scholarly journals High Bodyweight Variability Increases Depression Risk in Patients With Type 2 Diabetes Mellitus: A Nationwide Cohort Study in Korea

2021 ◽  
Vol 12 ◽  
Author(s):  
Ji Hyun An ◽  
Kyung-do Han ◽  
Jin-Hyung Jung ◽  
Juhwan Yoo ◽  
Maurizio Fava ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Obese Patients ◽  
Type 2 Dm ◽  
Increased Risk ◽  
Quartile Group ◽  
New Onset

Objectives: Although obesity is associated with increased risk for depression in patients with type 2 diabetes mellitus (DM), the relationship between body weight variability (BWV) and depression remains poorly studied. This study was to investigate the incidence of depression in patients with type 2 DM according to their BWV.Methods: Intraindividual variation in body weight were measured in the nationwide, population-based retrospective cohort of 540,293 patients with type 2 DM from the Korean national health insurance system between 2009 and 2010. The diagnoses of new-onset depression occurring until the end of 2017 were ascertained. Risk of new-onset depression was examined using multivariate-adjusted Cox proportional hazards regression analysis by BWV quartile.Results: 93,149 (17.2%) patients developed new-onset depression for the follow up. BWV was significantly associated with an increased risk of depression after adjusting for confounding factors. The highest BWV quartile group had a hazard ratio (HR) of 1.17 (95% CI 1.15–1.19) compared to the lowest BWV quartile group as a reference. Obese patients in the highest BWV quartile group showed 12% increased risk of depression (HR 1.12, 95% CI 1.09–1.15) while non-obese patients in the highest BWV quartile group showed 20% increased risk of depression (HR: 1.20, 95% CI: 1.17–1.23) compared to their respective lowest BWV quartile groups.Conclusion: A higher BWV was significantly associated with an increased risk of depression in patients with type 2 DM. Thus, BWV may serve as an indicator for early detection of depression in type 2 DM patients.

Euglycemic Diabetic Ketoacidosis Associated With Sodium–Glucose Cotransporter Type 2 Inhibitors in Patients With Type 2 Diabetes Mellitus Receiving Oral Therapy

2017 ◽  
Vol 32 (2) ◽  
pp. 240-243 ◽  
Author(s):  
Ryan B. Dull ◽  
Mikayla L. Spangler ◽  
Emily L. Knezevich ◽  
Britney M. Lau
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Case Reports ◽  
Serious Adverse Events ◽  
Type 2 Dm ◽  
Sodium Glucose Cotransporter ◽  
Increased Risk

Introduction and Objective: Postmarketing reports and warnings of serious adverse events such as diabetic ketoacidosis (DKA) have raised concern regarding the safety of sodium–glucose cotransporter 2 inhibitors (SGLT2i). This report describes 2 cases of symptomatic SGLT2i-associated euglycemic DKA (euDKA) leading to hospitalization in patients with type 2 diabetes mellitus (DM) previously well controlled on oral medications. Case Reports: Subject 1 is a 55-year-old female admitted with euDKA precipitated by infection and managed with intravenous insulin. This case was notable for a delayed diagnosis of euDKA and lack of clinical improvement despite withholding dapagliflozin. Subject 2 is a 62-year-old male admitted with euDKA precipitated by infection. His clinical condition improved rapidly and euDKA responded to withdrawal of empagliflozin alone. Discussion: Applying the Naranjo adverse medication reaction probability scale to each case (subject 1 score = 3 points; subject 2 score = 4 points) suggests these are possible adverse reactions to SGLT2i. Data from randomized controlled trials suggest DKA events in adults with type 2 DM receiving SGLT2i are rare and similar to placebo. However, data from a large cohort suggest these events occur more frequently and are associated with a 2-fold increased risk of DKA. Conclusion: This class of medications may be associated with a higher real-world risk of DKA in adults with type 2 DM than previously reported. Patients prescribed these medications should receive vigilant assessment for features of traditional DKA as well as euDKA.

