scholarly journals Evaluation of Risk Factors for Dementia Incidence Based on Previous Questionnaire Results of Specific Health Checkups in Japan

2021 ◽  
Vol 1 (1) ◽  
pp. 48-59
Author(s):  
Yoh Tamaki ◽  
Yoshimune Hiratsuka ◽  
Toshiro Kumakawa
Keyword(s):  
Risk Factors ◽  
Lower Risk ◽  
Health Concern ◽  
Hypoglycemic Agents ◽  
Health Examination ◽  
Oral Hypoglycemic Agents ◽  
Lifestyle Modifications ◽  
Term Care ◽  
Treatment And Prevention ◽  
Specific Health

The prevalence of dementia is rapidly increasing worldwide, and its treatment and prevention are a health concern. The prevention of dementia requires the identification of risk factors through longitudinal studies of lifestyle. In this study, we aimed to identify the risk factors for the development of dementia in Japan and to clarify their primary care strategies. We analyzed the relationship between the cognitive ability level determined by the survey of long-term care certification and the past questionnaire results of a specific health examination in Japan 10 years ago. To analyze the risk factors for developing dementia, multivariate analysis was used, which showed that residents who gained more than 10 kg since reaching 20 years of age had a significantly lower risk of developing dementia. Regarding the “start of lifestyle modifications” question, those who answered “already started” had a significantly lower risk than those who answered “no plan to improve”. Conversely, residents receiving insulin injections or oral hypoglycemic agents were at a significantly higher risk of developing dementia based on the results of the questionnaire of the health checkups surveyed 10 years prior.

Type 2 diabetes mellitus in children and adolescents in the world and in Ukraine

2021 ◽  
pp. 4-16
Author(s):  
N. B. Zelinska ◽  
K. V. Grishchenko ◽  
E. V. Globa
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
The State ◽  
Hypoglycemic Agents ◽  
Oral Hypoglycemic Agents ◽  
Lifestyle Modifications ◽  
Metformin Monotherapy ◽  
The World ◽  
Diet And Lifestyle

Introduction. Recently, many studies have been devoted to the study of type 2 diabetes mellitus (DM2) worldwide. In most countries of the world, the increase in the prevalence of DM2 among children and adolescents is accompanied by an increase in childhood obesity. The presence of obesity or overweight in children can complicate the diagnosis of various types of DM. Detection and treatment of DM2 is extremely important for the society due to the wide range of severe diabetes complications.The aim of this work was to analyze the frequency of DM2 according to the Register of patients with DM, and to determine the state of glycemic control in children with DM2. Materials and methods. An analysis of glycemic control in children with DM2 who received various treatment regimens: with diet and lifestyle modifications, or with additional oral hypoglycemic agents (metformin monotherapy, or combination with insulin therapy). The glycemic control was assessed by measurement of glycated hemoglobin (HbA1c) level. Results. According to the data Register in Ukraine, the prevalence of DM among children has a tendency to rise — from 8.6 per 10 thousand children in 2005, to 13.14 — in 2019 year. The prevalence of DM2 in 2019 was 0.47 % of all cases of DM, and its prevalence contained 0.062 per 10 thousand children under 19 years of age with significant differences in the frequency of its diagnosis in different regions of Ukraine. We analyzed the state of glycemic control in children with DM2 aged from 9 up to 19 years old (Me 16.2 [15.5; 18.0]), with a  disease duration 0.5—12 years (Me 4.5 [1.0] ; 7.5]). The age of diagnosis of DM2 was 2-17 years old (Me 11.7 [8.5; 15.0]), and 91.3 % of patients had obesity. Diet and lifestyle modifications were used in 34.8 % of patients, metformin monotherapy in 52.2 %, and metformin and insulin combination therapy in 13 % of patients. HbA1c values ​​ranged from 5.0 to 11.4 % (Me 7.2 % [5,8; 8,0]). The proportion of children who had ideal or optimal glycemic control (HbA1c 7.0—7.5 %) was 52.2 %, suboptimal (HbA1c 7.6—9.0 %) — 39.1 %, high-risk glycemic control (HbA1c> 9.1 %) — 8.7 % of children. The most unsatisfactory HbA1c levels ​​were registered in children who received metformin in combination with insulin (Me 10.6 % [10,15; 11,4]). Chronic complications of DM2 have not been reported.Conclusions. We found a low prevalence of DM2 among the pediatric population in Ukraine, more likely due to the low quality of its detection among children diagnosed with DM, as well as among children among high risk groups. Most children with DM 2 were obese. The majority of patients with DM2 (52.2 %) received metformin monotherapy, more than a third did not receive oral hypoglycemic agents. In most children with DM2 (52,2 %), the state of glycemic control corresponded to the optimal (< 7.5 %), but higher levels of HbA1c were found children who received metformin in combination with insulin.

