scholarly journals Tackling the silent epidemic of Type-I Diabetes Mellitus (Type-1 DM) through National Health Programmes- A narrative review of available evidence

2021 ◽  
Vol 33 (2) ◽  
pp. 245-249
Author(s):  
Om Prakash Bera ◽  
Vandana Shah ◽  
Sudip Bhattacharya ◽  
Sheikh Mohd Saleem
Keyword(s):  
Diabetes Mellitus ◽  
Type I Diabetes ◽  
Surveillance Systems ◽  
Type I ◽  
Diabetes Research ◽  
Age Group ◽  
Type 2 Dm ◽  
Central Registry

Type 1 diabetes mellitus (T1DM) is an autoimmune ?-cell destruction, usually leading to absolute insulin deficiency, insulin resistance, or by a combination of both. Both the incidence and prevalence of diabetes T1DM is suspected to be high in India, but in the absence of nation-wide registry, the possibility of exact numbers is unsure. Till date, studies done among the population have seen prevalence more than the incidence of the disease, which has led to late screening and diagnosis of the disease within the community settings. India is already suffering from the burden of type 2 DM, in the process of screening those, patients with T1DM are somewhat getting ignored. Furthermore, cost associated with the treatment expenditure and social status of the people suffering from the disease too have a role to consider which has been totally side-lined in national programmes like National Program for Control of Diabetes, Cardiovascular disease, and Stroke (NPCDCS). There is also scarcity of data on the incidence of T1DM which could aid in formulating better policy avenues for the patients suffering from the disease.  Reports on trends in T1DM are more commonly available from countries with better established public health surveillance systems and diabetes research infrastructure. From India, due to scarcity of data on T1DM, we had to rely on published literature of some major centers across the country. Results from the Indian Council of Medical Research (ICMR) first phase, till July 2011 which included 5546 patients found T1DM among 63.9% cases and predominately among children; at registration 11.1% had already developed chronic complication of T1DM. As India is already suffering from the burden of type 2 DM, during current management and treatment, the problem lies at various levels which needs to be addressed. We propose a setting based, life course approach for T1DM where every age group will have access to the health care system either directly or indirectly from intra-natal life till elderly age group through health approach based on scientific methods delivered through health system. In this regard a central registry having enumeration and provisioning of mandatory Insulin to all through a national policy being implemented by NPCDCS is what policy makers must take up at urgent bases if we want to bend the curve of rising T1DM and prevalence of overall diabetes in India.

scholarly journals Study of cutaneous manifestations of type 2 diabetes mellitus

2018 ◽  
Vol 4 (1) ◽  
pp. 8
Author(s):  
Yoganand J. Phulari ◽  
Vidisha Kaushik
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Age Group ◽  
Cutaneous Manifestations ◽  
Skin Manifestations ◽  
Type 2 Dm ◽  
Type 1 Dm

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Poorly controlled Type 2 diabetes mellitus (DM) is associated with several disorders and microvascular, macrovascular and neuropathic complications. Multiple factors play a role in the manifestations of cutaneous signs of DM. The prevalence of a cutaneous disorder appears to be similar between Type 1 DM and Type 2 DM patients, but Type 2 DM patients develop more frequent cutaneous infections, and Type 1 DM patients manifest more autoimmune-type  cutaneous lesions. The objective of the study was to assess the various cutaneous manifestations of Type 2 DM and the relation of cutaneous manifestations with the duration of Type 2 DM.</span></p><p class="abstract"><strong>Methods:</strong> All patients of Type 2 DM, of age group 20 and above, of both sexes, attending   OPD or IPD at Dr. D. Y. Patil  Hospital, Kolhapur  willing to give written informed consent, were included for the study between August 2014 – July 2016. Complete history and examination of all the patients with regards to onset of cutaneous manifestations was taken.<strong></strong></p><p class="abstract"><strong>Results:</strong> Majority (49%) of respondents were in the age group of 41 to 60 years, and majority (66%) were males. 57.5% were new cases and 42.5% were known cases. Duration of illness- majority 50.58% were &lt;5 years, 27.05% in 6 to 10 years. In present study there were 61% who had infectious skin manifestations and 39% who had non-infectious skin manifestations. Out of infectious manifestations 39.5% had fungal infection<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Therefore on the basis of present study, we conclude that the skin is involved in DM quite often. The manifestations are numerous and varied and many a times they can serve as diagnostic marker for underlying DM. Whenever patients present with multiple skin manifestations, their diabetic status should be checked. The recognition of these skin findings is the key to treatment and prevention<span lang="EN-IN">.</span></p>

scholarly journals The structural and functional features of the microcirculatory bed in patients with arterial hypertension and type 2 diabetes mellitus

