Study of alimentary behavior of Tunisian diabetic patients with and without cardiovascular diseases

2017 ◽  
Author(s):  
khlifi sarra
Keyword(s):  
Cardiovascular Diseases ◽  
Diabetic Patients ◽  
Alimentary Behavior

A Clinical Decision Support System for Assessing the Risk of Cardiovascular Diseases in Diabetic Hemodialysis Patients

2020 ◽  
Vol 16 (3) ◽  
pp. 262-269
Author(s):  
Tahere Talebi Azad Boni ◽  
Haleh Ayatollahi ◽  
Mostafa Langarizadeh
Keyword(s):  
Decision Support ◽  
Cardiovascular Diseases ◽  
Decision Support System ◽  
Clinical Decision Support ◽  
Support System ◽  
Clinical Decision Support System ◽  
Clinical Decision ◽  
Diabetic Patients ◽  
K Value ◽  
Care Plans

Background: One of the greatest challenges in the field of medicine is the increasing burden of chronic diseases, such as diabetes. Diabetes may cause several complications, such as kidney failure which is followed by hemodialysis and an increasing risk of cardiovascular diseases. Objective: The purpose of this research was to develop a clinical decision support system for assessing the risk of cardiovascular diseases in diabetic patients undergoing hemodialysis by using a fuzzy logic approach. Methods: This study was conducted in 2018. Initially, the views of physicians on the importance of assessment parameters were determined by using a questionnaire. The face and content validity of the questionnaire was approved by the experts in the field of medicine. The reliability of the questionnaire was calculated by using the test-retest method (r = 0.89). This system was designed and implemented by using MATLAB software. Then, it was evaluated by using the medical records of diabetic patients undergoing hemodialysis (n=208). Results: According to the physicians' point of view, the most important parameters for assessing the risk of cardiovascular diseases were glomerular filtration, duration of diabetes, age, blood pressure, type of diabetes, body mass index, smoking, and C reactive protein. The system was designed and the evaluation results showed that the values of sensitivity, accuracy, and validity were 85%, 92% and 90%, respectively. The K-value was 0.62. Conclusion: The results of the system were largely similar to the patients’ records and showed that the designed system can be used to help physicians to assess the risk of cardiovascular diseases and to improve the quality of care services for diabetic patients undergoing hemodialysis. By predicting the risk of the disease and classifying patients in different risk groups, it is possible to provide them with better care plans.

scholarly journals Aszimmetrikus dimetilarginin: a cardiovascularis betegségek prediktora?

2016 ◽  
Vol 157 (13) ◽  
pp. 483-487
Author(s):  
Balázs Németh ◽  
Péter Kustán ◽  
Ádám Németh ◽  
Zsófia Lenkey ◽  
Attila Cziráki ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Diseases ◽  
Asymmetric Dimethylarginine ◽  
Disease Onset ◽  
Cardiovascular Prevention ◽  
Competitive Inhibitor ◽  
Diabetic Patients ◽  
Artery Disease

Cardiovascular diseases are the most common diseases worldwide. They are responsible for one third of global deaths and they are the leading cause of disability, too. The usage of different levels of prevention in combination with effective risk assessment improved these statistical data. Risk assessment based on classic risk factors has recently been supported with several new markers, such as asymmetric dimethylarginine, which is an endogenous competitive inhibitor of nitric oxide synthase. Elevated levels of asymmetric dimethylarginine have been reported in obese, smoker, hypercholesterolemic, hypertensive and diabetic patients. According to previous studies, asymmetric dimethylarginine is a suitable indicator of endothelial dysfunction, which is held to be the previous state of atherosclerosis. Several researches found positive correlation between higher levels of asymmetric dimethylarginine and coronary artery disease onset, or progression of existing coronary disease. According to a study involving 3000 patients, asymmetric dimethylarginine is an independent risk factor of cardiovascular mortality in patients with coronary artery disease. This article summarizes the role of asymmetric dimethylarginine in prediction of cardiovascular diseases, and underlines its importance in cardiovascular prevention. Orv. Hetil., 2016, 157(13), 483–487.

