scholarly journals THE FAMILY DOCTOR’S ROLE IN ACHIEVING TARGET LEVELS OF TREATMENT IN PATIENTS WITH TYPE 2 DIABETES

2020 ◽  
Vol 72 (2) ◽  
pp. 51-58
Author(s):  
О. Korzh ◽  
A. Titkova ◽  
M. Kochuieva ◽  
Yu. Vinnyk ◽  
L. A. Ruban ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Lifestyle Changes ◽  
Treatment Goal ◽  
Treatment Goals ◽  
Factors Associated ◽  
Triple Treatment

The aim of the study was to identify the proportion of patients with type 2 diabetes who were unable toachieve the triple treatment goal for concomitant control of blood glucose level, blood pressure, LDL and modifying factors associated with achieving triple therapy goals. The study included 675 patients with type 2 diabetes,dyslipidemia and hypertension. The analysis was performed using concurrent triple treatment goals with specific levels of HbA1c, LDL and blood pressure as the main result. The questionnaire for patients with dyslipidemiaincluded self-assessment of compliance with prescribed drugs and perceptions related to their understandingand attitude towards lifestyle changes and pharmacological treatment. The results of the analysis of the logistic regression of factors associated with the achievement of triple treatment goals showed that patients whoreceived moderate doses of statins with high intensity were less likely to achieve concurrent treatment of thegoal compared to low intensity. Younger patients were less likely to achieve the triple treatment goal than thoseover 60 years of age. Based on life expectancy, they will be more susceptible to vascular complications due to anearlier onset of the disease and a longer period of time during which these adverse events can develop. Fewerdrugs and a shorter duration of type 2 diabetes were significant factors in the triple control. It was proved thatsimultaneous control of glycemia, hypertension and lipids was achieved in 22.4% of patients, who were affectedby the intensity of statin treatment, the number of diabetic drugs and the presence of concomitant pathology.Thus, the simultaneous achievement of the triple goal is a more comprehensive mitigation measure to reduce therisk of both macro- and microvascular complications

scholarly journals THE FAMILY DOCTOR’S ROLE IN ACHIEVING TARGET LEVELS OF TREATMENT IN PATIENTS WITH TYPE 2 DIABETES

2020 ◽  
Vol 72 (2) ◽  
pp. 51-58
Author(s):  
О. Korzh ◽  
A. Titkova ◽  
M. Kochuieva ◽  
Yu. Vinnyk ◽  
L. A. Ruban ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Lifestyle Changes ◽  
Treatment Goal ◽  
Treatment Goals ◽  
Factors Associated ◽  
Triple Treatment

The aim of the study was to identify the proportion of patients with type 2 diabetes who were unable toachieve the triple treatment goal for concomitant control of blood glucose level, blood pressure, LDL and modifying factors associated with achieving triple therapy goals. The study included 675 patients with type 2 diabetes,dyslipidemia and hypertension. The analysis was performed using concurrent triple treatment goals with specific levels of HbA1c, LDL and blood pressure as the main result. The questionnaire for patients with dyslipidemiaincluded self-assessment of compliance with prescribed drugs and perceptions related to their understandingand attitude towards lifestyle changes and pharmacological treatment. The results of the analysis of the logistic regression of factors associated with the achievement of triple treatment goals showed that patients whoreceived moderate doses of statins with high intensity were less likely to achieve concurrent treatment of thegoal compared to low intensity. Younger patients were less likely to achieve the triple treatment goal than thoseover 60 years of age. Based on life expectancy, they will be more susceptible to vascular complications due to anearlier onset of the disease and a longer period of time during which these adverse events can develop. Fewerdrugs and a shorter duration of type 2 diabetes were significant factors in the triple control. It was proved thatsimultaneous control of glycemia, hypertension and lipids was achieved in 22.4% of patients, who were affectedby the intensity of statin treatment, the number of diabetic drugs and the presence of concomitant pathology.Thus, the simultaneous achievement of the triple goal is a more comprehensive mitigation measure to reduce therisk of both macro- and microvascular complications

