Sample records for japanese diabetic patients

  1. Social Orientation and Diabetes-Related Distress in Japanese and American Patients with Type 2 Diabetes

    PubMed Central

    Ikeda, Kaori; Fujimoto, Shimpei; Morling, Beth; Ayano-Takahara, Shiho; Carroll, Andrew E.; Harashima, Shin-ichi; Uchida, Yukiko; Inagaki, Nobuya

    2014-01-01

    Objective Recent evidence in cultural and social psychology suggests Eastern cultures' emphasis on harmony and connection with others and Western cultures' emphasis on self-direction and autonomy. In Eastern society, relational harmony is closely linked to people's well-being. The impact of this cultural and social orientation on diabetes-related distress was investigated. Research Design and Methods Japanese and American patients with type 2 diabetes were surveyed by well-established questionnaire in Japan and in the United States, respectively. The association of personal values for interdependence, perceived emotional support, and the Problem Areas in Diabetes scale (PAID) were analyzed. Results A positive correlation between interdependence and PAID (r?=?0.18; P?=?0.025) and a negative correlation between perceived emotional support and PAID (r?=?? 0.24; P?=?0.004) were observed after adjustments for other factors in Japanese data (n?=?149), but not in American data (r?=?0.00; P?=?0.990, r?=?0.02; P?=?0.917, respectively, n?=?50). In Japanese data, the three-factor structure of PAID (negative feelings about total life with diabetes, about living conditions with diabetes, and about treatment of diabetes) was identified, and interdependence showed significant positive correlations with the first and second factors and perceived emotional support showed significant negative correlations with all three factors of PAID. Conclusions These results suggest that personal values for interdependence may be linked to the level of diabetes-related distress and that the distress may be relieved by perception of emotional support, especially in an interdependent cultural context. PMID:25333692

  2. Aldose reductase C-106T gene polymorphism is associated with diabetic retinopathy in Japanese patients with type 2 diabetes.

    PubMed

    Katakami, N; Kaneto, H; Takahara, M; Matsuoka, T A; Imamura, K; Ishibashi, F; Kanda, T; Kawai, K; Osonoi, T; Matsuhisa, M; Kashiwagi, A; Kawamori, R; Shimomura, I; Yamasaki, Y

    2011-06-01

    It is likely that the C allele of the polymorphism at position -106 in the promoter of aldose reductase gene, which codes a rate-limiting enzyme of the polyol pathway, is a susceptibility allele for diabetic retinopathy in Japanese type 2 diabetic patients. PMID:21420193

  3. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study

    Microsoft Academic Search

    Yasuo Ohkubo; Hideki Kishikawa; Eiichi Araki; Takao Miyata; Satoshi Isami; Sadatoshi Motoyoshi; Yujiro Kojima; Naohiko Furuyoshi; Motoaki Shichiri

    1995-01-01

    To examine whether intensive glycemic control could decrease the frequency or severity of diabetic microvascular complications, we performed a prospective study of Japanese patients with non-insulin-dependent diabetes mellitus (NIDDM) treated with multiple insulin injection treatment. A total of 110 patients with NIDDM was randomly assigned to multiple insulin injection treatment group (MIT group) or to conventional insulin injection treatment group

  4. Association of plasma PAF acetylhydrolase gene polymorphism with IMT of carotid arteries in Japanese type 2 diabetic patients

    Microsoft Academic Search

    Isamu Yamamoto; Junko Fujitsu; Shinpei Nohnen; Tsuyoshi Igarashi; Takashi Motomura; Makiko Inaba; Shoji Tsubakimori; Junichi Azuma

    2003-01-01

    The aim of this study was to investigate association of a missense mutation in plasma PAF acetylhydrolase (G994T) with intima media thickness (IMT) of the carotid arteries. One hundred and forty Japanese type 2 diabetic patients aged from 40 to 79 years without severe nephropathy were enrolled in this study. The genotype of the patients was determined by allele specific

  5. Profile of saxagliptin in the treatment of type 2 diabetes: focus on Japanese patients

    PubMed Central

    Konya, Hiroyuki; Yano, Yuzo; Matsutani, Satoshi; Tsunoda, Taku; Ikawa, Takashi; Kusunoki, Yoshiki; Matsuo, Toshihiro; Miuchi, Masayuki; Katsuno, Tomoyuki; Hamaguchi, Tomoya; Miyagawa, Jun-ichiro; Namba, Mitsuyoshi

    2014-01-01

    Saxagliptin is a selective and potent dipeptidyl peptidase (DPP)-4 inhibitor, approved as an adjunct to diet and exercise to improve glycemic control in type 2 diabetes mellitus (T2DM) in the USA on July 2009, and had been launched globally in over 86 countries by September 2013. In patients with T2DM, once-daily administration of saxagliptin before breakfast achieves sustained inhibition of plasma DPP-4 activity and reduction of postprandial hyperglycemia, including after dinner, associated with an increase in plasma glucagon-like peptide-1 levels. This paper reviews the safety and efficacy of saxagliptin in Japanese patients with T2DM. The clinical development study in Japan supported its usefulness for the disease. Saxagliptin 1, 2.5, and 5 mg led to significant improvements in glycated hemoglobin (HbA1c), and was generally well tolerated. Treatment with saxagliptin 5 mg induced a sustained reduction in HbA1c over 52 weeks. Long-term combination therapy with saxagliptin and other oral hypoglycemic agents also provided sustained glycemic control and was well tolerated for up to 52 weeks. Saxagliptin as add-on to sulfonylureas or glinides has a tendency to increase hypoglycemia, but not with other oral antidiabetic agents, such as ?-glucosidase inhibitors, metformin, or thiazolidinediones. The results of clinical trials have confirmed the long-term efficacy and safety of saxagliptin monotherapy as well as its use as add-on combination therapy, and support its usefulness as a therapeutic agent for T2DM. Saxagliptin has less concern for hypoglycemia and weight gain, which often becomes problematic in routine care of T2DM. Meta-analysis of clinical trials in the USA showed no evidence of increased risk of cardiovascular events associated with saxagliptin, suggesting the superior of saxagliptin in terms of safety. Recently, investigators in the SAVOR-TIMI (Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus-Thrombolysis in Myocardial Infarction) 53 study suggested that DPP-4 inhibition with saxagliptin did not increase or decrease the rate of ischemic events, although the rate of hospitalization for heart failure was increased. Although saxagliptin improves glycemic control, other approaches are necessary to reduce cardiovascular risk in patients with diabetes. Saxagliptin is applicable for various pathological conditions, and is considered to be clinically significant as a new therapeutic option for Japanese patients with T2DM. PMID:25050065

