Functional electrical stimulation in the treatment of patients with type 2 diabetes mellitus complicated by diabetic angiopathy and polyneuropathy

2021 ◽  
pp. 16-26
Author(s):  
Denis Valerievich Frolov
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Lower Extremities ◽  
Whitney Test ◽  
Mann Whitney Test ◽  
Group 1

Diabetic distal polyneuropathy (DPN) is the main cause of disability in patients with type 2 diabetes mellitus (DM2). The purpose of the research with 72 patients was to study the effect of functional electrical stimulation (FES) on reducing the degree of functional motor disorders in patients with DM2, angiopathy and DPN. Method. The patients were divided into 3 randomized groups (2 main groups, 1 control group). In addition to basic therapy, the patients of the main groups were treated with FES of the lower extremities with a frequency of 10–30 Hz in group 1 and 80–100 Hz in group 2. Results: the dynamics of quantitative assessment of the overall score on the NSS scale after treatment was significantly higher in the main groups compared to group 3 (Mann-Whitney test p 1–3 = 0,001, p 2–3 = 0,006). There was no significant difference in the overall score of the NSS between groups 1 and 2. The most pronounced positive changes in neurofunctional disorders after treatment on the NDS scale were achieved in group 1: the overall score decreased by 52% after the treatment and was significantly lower than in other groups (p 1–2 = 0,014, p 1–3 = 0,002, Mann-Whitney test). According to the treadmill test, tolerance to physical activity increased in all patients after the treatment. Significant positive dynamics of the stabilometric index of the ratio of energy consumption with closed and open eyes while standing on a balancing pillow was observed only in main group 1 (decreased by 41%, p=0,000, Wilcoxon test). Conclusions. The use of FES of the lower extremities as part of complex therapy in patients with DM2 complicated by angiopathy and DPN is safe and allowed reducing the degree of functional disorders and neuropathic complaints to a greater extent in the study group using FES with a frequency of 10–30 Hz.

scholarly journals INFLUENCE OF HORMONAL DISORDERS ON ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION AND COMORBIDE ENDOCRINOPATHIES

2019 ◽  
Vol 6 (3) ◽  
pp. 132-136
Author(s):  
O. Bilovol ◽  
V. Nemtsova ◽  
I. Ilchenko ◽  
V. Zlatkina
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Endothelial Dysfunction ◽  
Arterial Hypertension ◽  
Subclinical Hypothyroidism ◽  
Control Group ◽  
Group 2 ◽  
Group 1

