Аlcohol and diabetes: a double-edged stick

2021 ◽  
Author(s):  
Л.Ю. Моргунов
Keyword(s):  
Diabetes Mellitus ◽  
Alcohol Consumption ◽  
Alcoholic Beverage ◽  
Late Complications ◽  
Self Control ◽  
Alcohol Abusers ◽  
Increased Risk ◽  
Patients With Diabetes

В данной работе изучены и обобщены исследования, посвященные эпидемиологии, риску развития сахарного диабета и влиянию на сердечно-сосудистую систему пациентов с диабетом и разным уровнем потребления алкоголя. Продемонстрированы высокие затраты на лечение злоупотребляющих алкогольными напитками. Описано влияние этанола на метаболизм глюкозы и механизмы, вызывающие гипергликемию и гипогликемию, роль грелина и лептина у употребляющих алкоголь пациентов с сахарным диабетом. Уделено внимание вопросам гипокоагуляции и системного воспаления у диабетиков, употребляющих этанол. Отдельно показано влияние алкоголя на пациентов с сахарным диабетом 1 типа. Описано влияние алкоголя на развитие атеросклероза, а также поздних осложнений сахарного диабета, таких как диабетическая ангиопатия нижних конечностей. Продемонстрировано влияние предпочтений алкогольных напитков на риски развития сахарного диабета. Подчеркнута низкая приверженность к самоконтролю у употребляющих этанол пациентов с сахарным диабетом. Показано, что употребление небольшого или среднего количества алкоголя снижает заболеваемость сахарным диабетом в большинстве исследований, в то время как сильно пьющие пациенты подвергаются повышенному риску развития этого заболевания. У людей с сахарным диабетом употребление алкоголя от легкого до умеренного снижает риск сердечно-сосудистых заболеваний и смертности от всех причин. Тип алкогольного напитка, пол и, вероятно, индекс массы тела – факторы, влияющие на эти результаты. This article examines and summarizes studies on the epidemiology, risk of developing diabetes, and the influence on the cardiovascular system of patients with diabetes and different levels of alcohol consumption. High costs for the treatment of alcohol abusers have been demonstrated. The article describes the effect of ethanol on glucose metabolism and the mechanisms that cause hyperglycemia and hypoglycemia, the role of ghrelin and leptin in alcohol-consuming patients with diabetes mellitus. Attention is paid to the issues of hypocoagulation and systemic inflammation in diabetics who use ethanol. The effect of alcohol on patients with type 1 diabetes mellitus is shown separately. The influence of alcohol on the development of atherosclerosis, as well as late complications of diabetes mellitus, such as diabetic angiopathy of the lower extremities, is described. The influence of alcoholic beverage preferences on the risk of developing diabetes mellitus has been demonstrated. Low adherence to self-control in ethanol-consuming patients with diabetes mellitus is emphasized.Drinking small or medium amounts of alcohol has been shown to reduce the incidence of diabetes in most studies, while heavy drinkers are at an increased risk of developing the disease. In people with diabetes, light to moderate alcohol consumption reduces the risk of cardiovascular disease and all-cause mortality. The type of alcoholic drink, gender, and probably body mass index are factors that influence these results.

scholarly journals General Principles for Rehabilitation of Patients With Type 1 Diabetes and Diabetic Nephropathy

2021 ◽  
Vol 7 (12) ◽  
pp. 97-103
Author(s):  
O. Terekhova ◽  
Furtikova
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
Insulin Therapy ◽  
Type 1 Diabetes Mellitus ◽  
Diabetic Complications ◽  
Late Complications ◽  
Genetically Engineered ◽  
Self Control