  6. Coffee consumption is inversely associated with depressive status in Japanese patients with type 2 diabetes

    PubMed Central

    Omagari, Katsuhisa; Sakaki, Mika; Tsujimoto, Yuki; Shiogama, Yukiko; Iwanaga, Akiko; Ishimoto, Makiko; Yamaguchi, Asami; Masuzumi, Miki; Kawase, Miku; Ichimura, Mayuko; Yoshitake, Takatoshi; Miyahara, Yoshiyuki

    2014-01-01

    Depression has been reported to be more prevalent among diabetic patients than non-diabetic individuals. Although depression and diabetes are causally and bi-directionally related, the influence of food intake frequency on depressive symptoms in diabetic patients has not been fully evaluated. This cross-sectional study analyzed data obtained from 89 patients with type 2 diabetes who completed self-administered questionnaires regarding food intake frequency, diabetic variables, physical activity and depressive states. The prevalence of a “definite” depressive state was 16.9%. The duration of diabetes, hemoglobin A1c levels, diabetic microvascular complications and physical activity levels were similar between depressed and non-depressed patients. Daily intakes of total lipids, n-6 polyunsaturated fatty acids and lipid energy ratios were significantly lower, and the carbohydrate energy ratio was significantly higher in depressed than in non-depressed patients. Coffee consumption was inversely associated with depressive symptoms, but no significant association was found between tea or green tea consumption and depressive symptoms. The logistic regression analysis showed that coffee consumption was an independent predictor of non-depressed status in diabetic patients. This might be due to biologically active compounds containing in coffee other than caffeine. PMID:25320461

  7. Coffee consumption is inversely associated with depressive status in Japanese patients with type 2 diabetes.

    PubMed

    Omagari, Katsuhisa; Sakaki, Mika; Tsujimoto, Yuki; Shiogama, Yukiko; Iwanaga, Akiko; Ishimoto, Makiko; Yamaguchi, Asami; Masuzumi, Miki; Kawase, Miku; Ichimura, Mayuko; Yoshitake, Takatoshi; Miyahara, Yoshiyuki

    2014-09-01

    Depression has been reported to be more prevalent among diabetic patients than non-diabetic individuals. Although depression and diabetes are causally and bi-directionally related, the influence of food intake frequency on depressive symptoms in diabetic patients has not been fully evaluated. This cross-sectional study analyzed data obtained from 89 patients with type 2 diabetes who completed self-administered questionnaires regarding food intake frequency, diabetic variables, physical activity and depressive states. The prevalence of a "definite" depressive state was 16.9%. The duration of diabetes, hemoglobin A1c levels, diabetic microvascular complications and physical activity levels were similar between depressed and non-depressed patients. Daily intakes of total lipids, n-6 polyunsaturated fatty acids and lipid energy ratios were significantly lower, and the carbohydrate energy ratio was significantly higher in depressed than in non-depressed patients. Coffee consumption was inversely associated with depressive symptoms, but no significant association was found between tea or green tea consumption and depressive symptoms. The logistic regression analysis showed that coffee consumption was an independent predictor of non-depressed status in diabetic patients. This might be due to biologically active compounds containing in coffee other than caffeine. PMID:25320461

  8. Microalbuminuria Reduction with Telmisartan in Normotensive and Hypertensive Japanese Patients with Type 2 Diabetes: A Post-Hoc Analysis of the Incipient to Overt: Angiotensin II Blocker, Telmisartan, Investigation on Type 2 Diabetic Nephropathy (INNOVATION) Study

    Microsoft Academic Search

    Hirofumi Makino; Masakazu Haneda; Tetsuya Babazono; Tatsumi Moriya; Sadayoshi Ito; Yasuhiko Iwamoto; Ryuzo Kawamori; Masahiro Takeuchi; Shigehiro Katayama

    2008-01-01

    The Incipient to Overt: Angiotensin II Blocker, Telmisartan, Investigation on Type 2 Diabetic Nephropathy (INNOVATION) study previously showed that treatment with telmisartan, an angiotensin II receptor blocker, effectively reduced the transition from incipient to overt nephropathy in Japanese type 2 diabetic patients. However, that large study included both normotensive and hypertensive patients. In the present post hoc analysis, we aimed

  9. Effects of pioglitazone on metabolic parameters, body fat distribution, and serum adiponectin levels in Japanese male patients with type 2 diabetes

    Microsoft Academic Search

    Hiroshi Hirose; Toshihide Kawai; Yukihiro Yamamoto; Matsuo Taniyama; Motowo Tomita; Koichi Matsubara; Yasunori Okazaki; Tatsuya Ishii; Yuko Oguma; Izumi Takei; Takao Saruta

