scholarly journals RESULTS OF CLINICAL STUDY OF COMPLEX TREATMENT OF GENERALIZED PERIODONTITIS WITH THE USE OF STRONTIUM DRUGS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

2021 ◽  
pp. 37-43
Author(s):  
A. V. Samoilenko ◽  
L. M. Matvyeyenko
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Bone Resorption ◽  
Strontium Ranelate ◽  
Alveolar Bone ◽  
Main Group ◽  
Complex Treatment ◽  
Periodontal Tissues

The most significant periodontal disorders associated with diabetes mellitus are due to changes in bone tissue. It has become necessary for specific osteotropic therapy that can normalize metabolic processes in the alveolar bone. In turn, currently the most promising in terms of improving osteogenic activity are strontium ions. Strontium ranelate is used to treat osteoporosis due to its antiresorptive and osteoanabolic action. However, its effectiveness against alveolar bone has not been sufficiently studied. The purpose of the work is to conduct a clinical study of complex treatment of generalized periodontitis, supplemented with strontium ranelate, in patients with type 2 diabetes mellitus. Materials and methods of the research. The study included 60 patients with generalized periodontitis of I-II degree of severity, chronic course, aged 35-45 years. Type 2 diabetes mellitus was diagnosed and two groups were formed. The traditional treatment regimen was used in the group of comparison (main group) where Strontium Ranelate was prescribed additionally. The treatment was evaluated according to the dynamics of clinical observations, orthopantomography and computed tomography data, the results of biochemical studies. As markers of bone resorption, tartrate-resistant acid phosphatase (TRAP) activity was determined in blood serum and the content of β-CrossLaps fragments was determined in urine. As markers of osteogenesis, the concentration of C-terminal propeptide type I procollagen (CICP) was detected in blood plasma, bone alkaline phosphatase (BAP) and osteocalcin were detected in serum. Serum parathyroid hormone concentrations, total blood calcium and total inorganic phosphorus in the blood were studied as indicators of mineral metabolism. Results of the research. In the earliest possible timeframe the complex treatment of generalized periodontitis was conducted during the observation which led to clinical stabilization of the inflammatorydestructive process in the periodontal tissues without a significant difference between the experimental groups (p ˃ 0.05). However, the condition of periodontal tissues in patients of the experimental groups differed in a year after treatment. In 16.7% of patients from the comparison group, recurrence of the inflammatory-destructive process in periodontal tissues was diagnosed, while the cases the deterioration of the pathological process was not detected in the main group. A significant difference was found for complex periodontal indices (Ramfjord, PI and SPITN) (p <0.05). Clinical and radiological stabilization was observed in 83.3% of patients of the comparison group and in 100% in the main group. According to the results of computed tomography of the alveolar bone, an increase in bone mineral density was established in both groups, but only in the main group the difference between indices before and after treatment was significant (p˂0.05). In patients of the main group a more pronounced decrease in the activity of tartrate-resistant acid phosphatase (TRAP) was found in the serum and the concentration of β-CrossLaps was found in the urine, indicating inhibition of bone resorption, as well as markers of bone formation the concentration of C-terminal propeptide (CICP) was found in blood plasma, bone alkaline phosphatase (BAP) was found in serum, osteocalcin (p <0.05). Indicators of mineral metabolism in bone tissue, both during treatment and for experimental groups, almost did not differ (p> 0.05). Thus, the use of strontium drugs in the complex treatment of generalized periodontitis in patients with type 2 diabetes mellitus provides a longer and more stable clinical and radiological stabilization of the pathological process in periodontal tissues, primarily by inhibiting bone resorption and enhancing osteogenesis. So, they can be recommended for the wide use in stomatological practice.

scholarly journals Ocular Risk Factors in the Primary Formation of Diabetic Macular Edema in Patients with Type 2 Diabetes Mellitus

2019 ◽  
Vol 16 (2) ◽  
pp. 225-229
Author(s):  
M. V. Pshenichnov ◽  
O. V. Kolenko ◽  
E. L. Sorokin ◽  
Ya. E. Pashentcev
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Macular Edema ◽  
Comparison Group ◽  
Mean Value ◽  
Main Group ◽  
The Mean