All over the world, an increase in type 1 diabetes mellitus is noted annually, along with its late complications. In recent years, more and more information has appeared aimed at the prevention and rehabilitation of children with diabetes. Type 1 diabetes mellitus is a genetically determined disease, in the development of which the main component is an autoimmune process that triggers the destruction of β-cells, which leads to a decrease in insulin production, and subsequently to its absolute insufficiency, the main method of treatment is insulin replacement therapy. To select an adequate dose of insulin, it is necessary to take into account HbA1c, glycemic and glucosuric profiles. Children are advised to use semi-synthetic or genetically engineered insulins. In children, intensified insulin therapy is more often used in the form of a combination of short and medium-acting insulins or ultra-short with prolonged ones. This article presents an analysis of insulin therapy and self-control in children and adolescents with type 1 diabetes mellitus and diabetic nephropathy. It was found that children with diabetic nephropathy approached their illness less responsibly, did not always count bread units and kept records in self-control diaries. Also, this group of children were more likely to receive human insulin with the use of syringe pens. The nutrition of children with diabetes should not be inferior in calories to that of healthy adolescents, while the energy value of the daily diet should be calculated taking into account age, gender, body weight, and energy expenditures. Taking into account the possibility of regression of the initial diabetic complications when the compensation of carbohydrate metabolism is achieved, therapy for type 1 diabetes is a means of preventing the development of severe diabetic complications.

scholarly journals Hypertriglyceridemia in Diabetes Mellitus: Implications for Pediatric Care

2018 ◽  
Vol 2 (6) ◽  
pp. 497-512 ◽  
Author(s):  
Jacob C Hartz ◽  
Sarah de Ferranti ◽  
Samuel Gidding
Keyword(s):  
Diabetes Mellitus ◽  
Children And Adolescents ◽  
Pediatric Care ◽  
Poor Control ◽  
Atherogenic Lipid Profile ◽  
Increased Risk ◽  
Atherogenic Lipid

Abstract Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). It is estimated that the risk of CVD in diabetes mellitus (DM) is 2 to 10 times higher than in the general population. Much of this increased risk is thought to be related to the development of an atherogenic lipid profile, in which hypertriglyceridemia is an essential component. Recent studies suggest that dyslipidemia may be present in children and adolescents with DM, particularly in T2DM and in association with poor control in T1DM. However, the role of hypertriglyceridemia in the development of future CVD in youth with DM is unclear, as data are scarce. In this review, we will evaluate the pathophysiology of atherogenic hypertriglyceridemia in DM, the evidence regarding an independent role of triglycerides in the development of CVD, and the treatment of hypertriglyceridemia in patients with DM, highlighting the potential relevance to children and the need for more data in children and adolescents to guide clinical practice.

scholarly journals The role of insulin analogs in the achievement of compensation and improvement of quality of life in children and adolescents with type 1 diabetes mellitus

2010 ◽  
Vol 13 (3) ◽  
pp. 147-152
Author(s):  
Tamara Leonidovna Kuraeva
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Self Control ◽  
Self Management ◽  
Insulin Analogs ◽  
Substantial Progress

Despite substantial progress in the treatment of type 1 diabetes mellitus achieved by the end of the last century due to the advent of human insulins,intensive insulinotherapy, means of glycemia self-control, and active patient self-management education, compensation of the diseases in childrenand adolescents remains a challenging problem. This paper is focused on the use of insulin analogs in these patients and main difficulties encounteredby pediatricians in the correction of therapy.

scholarly journals Increased levels of YKL-40 in patients with diabetes mellitus: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Wanwan Luo ◽  
Lingmin Zhang ◽  
Lingling Sheng ◽  
Zhencheng Zhang ◽  
Zaixing Yang
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Meta Analysis ◽  
Healthy Controls ◽  
Patients With Diabetes ◽  
Severe Degree ◽  
The Relationship

