scholarly journals Decompression of Multimorbidity Along the Disease Trajectories of Diabetes Mellitus Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Nils Haug ◽  
Johannes Sorger ◽  
Teresa Gisinger ◽  
Michael Gyimesi ◽  
Alexandra Kautzky-Willer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Respiratory Diseases ◽  
Heart Diseases ◽  
Cerebrovascular Diseases ◽  
Diabetic Patients ◽  
General Tendency ◽  
Efficient Management ◽  
Aging Populations ◽  
Multi Level ◽  
Specific Comparison

Multimorbidity, the presence of two or more diseases in a patient, is maybe the greatest health challenge for the aging populations of many high-income countries. One of the main drivers of multimorbidity is diabetes mellitus (DM) due to its large number of risk factors and complications. Yet, we currently have very limited understanding of how to quantify multimorbidity beyond a simple counting of diseases and thereby inform prevention and intervention strategies tailored to the needs of elderly DM patients. Here, we conceptualize multimorbidity as typical temporal progression patterns of multiple diseases, so-called trajectories, and develop a framework to perform a matched and sex-specific comparison between DM and non-diabetic patients. We find that these disease trajectories can be organized into a multi-level hierarchy in which DM patients progress from relatively healthy states with low mortality to high-mortality states characterized by cardiovascular diseases, chronic lower respiratory diseases, renal failure, and different combinations thereof. The same disease trajectories can be observed in non-diabetic patients, however, we find that DM patients typically progress at much higher rates along their trajectories. Comparing male and female DM patients, we find a general tendency that females progress faster toward high multimorbidity states than males, in particular along trajectories that involve obesity. Males, on the other hand, appear to progress faster in trajectories that combine heart diseases with cerebrovascular diseases. Our results show that prevention and efficient management of DM are key to achieve a compression of morbidity into higher patient ages. Multidisciplinary efforts involving clinicians as well as experts in machine learning and data visualization are needed to better understand the identified disease trajectories and thereby contribute to solving the current multimorbidity crisis in healthcare.

scholarly journals Cardiovascular diseases in diabetic patients

2010 ◽  
Vol 1 (1) ◽  
pp. 46-50
Author(s):  
I. Y Yarek-Martynova ◽  
M. V Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Cerebrovascular Diseases ◽  
Diabetic Patients ◽  
Metabolic Disturbances ◽  
Lower Extremity Ischemia ◽  
Traditional Risk Factors ◽  
Extremity Ischemia

The review pays attention to a considerable rise in the incidence of diabetes mellitus (DM) and to its association with cardiovascular diseases (CVD) and events. It is noted that these events may be present much earlier than DM is diagnosed. The paper also discusses in detail a role of hyperglycemia, postprandial one in particular, hyperinsulinemia, insulin resistance, endothelial dysfunction, impaired blood rheological properties, lipid metabolic disturbances, and genetic and traditional risk factors in the development of atherosclerosis, coronary heart disease, chronic heart failure, cerebrovascular diseases, and lower extremity ischemia in DM.

scholarly journals Cardiac Autonomic Neuropathy: Why Should Cardiologists Care about That?

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Andrzej Bissinger
Keyword(s):  
Diabetes Mellitus ◽  
Autonomic Neuropathy ◽  
Heart Diseases ◽  
Diagnostic Methods ◽  
Cardiac Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Everyday Clinical Practice ◽  
Adverse Cardiac Events ◽  
Cardiac Disorders

Background. Cardiac autonomic neuropathy (CAN) is a frequent but underdiagnosed complication of diabetes mellitus. It has a strong influence on various cardiac disorders including myocardial ischemia and infarction, hypertension, orthostatic hypotonia, heart failure, and arrhythmias. CAN can lead to severe morbidity and mortality and increase the risk of sudden cardiac death. Methods. This review article summarizes the latest evidence regarding the epidemiology, pathogenesis, influence on the cardiovascular system, and diagnostic methods for CAN. The methodology of this review involved analyzing available data from recent papers relevant to the topic of diabetic autonomic neuropathy and cardiac disorders. Conclusions. The early diagnosis of CAN can improve the prognosis and reduce adverse cardiac events. Methods based on heart rate variability enable the diagnosis of CAN even at a preclinical stage. These methods are simple and widely available for use in everyday clinical practice. According to the recently published Toronto Consensus Panel on Diabetic Neuropathy, all diabetic patients should be screened for CAN. Because diabetes mellitus often coexists with heart diseases and the most common methods used for diagnosis of CAN are based on ECG, not only diabetologists but also cardiologists should be responsible for diagnosis of CAN.

