Diabetic Patients
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2021 ◽  
Vol 2021 ◽  
pp. 1-11
Marco Bagnati ◽  
Chiara Puricelli ◽  
Giulia Bauce ◽  
Matteo Basile ◽  
Barbara Grigollo ◽  

Background and Aims. Inflammatory, oxidative stress, and endothelial dysfunction play a key role in the pathogenesis of long-term cardiovascular complications in patients with diabetes. The present observational prospective study is aimed at evaluating the effects of micronutrients and phytochemicals contained in the dietary supplement Flebotrofine® (AMNOL Chimica Biologica) on biochemical markers of inflammation, endothelial dysfunction, and glycemic control in patients with diabetes. Methods. 105 type 1 or type 2 diabetes patients regularly took a daily dose of the dietary supplement Flebotrofine® for three consecutive months, and haematological and biochemical parameters were checked at baseline, after three months of treatment, and one month after its suspension. Statistical comparison of the laboratory parameters was performed using the two-tailed ANOVA test for repeated samples with a statistical significance level set at p < 0.05 . Results. The daily use of Flebotrofine® did not change the glycemic metabolic compensation of enrolled patients. After three months of regular Flebotrofine® intake, the plasma levels of the antioxidant β-carotene and of arginine were significantly higher compared with the baseline values, with a decrease in the ADMA/arginine ratio. In contrast, apolipoprotein B, ApoB/ApoA1 ratio, and platelet and leukocyte counts significantly dropped. Conclusion. The daily use of Flebotrofine® might be a valid supplement of arginine, the precursor of NO, and essential in the prevention of endothelial dysfunction. The regular intake of arginine and phytochemicals also improved the antioxidant and antithrombotic profile of enrolled patients. Therefore, Flebotrofine® could be a useful dietary supplement to prevent long-term complications in patients with diabetes.

F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 969
Yuri Ishizaki ◽  
Ryuzoh Nishizono ◽  
Masao Kikuchi ◽  
Hiroko Inagaki ◽  
Yuji Sato ◽  

Basal ganglia lesions showing an expansile high signal intensity on T2-weighted MRI are termed the lentiform fork sign. This specific finding is mainly observed in diabetic patients with uremic encephalopathy with metabolic acidosis, although there are also reports in patients with ketoacidosis, dialysis disequilibrium syndrome, intoxication, and following drug treatment (e.g., metformin). A 57-year-old Japanese man on chronic hemodialysis for 4 years because of diabetic nephropathy was admitted to our hospital for relatively rapid-onset gait disturbance, severe dysarthria, and consciousness disturbance. Brain T2-weighted MRI showed the lentiform fork sign. Hemodialysis was performed the day before admission, and laboratory tests showed mild metabolic (lactic) acidosis, but no uremia. Surprisingly, metformin, which is contraindicated for patients with end-stage kidney disease, had been prescribed for 6 months in his medication record, and his sluggish speaking and dysarthria appeared gradually after metformin treatment was started. Thus, the encephalopathy was considered to be related to metformin treatment. He received hemodialysis treatment for 6 consecutive days, and his consciousness disturbance and dysarthria improved in 1 week. At the 8-month follow-up, the size of the hyperintensity area on MRI had decreased, while the mild gait disturbance remained. Considering the rapid onset of gait and consciousness disturbance immediately before admission, diabetic uremic syndrome may also have occurred with metformin-related encephalopathy, and resulted in the lentiform fork sign, despite the patient showing no evidence of severe uremia on laboratory data.

2021 ◽  
Vol 46 ◽  
pp. S629-S630
E. Delgado Garcia ◽  
J.J. Lopez Gomez ◽  
B. Torres Torres ◽  
E. Gomez Hoyos ◽  
C. Serrna Valles ◽  

2021 ◽  
Phuwadol Viroonluecha ◽  
Esteban Egea-Lopez ◽  
Jose Santa

Abstract Diabetes mellitus is a disease associated with abnormally high levels of blood glucose due to lack of insulin. Combining an insulin pump and continuous glucose monitor with a control algorithm to deliver insulin is an alternative to patient self-management of insulin doses to control blood glucose levels in diabetes mellitus patients. In this work we propose a closed-loop control for blood glucose levels based on deep reinforcement learning. We describe the initial evaluation of several alternatives conducted on a realistic simulator of the glucoregulatory system and propose a particular implementation strategy based on reducing the frequency of the observations and rewards passed to the agent, and using a simple reward function. We train agents with that strategy for three groups of patient classes, evaluate and compare it with alternative control baselines. Our results show that our method is able to outperform baselines as well as similar recent proposals, by achieving longer periods of safe glycemic state and low risk.

2021 ◽  
Vol 46 ◽  
pp. S702-S703
D. Bučan Nenadić ◽  
E. Kolak ◽  
M. Vučković ◽  
M. Radić ◽  
J. Radić

2021 ◽  
Vol 12 (12) ◽  
pp. 96-102
Tanmay Mukhopadhyay ◽  
Pankaj Sarkar ◽  
Somnath Naskar ◽  
Uttam Biswas ◽  
SK Saidul Islam

Background: Cardiovascular complications account for the highest mortality in diabetic patients, mainly due to coronary artery disease and congestive heart failure. Left ventricular hypertrophy (LVH) is an ominous prognostic sign and an independent risk factor for cardiac events which is frequently present in patients living with diabetes. Aims and Objectives: The aim of the study was to evaluate the LV mass and function in normotensive diabetes patients without antihypertensive medication. Materials and Methods: 100 normotensive diabetic patients were in study group and 100 control patients were studied. Hypertension and other known causes of LVH were excluded from the study. Data were analyzed using proper statistical method. Results: Left ventricular mass index (LVMI) is significantly higher in diabetic patients as compared to control population (P<0.001). It was also observed that the means of the left ventricular posterior wall thickness, interventricular septal thickness, and the left ventricular internal diameter during diastole (in all cases P<0.001) were statistically significantly high in diabetic patients in comparison to healthy control subjects. We have found that a significant systolic dysfunction in diabetic group and diastolic dysfunction also very common in diabetic group than the control group. The LVMI also increased in patients who have longer duration of diabetes and poor glycemic control. Conclusion: LVM is significantly higher in patients of type 2 diabetic without having hypertension, albuminuria, and apparent ischemic heart disease as compared to healthy controls. LVM in diabetic patients increases with duration of diabetes and is positively correlated with HbA1c and blood sugar level.

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