    2002-01-01

    The aim of this study was to evaluate the effects of pioglitazone on clinical and metabolic parameters, body fat distribution, and serum adiponectin, a recently discovered antiatherosclerotic hormone, in Japanese patients with type 2 diabetes. Ten male patients aged 40 to 66 (57.7 [plusmn] 7.4) years, who were being treated with dietary therapy alone (n = 7) or with a

  10. Assessment of Daily Food and Nutrient Intake in Japanese Type 2 Diabetes Mellitus Patients Using Dietary Reference Intakes

    PubMed Central

    Kobayashi, Yukiko; Hattori, Mikako; Wada, Sayori; Iwase, Hiroya; Kadono, Mayuko; Tatsumi, Hina; Kuwahata, Masashi; Fukui, Michiaki; Hasegawa, Goji; Nakamura, Naoto; Kido, Yasuhiro

    2013-01-01

    Medical nutrition therapy for the management of diabetes plays an important role in preventing diabetes complications and managing metabolic control. However, little is known about actual eating habits of individuals with type 2 diabetic mellitus (T2DM), especially in Japan. Therefore, we sought to (1) assess the dietary intake of individuals with T2DM, and (2) characterize their intake relative to national recommendations. This cross-sectional study involved 149 patients (77 males and 72 females) aged 40–79 years with T2DM recruited at a Kyoto hospital. Dietary intake was assessed using a validated self-administered diet history questionnaire. Under-consumption, adequacy, and over-consumption, of nutrients were compared to the age- and sex-based standards of the Japanese Dietary Reference Intakes. Among the results, most notable are (1) the inadequacy of diets in men with respect to intake of vitamins and minerals, likely owing to low intake of vegetables and fruits; (2) excess contributions of fat intake to total energy in both sexes; and (3) excess consumption of sweets and beverages relative to the national average. The prevalence of diabetes complications may be increasing because of a major gap between the typical dietary intake of individuals with T2DM and dietary recommendation. PMID:23803740

  11. Reduced beta-cell mass and expression of oxidative stress-related DNA damage in the islet of Japanese Type II diabetic patients

    Microsoft Academic Search

    H. Sakuraba; H. Mizukami; N. Yagihashi; R. Wada; C. Hanyu; S. Yagihashi

    2002-01-01

    .\\u000a Aims\\/hypothesis:   We examined the pancreatic islet lesions in Japanese patients with Type II diabetes mellitus to determine if the damage was\\u000a related to oxidative stress. \\u000a \\u000a \\u000a \\u000a Methods:   Morphometric analyses were performed on immunostained sections of the tail portion of the pancreas from 14 diabetic and 15\\u000a non-diabetic patients. Amyloid deposition and oxidative stress-induced tissue damage were evaluated by Congo-red staining

  12. Efficacy of Combination Therapy With Sitagliptin and Low-Dose Glimepiride in Japanese Patients With Type 2 Diabetes

    PubMed Central

    Ishii, Hiroaki; Ohkubo, Yosuke; Takei, Masahiro; Nishio, Shinichi; Yamazaki, Masanori; Kumagai, Mieko; Sato, Yoshihiko; Suzuki, Satoru; Aoki, Yuji; Miyamoto, Takahide; Kakizawa, Tomoko; Sakuma, Takahiro; Komatsu, Mitsuhisa

    2014-01-01

    Background We examined the effects of combination therapy with 50 mg/day of sitagliptin and low-dose glimepiride (1 mg/day) in patients with type 2 diabetes. Methods Twenty-six patients with poorly controlled type 2 diabetes currently taking high-dose glimepiride (? 2 mg/day) were enrolled in the study. The dose of glimepiride was reduced to 1 mg/day and 50 mg/day of sitagliptin was added without changing the doses of any other antihyperglycemic agents. The patients were divided into two groups: the low-dose group (2 or 3 mg glimepiride decreased to 1 mg: n = 15) and the high-dose group (4 or 6 mg glimepiride decreased to 1 mg: n = 11). Results Combination therapy significantly lowered HbA1c after 24 weeks of treatment in both groups. In the low-dose group, 8.1 ± 0.2% decreased to 7.0 ± 0.1%; in the high-dose group, 8.4 ± 0.1% decreased to 7.3 ± 0.2%. The time course of the degree of HbA1c reduction in the high-dose group was almost superimposable on that in the low-dose group. There were no changes in body weight and no hypoglycemia and in either group during the study period. In conclusion, our results suggested that the combination therapy used in the study is both well tolerated and effective. Conclusion This study indicated the usefulness of dipeptidyl peptidase (DPP)-4 inhibitors in Japanese patients with type 2 diabetes, and also reinforces the importance of low doses of sulfonylurea for effective glycemic management. PMID:24578754

  13. Efficacy and Safety of Sitagliptin Added to Insulin in Japanese Patients with Type 2 Diabetes: The EDIT Randomized Trial

    PubMed Central

    Sato, Seiji; Saisho, Yoshifumi; Kou, Kinsei; Meguro, Shu; Tanaka, Masami; Irie, Junichiro; Kawai, Toshihide; Itoh, Hiroshi