Purpose. Revealing of the ocular risk factors in the formation of diabetic macular edema (ME) in type 2 diabetes mellitus (DM2).Patients and methods. A 3.5-year research of 80 patients (160 eyes) with DM2 without signs of ME at the beginning of the research was performed. The main group consisted of 46 patients with ME symptoms on one or both eyes during the research period, the comparison group included 34 patients without ME symptoms to the end of the research. The initial ocular characteristics were retrospect compared in groups.Results. The mean value of the axial lengths (AL) in the eyes of the main group was 23.12 ± 0.75 mm compared to 23.82 ± 0.62 mm in the comparison group (significant difference, p < 0.01). AL was less than 23.5 mm in 66 % of the eyes in the main group and only in 22 % of the eyes in the comparison group (p < 0.01). The mean value of the initial macular retina volume in the main group was significantly higher than in the comparison group — 7.51 ± 0.22 mm3 and 7.21 ± 0.12 mm3, respectively (p < 0.01). Initial background diabetic retinopathy (DR) was noted in 73 % of the eyes in the main group, which significantly differed from the comparison group, where this index was noted only in 13 % of the eyes (p < 0.01).Conclusion. Significant ocular risk factors for the formation of ME in patients with DM2 are: the initial macular retina volume more than 7.3 mm3, the value of the AL less than 23.5 mm; the initial background DR. The use of the detected morphometric parameters of eye and retina in combination with an adequate assessment of the risk factors in human organism makes it possible to assume with high degree of probability a high risk of the primary formation of diabetic ME in patients with DM2. 

Bone mass and bone resorption in postmenopausal women with type 2 diabetes mellitus

Metabolism ◽  
2008 ◽  
Vol 57 (7) ◽  
pp. 940-945 ◽  
Author(s):  
Hiroko Hosoda ◽  
Michiaki Fukui ◽  
Ichiko Nakayama ◽  
Mai Asano ◽  
Mayuko Kadono ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Bone Resorption ◽  
Bone Mass ◽  
Postmenopausal Women

scholarly journals Immunohistochemical features of the bone tissue of the lower extremities in patients with type 2 diabetes mellitus

2022 ◽  
Vol 24 (5) ◽  
pp. 448-455
Author(s):  
A. Yu. Tokmakova ◽  
E. A. Kogan ◽  
E. L. Zaitseva ◽  
S. A. Demura ◽  
N. V. Zharkov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Bone Resorption ◽  
Bone Tissue ◽  
Immunohistochemical Study ◽  
Control Group ◽  
Diabetic Neuroosteoarthropathy ◽  
Group 1

Background: Diabetic neuroosteoarthropathy is a serious disabling complication of diabetes mellitus, which, in the absence of timely correct treatment, can lead to high amputations of the affected limb. At present, the reasons and mechanism of the development of Charcot’s foot are not completely clear. It is extremely important to determine the pathophysiological mechanisms of DNOAP formation and to search for reliable markers-predictors of this pathology.Aim: To study the immunohistochemical characteristics of the bone tissue of the lower extremities in patients with diabetic neuroosteoarthropathy in comparison with patients with diabetes mellitus without this pathology.Materials and methods: During the foot surgery, a bone fragment of the foot was harvested for immunohistochemical study of receptor markers for PINP, PIIINP, and RAGE in the group of patients with DNOAP compared with the control group.Results: The study included 20 patients with type 2 diabetes mellitus and were divided into 2 groups: 10 patients with DNOAP made up group 1, 10 patients without DNOAP — group 2.Patients in both groups were comparable in AGE, experience with type 2 diabetes, and glycemic control.During the immunohistochemical study, a significant increase in the staining intensity of receptor markers for PINP, PIIINP, and AGE was recorded in the group of patients with DNOAP compared with the control group (p <0.05).Conclusion: For the first time, an immunohistochemical study of markers of bone resorption and AGE was carried out in persons with DNOAP. The results obtained indicate impaired collagen formation and, as a consequence, impaired bone formation and bone resorption in patients with DNOAP: in group 1, a statistically significant increase in the expression of PINP, PIIINP, and RAGE was revealed.

scholarly journals Evaluation of clinical efficiency of Decap replacement therapy in patients with type 2 diabetes mellitus and concomitant nonalcoholic fatty liver disease in vitamin D deficiency

2021 ◽  
Vol 16 (8) ◽  
pp. 607-615
Author(s):  
М.B. Аludwan ◽  
N.M. Kobyliak ◽  
G.P. Pavlenko ◽  
Yu.I. Komisarenko
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Vitamin D Deficiency ◽  
Fatty Liver Disease ◽  
Main Group ◽  
Nonalcoholic Fatty Liver ◽  
Type 2 Dm

