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microvascular complications of diabet

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https://www.readbyqxmd.com/read/28107340/association-of-diabetes-related-complications-with-heart-rate-variability-among-a-diabetic-population-in-the-uae
#1
Ahsan H Khandoker, Haitham M Al-Angari, Kinda Khalaf, Sungmun Lee, Wael Almahmeed, Habiba S Al Safar, Herbert F Jelinek
Microvascular, macrovascular and neurological complications are the key causes of morbidity and mortality among type II diabetes mellitus (T2DM) patients. The aim of this study was to investigate the alterations of cardiac autonomic function of diabetic patients in relation to three types of diabetes-related complications. ECG recordings were collected and analyzed from 169 T2DM patients in supine position who were diagnosed with nephropathy (n = 55), peripheral neuropathy (n = 64) and retinopathy (n = 106) at two hospitals in the UAE...
2017: PloS One
https://www.readbyqxmd.com/read/28103890/the-association-between-diabetes-and-dermal-microvascular-dysfunction-non-invasively-assessed-by-laser-doppler-with-local-thermal-hyperemia-a-systematic-review-with-meta-analysis
#2
REVIEW
Dagmar Fuchs, Pepijn P Dupon, Laura A Schaap, Richard Draijer
BACKGROUND/INTRODUCTION: Diabetes and cardiovascular disease develop in concert with metabolic abnormalities mirroring and causing changes in the vasculature, particularly the microcirculation. The microcirculation can be affected in different parts of the body of which the skin is the most easily accessible tissue. PURPOSE: The association between diabetes and dermal microvascular dysfunction has been investigated in observational studies. However, the strength of the association is unknown...
January 19, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28102614/expression-of-cd4-cd28-null-t-lymphocytes-in-children-and-adolescents-with-type-1-diabetes-mellitus-relation-to-microvascular-complications-aortic-elastic-properties-and-carotid-intima-media-thickness
#3
Mona H El-Samahy, Azza A G Tantawy, Amira A M Adly, Nevin M Habeeb, Eman A R Ismail, Gehan M Hamed, Rasha Eladawy
BACKGROUND: Cardiovascular risk in type 1 diabetes mellitus (T1DM) is associated with endothelial dysfunction, inflammation, and altered immunity. CD4(+) CD28(null) T-cells are a subset of long-lived cytotoxic CD4(+) T-lymphocytes with proatherogenic and plaque-destabilizing properties. We hypothesized that the frequency of CD4(+) CD28(null) T-cells may be altered in T1DM and related to vascular complications. AIM: To assess the percentage of CD4(+) CD28(null) T-lymphocytes in children and adolescents with T1DM and their relation to vascular structure and glycemic control...
January 19, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28098719/regional-gray-matter-volumes-as-related-to-psychomotor-slowing-in-adults-with-type-1-diabetes
#4
Karen A Nunley, Christopher M Ryan, Howard J Aizenstein, Rebecca L MacCloud, Trevor J Orchard, Caterina Rosano
OBJECTIVE: Psychomotor slowing is a common cognitive complication in type 1 diabetes (T1D), but its neuroanatomical correlates and risk factors are unclear. In non-diabetic adults, smaller gray matter volume (GMV) and presence of white matter hyperintensities (WMH) are associated with psychomotor slowing. We hypothesize that smaller GMV in prefronto-parietal regions explains T1D-related psychomotor slowing. We also inspect the contribution of microvascular disease and hyperglycemia. METHODS: GMV, WMH, and glucose levels were measured concurrently with a test of psychomotor speed (Digit Symbol Substitution Test, DSST) in 95 adults with childhood-onset T1D (mean age/duration=49/41 years) and 135 similarly-aged non-T1D adults...
January 17, 2017: Psychosomatic Medicine
https://www.readbyqxmd.com/read/28096078/how-to-prevent-the-microvascular-complications-of-type-2-diabetes-beyond-glucose-control
#5
REVIEW
Willy Marcos Valencia, Hermes Florez
Microvascular complications (retinopathy, nephropathy, and neuropathy) affect hundreds of millions of patients with type 2 diabetes. They usually affect people with longstanding or uncontrolled disease, but they can also be present at diagnosis or in those yet to have a diagnosis made. The presentation and progression of these complications can lead to loss of visual, renal, and neurologic functions, impaired mobility and cognition, poor quality of life, limitations for employment and productivity, and increased costs for the patient and society...
