INTERRELATION OF HEMORHEOLOGICAL PARAMETERS WITH GLUCOSE AND GLYCATED HEMOGLOBIN IN PATIENTS WITH DIABETES MELLITUS TYPE2

Author(s):  
А.В. Муравьев ◽  
И.А. Тихомирова ◽  
С.В. Булаева ◽  
Ю.В. Малышева ◽  
А.В. Замышляев

Введение. Нарушения реологических свойств крови при сахарном диабете 2 типа (СД-2) может приводить к снижению микрососудистой перфузии. Основной механизм, вероятно, связан с ухудшением микрореологии эритроцитов, в том числе из-за высокого содержания глюкозы и гликозилирования белков мембран клеток. Цель исследования: провести анализ связи гемореологических характеристик цельной крови и эритроцитов с содержанием глюкозы и гликированного гемоглобина и выявить влияние ряда метаболических гормонов на микрореологию эритроцитов у больных СД-2. Материалы и методы. У 30 больных СД-2 регистрировали параметры гемореологического профиля. Наряду с измерениями вязкости, деформируемости эритроцитов (ДЭ) и их агрегации (АЭ) определяли содержание глюкозы, гликированного гемоглобина и белков плазмы (альбуминов, глобулинов, фибриногена). В in vitro исследованиях регистрировали микрореологические характеристики эритроцитов после их инкубации с глюкозой и рядом метаболических гормонов (инсулином, глюкагоном, адреналином). Результаты. Наиболее существенные отличия гемореологических профилей у больных СД-2 от данных здоровых лиц были в их микрореологической части. Значения глюкозы и гликированного гемоглобина более выражено коррелировали с показателями гемореологического профиля у больных СД-2, чем у здоровых лиц: коэффициент корреляции между АЭ и концентраций глюкозы у больных СД-2 составил 0,660, в контрольной группе — 0,480. Под влиянием инсулина ДЭ достоверно повышалась, а АЭ, напротив, снижалась (p < 0,05). При инкубации эритроцитов с глюкагоном у больных СД-2 и у здоровых лиц АЭ была снижена на сходную величину. Адреналин в трех концентрациях умеренно повышал ДЭ (p < 0,05), а наблюдавшийся прирост АЭ был наибольшим при низкой концентрации гормона (0,01 мкМ). Заключение. Анализ параметров гемореологического профиля у больных СД-2 свидетельствует о нарушениях текучести крови и снижении ее транспортных возможностей. Также было показано, что гормоны, участвующие в регуляции метаболизма, оказывают прямое воздействие на микрореологию эритроцитов. Introduction. Disorders of blood rheological properties in diabetes mellitus type 2 (DM-2) can lead to reduction of microvascular perfusion. The main mechanism is probably associated with impairment of erythrocytes microrheology and also due to high glucose content and glycosylation of cell membrane proteins. Aim: to analyze the relationship between hemorheological characteristics of whole blood and erythrocytes with glucose content and glycated hemoglobin level, and to reveal the infl uence of metabolic hormones on erythrocytes microrheology in patients with DM-2. Materials and methods. In 30 patients with DM-2 we determined hemorheological parameters, blood viscosity, erythrocytes deformability (ED), erythrocytes aggregation (EA), glucose and glycated hemoglobin content, plasma proteins (albumins, globulins, fibrinogen) levels. In in vitro studies we recorded the microrheological characteristics of erythrocytes after their incubation with glucose and with some metabolic hormones (insulin, glucagon, adrenaline). Results. Microrheological parameters in patients with DM-2 diff ered signifi cantly from the parameters in healthy individuals. Glucose and glycated hemoglobin values more evidently correlated with hemorheological parameters in patients with DM-2 than in healthy individuals: the correlation coeffi cient between EA and glucose concentration in patients with DM-2 was 0.660, in healthy individuals — 0.480. Under insulin stimulus ED signifi cantly increased and AE, on contrary, decreased (p < 0.05). During erythrocytes incubation with glucagon EA similar reduced in patients with DM-2 and in healthy individuals. Adrenaline in three concentrations moderately increased ED (p < 0.05), and the observed EA increasing was greatest at low hormone concentration (0.01 μM). Conclusion. Analysis of hemorheological parameters in patients with DM-2 showed disorders of blood fl uidity and decreasing of blood transport capacity. It was also shown that hormones involved in metabolism regulation had a direct effect on erythrocytes microrheology.

