Cardiac Function in Uncomplicated Type 2 Diabetes Mellitus

Objective: Diabetic cardiomyopathy (DC) is a myocardial disease characterized by myocyte hypertrophy, interstitial fibrosis, protein glycosylation and intra-myocardial micro-angiopathy due to prolonged exposure of myocardial tissues to hyperglycemia in diabetes mellitus (DM) patients. Alteration in cardiac function can be non-invasively assessed via echocardiography. The early recognition of cardiac dysfunction can prevent the symptomatic heart failure in DM patients. The study aimed at evaluating cardiac function in uncomplicated type 2 diabetes mellitus. Materials And Methods: Sixty Type 2 DM patients without any feature of the coronary arterial disease (CAD), hypertension, nephropathy and respiratory illness were enrolled in the study and compared with the sixty age matched healthy controls. Echocardiographic assessment was done in all subjects to evaluate the cardiac function. Results: Diastolic dysfunction was more common in diabetic patients when compared with normal healthy population. Systolic dysfunction progresses with age of the diabetic patient. Conclusion: Echocardiography is a simple noninvasive cost effective test for detecting cardiac dysfunction in Type 2 DM patients and should be applied to detect early Left ventricular(LV) dysfunction so that corrective measures may be initiated early and cardiac functions may be preserved for long. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.211-215

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Echocardiographic evaluation of left ventricular diastolic dysfunction in recently diagnosed type 2 diabetes mellitus

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20181760 ◽

2018 ◽

Vol 6 (5) ◽

pp. 1691

Author(s):

Swapnil Jain ◽

C. L. Nawal ◽

Amandeep Singh ◽

Radhey Shyam Chejara ◽

Sagar Barasara ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diastolic Dysfunction ◽

Left Ventricular Diastolic Dysfunction ◽

Left Ventricular ◽

P Value ◽

Diabetic Patients ◽

Ventricular Diastolic Dysfunction

Background: Diastolic dysfunction in patients suffering from diabetes mellitus represents an earlier stage in the natural history of cardiomyopathy. This study was done to assess the left ventricular diastolic dysfunction in recently diagnosed (<5yr) Type 2 Diabetes Mellitus by Echocardiography and also to determine association of glycemic status (by HBA1c levels) with left ventricular diastolic dysfunction (LVDD).Methods: An observational descriptive study involving 100 diabetic patients, taken on first come first serve basis after applying inclusion and exclusion criteria. In all the subjects, other than routine investigations, HbA1c was estimated and echocardiography was done to evaluate LVDD.Results: Mean value of HbA1c in the study was 8.31+ 1.408 %. 63 out of 100 subjects had LVDD. There was significant positive correlation between HbA1c and LVDD (p value <0.001). As HbA1c increased, severity of LVDD increased. In this study, as BMI increased, HbA1c and LVDD increased & both findings were statistically significant (p value =0.001).Conclusion: Our study indicates that myocardial damage in patients with diabetes affects diastolic function before systolic function &higher HbA1C level is strongly associated with presence of LVDD. Patients should be advised strict control of diabetes in order to reduce the risk for developing LVDD which is a precursor for more advanced disease.Keywords: Diabetes mellitus, Diastolic dysfunction, BMI, HbA1c

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Relationship between homocysteine and non-dipper pattern in patients with type 2 diabetes mellitus

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302012000500002 ◽

2012 ◽

Vol 56 (5) ◽

pp. 285-290 ◽

Cited By ~ 2

Author(s):

