scholarly journals Diabetes mellitus in patients using psychotropic medications: How does it work?

2021 ◽  
Vol 75 ◽  
pp. 398-405
Author(s):  
Marcin Kosmalski ◽  
Monika Różycka-Kosmalska ◽  
Joanna Sikora ◽  
Tadeusz Pietras
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Psychotropic Medications ◽  
Point Of View ◽  
Chronic Hyperglycemia ◽  
Therapeutic Procedures ◽  
Independent Risk Factors ◽  
Practice Questions ◽  
The Relationship

Diabetes mellitus (DM) is not a single disease, but a group of diseases that are characterized by chronic hyperglycemia and risk of damage to tissues and organs. The mechanisms of its development are different and due mainly to disorders of insulin secretion or its effects. For this reason, 4 types of DM have been distinguished. One of them is a specific type of DM, determined, inter alia, by the use of certain psychotropic medications. Chronic hyperglycemia often occurs in association with some of these drugs, but in many cases it is categorized erroneously as type 2 (T2DM) or 1 (T1DM). The relationship between DM and psychiatric disorders is bi-directional, involving two mutually independent risk factors for the development of the disease. However, not all patients with a mental illness develop carbohydrate metabolism disorders, which is due to a varied diabetogenic potential and mechanisms of action of psychotropic medications. In clinical practice, questions concerning the frequency of this type of DM, risk factors of its development and hyperglycemic mechanism of psychotropic medications arise. Therefore, the aim of this article is to attempt to answer these questions. From a practical point of view, obtaining such information should allow for the development of appropriate diagnostic and therapeutic procedures.

scholarly journals Urinary NGAL and RBP Are Biomarkers of Normoalbuminuric Renal Insufficiency in Type 2 Diabetes Mellitus

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Aimei Li ◽  
Bin Yi ◽  
Yan Liu ◽  
Jianwen Wang ◽  
Qing Dai ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Renal Insufficiency ◽  
Urinary Ngal ◽  
Independent Risk Factors ◽  
Pai 1 ◽  
E Cadherin

Objectives. As a screening index of diabetic kidney disease (DKD), urinary albumin/creatine ratio (UACR) is commonly used. However, approximately 23.3%-56.6% of DKD patients with estimated glomerular filtration rate eGFR<60 ml/min per 1.73 m2 are normoalbuminuric. Thus, urinary biomarkers of nonalbuminuric renal insufficiency in type 2 diabetes mellitus (T2DM) patients are urgently needed. Methods. This cross-sectional study enrolled 209 T2DM patients with normoalbuminuria whose diabetes duration was more than 5 years. The patients were classified into two groups, NO-CKD (eGFR≥60 ml/min per 1.73 m2, n=165) and NA-DKD (eGFR<60 ml/min per 1.73 m2, n=44). Levels of urinary neutrophil gelatinase-associated lipocalin (NGAL), retinol-binding protein (RBP), plasminogen activator inhibitor-1 (PAI-1), vascular cell adhesion molecule-1 (VCAM-1), and E-cadherin were detected, and their correlations with eGFR, plasma TNF-α, IL-6, endothelin-1 (ET-1), and 8-hydroxydeoxyguanosine (8-OHdG) were assessed. Results. Among patients with renal insufficiency, 26.0% was normoalbuminuric. Compared to the NO-CKD group, the NA-DKD group was older with lower hemoglobin (HB) levels and higher systolic blood pressure (SBP), plasma TNF-α, IL-6, and 8-OHdG levels. Logistic regression analysis suggested that age, TNF-α, and 8-OHdG were independent risk factors for nonalbuminuric renal insufficiency. Compared to the NO-CKD group, the NA-DKD group exhibited significant increases in urinary NGAL and RBP levels but not PAI-1, VCAM-1, and E-cadherin. Urinary NGAL and RBP both correlated negatively with eGFR and positively with plasma IL-6 and 8-OHdG. Multiple linear regression indicated NGAL (β=−0.287, p=0.008) and RBP (β=−44.545, p<0.001) were independently correlated with eGFR. Conclusion. Age, plasma TNF-α, and 8-OHdG are independent risk factors for renal insufficiency in T2DM patients with normoalbuminuria. Urinary NGAL and RBP can serve as noninvasive biomarkers of normoalbuminuric renal insufficiency in T2DM.

scholarly journals CHANGES OF COGNITIVE FUNCTION IN PATIENTS WITH HYPERTENSION WITH CONCOMITANT DIABETES MELLITUS TYPE 2

2020 ◽  
Vol 16 (2) ◽  
pp. 9-15
Author(s):  
V.Z. Netiazhenko ◽  
T.I. Malchevska ◽  
O.N. Plenova ◽  
V.S. Potaskalova ◽  
V.V. Taranchuk
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Mental State ◽  
Group I ◽  
Moderate Cognitive Impairment ◽  
The Relationship

