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microvascular complications of diabet

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https://www.readbyqxmd.com/read/29344329/major-adverse-cardiovascular-event-reduction-with-glp-1-and-sglt2-agents-evidence-and-clinical-potential
#1
REVIEW
Michael E Røder
Treatment of patients with type 2 diabetes is directed against treating symptoms of hyperglycemia, minimizing the risk of hypoglycemia, and the risk of microvascular and macrovascular complications. The majority of patients with type 2 diabetes die from cardiovascular or cerebrovascular disease. Future therapies should therefore focus on reducing cardiovascular morbidity in this high-risk population. Glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose co-transporter 2 inhibitors (SGLT2-i) are two drug classes with proven antihyperglycemic effect in type 2 diabetes...
January 2018: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/29336366/potential-value-of-datura-stramonium-agglutinin-recognized-glycopatterns-in-urinary-protein-on-differential-diagnosis-of-diabetic-nephropathy-and-nondiabetic-renal-disease
#2
Xiao-Li Yang, Han-Jie Yu, Han-Yu Zhu, Ying Zheng, Qiu-Xia Han, Guang-Yan Cai, Xiang-Mei Chen
BACKGROUND: Diabetic nephropathy (DN) is the most common and serious microvascular complication of diabetes. To date, the gold standard for identifying DN and nondiabetic renal disease (NDRD) is a renal biopsy; however, there is currently no reliable diagnostic marker to identify DN and NDRD in a noninvasive manner. This study aimed to investigate the different glycopatterns in urine specimens of DN patients and NDRD patients for a differential diagnosis. METHODS: In total, 19 DN patients and 18 NDRD patients who underwent renal biopsies between March 2015 and March 2016 at the Chinese People's Liberation Army General Hospital were enrolled in this study...
January 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29333660/interventions-to-increase-attendance-for-diabetic-retinopathy-screening
#3
REVIEW
John G Lawrenson, Ella Graham-Rowe, Fabiana Lorencatto, Jennifer Burr, Catey Bunce, Jillian J Francis, Patricia Aluko, Stephen Rice, Luke Vale, Tunde Peto, Justin Presseau, Noah Ivers, Jeremy M Grimshaw
BACKGROUND: Despite evidence supporting the effectiveness of diabetic retinopathy screening (DRS) in reducing the risk of sight loss, attendance for screening is consistently below recommended levels. OBJECTIVES: The primary objective of the review was to assess the effectiveness of quality improvement (QI) interventions that seek to increase attendance for DRS in people with type 1 and type 2 diabetes.Secondary objectives were:To use validated taxonomies of QI intervention strategies and behaviour change techniques (BCTs) to code the description of interventions in the included studies and determine whether interventions that include particular QI strategies or component BCTs are more effective in increasing screening attendance;To explore heterogeneity in effect size within and between studies to identify potential explanatory factors for variability in effect size;To explore differential effects in subgroups to provide information on how equity of screening attendance could be improved;To critically appraise and summarise current evidence on the resource use, costs and cost effectiveness...
January 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29329523/early-commitment-of-cardiovascular-autonomic-modulation-in-brazilian-patients-with-congenital-generalized-lipodystrophy
#4
Clarisse Mourão Melo Ponte, Virgínia Oliveira Fernandes, Maria Helane Costa Gurgel, Izabella Tamira Galdino Farias Vasconcelos, Lia Beatriz de Azevedo Souza Karbage, Christiane Bezerra Rocha Liberato, Carlos Antônio Negrato, Marília de Brito Gomes, Ana Paula Dias Rangel Montenegro, Renan Magalhães Montenegro Júnior
BACKGROUND: Metabolic abnormalities in congenital generalized lipodystrophy (CGL) are associated with microvascular complications. However, the evaluation of different types of neuropathy in these patients, including the commitment of cardiovascular autonomic modulation, is scarce. The objective of the present study was to determine the prevalence of cardiovascular autonomic neuropathy (CAN) in patients with CGL compared with individuals with type 1 diabetes and healthy subjects. METHODS: Ten patients with CGL, 20 patients with type 1 diabetes and 20 healthy subjects were included in the study...
