scholarly journals The Risk Factors of Severe Hypoglycemia in Older Patients with Dementia and Type 2 Diabetes Mellitus

2022 ◽  
Vol 12 (1) ◽  
pp. 67
Author(s):  
Nai-Ching Chen ◽  
Chien-Liang Chen ◽  
Feng-Chih Shen

Background: The adequate glycemic control and risk factors for hypoglycemia in older patients with dementia and type 2 diabetes mellitus (T2DM) remain unclear. This study aimed to analyze the status of glycemic control and determine the risk of hypoglycemia among these groups. Methods: A hospital admission record due to hypoglycemia through an emergency room with glucose supplementation in the Chang Gung Memorial Hospital was identified as a hypoglycemic event. Patients with dementia and T2DM without hypoglycemic events throughout the study period were defined as the control group. We gathered patients aged ≥65 years with a diagnosis of Alzheimer’s dementia (AD) and T2DM between 2001 and 2018 in the Chang Gung Research Database (CGRD). We extracted data included medication use, diagnoses, and biochemistry data from hospital records. Results: A total of 3877 older patients with dementia and T2DM with regular visits to the outpatient department were enrolled in this study. During the two-year follow-up period, 494 participants (12.7%) experienced hypoglycemia. Multivariable logistic multivariable regression models for hypoglycemic events showed that metformin had a protective effect (odds ratio (OR) = 0.75, p = 0.023), insulin had the highest risk (OR = 4.64, p < 0.001). Hemoglobin A1c (HbA1c) levels were not correlated with hypoglycemic events (OR = 0.95, p = 0.140). Patients with hypoglycemic episodes had a significantly higher proportion of ≥2 Charlson Comorbidity Index scores than those without hypoglycemic episodes (83.2% versus 56.4%, p < 0.001). Conclusions: Drug regimen affects hypoglycemic episodes but not HbA1c in older patients with dementia and T2DM. In addition, patients with more comorbidities experience an increased risk of hypoglycemia.

2010 ◽  
Vol 7 (6) ◽  
pp. 593-599 ◽  
Author(s):  
Christian S. Göbl ◽  
Werner Brannath ◽  
Latife Bozkurt ◽  
Ammon Handisurya ◽  
Christian Anderwald ◽  
...  

2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Freda Lalrohlui ◽  
Souvik Ghatak ◽  
John Zohmingthanga ◽  
Vanlal Hruaii ◽  
Nachimuthu Senthil Kumar

AbstractOver the last few decades, Mizoram has shown an increase in cases of type 2 diabetes mellitus; however, no in-depth scientific records are available to understand the occurrence of the disease. In this study, 500 patients and 500 healthy controls were recruited to understand the possible influence of their dietary and lifestyle habits in relation with type 2 diabetes mellitus. A multivariate analysis using Cox regression was carried out to find the influence of dietary and lifestyle factors, and an unpaired t test was performed to find the difference in the levels of biochemical tests. Out of 500 diabetic patients, 261 (52.3%) were males and 239 (47.7%) were females, and among the control group, 238 (47.7%) were males and 262 (52.3%) were females. Fermented pork fat, Sa-um (odds ratio (OR) 18.98), was observed to be a potential risk factor along with tuibur (OR 0.1243) for both males and females. Creatinine level was found to be differentially regulated between the male and female diabetic patients. This is the first report of fermented pork fat and tobacco (in a water form) to be the risk factors for diabetes. The unique traditional foods like Sa-um and local lifestyle habits like tuibur of the Mizo population may trigger the risk for the prevalence of the disease, and this may serve as a model to study other populations with similar traditional practices.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Xiaowen Zhang ◽  
Jie Sun ◽  
Wenqing Han ◽  
Yaqiu Jiang ◽  
Shiqiao Peng ◽  
...  

Objective. Type 2 deiodinase (Dio2) is an enzyme responsible for the conversion of T4 to T3. The Thr92Ala polymorphism has been shown related to an increased risk for developing type 2 diabetes mellitus (T2DM). The aim of this study is to assess the association between this polymorphism and glycemic control in T2DM patients as marked by the HbA1C levels.Design and Methods.The terms “rs225014,” “thr92ala,” “T92A,” or “dio2 a/g” were used to search for eligible studies in the PubMed, Embase, and Cochrane databases and Google Scholar. A systematic review and meta-analysis of studies including both polymorphism testing and glycated hemoglobin (HbA1C) assays were performed.Results. Four studies were selected, totaling 2190 subjects. The pooled mean difference of the studies was 0.48% (95% CI, 0.18–0.77%), indicating that type 2 diabetics homozygous for the Dio2 Thr92Ala polymorphism had higher HbA1C levels.Conclusions. Homozygosity for the Dio2 Thr92Ala polymorphism is associated with higher HbA1C levels in T2DM patients. To confirm this conclusion, more studies of larger populations are needed.