scholarly journals Cholesterol levels and development of cardiovascular disease in Koreans with type 2 diabetes mellitus and without pre-existing cardiovascular disease

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Mee Kyoung Kim ◽  
Kyungdo Han ◽  
Han Na Joung ◽  
Ki-Hyun Baek ◽  
Ki-Ho Song ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Cox Regression ◽  
Reference Group ◽  
Density Lipoprotein ◽  
Type 2 Dm ◽  
Increased Risk

Abstract Background The aim of the present study was to identify a threshold for the cholesterol level at which the risk of cardiovascular disease (CVD) begins to increase in people with type 2 diabetes mellitus (DM). Methods Using the Korean National Health Insurance Service database, 2,077,135 people aged ≥ 40 years with type 2 DM who underwent regular health checks between 2009 and 2012 were included. Subjects with previous CVD were excluded. Cox regression analyses were performed to estimate the risk of CVD for each low-density lipoprotein cholesterol (LDL-C) group using the < 70 mg/dL as the reference group. Results There were 78,560 cases of stroke (3.91%), and 50,791 myocardial infarction (MI, 2.53%) during a median follow-up of 7.1 years. Among participants not taking statins, LDL-C levels of 130–159 mg/dL and ≥ 160 mg/dL were significantly associated with the risk of MI: the hazard ratios (HRs) (95% confidence interval) were 1.19 (1.14–1.25) and 1.53 (1.46–1.62), respectively. Among participants taking statins, all categories of LDL-C level ≥ 70 mg/dL were significantly associated with increased risk of stroke and MI. Conclusions We identified an increased risk of CVD in people with an LDL-C level ≥ 130 mg/dL among individuals with type 2 DM not taking statins. The risk of CVD was significantly higher in those taking statins with an LDL-C level ≥ 70 mg/dL.

scholarly journals Role of CHA2DS2-VASc score in predicting new-onset atrial fibrillation in patients with type 2 diabetes mellitus with and without hyperosmolar hyperglycaemic state: real-world data from a nationwide cohort

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020065 ◽  
Author(s):  
Wei-Syun Hu ◽  
Cheng-Li Lin
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Predictive Ability ◽  
Type 2 Dm ◽  
History Of ◽  
New Onset

PurposeThe objective of the current study was to explore the role of CHA2DS2-VASc score in predicting incidence of atrial fibrillation (AF) in patients with type 2 diabetes mellitus (DM). Furthermore, the use of the CHA2DS2-VASc score for stratifying new-onset AF risk in patients with DM and with/without hyperosmolar hyperglycaemic state (HHS) was also compared.MethodsThe study subjects were identified from Longitudinal Health Insurance Database provided by the National Health Research Institutes. The patients with DM were divided into two groups based on a history of HHS or not. The predictive ability of CHA2DS2-VASc score for stratifying new-onset AF risk in the two groups was calculated using the area under the curve of receiver-operating characteristic (AUROC).ResultsThe present study involved a total of 69 530 patients with type 2 DM. Among them, 1558 patients had a history of HHS, whereas 67 972 patients did not. The AUROC of the CHA2DS2-VASc score as a predictor of incident AF in patients with DM and with/without HHS was 0.67 (95% CI 0.59 to 0.75) and 0.71 (95% CI 0.70 to 0.72), respectively.ConclusionsTo conclude, we reported for the first time on the assessment of CHA2DS2-VASc score for incident AF risk discrimination in patients with type 2 DM. We further found that the predictive ability of the CHA2DS2-VASc score was attenuated in patients with type 2 DM and with HHS in comparison with those without HHS.

scholarly journals Dipstick proteinuria and risk of type 2 diabetes mellitus: a nationwide population-based cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jimin Jeon ◽  
Jinkwon Kim
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Significant Risk ◽  
Health Screening ◽  
Increased Risk ◽  
New Onset

