scholarly journals Review of current guidelines for the treatment of type 2 diabetes

2021 ◽  
pp. 7-12
Author(s):  
O. V. Kaminsky
Keyword(s):  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
First Line ◽  
Pharmacological Management ◽  
Number Of Patients ◽  
Patients With Diabetes ◽  
Treatment Of Diabetes ◽  
New Guidelines

According to the WHO, diabetes is one of the five most dangerous chronic non-communicable diseases in the world. The annual increase in the number of patients with diabetes in Ukraine is about 5-10%. In 2020, the WHO published new guidelines for the diagnosis and treatment of diabetes and updated its classification. Along with the already familiar type 1 and 2 diabetes and gestational diabetes, a new category of disease has emerged – hybrid forms of diabetes. In the section «Pharmacological management of diabetes» the WHO gives priority to the level of glycemia, the control of which avoids the development of microvascular complications of type 2 diabetes. Initial treatment, according to the WHO 2020, should begin with the appointment of metformin - a drug of the first line of treatment of patients with this disease. It is important that metformin does not cause weight gain, does not provoke hypoglycemia and is recommended for the treatment of people who do not reach the desired level of glycemia through diet and physical activity. Secondgeneration sulfonylureas can be used as an initial first-line treatment when metformin is contraindicated or intolerant. However, this is quite rare: in most cases, metformin is well tolerated by patients if administered gradually. That is, metformin, and, if necessary, sulfonylureas - is an effective, safe and affordable choice compared to expensive novelties, the effectiveness and safety of which have not been proven in long-term studies. In addition, in type 2 diabetes, metformin drugs will form additional effects: cardioprotection, oncoprotection, hepatoprotection, nephroprotection, additional hypoglycemic effect and will fight insulin resistance.

scholarly journals Prevalence of Anaemia and Its Associated Factors among Type 2 Diabetes Mellitus Patients in University of Gondar Comprehensive Specialized Hospital

Anemia ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Sewnet Adem Kebede ◽  
Biruk Shalmeno Tusa ◽  
Adisu Birhanu Weldesenbet
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Associated Factors ◽  
Microvascular Complications ◽  
Combined Treatment ◽  
Factors Associated ◽  
Specialized Hospital ◽  
Patients With Diabetes

Background. Anaemia is one of the commonest blood disorders seen in patients with diabetes. In Ethiopia, chronic illnesses are tremendously raising with their complications. But very little research has been conducted, particularly on anaemia among diabetes mellitus (DM) patients. Therefore, this study aimed at assessing the prevalence of anaemia and associated factors among type 2 diabetes mellitus patients in Northwest Ethiopia. Methods. A cross-sectional study design was employed at University of Gondar Comprehensive Specialized Hospital from March 1 to April 15, 2019, among 372 type 2 diabetes mellitus patients (T2DM). Multivariable logistic regression analysis was fitted, and the corresponding adjusted odds ratio (AOR) and 95% CI were used to identify factors associated with anaemia. Level of significance was declared at the p value less than 0.05. Results. The study revealed 8.06% (95% CI: 5.68–11.31%) of the participants were anaemic. Being male (AOR = 2.74, CI: 1.02, 7.38), combined type of treatment (AOR = 8.38, CI: 1.66, 42.25), having diabetes-related microvascular complications (AOR = 3.24, CI: 1.14, 9.26), and hypertension (AOR = 0.01, CI: 0.002, 0.06) were the significant factors associated with anaemia. Conclusions. The finding of the current study revealed low prevalence of anaemia among T2DM patients. Sex, type of treatment, diabetes-related microvascular complications, and hypertension were factors associated with anaemia. Assessment of haemoglobin levels among T2DM patients may help to prevent ensuing microvascular complications. Incorporate anaemia screening into the routine assessment of diabetic complication particularly for those who are hypertensive and took combined treatment to allow early appreciation and treatment of anaemia and later improve the overall care of patients with diabetes.

scholarly journals Pasireotide in an insulin-requiring diabetic acromegalic patient without worsening of hyperglycemia

2017 ◽  
Vol 2017 ◽  
Author(s):  
Murray B Gordon ◽  
Kellie L Spiller
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
List Type ◽  
Effective Treatment Option ◽  
Patients With Diabetes ◽  
Long Acting ◽  
Learning Points

