scholarly journals Duplex Color Doppler Evaluation of Retinal Arterial Blood Flow in Type 2 Diabetic Subjects without Retinopathy

2014 ◽  
Vol 4 (3) ◽  
pp. 168-173
Author(s):  
Mashah Binte Amin ◽  
Farzana Shegufta ◽  
Md Towhidur Rahman ◽  
Tarana Yasmin ◽  
Khaleda Parvin Rekha ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Color Doppler ◽  
Peak Systolic Velocity ◽  
Resistive Index ◽  
Diabetic Patients ◽  
Diastolic Velocity ◽  
Healthy Control ◽  
Retinal Artery ◽  
Type 2 Diabetic

Background: Diabetic retinopathy is a vascular disorder affecting the microvasculature of retina. It is caused by changes in the blood vessels of retina. If untreated, it may lead to blindness which is usually preventable if retinopathy is diagnosed early and treated promptly. In ophthalmology, color Doppler imaging is a new method that enables us to assess the orbital vasculature. It allows for simultaneous two dimensional anatomical and Doppler evaluations of hemodynamic characteristics of retinal artery. Objective: To observe the difference between Doppler flow velocity indices (peak systolic velocity, end diastolic velocity and resistive index) of retinal artery in type 2 diabetic subjects without retinopathy and those of normal controls. Materials and Methods: This case-control study was carried out in the department of Radiology and Imaging, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) in collaboration with Ophthalmology Outpatient Department, BIRDEM, Dhaka from July 2011 to June 2013. Eighty diabetic patients without retinopathy aged 27–68 years were enrolled as cases and age and sex matched 80 healthy subjects were selected as controls. Type 1 diabetic patients, type 2 diabetics with retinopathy, hypertensive and dyslipidemic subjects were excluded from the study. All the selected subjects underwent duplex Doppler ultrasonography of both eyes using 5 to 7.5 MHZ linear phase transducer. Duplex color Doppler findings including spectral analysis (PSV, EDV and RI) were recorded. Unpaired t test was done to compare blood flow velocity indices of retinal artery in type 2 diabetic patients without retinopathy and that of healthy control subjects. p value <0.05 was considered as significant. Results: Majority (42.5% and 47.5%) of subjects were in 4th decade of life in both groups with predominance of males. The mean duration of diabetes was 4.56 ± 2.1 years. Mean peak systolic velocity (PSV) in 80 diabetic patients without retinopathy was 10.70 ± 1.50 cm/sec ranging 5.30–16.10 cm/sec and that of 80 healthy subjects was 11.27 ± 0.98 cm/sec ranging 9.0–13.10 cm/sec. Mean end diastolic velocity (EDV) in 80 diabetic patients without retinopathy was 2.58 ± 0.67 cm/sec ranging 1.00 –5.10 cm/sec and that of 80 healthy subjects was 4.11 ± 2.7 cm/sec ranging 3.00–4.60 cm/sec. Mean resistive index (RI) in 80 diabetic patients without retinopathy was 0.75 ± 0.04 ranging 0.66–0.81 and that of 80 healthy subjects was 0.64 ± 0.02 ranging 0.60–0.70. Mean difference of retinal arterial RI of diabetic subjects without retinopathy and healthy control eyes was statistically significant (p<0.001). Conclusion: From the present study it can be concluded that, there is statistically significant difference between retinal arterial RI of type 2 diabetic patients without retinopathy and that of healthy control adult subjects. DOI: http://dx.doi.org/10.3329/jemc.v4i3.20948 J Enam Med Col 2014; 4(3): 168-173

scholarly journals Acute plasma glucose increase, but not early insulin response, regulates plasma ghrelin

2003 ◽  
pp. 403-406 ◽  
Author(s):  
L Briatore ◽  
G Andraghetti ◽  
R Cordera
Keyword(s):  
Plasma Glucose ◽  
Healthy Subjects ◽  
Insulin Response ◽  
Glucose Levels ◽  
Healthy Control ◽  
Early Insulin Response ◽  
Effect Of Glucose ◽  
Type 2 Diabetic

