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 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 Type 2 diabetes mellitus: time to change the concept

2013 ◽  
Vol 16 (1) ◽  
pp. 91-102 ◽  
Author(s):  
Shmuel Levit ◽  
Yury Ivanovich Filippov ◽  
A S Gorelyshev
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Heterogeneous Group ◽  
Therapy Goals ◽  
Current Review ◽  
The Common ◽  
Contemporary Approach

Diabetes mellitus is a heterogeneous group of diseases that, although unified by a number of characteristics, require a differential thera- peutic approach. Current review discusses key pathogenic features of type 2 diabetes mellitus that determine therapy goals and options in management. We further enunciate and pathogenetically substantiate a new "gravicentric" concept for treatment of type 2 diabetes mellitus that differs in many ways from the common contemporary approach.

scholarly journals Dipeptidyl peptidase-4 inhibitor (teneligliptin) significantly reduces liver fat content and delays progression of non-alcoholic steatohepatitis in type 2 diabetes mellitus patients

2021 ◽  
Vol 8 (12) ◽  
pp. 1817
Author(s):  
Vishal Kumar Gupta ◽  
Richa Giri ◽  
Saurabh Agrawal
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Dipeptidyl Peptidase ◽  
Liver Fat ◽  
Liver Fat Content ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Dipeptidyl peptidase (DPP)-4 inhibitors, anti-diabetic agents, are expected to be effective for treatment of non-alcoholic fatty liver disease (NAFLD). Several studies have shown that some DPP-4 inhibitors alleviate hepatic steatosis or steatohepatitis in type 2 diabetic mice or rats. Teneligliptin is DPP4 inhibitor whose efficacy to control blood sugar is well established but its effect on liver is not studied well. In present study we investigated effect of teneligliptin, a DPP-4 inhibitor on patients of type 2 diabetes with non-alcoholic steatohepatitis (NASH). Methods: This was a randomized, double-blind study in which 64 patients between ages of 18 to 80 years were selected for study. Participants were identified as type 2 diabetes with biopsy confirmed NASH. We excluded the patients with glucocorticoid use, hepatitis B or C, and other diseases that might affect liver function. Results: The mean HbA1c change after 48 weeks of therapy in group A was-1.06 % and in group B was-0.77% and this was statistically insignificant (p>0.06). The mean AST change after 48 weeks of therapy in group A was-45.4% and in group B was-33.3% and this was statistically significant (p<0.001). The mean ALT change after 48 weeks of therapy in group A was-41.6% and in group B was-22.7% and this was statistically significant (p<0.001). The change in liver fat content (LFC) after 48 weeks of therapy in group A was-15.4% and group B was-7.14% and this was also statistically significant (p<0.001).Conclusions: Result of our study revealed that teneligliptin significantly reduce serum transaminases in patients of NASH with type 2 DM. Teneligliptin significantly reduce LFC and delay progression of NASH independent of diabetes control in type 2 diabetes mellitus (DM) patients. These data show significant antisteatotic and anti-inflammatory effect of teneligliptin in type 2 diabetes patients.

Neonatal Diabetes – From Gene Discovery yo Clinical Practice Changes

2013 ◽  
Vol 20 (3) ◽  
pp. 343-352
Author(s):  
Cristian Guja ◽  
Loreta Guja ◽  
Constantin Ionescu-Tîrgovişte
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Single Gene ◽  
Neonatal Diabetes ◽  
Monogenic Diabetes ◽  
Special Focus ◽  
Sulphonylurea Treatment ◽  
The Common

Abstract Diabetes mellitus is one of the most common chronic diseases but also one of the most heterogeneous. Apart the common phenotypes of type 1 and type 2 diabetes, around 1-2% of all cases arise from a single gene mutation and are known as monogenic diabetes. Diabetes diagnosed within the first 6 months of life is known as neonatal diabetes and has been extensively studied during the last two decades. Unraveling the genetic cause and molecular mechanism of this rare diabetes phenotype led to a dramatic change in the treatment of these children who often can be switched from insulin to sulphonylurea treatment. The aim of this paper is to review the known genetic causes of neonatal diabetes and to highlight the most recent aspects of the disease caused by mutations in the KATP and insulin genes, with a special focus on the individualized treatment of these cases

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 Polymorphism Study on SLC30A8 and Its Association with Type 2 Diabetes

2016 ◽  
Vol 02 ◽  
pp. 118
Author(s):  
M Vignesh ◽  
T Sangeetha ◽  
T Varsha ◽  
◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tryptophan Residue ◽  
Nucleotide Polymorphism ◽  
Single Nucleotide ◽  
The World ◽  
Hereditary Factors ◽  
The Common

Type 2 diabetes mellitus (T2DM) is one of the threatening disorders in the world. It affects people of all ages. Type 2 diabetes mellitus is a condition in which the glucose level in the blood is elevated due to improper function of the secretion of insulin from beta cells of the pancreas. It is a multifactorial disease because it is caused by both environmental and hereditary factors. One of the genes which play an important role in type 2 diabetes mellitus is SLC30A8 which encodes for zinc transporter ZnT8. The common polymorphic site for SLC30A8 is rs13266634. This single-nucleotide polymorphism leads to type 2 diabetes mellitus by replacing the arginine residue with tryptophan residue. This review mainly focuses on the polymorphic studies in the gene SLC30A8 and its association with type 2 diabetes mellitus.

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