Abstract. INFLUENCE OF HORMONAL DISORDERS ON ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION AND COMORBIDE ENDOCRINOPATHIES Bilovol O.M., Nemtsova V.D., Ilchenko I.A., Zlatkina V.V. Purpose: to investigate the effect of hormonal changes on endothelial dysfunction (ED) in patients with a comorbid course of hypertension (H), type 2 diabetes mellitus (T2DM) and subclinical hypothyroidism (SHT). Methods: 183 patients with  H stage II were divided into 3 groups: Group 1 (n=50) - with isolated H (comparison group); Group 2 (n=63) - with a combined course of H and T2DM; Group 3 (n=70) - with comorbidity of H, T2DM and SHT. Blood pressure levels, carbohydrate, lipid and thyroid metabolism, plasma insulin concentration, insulin resistance (IR) the HOMA-IR index, vascular endothelial growth factor (VEGF-A) plasma levels were investigated. Results: Dyslipidemia was more pronounced in group 2 than in group 1. The addition of SHT was accompanied by a tendency to increase all the atherogenic lipids. IR was observed in all patients groups and was significantly higher than in control group (p<0.05). Significant increase of VEGF-A levels in all patients groups in comparison with the control (p<0.05) was found. In group 2 VEGF-A was lower than in group 1, which is probably due to the protective effect of metformin. Analysis  of the influence of thyroid dysfunction degree on ED revealed significant increase of VEGF-A levels in TSH>6.0 μMU/ml subgroup (352.55±17.64 pg/ml vs 461.74±20.13 pg/ml (p<0.05)). Conclusion: Hormonal disorders contribute to aggravation of endothelial dysfunction in patients with hypertension and comorbid endocrinopathies - type 2 diabetes mellitus and subclinical hypothyroidism. Even minor decrease in thyroid function lead to the progression of endothelial dysfunction. Key words: hypertension, type 2 diabetes mellitus, subclinical hypothyroidism, endothelial dysfunction   Резюме. ВПЛИВ ГОРМОНАЛЬНИХ ПОРУШЕНЬ НА ЕНДОТЕЛІАЛЬНУ ДИСФУНКЦІЮ УПАЦІЄНТІВ З АРТЕРІАЛЬНОЮ ГІПЕРТЕНЗІЄЮ ТА КОМОРБІДНИМИ ЕНДОКРИНОПАТІЯМИ Біловол О.М., Немцова В.Д., Ільченко І.А., Златкіна В.В. Мета: дослідити вплив гормональних змін на ендотеліальну дисфункцію (ЕД) у пацієнтів з коморбідним перебігом артеріальної гіпертензії (АГ), цукрового діабету 2 типу (ЦД2Т) тасубклінічного гіпотиреозу (СГТ). Матеріали та методи: 183 пацієнта з АГ II стадії були розділені на 3 групи: 1-а група (n=50) - з ізольованою АГ (група порівняння); Група 2 (n=63) - з поєднаним перебігом АГ та ЦД2Т; Група 3 (n 70) – з комбінованим перебігом АГ, ЦД2Т і СГТ. Вивчали рівні артеріального тиску, показники вуглеводного, ліпідного і тиреоїдного обміну, концентрацію інсуліну в плазмі, індекс інсулінорезистентності (ІР) - HOMA-IR, рівні васкулоендотеліального фактора росту (VEGF-A) в плазмі. Результати. Ступінь дисліпідемії у 2-й групі була більш вираженою, ніж в 1-й. Приєднання СГТ супроводжувалося тенденцією до збільшення всіх атерогенних фракцій ліпідів. ІР спостерігалася у всіх групах пацієнтів і була достовірно більше, ніж у контрольній групі (р<0,05). Виявлено достовірне підвищення рівнів VEGF-A у всіх групах пацієнтів в порівнянні з контролем (р<0,05). В 2-й групі рівні VEGF-A були нижче, ніж в 1-й групі, що, ймовірно, пов'язано з протективним ефектом метформіну. Аналіз впливу ступеня гіпофункції щитовидної залози на ЕД виявив значне збільшення рівнів VEGF-A в підгрупі TSH> 6,0 мкМ / мл (352,55 ± 17,64 пг / мл і 461,74 ± 20,13 пг / мл відповідно, р <0,05). Висновки. Гормональні порушення сприяють погіршенню ендотеліальної дисфункції у пацієнтів з артеріальною гіпертензією та супутніми ендокринопатіями - цукровим діабетом 2 типу та субклінічним гіпотиреозом. Навіть незначне зниження функції щитовидної залози призводить до прогресування ендотеліальної дисфункції. Ключові слова:  гіпертензія, цукровий діабет 2 тип, субклінічний гіпотиреоз, ендотеліальна дисфункція    Резюме. ВЛИЯНИЕ ГОРМОНАЛЬНЫХ НАРУШЕНИЙ НА ЭНДОТЕЛИАЛЬНУЮ ДИСФУНКЦИЮ У ПАЦИЕНТОВ С АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ И КОМОРБИДНЫМИ ЭНДОКРИНОПАТИЯМИ Беловол О.М., Немцова В.Д., Ильченко И.А., Златкина В.В. Цель: исследовать влияние гормональных изменений на эндотелиальную дисфункцию (ЭД) у пациентов с коморбидным течением артериальной гипертензии (АГ), сахарного диабета 2 типа (СД2Т) и субклинического гипотиреоза (СГТ). Материалы и методы: 183 пациента с АГ IIстадии были разделены на 3 группы: 1-я группа (n = 50) - с изолированной АГ (группа сравнения); Группа 2 (n = 63) - с сочетанным течением АГ и СД2Т; Группа 3 (n = 70) - комбинированное течение АГ, СД2Т и СГТ. Изучали уровни артериального давления,  показатели  углеводного, липидного и тиреоидного обмена, концентрацию инсулина в плазме, индекс инсулинорезистентности (ИР)- HOMA-IR, уровни васкулоэндотелиального фактора роста(VEGF-A) в плазме. Результаты. Степень дислипидемии во 2-й группе была более выраженной, чем в 1-й.  Присоединение СГТ сопровождалось тенденцией к увеличению всех атерогенных фракций липидов. ИР наблюдалась во всех группах пациентов и была достоверно больше, чем в контрольной группе (р<0,05). Выявлено достоверное повышение уровней VEGF-A во всех группах пациентов по сравнению с контролем (р <0,05). Во 2-й группе уровни VEGF-A были ниже, чем в 1-й группе, что, вероятно, связано с протективным эффектом метформина. Анализ влияния степени дисфункции щитовидной железы на ЭД выявил значительное увеличение уровней VEGF-A в подгруппе TSH> 6,0 мкМ/мл (352,55 ± 17,64 пг / мл и 461,74 ± 20,13 пг / мл соответственно, р<0,05). Заключение. Гормональные нарушения способствуют ухудшению эндотелиальной дисфункции у пациентов с артериальной гипертензией и сопутствующими эндокринопатиями - сахарным диабетом 2 типа и субклиническим гипотиреозом. Даже незначительное снижение функции щитовидной железы приводит к прогрессированию эндотелиальной дисфункции. Ключевые слова: гипертензия, сахарный диабет 2 тип, субклинический гипотиреоз, эндотелиальная дисфункция     

