scholarly journals Novel Molecular Evidence Related to COVID-19 in Patients with Diabetes Mellitus

2020 ◽  
Vol 9 (12) ◽  
pp. 3962
Author(s):  
Yu-Huang Liao ◽  
Jing-Quan Zheng ◽  
Cai-Mei Zheng ◽  
Kuo-Cheng Lu ◽  
You-Chen Chao
Keyword(s):  
Diabetes Mellitus ◽  
Viral Entry ◽  
Cell Injury ◽  
Molecular Evidence ◽  
Protective Effects ◽  
Cytosolic Ph ◽  
S Protein ◽  
Patients With Diabetes ◽  
Type 1 Dm

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly evolved into a global pandemic. The hyperglycemia in patients with diabetes mellitus (DM) substantially compromises their innate immune system. SARS-CoV-2 uses human angiotensin-converting enzyme 2 (ACE2) receptors to enter the affected cell. Uncontrolled hyperglycemia-induced glycosylation of ACE2 and the S protein of SARS-CoV-2 could facilitate the binding of S protein to ACE2, enabling viral entry. Downregulation of ACE2 activity secondary to SARS-CoV-2 infection, with consequent accumulation of angiotensin II and metabolites, eventually leads to poor outcomes. The altered binding of ACE2 with SARS-CoV-2 and the compromised innate immunity of patients with DM increase their susceptibility to COVID-19; COVID-19 induces pancreatic β-cell injury and poor glycemic control, which further compromises the immune response and aggravates hyperglycemia and COVID-19 progression, forming a vicious cycle. Sequential cleavage of viral S protein by furin and transmembrane serine protease 2 (TMPRSS2) triggers viral entry to release the viral genome into the target cell. Hence, TMPRSS2 and furin are possible drug targets. As type 1 DM exhibits a Th1-driven autoimmune process, the relatively lower mortality of COVID-19 in type 1 DM compared to type 2 DM might be attributed to an imbalance between Th1 and Th2 immunity. The anti-inflammatory effects of dipeptidyl peptidase-4 inhibitor may benefit patients with DM and COVID-19. The potential protective effects of sodium–glucose cotransporter-2 inhibitor (SGLT2i), including reduction in lactate level, prevention of lowering of cytosolic pH and reduction in pro-inflammatory cytokine levels may justify the provision of SGLT2i to patients with DM and mild or asymptomatic COVID-19. For patients with DM and COVID-19 who require hospitalization, insulin-based treatment is recommended with cessation of metformin and SGLT2i. Further evidence from randomized or case–control clinical trials is necessary to elucidate the effectiveness and pitfalls of different types of medication for DM.

scholarly journals A literature review and meta-analysis of safety profiles of SGLT2 inhibitors in Japanese patients with diabetes mellitus

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Junichi Mukai ◽  
Shinya Kanno ◽  
Rie Kubota
Keyword(s):  
Diabetes Mellitus ◽  
Meta Analysis ◽  
Japanese Patients ◽  
Sglt2 Inhibitors ◽  
Patients With Diabetes ◽  
Language Restriction ◽  
Calculated Risk ◽  
Favorable Safety ◽  
Type 1 Dm

AbstractThe safety profiles of sodium-glucose co-transporter 2 (SGLT2) inhibitors may depend on races/ethnicities. We aimed to assess the safety profiles of SGLT2 inhibitors in Japanese patients with diabetes mellitus (DM). The electronic databases MEDLINE, CENTRAL, and Ichushi-web were searched for studies with no language restriction from their inception to August 2019. Trials were included in the analysis if they were randomized controlled trials (RCTs) comparing the effects of SGLT2 inhibitors with a placebo in Japanese patients with DM > 18 years and reporting HbA1c and at least 1 adverse event. We calculated risk ratios with 95% CIs and used a random-effects model. Of the 22 RCTs included in our review, only 1 included patients with type 1 DM. The durations of RCTs ranged between 4 and 24 weeks. In comparison with a placebo, SGLT2 inhibitors were associated with similar risks of hypoglycemia, urinary tract infection, genital infection, hypovolemia, and fracture. The outcomes of treatment with SGLT2 inhibitors among Japanese patients with DM suggest favorable safety profiles. However, further evidence from studies with a longer duration, involving more diverse populations, such as patients with different types of DM, or including individual SGLT2 inhibitors is needed to resolve the limitations of the present study.

