CHRONIC MESENTERIC ISCHEMIA IN TYPE 2 DIABETES PATIENTS

2021 ◽  
pp. 62-64
Author(s):  
S Mahaboob Fayaz ◽  
V Sai Vivek
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Duplex Ultrasound ◽  
The Other ◽  
Chronic Mesenteric Ischemia ◽  
Coeliac Artery ◽  
Ct Angiogram

BACKGROUND: Type 2 Diabetes mellitus (T2DM) currently effects 8.9% of the world's population.The macrovascular complications of diabetes are 3 times more common than the microvascular complications.Involvement of the vessels of gut in T2DM hasn't been studied exclusively like the other known macrovascular complications.This study focusses on the effect of T2DM on the Coeliac artery(CA) and Superior Mesenteric artery (SMA) which are the main source of blood supply to the organs derived from fore and midgut . METHODS: In our study over 2 years, 72 patients of T2DM were subjected to Duplex Ultrasonography.15 randomly selected patients who satised the Fasting Duplex velocity criteria and 15 randomly selected patients who did not were subjected to CT Angiography. RESULTS: We found that 22 patients (30.55%) out of the 72 had features suggestive of Chronic Mesenteric Ischemia (CMI) in both the coeliac artery and SMA on duplex ultrasound and 8 patients (26.66%) out of 30 had conrmed CMI by CT angiogram. CONCLUSION: th We found that every 4 diabetic had CMI. We would like to emphasize that the vasculature of the gut can be affected in T2DM and this should inspire a lot of research and prospective studies relating CMI to GIT manifestations of T2DM.

scholarly journals Development of Type 2 Diabetes Mellitus Phenotyping Framework Using Expert Knowledge and Machine Learning Approach

2016 ◽  
Vol 11 (4) ◽  
pp. 791-799 ◽  
Author(s):  
Rina Kagawa ◽  
Yoshimasa Kawazoe ◽  
Yusuke Ida ◽  
Emiko Shinohara ◽  
Katsuya Tanaka ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Machine Learning ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Expert Knowledge ◽  
The Other ◽  
Learning Approach ◽  
Research Subjects ◽  
Machine Learning Approach

Background: Phenotyping is an automated technique that can be used to distinguish patients based on electronic health records. To improve the quality of medical care and advance type 2 diabetes mellitus (T2DM) research, the demand for T2DM phenotyping has been increasing. Some existing phenotyping algorithms are not sufficiently accurate for screening or identifying clinical research subjects. Objective: We propose a practical phenotyping framework using both expert knowledge and a machine learning approach to develop 2 phenotyping algorithms: one is for screening; the other is for identifying research subjects. Methods: We employ expert knowledge as rules to exclude obvious control patients and machine learning to increase accuracy for complicated patients. We developed phenotyping algorithms on the basis of our framework and performed binary classification to determine whether a patient has T2DM. To facilitate development of practical phenotyping algorithms, this study introduces new evaluation metrics: area under the precision-sensitivity curve (AUPS) with a high sensitivity and AUPS with a high positive predictive value. Results: The proposed phenotyping algorithms based on our framework show higher performance than baseline algorithms. Our proposed framework can be used to develop 2 types of phenotyping algorithms depending on the tuning approach: one for screening, the other for identifying research subjects. Conclusions: We develop a novel phenotyping framework that can be easily implemented on the basis of proper evaluation metrics, which are in accordance with users’ objectives. The phenotyping algorithms based on our framework are useful for extraction of T2DM patients in retrospective studies.

scholarly journals Case Report: Type 2 Diabetes Mellitus

2018 ◽  
Vol 1 (2) ◽  
pp. 45
Author(s):  
Shofi Hesfianto
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Chronic Disease ◽  
Health Care Providers ◽  
The Other ◽  
Shared Understanding ◽  
Care Providers ◽  
Patient’S Expectation

.......A patient who was first diagnosed with a chronic disease often does not fully understand the meaning or significanceof the chronic disease with which his/ her body suffers, against the risk of future complications if the disease is not well-controlled. On the other hand, in this reported case, the patient’s expectation was that her chronic disease, the T2DM, can be cured. Therefore, a shared understanding between health care providers and patient is likely the key to commencing the course of managing any chronic disease in a patient effectively.......