Diseases ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 16
Author(s):  
Giulia Casadei ◽  
Marta Filippini ◽  
Lorenzo Brognara

Background: Diabetic peripheral neuropathy (DPN) is known to predict foot ulceration, lower-extremity amputation and mortality. Patients with diabetes mellitus have a predisposition toward developing chronic inflammatory demyelinating polyneuropathy, and this may also facilitate the formation of diabetic foot and cutaneous impairment, which are considered one of the most serious impairments of diabetes mellitus, with a prevalence of 4–10% in this population. Biomarkers research provides opportunities for the early diagnosis of these complications for specific treatments useful to prevent amputation and, therefore, physical inability and mental disturbance. The recent literature has suggested that glycemic levels may be a novel factor in the pathogenesis of diabetic foot complications and is an important mediator of axonal dysfunction. The aim of this systematic literary review is to determine whether hemoglobin A1c (HbA1c) is a positive predictor for diabetic foot peripheral neuropathy and its complications, such as foot cutaneous impairments. There is a lack of consensus regarding the effect of glycemic variability on diabetic foot peripheral neuropathy, unlike other complications such as retinopathy, nephropathy or micro/macrovascular pathology. Methods: Relevant articles were searched in the Medline database using PubMed and Scopus and relevant keywords. The primary search terms used were “glycated hemoglobin” OR “HbA1c” AND “diabetic neuropathies” AND “Foot”. Results: A number of articles (336) were initially identified while searching the scientific literature regarding this topic, and 32 articles were selected and included in this review. Conclusions: This review highlights the role of HbA1c in diabetic foot peripheral neuropathy. Biomarkers play an important role in the decision-making process, and HbA1c levels are extensively used for diabetic foot clinical outcomes and settings, but biomarker research in diabetic foot peripheral neuropathy is in its infancy and will require careful attention to a number of factors and associations, since the consequences of DPN also include neurological alterations. HbA1c is an accurate and easy-to-administer test and can be an effective biomarker in establishing the diagnosis of diabetes, but future research should focus on standardizing the HbA1c level and selecting which DPN value and its correlated complications, such as foot cutaneous impairments, are the most informative.


2021 ◽  
Vol 9 (2) ◽  
pp. 6-9
Author(s):  
O.V. Zavoloka ◽  
P.A. Bezditko ◽  
L.P. Abramova ◽  
V.O. Vekshyn

Background. The purpose was to analyze the cytokine balance of lacrimal fluid in patients with bacterial keratitis and diabetes mellitus (DM) at the first visit and to identify the immunological aspects of the disease. Materials and methods. The analysis of pro- and anti-inflammatory cytokine concentration in the lacrimal fluid was performed in 17 patients with type 1 DM and bacterial keratitis and 15 nondiabetic patients with bacterial keratitis at the first visit. Data from 14 healthy individuals were used for comparison. In addition to standard ones, ophthalmic examination methods included bacteriological examination, fluorescein test, anterior segment optical coherence tomography, non-contact corneal aesthesiometry. The levels of interleukin (IL) 1β, IL-6 and IL-10 in the lacrimal fluid of the sick and the contralateral eye were determined by a quantitative colorimetric enzyme-linked immunosorbent assay using ELISA kits. Results. In DM patients with bacterial keratitis, the concentration of IL-1β and IL-6 in the lacrimal fluid of the sick eye exceeded that in healthy individuals (p < 0.05) and did not differ significantly from nondiabetic patients with bacterial keratitis (p > 0.05). In the lacrimal fluid of the contralateral eye of DM patients with bacterial keratitis, the level of IL-1β and IL-6 exceeded the corresponding indicators of nondiabetic patients with bacterial keratitis and healthy individuals (p < 0.05). The concentration of IL-10 in the lacrimal fluid of the contralateral eye in DM patients with bacterial keratitis exceeded that in healthy individuals (p < 0.05) and did not significantly differ from those in nondiabetic patients with bacterial keratitis (p > 0.05). Conclusions. DM patients with bacterial keratitis have immunological features of the disease.


2010 ◽  
Vol 49 (178) ◽  
Author(s):  
P Jha ◽  
BKL Das ◽  
S Shrestha ◽  
S Majhi ◽  
L Chandra ◽  
...  

INTRODUCTION: Diabetic nephropathy is one of the major complications of Diabetes Mellitus characterized by persistent albuminuria, elevated arterial blood pressure, a relentless decline in glomerular filtration rate (GFR) and a high risk of cardiovascular morbidity and mortality. METHODS: In this study, urinary micro-albumin estimation was done in 177 diabetic patients. This study aims to ascertain association of glycemicstatus, lipid profile and proteinuria in Type 2 Diabetes Mellitus with nephropathy. RESULTS: Among 177 patients, 26 had frank proteinuria, 79 had micro-albuminuria and 72 were without proteinuria. Increased frequency ofproteinuria was seen in male than female. Micro-albuminuria and frank proteinuria was seen more in older age group. The multiple comparisons showed the significantly increased levels of urea, creatinine, fasting blood glucose in micro-albuminuria and overt proteinuria patients in comparison to without proteinuria. Glycated hemoglobin level was increased with the increasing age group particularly in overt proteinuric patients. CONCLUSIONS: The glycemic control, monitoring of lipid profile and early urinary protein estimation with better management may delay diabetic nephropathy or its further complications in diabetes mellitus.  KEYWORDS: diabetes mellitus, diabetic nephropathy, frank proteinuria, glycated hemoglobin, micro-albuminuria.