scholarly journals Prevalence of overweight, obesity and its associated risk factors among school children aged 6-16 years of Biratnagar

2016 ◽  
Vol 5 (2) ◽  
pp. 22-25 ◽  
Author(s):  
Vijay Kumar Sah ◽  
Arun Giri ◽  
Rupak Acharya
Keyword(s):  
Risk Factors ◽  
Private Schools ◽  
Family Income ◽  
Cross Sectional Study ◽  
World Health ◽  
Physical Work ◽  
Lifestyle Modifications ◽  
Cross Sectional ◽  
Global Epidemic ◽  
Treatment And Prevention

Background The World Health Organization (WHO) defines obesity as a ‘global epidemic. Overweight and obese children are at higher risk for developing long-term chronic diseases like hypertension. With globalization bringing more lifestyle modifications, adolescents are exposed to multiple risk factors including obesity, diet, academic stress, lack of physical work apart from hereditary risk factors. Early diagnosis of obesity and hypertension is an important strategy in its control, effective treatment and prevention of complications. The aim of the study is to assess the prevalence of and the factors associated with childhood overweight/obesity among school childrenMaterial and Methods It is a school based cross sectional study done in schools of Biratnagar. School going children aged 6 to 16 years from 10 different schools of Biratnagar were taken as study population. Five were private schools and five were government schools. All the school going children aged 6 to 16 years were included in the study. Children with any chronic illness were excluded from the study.Results A total of 1900 students were included between age group of 6 to 16 years. The prevalence of overweight, obesity and hypertension were 2.9%, 1.8% and 6.1%.Conclusion Overweight, obesity was significantly associated with hypertension. Students studying in private schools and family income > Rs.10,000 were strongly associated with overweight, obesity and hypertension. Family history of hypertension was also associated with overweight/obesity.Journal of Nobel Medical College Vol.5(2) 2016; 22-25

La gestione della terapia ipoglicemizzante nel paziente con nefropatia da diabete mellito tipo 2

2019 ◽  
Vol 31 (3) ◽  
pp. 155-159
Author(s):  
Francesco Manetti
Keyword(s):  
Risk Factors ◽  
Impaired Renal Function ◽  
Renal Damage ◽  
Drug Dosage ◽  
Risk Profile ◽  
Hypoglycemic Agents ◽  
Cardiovascular Risk Profile ◽  
Oral Hypoglycemic Agents ◽  
Diabete Mellito ◽  
Associated Risk Factors

Chronic kidney disease (CKD) is constantly increasing in terms of prevalence and incidence. Subjects with impaired renal function, even if only in the presence of micro/macroalbuminuria, have an increased cardiovascular risk profile. Therefore, we must pay particular attention to the treatment of all associated risk factors. Therapy with oral hypoglycemic agents often requires modulation of drug dosage based on kidney function. Today, there are molecules available that are able not only to induce cardiovascular protection, but also to slow the progression of renal damage.

scholarly journals Potent Oral Hypoglycemic Agents for Microvascular Complication: Sodium-Glucose Cotransporter 2 Inhibitors for Diabetic Retinopathy

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Eun Hyung Cho ◽  
Se-Jun Park ◽  
Seongwook Han ◽  
Ji Hun Song ◽  
Kihwang Lee ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Medical Records ◽  
Lower Risk ◽  
Hypoglycemic Agents ◽  
Diabetic Patients ◽  
Oral Hypoglycemic Agents ◽  
Type 2 Diabetic Patients ◽  
Sodium Glucose Cotransporter ◽  
Type 2 Diabetic