2005 ◽  
Vol 11 (3) ◽  
pp. 177-180 ◽  
Author(s):  
L. A. Lohankova ◽  
Yu. V. Kotovskaya ◽  
A. S. Milto ◽  
Zh. D. Kobalava
Keyword(s):  
Diabetes Mellitus ◽  
Blood Flow ◽  
Arterial Hypertension ◽  
Control Group ◽  
Microcirculatory Bed ◽  
Type 2 Dm ◽  
Group A ◽  
Functional Features

The structural and functional features of the microcirculatory heel (MCB) were studied in patients with arterial hypertension (AH) in relation to the presence or absence of type 1 diabetes mellitus (DM). Two hundred and twelve patients were examined. These included 110 patients with grades 1 and 2 arterial hypertension (AH) and type 2 DM, 82 patients with AH without type 2 DM, and 20 apparently healthy individuals. Laser Doppler flowmetry (LDF) was used to estimate basal blood flow, the loading test parameters characterizing the structural and functional status of MCB, and the incidence of hemodynamic types of microcirculation. Patients with AH concurrent with type 1 DM were found to have the following microcirculatory features: an increase in perfusion blood flow (microcirculation index, 8,8±1,8 perf. units versus 4,9±0,8 perf, units in patients with AH without DM and 6,7±0,9 perf. units in the control group), a drastic reduction in myogenic activity to 13,2±5,7 % versus 16,7±6,8 and 25,2±6,4 %, respectively, a decrease in vascular resistance, impairment of autoregulation, and low reserve capacities (reserve capillary blood flow was 197,8±31,6 % versus 429,9±82,01 % in the group of AH without DM and 302,8±50,1 % in the control group), a predominance of the hyperemic hemodynamic type (58,8 % in patients with AH and DM, 20,9 % in those with AH without DM, and 20,0 % in the controls). The specific features of the altered microcirculatory bed in patients with AH concurrent with type 2 DM were ascertained. These included the predominance of hyperemic microcirculation, impaired autoregulation. diminished microvascular resistance, and the low reserve capacities of the microcirculatory bed.

Associations between Diabetes Mellitus and Nontuberculous Mycobacterium-Caused Diseases in Taiwan: A Nationwide Cohort Study

2021 ◽  
Author(s):  
Jui-Yang Wang ◽  
Hsin-Chung Lin ◽  
Hsin-An Lin ◽  
Chi-Hsiang Chung ◽  
Lih-Chyang Chen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Cox Regression ◽  
Nontuberculous Mycobacterium ◽  
Research Database ◽  
Cox Regression Analysis ◽  
Type 2 Dm ◽  
Type 1 Dm

Patients with diabetes mellitus (DM) are at greater risk of developing active tuberculosis and other intracellular bacterial infections, although the risk of acquiring infections from nontuberculous Mycobacterium (NTM) remains undefined. This study evaluated associations between DM and incidence of NTM infection-caused pulmonary and cutaneous diseases. Data for DM patients were extracted from the National Health Insurance Research Database of Taiwan. The DM cohort included 136,736 patients, and cases were matched randomly by age, gender, and index year with non-DM patients. Multivariate Cox proportional hazards regression was used to calculate adjusted hazard ratios of incident NTM-caused diseases in the DM cohort compared with non-DM control subjects. The frequency of incident NTM-caused diseases was significantly greater in DM patients (0.12%) than in non-DM patients (0.08%) (P < 0.05), including patients with type 1 DM (0.12%) and type 2 DM (0.12%) (all P < 0.05). Adjusted multivariate Cox regression analysis revealed that the incidence of NTM-caused diseases in DM patients was 1.43-fold greater than that in non-DM patients overall (P < 0.05), particularly in pulmonary (1.13-fold), other specific (excluding pulmonary, cutaneous, and disseminated diseases; 3.88-fold), and unspecific (atypical NTM infection; 1.54-fold) diseases (all P < 0.05). In conclusion, both type 1 DM and type 2 DM patients have high risk of NTM-caused diseases, suggesting that physicians need to pay more attention to this issue concerning the high risk of NTM-caused infection in DM patients.