    2015-01-01

    Aims To clarify the efficacy and safety of adding sitagliptin to insulin therapy in Japanese patients with suboptimally controlled type 2 diabetes (T2DM). Study Design and Methods This was a 24-week, prospective, randomized, open-labeled, controlled trial. Patients with T2DM who were suboptimally controlled despite receiving at least twice daily injection of insulin were enrolled in the study. The patients were randomized to continuation of insulin treatment (Insulin group) or addition of sitagliptin 50 to 100 mg daily to insulin treatment (Ins+Sita group). The primary outcome was change in HbA1c at week 24. Results Adding sitagliptin to insulin significantly reduced HbA1c from 7.9 ± 1.0% at baseline to 7.0 ± 0.8% at week 24 (P <0.0001), while there was no significant change in HbA1c in the Insulin group (7.8 ± 0.7% vs. 7.8 ± 1.1%, P = 0.32). The difference in HbA1c reduction between the groups was 0.9% (95% confidence interval, 0.4 to 1.5, P = 0.01). There was no significant weight gain in either group. Incidence of hypoglycemia was significantly reduced in the Ins+Sita group compared with the Insulin group. Treatment satisfaction was improved in the Ins+Sita group. Baseline HbA1c level and beta cell function were associated with the magnitude of reduction in HbA1c in the Ins+Sita group. Conclusion Adding sitagliptin to insulin reduced HbA1c without weight gain or increase in hypoglycemia, and improved treatment satisfaction in Japanese patients with T2DM who were suboptimally controlled despite at least twice daily injection of insulin. Trial Registration The University Hospital Medical Information Network (UMIN) Clinical Trials Registry UMIN000004678 PMID:25816296

  14. Polymorphism of BF, C2, and GLO in Japanese patients with insulin-dependent diabetes mellitus: Confirmation of an increase of BF * FT

    Microsoft Academic Search

    Katsushi Tokunaga; Keiichi Omoto; Takeo Juji; Tokuji Itoh

    1982-01-01

    The distribution of phenotypes controlled by three HLA-linked loci BF, C2, and GLO has been studied in Japanese patients with insulin-dependent diabetes mellitus (IDDM). A slight but significant higher incidence of a rare varian BF*FT (=*F075) in patients was confirmed in the combined data with our previous study (Tokunaga et al. 1981 b). No significant association of C2 and GLO

  15. Teneligliptin improves glycemic control with the reduction of postprandial insulin requirement in Japanese diabetic patients.

    PubMed

    Tsuchimochi, Wakaba; Ueno, Hiroaki; Yamashita, Eiichiro; Tsubouchi, Chikako; Sakoda, Hideyuki; Nakamura, Shuji; Nakazato, Masamitsu

    2015-01-30

    Teneligliptin is a novel peptidomimetic-chemotype prolylthiazolidine-based inhibitor of dipeptidyl peptidase-4 (DPP-4). The aim of this study was to evaluate the effects of teneligliptin on 24 h blood glucose control and gastrointestinal hormone responses to a meal tolerance test, and to investigate the glucose-lowering mechanisms of teneligliptin. Ten patients with type 2 diabetes mellitus (T2DM) were treated for 3 days with teneligliptin (20 mg/day). Postprandial profiles for glucose, insulin, glucagon, active glucagon-like peptide-1 (GLP-1), active glucose-dependent insulinotropic polypeptide (GIP), ghrelin, des-acyl ghrelin, and 24 h glycemic fluctuations were measured via continuous glucose monitoring for 4 days. Once daily teneligliptin administration for 3 days significantly lowered postprandial and fasting glucose levels. Significant elevations of fasting and postprandial active GLP-1 and postprandial active GIP levels were observed. Teneligliptin lowered postprandial glucose elevations, 24 h mean blood glucose levels, standard deviation of 24 h glucose levels and mean amplitude of glycemic excursions (MAGE) without hypoglycemia. Serum insulin levels in the fasting state and 30 min after a meal were similar before and after teneligliptin treatment; however significant reductions at 60 to 180 min after treatment were observed. A significant elevation in early-phase insulin secretion estimated by insulinogenic and oral disposition indices, and a significant reduction in postprandial glucagon AUC were observed. Both plasma ghrelin and des-acyl ghrelin levels were unaltered following teneligliptin treatment. Teneligliptin improved 24 h blood glucose levels by increasing active incretin levels and early-phase insulin secretion, reducing the postprandial insulin requirement, and reducing glucagon secretion. Even short-term teneligliptin treatment may offer benefits for patients with T2DM. PMID:25252844

  16. Structure of the human glucokinase gene and identification of a missense mutation in a Japanese patient with early-onset non-insulin-dependent diabetes mellitus

    SciTech Connect

    Sakura, Hiroshi; Eto, Kazuhiro; Ueno, Hirohisa; Yazaki, Yoshio; Kadowaki, Takashi (Univ. of Tokyo (Japan)); Kadowaki, Hiroko; Simokawa, Kotaro; Akanuma, Yasuo (Asahi Life Foundation, Tokyo (Japan)); Koda, Naoya; Fukushima, Yoshimitsu (Saitama Children's Medical Center (Japan))

    1992-12-01

    Glucokinase is thought to play a glucose-sensor role in the pancreas, and abnormalities in its structure, function, and regulation can induce diabetes. The authors isolated the human glucokinase gene, and determined its genomic structure including exon-intron boundaries. Structure of the glucokinase gene in human was very similar to that in rat. Then, by screening Japanese diabetic patients using polymerase chain reaction - single strand conformation polymorphism (PCR-SSCP) and direct-sequencing strategies, they identified a missense mutation substituting ariginine (AGG) for glycine (GGG) at position 261 in exon 7 of the glucokinase gene in a patient with early-onset non-insulin-dependent diabetes (NIDDM). 12 refs., 3 figs., 2 tabs.