Analysis of Population Representation Among Willed Whole-Body Donors to Facilitate the Construction of a Body Donation Program in China: From the Perspective of Medical Students and Anatomists

2020 ◽  
pp. 003022282091371
Author(s):  
Hanlin Zhang ◽  
Kang Chen ◽  
Naili Wang ◽  
Di Zhang ◽  
Qing Zhang ◽  
...  
Keyword(s):  
Respiratory Diseases ◽  
Causes Of Death ◽  
Heart Diseases ◽  
Cerebrovascular Diseases ◽  
The Body ◽  
Whole Body ◽  
Age At Death ◽  
Medical College ◽  
Body Donation ◽  
Population Representation

The body donation program of Peking Union Medical College was established in May 1999. From May 1999 to December 2017, a total of 5,576 registrants registered and 1,459 donors donated their bodies. Demographic and medical characteristics of the donors were analyzed. The top four causes of death were neoplasms, heart diseases, respiratory diseases, and cerebrovascular diseases. Age at death among donors who died of neoplasms were significantly lower than other causes of death (all p < .05), and the interval between registration and donation among donors who died of neoplasms was significantly shorter than that among donors with other causes (all p < .001). The age of donors when they registered ( p < .001) and donated ( p < .001) was significantly older than that of general Beijing population. This study may provide a guide for medical colleges or research institutions to establish or enhance their own body donation programs.

Diabetes

2020 ◽  
pp. 106-133
Author(s):  
Fabian Miller ◽  
Melisa Anderson ◽  
Dwayne Tucker ◽  
Kurt Vaz ◽  
Jabari Brown ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetes Management ◽  
Cerebrovascular Diseases ◽  
Sociocultural Factors ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Treatment Practices ◽  
Psychological Conditions ◽  
Sociocultural Issues

Worldwide diabetes mellitus affects millions of individuals. Diabetes mellitus presents biopsychosocial challenges for diabetic patients and their families. Psychological and sociocultural issues that affect individuals with Type 1 and Type 2 diabetic patients negatively impact self-management activities aimed at attaining metabolic control and prevents future diabetic complications such as retinopathy, nephropathy, and cerebrovascular diseases. There is increasing evidence that diabetes mellitus is associated with a number of psychological and psychiatric conditions. This review addresses the distinctive biological, psychological, and sociocultural factors such as social support, socioeconomic status and family interaction encountered by diabetic patients. Recommendations are provided that can enhance diabetic care and include improving current screening of psychological conditions as well as treatment practices. There is also the need for more support from family, friends and medical staff in addressing sociocultural issues that impede favorable diabetes management.

scholarly journals Pattern of Tobacco Consumption among the Diabetic Patients

1970 ◽  
Vol 6 (2) ◽  
pp. 95-99
Author(s):  
MK Biswas ◽  
AK Biswas ◽  
G Biswas ◽  
J Begum
Keyword(s):  
Diabetes Mellitus ◽  
Smokeless Tobacco ◽  
Heart Diseases ◽  
Smoking Habit ◽  
Positive Association ◽  
Tobacco Consumption ◽  
Key Words Diabetes Mellitus ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Cross Sectional

Diabetes Mellitus (DM) is a public health challenge all over the world. Recent evidence suggests that there is a positive association between smoking and the risk of diabetes. This descriptive cross-sectional study was conducted from March to June 2008 at BIRDEM Hospital, Shahbagh, Dhaka to find out pattern of tobacco consumption among diabetic patients. Age of the respondents was >15 years. With purposive sampling total 255 respondents were selected. Data was collected through face-to-face interview with structured questionnaire. Out of 255 respondents, 51.4% consumed deferent type of tobacco. Smoker was 63.36% and smokeless tobacco user was 52.67%. The highest (45.80%) had habit of smoking, 36.64% had habit of smokeless tobacco and 17.56% had habit both types of tobacco consumption. The highest smoking and smokeless tobacco consumption found within 50-60 years age group. Total 60.80% male had smoking habit and 32.82% female were smokeless tobacco consumer but no female was smoker. Twenty nine percent tobacco consumers were primarily educated, 16.08% service holders were tobacco consumer and 13.75% service holders were smoker. Among respondents lung diseases and heart diseases were common (78.54.0% and 49.36%). Respondents who consumed tobacco were suffered (74.36%) more complication than non-tobacco consumer (25.64%). So an effective awareness program is required to discourage the consumption of tobacco to protect diabetic patients. Key words: Diabetes mellitus; Smoking; Tobacco DOI: http://dx.doi.org/10.3329/fmcj.v6i2.9210 FMCJ 2011; 6(2): 95-99

Intramuscular Nerve and Neuromuscular Junction Alteration In Extraocular Muscles of Diabetic Mice

1985 ◽  
Vol 43 ◽  
pp. 682-683
Author(s):  
Bruce R. Pachter
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Nerves ◽  
Sudden Onset ◽  
Extraocular Muscles ◽  
Diabetic Patients ◽  
Oculomotor Palsy ◽  
Third Nerve Palsy ◽  
Patients With Diabetes ◽  
Intramuscular Nerve ◽  
Oculomotor Nerves

Diabetes mellitus is one of the commonest causes of neuropathy. Diabetic neuropathy is a heterogeneous group of neuropathic disorders to which patients with diabetes mellitus are susceptible; more than one kind of neuropathy can frequently occur in the same individual. Abnormalities are also known to occur in nearly every anatomic subdivision of the eye in diabetic patients. Oculomotor palsy appears to be common in diabetes mellitus for their occurrence in isolation to suggest diabetes. Nerves to the external ocular muscles are most commonly affected, particularly the oculomotor or third cranial nerve. The third nerve palsy of diabetes is characteristic, being of sudden onset, accompanied by orbital and retro-orbital pain, often associated with complete involvement of the external ocular muscles innervated by the nerve. While the human and experimental animal literature is replete with studies on the peripheral nerves in diabetes mellitus, there is but a paucity of reported studies dealing with the oculomotor nerves and their associated extraocular muscles (EOMs).