Abstract Background: Diabetes mellitus (DM) could be classified as type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), gestational diabetes mellitus (GDM) and others according to etiology and pathology. Diabetic nephropathy (DN) is one of the most serious complications of DM. YKL-40 is a marker of inflammation and some studies have indicated that DM was related with inflammation. The objective of our study is to perform a systematic review and meta-analysis to confirm the relationship between YKL-40 and DM as well as DN.Methods: Pubmed, Embase, CNKI and Chinese wanfang databases were searched for eligible studies by two independent authors. Studies were included in this meta-analysis if they fulfilled the following inclusion criteria: (1) a study involving the role of YKL-40 in DM (or DN) designed as a case-control study or cohort study; (2) the data of serum YKL-40 levels were available; (3) studies were published in English or Chinese.Results: Twenty-five studies involving 2498 DM patients and 1424 healthy controls were included. Compared with healthy controls, DM patients had significantly higher levels of YKL-40 (DM: SMD=1.62, 95%CI, 1.08 to 2.25, P=0.000; GDM: SMD=2.85, 95%CI, 1.01 to 4.70, P=0.002). Additionally, DM patients with different degree of albuminuria had significantly higher levels of YKL-40 compared with healthy controls (normoalbuminuria: SMD=1.58, 95%CI, 0.59 to 2.56, P=0.002; microalbuminuria: SMD=2.57, 95%CI, 0.92 to 4.22, P=0.002; macroalbuminuria: SMD=2.69, 95%CI, 1.40 to 3.98, P=0.000) and serum YKL-40 levels increased with increasing severity of albuminuria among DM patients (microalbuminuria vs normoalbuminuria: SMD=1.49, 95%CI, 0.28 to 2.71, P=0.016; macroalbuminuria vs microalbuminuria: SMD=0.93, 95%CI, 0.34 to 1.52, P=0.002).Conclusions: DM patients have higher levels of YKL-40 compared with healthy controls. Additionally, levels of YKL-40 are significantly higher in DM patients with different degree of albuminuria than in the healthy controls and the levels of YKL-40 are positively related with the severe degree of albuminuria. Therefore, our current meta-analysis suggests that their sera should be detected for YKL-40, if DM, especially DN, is suspected in patients.

scholarly journals Increased Levels of YKL-40 in Patients With Diabetes Mellitus: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Wanwan Luo ◽  
Lingmin Zhang ◽  
Lingling Sheng ◽  
Zhencheng Zhang ◽  
Zaixing Yang
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Meta Analysis ◽  
Healthy Controls ◽  
Patients With Diabetes ◽  
Severe Degree ◽  
The Relationship

Abstract Background: Diabetes mellitus (DM) could be classified as type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), gestational diabetes mellitus (GDM) and others according to etiology and pathology. Diabetic nephropathy (DN) is one of the most serious complications of DM. YKL-40 is a marker of inflammation and some studies have indicated that DM was related with inflammation. The objective of our study is to perform a systematic review and meta-analysis to confirm the relationship between YKL-40 and DM as well as DN.Methods: Pubmed, Embase, CNKI and Chinese wanfang databases were searched for eligible studies by two independent authors. Studies were included in this meta-analysis if they fulfilled the following inclusion criteria: (1) a study involving the role of YKL-40 in DM (or DN) designed as a case-control study or cohort study; (2) the data of serum YKL-40 levels were available; (3) studies were published in English or Chinese.Results: Twenty-five studies involving 2498 DM patients and 1424 healthy controls were included. Compared with healthy controls, DM patients had significantly higher levels of YKL-40 (DM: SMD=1.62, 95%CI, 1.08 to 2.25, P=0.000; GDM: SMD=2.85, 95%CI, 1.01 to 4.70, P=0.002). Additionally, DM patients with different degree of albuminuria had significantly higher levels of YKL-40 compared with healthy controls (normoalbuminuria: SMD=1.58, 95%CI, 0.59 to 2.56, P=0.002; microalbuminuria: SMD=2.57, 95%CI, 0.92 to 4.22, P=0.002; macroalbuminuria: SMD=2.69, 95%CI, 1.40 to 3.98, P=0.000) and serum YKL-40 levels increased with increasing severity of albuminuria among DM patients (microalbuminuria vs normoalbuminuria: SMD=1.49, 95%CI, 0.28 to 2.71, P=0.016; macroalbuminuria vs microalbuminuria: SMD=0.93, 95%CI, 0.34 to 1.52, P=0.002).Conclusions: DM patients have higher levels of YKL-40 compared with healthy controls. Additionally, levels of YKL-40 are significantly higher in DM patients with different degree of albuminuria than in the healthy controls and the levels of YKL-40 are positively related with the severe degree of albuminuria.