OBJECTIVE: The independent role of glucose and insulin in ghrelin regulation is still controversial; this is also because in healthy subjects it is difficult to isolate the increase of glucose from that of insulin. The aim of this study was to discriminate the effect of glucose increase alone and early insulin response on plasma ghrelin, comparing ghrelin variation after i.v. glucose between healthy subjects and type 2 diabetic (T2DM) subjects, in whom the early insulin response to i.v. glucose is abolished. METHODS: Plasma glucose, insulin and ghrelin levels were measured 0, 3, 5, 10, 30, 45 and 60 min after a 5 g glucose i.v. bolus in seven healthy control subjects and eight T2DM subjects. RESULTS: There were no significant differences in body mass index, basal insulin and basal ghrelin between T2DM and healthy subjects. Basal glucose levels were higher in T2DM subjects than in controls. After i.v. glucose administration, plasma glucose increased significantly in both groups and the glucose peak was higher in T2DM subjects than in controls (9.67+/-1.25 (s.d.) vs 6.88+/-1.00 mmol/l, P<0.01). Insulin increased rapidly in controls, while in T2DM subjects, plasma insulin did not rise in the first 10 min. After the glucose bolus, plasma ghrelin showed a significant reduction both in controls and in T2DM subjects after 5 min. CONCLUSION: These findings indicate that a low-dose i.v. glucose bolus reduces ghrelin both in controls and in T2DM subjects and therefore that early insulin response does not affect plasma ghrelin.

scholarly journals Compromised Barrier Function in Human Induced Pluripotent Stem-Cell-Derived Retinal Pigment Epithelial Cells from Type 2 Diabetic Patients

2019 ◽  
Vol 20 (15) ◽  
pp. 3773 ◽  
Author(s):  
Mostafa Kiamehr ◽  
Alexa Klettner ◽  
Elisabeth Richert ◽  
Ali Koskela ◽  
Arto Koistinen ◽  
...  
Keyword(s):  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Induced Pluripotent Stem Cell ◽  
Diabetic Patients ◽  
Rpe Cells ◽  
Normal Glucose ◽  
Healthy Control ◽  
Induced Pluripotent ◽  
Type 2 Diabetic

In diabetic patients, high blood glucose induces alterations in retinal function and can lead to visual impairment due to diabetic retinopathy. In immortalized retinal pigment epithelial (RPE) cultures, high glucose concentrations are shown to lead to impairment in epithelial barrier properties. For the first time, the induced pluripotent stem-cell-derived retinal pigment epithelium (hiPSC-RPE) cell lines derived from type 2 diabetics and healthy control patients were utilized to assess the effects of glucose concentration on the cellular functionality. We show that both type 2 diabetic and healthy control hiPSC-RPE lines differentiate and mature well, both in high and normal glucose concentrations, express RPE specific genes, secrete pigment epithelium derived factor, and form a polarized cell layer. Here, type 2 diabetic hiPSC-RPE cells had a decreased barrier function compared to controls. Added insulin increased the epithelial cell layer tightness in normal glucose concentrations, and the effect was more evident in type 2 diabetics than in healthy control hiPSC-RPE cells. In addition, the preliminary functionality assessments showed that type 2 diabetic hiPSC-RPE cells had attenuated autophagy detected via ubiquitin-binding protein p62/Sequestosome-1 (p62/SQSTM1) accumulation, and lowered pro- matrix metalloproteinase 2 (proMMP2) as well as increased pro-MMP9 secretion. These results suggest that the cellular ability to tolerate stress is possibly decreased in type 2 diabetic RPE cells.

scholarly journals Role of Color Doppler Imaging in Early Diagnosis and Prediction of Progression in Glaucoma

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Fatima Jimenez-Aragon ◽  
Elena Garcia-Martin ◽  
Raquel Larrosa-Lopez ◽  
Jose M. Artigas-Martín ◽  
Pilar Seral-Moral ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Color Doppler ◽  
Resistive Index ◽  
Color Doppler Imaging ◽  
Roc Curves ◽  
Doppler Imaging ◽  
Operating Characteristics ◽  
Diastolic Velocity ◽  
Retinal Artery

