scholarly journals Factors predicting the progression of diabetic kidney disease in type 2 diabetic patients using continuous glucose monitoring

2021 ◽  
Vol 17 (7) ◽  
pp. 552-556
Author(s):  
K.I. Moshenets ◽  
N.O. Pertseva

Background. An increase in the prevalence of type 2 diabetes mellitus (DM) is accompanied by an increase in the number of patients with severe chronic complications. Diabetic kidney disease (DKD) is the leading cause of death in these patients after cardiovascular diseases. The purpose was to predict the progression of DKD in patients with type 2 diabetes mellitus depending on the glucose variability (GV) measured by continuous glucose monito­ring. Materials and methods. We examined 53 type 2 DM patients aged 57.0 (51.0; 64.0) years with an average disease duration of 9.0 (6.0; 13.0) years. The laboratory examination included determination of glycated hemoglobin, blood creatinine, albuminuria (AU), glomerular filtration rate (GFR) according to CKD-EPI equation. GV was measured by iPro2 GMS system. The maximum and minimum blood glucose levels and standard deviation (SD) of glycemia were considered. The role of GV in predicting DKD progression has been established using stepwise multiple regression analysis. Results. DKD was detected in 41.51 % of patients. In regression analysis, we created a linear multiple regression equation to describe the dependence of AU on the GV, F = 10.39 (p < 0.001). The variability of AU by 36.7 % is due to the minimum level of glycemia and SD of glycemia — multiple correlation coefficient R is 0.6372, the coefficient of determination R2 is 0.4060, adjusted R2 is 0.3670. Partial coefficient of correlation between AU and SD of glycemia, r = 0.25 (p = 0.027); between AU and the minimum blood glucose level, r = 0.31 (p = 0.005). Conclusions. According to the results of correlation analysis, a significant effect of GV, as well as the value of minimum blood glucose level on AU was established. It is statistically proved that high fluctuations of glycemia (SD) should be considered as a factor predicting the progression of DKD in type 2 DM patients. Using regression analysis, a mathematical model of DKD progression in type 2 DM patients was developed based on GV parameters.

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ligia Petrica ◽  
FLORICA GADALEAN ◽  
ADRIAN VLAD ◽  
Mihaela Vlad ◽  
VICTOR DUMITRASCU ◽  
...  

Abstract Background and Aims Interactions among multiple molecules and signalling pathways contribute to the pathogenesis and progression of diabetic kidney disease (DKD). Long noncoding RNAs (lncRNAs) play key roles in the pathophysiology of DKD involving actions of microRNAs (miRNAs). The aim of the study was to establish the involvement of selected lncRNAs in the epigenetic mechanisms of podocyte damage and tubular injury in DKD of type 2 diabetes mellitus (DM) patients. The molecular mechanisms of lncRNAs intervention were evaluated in relation to a particular miRNA profile. Method A total of 136 patients with type 2 DM and 25 healthy subjects were enrolled in a cross-sectional case series study and assessed concerning urinary albumin: creatinine ratio (UACR), eGFR, biomarkers of podocyte damage (synaptopodin, podocalyxin) and proximal tubule (PT) dysfunction (Kidney injury molecule-1-KIM-1, N-acetyl-D-glucosaminidase-NAG), urinary lncRNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), nuclear-enriched abundant transcript 1 (NEAT1), myocardial infarction-associated transcript (MIAT), taurine-upregulated gene 1 (TUG1), and urinary miRNA21, 124, 93, 29a (quantified by a real-time PCR System). Results Multivariable regression analysis yielded models in which urinary lncRNA MALAT1 correlated directly with urinary synaptopodin, podocalyxin, KIM-1, NAG, miRNA21, 124, UACR, and negatively with eGFR, miRNA93 and 29a (p&lt;0.0001; R2=0.727); urinary lncRNA NEAT1 correlated directly with synaptopodin, KIM-1, NAG, miRNA21, 124, and negatively with eGFR, miRNA93, and 29a (p&lt;0.0001; R2=0.702); urinary lncRNA MIAT correlated directly with miRNA93 and 29a, and eGFR (p&lt;0.0001; R2=0.671) and negatively with synaptopodin, KIM-1, NAG, UACR, miRNA21, and 124 (p&lt;0.0001; R2=0.654); urinary lncRNA TUG1 correlated directly with eGFR, miRNA93 and 29a, and negatively with synaptopodin, podocalyxin, NAG, miRNA21, and 124 (p&lt;0.0001; R2=0.748). The results provided document upregulated lncRNA MALAT1 and NEAT1, as well as miRNA21 and 124. By contrast, lncRNA MIAT and TUG1, and miRNA93 and 29a were downregulated. Conclusion In patients with type 2 DM lncRNAs exert distinct functions in different cell types, either deleterious or protective, at both glomerular and tubular level. LncRNAs may contribute to DKD through modulating miRNAs expression and activities. This observation holds true independently of albuminuria and DKD stage.