Mean Platelet Volume and Platelet Distribution Width Correlate with Microvascular Complications in Egyptian People with Type 2 Diabetes Mellitus

2021 ◽  
Vol 17 ◽  
Author(s):  
Mohammed I. Abd El-Ghany ◽  
Nahed Abdallah ◽  
Waleed Eldars
Keyword(s):  
Type 2 Diabetes ◽  
Mean Platelet Volume ◽  
Microvascular Complications ◽  
Fasting Blood Glucose ◽  
Vascular Complications ◽  
Platelet Distribution Width ◽  
Platelet Volume ◽  
Distribution Width ◽  
Diabetic Microvascular Complications

Background: Type 2 diabetes is a part of metabolic syndrome associated with a higher risk of vascular complications. Diabetes is characterized by changes in platelet morphology, function, and platelet hyperactivity so, it's considered a prothrombotic condition. Morbidity and mortality in people with type 2 diabetes-related to micro and macrovascular complications. Novel biomarkers are needed to identify and treat people at higher risk. Objective: The main objective of this controlled cross-sectional study was to evaluate Platelet volume indices (PVI) in subjects with type 2 diabetes with and without complications in comparison to subjects without diabetes. Methods: Hundred and thirty-five subjects aged from 35 to 60 years were subdivided into 3 groups. Group A includes 55 subjects with type 2 diabetes with complications. Group B includes 45 subjects with type 2 diabetes without complications. Group C includes 35 normal healthy subjects. Detailed clinical history was taken. Also, PVI, fasting blood glucose (FBG), hemoglobin A1c, and creatinine were obtained. Results: Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Plateletcrit (PCT), and Platelet large cell ratio (P-LCR) were significantly higher among subjects with retinopathy, nephropathy, and neuropathy than other subjects with diabetes who didn't develop complications (P<0.001). At cutoff value > 11.9 fL, MPV have diagnostic sensitivity 80% and specificity 97.8%. Whereas PDW >16.9fL has a sensitivity of 74.5% and specificity of 100% for diabetic microvascular complications (retinopathy, nephropathy, and neuropathy). Conclusion: MPV and PDW may be considered as possible biomarkers for the early detection of diabetic microvascular complications.

scholarly journals Prevalence of Anaemia and Its Associated Factors among Type 2 Diabetes Mellitus Patients in University of Gondar Comprehensive Specialized Hospital

Anemia ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Sewnet Adem Kebede ◽  
Biruk Shalmeno Tusa ◽  
Adisu Birhanu Weldesenbet
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Associated Factors ◽  
Microvascular Complications ◽  
Combined Treatment ◽  
Factors Associated ◽  
Specialized Hospital ◽  
Patients With Diabetes

Background. Anaemia is one of the commonest blood disorders seen in patients with diabetes. In Ethiopia, chronic illnesses are tremendously raising with their complications. But very little research has been conducted, particularly on anaemia among diabetes mellitus (DM) patients. Therefore, this study aimed at assessing the prevalence of anaemia and associated factors among type 2 diabetes mellitus patients in Northwest Ethiopia. Methods. A cross-sectional study design was employed at University of Gondar Comprehensive Specialized Hospital from March 1 to April 15, 2019, among 372 type 2 diabetes mellitus patients (T2DM). Multivariable logistic regression analysis was fitted, and the corresponding adjusted odds ratio (AOR) and 95% CI were used to identify factors associated with anaemia. Level of significance was declared at the p value less than 0.05. Results. The study revealed 8.06% (95% CI: 5.68–11.31%) of the participants were anaemic. Being male (AOR = 2.74, CI: 1.02, 7.38), combined type of treatment (AOR = 8.38, CI: 1.66, 42.25), having diabetes-related microvascular complications (AOR = 3.24, CI: 1.14, 9.26), and hypertension (AOR = 0.01, CI: 0.002, 0.06) were the significant factors associated with anaemia. Conclusions. The finding of the current study revealed low prevalence of anaemia among T2DM patients. Sex, type of treatment, diabetes-related microvascular complications, and hypertension were factors associated with anaemia. Assessment of haemoglobin levels among T2DM patients may help to prevent ensuing microvascular complications. Incorporate anaemia screening into the routine assessment of diabetic complication particularly for those who are hypertensive and took combined treatment to allow early appreciation and treatment of anaemia and later improve the overall care of patients with diabetes.

