scholarly journals Hypoglycaemia as predictor of cardiovascular accidents

2013 ◽  
Vol 4 (2) ◽  
pp. 67-71
Author(s):  
E. V Doskina ◽  
B. M Tankhilevich
Keyword(s):  
Vascular Complications ◽  
Severe Hypoglycemia ◽  
Dietary Recommendations ◽  
Drug Induced ◽  
Self Monitoring ◽  
Target Values ◽  
Acute Disturbance ◽  
Cardio Vascular ◽  
Cerebral Blood Circulation

Diabetes mellitus type 2 is not only a chronic disease, but also refers to a group of constantly progressing pathologies. Regardless of the level of development of medicine and used therapeutic approaches, mortality from cardio-vascular complications of diabetes exceeds the figures of the General population. According to the results of Veterans Affairs Diabetes Trial it was revealed that severe hypoglycemia are predictors for the development of myocardial infarction and acute disturbance of cerebral blood circulation. Pledge of successful treatment of patients with type 2 diabetes is the adequate choice of target values of glycemia and maintaining it by means of a combination of curative (observance of dietary recommendations, reception of hypoglycemic drugs, etc.) and not drug-induced (by which primarily active self-monitoring of blood glucose) activities.

Mechanisms underlying heart failure in type 2 diabetes mellitus

2019 ◽  
pp. 37-39
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Experimental Studies ◽  
Vascular Complications ◽  
Molecular Alterations ◽  
Increased Risk ◽  
Cardioprotective Effects ◽  
Underlying Mechanisms ◽  
Cardio Vascular

The prevalence of heart failure is markedly increased in individuals with diabetes mellitus. Numerous observational studies suggest that this increased risk for heart failure can be attributed to exacerbated vascular complications and the presence of increased risk factors in diabetic subjects. In addition, experimental studies revealed the presence of a number of distinct molecular alterations in the myocardium that occur independently of vascular disease and hypertension. Many of these molecular alterations are similarly observed in failing hearts of nondiabetic patients and have thus been proposed to contribute to the increased risk for heart failure in diabetes. The interest in understanding the underlying mechanisms of impaired cardio- vascular outcomes in diabetic individuals has much increased since the demonstration of cardioprotective effects of SGLT-2 inhibitors and GLP-1 receptor agonists in recent clinical trials. The current review therefore summarizes the distinct mechanisms that have been proposed to increase the risk for heart failure in diabetes mellitus.

scholarly journals Economic evaluation of type 2 diabetes mellitus burden and its main cardiovascular complications in the Russian Federation

2016 ◽  
Vol 19 (6) ◽  
pp. 518-527 ◽  
Author(s):  
Ivan I. Dedov ◽  
Anna V. Koncevaya ◽  
Marina V. Shestakova ◽  
Yuriy B. Belousov ◽  
Julia A. Balanova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Russian Federation ◽  
Complex Analysis ◽  
Vascular Complications ◽  
Cardiovascular Complications ◽  
Permanent Disability ◽  
Clinical Investigations ◽  
The Russian Federation ◽  
Cardio Vascular

Background. Diabetes Mellitus Type 2 (DMT2) is a complex medical and social problem in the world and in the Russian Federation also due to prevalence and probability of cardio-vascular complications (CVC).Aim. Economic burden evaluation of DMT2 in the Russian Federation.Methods. Complex analysis of expenditures (direct and non-direct costs) based on epidemiological, pharmacoeconomics and clinical investigations, population and medical statistics data.Results. Calculated expenditures for DMT2 are 569 bln RUR per year, that is correspond to 1% of the Russian GDP, and 34,7% of that are expenditures for main CVC (ischemic heart disease, cardiac infarction, stroke). Main part of expenses are non-medical (losses GDP) due to temporary and permanent disability, untimely mortality – 426,7 bln RUR per year. Expenditures in estimated group of patients with non-diagnosed DMT2 but with already having CVC were at least 107 bln per year (18,8% from total cost). Relationship between cost of DMT2 and degree of it’s control was found in the Russian conditions. Estimated cost for compensated patient (HbA1c6,5%) per year was 88 982 RUR, in the same time cost of non-control patient (HbA1c9,5%) was in 2,8 times higher due to more often main CVC in this group.Conclusion. DMT2 diagnosis improvement as well as effective treatment of early stages of illness can decrease probability of CVC and social economic expenditures. 

