scholarly journals Diagnosis of neuropathy and risk factors for corneal nerve loss in type 1 and type 2 diabetes: A corneal confocal microscopy study

2020 ◽  
Author(s):  
Maryam Ferdousi ◽  
Alise Kalteniece ◽  
Shazli Azmi ◽  
Ioannis N Petropoulos ◽  
Georgios Ponirakis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Peripheral Neuropathy ◽  
Nerve Fibre ◽  
Fibre Length ◽  
Corneal Confocal Microscopy ◽  
Corneal Nerve

<b>Purpose: </b>To assess the diagnostic utility of corneal confocal microscopy (CCM) for diabetic peripheral neuropathy (DPN) and the risk factors for corneal nerve loss. <p><b>Methods: </b>490 participants including 72 healthy controls, 149 with type 1 diabetes and 269 with type 2 diabetes underwent detailed assessment of peripheral neuropathy and CCM in relation to risk factors.</p> <p><b>Results: </b>Corneal nerve fibre density (CNFD) (P<0.0001, P<0.0001), branch density (CNBD) (P<0.0001, P<0.0001) and length (CNFL) (P<0.0001, P=0.02) were significantly lower in patients with type 1 and type 2 diabetes, compared to controls. CNFD (P<0.0001), CNBD (P<0.0001) and CNFL (P<0.0001) were lower in type 1 diabetes compared to type 2 diabetes. Receiver operating characteristics (ROC) curve analysis for the diagnosis of DPN demonstrated a good area under the curve (AUC) for CNFD=0.81, CNBD=0.74 and CNFL=0.73. Multivariable regression analysis showed a significant association between reduced corneal nerve fibre length with age (β=-0.27, P=0.007), HbA1c (β=-1.1, P=0.01) and weight (β=-0.14, P=0.03) in patients with type 2 diabetes and with duration of diabetes (β=-0.13, P=0.02), LDL cholesterol (β=1.8, P=0.04), and triglycerides (β=-2.87, P=0.009) in patients with type 1 diabetes. </p> <b>Conclusion: </b>CCM identifies more severe corneal nerve loss in patients with type 1 compared to type 2 diabetes and shows good diagnostic accuracy for DPN. Furthermore, the risk factors for a reduction in corneal nerve fibre length differ between type 1 and type 2 diabetes.

scholarly journals Diagnosis of neuropathy and risk factors for corneal nerve loss in type 1 and type 2 diabetes: A corneal confocal microscopy study

2020 ◽  
Author(s):  
Maryam Ferdousi ◽  
Alise Kalteniece ◽  
Shazli Azmi ◽  
Ioannis N Petropoulos ◽  
Georgios Ponirakis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Peripheral Neuropathy ◽  
Nerve Fibre ◽  
Fibre Length ◽  
Corneal Confocal Microscopy ◽  
Corneal Nerve

<b>Purpose: </b>To assess the diagnostic utility of corneal confocal microscopy (CCM) for diabetic peripheral neuropathy (DPN) and the risk factors for corneal nerve loss. <p><b>Methods: </b>490 participants including 72 healthy controls, 149 with type 1 diabetes and 269 with type 2 diabetes underwent detailed assessment of peripheral neuropathy and CCM in relation to risk factors.</p> <p><b>Results: </b>Corneal nerve fibre density (CNFD) (P<0.0001, P<0.0001), branch density (CNBD) (P<0.0001, P<0.0001) and length (CNFL) (P<0.0001, P=0.02) were significantly lower in patients with type 1 and type 2 diabetes, compared to controls. CNFD (P<0.0001), CNBD (P<0.0001) and CNFL (P<0.0001) were lower in type 1 diabetes compared to type 2 diabetes. Receiver operating characteristics (ROC) curve analysis for the diagnosis of DPN demonstrated a good area under the curve (AUC) for CNFD=0.81, CNBD=0.74 and CNFL=0.73. Multivariable regression analysis showed a significant association between reduced corneal nerve fibre length with age (β=-0.27, P=0.007), HbA1c (β=-1.1, P=0.01) and weight (β=-0.14, P=0.03) in patients with type 2 diabetes and with duration of diabetes (β=-0.13, P=0.02), LDL cholesterol (β=1.8, P=0.04), and triglycerides (β=-2.87, P=0.009) in patients with type 1 diabetes. </p> <b>Conclusion: </b>CCM identifies more severe corneal nerve loss in patients with type 1 compared to type 2 diabetes and shows good diagnostic accuracy for DPN. Furthermore, the risk factors for a reduction in corneal nerve fibre length differ between type 1 and type 2 diabetes.

