scholarly journals Diabetic Pneumopathy–A New Diabetes-Associated Complication: Mechanisms, Consequences and Treatment Considerations

2021 ◽  
Vol 12 ◽  
Author(s):  
Stefan Kopf ◽  
Varun Kumar ◽  
Zoltan Kender ◽  
Zhe Han ◽  
Thomas Fleming ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Dna Damage ◽  
Dna Repair ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Diabetic Patients ◽  
Dna Damage Signaling ◽  
Patients With Diabetes ◽  
Treatment Considerations

Patients with diabetes are over-represented among the total cases reported with “idiopathic” pulmonary fibrosis (IPF). This raises the question, whether this is an association only or whether diabetes itself can cause pulmonary fibrosis. Recent studies in mouse models of type 1 and type 2 diabetes demonstrated that diabetes causes pulmonary fibrosis. Both types of diabetes trigger a cascade, starting with increased DNA damage, an impaired DNA repair, and leading to persistent DNA damage signaling. This response, in turn, induces senescence, a senescence-associated-secretory phenotype (SASP), marked by the release of pro-inflammatory cytokines and growth factors, finally resulting in fibrosis. Restoring DNA repair drives fibrosis into remission, thus proving causality. These data can be translated clinically to patients with type 2 diabetes, characterized by long-term diabetes and albuminuria. Hence there are several arguments, to substitute the term “idiopathic” pulmonary fibrosis (IPF) in patients with diabetes (and exclusion of other causes of lung diseases) by the term “diabetes-induced pulmonary fibrosis” (DiPF). However, future studies are required to establish this term and to study whether patients with diabetes respond to the established therapies similar to non-diabetic patients.

Prevalence of Toenail Onychomycosis in Patients with Type 2 Diabetes Mellitus and Evaluation of Risk Factors

2011 ◽  
Vol 101 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Aynur Gulcan ◽  
Erim Gulcan ◽  
Sukru Oksuz ◽  
Idris Sahin ◽  
Demet Kaya
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Fasting Blood Glucose ◽  
Diabetic Patients ◽  
Essential Components ◽  
Patients With Diabetes ◽  
Epidemiologic Risk

Background: We sought to determine the frequency of toenail onychomycosis in diabetic patients, to identify the causative agents, and to evaluate the epidemiologic risk factors. Methods: Data regarding patients’ diabetic characteristics were recorded by the attending internal medicine clinician. Clinical examinations of patients’ toenails were performed by a dermatologist, and specimens were collected from the nails to establish the onycomycotic abnormality. All of the specimens were analyzed by direct microscopy and culture. Results: Of 321 patients with type 2 diabetes mellitus, clinical onychomycosis was diagnosed in 162; 41 of those diagnoses were confirmed mycologically. Of the isolated fungi, 23 were yeasts and 18 were dermatophytes. Significant correlations were found between the frequency of onychomycosis and retinopathy, neuropathy, obesity, family history, and duration of diabetes. However, no correlation was found with sex, age, educational level, occupation, area of residence, levels of hemoglobin A1c and fasting blood glucose, and nephropathy. The most frequently isolated agents from clinical specimens were yeasts. Conclusions: Long-term control of glycemia to prevent chronic complications and obesity and to promote education about the importance of foot and nail care should be essential components in preventing onychomycosis and its potential complications, such as secondary foot lesions, in patients with diabetes mellitus. (J Am Podiatr Med Assoc 101(1): 49–54, 2011)

scholarly journals Extremely high-dose insulin requirement in a diabetic patient with COVID-19: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
François R. Jornayvaz ◽  
Benjamin Assouline ◽  
Jérôme Pugin ◽  
Karim Gariani
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Patient ◽  
Insulin Requirement ◽  
Diabetic Patients ◽  
High Dose ◽  
Intravenous Insulin ◽  
Patients With Diabetes ◽  
Mechanical Ventilation Support ◽  
High Insulin