This longitudinal and prospective study analyzes the ability of orbital blood flow measured by color Doppler imaging (CDI) to predict glaucoma progression in patients with glaucoma risk factors. Patients with normal perimetry but having glaucoma risk factors and patients in the initial phase of glaucoma were prospectively included in the study and divided, after a five-year follow-up, into two groups: “Progression” and “No Progression” based on the changes in the Moorfields regression analysis (MRA) classification of Heidelberg retina tomograph (HRT). An orbital CDI was performed in all patients and the parameters obtained were correlated with changes in HRT. A logistic discrimination function (LDF) was calculated for ophthalmic artery (OA) and central retinal artery (CRA) parameters. Receiver operating characteristics curves (ROC) were used to assess the usefulness of LDFs to predict glaucomatous progression. A total of 71 eyes were included. End-diastolic velocity, time-averaged velocity, and resistive index in the OA and CRA were significantly different (P<0.05) between the Progression and No Progression groups. The area under the ROC curves calculated for both LDFs was of 0.695 (OA) and 0.624 (CRA). More studies are needed to evaluate the ability of CDI to perform early diagnosis and to predict progression in glaucoma in eyes.

scholarly journals Evaluation of Serum High Sensitivity C-reactive Protein (hs-CRP) In Type-2 Diabetic Patient

1970 ◽  
Vol 11 (1) ◽  
pp. 20-23
Author(s):  
AKM Fazlul Haque ◽  
ARM Saifuddin Ekram ◽  
Quazi Tarikul Islam ◽  
Md Sarwar Jahan ◽  
Md Zahirul Haque
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Patient ◽  
Healthy Subjects ◽  
High Sensitivity ◽  
Diabetic Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hs Crp ◽  
Type 2 Diabetic

Type-2 diabetes may remain in subclinical form for years before diagnosis. This quiescence of type-2 diabetes is a great concern for health care providers. The earliest change of the type-2 diabetes is the insulin resistance, which is associated with the increased macrovascular risk due to induction of chronic inflammation in the vessels of the body which leads to atherosclerotic change in the vessels. High sensitivity CRP (hs-CRP) is the measure of C-reactive protein with greater accuracy and the lower limit of its assay is .01 mg/L which is more than 100 times as sensitive as the usual CRP measurement (lower limit 5 mg/L). The median level of hs-CRP from blood samples of apparent healthy subjects is 0.8 mg/L. For this, physician uses the hs-CRP parameter as a marker of chronic inflammation in apparently normal healthy individuals, specially for the assessment of atherosclerosis, which is a chronic inflammatory procedure from the very beginning, in type-2 diabetic, obese and hypertensive patients. This vascular atherosclerosis assessment help them to calculate the cardiovascular as well as cerebrovascular risk of those patients. To help the type-2 diabetic patients from the very begining in respect of the prognostic view of the macrovascular risk, estimations of serum hs-CRP in the early stage of these patient may be a enthusiastic one. This descriptive study was carried out by choosing 70 diabetic patient who had no other comorbidity or any complications of diabetes and 35 healthy subjects who were neither diabetic nor had any diseases. Both the groups were non-smoker and non-alcoholic and non-hypertensive, hs-CRP level was measured in both the groups along with the HbA1c%. The mean hs-CRP in diabetic group was 1.13 mg/L and in normal healthy subjects was 0.39 mg/L. This higher level of mean hs-CRP (1.13 mg/L) in diabetic patients is statisticaly significant (P<0.01) compared with that of the normal healthy subjects mean hs-CRP (0.39 mg/L). This mean level of hs-CRP in normal healthy subjects was below the lower level of cardiovascular risk (1 mg/L). Keywords: High sensitivity CRP, C-reactive protein, diabetes DOI:10.3329/jom.v11i1.4263 J Medicine 2010: 11: 20-23

scholarly journals Role of Duplex Color Doppler Study of Uterine Artery in the Early Diagnosis of Preeclampsia in Pregnant Women

2019 ◽  
Vol 20 (2) ◽  
pp. 87-91
Author(s):  
Sohely Sultana ◽  
Tarana Yasmin ◽  
Md Nazir Uddin Mollah ◽  
Shyamal Kumar Roy ◽  
Mohammad Sazzad Hossain ◽  
...  
Keyword(s):  
Complex Disease ◽  
Color Doppler ◽  
Peak Systolic Velocity ◽  
Resistive Index ◽  
Wave Form ◽  
College Hospital ◽  
Doppler Study ◽  
Diastolic Velocity ◽  
Significant Difference ◽  
Doppler Indices