scholarly journals Thyroid dysfunction in patients with diabetes mellitus at Puducherry, India: a retrospective study

2018 ◽  
Vol 5 (4) ◽  
pp. 822
Author(s):  
K. Shaik Anwar Hussain
Keyword(s):  
Diabetes Mellitus ◽  
Retrospective Study ◽  
Thyroid Dysfunction ◽  
Diabetic Patients ◽  
Type Ii ◽  
Patients With Diabetes ◽  
Study Participants ◽  
Type 1 Dm

Background: There is a complex interrelationship in the co-existence of thyroid dysfunction among diabetic patients and may be related to the development of cardiovascular diseases and other complications of long term metabolic derangements. The prevalence of thyroid dysfunction varies from 10 to 24% among diabetic patients. The objective of the present study was to determine the prevalence of thyroid dysfunction among the patients with diabetes mellitus in a tertiary care hospital at Puducherry, India.Methods: This retrospective study was conducted during June 2018 analysing the records of diabetes patients attending to the diabetes OPD, Department of General Medicine in the past one year and their association with thyroid dysfunction was studied.Results: Among the study participants (n=200), 14.5% (n=29) were Type I diabetics and 85.5% (n=171) were type II Diabetes patients. The prevalence of Thyroid Dysfunction (TD) among the study participants was 28.5% (n=57). The proportion of TD was higher among type 1 DM compared to type 2 (p<0.001).  The prevalence of subclinical hypothyroidism was more (n=7, 24.1%) among type 1DM compared to type II DM patients (p=0.05).Conclusions: There was a higher prevalence of TD among the diabetics. TD was more frequent among type 1 DM compared to Type 2 DM patients and the most frequent TD associated with diabetes was subclinical hypothyroidism.

scholarly journals Hepatocellular Glycogen Accumulation in the Setting of Poorly Controlled Type 1 Diabetes Mellitus: Case Report and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Atinuke Aluko ◽  
Ikponmwosa Enofe ◽  
Jacob Burch ◽  
Julie Yam ◽  
Nazia Khan
Keyword(s):  
Diabetes Mellitus ◽  
Rare Complication ◽  
Diagnostic Workup ◽  
Review Of Literature ◽  
Glycogen Accumulation ◽  
Control Regimen ◽  
Patients With Diabetes ◽  
History Of ◽  
Type 1 Dm

Glycogenic hepatopathy (GH) is the accumulation of glycogen in the hepatocytes and represents a rare complication in patients with diabetes mellitus (DM), most commonly type 1 DM. We present a case of a 23-year-old woman with a medical history of poorly controlled type 1 DM and gastroesophageal reflux disease (GERD) who presented with progressively worsening right-sided abdominal pain. Diagnostic workup resulted in a liver biopsy with hepatocytes that stained heavily for glycogen with no evidence of fibrosis or steatohepatitis. A diagnosis of glycogenic hepatopathy was made, and an aggressive glucose control regimen was implemented leading to resolution of symptoms and improvement in AST, ALT, and ALP. In addition to presenting this rare case, we offer a review of literature and draw important distinctions between glycogenic hepatopathy and other differential diagnoses with the aim of assisting providers in the diagnostic workup and treatment of glycogenic hepatopathy.