Abstract Background Detailed description of hyperglycemia management in diabetic patients infected with SARS-CoV-2 remain limited, although patients with diabetes show higher complication and mortality rate than patients without diabetes. Transient non-severe increased insulin requirement in patients hospitalized for medical conditions such as sepsis or myocardial infarction is a well-known phenomenon. However, extremely high-dose insulin requirement remains a very rarely reported entity. Here, we report the case of an extreme and transitory insulin requirement episode in a type 2 diabetic patient presenting an acute respiratory distress syndrome caused by SARS-CoV-2. Case presentation A 57-year-old man resident in Geneva, Switzerland, previously known for type 2 diabetes for 3 years was admitted for an aggravation of his dyspnea. His type 2 diabetes was treated only with metformin and his latest Hb1Ac was 6.1%. Chest CT SCAN showed a bilateral multilobar ground-glass opacification. Twenty-four hours after his admission he presented a worsening of dyspnea and severe hypoxemia requiring a transfer to the intensive care unit rapidly followed by oro-tracheal intubation for mechanical ventilation support. A bronchoalveolar lavage was performed and test of SARS-CoV-2 by RT-qPCR assay was positive. At day 3, he presented a rapidly progressive insulin requirement at a rate of up to 50 units/hour intravenous insulin aspart. Despite the high insulin doses, he maintained an elevated plasma glucose level at 270 mg/dL on average. His extremely high-dose insulin requirement “resolved” at day 9, and the insulin infusion rate was rapidly reduced. Conclusions This case may reflect a specific and profound impact of SARS-CoV-2 on metabolic homeostasis, in particular in diabetic patients that appear more prone to complications of COVID-19 infection. Yet, the mechanisms behind this remain to be elucidated. The optimal management of hyperglycemia of diabetic patients infected with SARS-CoV-2 has yet not be defined, however insulin remain the mainstay of treatment approach. Report of extreme dysregulation of chronic conditions such as diabetes in patients with COVID-19 may help clinicians to better take care of patients during the pandemic of SARS-CoV-2. To the best of our knowledge this is the first description of extremely high-dose insulin requirement in patient with COVID-19.

scholarly journals Study on Thyroid Dysfunction in Patients with Type-2 Diabetes

2020 ◽  
Vol 7 (52) ◽  
pp. 3142-3147
Author(s):  
Senthil Chander ◽  
Kalpana Dev Venkatesan ◽  
Christina Mary Paul
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
General Medicine ◽  
Diabetic Patients ◽  
Endocrine Disorders ◽  
Cross Sectional ◽  
Patients With Diabetes

BACKGROUND Diabetes mellitus is one of the leading endocrine disorders worldwide. Thyroid dysfunction is a common endocrine disorder affecting the general population next to diabetes. The objective of this study was to determine the prevalence of thyroid dysfunction among patients with Type 2 diabetes. METHODS This analytical cross sectional study was conducted from June 2019 to Dec 2019. One hundred and fifty type–2 diabetes patients who attended the outpatient clinic of General Medicine Department, ACS Medical College and Hospital were included in the study. A detailed history and examination was done after getting informed consent. Blood samples were collected and sent to the laboratory for the evaluation of thyroid profile. RESULTS Thyroid dysfunction was found in 27 % of the patients with diabetes. Subclinical hypothyroidism was the most common thyroid dysfunction reported (14.7 %) followed by clinical hypothyroidism (10 %), subclinical hyperthyroidism (2 %) and clinical hyperthyroidism (0.6 %). CONCLUSIONS Thyroid dysfunction is common in patients with type-2 diabetes. A substantial proportion of the diabetic patients with thyroid dysfunction have subclinical hypothyroidism. Unidentified thyroid dysfunction could negatively impact diabetes and its complications. Therefore, early and routine screening of thyroid is recommended in all patients with diabetes to reduce the burden of the disease. KEYWORDS Type-2 Diabetes Mellitus, Thyroid Dysfunction, Hypothyroidism

scholarly journals DNA damage and efficacy of DNA repair in patients with type 2 diabetes and coexisting colorectal cancer

2014 ◽  
Vol 124 (7-8) ◽  
pp. 352-358
Author(s):  
Izabela Szymczak ◽  
Agnieszka Śliwińska ◽  
Józef Drzewoski
Keyword(s):  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Dna Damage ◽  
Dna Repair

scholarly journals 564 Cardiac magnetic resonance myocardial feature tracking for optimized risk assessment after acute myocardial infarction in patients with type 2 diabetes

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
J T Kowallick ◽  
S J Backhaus ◽  
T Stiermaier ◽  
T Lange ◽  
J L Navarra ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Risk Assessment ◽  
Acute Myocardial Infarction ◽  
Magnetic Resonance ◽  
Feature Tracking ◽  
Multivariable Analysis ◽  
Diabetic Patients ◽  
Patients With Diabetes