Association of Major Dietary Patterns with General and Abdominal Obesity in Iranian Patients with Type 2 Diabetes Mellitus

2015 ◽  
Vol 85 (3-4) ◽  
pp. 145-155 ◽  
Author(s):  
Marjan Ghane Basiri ◽  
Gity Sotoudeh ◽  
Mahmood Djalali ◽  
Mohammad Reza Eshraghian ◽  
Neda Noorshahi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Abdominal Obesity ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Diabetic Patients ◽  
General Obesity ◽  
Healthy Dietary Pattern

Abstract. Background: The aim of this study was to identify dietary patterns associated with general and abdominal obesity in type 2 diabetic patients. Methods: We included 728 patients (35 - 65 years) with type 2 diabetes mellitus in this cross-sectional study. The usual dietary intake of individuals over 1 year was collected using a validated semi-quantitative food frequency questionnaire. Weight, height, and waist circumference were measured according to standard protocol. Results: The two major dietary patterns identified by factor analysis were healthy and unhealthy dietary patterns. After adjustment for potential confounders, subjects in the highest quintile of the healthy dietary pattern scores had a lower odds ratio for the general obesity when compared to the lowest quintile (OR = 0.45, 95 % CI = 0.26 - 0.79, P for trend = 0.02), while patients in the highest quintile of the unhealthy dietary pattern scores had greater odds for the general obesity (OR = 3.2, 95 % CI = 1.8 - 5.9, P for trend < 0.001). There were no significant associations between major dietary patterns and abdominal obesity, even after adjusting for confounding factors. Conclusion: This study shows that in patients with type 2 diabetes mellitus, a healthy dietary pattern is inversely associated and an unhealthy dietary pattern is directly associated with general obesity.

Tests for Platelet Changes, Acute Phase Reactants and Serum Lipids in Diabetes mellitus and Peripheral Vascular Disease

1982 ◽  
Vol 48 (03) ◽  
pp. 289-293 ◽  
Author(s):  
B A van Oost ◽  
B F E Veldhuyzen ◽  
H C van Houwelingen ◽  
A P M Timmermans ◽  
J J Sixma
Keyword(s):  
Diabetes Mellitus ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Acute Phase ◽  
Serum Lipids ◽  
Diabetic Patients ◽  
Peripheral Vascular ◽  
Acute Phase Reactants ◽  
Control Subjects ◽  
And Control

SummaryPlatelets tests, acute phase reactants and serum lipids were measured in patients with diabetes mellitus and patients with peripheral vascular disease. Patients frequently had abnormal platelet tests and significantly increased acute phase reactants and serum lipids, compared to young healthy control subjects. These differences were compared with multidiscriminant analysis. Patients could be separated in part from the control subjects with variables derived from the measurement of acute phase proteins and serum lipids. Platelet test results improved the separation between diabetics and control subjects, but not between patients with peripheral vascular disease and control subjects. Diabetic patients with severe retinopathy frequently had evidence of platelet activation. They also had increased acute phase reactants and serum lipids compared to diabetics with absent or nonproliferative retinopathy. In patients with peripheral vascular disease, only the fibrinogen concentration was related to the degree of vessel damage by arteriography.

ESTIMATION OF SERUM FERRITIN LEVELS IN TYPE 2 DIABETIC PATIENTS AND ITS RELATION WITH HbA1C LEVEL.

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Shah Namrata Vinubhai ◽  
Pardeep Agarwal ◽  
Bushra Fiza ◽  
Ramkishan Jat
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Sugar ◽  
Serum Ferritin ◽  
Inflammatory Marker ◽  
Control Group ◽  
Diabetic Patients ◽  
Positive Correlation

Background: Serum ferritin is known as an index for body iron stores also as an inflammatory marker and it is influenced by several disease. We were looking for a correlation between HbA1c and S. Ferritin in type 2 DM. Methodology: The present study a total of 150 participants were enrolled of which 100 were confirmed cases of Type 2 Diabetes Mellitus and rest 50 age and sex matched healthy subjects constituted the control group. All were screened for HbA1c, Fasting blood sugar, Post prandial blood sugar and S.Ferritin. Results: A highly significant variation and positive correlation was observed with respect to S.Ferritin and HbA1c levels. Mean S.Ferritin was high in the subgroup with poor glycemic control. Conclusion: The fasting, post prandial sugar levels, HbA1c and S.Ferritin were significantly higher in the diabetic subjects. This study shows a positive correlation between HbA1c and S. Ferritin levels. So we can conclude that in diabetic patients S. Ferritin may serve as an independent marker of poor glycemic and metabolic control. Keywords: Serum ferritin, Type 2 Diabetes Mellitus, HbA1c.

Sign in / Sign up

Export Citation Format

Share Document