scholarly journals Diagnosis of Neuropathy and Risk Factors for Corneal Nerve Loss in Type 1 and Type 2 Diabetes: A Corneal Confocal Microscopy Study

Diabetes Care ◽  
2020 ◽  
Vol 44 (1) ◽  
pp. 150-156
Author(s):  
Maryam Ferdousi ◽  
Alise Kalteniece ◽  
Shazli Azmi ◽  
Ioannis N. Petropoulos ◽  
Georgios Ponirakis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Confocal Microscopy ◽  
Microscopy Study ◽  
Corneal Confocal Microscopy ◽  
Corneal Nerve

The world pandemic of diabetes

2011 ◽  
pp. 1795-1799
Author(s):  
Nigel Unwin
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Geographical Area ◽  
Age Groups ◽  
The World ◽  
Level Of Economic Development ◽  
Increasing Trends

A pandemic refers to a disease that is rapidly increasing in frequency across many populations, over a wide geographical area (1). Put another way, it refers to the situation in which epidemics of the disease are occurring simultaneously in many countries. This is the case for diabetes, which has the dubious distinction of being one of the few chronic non-communicable diseases known to be increasing in all countries from which data are available, irrespective of the level of economic development (2). This is mirrored by a pandemic of people who are overweight or obese (3), the major risk factors for type 2 diabetes. This chapter focuses on diabetes in adults (aged 20 years old and above), of which 85% to more than 95%, depending on the population, have type 2 diabetes (2, 4), which is thus the main contributor to the growing burden of diabetes. However, it is worth noting that, in children (<15 years old), the incidence of type 1 diabetes is also increasing, particularly in the youngest age groups, across the vast majority of countries from which good data are available (5). The reasons for this increase are unclear, although various environmental risk factors have been implicated (5). This chapter aims to do the following: ◆ provide an overview of the prevalence and trends in diabetes in adults across the world and its contribution to mortality ◆ describe the broad determinants that underlie the increasing trends in diabetes in adults ◆ provide an introduction to variations by ethnicity in the prevalence of type 2 diabetes

scholarly journals Reduced corneal nerve fibre length in prediabetes and type 2 diabetes: The Maastricht Study

2020 ◽  
Vol 98 (5) ◽  
pp. 485-491 ◽  
Author(s):  
Eline E.B. De Clerck ◽  
Jan S.A.G. Schouten ◽  
Tos T.J.M. Berendschot ◽  
Renée S. Koolschijn ◽  
Rudy M.M.A. Nuijts ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Nerve Fibre ◽  
Fibre Length ◽  
Corneal Nerve

scholarly journals Cohort profile: the Funen Diabetes Database—a population-based cohort of patients with diabetes in Denmark

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e035492
Author(s):  
Kasper Adelborg ◽  
Péter Szentkúti ◽  
Jan Erik Henriksen ◽  
Reimar Wernich Thomsen ◽  
Lars Pedersen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Geographical Area ◽  
Population Based ◽  
Haemoglobin A1c ◽  
Patients With Diabetes

