scholarly journals Review on Coexistence of Hypertension with Diabetes Mellitus

2021 ◽  
pp. 220-223
Author(s):  
Nargis Saharan
Keyword(s):  
Diabetes Mellitus ◽  
Drug Therapy ◽  
Ace Inhibitors ◽  
Beta Blockers ◽  
Diabetic Patients ◽  
Beneficial Effects ◽  
Low Sodium ◽  
Target Organs ◽  
Effective Role ◽  
Common Target

The coexistence of both diabetes mellitus and hypertension affect the some major target organs. Their common target organ is heart and kidney. The primary goal in the management of the hypertensive diabetic patients is lowering blood pressure to less than 130/80mm Hg Beta- blockers have been reported to adversely affect the overall risk factor profile in the diabetic patient. Initially ACE inhibitors and ARB are initially can be given to diabetic hypertensive. Beta blockers also show great effects in preventing further cardiovascular diseases in diabetic hypertensive. Although combined drug therapy is usually required to achieve goal but in addition to drug therapy some other precautions should also plays effective role like exercise، low sodium chloride intake, lower lipids in diet, maintaining glucose level, stress less patients environment. Calcium channels blockers and diuretics in combination with ACE inhibitors and antidiabetic drugs will also exerts beneficial effects.

Once-weekly supervised combined training improves neurocognitive and psychobehavioral outcomes in young patients with type 1 diabetes mellitus

2019 ◽  
Vol 32 (12) ◽  
pp. 1341-1350 ◽  
Author(s):  
Junghwan Suh ◽  
Han Saem Choi ◽  
Ahreum Kwon ◽  
Hyun Wook Chae ◽  
Soyong Eom ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Resistance Exercise ◽  
Type 1 Diabetes Mellitus ◽  
Exercise Program ◽  
Exercise Group ◽  
Control Group ◽  
Diabetic Patients ◽  
Beneficial Effects

Abstract Background Previous studies investigating the beneficial effects of exercise in type 1 diabetes mellitus (T1DM) are relatively insufficient compared to studies on type 2 diabetes mellitus (T2DM), due to the fear of hypoglycemia. Recently, several researchers have reported that combined aerobic and resistance exercise prevents hypoglycemia during and after exercise. Furthermore, exercise has been shown to have beneficial effects on the psychological status of patients with various diseases. The aim of this study was to evaluate the effect of combined aerobic and resistance exercise in adolescents with T1DM. Methods Thirty-five type 1 diabetic patients were enrolled, and subjects were divided into either an exercise group or a control group. Thirty patients (20 patients in the exercise group, 10 patients in the control group) completed the study. The exercise program was performed for 1 h at a time, once a week, for 12 weeks. Study parameters were evaluated at baseline and 3 months after baseline evaluation. Results Combined aerobic and resistance exercise better controlled the body mass index (BMI), and also improved maximum muscular strength and maximum exercise intensity. On psychological tests, subjects’ attention and quality of life showed improving tendency, while their stress and behavioral problems diminished. The number of exercise events increased in the training group, while the daily total insulin dose and glycated hemoglobin (HbA1c) level showed no significant changes. Conclusions A 12-week structured exercise program consisting of aerobic and resistance exercises improves cardiovascular, neurocognitive and psychobehavioral functions, and positively helps lifestyle modification in patients with T1DM.

scholarly journals Impact of type 2 diabetes mellitus on clinical outcomes in patients with COVID-19 and cardiovascular disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
K G Lobanova ◽  
T Y U Demidova ◽  
V M Plakhotnyaya
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Mortality Rate ◽  
Clinical Outcomes ◽  
Antihypertensive Therapy ◽  
Ace Inhibitors ◽  
Beta Blockers