Oxidative stress and diabetic cardiovascular disorders: roles of mitochondria and NADPH oxidaseThis review is one of a selection of papers published in a Special Issue on Oxidative Stress in Health and Disease.

2010 ◽  
Vol 88 (3) ◽  
pp. 241-248 ◽  
Author(s):  
Garry X. Shen
Keyword(s):  
Oxidative Stress ◽  
Nitric Oxide ◽  
Endothelial Cells ◽  
Cardiovascular Diseases ◽  
Mitochondrial Dysfunction ◽  
Cardiovascular Complications ◽  
Hypoglycemic Agents ◽  
Diabetic Patients ◽  
Plasminogen Activator Inhibitor 1 ◽  
In Cells

Cardiovascular diseases are the predominant cause of death in patients with diabetes mellitus. Underlying mechanism for the susceptibility of diabetic patients to cardiovascular diseases remains unclear. Elevated oxidative stress was detected in diabetic patients and in animal models of diabetes. Hyperglycemia, oxidatively modified atherogenic lipoproteins, and advanced glycation end products are linked to oxidative stress in diabetes. Mitochondria are one of major sources of reactive oxygen species (ROS) in cells. Mitochondrial dysfunction increases electron leak and the generation of ROS from the mitochondrial respiratory chain (MRC). High levels of glucose and lipids impair the activities of MRC complex enzymes. NADPH oxidase (NOX) generates superoxide from NADPH in cells. Increased NOX activity was detected in diabetic patients. Hyperglycemia and hyperlipidemia increased the expression of NOX in vascular endothelial cells. Accumulated lines of evidence indicate that oxidative stress induced by excessive ROS production is linked to many processes associated with diabetic cardiovascular complications. Overproduction of ROS resulting from mitochondrial dysfunction or NOX activation is associated with uncoupling of endothelial nitric oxide synthase, which leads to reduced production of nitric oxide and endothelial-dependent vasodilation. Gene silence or inhibitor of NOX reduced oxidized or glycated LDL-induced expression of plasminogen activator inhibitor-1 in endothelial cells. Statins, hypoglycemic agents, and exercise may reduce oxidative stress in diabetic patients through the reduction of NOX activity or the improvement of mitochondrial function, which may prevent or postpone the development of cardiovascular complications.

scholarly journals A new approach to the treatment of dyslipidemia

Medicina ◽  
2008 ◽  
Vol 44 (5) ◽  
pp. 407 ◽  
Author(s):  
Sigita Kėvelaitienė ◽  
Rimvydas Šlapikas
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
High Risk ◽  
Statin Therapy ◽  
Cholesterol Absorption ◽  
Diabetic Patients ◽  
Intestinal Cholesterol Absorption ◽  
Beneficial Effects ◽  
European Society Of Cardiology

During the last decade, the evidence of beneficial effects of cholesterol lowering in patients with coronary heart disease has been proven in many clinical trials. The National Cholesterol Education Program (NCEP) released 2004 update to the Adult Treatment Panel III (ATP III) guidelines. The new guidelines of European Society of Cardiology announced in 2007 support more intensive LDL-C lowering in patients at high risk of cardiovascular diseases. For patients at the highest risk of cardiovascular diseases (diabetic patients with coronary heart disease), the recommended LDL-C goal is <1.8 mmol/L. In very high-, high-, and moderately high-risk patients, statin therapy should be considered with a treatment targeting an LDL-C reduction of 30– 40%. Clinical studies have shown that statin therapy alone is not always effective, especially in patients with primary hypercholesterolemia. Furthermore, high doses of statins can increase the possibility of adverse events. The combination of statins with intestinal cholesterol absorption inhibitors is more effective than statin monotherapy in LDL-C lowering and is well tolerated.