scholarly journals Activation of CD4+ and CD8+ T-lymphocytes by insulin and GAD in patients with type 1 or 2 diabetes mellitus

2017 ◽  
Vol 6 (8) ◽  
pp. 758-765 ◽  
Author(s):  
Borros Arneth
Keyword(s):  
Diabetes Mellitus ◽  
T Lymphocytes ◽  
Whole Blood ◽  
Blood Samples ◽  
Cd8 T Lymphocytes ◽  
Type 2 Dm ◽  
Whole Blood Samples ◽  
Type 1 Dm

Background The origin of autoimmune disease type 1 diabetes is still unknown. Aim This study assessed the activation of CD4+ and CD8+ T-lymphocytes by human insulin and human glutamate decarboxylase (GAD) in patients with type 1 or type 2 diabetes mellitus (DM) and healthy volunteers. Materials and methods The expression of CD69, a marker of T-lymphocyte activity, was determined in whole blood samples by flow cytometry after 12 h of incubation with or without insulin or GAD. The analysis included samples from 12 type 1 DM patients, 14 type 2 DM patients and 12 healthy volunteers. Results Significant increases in the number of activated CD4+ and CD8+ T-lymphocytes following pre-incubation of whole blood samples with human insulin or GAD were observed in samples from patients with type 1 DM, whereas no activation of these cells was detected in samples from either type 2 DM patients or healthy subjects. Discussion These results indicated that latent pre-activation of CD4+ and CD8+ T-lymphocytes in response to insulin or GAD epitopes occurred in type 1 DM patients. Conclusion These findings suggest that pre-immunization against insulin and/or GAD might be associated with the development of type 1 DM. Alternatively, these results might reflect a non-specific, bystander autoimmune response.

scholarly journals Treatment with Mammalian Ste-20-like Kinase 1/2 (MST1/2) Inhibitor XMU-MP-1 Improves Glucose Tolerance in Streptozotocin-Induced Diabetes Mice

Molecules ◽  
2020 ◽  
Vol 25 (19) ◽  
pp. 4381
Author(s):  
Zakiyatul Faizah ◽  
Bella Amanda ◽  
Faisal Yusuf Ashari ◽  
Efta Triastuti ◽  
Rebecca Oxtoby ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glucose Tolerance ◽  
Diabetic Mice ◽  
Β Cells ◽  
Pancreatic Β Cells ◽  
In Vivo Models ◽  
Type 2 Dm ◽  
Type 1 Dm

Diabetes mellitus (DM) is one of the major causes of death in the world. There are two types of DM—type 1 DM and type 2 DM. Type 1 DM can only be treated by insulin injection whereas type 2 DM is commonly treated using anti-hyperglycemic agents. Despite its effectiveness in controlling blood glucose level, this therapeutic approach is not able to reduce the decline in the number of functional pancreatic β cells. MST1 is a strong pro-apoptotic kinase that is expressed in pancreatic β cells. It induces β cell death and impairs insulin secretion. Recently, a potent and specific inhibitor for MST1, called XMU-MP-1, was identified and characterized. We hypothesized that treatment with XMU-MP-1 would produce beneficial effects by improving the survival and function of the pancreatic β cells. We used INS-1 cells and STZ-induced diabetic mice as in vitro and in vivo models to test the effect of XMU-MP-1 treatment. We found that XMU-MP-1 inhibited MST1/2 activity in INS-1 cells. Moreover, treatment with XMU-MP-1 produced a beneficial effect in improving glucose tolerance in the STZ-induced diabetic mouse model. Histological analysis indicated that XMU-MP-1 increased the number of pancreatic β cells and enhanced Langerhans islet area in the severe diabetic mice. Overall, this study showed that MST1 could become a promising therapeutic target for diabetes mellitus.