scholarly journals A Study of Effect of Glycaemic Status on Pulmonary Function Test in Type 2 Diabetes Mellitus

2021 ◽  
Vol 10 (18) ◽  
pp. 1343-1346
Author(s):  
Basavaraj G.T ◽  
Mudassir Indikar ◽  
Malingaraya Negali
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pulmonary Function ◽  
Pulmonary Function Test ◽  
Pulmonary Complications ◽  
The Other ◽  
Duration Of Diabetes ◽  
Function Test

BACKGROUND Diabetes mellitus is a metabolic disorder precipitating micro vascular, macro vascular complications and peripheral vascular diseases. Pulmonary complications of diabetes mellitus have been poorly characterised. Glycaemic status has shown varied impact on lung functions. In type-2 diabetes there is resistance to insulin action and also inadequate insulin secretion. Diabetes mellitus is associated with morphological and functional abnormalities. Several studies have shown that diabetes is associated with impaired pulmonary function. Pulmonary complications of diabetes mellitus (DM) have been poorly characterised. Some authors have reported normal pulmonary functions and even concluded that spirometry is not at all necessary in diabetic patients. We wanted to highlight the evidence-based significance of spirometry. METHODS This cross-sectional study was done for a period of 1 year from September 2017 to July 2018. The study sample consisted of 50 type-2 diabetes patients and 50 controls. RESULTS A total of 100 subjects were included in the present study; 50 of them were diabetics and the other 50 were non-diabetic controls matched by age, sex and body mass index (BMI). The range of forced vital capacity (FVC) in diabetic group was from 1.36 litres, which is lesser than range in controls (2.06 litres). Forced expiratory volume (FEV1) / FVC ranged from 0.59 in diabetics compared to 0.84 in controls. Mean FVC value was higher in diabetics with a duration of diabetes of less than 5 years (2.72) as compared to those with diabetes of more than 5 years (2.03) with a P value of 0.0004 which is statistically significant. CONCLUSIONS Type 2 diabetes mellitus is associated with restrictive pattern of respiratory abnormality. As the duration of diabetes increases the restrictive profile was more prominent. There was inverse relation between glycaemic status and spirometric indices FEV1 and FVC. Thus, an intensive glycaemic management may reduce the risk of death through an improved ventilator function which is independent of the other beneficial effects. KEY WORDS Pulmonary Function Test, Type 2 Diabetes Mellitus, Glycaemic Status

Diabetes Mellitus as Dysfunction of Interactions among all Organs: “Ominous Orchestra of Organs”

2008 ◽  
Vol 1 ◽  
pp. CMED.S552 ◽  
Author(s):  
Hiroyuki Koshiyama ◽  
Yoshihiro Ogawa ◽  
Kiyoshi Tanaka ◽  
Issei Tanaka
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Visceral Obesity ◽  
The Other ◽  
Liver Fat ◽  
Epidemiological Evidence ◽  
Humoral Factors ◽  
The Common ◽  
Fat Liver

Epidemiological evidence has established a link among hyperlipidemia, visceral obesity, osteoporosis, and cardiovascular diseases. We have recently proposed a hypothesis that the associations of those disorders are based on interactions of the three organs, i.e. the bone, adipose, and vascular tissues, possibly through multiple actions of several humoral factors and/or transcription factors. We call this unified hypothesis “osteo-lipo-vascular interactions”, which may be explained by the common origin of the cells in each organ, such as mesenchymal stem cells or macrophages. Several groups proposed similar hypotheses. On the other hand, there have been accumulating evidences which indicate that there exist hitherto unknown various interactions between many organs, such as hypothalamus-liver, fat-liver, liver-muscle, intestine-pancreas, kidney-heart and so on. Therefore, it seems insufficient to consider only the interactions among several organs, and the standpoint of considering interactions among all organs may be warranted, especially in order to understand the pathogenesis of metabolic syndrome, insulin resistance and type 2 diabetes. We here propose a hypothesis that the abnormal interactions of all organs (“Ominous Orchestra of Organs”) underlies the pathogenesis of type 2 diabetes. It is to be elucidated which of the “players” or the “conductor” may be mainly responsible for disharmony of the orchestra.