Atherosclerosis of the arteries of the lower extremities in a patient with type 2 diabetes mellitus

Therapy ◽  
2020 ◽  
Vol 8_2020 ◽  
pp. 149-155
Author(s):  
Kishkovich Yu.S. Kishkovich ◽  
Demidova T.Yu. Demidova ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lower Extremities

scholarly journals Immunohistochemical features of the bone tissue of the lower extremities in patients with type 2 diabetes mellitus

2022 ◽  
Vol 24 (5) ◽  
pp. 448-455
Author(s):  
A. Yu. Tokmakova ◽  
E. A. Kogan ◽  
E. L. Zaitseva ◽  
S. A. Demura ◽  
N. V. Zharkov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Bone Resorption ◽  
Bone Tissue ◽  
Immunohistochemical Study ◽  
Control Group ◽  
Diabetic Neuroosteoarthropathy ◽  
Group 1

Background: Diabetic neuroosteoarthropathy is a serious disabling complication of diabetes mellitus, which, in the absence of timely correct treatment, can lead to high amputations of the affected limb. At present, the reasons and mechanism of the development of Charcot’s foot are not completely clear. It is extremely important to determine the pathophysiological mechanisms of DNOAP formation and to search for reliable markers-predictors of this pathology.Aim: To study the immunohistochemical characteristics of the bone tissue of the lower extremities in patients with diabetic neuroosteoarthropathy in comparison with patients with diabetes mellitus without this pathology.Materials and methods: During the foot surgery, a bone fragment of the foot was harvested for immunohistochemical study of receptor markers for PINP, PIIINP, and RAGE in the group of patients with DNOAP compared with the control group.Results: The study included 20 patients with type 2 diabetes mellitus and were divided into 2 groups: 10 patients with DNOAP made up group 1, 10 patients without DNOAP — group 2.Patients in both groups were comparable in AGE, experience with type 2 diabetes, and glycemic control.During the immunohistochemical study, a significant increase in the staining intensity of receptor markers for PINP, PIIINP, and AGE was recorded in the group of patients with DNOAP compared with the control group (p <0.05).Conclusion: For the first time, an immunohistochemical study of markers of bone resorption and AGE was carried out in persons with DNOAP. The results obtained indicate impaired collagen formation and, as a consequence, impaired bone formation and bone resorption in patients with DNOAP: in group 1, a statistically significant increase in the expression of PINP, PIIINP, and RAGE was revealed.