scholarly journals Helicobacter pyloriInfection Is Associated with Type 2 Diabetes, Not Type 1 Diabetes: An Updated Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-15 ◽  
Author(s):  
Jun-Zhen Li ◽  
Jie-Yao Li ◽  
Ting-Feng Wu ◽  
Ji-Hao Xu ◽  
Can-Ze Huang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Knowledge Database ◽  
Type 2 Dm ◽  
The Difference ◽  
H Pylori ◽  
Type 1 Dm

Background. Extragastric manifestations ofHelicobacter pylori(H. pylori) infection have been reported in many diseases. However, there are still controversies about whetherH. pyloriinfection is associated with diabetes mellitus (DM). This study was aimed at answering the question.Methods. A systematic search of the literature from January 1996 to January 2016 was conducted in PubMed, Embase databases, Cochrane Library, Google Scholar, Wanfang Data, China national knowledge database, and SinoMed. Published studies reportingH. pyloriinfection in both DM and non-DM individuals were recruited.Results. 79 studies with 57,397 individuals were included in this meta-analysis. The prevalence ofH. pyloriinfection in DM group (54.9%) was significantly higher than that (47.5%) in non-DM group (OR = 1.69,P<0.001). The difference was significant in comparison between type 2 DM group and non-DM group (OR = 2.05), but not in that between type 1 DM group and non-DM group (OR = 1.23, 95% CI: 0.77–1.96,P=0.38).Conclusion. Our meta-analysis suggested that there is significantly higher prevalence ofH. pyloriinfection in DM patients as compared to non-DM individuals. And the difference is associated with type 2 DM but not type 1 DM.

scholarly journals BONE REMODELING IN WOMEN WITH DIABETES MELLITUS

2018 ◽  
Vol 2 (5) ◽  
pp. 33-36
Author(s):  
Татьяна Бардымова ◽  
Tatyana Bardymova ◽  
Максим Мистяков ◽  
Maksim Mistyakov ◽  
Юлия Башарина ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin D ◽  
Bone Remodeling ◽  
Menstrual Function ◽  
Type 2 Dm ◽  
Bone Remodeling Markers ◽  
25 Oh Vitamin D ◽  
Post Menopausal

Background. It is known that the type 2 diabetes mellitus (DM) and osteoporosis are more often diagnosed in senior women. The condition of a bone tissue is accompanied by the metabolic violations that are typical for DM. The recent researches established the multidirectional changes of bone remodeling markers in women with type 2 DM at differ- ent age periods. Aims: to study the condition of bone remodeling in women with type 2 DM at different age periods. Materials and methods. We examined 27 women with type 2 DM, among them 15 were in the post-menopausal period and 12 with preserved menstrual function. Levels of osteocalcin, N-terminal propeptide of type 1 collagen (P1NP), C- terminal telopeptide of type 1 collagen (β-Crosslaps), 25-OH vitamin D, the ionized calcium were researched. Results. The analysis showed that increase in β-Crosslaps levels, P1NP, levels of osteocaltcin were observed in women with type 2 DM in the post-menopausal period, compared to parameters of women with type 2 DM with preserved menstrual function. Inverse correlation relation of osteocaltcin and 25-OH vitamin D was revealed in women with type 2 DM. Conclusion. Significant increase in markers of osteosynthesis and osteoresorption in women with type 2 DM was shown in the post-menopausal period compared with indicators of women with type 2 DM with preserved men- strual function.

scholarly journals Relationship between TP53 and interleukin-6 gene variants and the risk of types 1 and 2 diabetes mellitus development in the Kermanshah province

2021 ◽  
Vol 14 (1) ◽  
pp. 37-44
Author(s):  
Lida Haghnazari ◽  
◽  
Ramin Sabzi ◽  
◽  
Keyword(s):  
Diabetes Mellitus ◽  
Tp53 Gene ◽  
Control Group ◽  
Control Groups ◽  
Codon 72 ◽  
Type 2 Dm ◽  
And Control ◽  
Type 1 Dm