Serdal Korkmaz ◽

Abdulkerim Yilmaz ◽

Gürsel Yildiz ◽

Fatih Kiliçli ◽

Serhat Içağasioğlu

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Control Group ◽

Diabetic Patients ◽

Nocturnal Blood Pressure ◽

Type 2 Dm ◽

Significant Difference

OBJECTIVE: The rate of reduction of nocturnal blood pressure (NBP) is lesser than normal in patients with type 2 diabetes mellitus (type 2 DM). Hyperhomocysteinemia (HHC) disrupts vascular structure and function, no matter the underlying causes. The risk of development of vascular disease is greater in diabetic patients with hyperhomocysteinemia than in patients with normal homocystein levels. The aim of the study was to investigate whether there are differences of homocystein levels in dipper and non-dippers patients with type 2 DM. SUBJECTS AND METHODS: We compared 50 patients (33 females, 17 males) with type 2 DM and 35 healthy individuals (18 females, 17 males ) in a control group. Ambulatory blood pressure monitoring (ABPM) was performed and homocysteine levels were measured in all patients. RESULTS: We found that the percentage of non-dipper pattern was 72% in patients with type 2 DM and 57% in control group. In diabetic and control individuals, homocystein levels were higher in non-dipper (respectively 13.4 ± 8.1 µmol/L and 11.8 ± 5 µmol/L) than in dipper subjects (respectively, 11.8 ± 5.8 µmol/L and 10.1 ± 4.2 µmol/L), but there was no significant difference between the two groups (respectively, p = 0.545, p = 0.294). CONCLUSION: In both groups, homocystein levels were higher in non-dipper than in dipper participants, but there was no significant difference between the groups. High homocystein levels and the non-dipper pattern increases cardiovascular risk. Therefore, the relationship between nocturnal blood pressure changes and homocystein levels should be investigated in a larger study.

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Prevalence and Genotype Distribution of Hepatitis C Virus Infection among Patients with Type 2 Diabetes Mellitus

Medical Principles and Practice ◽

10.1159/000488985 ◽

2018 ◽

Vol 27 (4) ◽

pp. 308-316 ◽

Cited By ~ 5

Author(s):

Fatemeh Farshadpour ◽

Reza Taherkhani ◽

Mohammad Reza Ravanbod ◽

Seyed Sajjad Eghbali

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Hcv Infection ◽

Diabetic Patients ◽

Genotype Distribution ◽

Type 2 Dm

Objective: This study was conducted to determine the prevalence and genotype distribution of hepatitis C virus (HCV) infection among patients with type 2 diabetes mellitus (DM). Subjects and Methods: We included 556 consecutive patients with confirmed type 2 DM attending the Diabetic Clinic of the Bushehr University of Medical Sciences and 733 nondiabetic subjects as controls. Serum levels of fasting blood sugar (FBS), alanine transaminase (ALT), aspartate transaminase (AST), total cholesterol (TCH), and triglycerides (TG) were measured by enzymatic colorimetric methods, and the presence of anti-HCV antibodies was determined by enzyme-linked immunosorbent assay. Semi-nested reverse transcriptase-polymerase chain reaction (RT-PCR) followed by sequencing was performed on all anti-HCV-seropositive samples. Data were analyzed using the Statistical Package for the Social Sciences 17, and descriptive statistics, χ2 test, Fisher exact test, and the Student t test were used for analysis. Results: The seroprevalence of HCV in the diabetic patients was 1.98% (11/556), which was higher than HCV prevalence among the nondiabetic controls (4/733, 0.54%) (p = 0.032). No significant differences in ALT, AST, FBS, TG, and TCH levels were found between the HCV-seropositive and HCV-seronegative diabetic patients, although HCV-seropositive diabetic patients tended to have higher ALT, AST, and TCH levels, but lower TG and FBS levels than HCV-seronegative patients. In logistic regression analysis, only AST levels were significantly associated with HCV seropositivity among diabetic patients. The AST level of 41–80 IU/L was the only significant predictive variable for HCV seropositivity in the diabetic patients (odds ratio, 4.89; 95% CI: 1.06–22.49; p = 0.041). Of the 11 HCV-seropositive diabetic patients, 10 (91%) had HCV viremia with genotype 3a. Conclusion: Patients with type 2 DM had a higher prevalence of HCV infection than controls, and HCV seropositivity was independent of biochemical parameters.

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Overview of Supports Obtained by Type 2 Diabetes Mellitus Patient in Sampit, Central Borneo

International Journal of Nursing and Health Services (IJNHS) ◽

10.35654/ijnhs.v2i2.126 ◽

2019 ◽

Vol 2 (2) ◽

pp. 110-115

Author(s):

Cici Desiyani ◽

Kusnanto Kusnanto ◽

Tri Johan Agus Yuswanto

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Health Workers ◽

Social Situation ◽

Diabetes Mellitus Patient ◽

Diabetic Patients ◽

Type 2 Dm ◽

Family Supports

Type 2 diabetes mellitus is a chronic metabolic disease that continues to develop over time and requires complex treatment. while undergoing treatment DM, diabetic patients need supports in order to be able to carry out their treatment on an ongoing basis. This study aims to describe supports obtained by Type 2 DM patients during their treatment and caring. This is a qualitative research study with phenomenological approach. Sampling was conducted from social situation with a sample size 20 participants. Data were collected using semi-structured in-depth interviews and analysis were used Colaizzi methods. The results showed three themes. Theme 1) family supports; 2) social supports, 3) health workers supports. Family supports is the most important part, but the supports from health workers also play a role in increasing the motivation of type 2 DM patients in undergoing treatment and diet. it is important to explore more deeply and more specifically how the role of health workers in the care of DM patients for further studies