scholarly journals EFFECTS OF TYPE 2 DIABETES MELLITUS INDUCTION AND OF MODERATE PHYSICAL EXERCISE ON THE HEPATIC METABOLISM AND OXIDATIVE STRESS IN WISTAR RATS

2020 ◽  
Vol 20 (39) ◽  
pp. 55-61
Author(s):  
Denise Silva de Oliveira ◽  
Júlia Matzenbacher dos Santos ◽  
Kayorrany Gomes Galvão do Prado ◽  
Andreia Vitor Couto Amaral ◽  
Sandra Aparecida Benite-Ribeiro
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Physical Exercise ◽  
Wistar Rats ◽  
Alanine Transaminase ◽  
The Other ◽  
Low Density ◽  
Aspartate Transaminase

AIMS: The aim of the study was to verify if the induction of Type 2 Diabetes Mellitus (T2DM) by the association of streptozotocin and high fat diet causes hepatic alterations and if physical exercise can improve these alterations.  METHODS: Forty-six Wistar rats were divided into two groups. One group received a diet containing 60% of fat for 9 weeks and on the 14th day they were injected with a single dose of streptozotocin (25mg/kg). The other group, named control group, received a standard diet and a single dose of citrate buffer was given. Animals were them divided into two subgroups: one sedentary (S) and the other submitted to physical exercise (PE), totalizing four groups: C-S; C-PE; HF-S; HF-PE. After euthanasia blood and liver were collected. Plasma and hepatic concentrations of triacylglycerol and very low density lipoprotein; enzyme alanine transaminase, aspartate transaminase and arginase; urea, lactate and 8-isoprostane (an oxidative stress marker) were dosed. RESULTS: Capillary glucose was significantly higher in HF-S and HF-PE group animals compared to C-S and C-PE groups. There were no significant differences in alanine transaminase, arginase, oxidative stress and lactate concentration among the groups. Plasma urea concentration and hepatic aspartate transaminase concentration was lower in HF-S and HF-PE than in C-PE. Concerning liver triacylglycerol and very low density lipoproteins, both were higher in the HF-PE group when compared to the C-S. CONCLUSIONS: We conclude that diet was decisive for the aforementioned parameters alterations and that physical exercise protocol was not efficient to improve analyzed parameters.

scholarly journals Effects of Duration and Complications of Type 2 Diabetes Mellitus on Diabetic Related Parameters, Adipocytokines and Calcium Regulating Hormones

2019 ◽  
pp. 2335-2361
Author(s):  
Aseel Khalid Thabah Al-Attaby ◽  
Makarim Qassim Dawood Al-Lami
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
The Other ◽  
Diabetic Patients ◽  
The Third ◽  
First Category ◽  
Duration Of Disease

The present study aims to investigate the effects of duration and complications of type 2 diabetes mellitus on diabetic related parameters, adipocytokines and calcium regulating hormones. This study was conducted on eighty diabetic patients (41 male and 39 female) in Iraq, with an age range of 20-60 years and a disease duration range of 1-180 months. Blood samples were collected from the patients to determine three main types of biomarkers: diabetic-related parameters [Fasting blood sugar is FBS glycated hemoglobin (HbA1c), insulin, and insulin resistance (IR)], adipocytokines [adiponectin and tumor necrosis factor-α (TNF-α), and calcium regulating hormones [parathyroid hormone (PTH), calcitonin, and vitamin D].      The result showed increased levels of some parameters with the increase in duration of disease. Levels of FBS and HbA1c increased significantly (probability <0.05) in the second and the third categories of duration of disease (61-120 and 121-180 month) compared with the first category (1-60 month). Levels of insulin and IR were increased with the increase in duration of disease; this increase was found to be significant (p<0.05) when a comparison was made between the second and the third categories with the first category. Also, a similar trend was observed when a comparison was made between the third category and the second category. There was a significant (P<0.05) increase in the levels of TNF-α and calcitonin in the last category compared with the other categories, and a significant (P<0.05) increase in vitamin D levels in the last category compared with the first category. Non-significant (P>0.05) differences were found in the levels of adiponectin and PTH among all categories of duration of disease.      When a comparison was made between the two groups of patients (with complications and without complications), a significant (P<0.05) increase was found in the levels of FBG, HbA1c, insulin, and IR in patients with complications as compared with patients without complications. A significant (P<0.05) decrease was found in calcitonin levels in patients with complications as compared with patients without complications. Non-significant (P>0.05) differences were found in the levels of the other parameters (adiponectin, TNF-α, PTH and vitamin D) between the two groups of patients.      It can be concluded from the present study that duration of disease affects diabetic related parameters, TNF-α and some calcium regulating hormones (calcitonin and vitamin D), while complications of disease affect diabetic related parameters and calcitonin. It can be suggested that the duration of diabetes is one of the strongest determinants of complication risk.