Author(s):  
Alaa M. Hammad ◽  
Waleed Qirim ◽  
Ameen Alassi ◽  
Dana Hyassat

Background: Type 2 diabetes mellitus (T2DM) is a chronic condition with an impairing effect on multiple organs. Numerous respiratory disorders have been observed in patients with T2DM. However, T2DM e ect on pulmonary function is ff inconclusive. Aims: In this study, we investigated the effect of T2DM on respiratory function and the correlation of glycemic control, diabetes duration and insulin intake. Methods: 1500 patients were recruited for this study, 560 having T2DM for at least a year were included in the final data, in addition to 540 healthy volunteers. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory flow at 25-75% (FEF 25-75%), as well as FEV1/FVC ratio values were measured. Results: A two-sample t-test showed that z-scores produced by Al-Qerem et al.’s equations for FEV1, FVC, and FEF 25-75% were significantly lower for the T2DM group than the control group (p < 0.01). FEV1/FVC ratio in T2DM group were significantly higher (p < 0.01). Multiple linear regression analysis found that glycemic control represented by HbA1c as well as disease duration were negatively associated with pulmonary function (p < 0.01). However, insulin intake was found to have no significant correlation with the pulmonary function. Conclusion: T2DM was linked to reduced pulmonary function and was consistent with a restrictive ventilation pattern. HbA1c as well as disease duration were independent risk factors for reduced pulmonary function.


2018 ◽  
Vol 90 (10) ◽  
pp. 60-64
Author(s):  
S K Yarovoy ◽  
E N Kareva ◽  
O V Djalilov

Aim. To study the effects of oral hypoglycemic agents that can affect the probability of recurrence of nephrolithiasis. Materials and methods. The article is based on the results of examination and treatment of 315 patients suffering from recurrent nephrolithiasis and medically compensated type 2 diabetes mellitus treated at the N.A. Lopatkin Institute of Urology and Interventional Radiology - the branch of the SMRC of Radiology, Ministry of Health of Russia and D.D. Pletnev City Hospital Moscow Healthcare Department in 2012-2017. The patients were divided into three groups according to the applied tool antidiabetic: metformin, glibenclamide, canagliflozin. The control group consisted of patients receiving insulin therapy. Results and discussion. The propensity of Metformin to reduce the pH of urine, which has a negative impact in the conditions of urate nephrolithiasis, which is most common in the population of patients with type 2 diabetes mellitus. Glibenclamide, on the contrary, somewhat latches urine. But changes in the reaction of urine under the influence of the drug do not go beyond normal values and are not clinically significant. Canagliflozin increases diuresis due to medication induced glycosuria and stimulates renal excretion of uric acid and its salts. However canagliflozin does not cause significant shifts in the pH of urine that may somewhat negates the increased risk of recurrence of urate stone formation in the background of the uricosuric effect of the drug. Conclusion. Drug therapy of type 2 diabetes mellitus significantly affects the properties of urine from patients with nephrolithiasis.


2016 ◽  
Vol 19 (1) ◽  
pp. 63-70 ◽  
Author(s):  
D Popović ◽  
J Nikolajević Starčević ◽  
M Šantl Letonja ◽  
J Makuc ◽  
A Cokan Vujkovac ◽  
...  

ABSTRACTThe platelet endothelial cell adhesion molecule 1 (PECAM-1) plays an important role in many inflammatory processes, including the development of atherosclerosis. Polymorphism rs668 of the PECAM-1 gene (373C/G) is functional, and it was reported to be associated with increased serum levels of PECAM-1. We investigated the association between the rs668 polymorphism of PECAM-1 and subclinical markers of carotid atherosclerosis in subjects with type 2 diabetes mellitus (T2DM). Five hundred and ninety-five T2DM subjects and 200 control subjects were enrolled. The carotid intima-media thickness (CIMT) and plaque characteristics (presence and structure) were assessed ultrasonographically. Biochemical analyses were performed using standard biochemical methods. Geno-typing of the PECAM-1 gene polymorphism (rs668) was performed using KASPar assays. The control examinations were performed 3.8 ± 0.5 years after the initial examination. Higher CIMT was found in patients with T2DM in comparison with subjects without T2DM. Statistically sig-nificantly faster progression of the atherosclerotic markers was shown in subjects with T2DM in comparison with the control group. When adjusted to other risk factors, the rs668 GG genotype was associated with an increased risk of carotid plaques in subjects with T2DM. We concluded that our study demonstrated a minor effect of the rs668 PECAM-1 on markers of carotid atherosclerosis in subjects with T2DM.


2017 ◽  
Vol 11 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Muhammad Abdur Rahim ◽  
Palash Mitra ◽  
Hasna Fahmima Haque ◽  
Tasrina Shamnaz Samdani ◽  
Shahana Zaman ◽  
...  