  17. Microalbuminuria reduction with telmisartan in normotensive and hypertensive Japanese patients with type 2 diabetes: a post-hoc analysis of The Incipient to Overt: Angiotensin II Blocker, Telmisartan, Investigation on Type 2 Diabetic Nephropathy (INNOVATION) study.

    PubMed

    Makino, Hirofumi; Haneda, Masakazu; Babazono, Tetsuya; Moriya, Tatsumi; Ito, Sadayoshi; Iwamoto, Yasuhiko; Kawamori, Ryuzo; Takeuchi, Masahiro; Katayama, Shigehiro

    2008-04-01

    The Incipient to Overt: Angiotensin II Blocker, Telmisartan, Investigation on Type 2 Diabetic Nephropathy (INNOVATION) study previously showed that treatment with telmisartan, an angiotensin II receptor blocker, effectively reduced the transition from incipient to overt nephropathy in Japanese type 2 diabetic patients. However, that large study included both normotensive and hypertensive patients. In the present post hoc analysis, we aimed to assess whether or not telmisartan elicits beneficial effects on the progression of microalbuminuria in normotensive patients. We randomized 163 microalbuminuric (urinary albumin-to-creatinine ratio: UACR of 100 to 300 mg/g creatinine) normotensive type 2 diabetic patients to treatment with telmisartan (40 or 80 mg once daily) or placebo over 52 weeks. The patients treated with either dose of telmisartan showed lower transition rates from microalbuminuria to overt nephropathy compared to the placebo group. In addition, more patients on telmisartan reverted to normoalbuminuria (UACR<30 mg/g creatinine): 15.5% of the 40 mg group, 19.6% of the 80 mg group, and 1.9% of the placebo group. In normotensive patients treated with telmisartan, changes in UACR were not significantly correlated with changes in blood pressure. Side effects did not differ among the groups. The present study demonstrates that telmisartan prevents the progression of microalbuminuria (in some cases induces remission of albuminuria) in normotensive Japanese patients with type 2 diabetes. Telmisartan is shown to be safe and well tolerated in these patients. PMID:18633177

  18. Decreased activity of arachidonate 12-lipoxygenase in platelets of Japanese patients with non—insulin-dependent diabetes mellitus

    Microsoft Academic Search

    Toshio Tohjima; Naoko Honda; Kentaro Mochizuki; Junichiro Kinoshita; Kenji Watanabe; Tomoyuki Arisaka; Ryuzo Kawamori; Michihiro Nakamura; Yuko Kurahashi; Tanihiro Yoshimoto; Shozo Yamamoto

    1998-01-01

    To study the metabolism of the platelet 12-lipoxygenase pathway in diabetes, we evaluated the correlation between the activity and amount of arachidonate 12-lipoxygenase in the platelets of patients with non—insulin-dependent-diabetes mellitus (NIDDM). There were four parts in this investigation: (1) examination of abnormalities in platelet 12-lipoxygenase in patients with NIDDM recruited from the Hospital of Juntendo University School of Medicine;

  19. Addition of sitagliptin to ongoing glimepiride therapy in Japanese patients with type 2 diabetes over 52 weeks leads to improved glycemic control

    Microsoft Academic Search

    Naoko Tajima; Takashi Kadowaki; Masato Odawara; Mikio Nishii; Tadaaki Taniguchi; Juan Camilo Arjona Ferreira

    2011-01-01

    The efficacy and safety of sitagliptin as an add-on therapy to glimepiride were evaluated in a multicenter, randomized, double-blind,\\u000a placebo-controlled study, followed by an uncontrolled open-label period, in Japanese patients with type 2 diabetes who had\\u000a inadequate glycemic control on diet\\/exercise therapy and glimepiride monotherapy. During the initial double-blind period,\\u000a sitagliptin (50 mg q.d.) or placebo was added to ongoing glimepiride

  20. Add-On Treatment with Teneligliptin Ameliorates Glucose Fluctuations and Improves Glycemic Control Index in Japanese Patients with Type 2 Diabetes on Insulin Therapy

    PubMed Central

    Tanaka, Seiichi; Aoki, Chie; Niitani, Mai; Kato, Kanako; Tomotsune, Takanori; Aso, Yoshimasa

    2014-01-01

    Abstract Background: This study investigated whether teneligliptin, a novel dipeptidyl peptidase-4 inhibitor, ameliorated glucose fluctuations in hospitalized Japanese patients with type 2 diabetes receiving insulin therapy, with or without other antidiabetes drugs, and using continuous glucose monitoring (CGM). Patients and Methods: Twenty-six patients with type 2 diabetes were admitted for glycemic control. After admission, patients continued to be treated with optimal dietary therapy plus insulin therapy, with or without other antidiabetes drugs, until they achieved stable glycemic control. CGM measurements were made for 7 consecutive days. On Days 1–3, patients received insulin with or without other antidiabetes drugs, and on Days 4–7, teneligliptin 20?mg once daily at breakfast was added to ongoing therapy. Doses of insulin were fixed during the study. Levels of serum glycated albumin (GA), 1,5-anhydro-d-glucitol (1,5-AG), and high-sensitivity C-reactive protein (hsCRP) were measured. Results: Add-on treatment with teneligliptin led to significant improvements in 24-h mean glucose levels, the proportion of time in normoglycemia, mean amplitude of glycemic excursions, and total area under the curve within 2?h after each meal. The proportion of time in hypoglycemia and hsCRP levels did not increase significantly compared with before teneligliptin. Values of 1,5-AG and GA were significantly improved by treatment with teneligliptin. Conclusions: Addition of teneligliptin to insulin therapy led to a significant improvement in diurnal glycemic control and significant reductions in glucose fluctuations in 24-h periods without increasing hypoglycemia in Japanese patients with type 2 diabetes on insulin therapy, with or without other antidiabetes agents. PMID:25144424