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Frequency of depression in patients with Type 2 Diabetes Mellitus: Psychiatric support necessity for diabetic patients

Medical Science and Discovery ◽

10.36472/msd.v6i10.312 ◽

2019 ◽

Vol 6 (10) ◽

pp. 268-271

Author(s):

Erhan Önalan ◽

Yusuf Gökalp ◽

Mehmet Aslan ◽

Burkay Yakar ◽

Emir Döner

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Severe Depression ◽

Diabetic Patients ◽

Mild Depression ◽

Type 2 Dm ◽

Moderate Depression ◽

Healthy Control

Objective: This study aims to determine the relationship between type 2 diabetes mellitus (DM) and the risk of depression in T2DM patients in comparison to a healthy control group. Materials and Methods: The study sample included 100 patients diagnosed with Type 2 DM who were recruited consecutively from the general internal medicine polyclinic (46 males, 54 females, mean age 55.4±11.9 years) and 100 healthy control subjects who had no known diseases and had presented for routine check-up examinations (60 males, 40 females, mean age 37.6±3.7 years). The participants completed a questionnaire composed of a sociodemographic characteristics section and the Beck Depression Inventory, which probes the depression states of individuals based on self-report. Laboratory results of the participants were recorded. Results: Mean Beck Depression Inventory scores of the patient and control groups, which represent self-reported depression states, were determined as 17±8.5 and 8.5±7.3, respectively. Of the 100 diabetic patients, 8 were determined to have severe depression, 38 moderate depression, 34 mild depression, and 20 minimal depression; whereas, of the 100 healthy controls, 20 were determined to have moderate depression, 18 mild depression, and 62 minimal depression, with no cases of severe depression in this group. Conclusion: Our study reveals the importance of complementing the conventional patient follow-up procedure with psychiatric support in the management of type 2 DM patients.

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Microalbuminuria as an early marker of left ventricular hypertrophy in type 2 diabetes mellitus

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20171477 ◽

2017 ◽

Vol 4 (3) ◽

pp. 666

Author(s):

Balshine S. Kanwar ◽

Abhishek Gupta ◽

Sunil K. Virmani

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Left Ventricular Hypertrophy ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

P Value ◽

Type 2 Dm ◽

Lv Mass

Background: Microalbuminuria and left ventricular hypertrophy (LVH) have both been shown independently to be associated with increased cardiovascular (CVS) mortality in type 2 diabetes mellitus (DM) patients. This cross-sectional study was conducted to examine whether microalbuminuria is associated with LVH in non-hypertensive type 2 DM patients with early or no diabetic nephropathy.Methods: 100 patients of type 2 DM were studied. Patients with Hypertension (BP >140/90 mm hg or on anti-hypertensive medication), history of coronary artery disease or valvular heart disease, estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, known thyroid disease or active urinary tract infection (UTI) were excluded from the study. All patients were subjected to spot urine test for microalbuminuria by urinary albumin creatinine ratio (UACR), 12 lead ECG to detect LVH, 2D echocardiography to calculate LV mass index (LVMI), anthropometry, urine routine examination, kidney function test, fasting lipid profile and HbA1c.Results: Of the 100 enrolled patients, 39 were found to have normoalbuminuria, 39 had microalbuminuria & 22 patients had macroalbuminuria. The correlation between increased albuminuria and LVMI was found to be statistically significant (P value < 0.001) and the LV mass significantly increased as albuminuria increased along the continuum of normoalbuminuria to macroalbuminuria. UACR showed a statistically significant correlation with age, eGFR, duration of diabetes (P value < 0.01) and HbA1c (P value < 0.05).Conclusions: Microalbuminuria is associated with LVH in non-hypertensive type 2 DM patients and thus may serve as an early marker of LVH and help identify patients at high CVS risk.