Abstract Introduction Cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) are independent risk factors for the severe course of COVID-19. Thus, all patients with COVID-19, T2DM and CVD should be constant medical control and receive adequate therapy for concomitant diseases. Purpose To study the effect of T2DM on the clinical outcomes of patients with COVID-19 and CVD. Methods Retrospective analysis of clinical outcomes of 1665 patients with a confirmed diagnosis of COVID-19, depending on the presence of CVD, T2DM and received therapy. Results The study included 866 men and 799 women; 299 patients (17.96%) had T2DM. The average age of the patients was 57.56±15.04 years. We noted a high prevalence of CVD: 747 patients (44.9%) had hypertension, 362 patients (21.7%) – coronary heart disease (CHD): 109 (6.5%) – myocardial infarction, 23 (1.4%) – exertional angina, 106 (6.4%) – atrial fibrillation, 98 (5.9%) – chronic heart failure. The patients with T2DM had hypertension in 80% of cases and CHD in 42%. Overall, 65.2% of patients had at least 1 concomitant CVD. Mortality of patients with COVID-19 without concomitant pathology was 0.5%, and in the patients with CHD – 20.7%, with hypertension – 12.9%. Mortality in the patients without T2DM was 7.4%, in the patients with T2DM – 14.0%. Hyperglycemia was associated with a higher mortality rate: the median of glycemia was 5.7 mmol/L in discharged patients and 7.2 mmol/L in deceased patients, regardless of the presence of T2DM (p<0.001). The deceased patients had a higher level of HbA1c compared to those discharged (7.8% vs 8.1%). 24.6% of patients received antihypertensive therapy: 15.5% of patients received ACE inhibitors or ARBs, 11.9% – beta-blockers, 7.1% – thiazide and thiazide-like diuretics, 3.1% – calcium channel blockers. Statins were received by 2.4% of patients, antiplatelet drugs – 2.1%. The mortality rate of patients with COVID-19 and hypertension who received antihypertensive therapy was comparable to the mortality rate of the patients without hypertension: 8.8% and 9.0%, respectively. A significant decrease in mortality was observed during therapy with ACE inhibitors/ARBs (OR 0.39, 95% CI 0.21–0.72, p<0.05), beta-blockers (OR 0.53, 95% CI 0.28–1, p<0.05). This decrease was more significant among patients with T2DM compared with patients without T2DM: a 2.27-fold decrease in mortality due to ACE inhibitors/ARBs in the group without T2DM (OR 0.44, 95% CI 0.2–0.96, p<0.05), in the T2DM group – 4.76 times (OR 0.21, 95% CI 0.07–0.6, p<0.05); decrease in mortality against the background of beta-AB in the group without T2DM – by 1.72 times (OR 0.58, 95% CI 0.26–1.37), in the group with T2DM – by 3 times (OR 0.33, 95% CI 0.12–0.97, p<0.05). Conclusion The presence of CVD and T2DM in the patients with COVID-19 worsens the prognosis of COVID-19. But the adequate therapy for concomitant diseases can have a positive effect on this group of patients. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Barbaloin Treatment Contributes to the Rebalance of Glucose and Lipid Homeostasis of Gestational Diabetes Mellitus Mice

Dose-Response ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 155932582098491
Author(s):  
Yong Wang ◽  
Haiying Wang ◽  
Fengzhen Yang
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Aloe Vera ◽  
Diabetic Patients ◽  
Peroxisome Proliferator ◽  
Type 2 Diabetic Patients ◽  
Peroxisome Proliferator Activated Receptor ◽  
Beneficial Effects ◽  
Glucose Levels

Aloe vera L has been shown to possess hypoglycemic and hypolipidemic effects on type 2 diabetic patients, and its major benefits may be linked to barbaloin, which is a major component of Aloe vera L. This study focused on investigating the potential effects and underlying mechanisms of barbaloin on gestational diabetes mellitus (GDM). The db/+ diabetic mice with GDM were daily orally administered with barbaloin or metformin during the gestational period. The results demonstrated that administration of barbaloin significantly reduced blood glucose levels and increased insulin levels in GDM mice. We further found that barbaloin treatment reduced inflammatory response and ROS levels in the liver. Finally, we revealed that the AMP-activated protein kinase (AMPK) / peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) signaling pathway was involved in BAT-mediated beneficial effects on mice with GDM. Our study suggested that barbaloin exerted hypoglycemic and hypolipidemic effects on GDM mice, via, at least in part, modulation of AMPK/ PGC-1α signaling in GDM mice.

scholarly journals MEDICATION ADHERENCE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS - A CROSS-SECTIONAL STUDY

2019 ◽  
pp. 177-180
Author(s):  
PRATHYUSHA RANI T ◽  
PRASHANTHI B ◽  
AYESHA AMREEN FATHIMA ◽  
AYESHA FIRDOSE ◽  
SARA NASER ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Drug Therapy ◽  
Medication Adherence ◽  
Diabetic Patients ◽  
Type Ii ◽  
Improve Medication Adherence ◽  
Cross Sectional

Objective: This study was conducted to determine the adherence of medications among type 2 diabetes mellitus (DM) patients. To evaluate adherence to therapy and study factors associated with non-adherence and adherence in patients with type II DM. Methods: A cross-sectional, observational study was conducted for 6 months in three hospitals. A total of 200 type II diabetic patients, who were on anti-diabetic drug therapy for at least 6 months, were enrolled. Blood glucose was measured and details of drug therapy were noted. Medication adherence was assessed using the Morisky Medication Adherence Scale and adherence scores were calculated. Results: Only 15% had high medication adherence, while 24% had moderate and 61% had low medication adherence. Only 30% were having optimally controlled glycemic levels, whereas 70% were having uncontrolled glycemic levels. Medication adherence scores were lower (reflecting lower adherence) in type II patients with uncontrolled glycemic levels than those having optimally controlled glycemic levels, but this difference was not statistically significant. Conclusion: Overall, medication adherence was low in type II diabetic patients. The study shows that to improve medication adherence, better counseling and health education of patients are required. Although several patients were adherent to therapy, adherent patients are more preferably to achieve glycemic control than nonadherent patients. Greater efforts are needed to facilitate diabetes self-management behaviors to improve patient outcomes.

scholarly journals Conservative treatment for acute coronary syndrome in patients with type 2 diabetes mellitus

