scholarly journals Quantitative Analysis of Myocardial Work by Non-invasive Left Ventricular Pressure-Strain Loop in Patients With Type 2 Diabetes Mellitus

2021 ◽  
Vol 8 ◽  
Author(s):  
Danqing Huang ◽  
Cunying Cui ◽  
Qiang Zheng ◽  
Yanan Li ◽  
Yuanyuan Liu ◽  
...  

Background: Type 2 diabetes mellitus (T2DM) is a common risk factor for cardiovascular diseases. The aims of this study were to evaluate the changes in the left ventricular myocardial work in T2DM patients using the left ventricular pressure-strain loop (PSL) technique, and to explore the risk factors for the left ventricular myocardial work impairment.Methods: Fifty patients with T2DM and 50 normal controls (NCs) were included in the study. In addition to conventional echocardiography and two-dimensional speckle tracking echocardiography, the left ventricular myocardial work parameters were measured using PSL technology.Results: The absolute value for global longitudinal strain (GLS), global work index (GWI) and, global constructive work (GCW) were significantly decreased in the T2DM group (P < 0.05), while the left ventricular ejection fraction (LVEF) was not significantly different between the T2DM and NC groups. Multivariable linear regression analysis showed that hemoglobin A1c (HbA1c) was independently related to GWI (β = −0.452, P < 0.05), while HbA1c and the diabetes duration were independently related to GCW (β = −0.393, P < 0.05 and β = −0.298, P < 0.05, respectively).Conclusions: Changes in the left ventricular myocardial systolic function in T2DM patients were identified using PSL technology. HbA1c was shown to be an independent risk factor affecting GWI, while HbA1c and diabetes duration were demonstrated to be independent risk factors affecting GCW.

Author(s):  
Masemiano P. Chege

Background: The Diabetes Management and Information Center in Nairobi has conducted population surveys among rural and urban Kenyans during the last decade. They have reported a rise in the prevalence of diabetes among rural Kenyans from 3% in 2003 to 7% in 2007. Our study was undertaken to investigate rural factors for type 2 diabetes and determine those that could be responsible for this rise in prevalence.Objectives: To describe the risk factors for type 2 diabetes mellitus among patients attending the outpatient clinics in a rural mission hospital in Kenya.Method: Forty-five diabetics and forty-five non-diabetics, resident in this rural hospital’s catchment area for at least 10 years, were randomly selected from patients attending outpatient clinics. Diabetics in a stable condition (not requiring hospitalisation), whose fasting blood sugars were below 6.1 mmol/L, were matched for age and gender with the non-diabetics who came to the hospital for outpatient services. A pilot-tested questionnaire on demography, current and past dietary habits, social habits, and family history was used to collect data. Waist circumference, height and weight were measured and BMI calculated. Data was analysed using SPSS for Windows. The Kruskal–Wallis test was used to compare the medians for the continuous variables, while the chi-squared test was used for the categorical variables. The z-test was used to calculate the relative risk.Results: Ninety participants (26 males, 64 females). The mean age was 61.8 for diabetics and 61.4 for non-diabetics. Childhood starvation (relative risk 2.08, p = 0.0090) and use of cassava for sustenance during childhood starvation (relative risk 3.12, p = 0.0090) were identified as risk factors. Diabetes in close relatives, another risk factor for this population (relative risk 2.2, p = 0.0131). Abdominal obesity was a risk factor for this population (in females relative risk 2.0, p = 0.0010).Conclusion: The risk factors for type 2 diabetes mellitus described in this rural population include advancing age, diabetes in a first-degree relative and abdominal obesity. This is similar to what has been cited in other studies. At variance, we found that more than 50% of the diabetics reported having suffered malnutrition/starvation in childhood, with more than half of them reporting their dependence on cassava as the only food source during starvation.


2014 ◽  
Vol 32 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Josep Franch-Nadal ◽  
Pilar Roura-Olmeda ◽  
Belén Benito-Badorrey ◽  
Antonio Rodriguez-Poncelas ◽  
Gabriel Coll-de-Tuero ◽  
...  

2019 ◽  
Vol 8 (4) ◽  
pp. 11273-11277

Rising prevalence of type 2 diabetes mellitus is a vital health concern today, not only in India but across the world. Several factors including dietary habits, genetics, lack of physical exercise and stress are known to affect the risk of type 2 diabetes. Although awareness has increased to some extent, many people with diabetes have limited knowledge about the risk factors before the diagnosis of disease. For chronic disease prevention there is a necessity to find out such risk factors and manage them appropriately. Statistical techniques can be employed to understand the risk of type 2 diabetes in different age group of people. The objective of the research was to evaluate relationship among stress and type 2 diabetes in people with different age groups by a statistical tool. The proposed method uses three machine learning classifiers namely Support Vector Machine (SVM), Logistic Regression and Random Forest (RF) to detect type 2 diabetes at an early stage. To develop an adaptive model the preprocessing step has been applied. The accuracy of predicting diabetes using SVM, Random Forest and Logistic Regression was 80.17%, 79.37%, 78.67% respectively. The results suggest that as compared to Random Forest and Logistic Regression, SVM is better in predicting occurrence and progress of type 2 diabetes mellitus with stress as a risk factor.