Background. Recently, vitamin D deficiency has been considered one of the factors in the development of type 2 diabetes mellitus (DM) and nonalcoholic fatty liver disease (NAFLD). The purpose was to establish the effectiveness of Decap (cholecalcife­rol) in patients with its deficiency who suffered from type 2 DM and NAFLD. Materials and methods. Fifty-two people with NAFLD and type 2 DM on the background of established D-deficiency were treated, they were evenly divided into two groups. Patients in the comparison group (n = 26) received only traditional antidiabetic therapy, and the main group (n = 26) additio­nally took vitamin D — Decap, which was prescribed at a dose of 4,000 IU/day for 6 months. Results. Vitamin D use was associated with a statistically significant reduction in fasting blood glucose after 6 months of treatment — by 4.2 % (p = 0.041). The level of glycated hemoglobin in the main group of patients decreased on ave­rage by 0.38 % (p = 0.121) after 3 months, and remained almost at the same level after 6 months — by 0.44 % (p = 0.088). In parallel with the improvement of glycemic control parameters in the main group, there was a tendency to a decrease in the HOMA-2-IR by 0.28 (–0.11; 0.86; p = 0.152) and to a better insulin sensitivity by 1.39 (–10.04; 6.01; p = 0.621) compared to the baseline. The use of vitamin D (Decap) is associated with a decrease in steatosis indices FLI and TyG. The baseline values for FLI was 74.11 ± 18.71 and for TyG — 5.21 ± 0.29, and after a six-month course of vitamin D treatment, they decreased by 4.4 % (p = 0.029) and 2.68 % (p = 0.031), respectively, compared to baseline. Conclusions. It was found that the use of Decap in patients with vitamin D deficiency at a dose of 4,000 IU/day for a course of at least six months improved glycemic control and metabolic profile in those with type 2 DM and NAFLD.

Calcium-dependent complications of lactase deficiency in patients with type 2 diabetes mellitus

2021 ◽  
Author(s):  
A. B. Andrusha
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Bone Resorption ◽  
Bone Tissue ◽  
Bone Remodelling ◽  
Osteoporotic Fractures ◽  
Lactase Deficiency ◽  
X Ray

Objective — to assess the degree of osteodeficiency and probability of osteoporotic fractures in patients with type 2 diabetes mellitus in the absence or presence of lactase deficiency. Materials and methods. All examined patients with type 2 diabetes mellitus were divided into 2 groups depending on the presence/absence of lactase deficiency. In addition to routine examination methods, specific methods were used for diagnosing lactase deficiency, assessing bone mineral density (using dual‑energy X‑ray absorptiometry) and bone quality (ultrasound densitometry), the state of bone remodelling (according to markers of bone resorption and formation), probability of osteoporotic fractures (using FRAX and QFracture calculators), dietary and lifestyle habits were also studied. Results. The changes have been revealed in both processes of bone remodelling — increased bone resorption and insufficient bone formation, and the activity of bone formation, which was the lowest in patients with lactase deficiency and type 2 diabetes mellitus. The results of X‑ray absorptiometry confirmed that osteoporosis was significantly more often in patients with type 2 diabetes mellitus in the presence of lactase deficiency. The use of ultrasonic densitometry confirmed the violation of bone tissue micro architectonics. The indicator of broadband ultrasound attenuation, which reflects the qualitative characteristics of bone tissue, was the lowest in patients with type 2 diabetes mellitus accompanied by lactase deficiency. The probability of osteoporotic fractures according to the results of the assessment with the online calculator FRAX® was higher than the average risk in both groups of patients. No significant difference was established in this indicator between these groups of patients in contrast to the risk calculated with the QFracture instrument — it was the highest in patients with lactase deficiency. Conclusions. The presence of lactase deficiency in patients with type 2 diabetes mellitus can be considered as a factor that contributes to the development of osteodeficiency, deterioration of the quality of bone tissue, imbalance in bone remodelling and an increase in the probability of osteoporotic fractures.  

scholarly journals AdipoRon Promotes the Osseointegration of Dental Implants in Mice With Type 2 Diabetes Mellitus

2021 ◽  
Vol 12 ◽  
Author(s):  
BoRui Huang ◽  
Wei Bi ◽  
Yang Sun ◽  
Ruixue Li ◽  
Xingwen Wu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Bone Resorption ◽  
Bone Mass ◽  
Dental Implants ◽  
Diabetic Mice ◽  
Dental Implantation ◽  
Bone Integration

AdipoRon is an oral active synthetic small molecule with biological functions similar to adiponectin (APN). It is an APN receptor agonist that can improve insulin resistance and glucose intolerance. However, the role of AdipoRon in bone metabolism and related molecular mechanisms remains to be investigated. To explore the effect of AdipoRon on bone absorption and bone integration of type 2 diabetes mellitus (T2DM) mice with implants, we established surgery-induced model of osseointegration of dental implantation in T2DM mice of C57BL/6 db/db and normal mice homologous to diabetic mice. Micro-CT was used to analyze the femurs with the implant in the mice to detect the bone mass, H&amp;E, and tartrate-resistant acid phosphatase (TRAP), and Safranin O-fast green staining was performed to analyze the bone formation and bone resorption. Bone integration-related markers as Rankl, bone morphogenetic protein 2 (BMP2), osteoprotegerin (OPG), osteopontin (OPN), and runt-related transcription factor 2 (Runx2) were also measured using immunohistochemistry. Our results indicated that diabetic mice showed a lower bone mass and decreased the osteoblast differentiation. AdipoRon attenuated diabetes-impaired bone volume (BV)/total volume (TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), trabecular separation (Tb.Sp), and bone integration-related markers variation and promoted bone hyperplasia as well as repressed the osteoclast formation, especially in diabetic mice. AdipoRon may improve the osseointegration of dental implants in mice with T2DM by promoting osteogenesis and inhibiting bone resorption, and AdipoRon may serve as a promising oral strategy to improve the osseointegration ability of patients with diabetes.