Summary Long-acting pasireotide is an effective treatment option for acromegaly, but it is associated with hyperglycemia, which could impact its use in patients with diabetes. We present a case of a 53-year-old man with acromegaly and type 2 diabetes mellitus (glycated hemoglobin (HbA1c): 7.5%), who refused surgery to remove a pituitary macroadenoma and enrolled in a Phase 3 clinical trial comparing long-acting pasireotide and long-acting octreotide in acromegalic patients. The patient initially received octreotide, but insulin-like growth factor 1 (IGF-1) levels remained elevated after 12 months (383.9 ng/mL; 193.0 ng/mL; reference range: 86.5–223.8 ng/mL), indicating uncontrolled acromegaly. He switched to pasireotide 40 mg and subsequently increased to 60 mg. Within 6 months, IGF-1 levels normalized (193.0 ng/mL), and they were mostly normal for the next 62 months of treatment with pasireotide (median IGF-1: 190.7 ng/mL). Additionally, HbA1c levels remained similar to or lower than baseline levels (range, 6.7% to 7.8%) during treatment with pasireotide despite major changes to the patient’s antidiabetic regimen, which included insulin and metformin. Uncontrolled acromegaly can result in hyperglycemia due to an increase in insulin resistance. Despite having insulin-requiring type 2 diabetes, the patient presented here did not experience a long-term increase in HbA1c levels upon initiating pasireotide, likely because long-term control of acromegaly resulted in increased insulin sensitivity. This case highlights the utility of long-acting pasireotide to treat acromegaly in patients whose levels were uncontrolled after long-acting octreotide and who manage diabetes with insulin. Learning points Long-acting pasireotide provided adequate, long-term biochemical control of acromegaly in a patient with insulin-requiring type 2 diabetes mellitus who was unresponsive to long-acting octreotide. Glycemic levels initially increased after starting treatment with pasireotide but quickly stabilized as acromegaly became controlled. Long-acting pasireotide, along with an appropriate antidiabetic regimen, may be a suitable therapy for patients with acromegaly who also have insulin-requiring type 2 diabetes mellitus.

A Review of Pramlintide in the Management of Diabetes

2009 ◽  
Vol 1 ◽  
pp. CMT.S2369
Author(s):  
Caroline Messer ◽  
Dina Green
Keyword(s):  
Microvascular Complications ◽  
Effective Means ◽  
Postprandial Glucose ◽  
Tight Glycemic Control ◽  
Minimal Risk ◽  
Patients With Diabetes ◽  
Insulin Dependent

Tight glycemic control in type 1 and type 2 diabetes reduces the risk for microvascular complications, including retinopathy, nephropathy, and neuropathy. Yet, despite intensive insulin regimens, many insulin-dependent patients are unable to achieve euglycemic states. This review will focus on pramlintide, an equipotent amylin analog, and its role in the management of diabetes. Pramlintide lowers glucose through the same mechanisms as amylin: it slows gastric emptying, suppresses the postprandial rise of glucagon in patients with diabetes, and promotes satiety. Long-term clinical trials have shown that the use of pramlintide as an adjunct to insulin minimizes postprandial glucose excursions and reduces both HbA1C and body weight when compared to placebo. Although its effects on HbA1C are modest, pramlintide has gained popularity as a result of its relatively few contraindications, limited side effects, minimal risk for hypoglycemia, and potential for weight loss. The combination of insulin and pramlintide may provide an effective means for patients with diabetes to meet their HbA1C goals.

scholarly journals Anxiety among patients with diabetes mellitus evaluated using generalized anxiety disorder 7-item scale

2016 ◽  
Vol 04 (02) ◽  
pp. 133-136 ◽  
Author(s):  
Amit Thour ◽  
Ramninder Nagra ◽  
Arunjeet Gosal ◽  
Tejasav Sehrawat ◽  
Subhash Das ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Tertiary Care Hospital ◽  
Microvascular Complications ◽  
Tertiary Care ◽  
Generalized Anxiety ◽  
Care Hospital ◽  
Cross Sectional ◽  
Patients With Diabetes

Abstract Background: Anxiety has been shown to be associated with poor outcomes in people with diabetes. However, there has been limited data, especially from India, which has specifically examined whether diabetes mellitus is associated with an increased likelihood of comorbid anxiety. Aim: The aim was to estimate the prevalence of anxiety in patients with diabetes and to determine the association of anxiety with age, sex, and other related parameters. Setting: Endocrine clinic, tertiary care hospital. Design: Cross-sectional. Materials and Methods: The study was cross-sectional carried out in endocrinology clinic of tertiary care hospital in North India. Cases were patients with type 2 diabetes mellitus above 30 years of age. Anxiety was assessed using the generalized anxiety disorders 7-item (GADs-7) scale. The relationship with a sociodemographic profile, duration of diabetes, hypertension, and microvascular complications was also analyzed. Results: Seventy-three subjects (42.5% females) with mean age 50.8 ± 9.2 years were evaluated. The prevalence of anxiety was 34%. Severe anxiety (GAD-7 score ≥15) was present in three (4%) subjects, moderate anxiety (GAD-7 score ≥10) was present in six (8%) subjects, and mild anxiety was present in 16 (22%) of subjects. Anxiety increased with fasting plasma glucose, hypertension, was more in women, but the differences were not statistically significant. Conclusions: Our study demonstrates a higher prevalence of anxiety in patients with type 2 diabetes. No factor was significantly associated with anxiety. Therefore, anxiety should be assessed in each and every patient, irrespective of other factors.