scholarly journals Risk management of micro- and macrovascular complications of diabetes mellitus: the importance of glycemic self-control

2021 ◽  
Vol 2 (8) ◽  
pp. 36-41
Author(s):  
Olga A. Polyakov ◽  
◽  
Dinara G. Gusenbekova ◽  
Olga D. Ostroumova ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Severe Hypoglycemia ◽  
Glycemic Variability ◽  
Premature Death ◽  
Self Control ◽  
Macrovascular Complications ◽  
Self Monitoring ◽  
Glycemic Profile

As the incidence of obesity, unhealthy lifestyles and an aging population increases, the global prevalence of diabetes mellitus (DM) is projected to rise sharply in the coming decades. A significant part of the burden of DM is associated with the development of micro- and macrovascular complications, which are the cause of a deterioration in the quality of life, disability and premature death of patients with DM. Cardiovascular disease (CVD) is the leading cause of death in patients with DM, especially those with type 2 DM The risk of CVD in people with DM is 2–4 times higher than in people without DM, and this risk increases with the deterioration of glycemic control. Disorders of the glycemic profile such as hyperglycemia, hypoglycemia and high variability of glycemia negatively affect the prognosis of patients with DM. Self-monitoring of blood glucose is an effective tool for managing DM, which allows not only achieving the target level of glycated hemoglobin and minimizing glycemic variability, but predicting the risk of severe hypoglycemia.

scholarly journals The importance of combined glycemic control in patients with type 2 diabetes mellitus

2010 ◽  
Vol 56 (5) ◽  
pp. 43-51
Author(s):  
I V Kononenko ◽  
O M Smirnova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Plasma Glucose ◽  
Diabetic Complications ◽  
Microvascular Complications ◽  
Full Range ◽  
Vascular Complications ◽  
Target Values

The contribution of intensive control of glycemia to the reduction of the risk of microvascular complications of type 2 diabetes mellitus is known perfectly well whereas its influence on the development of macrovascular complications remains to be clarified and remains a subject of debates. Bearing in mind that hyperglycemia is a key pathogenetic factor triggering formation of diabetic complications, it is necessary to identify characteristics of carbohydrate metabolism to be taken into account when choosing therapeutic strategies and to determine their target values. Control of the HbA1c level remains the most accessible and informative tool for the assessment of the efficiency of long-term compensation of type 2 diabetes mellitus. However, this method is not altogether free from limitations that can hamper its clinical application. The fasting glycemia level does not completely reflect the quality of DM2 treatment. There is potential relationship between high postprandial plasma glucose levels and the development of vascular complications. Also, it has been shown that variability of glucose concentration may be an important risk factor of diabetic complications. Measurement of the full range of glycemic parameters including fasting plasma glucose level, HbA1c and postprandial glycemia gives an idea of the general picture of the course of the disease necessary for the choice of the treatment strategy.

scholarly journals Cardio-Vascular Complications of Hydroxychloroquine Use: Can Impact COVID-19 Pandemic

2020 ◽  
Vol 4 (3) ◽  
pp. 56-59
Author(s):  
Taruna Singh ◽  
Rakshit Arora ◽  
Amrit Sharma
Keyword(s):  
Lupus Erythematosus ◽  
Safety Information ◽  
Vascular Complications ◽  
Interval Prolongation ◽  
Drug Induced ◽  
Qt Interval Prolongation ◽  
Immunomodulatory Drug ◽  
Qt Syndrome ◽  
Cardio Vascular ◽  
Drug Leads

As the coronavirus pandemic is on the rise, many compounds with anti-viral properties are under investigation. Hydroxychloroquine (HCQ) being the daily debated daily during this COVID-19 pandemic is an immunomodulatory drug which has been used for indications like malaria, systemic lupus erythematosus and arthritis. Although some researchers have claimed its effectiveness against coronavirus, it results in proarrhythmic effects and drug-induced long QT syndrome. These cardiac issues while using hydroxychloroquine, have limited its use against coronavirus. A literature search was performed, and general safety information of this drug was collected. It can be concluded that this drug leads to cardiovascular events, heart disease, hypotension, tachycardia, and QT interval prolongation, sometimes in combination with other drugs and should be prescribed to the patients only after thoroughly estimating its benefit risk ratio.