January 17, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28095040/consensus-statement-by-the-american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-on-the-comprehensive-type-2-diabetes-management-algorithm-2017-executive-summary
#6
Alan J Garber, Martin J Abrahamson, Joshua I Barzilay, Lawrence Blonde, Zachary T Bloomgarden, Michael A Bush, Samuel Dagogo-Jack, Ralph A DeFronzo, Daniel Einhorn, Vivian A Fonseca, Jeffrey R Garber, W Timothy Garvey, George Grunberger, Yehuda Handelsman, Irl B Hirsch, Paul S Jellinger, Janet B McGill, Jeffrey I Mechanick, Paul D Rosenblit, Guillermo E Umpierrez
EXECUTIVE SUMMARY This algorithm for the comprehensive management of persons with type 2 diabetes (T2D) was developed to provide clinicians with a practical guide that considers the whole patient, their spectrum of risks and complications, and evidence-based approaches to treatment. It is now clear that the progressive pancreatic beta-cell defect that drives the deterioration of metabolic control over time begins early and may be present before the diagnosis of diabetes (1). In addition to advocating glycemic control to reduce microvascular complications, this document highlights obesity and prediabetes as underlying risk factors for the development of T2D and associated macrovascular complications...
January 17, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28089751/reduced-serum-milk-fat-globule-epidermal-growth-factor-8-mfg-e8-concentrations-are-associated-with-an-increased-risk-of-microvascular-complications-in-patients-with-type-2-diabetes
#7
Jinxing Quan, Guohua Sun, Juxiang Liu, Guanghao Xia, Lijuan Zhang, Yonghong Li, Zubang Zhou, L V Yaya, Suhong Wei, Jing Liu
BACKGROUND: The association between serum milk fat globule-epidermal growth factor 8 (MFG-E8) concentrations and vascular complications in T2DM remains unclear. METHODS: A total of 149 patients with T2DM were included. The serum concentrations of MFG-E8, glycosylated hemoglobin (HbA1c), and high-sensitivity C-reactive protein (hs-CRP) were measured. RESULTS: There was no significant difference in serum MFG-E8 concentrations between the T2DM group and the T2DM with subclinical atherosclerosis (AS) group (615...
January 12, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28077412/microvascular-outcomes-after-metabolic-surgery-moms-in-patients-with-type-2-diabetes-mellitus-and-class-i-obesity-rationale-and-design-for-a-randomised-controlled-trial
#8
Ricardo Vitor Cohen, Tiago Veiga Pereira, Cristina Mamédio Aboud, Pedro Paulo de Paris Caravatto, Tarissa Beatrice Zanata Petry, José Luis Lopes Correa, Carlos Aurélio Schiavon, Mariangela Correa, Carlos Eduardo Pompílio, Fernando Nogueira Quirino Pechy, Carel le Roux
INTRODUCTION: There are several randomised controlled trials (RCTs) that have already shown that metabolic/bariatric surgery achieves short-term and long-term glycaemic control while there are no level 1A of evidence data regarding the effects of surgery on the microvascular complications of type 2 diabetes mellitus (T2DM). PURPOSE: The aim of this trial is to investigate the long-term efficacy and safety of the Roux-en-Y gastric bypass (RYGB) plus the best medical treatment (BMT) versus the BMT alone to improve microvascular outcomes in patients with T2DM with a body mass index (BMI) of 30-34...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28075544/the-impact-of-type%C3%A2-2-diabetes-prevention-programmes-based-on-risk-identification-and-lifestyle-intervention-intensity-strategies-a-cost-effectiveness-analysis
#9
P R Breeze, C Thomas, H Squires, A Brennan, C Greaves, P J Diggle, E Brunner, A Tabak, L Preston, J Chilcott
AIMS: To develop a cost-effectiveness model to compare Type 2 diabetes prevention programmes targeting different at-risk population subgroups with a lifestyle intervention of varying intensity. METHODS: An individual patient simulation model was constructed to simulate the development of diabetes in a representative sample of adults without diabetes from the UK population. The model incorporates trajectories for HbA1c , 2-h glucose, fasting plasma glucose, BMI, systolic blood pressure, total cholesterol and HDL cholesterol...