scholarly journals Serum Levels of Progranulin Are Closely Associated with Microvascular Complication in Type 2 Diabetes

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Lin Xu ◽  
Bo Zhou ◽  
Huixia Li ◽  
Jiali Liu ◽  
Junhui Du ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
Linear Regression Analysis ◽  
Serum Levels ◽  
Diabetic Microangiopathy ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Objective. Progranulin (PGRN) was recently introduced as a novel marker of chronic inflammatory response in obesity and type 2 diabetes capable of directly affecting the insulin signaling pathway. This study aimed to investigate the correlation between PGRN and type 2 diabetics with microvascular complications.Methods. PGRN serum levels and glucose metabolism related substance were measured in 84 type 2 diabetic patients with or without microangiopathies and 12 health persons. Further analyses of serum PGRN in different stages of diabetic microangiopathies were conducted.Results. Serum levels of PGRN were markedly higher in type 2 diabetic patients with microangiopathies. PGRN serum levels increased with the progress of diabetic microangiopathies with significantly highest values detectable in clinical diabetic nephropathy (CDN) and proliferative diabetic retinopathy (PDR) groups. Serum PGRN concentrations in all individuals positively and markedly correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), triglyceride (TG), urinary albumin excretion rate (UAER), blood urea nitrogen (BUN), creatinine (CRE), white blood cell (WBC), disease duration, IL-6, and TNF-α, while correlating negatively and significantly with eGFR. Multiple linear regression analysis showed that only UAER and CRE were independently associated with serum PGRN.Conclusion. PGRN might be considered as a marker for diabetic microangiopathy and its severity.

scholarly journals The Role of Liuwei Dihuang Pills and Ginkgo Leaf Tablets in Treating Diabetic Complications

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Yue Zhao ◽  
Jiangyi Yu ◽  
Jingshun Liu ◽  
Xiaofei An
Keyword(s):  
Blood Pressure ◽  
Treatment Group ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Cerebrovascular Events ◽  
Liuwei Dihuang Pills ◽  
Ginkgo Leaf

Objective. To observe the clinical prophylactic and therapeutic efficacy of Liuwei Dihuang Pills and Ginkgo Leaf Tablets for type 2 diabetic vascular complications. Methods. It was a randomized, double-blind and placebo-controlled clinical trial. 140 outpatients with type 2 diabetes were recruited and randomly divided into the treatment group and control group. The two groups were given basic therapy (management of blood sugar, blood pressure, etc.). Additionally, the treatment group was given Liuwei Dihuang Pills and Ginkgo Leaf Tablets, while the control group was given Liuwei Dihuang Pills and Ginkgo Leaf Tablets placebos. All subjects were followed up for consecutive 36 months and observed monthly. The clinical data as urinary microalbumin to urinary creatinine ratio (Umalb/cr), carotid intima-media thickness (IMT), diabetic nephropathy (DN) and diabetic retinopathy (DR) prevalence, cardiovascular and cerebrovascular events, blood glucose, and blood pressure were collected and analyzed statistically. Results. After 36-month treatment, the Umalb/cr level and DN and DR prevalence in treatment group were all significantly lower than control group (P<0.05). However, the IMT level and the incidence of cardiovascular and cerebrovascular events were not significantly different between the two groups (P>0.05). Conclusions. Liuwei Dihuang Pills and Ginkgo Leaf Tablets are beneficial to diabetic microvascular complications, while the efficacy to diabetic macrovascular complications needs more observations.