Abstract Objective Type 2 diabetes mellitus (T2DM) associates with worse cardiovascular outcome following acute myocardial infarction (AMI) as compared to non-diabetic patients. Since the mechanisms behind these observations are not fully understood we aimed to quantify the underlying pathophysiology on ventricular and atrial levels and study their prognostic implications using cardiovascular magnetic resonance (CMR) quantitative feature-tracking (FT) and tissue characterization. Research Design and Methods: A total of 1147 consecutive patients with AMI (n = 265 with diabetes; n = 882 without diabetes) undergoing cardiac magnetic resonance (CMR) imaging in median 3 days after AMI were included in this multicenter study. Left ventricular (LV) function and volumetry included LV ejection fraction (LV-EF), global longitudinal (GLS), radial (GRS) and circumferential strain (GCS) as well as left atrial (LA) strain and strain rate parameters of LA reservoir, conduit and booster pump function. LV damage assessment included infarct size (IS), edema and microvascular obstruction (MO). The clinical study endpoint was the rate of major adverse cardiovascular events (MACE) at 12 months. Results T2DM patients had impaired LA reservoir (19.8 vs. 21.2%, p < 0.01) and conduit strains 7.6 vs. 9.0%, p < 0.01) but no differences in ventricular function or myocardial damage. They were at higher risk of MACE than non-diabetic patients (10.2% vs. 5.8%, p < 0.01) with the majority of MACE occurring in patients with LVEF ≥ 35%. Whilst LVEF was an independent predictor of adverse events in non-diabetic patients (p = 0.04 on multivariable analysis), LV GLS as well as LA strain emerged as independent predictors of poor prognosis in patients with diabetes (p < 0.02 on multivariable analysis). Considering patients with diabetes and LVEF ≥35% (n = 237), GLS and LA reservoir strain below median were significantly associated with higher 12-month event rates. Conclusions In patients with diabetes, LA and LV longitudinal strain permit optimized risk assessment early after reperfused AMI with incremental prognostic value over and above LVEF.

COMPARATIVE HEMATOLOGICAL STUDY OF TYPE 2 DIABETIC AND NON-DIABETIC PATIENTS IN ERODE DISTRICT, TAMIL NADU

2021 ◽  
pp. 29-30
Author(s):  
Murugesan Thinakaran ◽  
Thangadurai Chitra
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Tamil Nadu ◽  
Haematological Parameters ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Hematological Indices ◽  
Patients With Diabetes ◽  
Type 2 Diabetic

Background And Objectives: Previous studies have shown that hematological alterations are a common nding in patients with diabetes. To aim of our study was to explore the hematological indices in type 2 diabetic patients compared with non-diabetic individual. Establish the role of haematological parameters as an early prevention strategy. Materialand Method: Two hundred and forty-six subjects were recruited for this study, one hundred and fourteen with type 2 diabetes and One hundred and thirty-two non-diabetes, were evaluated for haematological parameters using hematologic analyzer. All the information's about the disease was collected with the knowledge of the patients form the concern hospital and laboratory. Results And Conclusions: Results were compared with the same measurements in 132 subjects without diabetes mellitus. The haematological prole associated with Type2 diabetic patients signicantly reduced Hb, RBCs, PCV and MCV than Non diabetes. Increased MCHC and WBCs were noted in Type2 diabetes. Our ndings suggest the need of screening for routine hematological tests in type 2 diabetes mellitus

scholarly journals Physical Exercise and Redox Balance in Type 2 Diabetics: Effects of Moderate Training on Biomarkers of Oxidative Stress and DNA Damage Evaluated through Comet Assay

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Monica Pittaluga ◽  
Antonio Sgadari ◽  
Ivan Dimauro ◽  
Barbara Tavazzi ◽  
Paolo Parisi ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Type 2 Diabetes ◽  
Dna Damage ◽  
Ascorbic Acid ◽  
Exercise Training ◽  
Comet Assay ◽  
Redox Homeostasis ◽  
Diabetic Patients ◽  
Biomarkers Of Oxidative Stress

Objective.Hyperglycemia leads to increased production of reactive oxygen species (ROS) in type 2 diabetes, which reduces cellular antioxidant defenses and induces DNA lesions. The aim of this study was to investigate the effects on redox homeostasis and DNA oxidative damage of exercise training in patients with type 2 diabetes compared with nondiabetic individuals.Methods and Results.12 sedentary type 2 diabetic males (62.1 ± 4.3 yrs) and 12 sedentary healthy males (61.7 ± 3.9 yrs) were exposed to 4-month moderate training, 3 times per week, to evaluate the effect on plasma biomarkers of oxidative stress malondialdehyde and antioxidant status (GSSG, GSH/GSSG, and ascorbic acid) as well as basal and H2O2-induced DNA damage trough alkaline comet assay in peripheral blood lymphocytes. After training, glutathione and ascorbic acid levels increased in both groups, but only in diabetics the malondialdehyde as well as the DNA damage decreased.Conclusion.Our study demonstrates for the first time that moderate exercise training is not only effective in improving the redox homeostasis, through an increase of the endogenous antioxidant defences in healthy as well as in diabetic patients, but also, specifically in diabetic patients, effective in lowering the susceptibility to oxidative DNA damage and the lipid peroxidation levels.

scholarly journals Smoking Counteracts the Favorable Effect of Exercise Training on Endothelial Function in Patients with Type 2 Diabetes