IMMUNOLOGICAL FEATURES OF THE DYNAMICS OF THE I DEGREE SEVERETY BACTERIAL KERATITES DEPENDING ON THE PRESENCE OF DIABETES MELLITUS

2021 ◽  
pp. 63-68
Author(s):  
O. V. Zavoloka ◽  
P. A. Bezditko ◽  
L. P. Abramova ◽  
V. O. Vekshyn
Keyword(s):  
Diabetes Mellitus ◽  
Enzyme Linked Immunosorbent Assay ◽  
Observation Data ◽  
Bacterial Keratitis ◽  
Lacrimal Fluid ◽  
Patients With Diabetes ◽  
Contralateral Eye ◽  
Instructions For Use ◽  
Type 1 Dm

Summary. In patients with diabetes mellitus (DM) there are features of the dynamics of the I degree severity bacterial keratitis, leading to prolongation of the disease and worsening of its consequences. The aim was to identify immunological features of the dynamics of the I degree severity bacterial keratitis depending on the presence of type 1 DM. Materials and methods. The level of interleukins (IL) was analyzed, namely IL-1β, IL-6 and IL-10 in the lacrimal fluid of the sick and the contralateral eye of 6 patients with type 1 DM and the I degree severity bacterial keratitis and 6 nondiabetic patients with I degree severity bacterial keratitis on the 1st day, 10-14th day and 24th day of observation. Data from 14 healthy individuals of the appropriate age were used for comparison. The severity of bacterial keratitis was determined according to our scheme at a total score of ≤ 14. All patients were treated with instillations of ofloxacin, antiseptics, antioxidants, reparents, artificial tears, mydriatics, systemic anti-inflammatory therapy. The level of IL in the lacrimal fluid was determined by quantitative colorimetric enzyme-linked immunosorbent assay using ELISA kits by ANOGEN according to the instructions for use. Results and discussion. In patients with I degree severity bacterial keratitis, both DM and nondiabetic, on the 1st day of observation there was an increase in the level of IL-1β and IL-6 in the lacrimal fluid of the sick eye and IL-10 – of the contralateral eye compared to healthy persons, on the 10th-14th day — increase in the level of IL-1β and IL-6 of the sick and the contralateral eye, as well as IL-10 – of the contralateral eye (p<0.05). On the 24th day in nondiabetic patients with I degree severity bacterial keratitis normalization of interleukin levels in the lacrimal fluid of the sick and the contralateral eye was found, but in DM patients remained elevated levels of IL-1β, IL-6, both in the sick and in the contralateral eye (p<0.05). Conclusions. In DM patients there are immunological features of the dynamics of the I degree severity bacterial keratitis, namely a longer increase in the level of proinflammatory cytokines IL-1β, IL-6 in the lacrimal fluid of the sick and the contralateral eye.

Model estimates of the results of diabetes patients using modern glucometers with tri-color technology for displaying test results

2019 ◽  
pp. 81-89
Author(s):  
Larisa Dmitrievna Popovich ◽  
Svetlana Valentinovna Svetlichnaya ◽  
Aleksandr Alekseevich Moiseev
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Economic Benefits ◽  
Test Results ◽  
Self Monitoring ◽  
Patients With Diabetes ◽  
The Impact

Diabetes – a disease in which the effect of the treatment substantially depends on the patient. Known a study showed that the use of glucometers with the technology of three-color display of test results facilitates self-monitoring of blood sugar and leads to a decrease in glycated hemoglobin (HbAlc). Purpose of the study: to modeling the impact of using of a glucometer with a color-coded display on the clinical outcomes of diabetes mellitus and calculating, the potential economic benefits of reducing the hospitalization rate of patients with diabetes. Material and methods. Based on data from two studies (O. Schnell et al. and M. Baxter et al.) simulation of the reduction in the number of complications with the use of a glucometer with a color indication. In a study by O. Schnell et al. a decrease of HbA1c by 0.69 percent is shown when using the considered type of glucometers, which was the basis of the model. Results. In the model, the use of a glucometer with a color-coded display for type 1 diabetes led to a decrease in the total number of complications by 9.2 thousand over 5 years per a cohort of 40 thousand patients with different initial levels of HbA1c. In a cohort of 40 thousand patients with type 2 diabetes, the simulated number of prevented complications was 1.7 thousand over 5 years. When extrapolating these data to all patients with diabetes included in the federal register of diabetes mellitus (FRD), the number of prevented complications was 55.4 thousand cases for type 1 diabetes and 67.1 thousand cases for type 2 diabetes. The possible economic effect from the use of the device by all patients with a diagnosis of diabetes, which are included in the FRD, estimated at 1.5 billion rubles for a cohort of patients with type 1 diabetes and 5.3 billion rubles for patients with type 2 diabetes. Conclusion. Improving the effectiveness of self-monitoring, which is the result of the use of glucometers with color indicators, can potentially significantly reduce the incidence of complications in diabetes and thereby provide significant economic benefits to society.