scholarly journals Economic Value of Improved Accuracy for Self-Monitoring of Blood Glucose Devices for Type 1 and Type 2 Diabetes in England

2018 ◽  
Vol 12 (5) ◽  
pp. 992-1001 ◽  
Author(s):  
Robert Brett McQueen ◽  
Marc D. Breton ◽  
Joyce Craig ◽  
Hayden Holmes ◽  
Melanie D. Whittington ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Severe Hypoglycemia ◽  
Economic Outcomes ◽  
Self Monitoring ◽  
Life Years ◽  
Improved Accuracy ◽  
Diabetes Patients

Objective: The objective was to model clinical and economic outcomes of self-monitoring blood glucose (SMBG) devices with varying error ranges and strip prices for type 1 and insulin-treated type 2 diabetes patients in England. Methods: We programmed a simulation model that included separate risk and complication estimates by type of diabetes and evidence from in silico modeling validated by the Food and Drug Administration. Changes in SMBG error were associated with changes in hemoglobin A1c (HbA1c) and separately, changes in hypoglycemia. Markov cohort simulation estimated clinical and economic outcomes. A SMBG device with 8.4% error and strip price of £0.30 (exceeding accuracy requirements by International Organization for Standardization [ISO] 15197:2013/EN ISO 15197:2015) was compared to a device with 15% error (accuracy meeting ISO 15197:2013/EN ISO 15197:2015) and price of £0.20. Outcomes were lifetime costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). Results: With SMBG errors associated with changes in HbA1c only, the ICER was £3064 per QALY in type 1 diabetes and £264 668 per QALY in insulin-treated type 2 diabetes for an SMBG device with 8.4% versus 15% error. With SMBG errors associated with hypoglycemic events only, the device exceeding accuracy requirements was cost-saving and more effective in insulin-treated type 1 and type 2 diabetes. Conclusions: Investment in devices with higher strip prices but improved accuracy (less error) appears to be an efficient strategy for insulin-treated diabetes patients at high risk of severe hypoglycemia.

Algorithmic Evaluation of Metabolic Control and Risk of Severe Hypoglycemia in Type 1 and Type 2 Diabetes Using Self-Monitoring Blood Glucose Data

2003 ◽  
Vol 5 (5) ◽  
pp. 817-828 ◽  
Author(s):  
Boris P. Kovatchev ◽  
Daniel J. Cox ◽  
Anand Kumar ◽  
Linda Gonder-Frederick ◽  
William L. Clarke
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Metabolic Control ◽  
Severe Hypoglycemia ◽  
Self Monitoring

scholarly journals Relationship and influences of behavioral and psychological factors on metabolic control of patients with type 2 diabetes mellitus

2021 ◽  
pp. 104-104
Author(s):  
Vojislav Stanojevic ◽  
Marija Jevtic ◽  
Milena Mitrovic ◽  
Marko Panajotovic ◽  
Aleksandar Aleksic ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Metabolic Control ◽  
Psychological Factors ◽  
Self Management ◽  
Anthropometric Measurement ◽  
Dietary Recommendations ◽  
Cross Sectional ◽  
Target Values

Background/Aim. Achieving good metabolic control, which play a key role in reducing or preventing macrovascular and microvascular complication of diabetes, requires continuous patient involvement in self-management of diabetes. This continued engagement, which makes type 2 diabetes (T2DM) one of most demanding diseases, physically and emotionally, can become, at certain periods of life, too severe and lead to emotional distress (symptoms of depression and diabetes-related distress) and deterioration of metabolic control. The aim of this study was to examine association and influence of behavioral and psychological factors on the metabolic control of patients with T2DM. Methods. The research was conducted as a descriptive-analytic cross-sectional study. The method of random sampling included 324 subjects with T2DM in research. The values of biochemical parameters of metabolic control were measured by standard laboratory methods. Blood pressure was measured in two times and the arithmetic mean was calculated. Anthropometric measurement were performed and Body Mass Index (BMI) was calculated. Attitudes toward medication adherence, adherence to dietary recommendations, level of physical activity, presence of depressive symptoms and level of diabetes-related distress were examined using standardized questionnaires. Results. The target values of metabolic control parameters were reached by 21.6% of respondents. Multivariate analysis as predictors of poor metabolic control identified: obesity, non-adherence toward dietary recommendations, insulin therapy, low level of physical activity and clinically significant diabetes-related distress. Conclusions. Routine application of the questionnaire used in this study in initial stages or critical moments of disease can assess patient?s attitudes and knowledge about behavioral determinants of diabetes self-management and timely detect psychological conditions that affect them. It would be realistic to expect that such a comprehensive holistic approach would contribute to lower incidence of complication and better metabolic control of T2DM.

scholarly journals HbA1c and Blood Pressure Levels in Type 2 Diabetes: How Many Patients are on Target?