Author(s):  
I.M. Fushtey ◽  
Ye.A. Solovyuk ◽  
A.O. Solovyuk

The purpose of this work was to study the general characteristics of quality of life (QoL), the effect of overweight on QoL, the nature of eating behaviour in patients with diabetes mellitus (DM) type 2 and   concomitant overweight (OW) and obesity, as well as to establish the correlation with indicators of functional state of the arterial vessels. 64 people (34 women and 30 men) with DM and concomitant  overweight and obesity (average age 56.3 ± 10.23 years) formed the 1 group, 34 people (19 women and 15 men), whose average age was 55.6 ± 11.92 years constituted the 2 group, and  28 healthy individuals formed the control group. SF-36v2 questionnaires were used to evaluate QoL. The effect of overweight on QoL was analyzed according to the IWQOL-Lite questionnaire data, the patterns of eating behaviour were determined by the COEQ4 for 7 days using FPRS questionnaire. The functional state of the arterial vessels was assessed by estimating the pulse wave velocity using the automated rheographic complex ReoCom (KhAI Medika (Ukraine)). The patients with DM and concomitant overweight and obesity were found to experience some changes in QoL according to the SF-36v2 questionnaire. The changes were primarily characterized by a decrease in physical activity, as well as in social and emotional status. These changes differed not only from the QoL assessment by healthy individuals, but also from those of patients with DM and normal body weight. The nature of eating behaviour in overweight or obese patients with DM was characterized by an increased hunger in parallel with a worsened emotional state and an increased desire to eat certain types of foods that can contribute to weight gain. Structural changes in arterial vessels that typically are indicative of arterial stiffness correlate with indicators of emotional state and physical activity in patients with DM and comorbid overweight and obesity.


2021 ◽  
Vol 15 (12) ◽  
pp. 3513-3515
Author(s):  
Bader Alsuwayt

Aim: To describe the rate of the controlled level of glycosylated hemoglobin (HbA1c) among diabetes mellitus patients in Dammam city, Kingdom of Saudi Arabia (KSA). To assess the association between the status of HbA1c and the different patient-related factors namely: insulin use, metformin, dyslipidemia, and statin use. Methods: This cross-sectional study was performed at Security Forces Hospital, Dammam, KSA, between November 2020 and February 2021. A sample of two hundred known diabetic patients who were regularly followed up at the outpatient department (OPD) was selected randomly for the current study. Results: A very low rate (24%) of controlled HbA1C levels in patients with diabetes (type 1 DM and type 2 DM), The data showed that 85 % of all participants in our study are T2DM patients, while only 15% are T1DM patients, Our data showed that patients with dyslipidemia, hypothyroidism, or hypertension have a high level of uncontrolled HbA1C levels. Surprisingly, both dyslipidemia and statin use were predictors of uncontrolled HbA1C, Unexpectedly, non-metformin use has a protective effect toward controlling HbA1C, While insulin use is a strong predictor of uncontrolled HbA1C (OD 5.20). Conclusion: A low rate of controlled glycated hemoglobin (HbA1c) level among patients with diabetes (T1DM and T2DM) in our sample urges the need for immediate intervention to investigate and improve the current findings. Further investigations are needed to fully explain the high rate of uncontrolled HbA1c among insulin, metformin and statins users. Keywords: Glycated hemoglobin, HbA1c, Diabetes mellitus, Statins, Metformin.


Cells ◽  
2020 ◽  
Vol 9 (7) ◽  
pp. 1731
Author(s):  
Caomhán J. Lyons ◽  
Timothy O'Brien

Endothelial-colony-forming cells (ECFCs) are a population of progenitor cells which have demonstrated promising angiogenic potential both in vitro and in vivo. However, ECFCs from diabetic patients have been shown to be dysfunctional compared to ECFCs from healthy donors. Diabetes mellitus itself presents with many vascular co-morbidities and it has been hypothesized that ECFCs may be a potential cell therapy option to promote revascularisation in these disorders. While an allogeneic cell therapy approach would offer the potential of an ‘off the shelf’ therapeutic product, to date little research has been carried out on umbilical cord-ECFCs in diabetic models. Alternatively, autologous cell therapy using peripheral blood-ECFCs allows the development of a personalised therapeutic approach to medicine; however, autologous diabetic ECFCs are dysfunctional and need to be repaired so they can effectively treat diabetic co-morbidities. Many different groups have modified autologous diabetic ECFCs to improve their function using a variety of methods including pre-treatment with different factors or with genetic modification. While the in vitro and in vivo data from the literature is promising, no ECFC therapy has proceeded to clinical trials to date, indicating that more research is needed for a potential ECFC therapy in the future to treat diabetic complications.