January 12, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29326539/microvascular-outcomes-of-pediatric-onset-type-1-diabetes-mellitus-a-single-center-observational-case-reviews-in-sana-a-yemen
#5
Abdallah Ahmed Gunaid
Microvascular complications of pediatric-onset type 1 diabetes are common in low-income countries. In this study, we aimed at reviewing microvascular outcomes in 6 cases with type 1 diabetes over 14 to 31 years of follow-up. Severe proliferative diabetic retinopathy (PDR) and/or diabetic macular edema (maculopathy) (DME) and overt diabetic nephropathy (macroalbuminuria) were seen among 4 of 6 patients, whereas severe diabetic peripheral neuropathy with Charcot neuroarthropathy was seen in 1 patient only, who had the longest duration of follow-up...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
https://www.readbyqxmd.com/read/29326023/exploring-quality-of-care-and-social-inequalities-related-to-type-2-diabetes-in-hungary-nationwide-representative-survey
#6
Attila Nagy, Nóra Kovács, Anita Pálinkás, Valéria Sipos, Ferenc Vincze, Gergő Szőllősi, Orsolya Csenteri, Róza Ádány, János Sándor
AIMS: The study aimed to launch a T2DM adult cohort that is representative of Hungary through a cross-sectional study, to produce the most important quality indicators for T2DM care, to describe social inequalities, and to estimate the absolute number of T2DM adult patients with uncontrolled HbA1c levels in Hungary. METHODS: A representative sample of the Hungarian T2DM adults (N=1280) was selected in 2016. GPs collected data on socio-demographic status by questionnaire, and on history and laboratory parameters from medical records...
January 8, 2018: Primary Care Diabetes
https://www.readbyqxmd.com/read/29325551/relationship-between-cardiac-microvascular-dysfunction-measured-with-82rubidium-pet-and-albuminuria-in-patients-with-diabetes-mellitus
#7
Louis Potier, Renata Chequer, Ronan Roussel, Kamel Mohammedi, Souad Sismail, Agnès Hartemann, Chloé Amouyal, Michel Marre, Dominique Le Guludec, Fabien Hyafil
BACKGROUND: Albuminuria is of one the strongest predictors of cardiovascular disease (CVD) in diabetes. Diabetes is associated with cardiac microvascular dysfunction (CMD), a powerful, independent prognostic factor for cardiac mortality. The aim of this study was to evaluate the relationship between CMD and microvascular complications in patients without known CVD. METHODS: In this monocentric study, myocardial flow reserve (MFR) was measured with cardiac 82Rubidium positron emission tomography (Rb-PET) in 311 patients referred to nuclear medicine department of Bichat University Hospital for screening of coronary artery disease from 2012 to 2014...
January 11, 2018: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29323186/combination-of-high-fat-high-fructose-diet-and-low-dose-streptozotocin-to-model-long-term-type-2-diabetes-complications
#8
David André Barrière, Christophe Noll, Geneviève Roussy, Farah Lizotte, Anissa Kessai, Karyn Kirby, Karine Belleville, Nicolas Beaudet, Jean-Michel Longpré, André C Carpentier, Pedro Geraldes, Philippe Sarret
The epidemic of type 2 diabetes mellitus (T2DM) is fueled by added fructose consumption. Here, we thus combined high-fat/high-fructose diet, with multiple low-dose injections of streptozotocin (HF/HF/Stz) to emulate the long-term complications of T2DM. HF/HF/Stz rats, monitored over 56 weeks, exhibited metabolic dysfunctions associated with the different stages of the T2DM disease progression in humans: an early prediabetic phase characterized by an hyperinsulinemic period with modest dysglycemia, followed by a late stage of T2DM with frank hyperglycemia, normalization of insulinemia, marked dyslipidemia, hepatic fibrosis and pancreatic β-cell failure...
January 11, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29322300/glycemic-control-in-type-2-diabetes-from-medication-nonadherence-to-residual-vascular-risk
#9
Dario Giugliano, Maria Ida Maiorino, Giuseppe Bellastella, Katherine Esposito
Despite the availability of many new treatment options for type 2 diabetes, the proportion of patients achieving the HbA1c target < 7.0% remains around 50%. We put forward the hypothesis that the unchanged HbA1c results, observed in the last decade in type 2 diabetes patients, are also a consequence of medication nonadherence and clinical inertia. Poor medication-taking behavior is usually defined as medication nonadherence and is responsible for uncontrolled hemoglobin A1c level in 23% of cases. Medication nonadherence may also affect clinical outcomes, as diabetic patients with good adherence (≥80%) had a significant 10% lower rate of hospitalization events and a significant 28% lower rate of all-cause mortality when compared with patients with poor adherence (<80%)...