2013 ◽  
Vol 4 ◽  
pp. JCM.S11152 ◽  
Author(s):  
Shinji Sato ◽  
Noriko Nakayama ◽  
Shingo Otsuki ◽  
Shiro Tanaka ◽  
Hajime Nakamura ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Exercise Training ◽  
Endothelial Function ◽  
Favorable Effect ◽  
Diabetic Patients ◽  
Post Exercise ◽  
Home Based ◽  
Patients With Diabetes ◽  
Smoking Group

Background Exercise training can improve endothelial function in patients with diabetes. We hypothesized that the favorable effect of exercise training on endothelial function in patients with diabetes is counteracted by cigarette smoking. Purpose To assess whether there is a difference in the effect of exercise on endothelial function in smokers and non-smokers with type 2 diabetes. Methods We performed a 3-month controlled trial in 27 never-smoking and 17 smoking individuals with type 2 diabetes who participated in a home-based walking program. The percentage decrease in post-exercise ankle-brachial pressure index (ABI), which is an index of endothelial function, was assessed at baseline and after 3 months. Results Compared to the smoking group, the never-smoking group showed a more significant improvement in post exercise ABI during the 3 months of home-based training (interaction, P < 0.01). Conclusions These results indicate that smoking may counteract the favorable effects of exercise training on endothelial function. Endothelial function plays an important role in the prevention of cardiovascular disease among patients with diabetes. Therefore, a Certified Diabetes Educator should strongly advise diabetic patients not to smoke.

scholarly journals Study Comparing the Liver Enzymes in Hypertensive and Normotensive Patients with Type 2 Diabetes

2021 ◽  
Vol 8 (7) ◽  
pp. 207-211
Author(s):  
Rishad Ahmed
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Liver Enzymes ◽  
Good Control ◽  
Diabetic Patients ◽  
Uncontrolled Diabetes ◽  
Elevated Liver Enzymes ◽  
Patients With Diabetes ◽  
Altered Liver

Objective: There were few clinical trials which indicate altered liver biochemical findings in diabetic patients, but through investigation to compare the liver enzymes in-between hypertensive and normotensive patients with type 2 diabetes was not evaluated. Thus main objective of current study was to compare the liver enzymes in hypertensive and normotensive patients with type 2 diabetes. Materials and Methods: This was a retrospective observational study conducted in a tertiary medical teaching hospital in Kolkata. Hospital OPD reports and patients clinical case records were used to fetch the required data in a predesigned clinical record pro forma. Result: Total 180 patients were participated in this observational retrospective trial where 33% patient were normotensive but having T2DM and 67% patients were hypertensive with T2DM. There were no statistically significant differences between the study variables among both the groups. However elevated level of GGT, ALT and AST were observed in T2DM normotensive patients as compare to T2DM hypertensive patients. abnormal liver functions were recorded in patients with uncontrolled diabetes as compared to patients with good control (p<0.05). Conclusion: The current study concluded that elevated liver enzymes like bilirubin, GGT, SGOT and SGPT were common among diabetes mellitus patients and comparable with patients with hypertensive as well as normotensive patients with diabetes mellitus. Keywords: Liver enzymes, T2DM, hypertension.

Pulmonary function in patients with type 2 diabetes and coronary artery disease

2016 ◽  
Vol 94 (5) ◽  
pp. 366-373 ◽  
Author(s):  
Evgeniy D. Bazdyrev ◽  
O. M. Polikutina ◽  
N. A. Kalichenko ◽  
Yu. S. Slepynina ◽  
O. L. Barbarash
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Respiratory Failure ◽  
Coronary Artery ◽  
Pulmonary Function ◽  
Diabetic Patients ◽  
Carbohydrate And Lipid Metabolism ◽  
Patients With Diabetes ◽  
Artery Disease

Currently, there is no convincing evidence of respiratory failure in patients with diabetes mellitus (DM) and coronary artery disease (CAD). Aim: To evaluate the differences in the main parameters of pulmonary function in patients with isolated type 2 diabetes and diabetic patients with CAD. Materials and methods: Patients with diabetes were allocated to two groups depending to the presence of CAD. The assessment of carbohydrate and lipid metabolism, as well as the measurement of inflammatory markers were performed using standard methods of clinical and biochemical analysis. Respiratory function and diffusion capacity of the lungs (DLCO) were assessed using a body plethysmograph Elite Dl-220v. Results. Main pulmonary functional test parameters were within normal values, except residual volume in diabetic patients. Patients with concomitant CAD demonstrated lower values of the studied parameters compared to non-diabetic ones. A number of volume and flow rate parameters as well as DLCO correlated with systemic inflammation, decompensation of carbohydrate and lipid metabolism, and duration of diabetes. Conclusion. Diabetic patients with CAD suffered from respiratory failure, manifested as decline in pulmonary function and DLCO. Blood glucose levels, inflammation symptoms, dyslipidemia and myocardial dysfunction are among suspected causes contributing to the development and acceleration of this decline.

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