Background and objectives: Diabetes mellitus is one of the most common causes of chronic kidney disease (CKD). The prevalence of CKD in type 2 diabetes mellitus (T2DM) in Bangladesh is not well described. The present study aimed to find out the prevalence of CKD stages 3-5 and its risk factors among selected Bangladeshi T2DM patients.Methods: This cross-sectional study was conducted in BIRDEM (Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital, Dhaka, Bangladesh from July to December 2015. Diagnosed adult T2DM patients were consecutively and purposively included in this study. Pregnant women, patients with diagnosed kidney disease due to non-diabetic etiology, acute kidney injury (AKI), AKI on CKD and patients on renal replacement therapy were excluded. Age, gender, body mass index (BMI) and laboratory parameters were recorded systematically in a predesigned data sheet. Diagnosis of CKD and its stages were determined according to Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guidelines 2012 and estimated glomerular filtration rate (eGFR). Estimated GFR was calculated by using Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault (CG) and Chronic Kidney Disease Epidemiology (CKDEPI) creatinine based formula.Results: A total of 400 patients with T2DM of various durations were enrolled in the study. Out of 400 patients, 254 (63.5%), 259 (64.75%) and 218 (54.5%) cases had CKD stages 3-5 according to MDRD, C-G and CKD-EPI equations respectively. CKD was significantly more common in females (p<0.001) and in cases with long duration of diabetes (?5 years; p=0.007). CKD stages 3-5 were significantly associated with hypertension (?2=5.2125, p =0.02) and good control of diabetes (HbA1c <7%) as evidenced by higher proportion of CKD in them (73.3%) compared to those with poor glycemic control (52.1%).Conclusions: More than half of T2DM patients had CKD stages 3-5. Female gender, duration of diabetes and hypertension were significant risk factors and should be emphasized for the prevention of CKD in T2DM. Glycemic control may not reduce CKD in diabetes.IMC J Med Sci 2017; 11(1): 19-24


2014 ◽  
Vol 18 (9) ◽  
pp. 1698-1705 ◽  
Author(s):  
Danielle H Bodicoat ◽  
Patrice Carter ◽  
Alexis Comber ◽  
Charlotte Edwardson ◽  
Laura J Gray ◽  
...  

AbstractObjectiveWe investigated whether a higher number of fast-food outlets in an individual’s home neighbourhood is associated with increased prevalence of type 2 diabetes mellitus and related risk factors, including obesity.DesignCross-sectional study.SettingThree UK-based diabetes screening studies (one general population, two high-risk populations) conducted between 2004 and 2011. The primary outcome was screen-detected type 2 diabetes. Secondary outcomes were risk factors for type 2 diabetes.SubjectsIn total 10 461 participants (mean age 59 years; 53 % male; 21 % non-White ethnicity).ResultsThere was a higher number of neighbourhood (500 m radius from home postcode) fast-food outlets among non-White ethnic groups (P<0·001) and in socially deprived areas (P<0·001). After adjustment (social deprivation, urban/rural, ethnicity, age, sex), more fast-food outlets was associated with significantly increased odds for diabetes (OR=1·02; 95 % CI 1·00, 1·04) and obesity (OR=1·02; 95 % CI 1·00, 1·03). This suggests that for every additional two outlets per neighbourhood, we would expect one additional diabetes case, assuming a causal relationship between the fast-food outlets and diabetes.ConclusionsThese results suggest that increased exposure to fast-food outlets is associated with increased risk of type 2 diabetes and obesity, which has implications for diabetes prevention at a public health level and for those granting planning permission to new fast-food outlets.


2021 ◽  
Vol 6 (2) ◽  
pp. 1444-1448
Author(s):  
Santosh Timalsina ◽  
Shishir Mahato ◽  
Sandesh Nepal

Introduction: Insulin resistance (IR) and glycemic control are two very important aspects to be considered during management of patients with Type 2 Diabetes Mellitus (T2DM). The triglyceride-glucose (TyG) index has been proposed as a simple and inexpensive parameter that correlates well with IR and glycemic control. Objectives: To explore the association of TyG index (and other TyG derived indices) with glycated hemoglobin (HbA1c) and evaluate their predictive ability for glycemic control in patients with T2DM. Methodology: This cross-sectional study comprised of 160 adult patients diagnosed with T2DM visiting the medical outpatient department of Chitwan Medical College, Bharatpur, Chitwan between July–December 2019. Socio-demographic data and anthropometric measurements were collected. Glycemic control was assessed by HbA1c. TyG index was calculated by the formula: ln [fasting TG (mg/dl) x fasting glucose (mg/dl)/2]. Receiver operating characteristic (ROC) curve analysis was performed to analyze the predictive ability of TyG-index for poor glycemic control. Results: One hundred and sixty patients (mean age: 53.6 ± 10.7 years, 55.0% males) were included in the study. Eighty (50.0%) had good glycemic control (HbA1c <7.0%). TyG index, along with TyG-BMI and TyG-WC (other TyG derived indices) were significantly increased in the poor glycemic control group. TyG index had a good predictive ability for poor glycemic control (AUC: 0.803, 95% CI: 0.731 – 0.874). A TyG cutoff ≥ 9.12 was optimal for predicting poor glycemic control, with 86.1% sensitivity and 61.5% specificity. Conclusion: TyG index could be a simple and cost-effective screening tool for assessment of glycemic control in patients with T2DM.


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