January 11, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28075427/evaluation-of-sudomotor-function-in-adult-patients-with-long-lasting-type-1-diabetes
#10
Agnieszka Gandecka, Aleksandra Araszkiewicz, Stanisław Piłaciński, Bogna Wierusz-Wysocka, Dorota Zozulińska-Ziółkiewicz
INTRODUCTION    The function of sweat glands appears to be impaired in patients with diabetic complications.  OBJECTIVES    The aim of the study was to evaluate the sudomotor function in adult patients with type 1 diabetes (DM1) and healthy controls and its relationship with metabolic control and diabetic complications. PATIENTS AND METHODS    The study included 404 adult patients with DM 1 (194 women) aged 41 years (IQR: 32-51), disease duration 23 years (IQR: 18-31). Electrochemical skin conductance (ESC) was measured with SUDOSCAN+ on feet and hands in the study group and in the control group of 84 healthy volunteers...
January 10, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28073426/the-prevention-and-treatment-of-retinal-complications-in-diabetes
#11
Susanne Gabriele Schorr, Hans-Peter Hammes, Ulrich Alfons Müller, Heinz-Harald Abholz, Rüdiger Landgraf, Bernd Bertram
BACKGROUND: Microvascular complications of diabetes mellitus can cause retino pathy and maculopathy, which can irreversibly damage vision and lead to blindness. The prevalence of retinopathy is 9-16% in patients with type 2 diabetes and 24-27% in patients with type 1 diabetes. 0.2-0.5% of diabetics are blind. METHODS: The National Disease Management Guideline on the prevention and treatment of retinal complications in diabetes was updated according to recommendations developed by seven scientific medical societies and organizations and by patient representatives and then approved in a formal consensus process...
December 2, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28069712/an-evidence-based-medicine-approach-to-antihyperglycemic-therapy-in-diabetes-mellitus-to-overcome-overtreatment
#12
Anil N Makam, Oanh K Nguyen
Overtreatment is pervasive in medicine and leads to potential patient harms and excessive costs in health care. Although evidence-based medicine is often derided as practice by rote algorithmic medicine, the appropriate application of key evidence-based medicine principles in clinical decision making is fundamental to preventing overtreatment and promoting high-value, individualized patient-centered care. Specifically, this article discusses the importance of (1) using absolute rather than relative estimates of benefits to inform treatment decisions; (2) considering the time horizon to benefit of treatments; (3) balancing potential harms and benefits; and (4) using shared decision making by physicians to incorporate the patient's values and preferences into treatment decisions...
January 10, 2017: Circulation
https://www.readbyqxmd.com/read/28062940/vitamin-d-and-diabetes-mellitus-causal-or-casual-association
#13
REVIEW
M Grammatiki, E Rapti, S Karras, R A Ajjan, Kalliopi Kotsa
The incidence of both type 2 and type 1 diabetes mellitus has been increasing worldwide. Vitamin D deficiency, or the awareness of its prevalence, has also been increasing. Vitamin D may have a role in the pathogenic mechanisms predisposing to type 2 diabetes by modulating insulin resistance and/or pancreatic β-cell function. Vitamin D status or elements involved in its activation or transport may also be involved in the development of type 1 diabetes mellitus through immunomodulatory role . Based on these observations a potential association between vitamin D and diabetes has been hypothesized...
January 7, 2017: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/28056987/blood-pressure-control-in-type-2-diabetic-patients
#14
REVIEW
Alon Grossman, Ehud Grossman
Diabetes mellitus (DM) and essential hypertension are common conditions that are frequently present together. Both are considered risk factors for cardiovascular disease and microvascular complications and therefore treatment of both conditions is essential. Many papers were published on blood pressure (BP) targets in diabetic patients, including several works published in the last 2 years. As a result, guidelines differ in their recommendations on BP targets in diabetic patients. The method by which to control hypertension, whether pharmacological or non-pharmacological, is also a matter of debate and has been extensively studied in the literature...
January 6, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28054988/recent-update-on-the-role-of-chinese-material-medica-and-formulations-in-diabetic-retinopathy
#15
REVIEW
Sandeep Vasant More, In-Su Kim, Dong-Kug Choi
Diabetes mellitus is one of the most frequent endocrine disorders, affecting populations worldwide. Diabetic retinopathy (DR) is the most frequent microvascular complication of diabetes in patients aged 20 and over. Major complications of DR include intraocular neovascularization, inter-retinal edema, hemorrhage, exudates and microaneurysms. Therefore, timely medical attention and prevention are required. At present, laser-assisted therapy and other operational procedures are the most common treatment for DR...