January 10, 2018: Endocrine
https://www.readbyqxmd.com/read/29311660/defining-phenotypes-in-diabetic-nephropathy-a-novel-approach-using-a-cross-sectional-analysis-of-a-single-centre-cohort
#10
Rosa M Montero, Athula Herath, Ashfaq Qureshi, Ehsanollah Esfandiari, Charles D Pusey, Andrew H Frankel, Frederick W K Tam
The global increase in Diabetes Mellitus (DM) has led to an increase in DM-Chronic Kidney Disease (DM-CKD). In this cross-sectional observational study we aimed to define phenotypes for patients with DM-CKD that in future may be used to individualise treatment We report 4 DM-CKD phenotypes in 220 patients recruited from Imperial College NHS Trust clinics from 2004-2012. A robust principal component analysis (PCA) was used to statistically determine clusters with phenotypically different patients. 163 patients with complete data sets were analysed: 77 with CKD and 86 with DM-CKD...
January 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29306791/empagliflozin-rescues-diabetic-myocardial-microvascular-injury-via-ampk-mediated-inhibition-of-mitochondrial-fission
#11
Hao Zhou, Shuyi Wang, Pingjun Zhu, Shunying Hu, Yundai Chen, Jun Ren
Impaired cardiac microvascular function contributes to diabetic cardiovascular complications although effective therapy remains elusive. Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor recently approved for treatment of type 2 diabetes, promotes glycosuria excretion and offers cardioprotective actions beyond its glucose-lowering effects. This study was designed to evaluate the effect of empagliflozin on cardiac microvascular injury in diabetes and the underlying mechanism involved with a focus on mitochondria...
December 30, 2017: Redox Biology
https://www.readbyqxmd.com/read/29305779/evidence-of-glucuronidation%C3%A2-of-the-glycation-product-lw-1-tentative-structure-and-implications-for-the-long-term-complications-of-diabetes
#12
David R Sell, Ina Nemet, Zhili Liang, Vincent M Monnier
LW-1 is a collagen-linked blue fluorophore whose skin levels increase with age, diabetes and end-stage renal disease (ESRD), and correlate with the long-term progression of microvascular disease and indices of subclinical cardiovascular disease in type 1 diabetes. The chemical structure of LW-1 is still elusive, but earlier NMR analyses showed it has a lysine residue in an aromatic ring coupled to a sugar molecule reminiscent of advanced glycation end-products (AGEs). We hypothesized and demonstrate here that the unknown sugar is a N-linked glucuronic acid...
January 5, 2018: Glycoconjugate Journal
https://www.readbyqxmd.com/read/29301251/the-role-of-microglia-in-diabetic-retinopathy-inflammation-microvasculature-defects-and-neurodegeneration
#13
REVIEW
Christine Altmann, Mirko H H Schmidt
Diabetic retinopathy is a common complication of diabetes mellitus, which appears in one third of all diabetic patients and is a prominent cause of vision loss. First discovered as a microvascular disease, intensive research in the field identified inflammation and neurodegeneration to be part of diabetic retinopathy. Microglia, the resident monocytes of the retina, are activated due to a complex interplay between the different cell types of the retina and diverse pathological pathways. The trigger for developing diabetic retinopathy is diabetes-induced hyperglycemia, accompanied by leukostasis and vascular leakages...
January 1, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29286050/nonalcoholic-fatty-liver-disease-and-chronic-vascular-complications-of-diabetes-mellitus
#14
REVIEW
Giovanni Targher, Amedeo Lonardo, Christopher D Byrne
Nonalcoholic fatty liver disease (NAFLD) and diabetes mellitus are common diseases that often coexist and might act synergistically to increase the risk of hepatic and extra-hepatic clinical outcomes. NAFLD affects up to 70-80% of patients with type 2 diabetes mellitus and up to 30-40% of adults with type 1 diabetes mellitus. The coexistence of NAFLD and diabetes mellitus increases the risk of developing not only the more severe forms of NAFLD but also chronic vascular complications of diabetes mellitus. Indeed, substantial evidence links NAFLD with an increased risk of developing cardiovascular disease and other cardiac and arrhythmic complications in patients with type 1 diabetes mellitus or type 2 diabetes mellitus...
December 29, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/29285450/neutrophil-lymphocyte-ratio-is-a-novel-reliable-predictor-of-nephropathy-retinopathy-and-coronary-artery-disease-in-indians-with-type-2-diabetes
#15
Sachin Chittawar, Deep Dutta, Zahran Qureshi, Vineet Surana, Sagar Khandare, Tribhuvan Nath Dubey
Background and Aims: Neutrophil-lymphocyte ratio (NLR) has been suggested to be a predictor of coronary artery disease (CAD), and end-organ damage in type-2 diabetes mellitus (T2DM). Similar data are lacking from Indians with T2DM. Hence, this study aimed to evaluate the role of NLR as a predictor of microvascular complications and CAD in T2DM. Subjects and Methods: Consecutive T2DM patients attending the outpatient services of 2 different hospitals, who gave consent, underwent clinical, anthropometric evaluation, and evaluation for the occurrence of retinopathy, nephropathy, neuropathy, and CAD...