Background: Duplex Colour Doppler Sonography is gaining increasing popularity for assessment of blood vessels in various disease processes around the world as well as for the surveillance of fetus compromised by intra uterine growth retardation (IUGR) and to assess foetal structural abnormalities and complex disease processes. Materials & methods: This cross sectional study was carried out to observe Doppler wave form in subjects with preeclampsia enrolling 40 subjects with preeclampsia, in the Department of Radiology and Imaging, Dhaka Medical College Hospital, Dhaka, over a period of six months from 20th May 2012 to 19th November 2012. A total number of 40 normal pregnancies were also included for comparison. Peak systolic velocity (PSV), end diastolic velocity (EDV), Resistive index (RI), Pulsatility index (PI) in different groups of study subjects from 24th to 37th weeks were observed and compared for any significant differences. Results: Majority (35% in normal and 37.5% in preeclampsia) of the respondents were found in the age group of 21-30 years. Unpaired t-test revealed no significant difference between mean age between two groups. Among normal group, mean±SD PSV, EDV, PI and RI were 43.94±15.41 cm/sec and 15.51 (±4.93) cm/sec, 1.12±0.0846 and 0.571 (±0.058) respectively. Mean PSV, EDV, PI and RI were 83.19±18.44 cm/sec, 11.86±5.19 cm/sec, 2.497±0.369 and 0.8255±0.087 in preeclampsia group. There was statistically significant (By unpaired ttest) difference in mean Doppler indices between these two groups. It was observed that early diastolic notch was found in 90% subjects with preeclampsia. Early diastolic notch was observed in Doppler wave form in 5% subject with normal pregnancy. Chi-square test showed that there was statistically significant difference in presence of early diastolic notch between normal subjects and subjects with preeclampsia. Conclusions: From the study result it was concluded that Doppler indices with presence of early diastolic notch are reliable indicators for early detection of preeclampsia. J MEDICINE JUL 2019; 20 (2) : 87-91

scholarly journals Correlation of progression of diabetic retinopathy with the alterations in retrobulbar circulation

2013 ◽  
Vol 5 (2) ◽  
pp. 147-153 ◽  
Author(s):  
S Sood ◽  
Subina Narang ◽  
S Kocchhar ◽  
S Sarda ◽  
S Aggarwal ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Normal Population ◽  
Color Doppler ◽  
Case Series ◽  
Peak Systolic Velocity ◽  
Resistive Index ◽  
Doppler Imaging ◽  
Arterial Circulation ◽  
Diastolic Velocity ◽  
Group I

Introduction: Color Doppler Imaging (CDI) is used widely to study retrobulbar circulation. Objectives: To determine the association between progression of diabetic retinopathy (DR) and alterations in retrobulbar arterial circulation using CDI studies. Materials and methods: Prospective observational case series. It is single institutional study of 50eyes of nonproliferative diabetic retinopathy in 50 patients with type II diabetes mellitus. DR was graded according to ETDRS system. Retrobulbar circulation was studied in patients for Peak systolic velocity (PSV), End diastolic velocity (EDV) and Resistive index (RI) in Central retinal artery (CRA), Ophthalmic artery (OA) and Posterior ciliary artery (PCA) using CDI initially and reevaluated after 6 months or later for any change in retinopathy grade and arterial circulation parameters. The patients were grouped as Group I not showing progression of DR and Group II showing progression. The two groups were compared for any significant change in CDI parameters. Results: The baseline resistive indices were higher than normal population. There was significant increase in RI in PCA and CRA in all patients after 6 months. 14 patients (28%) showed progression of DR and 36 (72%) did not show progression of DR. There was no significant association with progression of retinopathy and CDI findings. (p=>0.05). Conclusion: The retrobulbar arterial circulation seems to be affected in all diabetics with DR. The changes appear to be progressive. The CDI findings in arterial circulation however lack predictive power for progression of diabetic retinopathy in non proliferative DR. Nepal J Ophthalmol 2013; 5(10): 147-153 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8705

Effect of glycemic control on prooxidant–antioxidant balance in type 2 diabetic patients and its comparison with healthy subjects

2011 ◽  
Vol 44 (13) ◽  
pp. S83
Author(s):  
Heidari Hossein ◽  
Rajai Zahra ◽  
Khozeime Fahime ◽  
Anvari Milad ◽  
Hadizadeh yazdi Niloofar ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Healthy Subjects ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic
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