January 4, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28052873/path-of-translational-discovery-of-urological-complications-of-obesity-and-diabetes-ucod
#16
Firouz Daneshgari, Guiming Liu, Ann T Hanna-Mitchell
Diabetes Mellitus (DM) is a prevalent chronic disease. Type 1 diabetes mellitus (T1DM) is a metabolic disorder that is characterized by hyperglycemia in the context of absolute lack of insulin; whereas type 2 diabetes mellitus (T2DM) is due to insulin resistance-related relative insulin deficiency. Obesity is an established risk factor for T2DM. In comparison with T1DM, T2DM is more complex. The natural history of T2DM in most patients typically involves a course of obesity to impaired glucose tolerance, to insulin resistance and hyperglycemia...
January 4, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28044409/macro-and-microvascular-endothelial-dysfunction-in-diabetes
#17
REVIEW
Yi Shi, Paul M Vanhoutte
Endothelial cells, as well as their major products nitric oxide and prostacyclin, play a key role in the regulation of vascular homeostasis. Diabetes mellitus is an important risk factor for cardiovascular disease. Diabetes-induced endothelial dysfunction is a critical and initiating factor in the genesis of diabetic vascular complications. The present review focuses on both large blood vessels and the microvasculature. The endothelial dysfunction in diabetic macrovascular complications is characterized by a reduced nitric oxide bioavailability, poorly compensated for by increased production of prostacyclin and/or endothelium-dependent hyperpolarizations, and increased production /action of endothelium-derived vasoconstrictors...
January 3, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/28040315/-barometer-of-type-2-diabetes-in-primary-care-metabolic-control-styles-of-life-and-morbidity-profile
#18
David Pérez-Manchón, María Lorena Rodríguez-Álvarez, Claudia Alcívar-Arteaga, Mercedes Redondo-Pico, Elena Ramos-Quirós
OBJECTIVE: Knowing the profile of cardiovascular morbidity, degree of control and lifestyles in type 2 diabetes. METHOD: Randomized multicenter cross-sectional study conducted in 2015 in primary care with 129 diabetics. It included sociodemographic variables, microvascular and macrovascular complications, organic damage, comorbidity and lifestyles of smoking, exercise and adherence to Mediterranean diet. Metabolic control was assessed with the latest annual glycosylated haemoglobin...
December 28, 2016: Enfermería Clínica
https://www.readbyqxmd.com/read/28033273/nailfold-capillary-abnormalities-are-associated-with-type-2-diabetes-progression-and-correlated-with-peripheral-neuropathy
#19
Po-Chi Hsu, Pei-Yung Liao, Hen-Hong Chang, John Y Chiang, Yu-Chuen Huang, Lun-Chien Lo
Diabetes mellitus (DM) is associated with a state of chronic hyperglycemia with a highly increased risk of vascular complications. The current study aimed to investigate microcirculation abnormalities in patients with type 2 DM and those with pre-DM using nailfold videocapillaroscopy (NVC) and evaluate the possible correlation with microvascular complications.A total of 115 patients with type 2 DM, 41 patients with pre-DM, and 37 healthy subjects without diabetes were enrolled. All subjects underwent NVC to evaluate capillary density, length, morphology, distribution, presence of enlarged loops or hemorrhages, and blood flow...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28011232/cardiac-biomarkers-in-diabetes-mellitus-new-dawn-for-risk-stratification
#20
REVIEW
Alexander E Berezin
Type 2 diabetes mellitus (T2DM) remains a leading cause of cardiovascular (CV) events and diseases worldwide. The aim of the review is to summarize our knowledge regarding clinical implementation of the biomarker-based strategy of the CV risk assessment in T2DM patient population. There is large body of evidence regarding use of the cardiac biomarkers to risk stratification at higher CV risk individuals who belongs to general population and cohort with established CV disease. Although T2DM patients have higher incidence of macrovascular and microvascular CV complications than the general population, whether cardiac biomarkers would be effective to risk stratification of the T2DM is not fully understood...
December 13, 2016: Diabetes & Metabolic Syndrome
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