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https://www.readbyqxmd.com/read/28550608/shifting-paradigms-in-the-medical-management-of-type-2-diabetes-reflections-on-recent-cardiovascular-outcome-trials
#1
Faramarz Ismail-Beigi, Etie Moghissi, Mikhail Kosiborod, Silvio E Inzucchi
An important challenge in the management of patients with type 2 diabetes is cardiovascular disease (CVD) prevention. While it is well established that intensive glycemic control prevents the onset and slows the progression of certain microvascular complications, such a strategy utilized in multiple clinical trials over the past few decades has failed to show a similar benefit with regard to cardiovascular events, including mortality. Despite this, a major hope has been the discovery of glucose-lowering medications that simultaneously improve cardiovascular outcomes...
May 26, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28546762/cardiovascular-magnetic-resonance-imaging-clinical-implications-in-the-evaluation-of-connective-tissue-diseases
#2
REVIEW
Sophie Mavrogeni, George Markousis-Mavrogenis, Loukia Koutsogeorgopoulou, Genovefa Kolovou
Cardiovascular magnetic resonance imaging is a recently developed noninvasive, nonradiating, operator-independent technique that has been successfully used for the evaluation of congenital heart disease, valvular and pericardial diseases, iron overload, cardiomyopathies, great and coronary vessel diseases, cardiac inflammation, stress-rest myocardial perfusion, and fibrosis. Rheumatoid arthritis and other spondyloarthropathies, systemic lupus erythematosus, inflammatory myopathies, mixed connective tissue diseases (CTDs), systemic sclerosis, vasculitis, and sarcoidosis are among CTDs with serious cardiovascular involvement; this is due to multiple causative factors such as myopericarditis, micro/macrovascular disease, coronary artery disease, myocardial fibrosis, pulmonary hypertension, and finally heart failure...
2017: Journal of Inflammation Research
https://www.readbyqxmd.com/read/28542516/evaluation-of-the-systemic-micro-and-macrovasculature-in-stable-angina-a-case-control-study
#3
Ulf Neisius, Erin Olson, Sabrina H Rossi, Hagar A Ibrahim, Gemma Currie, Anna F Dominiczak, Christian Delles
AIMS: The diagnosis of stable angina involves the use of probability estimates based on clinical presentation, age, gender and cardiovascular risk factors. In view of the link between the cardiac and systemic vasculature we tested whether non-invasive measures of systemic micro- and macrovascular structure and function differentiate between individuals with flow-limiting coronary artery disease (CAD) and those with normal coronary arteries (NCA). METHODS AND RESULTS: We recruited 84 patients undergoing elective coronary angiography for investigation of symptoms of stable angina...
2017: PloS One
https://www.readbyqxmd.com/read/28539866/effect-of-diet-on-type-2-diabetes-mellitus-a-review
#4
REVIEW
Waqas Sami, Tahir Ansari, Nadeem Shafique Butt, Mohd Rashid Ab Hamid
Globally, type 2 diabetes mellitus (T2DM) is considered as one of the most common diseases. The etiology of T2DM is complex and is associated with irreversible risk factors such as age, genetic, race, and ethnicity and reversible factors such as diet, physical activity and smoking. The objectives of this review are to examine various studies to explore relationship of T2DM with different dietary habits/patterns and practices and its complications. Dietary habits and sedentary lifestyle are the major factors for rapidly rising incidence of DM among developing countries...
April 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28530383/diabetes-update-prevention-and-management-of-diabetes-complications
#5
Beth Choby
Macrovascular complications of diabetes include cardiovascular events, whereas common microvascular complications include neuropathy, retinopathy, and diabetic kidney disease. Control of hypertension and dyslipidemia is an important step in minimizing the risk of complications. Blood pressure (BP) levels should be maintained at less than 140 mm Hg systolic and less than 90 mm Hg diastolic. In older adults, medical therapy to reduce BP to less than 130/70 mm Hg is not recommended. In these patients, a systolic BP level less than 130 mm Hg has not been shown to improve atherosclerotic cardiovascular disease (ASCVD) outcomes, and a diastolic BP less than 70 mm Hg is associated with a higher mortality risk...