The Role of Anti-obesity Drugs in Patients with Type 2 Diabetes

2013 ◽  
Vol 09 (02) ◽  
pp. 101 ◽  
Author(s):  
Priscilla Hollander ◽  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Lifestyle Changes ◽  
Important Concern ◽  
Increased Risk ◽  
The Us ◽  
Patients With Diabetes ◽  
Obesity Drugs

The prevalence of diabetes continues to rise, following the rising rates of obesity. Obesity is not only associated with an increased risk for developing type 2 diabetes but also an elevated probability of developing long-term complications associated with the disease. Weight gain is also an important concern as a potential side effect of therapies that improve glycemic control in diabetes, including insulin therapy. As a result, patients with type 2 diabetes are at risk for a vicious circle of increasing weight and increasing insulin resistance, thus requiring further intensification of glycemic treatment. It is therefore important to address the problem of obesity in patients with type 2 diabetes. In 2012, the US Food and Drug Administration (FDA) approved two new anti-obesity medications: lorcaserin and phentermine/topiramate extended-release. Both agents have demonstrated clinically meaningful weight reduction as well as significant improvements in glycemic control in obese patients with diabetes. Liraglutide has also shown weight loss and improvements in glycemic control in patients with diabetes. Anti-obesity drugs, in conjunction with lifestyle changes, may play a valuable role in the management of diabetes.

scholarly journals Empowerment in the Treatment of Diabetes and Obesity

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Włodzimierz Łuczyński ◽  
Barbara Głowińska-Olszewska ◽  
Artur Bossowski
Keyword(s):  
Standard Of Care ◽  
Patients With Diabetes ◽  
Treatment Of Diabetes ◽  
Based Medicine ◽  
Diabetes And Obesity ◽  
Positive Effect

As the available therapies for diabetes and obesity are not effective enough, diabetologists and educators search for new methods to collaborate with patients in order to support their health behaviors. The aim of this review is to discuss perspectives for the development of new empowerment-type therapies in the treatment of diabetes/obesity. Empowerment is a process whereby patients gain the necessary knowledge to influence their own behavior to improve the quality of their lives. It is carried out in five stages: (1) identify the problem, (2) explain the feelings and meanings, (3) build a plan, (4) act, and (5) experience and assess the execution. Although many years have passed since the advent and popularization of the concept of empowerment, the area remains controversial, mainly with regard to the methodology of therapy. Some previous studies have confirmed the positive effect of empowerment on body weight, metabolic control, and quality of life of patients with type 2 diabetes; however, few studies have been conducted in patients with type 1 diabetes. There is still a need to confirm the effectiveness of empowerment in accordance with Evidence Based Medicine by performing long-term observational studies in a large group of patients. In future, empowerment may become part of the standard of care for patients with diabetes and/or obesity.

Cardivascular Risk Profile in Patients with Diabetes and Acromegaly or Cushing’s Disease – Analysis from the DPV Database

2018 ◽  
Vol 128 (02) ◽  
pp. 104-110 ◽  
Author(s):  
Katharina Warncke ◽  
Sebastian Kummer ◽  
Peter Herbert Kann ◽  
Dominik Bergis ◽  
Esther Bollow ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Cushing’S Disease ◽  
Cushing's Disease ◽  
Dipeptidyl Peptidase 4 ◽  
Number Of Patients ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Patients With Diabetes