The purpose of this study was to investigate the effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on the progression of diabetic retinopathy (DR) in patients with type 2 diabetes. The medical records of 21 type 2 diabetic patients who used a SGLT2i and 71 patients with sulfonylurea (control) were reviewed retrospectively. The severity of DR was assessed using the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. Fewer patients who used a SGLT2i than control patients with sulfonylurea showed progression of DR based on ETDRS scale (44% versus 14%, P=0.014). Moreover, treatment with a SGLT2i was associated with a significantly lower risk of DR progression (P=0.021), and this effect remained significant after adjusting for the age, duration of diabetes, initial DR grade, and HbA1c level by propensity score matching (P=0.013). Treatment of type 2 diabetic patients with a SGLT2i slowed the progression of DR compared to sulfonylurea, which is independent of its effect on glycemic control. This study provides a foundation for further evaluation of the effect of SGLT2i on the progression of DR.

scholarly journals Risk Factors for Dementia Incidence Based on Previous Results of the Specific Health Checkups in Japan

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 491
Author(s):  
Yoh Tamaki ◽  
Yoshimune Hiratsuka ◽  
Toshiro Kumakawa
Keyword(s):  
Risk Factors ◽  
Abdominal Circumference ◽  
Multivariable Logistic Regression Analysis ◽  
Common Disease ◽  
Term Care ◽  
Dementia Incidence ◽  
Oral Hypoglycemic Medications ◽  
Larger Sample ◽  
Specific Health

Dementia is a common disease in elderly people, with its prevalence expanding rapidly worldwide. Longitudinal and cohort studies on lifestyle and health conditions are needed to identify the risk of dementia. This study aimed to identify the risk factors for dementia incidence in Japan and to clarify the strategy for its primary care. In this study, an analysis was performed to investigate the association between the cognitive faculty level of the long-term care certification survey and the previous results of the specific health checkups in Japan. To investigate the risk factor for dementia incidence, a multivariable logistic regression analysis was performed, which showed a significant odds ratio for the incidence of dementia for two items, including abdominal circumference and insulin injections or oral hypoglycemic medications. The findings of our study suggested that a lower abdominal circumference had a higher risk for dementia incidence, and individuals who received insulin injections or oral hypoglycemic medications had a higher risk for dementia incidence based on the results of the health checkups conducted 10 years previously. Further, longer duration study with a larger sample is needed to identify the items from the specific health checkups that are associated with the risk of dementia.

scholarly journals A Short Review on Anti-diabetics for Uncontrolled Type 2 Diabetes Mellitus

2019 ◽  
Vol 31 (2) ◽  
pp. 120-127 ◽  
Author(s):  
Hussain Ahmad ◽  
Md Abu Nayeem Chowdhury
Keyword(s):  
World Health ◽  
Metabolic Inhibitors ◽  
Hypoglycemic Agents ◽  
Treatment Modalities ◽  
Oral Hypoglycemic Agents ◽  
Lifestyle Modifications ◽  
Glucagon Receptor ◽  
Glucokinase Activators ◽  
Glucose Output

Introduction: This article reviews the treatments available for patients with T2DM, with an emphasis on agents introduced within the last decade. Materials and Methods: This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include type 2 diabetes mellitus, prevalence, current diagnosis, and current treatment. Only articles in English were included. Materials & Methods: Screening and diagnosis is still based on World Health Organization (WHO) and American Diabetes Association (ADA) criteria which include both clinical and laboratory parameters. No cure has yet been found for the disease; however, treatment modalities include lifestyle modifications, treatment of obesity, oral hypoglycemic agents, and insulin sensitizers is still the recommended first line medication. Other effective medications include non-sulfonylurea secretagogues, thiazolidinediones, alpha glucosidase inhibitors, and insulin. Recent research into the pathophysiology of type 2 DM has led to the introduction of new medications like glucagon-like peptide 1 analogoues: dipeptidyl peptidase-IV inhibitors, inhibitors of the sodium-glucose cotransporter 2 and 11ß-hydroxysteroid dehydrogenase 1, insulin-releasing glucokinase activators and pancreatic-G-protein-coupled fatty-acid-receptor agonists, glucagon-receptor antagonists, metabolic inhibitors of hepatic glucose output and quick-release bromocriptine. Discussion: Screening and diagnosis is still based on World Health Organization (WHO) and American Diabetes Association (ADA) criteria which include both clinical and laboratory parameters. No cure has yet been found for the disease; however, treatment modalities include lifestyle modifications, treatment of obesity, oral hypoglycemic agents, and insulin sensitizers is still the recommended first line medication. Other effective medications include non-sulfonylurea secretagogues, thiazolidinediones, alpha glucosidase inhibitors, and insulin. Recent research into the pathophysiology of type 2 DM has led to the introduction of new medications like glucagon-like peptide 1 analogoues: dipeptidyl peptidase-IV inhibitors, inhibitors of the sodium-glucose cotransporter 2 and 11ß-hydroxysteroid dehydrogenase 1, insulin-releasing glucokinase activators and pancreatic-G-protein-coupled fatty-acid-receptor agonists, glucagon-receptor antagonists, metabolic inhibitors of hepatic glucose output and quick-release bromocriptine. Conclusion: Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. Medicine Today 2019 Vol.31(2): 120-127