scholarly journals Distribution of ABO and Rhesus Blood groups among Type-2 Diabetic subjects

2020 ◽  
Vol 1 (1) ◽  
pp. 17-22
Author(s):  
C K Akshaya ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Group ◽  
Blood Groups ◽  
Group 2 ◽  
Group B ◽  
Type 2 Diabetic ◽  
Group 1

ABO and Rh blood group systems have been associated with a number of diseases including type-2 diabetes mellitus (T2DM). Epidemiological studies have inconsistently associated ABO and Rhesus (Rh) blood groups with T2DM risk. To assess the distribution of ABO and Rh blood groups among type-2 diabetic subjects and to check the potential association between ABO and Rh blood groups with T2DM. This small retrospective case-control study was conducted at DM WIMS Hospital, Wayanad. One-year data (from Jan-18 to Jan-19) of fasting, postprandial or random plasma/serum glucose, HbA1c, ABO and Rh blood groups of Non- diabetic and type -2 diabetic subjects were collected from the Hospital Clinical Laboratory Medicine department. Among 280 randomly selected data, 147 are non-diabetic subjects, and 133 are confirmed and known cases of type 2 diabetic mellitus. Subjects with Blood group B has the highest distribution percentage among group-2 (59.39%) in comparison with group-1 (34.02%), followed by A (19.55%), O (18.79%), AB (2.27%). Statistical analysis using Chi-square test among ABO and Rh blood groups between group-1 and group-2 showed a significant (p< 0.001) association of blood group “B +ve” and least association of blood group “O +ve” with T2DM. However, the Rh Blood groups evaluation for T2DM showed no clear association, as both Rh +ve and Rh -ve were uniformly distributed in the groups. The ABO and Rh blood groups may have a possible role to play in the development of T2DM. The subjects with B + ve blood group are at greater risk for T2DM and O + ve blood group individuals are at lower risk for T2DM. Keywords: Blood groups; ABO blood groups; Rh blood groups; Type 2 Diabetes Mellitus; distribution; association REFERENCES

scholarly journals INFLUENCE OF NEURO-LIKE DYNAMIC ELECTRICAL STIMULATION ON NEURAL CONDUCTIVITY AND BASAL MICROCIRCULATION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS WITH PERIPHERAL NEUROPATHY

2021 ◽  
pp. 51-56
Author(s):  
V.А. Drobyshev ◽  
◽  
L.А. Shpagina ◽  
G.S. Logacheva ◽  
S.Yu. Ryavkin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Electrical Stimulation ◽  
Electric Pulse ◽  
Sensory Neuropathy ◽  
Controlled Study ◽  
Double Blind ◽  
Therapy Effect

The results of the study of the electric pulse therapy effect on the state of neural conductivity and microvasculature in 60 patients with moderate type 2 diabetes mellitus (DM2), accompanied by the peripheral sensory neuropathy, are presented. A comparative double-blind, placebo-controlled study of the inclusion of neuro-like dynamic electrical stimulation in the rehabilitation course was carried out. By the end of the rehabilitation course, the patients of the experimental group showed an increase in the velocity of excitation propagation along the tibial and peroneal nerves, restoration of the impaired spontaneous activity of deafferentated central neurons at the spinal and cerebral levels, and an improvement of basal microcirculation indices.