Simultaneous Juvenile Idiopathic Arthritis and Diabetes Mellitus Type 1 — A Finnish Nationwide Study

2011 ◽  
Vol 39 (2) ◽  
pp. 377-381 ◽  
Author(s):  
HEINI POHJANKOSKI ◽  
HANNU KAUTIAINEN ◽  
MATTI KORPPI ◽  
ANNELI SAVOLAINEN
Keyword(s):  
Diabetes Mellitus ◽  
Juvenile Idiopathic Arthritis ◽  
Autoimmune Disease ◽  
Diabetes Mellitus Type 1 ◽  
Diabetes Mellitus Type ◽  
Laboratory Findings ◽  
Type 1 Dm ◽  
Psychiatric Problems ◽  
Rheumatoid Factor Seropositivity

Objective.To describe the occurrence and main clinical and laboratory findings of patients having both juvenile idiopathic arthritis (JIA) and diabetes mellitus type 1 (DM-1) in a period of 30 years.Methods.Eighty-two patients having simultaneous JIA and DM-1 were identified in the reimbursement registers of the Finnish National Institute of Insurance during the period 1976–2005. Data on their clinical histories were collected from patient files.Results.Occurrence of simultaneous JIA and DM-1 increased 4.5-fold between the first (1976-85) and the last (1996–2005) decade. Prevalence of uveitis was 7%, of rheumatoid factor seropositivity 15%; 22% of patients had a third autoimmune disease [autoimmune disease (AID)], and 16% had serious psychiatric problems.Conclusion.The occurrence of patients with the 2 diseases, JIA and DM-1, increased over 3 decades. The prevalence of uveitis was low, the number of seropositive patients was high, and further cases of AID were frequent. Patients had multiple additional problems necessitating multiprofessional care.

Autoimmune thyroid disease in patients with anti-GAD positive type 1 diabetes mellitus

Open Medicine ◽  
2009 ◽  
Vol 4 (4) ◽  
pp. 415-422
Author(s):  
Kamile Gul ◽  
Ihsan Ustun ◽  
Yusuf Aydin ◽  
Dilek Berker ◽  
Halil Erol ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Statistical Significance ◽  
Control Group ◽  
Acid Decarboxylase ◽  
Thyroid Peroxidase ◽  
The Difference ◽  
Type 1 Dm

AbstractThe aim of the study was to determine the frequency and titers of anti-thyroid peroxidase (Anti-TPO), anti-thyroglobulin (Anti-TG), and anti-glutamic acid decarboxylase (Anti-GAD) antibodies in Turkish patients with type 1 diabetes mellitus (DM), and to compare the frequency of anti-TPO and anti-TG titers in the presence or absence of anti-GAD. A total of 104 patients including 56 males and 48 females with type 1 DM and their age-, gender-, and body mass index-matched control group, including 31 males and 27 females, 58 cases in total with an age range of 15-50 years, were recruited into this study. In patients with type 1 DM, positive anti-GAD was detected in 30.8% (n=32). In patients with positive anti-GAD, rate of positive anti-TPO was 37.5%; however, in patients with negative anti-GAD, the rate of positive anti-TPO was 9.7% and the difference was statistically significant (p=0.001). In patients with positive anti-GAD, the rate of positive anti-TG was 18.8%. In patients with negative anti-GAD, the rate of positive anti-TG was 2.8%, and the difference between them was statistically significant (p=0.005). In patients with positive and negative anti-GAD, rates of both positive anti-TPO and anti-TG were 15.6% and 1.4%, respectively, with the difference showing statistical significance (p=0.004). Thyroid autoimmunity in type 1 DM patients with positive anti-GAD was apparently higher; therefore, these patients should be followed more frequently and carefully.

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