  1. A pilot three-month sitagliptin treatment increases serum adiponectin level in Japanese patients with type 2 diabetes mellitus- a randomized controlled trial START-J study

    PubMed Central

    2014-01-01

    Background The dipeptidyl-peptidase-IV (DPP-4) inhibitors, including sitagliptin, are used for the treatment of type 2 diabetes mellitus (T2DM). Adiponectin, an adipocyte-derived circulating protein, has anti-atherosclerotic and anti-diabetic properties and is effectively elevated in bloodstream by thiazolidinediones, an insulin sensitizer. However, the effect of sitagliptin treatment on serum adiponectin level in T2DM has not fully elucidated in Japanese T2DM patients. The aim of the present study was to examine the effect of sitagliptin treatment on serum adiponectin levels in T2DM subjects. Methods Twenty-six consecutive Japanese T2DM outpatients were recruited between April 2011 and March 2013, and randomized into the control (conventional treatment, n?=?10) group and sitagliptin treatment group (n?=?16). Serum adiponectin was measured by enzyme-linked immunosorbent assay. Results Indices of glycemic control, such as hemoglobin A1c, glycated albumin, and 1.5-anhydro-D-glucitol, were significantly improved after the three-month treatment in both the control and sitagliptin groups. Serum adiponectin level was significantly increased in sitagliptin group from 6.7?±?0.8 to 7.4?±?1.0 ?g/mL without change of body mass index (p?=?0.034), while serum adiponectin level was not altered in the control group (p?=?0.601). Conclusion In Japanese T2DM patients, serum adiponectin level was elevated by three-month treatment with sitagliptin without change of body weight. Trial registration UMIN000004721 PMID:24884787

  2. Ipragliflozin in combination with metformin for the treatment of Japanese patients with type 2 diabetes: ILLUMINATE, a randomized, double-blind, placebo-controlled study

    PubMed Central

    Kashiwagi, A; Kazuta, K; Goto, K; Yoshida, S; Ueyama, E; Utsuno, A

    2015-01-01

    This multicenter, double-blind, placebo-controlled study examined the efficacy and safety of ipragliflozin, a sodium-glucose co-transporter 2 inhibitor, in combination with metformin in Japanese patients with type 2 diabetes mellitus (T2DM). Patients were randomized in a 2: 1 ratio to 50 mg ipragliflozin (n = 112) or placebo (n = 56) once daily for 24 weeks, followed by a 28-week open-label extension in which all patients received 50 or 100 mg ipragliflozin, while continuing metformin. The primary outcome was the change in glycated haemoglobin (HbA1c) from baseline to week 24. HbA1c decreased significantly in the ipragliflozin group (?0.87%; adjusted mean difference from placebo: ?1.30%; p < 0.001). The overall incidence of treatment-emergent adverse events was similar in both groups, although pollakiuria and constipation were more common in the ipragliflozin group; thus, ipragliflozin significantly improved glycaemic control and reduced body weight without major safety issues in Japanese patients with T2DM. PMID:24919820

  3. Addition of sitagliptin or metformin to insulin monotherapy improves blood glucose control via different effects on insulin and glucagon secretion in hyperglycemic Japanese patients with type 2 diabetes.

    PubMed

    Otsuka, Yuichiro; Yamaguchi, Suguru; Furukawa, Asami; Kosuda, Minami; Nakazaki, Mitsuhiro; Ishihara, Hisamitsu

    2015-02-27

    This study aimed to explore the effects of the dipeptidyl peptidase-4 inhibitor sitagliptin and the biguanide metformin on the secretion of insulin and glucagon, as well as incretin levels, in Japanese subjects with type 2 diabetes mellitus poorly controlled with insulin monotherapy. This was a single-center, randomized, open-label, parallel group study, enrolling 25 subjects. Eleven patients (hemoglobin A1c [HbA1c] 8.40 ± 0.96%) and 10 patients (8.10 ± 0.54%) on insulin monotherapy completed 12-week treatment with sitagliptin (50 mg) and metformin (750 mg), respectively. Before and after treatment, each subject underwent a meal tolerance test. The plasma glucose, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), C-peptide, and glucagon responses to a meal challenge were measured. HbA1c reductions were similar in patients treated with sitagliptin (0.76 ± 0.18%) and metformin (0.77 ± 0.17%). In the sitagliptin group, glucose excursion during a meal tolerance test was reduced and accompanied by elevations in active GLP-1 and active GIP concentrations. C-peptide levels were unaltered despite reduced glucose responses, while glucagon responses were significantly suppressed (-7.93 ± 1.95% of baseline). In the metformin group, glucose excursion and incretin responses were unaltered. C-peptide levels were slightly increased but glucagon responses were unchanged. Our data indicate that sitagliptin and metformin exert different effects on islet hormone secretion in Japanese type 2 diabetic patients on insulin monotherapy. A glucagon suppressing effect of sitagliptin could be one of the factors improving blood glucose control in patients inadequately controlled with insulin therapy. PMID:25328079

  4. Efficacy and safety of lixisenatide in Japanese patients with type 2 diabetes mellitus inadequately controlled by sulfonylurea with or without metformin: Subanalysis of GetGoal-S

    PubMed Central

    Onishi, Yukiko; Niemoeller, Elisabeth; Ikeda, Yukio; Takagi, Hiroki; Yabe, Daisuke; Seino, Yutaka