scholarly journals Lesions of paired eyes at the initial stages of non-proliferative diabetic retinopathy in patients with type 2 diabetes mellitus

2021 ◽  
Vol 9 (1) ◽  
pp. 21-27
Author(s):  
S.O. Rykov ◽  
K.V. Korobov ◽  
S.Yu. Mogilevskyy
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Vascular Anomalies ◽  
Vascular Changes ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background. One of the early microvascular complications of type 2 diabetes mellitus (T2DM) is diabetic retino­pathy (DR). Its main cause is prolonged hyperglycemia, which triggers the development of microangiopathy. In this regard, the issue of damage to paired eyes and the spread of DR in the initial stages has not been fully clarified. The purpose: to study the peculiarities of lesions of paired eyes at the initial stages of non-proliferative diabetic retinopathy in patients with type 2 dia­betes mellitus. Materials and methods. We examined 91 patients with T2DM (182 eyes), who did not have retinopathy according to the International Diabetic Retinopathy Severity Scale of the American Academy of Ophthalmology (2002). Paired eyes were divided into three groups: group 1 included 132 paired eyes (66 patients) with 10 points according to the Early Treatment Diabetic Retinopathy Group Study (ETDRS); group 2 consisted of 25 eyes with 10 points on ETDRS, and group 3 — 25 paired eyes with retinal vascular anomalies (14–15 points on ETDRS). The patients were examined again after 1 year. According to the ETDRS, Airlie House classification, microaneurysms, microhemorrhages, intraretinal microvascular abnormalities, retinal vascular abnormalities, and retinal nonperfusion were detec­ted. Results. The majority (58.3 %) of paired eyes without initial changes (group 1) had no progression of DR within 1 year, 12.9 % had vascular anomalies (14–15 points on ETDRS), 13.6 % deve­loped mild, and 15.2 % — moderate non-proliferative DR. The highest progression of DR (88.0 % of eyes) was observed in eyes without diabetic vascular changes, which were paired to eyes with such changes (group 2) that was 2.1 times (p < 0.001) higher than the indicator of paired eyes without diabetic changes (group 1; 41.7 %). Most eyes that had mild vascular changes (group 3) progressed to moderate non-proliferative DR after 1 year, which was four times more often than in eyes that had no initial changes (60.0 versus 15.2 %; p < 0.001). DR in the eyes of group 3 with progression accounted for 43–47 points on EDTRS; the visual acuity of these eyes, both before and after 1 year, was significantly lower than in other groups, and the level of glycated hemoglobin in the blood of patients with such eyes was significantly higher. Conclusions. This study established the features of the progression of early stages of DR in patients with T2DM, and the significance of primary retinal vascular anomalies in the presence of which the progression of DR was faster.

scholarly journals Risk factors of the development of vascular and neuropathic complications in patients with type 2 diabetes mellitus and autoimmune thyroiditis

2021 ◽  
Vol 98 (9-10) ◽  
pp. 699-708
Author(s):  
T. A. Meleshkevich ◽  
I. A. Kurnikova ◽  
A. E. Mitichkin ◽  
E. I. Luchina ◽  
M. E. Shevchenko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Rating Scale ◽  
Vascular Complications ◽  
Lower Extremities ◽  
Complications Of Diabetes ◽  
Duration Of Diabetes