May 2017: FP Essentials
https://www.readbyqxmd.com/read/28526767/migraine-and-cerebrovascular-atherosclerosis-in-patients-with-ischemic-stroke
#6
Hendrikus J A van Os, Inge A Mulder, Alexander Broersen, Ale Algra, Irene C van der Schaaf, L Jaap Kappelle, Birgitta K Velthuis, Gisela M Terwindt, Wouter J Schonewille, Marieke C Visser, Michel D Ferrari, Marianne A A van Walderveen, Marieke J H Wermer
BACKGROUND AND PURPOSE: Migraine is a well-established risk factor for ischemic stroke, but migraine is also related to other vascular diseases. This study aims to investigate the association between migraine and cerebrovascular atherosclerosis in patients with acute ischemic stroke. METHODS: We retrieved data on patients with ischemic stroke from the DUST (Dutch Acute Stroke Study). Migraine history was assessed with a migraine screener and confirmed by telephone interview based on the ICHD criteria (International Classification of Headache Disorders)...
May 19, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28526186/cardiovascular-protection-in-the-treatment-of-type-2-diabetes-a-review-of-clinical-trial-results-across-drug-classes
#7
Francesco Paneni, Thomas F Lüscher
Patients with type 2 diabetes (T2DM) have a significantly higher risk of developing cardiovascular disease (CVD)-namely myocardial infarction, heart failure, and stroke. Despite clear advances in the prevention and treatment of CVD, the impact of T2DM on CVD outcome remains high and continues to escalate. Available evidence indicates that the risk of macrovascular complications increases with the severity of hyperglycemia, thus suggesting that the relation between metabolic disturbances and vascular damage is approximately linear...
May 15, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28526185/empa-reg-outcome-the-endocrinologist-s-point-of-view
#8
Leigh Perreault
For many years, it was widely accepted that control of plasma lipids and blood pressure could lower macrovascular risk in patients with type 2 diabetes mellitus (T2DM), whereas the benefits of lowering plasma glucose were largely limited to improvements in microvascular complications. The Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients-Removing Excess Glucose (EMPA-REG OUTCOME) study demonstrated for the first time that a glucose-lowering agent, the sodium glucose cotransporter 2 (SGLT2) inhibitor empagliflozin, could reduce major adverse cardiovascular events, cardiovascular mortality, hospitalization for heart failure, and overall mortality when given in addition to standard care in patients with T2DM at high cardiovascular risk...
May 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28521931/hemodynamic-measurements-for%C3%A2-the%C3%A2-selection-of-patients-with-renal%C3%A2-artery%C3%A2-stenosis-a-systematic-review
#9
REVIEW
Peter M van Brussel, Tim P van de Hoef, Robbert J de Winter, Liffert Vogt, Bert-Jan van den Born
Interventions targeting renal artery stenoses have been shown to lower blood pressure and preserve renal function. In recent studies, the efficacy of catheter-based percutaneous transluminal renal angioplasty with stent placement has been called into question. In the identification of functional coronary lesions, hyperemic measurements have earned a place in daily practice for clinical decision making, allowing discrimination between solitary coronary lesions and diffuse microvascular disease. Next to differences in clinical characteristics, the selection of renal arteries suitable for intervention is currently on the basis of anatomic grading of the stenosis by angiography rather than functional assessment under hyperemia...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28508133/children-and-adolescents-macrovascular-reactivity-level-and-dynamics-but-not-the-microvascular-response-is-associated-with-body-mass-index-and-arterial-stiffness-levels
#10
Yanina Zócalo, Marco Marotta, Victoria García-Espinosa, Santiago Curcio, Pedro Chiesa, Gustavo Giachetto, Daniel Bia
INTRODUCTION: The existing evidence indicates that primary prevention of atherosclerotic disease should begin in childhood. Detection of children and adolescents at risk for atherosclerosis may allow early intervention to decrease the atherosclerotic process, thereby preventing or delaying cardiovascular disease. Vascular reactivity (VR) is altered even by early atherosclerosis. Obesity is a main cardiovascular risk factor (CVRF) observed in childhood. If childhood obesity associates impaired macro and/or micro VR is controversial...