scholarly journals Cardiovascular diseases in diabetic patients

2010 ◽  
Vol 1 (1) ◽  
pp. 46-50
Author(s):  
I. Y Yarek-Martynova ◽  
M. V Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Cerebrovascular Diseases ◽  
Diabetic Patients ◽  
Metabolic Disturbances ◽  
Lower Extremity Ischemia ◽  
Traditional Risk Factors ◽  
Extremity Ischemia

The review pays attention to a considerable rise in the incidence of diabetes mellitus (DM) and to its association with cardiovascular diseases (CVD) and events. It is noted that these events may be present much earlier than DM is diagnosed. The paper also discusses in detail a role of hyperglycemia, postprandial one in particular, hyperinsulinemia, insulin resistance, endothelial dysfunction, impaired blood rheological properties, lipid metabolic disturbances, and genetic and traditional risk factors in the development of atherosclerosis, coronary heart disease, chronic heart failure, cerebrovascular diseases, and lower extremity ischemia in DM.

scholarly journals Self Management Pasien Diabetes Melitus dengan Komplikasi Kardiovaskular dan Implikasinya terhadap Indikator Klinik

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Titis Kurniawan ◽  
Citra Windani Mambang Sari ◽  
Iis Aisyah
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Blood Glucose ◽  
Coronary Artery ◽  
Cardiovascular Diseases ◽  
Self Management ◽  
Diabetic Patients ◽  
Coronary Artery Diseases ◽  
Clinical Indicators ◽  
Diabetes Melitus

 ABSTRAKPenyakit kardiovaskular merupakan salah satu komplikasi utama diabetes melitus (DM) dan berisiko memperburuk prognosis, kualitas hidup serta meningkatkan risiko kematian. Self-management merupakan kunci utama dalam pengelolaan penyakit maupun pencegahan komplikasi dan dampak negatif yang diakibatkanya. Penelitian deskriptif ini bertujuan untuk mengidentifikasi self-management pada pasien DM dengan komplikasi kardiovaskular beserta dampaknya terhadap indikator klinik. Seluruh pasien (123 orang) diabetes mellitus yang didiagnosa menderita penyakit kardiovaskular (hipertensi, dislipidemia, dan/atau coronary artery diseases) dilibatkan dari unit rawat jalan salah satu rumah sakit swasta di Kota Bandung, Jawa Barat secara total sampling. Data self-management dikumpulkan menggunakan kuesioner yang dikembangkan oleh peneliti yang mencakup 6 domain (pemantauan, aktivitas fisik, pencegahan komplikasi, diet, pengobatan, dan merokok) dan mencakup 28 item pernyataan dengan skor Alpha Chronbach 0,738 dan validitas (r 0,377-0,760). Adapun data tentang indikator klinik dikumpulkan berdasarkan data sekunder dari rekam medik yang mencakup tekanan darah, kadar gula darah sewaktu, dan kadar kolesterol. Data yang terkumpul dianalisis menggunakan analisis deskriptif dan uji beda. Hasil penelitian menunjukkan lebih dari setengah responden (54,5%) berada pada kategori self-management rendah dimana domain pemantauan merupakan domain dengan persentase kategori rendah paling besar (62,6%). Rerata skor self-management yang lebih tinggi ditemukan pada pasien yang mencapai target indikator klinik; tekanan darah sistolik 140mmHg, kolesterol darah 200mg%, dan gula darah sewaktu 200mg%. Namun, perbedaan skor self-management yang signifikan hanya ditemukan pada indikator gula darah (p = 0,05). Hasil penelitian ini menunjukkan bahwa pasien DM dengan komplikasi kardiovaskular di tempat penelitian ini perlu meningkatkan perilaku self-management terutama dalam aspek pemantauan. Penting juga bagi pihak rumah sakit untuk mengintensifkan upaya yang sudah dijalankan guna memfasilitasi kebutuhan tersebut. ABSTRACTCardiovascular problem is one of the main diabetes mellitus complications that potentially worsen patients’ prognosis, quality of life as well as increase the patient mortality rate. Self-management in the other hand is a key success of diseases management and complication prevention. This descriptive study aimed to identify self-management of diabetic patients who diagnosed with cardiovascular diseases and its impact on clinical indicators. All 123 diabetic patients with cardiovascular diseases (hypertension, dyslipidaemia, dan coronary artery diseases) were involved in this study (total sampling) and recruited from an outpatient clinic of a private hospital in Bandung Municipality, West-Java. Data self-management were collected using questionnaire developed by the researcher covering 6 domains (monitoring, Physical exercise, complication management and prevention, diet, medication and smoking) consisted of 28 items with Alpha Chronbach 0,738 and inter-item correlation r 0.377 - 0.760. Data regarding clinical indicators were secondarily collected from patients’ medical record including current blood pressure, blood sugar level and cholesterol level. Collected data were analysed descriptively and comparatively with significance at p 0.05. The results suggested that more than half patients (54.5%) report low level of self-management where monitoring domain found as the domain with the biggest percentage of low self-management category (62.6%). In addition, respondents with higher mean score of self-management was found in patient who achieved the clinical outcomes; blood pressure 140mmHg, cholesterol 200mg%, and blood glucose 200mg%. However, statistically significant finding only identified in blood glucose indicator (p = 0.05). These results indicated that diabetic patients with cardiovascular problem in this setting need program or strategy to improve their capability in performing self-management particularly in the monitoring aspect. It also is significance for hospital to address those issues.  