scholarly journals Increased levels of YKL-40 in patients with diabetes mellitus: a systematic review and meta-analysis

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Wanwan Luo ◽  
Lingmin Zhang ◽  
Lingling Sheng ◽  
Zhencheng Zhang ◽  
Zaixing Yang
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Meta Analysis ◽  
Healthy Controls ◽  
Patients With Diabetes ◽  
Severe Degree ◽  
The Relationship

Abstract Background Diabetes mellitus (DM) could be classified as type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), gestational diabetes mellitus (GDM) and others according to etiology and pathology. Diabetic nephropathy (DN) is one of the most serious complications of DM. YKL-40 is a marker of inflammation and some studies have indicated that DM was related with inflammation. The objective of our study is to perform a systematic review and meta-analysis to confirm the relationship between YKL-40 and DM as well as DN. Methods Pubmed, Embase, CNKI and Chinese wanfang databases were searched for eligible studies by two independent authors. Studies were included in this meta-analysis if they fulfilled the following inclusion criteria: (1) a study involving the role of YKL-40 in DM (or DN) designed as a case–control study or cohort study; (2) the data of serum YKL-40 levels were available; (3) studies were published in English or Chinese. Finally, twenty-five studies were included in this meta-analysis. Results Compared with healthy controls, DM patients had significantly higher levels of YKL-40 (DM: SMD = 1.62, 95% CI 1.08 to 2.25, P = 0.000; GDM: SMD = 2.85, 95% CI 1.01 to 4.70, P = 0.002). Additionally, DM patients with different degree of albuminuria had significantly higher levels of YKL-40 compared with healthy controls (normoalbuminuria: SMD = 1.58, 95% CI 0.59 to 2.56, P = 0.002; microalbuminuria: SMD = 2.57, 95% CI 0.92 to 4.22, P = 0.002; macroalbuminuria: SMD = 2.69, 95% CI 1.40 to 3.98, P = 0.000) and serum YKL-40 levels increased with increasing severity of albuminuria among DM patients (microalbuminuria vs normoalbuminuria: SMD = 1.49, 95% CI 0.28 to 2.71, P = 0.016; macroalbuminuria vs microalbuminuria: SMD = 0.93, 95% CI 0.34 to 1.52, P = 0.002). Conclusions Our current meta-analysis demonstrates that serum level of YKL-40 is increased in DM and positively associated with the severe degree of albuminuria. Therefore, we suggest that YKL-40 could be considered to be detected, along with other inflammatory markers, if DM, especially DN, is suspected.

DIAGNOSTICS VALUE AND REGULATORY FUNCTIONS OF PROINSULIN

2019 ◽  
Vol 64 (7) ◽  
pp. 397-404 ◽  
Author(s):  
O. N. Poteryaeva ◽  
I. F. Usynin
Keyword(s):  
Diabetes Mellitus ◽  
Functional Activity ◽  
Retinal Dystrophy ◽  
Diagnostic Value ◽  
Diabetes Mellitus Type 1 ◽  
Neuroprotective Activity ◽  
Patients With Diabetes ◽  
Regulatory Functions