2019 ◽  
Vol 13 (18) ◽  
pp. 1577-1588 ◽  
Author(s):  
Ligia Petrica ◽  
Oana Milas ◽  
Mihaela Vlad ◽  
Adrian Vlad ◽  
Florica Gadalean ◽  
...  

Aim: The involvement of proinflammatory interleukins (IL) in diabetic kidney disease of Type 2 diabetes mellitus (DM) patients was studied in relation to a particular miRNA profile. Materials & methods: A total of 117 patients with Type 2 DM and 11 controls were enrolled in a case series study. Serum and urinary ILs and miRNAs were assessed. Results: IL-1α correlated with miRNA21, 124, estimated glomerular filtration rate (eGFR) and negatively with miRNA125a and 192; IL-8 with miRNA21, 124, eGFR and negatively with miRNA125a, 126 and 146a; IL-18 with miRNA21, 124 and negatively with miRNA146a, 192, eGFR. Conclusion: There is an association between specific serum and urinary ILs and serum and urinary miRNAs profiles in the inflammatory response in Type 2 DM patients with diabetic kidney disease.


2016 ◽  
Vol 144 (9-10) ◽  
pp. 474-477
Author(s):  
Katarina Radovic ◽  
Kosovka Obradovic-Djuricic ◽  
Aleksandra Cairovic ◽  
Mirko Glisic ◽  
Slobodan Djurisic

Introduction. Good and well balanced diet provided by adequate mastication is part of therapy in patients with type 2 diabetes mellitus (DM). The critical period presents the time immediately after teeth extractions; hence, immediate denture is a rational therapeutical choice for diabetic patients. The presence of immediate denture and its compression might compromise wound healing process, affect chewing ability, food intake and consequently blood glucose level in type 2 DM patients. Objective. The objective of this study was to compare socket opening diameters (SOD), chewing ability, changes in blood glucose level and food intake in type 2 DM patients with and without maxillary immediate complete denture (MICD) during a three-week wound healing period. Methods. The study comprised 78 type 2 DM partially removable denture wearers (42 candidates for teeth extractions and 36 candidates for teeth extractions and insertion of MICDs). During the three-week period participants were followed for SOD, chewing ability and changes in blood glucose level and food intake. Results. Patients with MICD showed significantly lower reduction of SOD (seventh, 14th, 21st day) and higher chewing ability (seventh, 14th, 21st day) in comparison to patients without an MICD. Significantly lower number of patients with an MICD had changes in blood glucose level and food intake. Conclusion. Maxillary immediate complete denture presents a good therapeutic choice for type 2 DM patients, as it provides possibility of adequate mastication after teeth extractions and maintenance of nutritional status and blood glucose level.


Author(s):  
Sumathi Chinnasamy Subramanian ◽  
Arjunan Porkodi ◽  
Pandurangan Akila

AbstractBackgroundThis study assesses the effectiveness of nurse-led intervention on self-management, self-efficacy, and blood glucose level among patients with Type 2 diabetes mellitus (DM) attending diabetic Out patient department (OPD) in Sri Ramachandra Hospital, Chennai.MethodsIn this study, the experimental group received nurse-led intervention on video-assisted teaching regarding nature of the disease condition including, diet, medication, hand and leg exercises, home care management, for 30 mins. Then a demonstration of hand and leg exercise was done followed by return demonstration done by the participants. The participants in the control group did not receive nurse-led intervention; they received only routine care. On the 15th day, when the patients came for the first follow-up, posttest was conducted for both the experimental and control groups.ResultsThere was a statistically considerable difference noted in self-management (t=29.639; p<0.001), self-efficacy (t=28.293; p<0.001), FBS (t=2.415; p<0.05), and PPBS (t=2.102; p<0.05) in the posttest among patients with Type 2 DM in the experimental group.ConclusionsThe study concluded that the nurse-led intervention through video-assisted teaching is an effective method to recover self-management and self-efficacy as well as reduce the fasting blood sugar and postprandial blood sugar among patients with Type 2 DM.


2021 ◽  
Vol 18 (3) ◽  
pp. 17-25
Author(s):  
Stoiţă Marcel ◽  
Popa Amorin Remus

Abstract The presence of albuminuria in patients with type 2 diabetes mellitus is a marker of endothelial dysfunction and also one of the criteria for diagnosing diabetic kidney disease. The present study aimed to identify associations between cardiovascular risk factors and renal albumin excretion in a group of 218 patients with type 2 diabetes mellitus. HbA1c values, systolic blood pressure, diastolic blood pressure were statistically significantly higher in patients with microalbuinuria or macroalbuminuria compared to patients with normoalbuminuria (p <0.01). We identified a statistically significant positive association between uric acid values and albuminuria, respectively 25- (OH)2 vitamin D3 deficiency and microalbuminuria (p <0.01).


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