Abstract Background Proteinuria has been recognized as a marker of systemic inflammation and endothelial dysfunction associated with insulin resistance and β-cell impairment, which can contribute to the development of type 2 diabetes mellitus (T2DM). However, it is unknown whether the dipstick proteinuria test has a predictive value for new-onset T2DM. Methods This retrospective cohort study analyzed 239,287 non-diabetic participants who participated in the Korean nationwide health screening program in 2009–2010. Proteinuria was determined by the urine dipstick test at the baseline health screening. We performed multivariate Cox proportional regression analyses for the development of new-onset T2DM. Follow-up was performed until December 2015. Results During the mean follow-up period of 5.73 years, 22,215 participants were diagnosed with new-onset T2DM. The presence of proteinuria was significantly associated with an increased risk of T2DM (adjusted hazard ratio: 1.19, 95% confidence interval: 1.10, 1.29). There was a positive dose–response relationship between the degree of dipstick proteinuria and T2DM risk. This significant association between proteinuria and T2DM risk was consistent regardless of the fasting glucose level at baseline. Conclusions Dipstick proteinuria is a significant risk factor for new-onset T2DM. Therefore, proteinuria might be a useful biomarker to identify those at a high risk for developing T2DM.

scholarly journals SGLT-2 Inhibitors - A Systematic Review of their Extra-Glycaemic Benefits and Safety Profile

2021 ◽  
Vol 8 (22) ◽  
pp. 1868-1874
Author(s):  
Pushkar Mani ◽  
Anusha Vohra ◽  
Shipra Jain
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Urinary Tract Infection ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Uric Acid ◽  
Adverse Effects ◽  
Increased Risk

BACKGROUND Type 2 Diabetes mellitus is a major cause of mortality due to its complications such as cardiovascular disease (CVD), stroke and end stage renal disease (ESRD). Sodium Glucose Co-Transporter-2 inhibitors is a new class of oral hypoglycaemics which impart additional benefits primarily on heart and kidney. The most commonly used drugs in this class include Canagliflozin, Dapagliflozin and Empagliflozin. However, these drugs are associated with certain adverse effects. This review aims to appraise the extra-glycaemic benefits and adverse effect profile of SGLT-2 inhibitors so as to minimize the morbidity and mortality associated with type 2 diabetes mellitus. METHODS Thorough literature search was made using search engines like PubMed, Cochrane library, Medline and Google scholar to retrieve articles pertaining to extra glycaemic benefits and adverse effects of SGLT2i. RESULTS Majority of studies like CANVAS, EMPA-REG and DECLARE-TIMI done on Canagliflozin, Empagliflozin and Dapagliflozin respectively have concluded that these drugs possess additional benefits like reduced risk of heart failure, positive effects on kidney functions, favourable effects on body weight, reduced levels of uric acid and reduction in blood pressure. However, these drugs are associated with certain adverse effects like increased risk of genital and urinary tract infection. CONCLUSIONS The extra-glycaemic benefits of SGLT2i on heart, kidney and other parameters like body weight, uric acid and blood pressure have been proven by a number of studies conducted over several years. Nevertheless, these drugs are associated with certain adverse effects like increased risk of genital and urinary tract infection which can be mitigated by maintaining hydration, perineal hygiene and educating the patient. KEYWORDS Sodium Glucose Co-Transporter-2 Inhibitors, Type 2 Diabetes mellitus, Canagliflozin, Dapagliflozin, Empagliflozin, Extra Glycaemic Effects, Adverse effects

scholarly journals Plasma Atherogenic Index in Type 2 Diabetes Mellitus Patients

2020 ◽  
Vol 15 (2) ◽  
pp. 204-205
Author(s):  
Most. Sarmin Sultana ◽  
Yasmin Akhter ◽  
Mimi Parvin ◽  
Lubna Naznin ◽  
Md Mahbub Ul Alam ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Personal Data ◽  
Armed Forces ◽  
Atherogenic Index ◽  
Cross Sectional ◽  
Type 2 Dm ◽  
Increased Risk