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Silent myocardial ischemia in patients with type 2 diabetes mellitus: a clinical case

EMERGENCY MEDICINE ◽

10.22141/2224-0586.17.4.2021.237725 ◽

2021 ◽

Vol 17 (4) ◽

pp. 39-42

Author(s):

O.O. Prokhorova ◽

M.S. Brynza

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Coronary Artery ◽

Lower Extremities ◽

Left Ventricular ◽

Silent Myocardial Ischemia ◽

Type 2 Dm ◽

The Right

Background. Type 2 diabetes mellitus (DM) is an important medical, social, and economic problem due to the high prevalence of the disease, which often leads to disability and significantly increases mortality in elderly people. One of the causes of coronary heart disease (CHD) in patients with type 2 DM is autonomic cardiovascular neuropathy, which is characterized by damage to the autonomic nervous system and manifests itself in a varying clinical picture, including silent myocardial ischemia (SMI). The prevalence of SMI among patients with type 2 DM is much higher than in people without it. The purpose was to study the clinical case of a patient with type 2 DM and CHD, raise awareness of the prevalence and influence of type 2 DM on CHD progression by focusing on diagnostic research and treatment strategies. Materials and methods. The clinical case of the detected silent ischemia in a patient with type 2 DM was analyzed. The complaints were as following: high blood pressure, moderate shortness of breath during walking, pain, and numbness of the lower extremities. Anamnesis: type 2 DM over 20 years; endovascular stenting of the right common iliac artery due to obliterating atherosclerosis of the arteries of the lower extremities; hypertension over 10 years; obesity. Based on this data, CHD was suspected. Results. The Holter monitoring revealed rare episodes of reversible ischemic repolarization. ECG demonstrated the deviation of the electrical axis to the left, hypertrophy of the left ventricular myocardium, diffuse violation of repolarization processes. Ultrasound of the heart found aortic atherosclerosis, left ventricular myocardial hypertrophy, a moderate decrease in myocardial contractility. Ultrasound of vessels of the lower extremities showed the signs of obliterating atherosclerosis with decompensation of peripheral blood flow. Coronary angiography demonstrated left coronary artery with critical subocclusions (90 %), right coronary artery with chronic occlusion in the middle segment (100 %). There was established the diagnosis: coronary heart disease (silent ischemia); diffuse stenotic atherosclerosis of the coronary artery (coronary angiography May 2019); arterial hypertension II stage, degree 2; HF II stage; II NYHA; type 2 diabetes mellitus, insulin-dependent, decompensated; obesity I stage; obliterating atherosclerosis of the arteries of the lower extremities (condition after endovascular stenting of the right common iliac artery on January 2018); chronic pancreatitis in remission, peptic ulcer of the duodenum (operated in 1981); chronic cholecystitis in remission. The treatment was prescribed: insulin therapy, nebivolol, eplerenone, candesartan, clopidogrel, rosuvastatin. Coronary artery bypass grafting is recommended. Conclusions. Thereby, timely diagnosis and adequate treatment can avoid complications of type 2 DM and improve quality and lifetime. With type 2 DM, CHD is often masked and remains undiagnosed, leading to complications and death, therefore more attention to such patients is needed.

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Expression of MRP8/MRP14 mRNA in Monocytes of Periodontitis: Comparison between Diabetic and Non Diabetic Patients

The Indonesian Journal of Dental Research ◽

10.22146/theindjdentres.9986 ◽

2010 ◽

Vol 1 (1) ◽

pp. 39

Author(s):

Ahmad Syaify ◽

Sri Budi Barunawati ◽

Suryono Suryono ◽

Marsetyawan HNES

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Mrna Expression ◽

Peripheral Blood ◽

Diabetic Patients ◽

Human Monocytes ◽

Total Rna ◽

Type 2 Dm

The severity of periodontitis on patients with type 2 Diabetes Mellitus patients was strongly thought caused by decreasing of leukocytes function such as monoctyes and neutrophils. In our previous research it was found that calprotectin (MRP8/MRP14) level in leukocytes of periodontitis patients with type 2 DM was higher than periodontitis in non DM. The aim of this study was to determine calprotectin (MRP8/MRP14)mRNA expression in human monocytes of periodontitis patients with type 2 DM and without DM. Monocytes were isolated from the peripheral blood of periodontitis patients with uncontrolled type 2 DM, controlled type 2 DM, and non DM. The expression of total RNA calprotectin (MRP8 and MRP14) were detected by RTPCR using GAPDH as the innate control. It was observed that the value of MRP8/MRP14 mRNA expression DM patients were higher than non DM, and the highly significant increase expression (p<0.05) was on the uncontrolled type 2 DM. The basal level of MRP8/MRP14 expression increased in monocyte of periodontitis and type 2 DM patients compared with non diabetes subjects. It was suggested that high basal level MRP8/MRP14 has role in the regulation of severity periodontitis with diabetes mellitus.