May 15, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28499961/towards-an-improved-global-understanding-of-treatment-and-outcomes-in-people-with-type-2-diabetes-rationale-and-methods-of-the-discover-observational-study-program
#11
Linong Ji, Fabrice Bonnet, Bernard Charbonnel, Marilia B Gomes, Mikhail Kosiborod, Kamlesh Khunti, Antonio Nicolucci, Stuart Pocock, Wolfgang Rathmann, Marina V Shestakova, Iichiro Shimomura, Hirotaka Watada, Peter Fenici, Niklas Hammar, Kiyoshi Hashigami, Greg Macaraeg, Filip Surmont, Jesús Medina
AIM: Contemporary global real-world data on the management of type 2 diabetes are scarce. The global DISCOVER study program aims to describe the disease management patterns and a broad range of associated outcomes in patients with type 2 diabetes initiating a second-line glucose-lowering therapy in routine clinical practice. METHODS: The DISCOVER program comprises two longitudinal observational studies involving more than 15,000 patients in 38 countries across six continents...
April 5, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28495931/neutrophil-extracellular-traps-drive-endothelial-to-mesenchymal-transition
#12
Elmar Pieterse, Nils Rother, Marjolein Garsen, Julia Hofstra, Simon Satchell, Markus Hoffmann, Markus Loeven, Hanneke Knaapen, Olivier van der Heijden, Jo Berden, Luuk Hilbrands, Johan van der Vlag
OBJECTIVE: An excessive release and impaired degradation of neutrophil extracellular traps (NETs) leads to the continuous exposure of NETs to the endothelium in a variety of hematologic and autoimmune disorders, including lupus nephritis. This study aims to unravel the mechanisms through which NETs jeopardize vascular integrity. APPROACH AND RESULTS: Microvascular and macrovascular endothelial cells were exposed to NETs, and subsequent effects on endothelial integrity and function were determined in vitro and in vivo...
May 11, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28495322/prevalence-and-control-of-type-2-diabetes-mellitus-among-primary-care-physicians-in-spain-prisma-study
#13
Josep Franch-Nadal, Javier Mediavilla-Bravo, Manuel Mata-Cases, Didac Mauricio, David Asensio, Jordi Sarroca
OBJECTIVE: To describe the prevalence of known and ignored type 2 diabetes mellitus (T2DM) among primary care physicians (PCP), as well as the treatment used and the degree of metabolic control reached. MATERIAL AND METHODS: Descriptive cross-sectional study on national level. The participants were randomly selected PCPs, members of the redGDPS Foundation. A total of 495 PCP were enrolled. Capillary HbA1c measurement was done with a A1CNow+(®) device and a diabetes-related survey specifically designed for the study was administered to the participants...
May 2017: Endocrinol Diabetes Nutr
https://www.readbyqxmd.com/read/28493291/prevalence-of-primary-aldosteronism-among-patients-with-type-2-diabetes
#14
M Tancredi, G Johansson, B Eliasson, R Eggertsen, U Lindblad, S Dahlqvist, H Imberg, M Lind
CONTEXT: Diabetes and hypertension coexist in 40-60% of individuals with type 2 diabetes. The coexistence of this two conditions is associated with increased risk of retinopathy, nephropathy and cardiovascular disease. OBJECTIVE: To investigate the prevalence of primary aldosteronism (PA) in a general cohort of persons with type 2 diabetes. DESIGN: Cross-sectional study involving 6 diabetes outpatient clinics in Sweden. PATIENTS: Were enrolled individuals with type 2 diabetes between February 2008 and December 2013...
May 10, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28490797/action-on-diabetic-macular-oedema-achieving-optimal-patient-management-in-treating-visual-impairment-due-to-diabetic-eye-disease
#15
R Gale, P H Scanlon, M Evans, F Ghanchi, Y Yang, G Silvestri, M Freeman, A Maisey, J Napier
This paper identifies best practice recommendations for managing diabetes and sight-threatening diabetic eye disease. The authors provide an update for ophthalmologists and allied healthcare professionals on key aspects of diabetes management, supported by a review of the pertinent literature, and recommend practice principles for optimal patient management in treating visual impairment due to diabetic eye disease. In people with diabetes, early optimal glycaemic control reduces the long-term risk of both microvascular and macrovascular complications...