2020 ◽  
Author(s):  
Camila Bergonsi de Farias ◽  
Themis Zelmanovitz ◽  
Sabrina Coelli ◽  
Fabíola Satler ◽  
Camila Kümmel Duarte ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Vascular Complications ◽  
Treat To Target ◽  
Blood Pressure Targets ◽  
Arterial Blood ◽  
Target Values ◽  
The Mean ◽  
Diabetes Patients

Abstract Background: Achieving HbA1c and blood pressure targets is an important strategy for preventing chronic vascular complications in diabetes. The aim of this paper was to determine the proportion of type 2 diabetes patients who meet the recommended HbA1c and arterial blood pressure targets and the determinants of failure to do so.Methods: A cross-sectional study was conducted in an outpatient endocrine clinic at a university hospital. HbA1c was measured with a certified HPLC method, with a goal of 7%, except for patients with advanced chronic complications where 8% was the goal. Blood pressure was measured with a validated device after a 5-minute rest, and the overall expected target was 140/90 mmHg. Results: A total of 602 type 2 diabetes patients were analyzed: 62% were female, 14% self-reported as black, the mean age was 63±11 years, the mean diabetes duration was 17±9 years, and the median (IQR) HbA1c was 8.0% (7.0-9.5%). Macrovascular disease was present in 198 (33%) patients, diabetic retinopathy in 283 (47%), peripheral neuropathy in 258 (43%) and diabetes kidney disease in 337 (56%). Regarding metabolic control, 403 (67%) patients were not at the adjusted target HbA1c level, and the main determinants of poor glycemic control were female gender, black skin color, younger age, and insulin use. Regarding blood pressure, 348 (58%) patients were not at the recommended targets, and a more advanced age was the main associated factor. Conclusions: Since more than half of Brazilian type 2 diabetes outpatients do not meet the recommended HbA1c and blood pressure target values, there is a major call to overcome therapeutic inertia and treat to target each individual patient. Female, black and younger individuals seem to be associated with a worse glycemic profile.

scholarly journals HEMORHEOLOGIC PROFILE AND MICROCIRCULATORY HEMOSTASIS IN PATIENTS WITH CEREBROVASCULAR DISEASE IN DIABETES MELLITUS

2021 ◽  
Vol 11 (4) ◽  
pp. 68-73
Author(s):  
Vladimir Shkarin ◽  
Oxana Anfinogenova ◽  
Taisiya Kochkonyan ◽  
Ghamdan Al-Harazi ◽  
Sergey Kubanov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Anticoagulant Activity ◽  
Vascular Complications ◽  
Diabetic Vascular Complications ◽  
Glycation End Products ◽  
Cerebral Circulation Disorders ◽  
Cerebral Blood Circulation

Diabetes mellitus is one of the most serious issues faced nowadays both by medicine and society in general, which is due to the wide spread of endocrine issues affecting nearly every country globally, the growing incidence rate, as well as the severity of complications that are hard to treat. Type 2 diabetes mellitus increases significantly the risk of developing acute cerebral blood circulation disorders, which urges further comprehensive studies focusing on the role played by the vascular-platelet relation and coagulation hemostasis in the development and progression of diabetic vascular complications. The results of our study, which involved 74 patients with acute cerebral circulation disorders against type 2 diabetes mellitus revealed alterations affecting the hemostasis system. This could be seen from activated vascular-platelet and coagulation links, decreased anticoagulant activity, and a slowdown in fibrinolysis. The severity of disorders induced by the alterations in the hemorheological profile and the microcirculatory hemostasis are associated with the duration of type 2 diabetes mellitus and the carbohydrate metabolism indicators (hyperglycemia, increased HbA1c levels and glycation end products).

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