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Prevalence of Thyroid Dysfunction in Type 2 Diabetes Mellitus

Journal of Dhaka Medical College ◽

10.3329/jdmc.v29i2.51190 ◽

2021 ◽

Vol 29 (2) ◽

pp. 149-152

Author(s):

Prodip Kumar Biswas ◽

Gopal Chandra Saha ◽

Mohammed Shahadat Hossain ◽

Md Nasir Uddin ◽

Muhammad Faizur Rahman ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Thyroid Function ◽

Thyroid Dysfunction ◽

Diabetic Patients ◽

Thyroid Disorder ◽

Medical College ◽

Type 2 Dm

Aim: The study was undertaken with an objective to know the thyroid functions in Type 2 diabetics and to know the spectrum of thyroid dysfunction in Type 2 DM. Methods: The present study included 68OPD and IPD patients of Type 2 DM who attended the Department of General Medicine at Dhaka Medical College Hospital Dhaka. Detailed history and examination were done, fasting blood samples of all the subjects were taken and at the same time samples were tested for HbA1C and thyroid profile (T3, T4 and TSH). Result: in this study 68 established diabetics were screened for thyroid disorders by TFT. Abnormal thyroid function was found in 43 T2DM cases and remaining diabetics had normal thyroid function. Among 68 cases low thyroid function was noted in 20 patients and 18 subjects had Sub-clinical hypothyroidism. Hyperthyroidism was noted in 05 patients. Conclusion: Type 2 diabetes mellitus is a major problem all over the world and many patients of Diabetes Mellitus are associated with thyroid dysfunction. So diabetic patients s should be screened for thyroid disorder especially hypothyroidism. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 149-152

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The relative apical sparing pattern is common in elderly patients with type 2 diabetes mellitus

European Heart Journal ◽

10.1093/eurheartj/ehab724.015 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

K Uneno

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Cardiac Function ◽

Cardiac Amyloidosis ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Left Ventricular

Abstract Background Type 2 diabetes mellitus (T2DM) impairs cardiac function and is one of the risk factors for heart failure. However, the mechanism of cardiac impairment is not elucidated. Despa et al. reported that amylin has aggregation properties similar to amyloidogenic proteins and impairs cardiac function in T2DM patients with hyperamylinemia. In this hypothesis, T2DM-induced myocardial impairment is thought of as amylin-induced cardiac amyloidosis. The purpose of this study is to clarify whether a relative apical sparing pattern (RASP), which is well known as a typical pattern of cardiac amyloidosis, is common in T2DM. Methods We studied patients aged 75 years or over who underwent echocardiography from January 2018 to December 2020 in our clinic. We calculated the quantitative relative apical sparing (qRASP) as average apical-longitudinal strain (LS)/(average basal-LS + average mid-LS) in each patient. According to the validated threshold, a qRASP ≥1.0 was defined as an obvious RASP (oRASP). We compared the ratio of oRASP between patients with and without T2DM. Results We researched 506 patients, mean 81.8 years, 290 females, 133 with T2DM. The average age, atrial fibrillation rate, heart failure rate, and hypertension rate were similar in both groups. The ratio of ischemic heart disease was higher in the T2DM group. Echocardiography showed that the left atrial dimension (LAD), E/e', and left ventricular hypertrophy (LVH) ratio was higher in the T2DM group. Speckle tracking echocardiography revealed that global longitudinal strain (GLS) and qRASP of the T2DM group were higher than the non-DM group (GLS;-18.0% vs. −19.2%, p<0.001. qRASP; 0.809 vs. 0.699, P<0.001). Furthermore, the ratio of oRASP was significantly higher in the T2DM group (19.0% vs. 1.34%, p<0.001). Multivariable logistic regression analysis showed T2DM was an independent predictor for oRASP. Conclusion This study revealed that the qRASP and the ratio of oRASP in the T2DM group were higher than non-DM group. This finding supports the hypothesis that T2DM related cardiomyopathy is a kind of cardiac amyloidosis caused by amylin. FUNDunding Acknowledgement Type of funding sources: None.

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