Diabetes mellitus (DM) is a metabolic disorder that results from insufficient secretion or insulin resistance, or both. Insulin secretion deficiency leads to chronic hyperglycemia along with impaired metabolism of proteins, lipids, and carbohydrates. This study aimed to investigate the TP53 gene SNP (single nucleotide polymorphism) rs1042522 genotype and the interleukin-6 (IL-6) gene SNP rs1800795 genotype in DM and control groups. This study was performed on 70 patients with type 1 DM, 100 patients with type 2 DM without related complications, 66 control subjects for type 1 DM, and 95 control subjects for type 2 DM. The control groups were matched regarding age and gender and did not have a familial relationship with the patient groups. All the subjects were residents of Kermanshah, located in the western part of Iran. Polymorphisms of TP53 and IL-6 genes were determined by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Lipid profile, fasting blood glucose, and HbA1c were measured using the ELISA and immunoturbidometric methods. The frequency of genotypes (CC, CG, GG) of the TP53 gene codon 72 in type 1 DM and its control group were significantly different (P= 0.013). Likewise, the frequency of genotypes (CC, CG, GG) of the TP53 gene codon 72 was significantly different between type 2 DM and control groups (P <0.001). The frequency of genotypes (GG, GC, CC) of G174C polymorphisms in the IL-6 gene was different between type 1 DM and control group as well as between type 2 DM and its control group, but it was not statistically significant. SNP rs1042522 genotypes in the dominant form (CG + GG vs. CC) (OR= 3.880; P < 0.001) and alleles G vs. C alleles (OR= 0.384; P < 0.001) increased the risk of type 2 DM significantly. There was no significant difference between type 1 and type 2 DM groups and respected control groups regarding the frequency of the IL-6 gene SNP rs1800795 alleles. The G allele of SNP rs1042522 encoding the TP53 gene increases the risk of developing DM in the population of the Kermanshah province, Iran.

scholarly journals Blood concentrations of endothelin, interleukins 6 and 10 in men with diabetes mellitus

2021 ◽  
Vol 17 (4) ◽  
pp. 280-286
Author(s):  
E.V. Luchytskiy ◽  
V.E. Luchytskiy ◽  
G.A. Zubkova ◽  
V.M. Rybalchenko ◽  
I.I. Skladanna
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Correlation Coefficient ◽  
Blood Concentration ◽  
Positive Correlation ◽  
Type 2 Dm ◽  
Type 1 Dm ◽  
Spearman’S Correlation

Background. Pathological activation of cytokines is one of the key links in the pathogenesis of diabetes mellitus (DM) and the development of its complications, in particular from the cardiovascular system. According to the vast majority of researchers, the imbalance of pro- and anti-inflammatory cytokines in patients with diabetes mellitus is a significant risk factor for mortality from cardiovascular disease. The purpose of the study was to determine the concentration of markers of a nonspecific inflammatory response (interleukin (IL) 6 and IL-10) in the blood of men with DM and their association with glycated hemoglobin levels and body mass index. Materials and methods. There were examined 46 men with type 2 DM and 28 men with type 1 DM. According to the results of the analysis of variance of the control group, type 2 DM and type 1 DM had significant differences in some indicators. Results. The correlation analysis of the obtained indicators of interleukin concentration showed that in men with type 2 DM under the age of 50 years, the indicators of IL-6 concentration significantly positively correlated with indicators of IL-10 concentration in blood (Spearman’s correlation coefficient 0.562, p < 0.031) and negatively with the duration of diabetes mellitus (Spearman’s correlation coefficient –0.508, p < 0.031). In the group of patients with type 2 DM aged 50 years and older, there was a positive correlation between the blood concentration of IL-6 with the blood concentration of IL-10 (Spearman’s correlation coefficient 0.509, p < 0.031), the blood concentration of IL-10 with glycated hemoglobin levels (Spearman’s correlation coefficient 0.391, p < 0.04) and the duration of diabetes mellitus (Spearman’s correlation coefficient 0.551, p < 0.005). In the group of patients with type 1 DM, there was a positive correlation of IL-6 in the blood with indicators of the blood concentration of IL-10 (Spearman’s correlation coefficient 0.707, p < 0.001) and a positive correlation between the concentration of IL-10 with the duration of DM (Spearman’s correlation coefficient 0.379, p < 0.039). Conclusions. Mean levels of IL-6 were significantly elevated in men with type 2 diabetes aged 50 years and older. Mean IL-10 levels were significantly elevated in men with type 2 diabetes regardless of the age of the patients. A significant positive correlation was found between the indicators of IL-6 and IL-10 in the examined patients with type 2 diabetes regardless of age also in patients with type 1 diabetes mellitus.

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