scholarly journals Duplex ultrasound: A diagnostic tool for carotid stenosis management in type 2 diabetes mellitus

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Yogan Kisten ◽  
Pravesen Govender ◽  
Nadraj G. Naidoo ◽  
Dhiro Gihwala ◽  
Ferial Isaacs
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Carotid Stenosis ◽  
Diagnostic Tool ◽  
Duplex Ultrasound ◽  
Diabetic Patients ◽  
Increased Risk

Background: Diabetic patients are at increased risk of developing cardiac events and stroke, and prevention of diabetes mellitus is therefore desirable. Marked geographical and ethnic variation in the prevalence of diabetes caused by urbanisation, demographic and epidemiological transitions has rendered this one of the major non-communicable diseases in South Africa. Duplex ultrasound (DUS) plays an important role in primary health care in early detection of carotid atherosclerotic disease and the degree of carotid stenosis present. It is a reliable, cost-effective and non-invasive diagnostic tool. The purpose of this study was to determine the role of ultrasound in carotid stenosis management in type 2 diabetes mellitus (T2DM).Objectives: To determine the prevalence of carotid stenosis in a selected T2DM population using DUS and to correlate these findings with other predisposing atherosclerotic risk factors.Methods: The study setting was at an academic hospital in the Western Cape using carotid DUS reports of 103 diabetic subjects ≥ 35 years old. Predisposing risk factors were correlated with degree of carotid stenosis present. Data were analysed using the Fischer exact test, Chisquare and Student t-test.Results: Carotid DUS reports of 63 out of 103 T2DM patients revealed no evidence of a carotid stenosis, thereby lowering the risk profile. Forty patients were identified as having carotidstenosis; 22 symptomatic patients had a > 70% carotid stenosis which warranted surgicalintervention. A greater prevalence of stenosis in the Caucasian group, in both the male (p =0.0411) and female (p = 0.0458) cohorts, was noted. The overall trend suggested a relationship between T2DM and lifestyle, and a statistically significant relationship (p = 0.0063) between smoking and carotid stenosis was observed.Conclusion: T2DM and predisposing atherosclerotic risk factors significantly increased thepossibility of carotid stenosis development.

Abstract 13363: Renoprotective Effects of Empagliflozin in Patients With Acute Myocardial Infarction and Type 2 Diabetes Mellitus; Subgroup Analysis of the Embody Trial

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kosuke Mozawa ◽  
Yoshiaki Kubota ◽  
Yu Hoshika ◽  
Shuhei Tara ◽  
Yukichi Tokita ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Acute Myocardial Infarction ◽  
Type 2 Diabetes Mellitus ◽  
Uric Acid ◽  
Placebo Group ◽  
Sglt2 Inhibitor ◽  
The Other