November 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29284520/chinese-herbal-medicine-tangbi-formula-treatment-of-patients-with-type-2-diabetic-distal-symmetric-polyneuropathy-disease-study-protocol-for-a-randomized-controlled-trial
#16
De Jin, Wen-Jing Huang, Xiang Meng, Fan Yang, Yu-Jiao Zheng, Qi Bao, Mei-Zhen Zhang, Ya-Nan Yang, Qing Ni, Feng-Mei Lian, Xiao-Lin Tong
BACKGROUND: Diabetic distal symmetric polyneuropathy (DSPN) is one of the most common microvascular complications of diabetes mellitus, and it has become a major public health problem worldwide because of its high and increasing prevalence, morbidity, and disability rate. The current medications for DSPN are not entirely satisfactory. Preliminary studies indicated that the Chinese herbal TangBi Formula may alleviate signs and symptoms and improve the velocity of nerve conduction in patients with DSPN...
December 29, 2017: Trials
https://www.readbyqxmd.com/read/29258533/incidental-branch-retinal-artery-occlusion-on-optical-coherence-tomography-angiography-presenting-as-segmental-optic-atrophy-in-a-child-a-case-report
#17
Ji Hyung Choi, Hee Kyung Yang, Ji Eun Lee
BACKGROUND: Retinal artery occlusion is extremely rare in the pediatric population and most patients have risk factors. We report a case of a healthy child with segmental optic atrophy, complicated by incidental branch retinal artery occlusion (BRAO). CASE PRESENTATION: A 10-year-old boy who had a history of his mother's gestational diabetes presented with an inferonasal visual field defect in the left eye. His best-corrected visual acuities were 20/20 in both eyes (OU)...
December 19, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/29238728/retinal-photoreceptors-and-microvascular-changes-in-prediabetes-measured-with-adaptive-optics-rtx1%C3%A2-a-case-control-study
#18
Anna Zaleska-Żmijewska, Paweł Piątkiewicz, Barbara Śmigielska, Anna Sokołowska-Oracz, Zbigniew M Wawrzyniak, Dorota Romaniuk, Jerzy Szaflik, Jacek P Szaflik
Background: Patients with prediabetes are at risk for diabetes, cardiovascular events, and microvascular complications. The rtx1 (Imagine Eyes, France) permits early detection of changes in the retinal photoreceptors and vessels. Objective: Cone parameters and retinal microvasculature were analyzed with the rtx1 in 12 prediabetic patients and 22 healthy subjects. The analysis was based on cone density (DM), interphotoreceptor distance (SM), cone packing regularity, and retinal vessel parameters: wall thickness, lumen diameter (LD), wall-to-lumen ratio (WLR), and cross-sectional area of the vascular wall...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/29237999/the-relationships-among-hyperuricemia-body-mass-index-and-impaired-renal-function-in-type-2-diabetic-patients
#19
Yongmei Li, Xing Fan, Chunjun Li, Xinyue Zhi, Liyuan Peng, Hongling Han, Bei Sun
Chronic kidney disease (CKD) is a common chronic microvascular complication and the major cause of death in diabetic patients. This study was conceived to explore the possible mechanisms of how hyperuricemia and obesity contribute to renal function impairment in type 2 diabetic (T2DM) patients. A cross-sectional study in 609 participants recruited from a T2DM population in North China was conducted. The multiplicative interaction between body mass index (BMI) and uric acid (UA) level was assessed using an interaction term in a logistic regression analysis...
December 13, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/29237716/shared-and-distinct-lipid-lipid-interactions-in-plasma-and-affected-tissues-in-a-diabetic-mouse-model
#20
Kelli M Sas, Jiahe Lin, Thekkelnaycke M Rajendiran, Tanu Soni, Viji Nair, Lucy M Hinder, Hosagrahar V Jagadish, Thomas W Gardner, Steven F Abcouwer, Frank C Brosius, Eva L Feldman, Matthias Kretzler, George Michailidis, Subramaniam Pennathur
Lipids are ubiquitous metabolites with diverse functions; abnormalities in lipid metabolism appear related to complications from multiple diseases, including type 2 diabetes. Through technological advances, the entire lipidome has been characterized, and researchers now need computational approaches to better understand lipid network perturbations in different diseases. Using a mouse model of type 2 diabetes with microvascular complications, we examined lipid levels in plasma and in renal, neural, and retinal tissues to identify shared and distinct lipid abnormalities...
December 13, 2017: Journal of Lipid Research
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