PurposeDetailed population-based data are essential to understanding the epidemiology of diabetes and its clinical course. This article describes the Funen Diabetes Database (FDDB). The purpose of the FDDB was to serve as a shared electronic medical record system for healthcare professionals treating patients with diabetes. The cohort can also be used for research.ParticipantsThe FDDB covers a geographical area of almost 500 000 Danish inhabitants. It currently includes 3691 patients with type 1 diabetes, 19 085 patients with type 2 diabetes, 292 patients with other types of diabetes and 5992 patients with an unknown type of diabetes. Patients have been continuously enrolled from general practitioners and endocrinology departments in the Funen area in Denmark since 2003. Patients undergo a clinical work-up at their first diabetes contact and during follow-up visits. The information collected includes type of diabetes contact, blood pressure, height, weight, lifestyle factors (smoking, exercise), laboratory records (eg, haemoglobin A1c and cholesterol levels), results from foot examinations (eg, pulse, cutaneous sensitivity and ankle brachial index), results from eye examinations (eg, degree of retinopathy assessed by retinal photo and eye examination), glucose-lowering drugs and diabetic complications.Findings to dateThe FDDB cohort was followed for a total of 212 234 person-years up to 2016. A cross-sectional study described the prevalence of diabetic retinopathy and its associated risk factors. The clinical outcomes of patients with type 1 diabetes, type 2 diabetes and latent autoimmune diabetes in adults have been assessed. Linkage to population-based medical registries with complete follow-up has enabled the collection of extensive continuous data on general practice contacts, diagnoses and procedures from hospital contacts, medication use and mortality.Future plansThe FDDB serves as a strong data resource that will be used in future studies of diabetes epidemiology with focus on occurrence, risk factors, treatment, complications and prognosis.

scholarly journals Evaluation of calcium level in patients with diabetes mellitus according to the examination in the mobile medical center (Diamodule)

2021 ◽  
Vol 23 (4) ◽  
pp. 382-388
Author(s):  
Anna V. Zheleznyakova ◽  
◽  
Victoriya L. Volodicheva ◽  
Olga K. Vikulova ◽  
Alexey A. Serkov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Serum Calcium ◽  
Calcium Level ◽  
Medical Center ◽  
Patients With Diabetes

Background. Diabetes mellitus (DM) is characterized by multiple risk factors for the combined development of disorders of phosphorus-calcium metabolism, due to more frequent overweight, decreased renal filtration function and vitamin D deficiency in this category of patients. Aim. To assess the level of calcium in blood serum and its correlations with parameters of carbohydrate metabolism, body mass index (BMI) and renal function in patients with type 1 and type 2 diabetes. Materials and methods. The object of the study: adult patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) ≥18 years old who underwent examination in Diamodule (n=294) in 2019 in the Voronezh region, who were additionally tested for serum calcium. The examination at the mobile medical center includes: assessment of anthropometric data (height, weight, BMI), biochemical data of blood lipids and creatinine levels with calculation of glomerular filtration rate (GFR-EPI), albuminuria and the albumin/creatinine in a single portion of urine, measurement of glycated hemoglobin (HbA1c), blood pressure, electrocardiogram, consultation with a cardiologist, ophthalmologist, specialist of the Diabetic Foot office, diabetologist. All biochemical parameters was carried out using commercial kits on a biochemical express analyzer Spotchem EZ ArkraySP-4430. Determination of HbA1c, albuminuria, albumin/creatinine was performed by immunochemical method on a DCA Vantage analyzer. Data analysis was carried out using the Statistica v.13.3 software package (TIBCO Software Inc., USA). The results are presented as medians and quartiles [25; 75], the level of reliability is taken as p<0.05. Results. Hypocalcemia (serum calcium level less 2.15 mmol/L) was detected in 88.3% of patients with T1DM and 73.6% of patients with T2DM. The level of serum calcium in T1DM was 1.96 [1.83; 2.07], in T2DM – 2.04 [1.97; 2.16] (p<0.001) with significant differences in GFR: in T1DM 69.6 [57.8; 82.5], with T2DM 50.5 [44.1; 59.9] (p<0.001). We observed correlation between GFR and calcium level r=-0.3 (p<0.05,). GFR<60 ml/min/1.73 m² was observed in 30.5% of T1DM patients, in 75.0% of T2DM. The HbA1c in T1DM was 8.7% [7.7; 9.8], in T2DM – 8.3% [6.8; 9.4] (p=0.01). Obesity was revealed in T1DM in 12.3%, in T2DM in 71.4%; the median BMI in T1DM was 25.5 kg/m2 [21.9; 28.4], in T2DM – 33.2 kg/m2 [29.7; 37.9]. There was correlation between BMI and calcium level r=0.26 (p<0.05). Conclusion. The results of the study revealed a high prevalence of hypocalcemia among patients with diabetes, the most pronounced in type 1 diabetes. In the presence of a correlation between calcium and GFR, there was a high incidence of hypocalcemia in patients with T1DM, even in the absence of a significant decrease in GFR, which may indicate to additional risk factors. Since the assessment of the level of calcium is not included in the list of standard clinical examination, it is recommended to include this parameter and conduct regular screening in risk groups, which include patients with diabetes. More extensive research is needed to analyze the factors.

