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Diabetes AND macrovascular

D Visca, P Pignatti, A Spanevello, E Lucini, E La Rocca
Diabetes is a common metabolic disorder affecting the entire body with high morbidity and mortality worldwide. The major complications related to diabetes are mostly due to the macrovascular and microvascular bed impairment due to metabolic, hemodynamic and inflammatory factors. However, studies over the past decades have added also the lung as a target organ in both type 1 and type 2 diabetes. Diabetes has always been addressed as a major comorbidity conditioning the disease behaviour and the natural history of several respiratory diseases...
October 9, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Godfrey M Rwegerera, Anthony Masaka, Yordanka Pina-Rivera, Thato Moshomo, Marea Gaenamong, Brian Godman, Taibat Aderonke Oyewo, Amos Massele, Dereje Habte
BACKGROUND AND AIMS: Glycemic control among patients with diabetes mellitus is associated with a marked reduction of both macrovascular and microvascular complications; however, glycemic control remains an elusive goal worldwide. The aim of this study was to determine factors associated with glycemic control among patients attending a tertiary clinic in Botswana as limited information to date. METHODS: Cross-sectional study in a tertiary clinic in Gaborone, Botswana...
October 12, 2018: Hospital Practice (Minneapolis)
Theresa Meldgaard, Søren Schou Olesen, Adam D Farmer, Klaus Krogh, Anne Astrid Wendel, Birgitte Brock, Asbjørn Mohr Drewes, Christina Brock
The incidence of the micro- and macrovascular complications of diabetes is rising, mirroring the increase in the worldwide prevalence. Arguably, the most common microvascular complication is neuropathy, leading to deleterious changes in both the structure and function of neurons. Amongst the various neuropathies with the highest symptom burden are those associated with alterations in the enteric nervous system, referred to as diabetic enteropathy. The primary aim of this review is to provide a contemporaneous summary of pathophysiology of diabetic enteropathy thereby allowing a "molecule to mechanism" approach to treatment, which will include 4 distinct aspects...
2018: Journal of Diabetes Research
Basem M Mishriky, Doyle M Cummings, Robert Tanenberg, Walter J Pories
In patients with type 2 diabetes secondary to excess nutrients and energy balance, relative - not absolute - insulin deficiency plays a key role in disease development and progression. Although patients with type 2 diabetes who have features of insulin resistance would usually have hyperinsulinemia, insulin therapy remains recommended by guidelines particularly when patients fail to achieve glycemic goals. This approach does not prevent complications particularly macrovascular complications. This raises a controversial question regarding the benefit of using exogenous insulin for glycemic control in patients with type 2 diabetes who have features of insulin resistance...
October 10, 2018: Postgraduate Medicine
Nan Xia, Afsaneh Morteza, Fengyu Yang, Hong Cao, Aiping Wang
Diabetic foot ulceration has been a serious issue over the past decades in Asia, causing economic and social problems. Therefore, it is important to identify and reduce risk factors of diabetic foot. Cigarette smoking has been reported to be associated with diabetes and its macrovascular complications, but the relationship between smoking and diabetic foot ulcers is still unclear. In this review, we summarizes the effects of cigarette smoking on diabetic foot ulcers with respect to peripheral neuropathy, vascular alterations and wound healing...
October 9, 2018: Journal of Diabetes Investigation
Hiddo J L Heerspink, James List, Vlado Perkovic
Despite advances in pharmacotherapy, diabetic kidney disease (DKD) remains associated with a high burden of micro- and macrovascular complications often leading to premature mortality. New therapies are highly desirable to mitigate the burden of this disease. However, there are a number of barriers that hamper drug development in DKD. These include, amongst others, the lengthy and complex clinical trials required to prove drug efficacy and safety, inefficiencies in clinical trial conduct, and the high costs associated with these development programs...
October 2018: Diabetes, Obesity & Metabolism
Bahira Shahim, Sofia Hasselberg, Oscar Boldt-Christmas, Viveca Gyberg, Linda Mellbin, Lars Rydén
Background Identifying type 2 diabetes mellitus (T2DM) is a prerequisite for the institution of preventive measures to reduce future micro and macrovascular complications. Approximately 50% of people with T2DM are undiagnosed, challenging the assumption that a traditional primary healthcare setting is the most efficient way to reach people at risk of T2DM. A setting of this kind may be even more suboptimal when it comes to reaching immigrants, who often appear to have inferior access to healthcare and/or are less likely to attend routine health checks at primary healthcare centres...