May 2017: Eye
https://www.readbyqxmd.com/read/28490557/the-effect-of-empagliflozin-on-oxidative-nucleic-acid-modifications-in-patients-with-type-2-diabetes-protocol-for-a-randomised-double-blinded-placebo-controlled-trial
#16
Emil List Larsen, Vanja Cejvanovic, Laura Kofoed Kjær, Tina Vilsbøll, Filip Krag Knop, Jørgen Rungby, Henrik Enghusen Poulsen
INTRODUCTION: Cardiovascular disease is the leading cause of morbidity and mortality in patients with type 2 diabetes (T2D). Although glycaemic control reduces microvascular complications, the effect of intensive treatment strategies or individual drugs on macrovascular diseases is still debated. RNA oxidation is associated with increased mortality in patients with T2D. Inspired by animal studies showing effect of a sodium-glucose cotransporter-2 (SGLT-2) inhibitor (empagliflozin) on oxidative stress and a recent trial evaluating empagliflozin that demonstrated improved cardiovascular outcomes in patients with T2D at high risk of cardiovascular events, we hypothesise that empagliflozin lowers oxidative stress...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28487136/role-of-micrornas-in-type-2-diabetes-and-associated-vascular-complications
#17
REVIEW
Joyita Banerjee, Vijay Nema, Yogita Dhas, Neetu Mishra
Type 2 diabetes mellitus (T2DM) has become a major health threat worldwide. MicroRNAs (miRNAs) are a group of non-coding RNAs known to regulate various biological processes including the pathogenesis of T2DM. Recent studies have pointed out that specific miRNAs play a critical role in controlling β cell activities and the development of diabetic vascular complications. Their association with the disease pathogenesis and omnipresence in body fluids have made them important players for prognosis, diagnosis and management of T2DM...
May 6, 2017: Biochimie
https://www.readbyqxmd.com/read/28484968/a-practical-review-of-c-peptide-testing-in-diabetes
#18
REVIEW
Emma Leighton, Christopher Ar Sainsbury, Gregory C Jones
C-peptide is a widely used measure of pancreatic beta cell function. It is produced in equimolar amounts to endogenous insulin but is excreted at a more constant rate over a longer time. Methods of estimation include urinary and unstimulated and stimulated serum sampling. Modern assays detect levels of c-peptide which can be used to guide diabetes diagnosis and management. We explore the evidence behind the various tests available. We recommend the glucagon stimulation c-peptide testing owing to its balance of sensitivity and practicality...
May 8, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28483426/diabetes-and-anemia-international-diabetes-federation-idf-southeast-asian-region-sear-position-statement
#19
REVIEW
Manisha Sahay, Sanjay Kalra, Rajesh Badani, Ganapathi Bantwal, Anil Bhoraskar, A K Das, Bharati Dhorepatil, Sujoy Ghosh, Tarun Jeloka, Deepak Khandelwal, Zafar Ahmed Latif, Milind Nadkar, Md Faruque Pathan, Banshi Saboo, Rakesh Sahay, Suleiman Shimjee, Dina Shrestha, Ali Siyan, Shamim Hayder Talukdar, Mangesh Tiwaskar, A G Unnikrishnan
Anemia is often associated with diabetes mellitus and is known to intensify the risk of developing diabetes-related microvascular and macrovascular complications. There is paucity in understanding of co-existence of these conditions, especially in Southeast Asian countries. Iron and/or erythropoietin deficiencies are the major causes of anemia in diabetes, and diabetic kidney disease plays a key role. Patients with diabetes need to be screened for anemia along with other risk factors and anemia should be corrected appropriately to improve overall clinical outcomes...
April 28, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28479387/the-effects-of-tlr3-trif-and-traf3-snps-and-interactions-with-environmental-factors-on-type-2-diabetes-mellitus-and-vascular-complications-in-a-han-chinese-population
#20
Zixing Zhou, Chengli Zeng, Lihong Nie, Shiqi Huang, Congcong Guo, Di Xiao, Yajing Han, Xiaohong Ye, Meiling Ou, Chuican Huang, Xingguang Ye, Zihao Wen, Guang Yang, Chunxia Jing
Toll-like receptor 3 (TLR3) is involved in type I interferon-β (IFN-β) via TIR-domain-containing adapter-inducing interferon-β (TRIF) and Tumor necrosis factor receptor-associated factor 3 (TRAF3), culminating in inflammation and immunity reactions. TLR3 is implicated in insulin resistance and type 2 diabetes mellitus (T2DM). Eight SNPs of these genes were detected in 552 T2DM patients and 552 matched healthy control subjects. Gene-gene and gene-environment interactions and haplotype associations were also evaluated...
May 4, 2017: Gene
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