Abstract Background Although diabetes is a common complication of acromegaly or Cushing´s disease, there are only few detailed studies with a focus on cardiovascular risk, metabolic control or diabetes therapy. Here, we provide a comprehensive characterization from the longitudinal DPV (Diabetes Patienten Verlaufsdokumentation) registry. Methods Patients from the registry≥18 years of age with diabetes and acromegaly or Cushing´s disease were compared to patients with type 1 diabetes or type 2 diabetes using the statistical software SAS 9.4. Results Patients with diabetes and acromegaly (n=52) or Cushing’s disease (n=15) were significantly younger at diabetes onset (median age 50.1 and 45.0 vs. 59.0 years in type 2 diabetes; both p<0.05). Dyslipidemia was common in both diseases (71.0% and 88.9% vs. 71.8% in type 2 diabetes; n.s.), while hypertension was most frequent in acromegaly (56.8% vs. 20.9% in type 1 diabetes, p<0.00001). 36.5% of patients with acromegaly and 46.7% with Cushing´s disease receive insulin, compared to 50.4% with type 2 diabetes. Oral antidiabetic drugs were used in 36.5% of patients with acromegaly and 40% with Cushing´s disease, with a predominance of biguanides and dipeptidyl peptidase-4 inhibitors. HbA1c was well controlled in both groups (median 7.0% and 6.5%; vs. 7.2% in type 2 diabetes). Conclusion Patients with acromegaly are at a high risk for cardiovascular disease, reflected by dyslipidemia and hypertension. A high proportion of patients with diabetes in acromegaly or Cushing´s disease receives insulin. Based on a multicenter register, a sufficient number of patients with rare forms of diabetes can be analyzed.

scholarly journals Mechanisms of macro-, micro- and ultramicroscopic transformation of bodies in diabetes

Morphologia ◽  
2021 ◽  
Vol 15 (3) ◽  
pp. 23-29
Author(s):  
I.I. Savka ◽  
M.N. Tsytovskyi ◽  
G.M. Dmytriv
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Diabetes Type 2 ◽  
Diabetes Type ◽  
Clinical Aspects ◽  
Number Of Patients ◽  
The World ◽  
Patients With Diabetes

The study of structural changes of organs and tissues in the context of diabetes is one of the urgent problems of modern medicine. According to WHO, in all countries of the world the number of patients with diabetes exceeds 175 million. According to an expert estimate of the spread of this disease by 2025 will make about 300 million people. More than 1 million people with diabetes have been officially registered in Ukraine. WHO has recognized the disease as a non-communicable epidemic. The dramatic increase in the prevalence of diabetes requires a detailed study of this problem. It is established that the prevalence of diabetes increases among the population of the countries of the world depending on the region, the level of economic development of the country, gender and age. Thus, according to IDF findings, there is a tendency for the highest prevalence of diabetes among the urban (urban) able-bodied population of developing countries in persons between 40 and 59 years of age, approximately equal in both male and female. The number of patients is increasing, mainly due to patients with type 2 diabetes. Type 2 diabetes (type 2 diabetes mellitus) is a severe progressive chronic disease that is an independent risk factor for heart failure (CH) and cardiovascular complications. In the XXI century. the steady growth of type 2 diabetes and the frequency of its serious consequences is of great concern to the world medical community. It is important that at the time of diagnosis of type 2 diabetes, the prevalence of complications leading to a decline in quality of life, early disability and premature death is already high enough. Despite the presence in the fight against this disease effective drugs, modern technologies, new educational and preventive techniques, mankind loses the fight against diabetes year after year, which leads to disability due to its complications, reducing the life expectancy and quality of life of patients, loss working capacity and premature mortality. Thus, the current prevalence and incidence of diabetes and life-threatening complications suggest that there is a non-communicable diabetes epidemic in the world and in Ukraine in particular. The article represents analysis of work of numerous researchers who studied statistіcal, clinical and morphological aspects of the impact of diabetes on cardiovascular system. Main morphogenetic, morphological and clinical aspects of complications of diabetes, pathologies of microcirculation of patients with diabetes were dedicated, what makes possible to predict and detect on the early stages vascular complications in diabetes and to perform effective prevention and treatment.

scholarly journals Renal experiences of bariatric surgery in patients with type 2 diabetes mellitus

2018 ◽  
Vol 90 (10) ◽  
pp. 99-108
Author(s):  
I I Larina ◽  
A S Severina ◽  
M S Shamkhalova ◽  
M V Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Diabetes Mellitus Type 2 ◽  
Diabetic Kidney Disease ◽  
Microvascular Complications ◽  
Incretin Effect ◽  
Patients With Diabetes ◽  
Surgically Induced

The review addresses the questions of the literature devoted to the problem of the influence of bariatric surgery on the course of diabetic nephropathy in patients with diabetes mellitus type 2 after achieving a surgically induced remission. This approach was shown to have positive aspects, such as decrease in creatinine, decrease in albuminuria, an increase in GFR, normalization of glycemia and blood pressure, "incretin effect"’s influence on the kidneys. Descriptions of the currently expected pathogenetic mechanisms involved in achieving the observed improvement in microvascular complications of diabetes, namely diabetic kidney disease, are also described in details.

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