October 5, 2018: European Journal of Preventive Cardiology
Marco Colombo, Helen C Looker, Bassam Farran, Sibylle Hess, Leif Groop, Colin N A Palmer, Mary Julia Brosnan, R Neil Dalton, Max Wong, Charles Turner, Emma Ahlqvist, David Dunger, Felix Agakov, Paul Durrington, Shona Livingstone, John Betteridge, Paul M McKeigue, Helen M Colhoun
AIMS/HYPOTHESIS: As part of the Surrogate Markers for Micro- and Macrovascular Hard Endpoints for Innovative Diabetes Tools (SUMMIT) programme we previously reported that large panels of biomarkers derived from three analytical platforms maximised prediction of progression of renal decline in type 2 diabetes. Here, we hypothesised that smaller (n ≤ 5), platform-specific combinations of biomarkers selected from these larger panels might achieve similar prediction performance when tested in three additional type 2 diabetes cohorts...
October 5, 2018: Diabetologia
Anoop Misra, Naveed Sattar, Nikhil Tandon, Usha Shrivastava, Naval K Vikram, Kamlesh Khunti, Andrew P Hills
Compared with other ethnic groups, south Asian people with type 2 diabetes tend to develop the disease at a younger age and manifest with higher glycaemia, dyslipidaemia, nephropathy, and cardiovascular diseases. Additionally, specific issues that can affect treatment of type 2 diabetes in south Asia include poor awareness of the disease, delay in diagnosis, inadequate treatment, the use of ineffective and often harmful alternative medicines, and frequent non-compliance with lifestyle recommendations and drug treatment...
October 1, 2018: Lancet Diabetes & Endocrinology
Jonathan D Newman, Anish K Vani, Jose O Aleman, Howard S Weintraub, Jeffrey S Berger, Arthur Z Schwartzbard
Type 2 diabetes mellitus (T2D) is a major risk factor for cardiovascular disease (CVD), the most common cause of death in T2D. Despite improved risk factor control, however, adults with T2D continue to experience substantial excess CVD risk. Until recently, however, improved glycemic control has not been associated with robust macrovascular benefit. The advent of 2 new classes of antihyperglycemic agents, the sodium-glucose cotransporter-2 inhibitors and the glucagon-like peptide-1 receptor agonists, and their respective large cardiovascular outcome trials, has led to a paradigm shift in how cardiologists and heath care practitioners conceptualize T2D treatment...
October 9, 2018: Journal of the American College of Cardiology
Carsten Alexander Böger, Bernhard Karl Krämer
UPDATE ON DIABETIC NEPHROPATHY 2018:  The prevalance of elevated albuminuria in patients with diabetes is decreasing, while that of reduced eGFR is increasing, probably owing to more stringent blood pressure and blood glucose control.Well validated online score calculators for risk for renal replacement therapy, cardiovascular events and death are available online.Clinical variables remain more suited than histology for predicting end stage renal disease. Extracapillary hypercellularity, segmental sclerosis and exsudative lesions could represent a distinct risk phenotype...
October 2018: Deutsche Medizinische Wochenschrift
Ian Pearce, Rafael Simó, Monica Lövestam-Adrian, David T Wong, Marc Evans
AIM: To examine associations between diabetic retinopathy (DR) and common micro- and macrovascular complications of diabetes mellitus, and how these could potentially impact clinical practice. MATERIALS AND METHODS: A structured search of the PubMed database identified studies of patients with diabetes that assessed the presence or development of DR in conjunction with other vascular complications of diabetes. RESULTS: From 70 included studies, we found that DR is consistently associated with other complications of diabetes, with the severity of DR linked to a higher risk of the presence of, or developing, other micro- and macrovascular complications...
October 2, 2018: Diabetes, Obesity & Metabolism
Julie A Lovshin, Petter Bjornstad, Leif E Lovblom, Johnny-Wei Bai, Yuliya Lytvyn, Geneviève Boulet, Mohammed A Farooqi, Sam Santiago, Andrej Orszag, Daniel Scarr, Alanna Weisman, Hillary A Keenan, Michael H Brent, Narinder Paul, Vera Bril, Bruce A Perkins, David Z I Cherney
OBJECTIVE: Type 1 diabetes carries a significant risk for cardiovascular mortality, but it is unclear how atherosclerosis associates with microvascular complications. We aimed to determine the relationships between atherosclerotic burden and neuropathy, retinopathy, and diabetic kidney disease (DKD) in adults with a ≥50-year history of type 1 diabetes. RESEARCH DESIGN AND METHODS: Adults with type 1 diabetes ( n = 69) underwent coronary artery calcification (CAC) volume scoring by wide-volume computerized tomography...
October 1, 2018: Diabetes Care
Michael Bergman, Melania Manco, Giorgio Sesti, Rachel Dankner, Manan Pareek, Ram Jagannathan, Angela Chetrit, Muhammad Abdul-Ghani, Martin Buysschaert, Michael H Olsen, Peter M Nilsson, José Luis Medina, Jesse Roth, Leif Groop, Stefano Del Prato, Itamar Raz, Antonio Ceriello
Many individuals with prediabetes, as presently defined, will progress to diabetes (T2D) despite the considerable benefit of lifestyle modification. Therefore, it is paramount to screen individuals at increased risk with a more sensitive method capable of identifying prediabetes at an even earlier time point in the lengthy trajectory to T2D. This petition reviews findings demonstrating that the 1-hour (1-h) postload plasma glucose (PG) ≥ 155 mg/dl (8.6 mmol/L) in those with normal glucose tolerance (NGT) during an oral glucose tolerance test (OGTT) is highly predictive for detecting progression to T2D, micro- and macrovascular complications and mortality in individuals at increased risk...