    2015-01-01

    Aims/Introduction This was a subanalysis of Japanese patients included in the glucagon-like peptide-1 receptor agonist AVE0010 in patients with type 2 diabetes mellitus for glycemic control and safety evaluation (GetGoal-S) study – a 24-week, randomized, placebo-controlled study of lixisenatide in patients with type 2 diabetes mellitus inadequately controlled by sulfonylurea with or without metformin. Materials and Methods In GetGoal-S, 127 Japanese patients received the once-daily prandial glucagon-like peptide-1 receptor agonist lixisenatide 20 ?g/day or a matching placebo. The primary outcome was change in glycated hemoglobin. Results At week 24, lixisenatide significantly reduced mean glycated hemoglobin (least squares mean difference vs the placebo ?1.1% [12 mmol/mol, P < 0.0001]), and significantly more lixisenatide patients reached glycated hemoglobin targets of <7% (53 mmol/mol) and ?6.5% (48 mmol/mol) vs the placebo. Lixisenatide produced statistically significant reductions in 2-h postprandial plasma glucose (least squares mean difference vs the placebo ?8.51 mmol/L, P < 0.0001) and glucose excursion vs the placebo, and significantly reduced fasting plasma glucose (least squares mean difference vs the placebo ?0.65 mmol/L, P = 0.0454). Bodyweight decreased with both lixisenatide and the placebo (least squares mean change ?1.12 kg for lixisenatide, ?1.02 kg for placebo). The overall incidence of adverse events was similar for lixisenatide and the placebo (84.2 and 82.4%, respectively), the most frequent being gastrointestinal disorders (52.6% for lixisenatide vs 29.4% for placebo). The incidence of symptomatic hypoglycemia was higher with lixisenatide vs the placebo (17.1 and 9.8%, respectively), with no cases of severe symptomatic hypoglycemia in either group. Conclusions In the Japanese subpopulation of the GetGoal-S study, lixisenatide produced a significant and clinically relevant improvement in glycated hemoglobin, with a pronounced improvement in postprandial plasma glucose, and a good safety and tolerability profile. PMID:25802728

  5. Association of cardiorespiratory fitness with elevated hepatic enzyme and liver fat in Japanese patients with impaired glucose tolerance and type 2 diabetes mellitus.

    PubMed

    Nagano, Mayumi; Sasaki, Haruka; Kumagai, Shuzo

    2010-01-01

    No study has so far determined whether a favorable level of cardiorespiratory fitness (CF) contributes to a reduced risk of elevated hepatic enzymes and a high degree of liver fat in patients having various metabolic risks. This study investigated the association between the maximal oxygen uptake (VO2 max) and the prevalence of elevated liver enzymes and high liver fat, while considering such factors as abdominal obesity, hyperinsulinemia and the other metabolic risks. The study enrolled newly diagnosed Japanese patients (n = 84; 52 males and 32 females; aged 25-69 years) with impaired glucose tolerance (IGT) and type 2 diabetes mellitus (Type2DM) who did not receive any intervention or pharmacological therapy. The subjects were divided into 3 groups according to the distribution of the VO2max for each sex. The odds ratios (ORs) for the prevalence of elevated aspartate and alanine aminotransferase (AST and ALT) and high degree of liver fat adjusted for age, sex, disease type, daily ethanol intake, and current smoking were significantly lower in the moderate- and high CF groups in comparison to the low CF group. In addition, a significant OR for AST was maintained in the moderate and high CF group after adjusting for abdominal obesity and/or hyperinsulinemia. The significant ORs for the prevalence of elevated ALT and a high degree of liver fat were attenuated after adjusting for abdominal obesity and/or hyperinsulinemia. No significant OR for the prevalence of elevated gamma-glutamyl transferase (GGT) was recognized in all logistic models. These results indicated that CF was negatively and independently associated with the prevalence of elevated AST even in Japanese diabetic patients having various metabolic risks. It was concluded that the AST level might be useful as a simple marker reflecting physical inactivity in such subjects. Key pointsThe prevalence of elevated AST was negatively, and strongly associated with the CF level independent of abdominal obesity, hyperinsulinemia, and the other confounders in the subjects with glucose intolerance.The association between the CF level and both an elevated ALT level and a high degree of liver fat, as defined by the L/S ratio of CT images depended on abdominal fat and/or hyperinsulinemia in the subjects with glucose intolerance.No association was recognized between CF and elevated GGT in the subjects with glucose intolerance in the subjects with glucose intolerance.Having a favorable level of CF could lead to a reduced risk of hepatic-related abnormalities even in diabetic patients having the other metabolic risks. PMID:24149634

  6. Comparison of cystatin C- and creatinine-based estimated glomerular filtration rate to predict coronary heart disease risk in Japanese patients with obesity and diabetes.

    PubMed

    Ito, Ryo; Yamakage, Hajime; Kotani, Kazuhiko; Wada, Hiromichi; Otani, Sumire; Yonezawa, Kazuya; Ogo, Atsushi; Okajima, Taiichiro; Adachi, Masahiro; Araki, Rika; Yoshida, Kazuro; Saito, Miho; Nagaoka, Tadasu; Toyonaga, Tetsushi; Tanaka, Tsuyoshi; Yamada, Tsutomu; Ota, Itsuro; Oishi, Mariko; Miyanaga, Fumiko; Shimatsu, Akira; Satoh-Asahara, Noriko