Introduction:Atherogenic index of plasma (AIP) is defined as log of TG to HDL-C ratio. People with high AIP have a higher risk for coronary heart disease (CHD) than those with low AIP. AIP is useful in predicting atherogenecity. Objectives:  To determination of AIP among the study subjects and find out the prevalence of AIP among type 2 diabetes mellitus (DM) patients. Materials and Methods: This cross sectional study was conducted at Armed Forces Institute of Pathology (AFIP) from November 2014 to October 2015. The study included 300 type 2 DM patients belonging to the age group 30-60 years. Fasting plasma glucose (FPG), HDL-C, TG were estimated. The AIP was calculated as log (TG/HDL-C) using the Czech online calculatorof atherogenic risk. Personal data and history of co-existing medical conditions were collected by data collection sheet. Data were analyzed by SPSS version 18.0. Results: Among 300 study subjects the AIP were found in the range of “increased risk” in 298(99.3%) and “low risk” in 02(0.7%). In this study mean FPG was 9.81±3.08 mmol/L and mean AIP was 0.73 ± 0.23A and significant positive correlation between FPG and AIP (r = 0.123, p < 0.05) was observed. Conclusion: The study revealed that AIP is significantly higher in type 2 DM patients. So, patients with type 2 DM should be followed up with AIP regularly. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 204-205

Increased risk of type 2 diabetes in patients with thyroid cancer after thyroidectomy: A nationwide cohort study

2021 ◽  
Author(s):  
Eun Roh ◽  
Eunjin Noh ◽  
Soon Young Hwang ◽  
Jung A Kim ◽  
Eyun Song ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Thyroid Cancer ◽  
Cancer Patients ◽  
Reference Group ◽  
Increased Risk ◽  
Quartile Group

Abstract Context Abnormal thyroid function after thyroidectomy and subsequent thyroid-stimulating hormone suppression can have detrimental effects on glucose homeostasis in thyroid cancer patients. Objective To investigate whether thyroidectomy increases the risk of type 2 diabetes in thyroid cancer patients and to explore the association between levothyroxine dosage and type 2 diabetes risk. Design A retrospective population-based cohort study. Setting The Korean National Health Insurance database. Participants We included 36,377 thyroid cancer patients without known diabetes who underwent thyroidectomy between 2004 and 2013. Matched non-thyroid cancer subjects were selected using 1:1 propensity score matching. Main Outcome Measure Newly developed type 2 diabetes mellitus. Results Thyroid cancer patients who underwent thyroidectomy had a higher risk of developing type 2 diabetes mellitus than the matched controls (hazard ratio [HR]: 1.43, 95% confidence interval [CI]: 1.39–1.47). Among thyroid cancer patients, when the second quartile group (in terms of the mean levothyroxine dosage; 101–127 μg/day) was considered the reference group, the risk of type 2 diabetes mellitus increased in the first quartile (&lt;101 μg/day; HR: 1.45, 95% CI: 1.36–1.54) and fourth quartile groups (≥150 μg/day; HR: 1.37, 95% CI: 1.29–1.45); meanwhile, the risk decreased in the third quartile group (128–149 μg/day; HR: 0.91, 95% CI: 0.85–0.97). Conclusion Thyroid cancer patients who underwent thyroidectomy were more likely to develop type 2 diabetes mellitus than the matched controls. There was a U-shaped dose-dependent relationship between the levothyroxine dosage and type 2 diabetes mellitus risk.

scholarly journals Endocrine effects of duodenal–jejunal exclusion in obese patients with type 2 diabetes mellitus

2016 ◽  
Vol 231 (1) ◽  
pp. 11-22 ◽  
Author(s):  
Petra Kaválková ◽  
Miloš Mráz ◽  
Pavel Trachta ◽  
Jana Kloučková ◽  
Anna Cinkajzlová ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Blood Cell ◽  
Cell Count ◽  
Glucose Regulation ◽  
Obese Patients ◽  
Blood Cell Count