Real-World Clinical Effectiveness and Tolerability of Hydroxychloroquine 400 Mg in Uncontrolled Type 2 Diabetes Subjects who are not Willing to Initiate Insulin Therapy (HYQ-Real-World Study)

2019 ◽  
Vol 15 (6) ◽  
pp. 510-519 ◽  
Author(s):  
Amit Gupta
Keyword(s):  
Body Weight ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Real World ◽  
Antidiabetic Drugs ◽  
Hypoglycemic Agents ◽  
Oral Hypoglycemic Agents ◽  
Good Glycemic Control ◽  
Hs Crp ◽  
Change In Mean

Objective: The epidemic of T2DM is rising across the globe. Systemic inflammation plays a pivotal role in the pathogenesis and complications of T2DM. Combination of two or more oral hypoglycemic agents (OHA) is widely prescribed in patients with T2DM, however many patients have poor glycemic control despite receiving combination therapy. The new antidiabetic drugs are relatively costly or many patients have anxiety over the use of injectable insulin. The objective of this observational study was to investigate the effectiveness and tolerability of hydroxychloroquine (HCQ) in T2DM patients uncontrolled on multiple OHA and despite high sugar level not willing to initiate insulin therapy in a real-world clinical setting. Methods: A prospective, investigator-initiated, observational, single-centred study was conducted where 250 patients (18-65 years) with T2DM for more than 5 years, with uncontrolled glycemia despite on a combination of multiple OHA, HbA1c between ≥7% and <10.5%, FPG >130 mg/dL or PPG >180 mg/dL and BMI between >25 and <39 kg/m2, were prescribed hydroxychloroquine sulphate 400 mg once daily for 48 weeks. Percentage of drugs used at the baseline were as follows: metformin 2000 mg (100%), glimepiride 4 mg (100%), pioglitazone 30 mg (100%), sitagliptin 100 mg (100%), canagliflozin 300 mg (52.4%), empagliflozin 25 mg (22.8%), dapagliflozin 10 mg (17.6%) and voglibose 0.3 mg (62%). Mean change in HbA1c, blood glucose and hs-CRP at baseline, week 12, 24 and 48 were assessed using the paired t-test. Results: After 48 weeks of add-on treatment with HCQ, almost all SGLT-2 inhibitors were withdrawn; metformin dose was reduced to 1000 mg, glimepiride reduced to 1 mg and sitagliptin reduced to 50 mg OD. Patients continued to have good glycemic control. HbA1c was reduced from 8.83% to 6.44%. Reduction in FPG was 40.78% (baseline 177.30 mg/dL) and PPG was reduced by 58.95% (baseline 329.86 mg/dL). Change in mean body weight was -4.66 Kg. The reduction in glycemic parameters and mean body weight was significant (p < 0.0001). Hs-CRP was significantly reduced from 2.70±1.98 mg/L to 0.71±0.30 mg/L 9 (p < 0.0001). More reduction in glycemic parameters and body weight was observed among the patients with higher hs-CRP (> 3 mg/L) as compared to patients with baseline hs- CRP ≤ 3 mg/L. Most common adverse events reported with the drug therapy were GI irritation (3.6%) and hypoglycemia (2%). None of the patients required medical assistance for hypoglycemia. Conclusion: Add-on treatment of HCQ effectively improved glycemic control in T2DM patients uncontrolled on multiple antidiabetic drugs. By virtue of its antidiabetic and anti-inflammatory properties, it may emerge as a valuable therapeutic intervention for the patients with T2DM.

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