scholarly journals Optimizing treatment goals for long-term health outcomes among patients with type 2 diabetes mellitus

2021 ◽  
Vol 9 (1) ◽  
pp. e002396
Author(s):  
Qian Shi ◽  
Yilu Lin ◽  
Vivian A Fonseca ◽  
Lizheng Shi
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Outcomes ◽  
Treatment Strategies ◽  
Optimal Treatment ◽  
Treatment Goals ◽  
Macrovascular Complication

IntroductionConsiderable confusions on treatment target have resulted from recent changes in guidelines. Evidence in medical guidelines came from clinical trials with highly selected patients, whereas treatment goals may differ in some subgroups. This study aimed to assess optimal treatment goals (A1C, blood pressure, low-density lipoprotein cholesterol (LDL-C)) for patients with type 2 diabetes mellitus (T2DM), which lead to optimal health outcomes by different treatment strategies.Research design and methodsA retrospective longitudinal study was conducted for veterans with T2DM by using US Veterans Affairs Administrative Database (2005−2015). Medical records were prepared for repeated evaluation performed at 6-month intervals and multivariate longitudinal regression was used to estimate the risk of microvascular and macrovascular complication events. Second-degree polynomial and splines were applied to identify the optimal goals in their associations with lowest risk of clinical outcomes, controlling for demographic characteristics, medical history, and medications.ResultsA total of 124 651 patients with T2DM were selected, with mean of 6.72 follow-up years. In the general population, to achieve the lowest risk of microvascular and macrovascular complication, the optimal goals were A1C=6.81%, LDL-C=109.10 mg/dL; and A1C=6.76%, LDL-C=111.65 mg/dL, systolic blood pressure (SBP)=130.60 mmHg, respectively. The optimal goals differed between age and racial subgroups. Lower SBP for younger patients and lower LDL-C for black patients were associated with better health outcomes.ConclusionsOptimal treatment goals were identified and multi-faceted treatment strategies targeting hyperglycemia and hyperlipidemia and hypertension may improve health outcome in veterans with T2DM. In addition to guidelines’ recommended goals, health systems may examine their own large diverse patients with T2DM for better quality of care.

scholarly journals ASSOCIATION OF HYPOTHYROIDISM WITH MICROVASCULAR COMPLICATIONS AMONG PATIENTS OF TYPE-2 DIABETES MELLITUS

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Krishan Kumar Meena ◽  
Praveen Sharma ◽  
Swati Srivastava ◽  
Uma Kumari Meena
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Vascular Complication ◽  
Cross Sectional ◽  
Type 2 Dm ◽  
Hypothyroid Patients

Introduction: Diabetes mellitus (DM) is common metabolic disorder leading to various complications including micro-vascular complication. Diabetes and thyroid dysfunction can result in abnormalities of one another, as both are strongly implicated in cellular metabolism.  Aim of study was to establish any association between hypothyroidism and micro-vascular complications in patients of type 2 DM. Material and Methods: This Hospital based Cross sectional analytical Study was included 80 Euthyroid and 80 hypothyroid patients of type 2 DM. These patients were subjected to fundus examination (for retinopathy), urine for spot albumin and creatinine ratio and routine microscopy (for nephropathy), clinical examination and NCV (for neuropathy). Results: Age of patients ranged from 30 – 80 years. Most patients had duration of Diabetes > 5 years. Diabetic retinopathy was found in 15% Euthyroid and 37.5% Hypothyroid diabetics (p=0.002). Neuropathy was more in Hypothyroid (35%) as compared to Euthyroid (12.5%) patients (p=0.003). Prevalence of Nephropathy was also significantly more (p=0.011) in Hypothyroids (60%) as compared to Euthyroid (38.75%). Conclusion: Significant association was found between hypothyroidism and micro vascular complications in type 2 Diabetes mellitus. Screening of diabetics for thyroid functions is essential to reduce morbidity. Keywords: Diabetes, thyroid, retinopathy, neuropathy, nephropathy

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