Angiology ◽  
2015 ◽  
Vol 67 (4) ◽  
pp. 384-390 ◽  
Author(s):  
Süleyman Karakoyun ◽  
Tayyar Gökdeniz ◽  
Mustafa Ozan Gürsoy ◽  
İbrahim Rencüzoğulları ◽  
Yavuz Karabağ ◽  
...  

2018 ◽  
Vol 56 (9) ◽  
pp. 1551-1558 ◽  
Author(s):  
Tinne Monteyne ◽  
Renaat Coopman ◽  
Antoine S. Kishabongo ◽  
Jonas Himpe ◽  
Bruno Lapauw ◽  
...  

Abstract Background: Glycated keratin allows the monitoring of average tissue glucose exposure over previous weeks. In the present study, we wanted to explore if near-infrared (NIR) spectroscopy could be used as a non-invasive diagnostic tool for assessing glycation in diabetes mellitus. Methods: A total of 52 patients with diabetes mellitus and 107 healthy subjects were enrolled in this study. A limited number (n=21) of nails of healthy subjects were glycated in vitro with 0.278 mol/L, 0.556 mol/L and 0.833 mol/L glucose solution to study the effect of glucose on the nail spectrum. Consequently, the nail clippings of the patients were analyzed using a Thermo Fisher Antaris II Near-IR Analyzer Spectrometer and near infrared (NIR) chemical imaging. Spectral classification (patients with diabetes mellitus vs. healthy subjects) was performed using partial least square discriminant analysis (PLS-DA). Results: In vitro glycation resulted in peak sharpening between 4300 and 4400 cm−1 and spectral variations at 5270 cm−1 and between 6600 and 7500 cm−1. Similar regions encountered spectral deviations during analysis of the patients’ nails. Optimization of the spectral collection parameters was necessary in order to distinguish a large dataset. Spectra had to be collected at 16 cm−1, 128 scans, region 4000–7500 cm−1. Using standard normal variate, Savitsky-Golay smoothing (7 points) and first derivative preprocessing allowed for the prediction of the test set with 100% correct assignments utilizing a PLS-DA model. Conclusions: Analysis of protein glycation in human fingernail clippings with NIR spectroscopy could be an alternative affordable technique for the diagnosis of diabetes mellitus.


Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 658
Author(s):  
Ieva Jurgeleviciene ◽  
Daiva Stanislovaitiene ◽  
Vacis Tatarunas ◽  
Marius Jurgelevicius ◽  
Dalia Zaliuniene

Background and objectives: Glycation occurs in a variety of human tissues and organs. Knowledge about the relationship between predictive biochemical factors such as absorption of glycated nail proteins and severity of type 2 diabetes mellitus (DM) and diabetic retinopathy (DR) remains limited. Materials and Methods: The study group consisted of patients with type 2 DM and DR (n = 32) and a control group (n = 28). Each patient underwent a comprehensive ophthalmic examination. The glycation process in nail clippings was evaluated in stages of in vitro glycation and deglycation stages. ATR–FTIR spectroscopy was used to calculate the infrared absorption in the region of interest. The absorption of solutions with nail clippings was evaluated by NanoDrop spectrophotometry. Absorption spectra differences before and after the exposure to fructosamine 3-kinase were compared between DM patients with DR and the control group. Results: The absorption of glycated nail protein greater than 83.00% increased the chance of developing DM and DR (OR = 15.909, 95% CI 3.914–64.660, p < 0.001). Absorption of glycated nail protein by ATR–FTIR spectroscopy in patients with DM and DR in vitro glycation was statistically significantly higher than in the control group; also absorption of solution with nails by NanoDrop spectroscopy was statistically significantly higher than in controls in vitro glycation and in vitro deglycation. After exposure to fructosamine 3-kinase, absorption of nail protein in DM + severe/proliferative DR group was statistically significantly lower in comparison with DM + mild/moderate group DR. Conclusions: Evaluation of glycated nail protein could be applied to evaluate the risk of having DM and for long-term observation of DM control.


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