Relevance. Till now there is no clear clinical trial understanding of the relationship between hypertension (AH) and the patient's cognitive function. Objective: the investigation of changes in cognitive function in patients with hypertension with concomitant type 2 diabetes mellitus (DM2). Materials and methods. 215 people were examined: Group I (n = 131) – stage II hypertensive disease (HD); Group II (n = 46) – HD, combined with diabetes mellitus2; Group III, control (n = 38) – without a diagnosis of HD and diabetes mellitus2. All examined blood pressure (BP), echocardiogram. Clinical complaints, anamnestic data, and neuropsychiatric testing data were used to diagnose moderate cognitive impairment (MCI). Used modified diagnostic criteria J. Touchon, R. Petersen. To assess cognitive function used: Short scale of assessment of mental state (Mini-Mental State Examination - MMSE); Frontal Assessment Battery (FAB); clock drawing test; test for literal and categorical associations; Schulte tables; the Global Deterioration Scale (GDS) and the Clinical Dementia Rating (CDR). Result. In patients with HD, the most significant risk factors for moderate cognitive impairment are hypercholesterolemia and overweight (with OR 1.8), obesity (OR 1.6), the presence of concomitant diabetes mellitus2, which, especially in overweight, significantly impairs cognitive function ( OR 2.56). Deterioration of cognitive function correlates with the duration of HD, cholesterol levels. Concomitant diabetes mellitus2 in patients with HD creates a statistically significant additional negative effect on the results of cognitive function. In patients with HD with a distorted daily blood pressure profile, the neurodynamic component of cognitive function is first of all affected - conceptualization, repetition, the reaction of choice. The relationship between cognitive function and daily monitoring of blood pressure often have a U-shaped relationship, where the maximum indicators of cognitive function are at the level of the optimal recommended blood pressure figures (130-139 mm Hg for SBP, and 75-85 mm Hg for DBP, and the daily index within 10%). Conclusions. There is a dependence on changes in cognitive function on the presence of risk factors and signs of subclinical damage to target organs. The nonlinear U-shaped character of the relationship between the average daily, average night, and average daily blood pressure and the results of screening tests and scales for assessing cognitive function are shown.

scholarly journals The prevalence and risk factors of sarcopenia in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Yaqin Ai ◽  
Ruoxin Xu ◽  
Lingping Liu
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Publication Bias ◽  
Meta Analysis ◽  
Male Gender ◽  
Funnel Plot ◽  
Chronic Hyperglycemia

Abstract Background Sarcopenia was a frequent chronic complication in patients with type 2 diabetes mellitus (T2DM), and previous evidence showed conflicting results regarding the prevalence and risk factors of sarcopenia in T2DM. In the current study, we aimed at systematically exploring the prevalence and risk factors of sarcopenia in patients with T2DM. Methods PubMed, Embase, and Cochrane Central Register of Controlled Trials were systematically searched to identify observational studies which investigated the prevalence and risk factors of sarcopenia in patients with T2DM. The quality of individual included studies was evaluated using The Newcastle–Ottawa scale. Pooled effects regarding prevalence and associated factors were calculated using random-effects models. The potential publication bias was assessed via funnel plot and Egger test. Results Twenty-eight studies involving 16,800 patients were included in our meta-analysis. The pooled prevalence of sarcopenia in patients with T2DM was 18% (95% CI 0.15–0.22; I2 = 97.4%). The pooled results showed that elder age (OR 4.73; 95% CI 4.30–5.19; I2 = 85.6%), male gender, chronic hyperglycemia (higher HbA1c) (OR 1.16; 95% CI 1.05–2.47; I2 = 99.2%) and osteoporosis (OR 1.16; 95% CI 1.05–2.47; I2 = 99.2%) was predictors for sarcopenia, whereas patients with lower BMI (OR 1.16; 95% CI 1.05–2.47; I2 = 99.2%) and metformin administrations (OR 1.16; 95% CI 1.05–2.47; I2 = 99.2%) were not prone to get sarcopenia. The funnel plot and statistical tests showed no obvious publication bias. Conclusions Sarcopenia was frequent in T2DM patients. Elder age, male gender and chronic hyperglycemia, Osteoporosis were significant risk factors for Sarcopenia. Lower BMI and metformin administrations were associated with lower risk of sarcopenia.

scholarly journals Clinical Significance of Hemostatic Parameters in the Prediction for Type 2 Diabetes Mellitus and Diabetic Nephropathy

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Lianlian Pan ◽  
Yali Ye ◽  
Mingyi Wo ◽  
Danni Bao ◽  
Fengjiao Zhu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
High Sensitivity ◽  
Area Under Roc Curve ◽  
Independent Risk Factors ◽  
Low Sensitivity

It would be important to predict type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN). This study was aimed at evaluating the predicting significance of hemostatic parameters for T2DM and DN. Plasma coagulation and hematologic parameters before treatment were measured in 297 T2DM patients. The risk factors and their predicting power were evaluated. T2DM patients without complications exhibited significantly different activated partial thromboplastin time (aPTT), platelet (PLT), and D-dimer (D-D) levels compared with controls (P<0.01). Fibrinogen (FIB), PLT, and D-D increased in DN patients compared with those without complications (P<0.001). Both aPTT and PLT were the independent risk factors for T2DM (OR: 1.320 and 1.211, P<0.01, resp.), and FIB and PLT were the independent risk factors for DN (OR: 1.611 and 1.194, P<0.01, resp.). The area under ROC curve (AUC) of aPTT and PLT was 0.592 and 0.647, respectively, with low sensitivity in predicting T2DM. AUC of FIB was 0.874 with high sensitivity (85%) and specificity (76%) for DN, and that of PLT was 0.564, with sensitivity (60%) and specificity (89%) based on the cutoff values of 3.15 g/L and 245 × 109/L, respectively. This study suggests that hemostatic parameters have a low predicting value for T2DM, whereas fibrinogen is a powerful predictor for DN.

Sign in / Sign up

Export Citation Format

Share Document