Prevalence of Periodontitis among the People with Diabetes Mellitus

2021 ◽  
Vol 18 (2) ◽  
pp. 72-74
Author(s):  
Bhawana Neupane Pant ◽  
Rajesh Kumar Goit ◽  
Biswas Satyal ◽  
Abhishek Poudel
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Periodontal Disease ◽  
Alveolar Bone ◽  
Group I ◽  
Periodontal Index ◽  
Diabetic Person ◽  
High Level

Introduction: Diabetes mellitus is a metabolic disorder characterized by a chronic high level of blood sugar with disturbances in carbohydrate, fat, and protein metabolism resulting from defects in insulin secretion, action or both. Periodontitis is a chronic infectious disease which leads to the destruction of the periodontal ligament fibers and alveolar bone until tooth loss. Among the several factors that may manifest periodontitis like aging, genetic factors, poor oral hygiene, obesity and virulence of the attacking micro-organisms, type 2 diabetes mellitus has received the greatest attention. Aims: The aim of the study was to determine the association type 2 diabetes mellitus with periodontal condition among population in mid-western region of Nepal. Methods: We screened 200 subjects of age group from 30 to 50 years and divided into two groups:  Group I – diabetic person and Group II were non diabetic. Oral examination was done to get the Community Periodontal Index of Treatment Need score and correlation between Diabetes mellitus and periodontal disease was determined. Results: Our result showed strong correlation between diabetes mellitus and periodontitis. When the evaluation was done for prevalence of periodontal disease according to diabetes mellitus,  the prevalence of periodontal disease was significantly higher in diabetic person compared to non-diabetic individuals (88% vs 74.4%, P=0.03).  [Odds Ratio = 11.826 and 95% confidence interval: 5.415-21.828]. Conclusion: Provided Diabetes mellitus related morbidity and mortality is burgeoning in our society and it is imperative to identify right indicators of periodontal disease for specific population.

Diagnostic value of microbiome biomarkers of the periodonite microbiome in patients with the association of chronic periodontitis and diabetes mellitus type 2

2021 ◽  
Vol 66 (11) ◽  
pp. 678-683
Author(s):  
I. P. Balmasova ◽  
V. N. Tsarev ◽  
K. G. Unanyan ◽  
E. V. Ippolitov ◽  
T. V. Tsareva ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Chronic Periodontitis ◽  
Periodontal Diseases ◽  
Diagnostic Value ◽  
High Tech ◽  
Periodontal Tissues ◽  
Systemic Pathology

The place of high-tech methods of molecular biology in clinical laboratory diagnostics of various diseases and the development of a system of biomarkers as an important component of diagnostic research is currently attracting the closest attention of the scientific community. In this paper, an attempt is made to use high-tech metagenomic analysis to solve problems that arise due to the high frequency of association of periodontal diseases with systemic pathology, in particular, with type 2 diabetes mellitus. The aim of the study was to determine the taxonomic and metabolic features of the microbiome of periodontal tissues in periodontal diseases associated with type 2 diabetes mellitus, as a model of the ratio of local and systemic effects of periodontal pathogenic bacteria. The study included 16S shotgun sequencing of bacterial DNA as part of biological material from periodontal pockets/dentoalveolar furrows of 46 people - 15 patients with chronic periodontitis associated with type 2 diabetes mellitus, 15 patients with chronic periodontitis unrelated to systemic pathology, as well as 16 healthy people in the control group, followed by bioinformatic processing of the data obtained. The obtained data allowed us to establish the taxonomic features of the periodontal microbiome in the association of chronic periodontitis with type 2 diabetes mellitus, which included the predominance of representatives of the families Prevotellaceae and Spirochaetaceae in its composition. The features of metabolic processes in periodontal tissues with the participation of the microbiome were also revealed, which consisted in an increase in the exchange of cysteine and methionine against the background of a decrease in the metabolism of pyrimidine, methane, sphingolipids, and the synthesis of fatty acids, which are of diagnostic value in assessing the condition of patients with type 2 diabetes mellitus.

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