Introduction: Although renoprotective effect of sodium glucose co-transporter-2 (SGLT2) inhibitors has been recognized in the patients with heart failure or type 2 diabetes mellitus (T2DM), this protection has not been fully examined in patients with acute myocardial infarction (AMI). We therefore examined renoprotection of the SGLT2 inhibitor empagliflozin in patients with AMI and T2DM. Methods: The EMBODY trial was a prospective, multicenter, randomized, double-blind, placebo-controlled trial to identify the effect of the SGLT inhibitor on cardiac sympathetic hyperactivity in patients with AMI and T2DM in Japan. One hundred and five patients were randomized (1:1) to receive once-daily 10-mg empagliflozin, or placebo 2 weeks after the onset of AMI. In this sub-analysis, we specifically focused on the time-course of renal function on baseline, weeks 4, 12 and 24. Results: Overall, 96 patients (64±11 y, 78 male) were included in the full analysis set (n = 46 and 50 in empagliflozin and placebo groups, respectively). In the placebo group, estimated glomerular filtration rate (eGFR) decreased from 66.1 at baseline to 62.8 mL/min/1.73m 2 on week 24, (P = 0.02). On the other hand, the empagliflozin group did not worsen it (from 64.6 to 64.4 mL/min/1.73m 2 , P = 0.84). The empagliflozin group exhibited the significant reduction in systolic blood pressure and uric acid level from baseline to week 24 (129.7 mmHg to 123.1 mmHg, P = 0.004, and 5.8 mg/dL to 4.9 mg/dL, P < 0.0001, respectively), whereas the reduction was not significant in the placebo group (123.1 mmHg to 126.2 mmHg, P = 0.19, and 5.7 mg/dL to 5.8 mg/dL, P = 0.82, respectively). The change in eGFR from baseline to 24 weeks was negatively correlated with the changes in uric acid in the placebo group (r=0.685, P<0.001), but not in the empagliflozin group. In stratified analysis among the patients with eGFR 60-90 mL/min/1.73m 2 , the empagliflozin group showed the significant increase in eGFR compared with the placebo group (+1.15 mL/min/1.73m 2 vs, - 6.43 mL/min/1.73m 2 , P=0.008), but not among the other population. Conclusions: Empagliflozin seemed to prevent the progression of renal dysfunction compared with placebo in the patients with AMI and T2DM. This tendency was remarkable when eGFR was 60-90 mL/min/1.73m 2 .

scholarly journals Role of Folic Acid in Type 2 Diabetes

2021 ◽  
pp. 137-143
Author(s):  
Akshunna Keerti ◽  
Jayshri Jankar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Folic Acid ◽  
No Synthase ◽  
The Other ◽  
Endothelial Layer ◽  
Pteroylglutamic Acid ◽  
Total Homocysteine

The metabolic condition known as diabetes mellitus is marked by hyperglycemia, a host of symptoms affecting the heart, kidneys, nerves, and other organs. Diabetes nephropathy is one of the leading causes of diabetic impermanence and morbid state. Low parameters of pteroylglutamic acid in the blood are associated with Diabetic Nephropathy, whereas endothelial dysfunction increases the risk for T2D. Endothelial dysfunction is associated with diabetes, which perhaps is caused by the disjunction of the endothelial nitric oxide (NO) synthase enzyme, which reduces NO availability. Because folic acid can repair the disjunction of NO synthase, we sought to see if pteroylglutamic acid supplementation may affect the function of the endothelial layer and inflammatory indicators in type 2 diabetes patients who did not have vascular disease. Recent studies have shown that pteroylglutamic acid also has direct benefits on the function of endo, in addition to its natural function of lowering homocysteine. Folic acid might serve as a "biomarker" for the function of endothelial cells. Many mechanisms have been linked to higher total homocysteine levels and type 2 diabetes risk in diabetic patients. Higher folic acid levels altered endothelial-dependent vasodilation in T2D patients. In patients with coronary heart disease (CAD), folic acid supplementation has been found to reduce homocysteine parameters and improve the function of the endothelial layer. On the other hand, RCTs looking at IR and T2D outcomes have shown mixed results. Several mechanisms link higher total homocysteine levels to increased risk of insulin resistance (IR) and type 2 diabetes mellitus (T2D). Treatment with folate has been shown to bring down homocysteine parameters and improve the endothelium functions in people with coronary heart disease (CAD). Randomized controlled trials (RCTs) on IR and T2D outcomes, on the other hand, have produced a wide range of results.

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