Duodenal–jejunal bypass liner (DJBL) is an endoscopically implantable device designed to noninvasively mimic the effects of gastrointestinal bypass operations by excluding the duodenum and proximal jejunum from the contact with ingested food. The aim of our study was to assess the influence of DJBL on anthropometric parameters, glucose regulation, metabolic and hormonal profile in obese patients with type 2 diabetes mellitus (T2DM) and to characterize both the magnitude and the possible mechanisms of its effect. Thirty obese patients with poorly controlled T2DM underwent the implantation of DJBL and were assessed before and 1, 6 and 10months after the implantation, and 3months after the removal of DJBL. The implantation decreased body weight, and improved lipid levels and glucose regulation along with reduced glycemic variability. Serum concentrations of fibroblast growth factor 19 (FGF19) and bile acids markedly increased together with a tendency to restoration of postprandial peak of GLP1. White blood cell count slightly increased and red blood cell count decreased throughout the DJBL implantation period along with decreased ferritin, iron and vitamin B12 concentrations. Blood count returned to baseline values 3months after DJBL removal. Decreased body weight and improved glucose control persisted with only slight deterioration 3months after DJBL removal while the effect on lipids was lost. We conclude that the implantation of DJBL induced a sustained reduction in body weight and improvement in regulation of lipid and glucose. The increase in FGF19 and bile acids levels could be at least partially responsible for these effects.

scholarly journals Correlation Between Onset of Diabetes Mellitus and Nitric Oxide Levels in Patient with Type 2 Diabetes Mellitus

2018 ◽  
Vol 4 (1) ◽  
pp. 8
Author(s):  
Theosobia Grace Orno ◽  
Mansyur Arif ◽  
Irfan Idris
Keyword(s):  
Nitric Oxide ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cross Sectional ◽  
Type 2 Dm ◽  
Increased Risk ◽  
Significant Difference ◽  
Onset Of Diabetes

Type 2 diabetes mellitus (DM) is associated with increased risk of endothelial dysfunction if it lasts a long time without control. This study aims to connect the Onset of Diabetes Mellitus (DM) with Nitric Oxide levels in patients of type 2 diabetes mellitus. The study used cross-sectional study method. The samples were 86 subjects, consisting of 38 subjects of Type 2 DM controlled and 48 subjects of Type 2 DM uncontrolled. The results of the Kruskal-Wallis statistical test showed no significant difference between the Onset of DM and Nitric Oxide levels in the categories of 4-6 years (19.4 ± 10.1), 7-9 years (17.3 ± 9.3) and 10-12 years (13.3 ± 8.5) (p=0.06). Furthermore, the Spearman correlation test revealed a negative correlation between the Onset of DM and Nitric Oxide level in patients with Type 2 DM with and without control (r =-0.217). The level of Nitric Oxide (NO) can consider as a predictor of long-term complication in patients with type 2 DM.

Clinic attendance and health outcomes of youth with type 2 diabetes mellitus

2015 ◽  
Vol 27 (3) ◽  
pp. 271-274 ◽  
Author(s):  
Elizabeth Rose Pulgarón ◽  
Jennifer Hernandez ◽  
Heather Dehaan ◽  
Anna Maria Patiño-Fernandez ◽  
Adriana Carrillo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Outcomes ◽  
Medical Care ◽  
Clinic Attendance ◽  
Type 2 Dm ◽  
Increased Risk ◽  
Hba1c Levels

Abstract This study assessed whether clinic attendance was related to health outcomes for youth with type 2 diabetes mellitus (type 2 DM). Medical records of pediatric patients with type 2 DM were retrospectively reviewed. Clinic attendance was much more infrequent than recommended by physicians, and 42% of the sample withdrew from medical care. Patients who had a history of not showing during appointments had higher HbA1c levels than those who attended regularly scheduled visits; however, contrary to our hypotheses, average number of clinic visits was not associated with HbA1c levels or zBMI. Given the increased risk for health complications, new strategies are needed to keep patients engaged with medical care.

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