scholarly journals Prevalence of and Risk Factors for Diabetic Peripheral Neuropathy in Youth With Type 1 and Type 2 Diabetes: SEARCH for Diabetes in Youth Study

Diabetes Care ◽  
2017 ◽  
Vol 40 (9) ◽  
pp. 1226-1232 ◽  
Author(s):  
Mamta Jaiswal ◽  
Jasmin Divers ◽  
Dana Dabelea ◽  
Scott Isom ◽  
Ronny A. Bell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Youth Study ◽  
Diabetes In Youth

scholarly journals Practical aspects of cardiovascular risk factors identify in patients with diabetes type 1 and 2

2011 ◽  
Vol 3 (1) ◽  
pp. 4-9
Author(s):  
Mehman N. Mamedov ◽  
Marina N. Kovrigina ◽  
Marina B. Buzurtanov
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Capillary Blood ◽  
The Difference

The aim of this study was to investigate the characteristics of the risk factors and comparative analysis of different methods of identify of cardiovascular risk factors in outpatient with diabetes mellitus (DM) type 1 and 2. Methods. In cross-sectional clinical study included 244 persons with type 1 and type 2 mean age 46,4 yrs. All patients were interviewed using a questionnaire of WHO, they were measured blood pressure, heart rate, anthropometric data, including total fat mass with fat analyzer OMRON BF508. All patients were also measured venous and capillary blood glucose level, glycated hemoglobin (%), total cholesterol and triglycerides. Results. The difference between the two measurement glucose methods (in venous and capillary blood) was 6,7 0,6%. In patients with type 1 diabetes hypertension occurs 2.5 times in less compared with patients with type 2 diabetes. The difference between blood pressure measured by mechanical and automatic devices was less than 1%. The percentage of body fat, including visceral fat, both women and men with type 2 diabetes by age corresponds to the high deviation from the norm. Most men and women with type 1 and type 2 had hypercholesterolemia. Conclusion. Traditional cardiovascular risk factors are identified, not only among individuals with type 2 diabetes, but among patients with type 1 diabetes.

scholarly journals Lower corneal nerve fibre length identifies diabetic neuropathy in older adults with diabetes: results from the Canadian Study of Longevity in Type 1 Diabetes

Diabetologia ◽  
2017 ◽  
Vol 60 (12) ◽  
pp. 2529-2531 ◽  
Author(s):  
Daniel Scarr ◽  
Leif E. Lovblom ◽  
Julie A. Lovshin ◽  
Geneviève Boulet ◽  
Mohammed A. Farooqi ◽  
...  
Keyword(s):  
Older Adults ◽  
Type 1 Diabetes ◽  
Diabetic Neuropathy ◽  
Nerve Fibre ◽  
Fibre Length ◽  
Canadian Study ◽  
Corneal Nerve
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