Issues of the formation and progression of late complications of diabetes mellitus remain interesting and foreground today, especially in cases of type 2 diabetes mellitus (dm) combined with other endocrine diseases. The pathogenetic relation between the mechanisms leading to blood vessels and nerves damage against the background of diabetes mellitus, and, for example, mechanisms of autoimmune thyroid abnormality (ait), is far from being unambiguous, but the very fact of its existence cannot be denied.Purpose: to determine the predominant type of comorbidity (trans-syndromal, trans-nosological or chronological) and the level of comorbidity according to the disease rating scale (cirs) in patients with type 2 diabetes and ait, to study the structure of later complications of diabetes mellitus in this group of patients and to assess the contribution of certain factors to increased risk of complications.Methods. 428 patients were examined in a specialized endocrinology department, and two groups were formed: an observation group — 213 people with diagnosed type 2 diabetes and ait, and a comparison group — 215 people with a diagnosis of type 2 diabetes. These groups were comparable in age, the duration of diabetes, body mass index, correction of the disease. The analysis included clinical and laboratory parameters, the results of hormones level studies (tsh, free t4, insulin, c-peptide) and antibodies (at-tpo), thyroid ultrasonography, calculation of the insulin resistance index (homa) and the comorbidity index (cirs — cumulative illness rating scale) followed by a correlation-regression analysis of statistical data. The state of the peripheral nervous system was evaluated with the use of electromyography in patients of both groups, and the severity of diabetic neuropathy was evaluated with the use of the neuropathy disability score and vas (visual analogue scale) scales. The state of the vascular system was studied according to the data of ultrasound examination of the vessels of the lower extremities, echocardiography, and ophthalmoscopy.Results. The obtained data made it possible to determine the factors infl uencing the risk of type 2 diabetes complications developement, and to establish that neuropathic complications begin and progress faster in patients with comorbid endocrine pathology, however, there is no such dependence for vascular complications. According to the linear regression equation of the dependence of total complications on the duration of the disease, it was revealed that the development of vascular complications in patients with combined endocrinopathy occurs even more slowly than in patients with diabetes. The contribution of diabetes compensation and identifi ed risk factors to the progression of diabetic complications was less important for patients with endocrinopathies. As for evaluating the contribution of individual parameters, the most signifi cant were the duration of diabetes mellitus, albuminuria, atherosclerosis of the vessels of the lower extremities.Conclusion. In addition to the known risk factors for the development and progression of vascular complications, in patients with overlapping endocrinopathy, the preservation of residual insulin secretion and renal function (chronic kidney disease, proteinuria) were important. the prevalence of “total” Complications in the group of patients with combined endocrine pathology was lower, however, neuropathic complications in the same group were observed more often,т which indicates the primary eff ect of thyroid dysfunction on the structure of the nervous tissue.

scholarly journals Outcomes of transition from premixed and intensive insulin therapies to insulin aspart/degludec co-formulation in type 2 diabetes mellitus: a real-world experience

2021 ◽  
Vol 17 (1) ◽  
pp. 1-8
Author(s):  
Serhat Özçelik ◽  
Mehmet Çelik ◽  
Aşkı Vural ◽  
Bünyamin Aydın ◽  
Melike Özçelik ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy ◽  
Body Mass ◽  
Insulin Dose ◽  
Group 2 ◽  
Daily Total ◽  
Group 1

IntroductionTo evaluate the efficacy and safety of transition from premixed and intensive insulin to twice-daily insulin degludec/aspart (IDegAsp) co-formulation in patients with type 2 diabetes mellitus.Material and methodsIn this 12-week study, patients receiving twice-daily premixed insulin therapy in group 1 (n = 55) were switched to twice-daily IDegAsp. In group 2 (n = 60), patients on intensive insulin therapy were switched to IDegAsp injected twice a day. Inter- and intragroup comparisons were made.ResultsA total of 115 patients were included in the study. There was a significant improvement in glycaemic control, median daily total insulin dose, body mass, body mass index, and hypoglycaemic events in group 1 and group 2 with the switch to IDegAsp (p < 0.05). The decrease in median daily total insulin dose requirement in group 2 was higher than that of group 1 (p = 0.001). There was no difference between groups in terms of other parameters (p > 0.05).ConclusionsThe current analysis indicates that IDegAsp treatment improves outcomes, with the most notable differences observed in daily total insulin requirement, body mass, and hypoglycaemia.

scholarly journals Glycemic variability in type 2 diabetes mellitus and acute coronary syndrome: liraglutide compared with insulin glargine: a pilot study