Proinsulin is one of the indicators reflecting the functional activity of the pancreas. In insulin-independent diabetes mellitus the ratio proinsulin / insulin is increased. The review examined the causes of hyperproinsulinemia and the diagnostic value of proinsulin in patients with diabetes mellitus type 1 and 2. The role of proinsulin in the regulation of metabolic pathways and the preservation of the functional activity of cells under physiological conditions, during aging and during pathological processes is discussed. Studies in these areas justify the inclusion of proinsulin in the superfamily of signaling factors. The neuroprotective activity of proinsulin and its potential as a therapeutic tool for neurodegenerative diseases and retinal dystrophy are considered.

scholarly journals The attitude of patients with types 1 and 2 diabetes mellitus towards having the disease

2017 ◽  
Vol 89 (10) ◽  
pp. 22-27 ◽  
Author(s):  
I E Sapozhnikova ◽  
E N Zotina
Keyword(s):  
Diabetes Mellitus ◽  
Self Control ◽  
Psychological Characteristics ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
Laboratory Examinations ◽  
Glycated Hemoglobin Level ◽  
Women Unemployed

Aim. To analyze the types of attitude towards disease, their relationships to its course in patients with diabetes mellitus (DM). Subjects and methods. 418 patients with DM, including 318 with type 2 DM (T2DM) and 100 with Type 1 (T1DM), were examined. Clinical and laboratory examinations were performed; the types of attitude towards the disease were studied. Results. The patients with T2DM were more frequently found to have anxious (12.9%) and hypochondriacal (10.7%) types of attitude towards the disease; those with T1DM had euphoric types. The paranoiac type of disease attitude, which was characterized by the presence of peculiar notions about the disease, was detected in 15.1% of the patients with T2DM and in 13% of those with T1DM. Hypernosognosia (overreaction to disease) was more often identified in T2DM (62.3% versus 39% in T1DM (χ2; p < 0.001). In the T2DM group, hypernosognosia was more frequently seen in women, unemployed persons, and obese patients. With the comparable awareness about the disease and degree of self-control, the patients with T2DM with no signs of hypernosognosia had a lower glycated hemoglobin level [7.35 (6.6; 8.6)%] than those with hypernosognosia [7.9 (7; 9.4)%] (p = 0.024). Conclusion. The revealed peculiarities of attitude towards the disease in patients with DM justify the need for increased attention to their psychological characteristics. The situation could be improved if the physicians are be informed, the time of outpatient care is prolonged, and psychotherapists and/or clinical psychologists are widely involved in the management of diabetic patients.

ROLE OF PROINFLAMMATORY CYTOKINES IN PATHOGENESIS OF ARTHROPATHIES IN PATIENTS WITH DIABETES MELLITUS

2020 ◽  
Vol 73 (11) ◽  
pp. 2476-2481
Author(s):  
Valeriya L. Orlenko ◽  
Maria H. Kravchuk
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Proinflammatory Cytokines ◽  
Joint Damage ◽  
Tnf Α ◽  
Patients With Diabetes

The aim: Of our work was to study the level of proinflammatory cytokines in patients with diabetic arthropathy and to investigate their possible effect on the development of this complication. Materials and methods: 118 patients were examined, which were divided into groups by type of diabetes, the presence and severity of diabetic arthropathy. The content of IL-1, TNF-α, IL-6 and receptors to S IL-6-R in serum was determined by immunoassay. Results: In patients with diabetic arthropathy, levels of TNF-α (with type 1 diabetes 44.5%, type 2 diabetes 42.9%) and IL-6 (with type 1 diabetes 52.1%, with diabetes 2 types by 64.4%) significantly increased. There is a direct correlation between the severity of joint damage and the level of TNF-α and IL-6. For IL -1, receptors for S IL-6-R have not been detected. Conclusions: The chances of detecting arthropathy with type 1 diabetes with increasing TNF levels increase by 1.7 times, with an increase in IL-6 by 1.5 times. For type 2 diabetes, it is 1.8 and 1.3 times, respectively. Thus, TNF-α and IL-6 may be markers of the presence and progression of arthropathy in patients with diabetes mellitus

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