminuria. A high statistically significant difference was found between the groups regarding age, sex, body mass index (BMI), diabetes mellitus (DM) duration, glucose, glycated haemoglobin (HbA1c), creatinine, glomerular filtration rate (GFR), lipid profile, tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), the albumin–creatinine ratio (ACR), vitamin D, total parathyroid hormone (PTH), urea, total calcium and chemerin (p < 0.001). It was found that the duration of DM, BMI, glucose, GFR, total cholesterol (TC), low-density lipoprotein (LDL), TNF-α, IL-6, CRP, ACR, vitamin D, PTH and chemerin are significant albuminuria risk factors in DN. Vitamin D deficiency and associated inflammatory mediators such as chemerin, TNF-α, IL-6 and CRP are the most essential risk factors for albuminuria in T2DM patients.

Microvascular complications and their associated risk factors in type 2 diabetes mellitus

2017 ◽  
Vol 11 ◽  
pp. S577-S581 ◽  
Author(s):  
Parvin Akter Khanam ◽  
Sayama Hoque ◽  
Tanjima Begum ◽  
Samira Humaira Habib ◽  
Zafar Ahmed Latif
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Microvascular Complications ◽  
Associated Risk Factors

scholarly journals Matrix metalloproteinase-9 gene polymorphism (-1562 C/T) and its correlation with diabetic nephropathy

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Kholoud Shalaby ◽  
Rania Bahriz ◽  
Nancy Mahsoub ◽  
Mohammed M. El-Arman ◽  
Ghada El-Said
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Gene Polymorphism ◽  
Matrix Metalloproteinase ◽  
Microvascular Complications ◽  
Matrix Metalloproteinase 9 ◽  
Metalloproteinase 9

Abstract Background Matrix metalloproteinase 9 (MMP-9) is an important inflammatory marker in diabetic nephropathy. Many studies assessed the association between MMP-9 gene polymorphism and different microvascular complications of type 2 diabetes mellitus, though the results were inconclusive and need further exploration. Our study aimed to assess the association between MMP-9 -1562C/T gene polymorphism and diabetic nephropathy in patients with type 2 diabetes mellitus. Results Taking CC genotype of rs3918242 (MMP-9-1562C/T SNP) as the reference genotype and C as the reference allele, TT genotype, T allele showed significantly lower frequency in diabetic nephropathy group than without nephropathy (2.9% versus 20%, 20% versus 35.7% respectively), with the possible significant protective effect against diabetic nephropathy development (OR = 0.269, 0.450 respectively); it was considered as an independent predictor for diabetic nephropathy occurrence. Conclusions This study suggested that T allele of MMP-9 -1562C/T single nucleotide polymorphism had a protective role against diabetic nephropathy development and also had a role for early prediction of patients susceptible to this complication, so it helps in prevention and management of those patients.

scholarly journals Endothelin-1 Gene Polymorphisms rs5370, rs1476046, and rs3087459 are not Associated with Diabetic Nephropathy in Caucasians with Type 2 Diabetes Mellitus

Folia Medica ◽  
2017 ◽  
Vol 59 (3) ◽  
pp. 261-269 ◽  
Author(s):  
Maja Šeruga ◽  
Stojan Kariž ◽  
Jana Makuc ◽  
Matej Završnik ◽  
Ines Cilenšek ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Gene Polymorphisms ◽  
Significant Difference ◽  
Study Population ◽  
Lines Of Evidence

AbstractBackground:Diabetic nephropathy (DN) is a major microvascular complication of type 2 diabetes mellitus (T2DM). Several lines of evidence implicate the endothelin (ET) system in the pathophysiology of DN. The aim of the present study was to analyze if genetic polymorphisms of the ET-1 (EDN1) gene affect susceptibility to DN in Caucasians with T2DM.Materials and methods:The study population consisted of 651 Caucasian subjects with T2DM of more than 10 years’ duration: 276 patients with DN (cases) and 375 patients without evidence of DN (controls). Polymorphisms in ET-1 (EDN1) gene, rs5370, rs1476046, and rs3087459, were studied.Results:Genotype distributions of the studied polymorphisms showed no significant difference between cases and controls.Conclusions:We provide evidence that the rs5370, rs1476046, and rs3087459 polymorphisms ofEDN1gene are not risk factors for DN in Caucasians with T2DM.

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