2012 ◽  
Vol 6 (1) ◽  
pp. 133-140 ◽  
Author(s):  
Jawad A Al-Lawati ◽  
Mohammed N. Barakat ◽  
Ibrahim Al-Zakwani ◽  
Medhat K. Elsayed ◽  
Masoud Al-Maskari ◽  
...  

Background: Despite the high burden of type 2 diabetes mellitus (T2DM) in Oman, there are scarce data from a nationally representative sample on the level of glycaemia and other cardiovascular (CVD) risk factor control. Objective: To estimate the proportion of patients with T2DM at goal for glycaemia and CVD risk factors using the National Diabetes Guidelines (NDG) and the American Diabetes Association (ADA) clinical care guidelines; and to assess the quality of selected services provided to patients with T2DM. Methods: A sample of 2,551 patients (47% men) aged ≥20 years with T2DM treated at primary health care centers was selected. Patient characteristics, medical history and treatment were collected from case notes, Diabetes Registers and computer frameworks including the use of the last 3 laboratory investigations results and blood pressure (BP) readings recorded in 2007. Results: The overall mean age of the cohort was 54±13 years with an average median duration of diabetes of 4 (range 2 to 6) years. Over 80% of patients were overweight or obese (body mass index (BMI) of ≥25 Kg/m2). Sixty-nine percent were on oral anti-diabetic medication, 52% on anti-hypertensives and 40% on lipid lowering drugs. Thirty percent of patients were at goal for glycosylated haemoglobin level (<7%), 26% for BP (systolic/diastolic <130/80 mmHg), 55% for total cholesterol (<5.2 mmol/l), 4.5% for low-density lipoprotein cholesterol (<1.8 mmol/l), 52% for high-density lipoprotein cholesterol (>1 mmol/l for men, >1.3 mmol/l for women), and 61% for triglycerides (<1.7 mmol/l). Over 37% had micro-albuminuria and 5% had diabetic nephropathy. Conclusion: Control of hyperglycaemia and other CVD risk factor appears to be suboptimal in Omani patients with T2DM and need to be addressed in the triad of patient, physician and health system.


2021 ◽  
Vol 7 (2) ◽  
pp. 5
Author(s):  
Muhamad Taufik Ismail ◽  
Hariadi Hariawan ◽  
Firman Fauzan Arief Lutfie ◽  
Dhite Bayu Nugroho ◽  
Vina Yanti Susanti ◽  
...  

Aim: Diabetes mellitus increases the risk of peripheral artery disease (PAD) 2 times. PAD is diagnosed by ABI (Ankle Brachial Index). PAD increases mortality and morbidity of patient with Diabetes Mellitus (DM) Type 2. This study aims to determine the prevalence and risk factors of PAD in the population of type 2 diabetes mellitus (DM) in Yogyakarta, Indonesia.   Methods: This study was a community-based descriptive and analytic observational study that examines the prevalence and risk factors of PAD in type 2 diabetes mellitus. Diagnosis of PAD was detected by ABI examination using VaSera VS-1500N. All patients with type 2 diabetes mellitus in Yogyakarta who meet the inclusion criteria will be enrolled in this study. The research subjects were taken in multi-stage, cluster-random sampling in Yogyakarta. The patient will undergo an interview of demographic data which were assessed by one assessor.  Data from interviews and ABI examinations were analysed statistically.   Results: Two hundred and fifty-six (256) patients with type 2 DM consisted of 188 patients (73.4%) women and 68 patients (26.6%) men. Prevalence of PAD diagnosed by abnormal ABI was found in 41 (16%) of 256 patients. Subjects with age more than 67 years old was significantly associated with PAD occurrence (P=0,001) in type 2 DM population.   Conclusion: The prevalence of PAD was 16% of 256 type 2 DM patients. Age more than 67 years old was the strong risk factor of PAD in type 2 DM.   Key words: Ankle Brachial Index, Peripheral Arterial Disease, Diabetes mellitus, Prevalence, Risk Factor


2020 ◽  
Author(s):  
Elina Rautio ◽  
Fredrik Gadler ◽  
Soffia Gudbjörnsdottir ◽  
Stefan Franzén ◽  
Lars Rydén ◽  
...  