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092606
Author(s):  
Maria Isabel del Olmo-García ◽  
David Hervás Marín ◽  
Jana Caudet Esteban ◽  
Antonio Ballesteros Martin-Portugués ◽  
Alba Cerveró Rubio ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Acute Coronary Syndrome ◽  
Hospital Setting ◽  
Glycemic Variability ◽  
Coronary Syndrome ◽  
Group 2 ◽  
Group 1

Objective To explore the glucagon-like peptide-1 analogue liraglutide in the hospital setting in patients with type 2 diabetes mellitus (T2DM) and acute coronary syndrome and to evaluate the safety and efficacy and its impact on hospitalization and short-term glycemic variability (GV). Methods A 12-week, open-label, prospective, randomized pilot clinical study with parallel groups that compared liraglutide (group 1) with glargine (group 2) and its impact on glycemic control and GV. Results Thirteen patients were included. During hospitalization, mean glucose was 164.75 mg/dL (standard deviation [SD] 19.94) in group 1 and 166.69 mg/dL (38.22) in group 2. GV determined by CV and SD was 20.98 (7.68) vs. 25.48 (7.19) and 34.37 (13.05) vs. 43.56 (19.53) in groups 1 and 2, respectively. Group 1 prandial insulin requirements during hospitalization were lower compared with group 2. Follow-up A1c in group 1 was 6.9% (−1.51%) and 6.5% in group 2 (−1.27). GV after discharge and hypoglycemia were lower in group 1 compared with group 2. Conclusions Liraglutide seems to reduce GV in the acute phase of acute coronary syndrome, and patients achieved optimal control with a low incidence of hypoglycemia. These results support the need to explore liraglutide in a larger multicenter trial. Trial registration: The study was approved by the National Medical Ethics Committee of Spain. The study was registered at European Clinical Trials Database (EudraCT): 2014003298-40.

Temperature proximal-to-distal dorsal hand gradient as a thermography signs of altered glucose metabolism. Variations and perspective to use

2020 ◽  
pp. 48-52
Author(s):  
I. M. Dolgov ◽  
M. G. Volovik
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glucose Metabolism ◽  
Dorsal Hand ◽  
Altered Glucose ◽  
Significant Difference ◽  
Group 3 ◽  
Group 1

Aim. To evaluate the temperature proximal-to-distal dorsalhand gradient (PDG) in patients with altered glucose metabolism.Methods. Analyzed 120 patients with altered glucose metabolism, divided to three groups: group 1 — abnormal glucose tolerance test (R73) and type 2 diabetes mellitus without complications (E11.9) — 50 pts, 30 m/20 f, mean age 61,5 ± 11,1), group 2 — Type 1 diabetes mellitus [Е10] — 25 pts, 7 m/18 f, mean age 44,4 ± 13,1); group 3 — type 2 diabetes mellitus with multiple complications [Е11.7] and type 2 diabetes mellitus with unspecified complications [Е11.8] — 45 pts, 14 m /31 f., mean age 62,2 ± 10,8). Thermal images were shoot by Russian made thermography camera TVS–300med, 388 x 360 pix, sensitivity 0,03℃. PDG calculated as a difference between mean temp of proximal and distal phalanges of 2–5 fingers and estimated for right or left hand separately.Results. Two thermography signs were observed: «inverted» PDG, when temperature of distal phalanges is higher than proximal and founded more often in group 1 and «false normal», when temperature of proximal phalanges is higher than distal, and name in this manner, because founded more often in «complicated» groups 2 and 3. Analysis confirmed that group 1 and group 3 pts significantly differed in mean PDG value (p<0,05).Conclusion. Our results show that thermography examination pointed out variety of dorsal hand signs for altered glucose metabolism and significant difference in mean PDG value for group 1 and 3. Therefore infrared thermography could be suggested as an objective tool for screening and monitoring of disease.

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