September 28, 2018: Diabetes Research and Clinical Practice
Maria Grammatiki, Spiros Karras, Kalliopi Kotsa
Diabetes mellitus, a metabolic disorder associated with chronic complications, is traditionally classified into two main subtypes. Type 1 diabetes mellitus (T1DM) results from gradual pancreatic islet β cell autoimmune destruction, extending over months or years. Type 2 diabetes mellitus (T2DM) is a heterogeneous disorder, with both insulin resistance and impairment in insulin secretion contributing to its pathogenesis. Vitamin D is a fat-soluble vitamin with an established role in calcium metabolism. Recently, several studies have provided evidence suggesting a role for it in various non-skeletal metabolic conditions, including both types of diabetes mellitus...
September 25, 2018: Hormones: International Journal of Endocrinology and Metabolism
Nam Hoon Kim, Soo Lim, Soo Heon Kwak, Min Kyong Moon, Jun Sung Moon, Yong-Ho Lee, Ho Chan Cho, Juneyoung Lee, Sin Gon Kim
INTRODUCTION: Patients with type 2 diabetes are at risk of microvascular and macrovascular complications. Intensive glycaemic control, especially in patients with short duration of diabetes, is the mainstay of management of type 2 diabetes to lower the risk of complications. However, despite the improvement in the understanding of the pathophysiology of type 2 diabetes and development of novel glucose-lowering agents, long-term durable glycaemic control remains a difficult goal to achieve...
September 24, 2018: BMJ Open
Mohammad Taghi Najafi, Pegah Khaloo, Hamid Alemi, Asma Jaafarinia, Michael J Blaha, Mohammadhassan Mirbolouk, Mohammad Ali Mansournia, Mohsen Afarideh, Sadaf Esteghamati, Manouchehr Nakhjavani, Alireza Esteghamati
Ambulatory blood pressure monitoring (ABPM) correlates more closely to organ damages than clinic blood pressure (BP). In the current study we aimed to investigate the association between micro- and macrovascular complications of diabetes and both diurnal and nocturnal variability in BP.A total of 192 patients with type 2 diabetes (T2DM) who had complete data on ABPM were selected. BP categories were defined based on 2017 ACC/American Heart Association BP guideline. The cross-sectional association between different BP phenotypes and diabetes complications including cardiovascular disease (CVD), nephropathy, retinopathy, and neuropathy was assessed using multiple logistic regression models adjusted for age, sex, body mass index, hypertension (HTN), hemoglobin A1c, fasting blood glucose (FBG), triglyceride (TG), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol...
September 2018: Medicine (Baltimore)
Alethia Muñiz, Efren Garcia, Daphne Gonzalez, Lizette Zuñiga
Hyperglycemia in diabetes mellitus causes irreversible life-threatening micro- and macrovascular complications. There is evidence that the glycation reaction leads to a chemical modification of the proteins contributing to the complications of diabetes. It is known that advanced glycation end products (AGEs) are formed by glycation and oxidation reactions called glycoxidation. CML, a nonfluorescent AGE, has become a biomarker of glycoxidative damage; other AGEs appear to induce oxidative stress, which results in cytotoxicity...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Pavan Malur, Arthur Menezes, James J DiNicolantonio, James H O'Keefe, Carl J Lavie
Background: The purpose of this article is to discuss the evidence regarding potential macrovascular and microvascular benefits of fibrate therapy in general and fenofibrate specifically. Methods: We performed a literature review summarizing the results of studies testing fibrates on relevant. Results: Although statins are the first line therapy with an unparalleled amount of evidence for reducing the risk of cardiovascular disease (CVD) in patients with dyslipidemia and the metabolic syndrome (MetS), there are several landmark studies that have focused on the potential benefits of fibrate therapy for reducing CVD risk...
November 2017: Missouri Medicine
Malak Almutairi, Rami Al Batran, John R Ussher
Glucagon-like peptide-1 receptor (GLP-1R) agonists augment insulin secretion and are thus used clinically to improve glycemia in subjects with type 2 diabetes (T2D). As recent data reveal marked improvements in cardiovascular outcomes in T2D subjects treated with the GLP-1R agonists liraglutide and semaglutide in the LEADER and SUSTAIN-6 clinical trials respectively, there is growing interest in delineating the mechanism(s) of action for GLP-1R agonist-induced cardioprotection. Of importance, negligible GLP-1R expression in ventricular cardiac myocytes suggests that cardiac-independent actions of GLP-1R agonists may account for the reduced death rates from cardiovascular causes in T2D subjects enrolled in the LEADER trial...
September 15, 2018: Peptides
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