2013 ◽  
Vol 16 (2) ◽  
pp. 43-51
Author(s):  
Sergey Valentinovich Kakorin ◽  
Lev Borisovich Kruglyi ◽  
Ashot Musaelovich Mkrtumyan
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Beta Blockers ◽  
Physical Exertion ◽  
Antiplatelet Agents ◽  
Diabetic Microangiopathy ◽  
Diabetic Patients ◽  
Rapid Improvement ◽  
Coronary Syndrome ◽  
History Of

2 diabetes mellitus (T2DM). Dyspnea during physical exertion should be considered an anginal equivalent in patients with T2DM, and suffocation causing admission to ICU ? as a possible sign of myocardial infarction. Proximal and distal coronary lesions combined with diabetic microangiopathy compromising collateral circulation are a frequent finding in these patients. Therefore an infusion of nitroglycerine may yield a rapid improvement in their condition. Treatment with low-molecular-weight heparin (LMWH) should be administered for a longer period due to rheological disturbances in T2DM. Diabetic patients with a history of myocardial infarction (MI) should receive a life-long therapeutic combination of two different antiplatelet agents. Carvedilol, a non-selective beta blocker/ alpha-1 blocker, and selective beta-1 blockers (e.g. nebivolol, bisoprolol) have better safety profile than other beta blockers concerning neurological aspects of hypoglycemic events.

Angiotensin Converting Enzyme Inhibitors May Cause Renal Impairment in Diabetes Mellitus

1988 ◽  
Vol 33 (2) ◽  
pp. 247-248 ◽  
Author(s):  
J. Webster ◽  
L.E. Murchison ◽  
O.J. Robb
Keyword(s):  
Diabetes Mellitus ◽  
Renal Function ◽  
Angiotensin Converting Enzyme ◽  
Ace Inhibitors ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Diabetic Patients ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Careful Investigation

Angiotensin converting enzyme (ACE) inhibitors have been recommended for the treatment of diabetic nephropathy. However, it should be remembered that diabetic patients may also develop atheromatous renal artery stenosis. In such patients ACE inhibitors may have adverse effects on renal function. Careful investigation and monitoring is essential when ACE inhibitors are used in diabetes.

Abstract P119: Comparison of Treatment of Acute Coronary Syndrome in a Cohort of Medicare Patients With and Without Diabetes Mellitus

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Zhenxiang Zhao ◽  
Xiaomei Peng ◽  
Douglas Faries ◽  
Jay Bae ◽  
Patrick McCollam ◽  
...  
Keyword(s):  
Ace Inhibitors ◽  
Beta Blockers ◽  
Treatment Patterns ◽  
Renal Diseases ◽  
Diabetic Patients ◽  
Index Hospitalization ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Hospitalization Period ◽  
Cardiovascular Medications

Objective: This study compared real-world treatment patterns for ACS patients with and without DM in a cohort of Medicare population. Methods: A retrospective cohort study was conducted using the MarketScan Medicare claims database. Patients aged ≥65 years, hospitalized with a primary diagnosis of ACS between 01/01/2007 and 12/31/2007 were categorized into 2 groups: with and without DM. Patient characteristics, treatment patterns during the index hospitalization, and cardiovascular medications use 12 months pre- and post-index hospitalization were analyzed. (All p<.01 unless otherwise stated.) Results: Of 8,666 ACS patients identified, 2,407 (28%) were diabetic and 6,259 (72%) were non-diabetic. Patients with DM were more likely to be younger (77.6 vs. 79.6), male (58.8% vs. 54.6%), and have higher rates of previous MI (17.2% vs. 12.0%), congestive heart failure (28% vs. 16.1%), PVD (19.2% vs. 12.8%), TIA/stroke (10.0% vs. 7.3%), hypertension (54.4% vs. 49.6%), and renal diseases (17.1% vs. 7.0%). Patients with DM were significantly more likely to present with non-ST-segment elevation myocardial infarction at the index hospitalization compared to those without DM (66.4% vs. 61.2%). During the index hospitalization, DM patients underwent less PCI (27.8% vs. 34.6%) but more CABG (9.7% vs. 7.6%), and were more likely to have medical management during the index hospitalization compared to non-DM patients. Compared to their non-DM counterparts, patients with DM utilized more statins (66.9% vs. 48.0%), beta blockers (53.0% vs .42.4%), thienopyridine (24.5% vs. 13.2%), and ACE inhibitors (42.3% vs. 28.6%) during the 12-month pre-hospitalization period, while during the 12-month post-hospitalization period, they utilized slightly more statins (85.8% vs. 82.1%) and had similar level of beta blockers (86.1% vs. 85.6%, p=0.57) and thienopyridine (62.5% vs. 64.7%, p=0.12) and ACE inhibitors use (54.8% vs. 56.1%, p=0.37). Conclusion: ACS patients with DM presented additional clinical risks than those without DM. Observed treatment patterns varied correspondingly between the 2 groups. Differences in cardiovascular medications usage between the 2 groups narrowed after the ACS hospitalization.

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