scholarly journals Risk of cardiovascular disease among diabetic patients in rural population of Central India

2017 ◽  
Vol 5 (4) ◽  
pp. 1563
Author(s):  
Prem S. Singh ◽  
K. S. Zafar ◽  
Manoj Kumar ◽  
Sudhir K. Yadav
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Cardiovascular Risk Factors ◽  
Indian Population ◽  
Central India ◽  
Diabetic Patients ◽  
Intensive Management ◽  
Atherosclerotic Cardiovascular Diseases

Background: Incidence and prevalence of diabetes is on surge day by day and increased longevity of diabetic patients put them at higher risk of chronic complications of hyperglycemia. Of these complications, atherosclerotic cardiovascular diseases (CVD) are of utmost importance and atherosclerotic cardiovascular diseases are the major cause of premature mortality in patients with type 2 diabetes as well. Regional variation of risk factors and sociocultural diversity of Indian population create a significant difference in atherosclerotic risk among the diabetic population across the country. There is a significant gap in the knowledge of CVD epidemiology and associated risk factors among the Indian population especially among the rural population. The objective of this study was to assess cardiovascular risk among diabetic patients of rural central India.Methods: The present cross-sectional study included 160 diabetic patients (78 males and 82 females) aged 35–75 years from the villages of district Etawah of UP, Central India. Sex-specific Framingham general cardiovascular risk prediction equations were used to calculate the 10years risk for cardiovascular disease. The probable risk factors were determined by cross-tabulation of cardiometabolic parameters with the 10-year cardiovascular risk level.Results: Males were found to be at higher risk of developing CVD in the future as compared to females with a discernible accumulation of adverse cardiovascular risk factors among them. 38.75% patients were at high risk, 37.50% at moderate risk and 23.75% at low risk for developing CVD in the next 10 years. Systolic blood pressure, total cholesterol, triglyceride and smoking contributed significantly to high degree of cardiovascular risk. Presence of cardiovascular risk factors among diabetic patients at diagnosis accentuates the need of intensive management of cardiovascular complications taking into consideration the traditional dietary pattern of the rural population.Conclusions: Both diabetes and CVD have common genetic and environmental antecedents. Furthermore, insulin resistance preceding long before the diagnosis of diabetes enhances atherogenic risk profile and has been delineated as a potential cause for subsequent increased risk of CVD among diabetic patients. There is need of intensive management of cardiovascular risk factors among diabetic individuals. Therefore, there is a need of a comprehensive study design which includes various factors (biological, sociodemographic and genetic) which directly or indirectly influence the disease incidence especially in a country (India) with diverse ethnic population.

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