<b><i>Objective</i></b><i>: </i>Patients with type 2<i> </i>diabetes mellitus have an increased risk for cardiovascular disease including arrhythmias. The prevalence of bradyarrhythmia and the subsequent need for treatment with pacemakers (PM) is less well explored in a contemporary patient population. The present study explores 1) whether patients with type 2 diabetes mellitus have an increased demand for PM implantation compared with an age- and sex-matched control population without diabetes mellitus; 2) Patient characteristics associated with increased demand of receiving a PM. <p><b><i>Methods</i></b><b>:</b> In this population-matched registry study a total of 416 247 patients with type 2 diabetes mellitus from the Swedish National Diabetes Registry (NDR) and 2 081 235 age and sex-matched controls selected from the general population were included between 1 January 1998 and 31 December 2012 and followed until 31 December 2013. Mean follow-up time was 7 years. Cox’s proportional hazard regression analyses were performed to estimate the demand of PM-treatment and factors identifying patients with such demand.</p> <p><b><i>Results:</i></b> Type 2 diabetes mellitus was associated with increased need of PM-treatment (Hazard ratio (HR) 1.65, 95% CI 1.60-1.69; p<0.0001) which remained (HR 1.56, 95% CI 1.51-1.60; p<0.0001) after adjustments for age, sex, educational level, marital status, country of birth and coronary heart disease. Risk factors for receiving a PM included increasing age, HbA1c, BMI, diabetes duration, blood pressure- and lipid lowering medication.</p> <p><b><i>Conclusion</i></b><i>: </i>The need for PM treatment is higher in patients with type 2 diabetes than in matched population-based controls. Age, diabetes duration and HbA1c seem to be risk factors for PM treatment. </p>


Author(s):  
Peter Godsk Jørgensen ◽  
Magnus Thorsten Jensen ◽  
Tor Biering‐Sørensen ◽  
Rasmus Mogelvang ◽  
Thomas Fritz‐Hansen ◽  
...  

Author(s):  
Krishna K Patel ◽  
Bernard Charbonnel ◽  
Hungta Chen ◽  
Javier Cid-Rufaza ◽  
Peter Fenici ◽  
...  

Background: Guidelines recommend optimal control of cardiovascular risk factors such as blood pressure, lipids and smoking in addition to glycemic control to reduce the risk of micro and macro-vascular complications in patients with type 2 diabetes mellitus (T2D). However, the extent of comprehensive cardiovascular risk factor control in T2D internationally is not well-known. Methods: A total of 14,169 T2D patients initiating second-line therapy across 37 countries were enrolled in the DISCOVER registry. Optimal cardiovascular risk factor management at study baseline was defined as control of the following risk factors among eligible patients: 1) Systolic BP <140mmHg for all T2D patients; 2) statin prescription in all T2D patients ≥ 40 years, high-intensity statin for those with T2D and ASCVD; 3) non-smoking status for all T2D patients; 4) treatment with ACE-Inhibitor/Angiotensin Receptor Blocker (ACEI/ARB) in patients with T2D and 5) hypertension (HTN)/albuminuria and secondary ASCVD prevention with low-dose aspirin (ASA) in those with T2D and ASCVD. Global and country specific rates of individual and combined risk factor control were calculated. Inter-country variability was estimated using median odds ratios (MOR). Results: Mean age of the DISCOVER cohort was 56.6 (SD= 11.7) years; 7534 (53.2%) were male, mean BMI was 29.6 (SD= 5.9) kg/m 2 , median duration of T2D was 4.1 (IQR 2.0, 7.8) years. A total of 1643 (11.9%) patients had ASCVD, 7221 (51.0%) had HTN and 606 (4.3%) had albuminuria. Overall, among eligible patients, BP was controlled in 67.2% (9043/13457); statin treatment was prescribed in 38.3% (4977/12987); 85.2% (12,075/14169) were not smoking; ACEI/ARB treatment was prescribed in 53.7% (4917/9151), and ASA for secondary prevention was prescribed in 51.6% (847/1643) patients with ASCVD. Of 13,118 patients with 3 or more risk factors, 5312 (40.5%) had optimal control of at least 3 risk factors with wide inter-country variability. Conclusion: In a global registry of individuals with T2D from 37 countries, comprehensive control of ASCVD risk factors was not achieved in most patients, with wide variability among countries. Better strategies are needed to consistently provide comprehensive cardiovascular risk factor control in patients with T2D to improve long term outcomes.


1970 ◽  
Vol 42 (2) ◽  
pp. 137-141
Author(s):  
T Jaja ◽  
IE Yarhere

Background: The prevalence of Type 2 diabetes mellitus (T2 DM) in children and adolescents is on the increase, therefore, prevention and early detection are important.Objective: To assess for easily identifiable risk factors (overweight/obesity, hypertension, Impaired Fasting Glucose (IFG) and family history of diabetes) for T2DM in adolescents in public secondary schoolsResult: Eight hundred and eighty adolescents aged 10 to 19 years were screened and 124(14.1%) were overweight/obese. 457 (51.9%) of students had none of the risk factors while 272(30.9%) had at least one risk factor. Using the American Diabetes Association criteria for identification of those at risk for T2DM, 21(2.4%) were identified. The frequency of presence of risk factors was more in females (3.3%), mid adolescent age group (3.1%) and those with positive family history of diabetes. These findings were however not statistically significant. There was a statistically significant association between presence of hypertension and impaired fasting glucose and risk factor for type 2 DM.Conclusion: The significant risk factors identified in this study were prehypertension/hypertension and impaired fasting blood glucose.Key words: Adolescence, Risk factors, Type 2 diabetes mellitus


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