    2015-02-27

    The aim of this study is to determine which indicator of chronic kidney disease most closely correlates with 10-year Framingham coronary heart disease (CHD) risk among serum creatinine, serum cystatin C (S-CysC), urine albumin-creatinine ratio (UACR), estimated creatinine-based GFRs (eGFRcre), and estimated CysC-based GFRs (eGFRcys) in patients with obesity and diabetes. Serum creatinine, S-CysC, UACR, and cardio-ankle vascular index (CAVI) were examined in 468 outpatients with obesity and type 2 diabetes, free of severe renal dysfunction or previous history of cardiovascular disease, as a cross-sectional survey using baseline data from the multi-centered Japan Diabetes and Obesity Study. S-CysC and eGFRcys had significantly stronger correlations with the 10-year Framingham CHD risk than serum creatinine, eGFRcre, and UACR (creatinine, ? = 0.318; S-CysC, ? = 0.497; UACR, ? = 0.174; eGFRcre, ? = -0.291; eGFRcys, ? = -0.521; P < 0.01 by Fisher's z-test). S-CysC and eGFRcys had significantly stronger correlations with CAVI than serum creatinine, eGFRcre, and UACR (creatinine, ? = 0.198; S-CysC, ? = 0.383; UACR, ? = 0.183; eGFRcre, ? = -0.302; eGFRcys, ? = -0.444; P < 0.05 by Fisher's z-test). The receiver operating characteristic curves to distinguish the high-risk patients for CHD revealed significantly larger areas under the curve of S-CysC and eGFRcys than those of serum creatinine, UACR, and eGFRcre (serum creatinine, 0.64; S-CysC, 0.75; UACR, 0.56; eGFRcre, 0.63; eGFRcys, 0.76; P < 0.01). The data suggested that eGFRcys can be more predictive of the 10-year CHD risk than eGFRcre in Japanese patients with obesity and diabetes. PMID:25399862

  7. Attainment of glycaemic goals by step-up therapy with biphasic insulin aspart-70/30 in Japanese type 2 diabetic patients.

    PubMed

    Hosoi, Yasuhiro; Ohtani, Ken-Ichi; Shimizu, Hiroyuki; Kashima, Kouji; Sato, Noriyuki; Akiyama, Hitoshi; Mori, Masatomo

    2011-01-01

    We have made step-up titration protocol with biphasic insulin aspart-70/30 (BIAsp 30), and tried to achieve glycemic goals in poorly controlled Japanese type 2 diabetic patients. We summarized all results obtained to analyze the effectiveness of our protocol. The target of glycaemic control was defined as HbA1c over 7.0 %. In our insulin initiation protocol, all patients started a once-daily injection of BIAsp 30 before the breakfast in addition to their oral hypoglycaemic agents. The patients who could not achieve the target from 12 to 16 weeks after the start of insulin treatment proceeded to twice daily insulin injection before breakfast and dinner. Next, the patients who could not achieve the target from 12 to 16 weeks after the addition of another BIAsp injection proceeded to thrice daily insulin injection before each meal a day. The results of 39 patients were analyzed, and 10.3 % of all patients achieved the target after the start of once daily injection of BIAsp 30, 41.7 % achieved in twice daily injection of BIAsp, and 51.4 % achieved in thrice daily injection of BIAsp. Daily insulin dose at the end of each treatment was 9.3±4.1 U in once daily, 17.4±6.3 U in twice daily, and 28.4±10.4 U in thrice daily. Total body weight increase by 2.0±2.6 kg. The initiation and titration protocol with BIAsp 30 improved glycaemic control, and increased the number of patients with the achievement of glycaemic goals. PMID:21186332

  8. Evaluation of the Long-Term Durability and Glycemic Control of Fasting Plasma Glucose and Glycosylated Hemoglobin for Pioglitazone in Japanese Patients with Type 2 Diabetes

    PubMed Central

    Stringer, Frances; DeJongh, Joost; Koumura, Emiko; Danhof, Meindert; Kaku, Kohei

    2015-01-01

    Abstract Background: This study applied a pharmacodynamic model-based approach to evaluate the long-term durability and glycemic control of pioglitazone in comparison with other oral glucose-lowering drugs in Japanese type 2 diabetes mellitus (T2DM) patients. Subjects and Methods: Japanese T2DM patients were enrolled in a prospective, randomized, open-label, blinded-end point study and received pioglitazone with or without other oral glucose-lowering drugs (excluding another thiazolidinedione [TZD]) (n=293) or oral glucose-lowering drugs excluding TZD (n=294). Treatment was adjusted to achieve glycosylated hemoglobin (HbA1c) <6.9%, and samples for fasting plasma glucose (FPG) and HbA1c were collected over 2.5–4 years. A simultaneous cascading indirect response model structure was applied to describe the time course of FPG and HbA1c. HbA1c levels were described using both an FPG-dependent and an FPG-independent function. To account for titration, drug effects for both treatment groups were implemented using a time-dependent Emax model. Results: Pioglitazone was superior in both time to maximum effect and the magnitude of reduction achieved in FPG and HbA1c. A greater reduction in median FPG (–21?mg/dL vs. ?9?mg/dL) was observed with pioglitazone (P<0.05). Maximum drug effect for FPG was predicted to occur earlier (11 months) for pioglitazone than for the control group (14 months). The simulated additional reduction in FPG and HbA1c achieved with pioglitazone was predicted to be maintained beyond the currently observed study duration. Conclusions: Pioglitazone was found to result in improved glycemic control and durability compared with control treatment. This model-based approach enabled the quantification of differences in FPG and HbA1c for both treatment groups and simulation to evaluate longer-term durability on FPG and HbA1c. PMID:25531677

  9. TNF, TNF receptor type 1, and allograft inflammatory factor-1 gene polymorphisms in Japanese patients with type 1 diabetes

    Microsoft Academic Search

    Masataka Nishimura; Hiroshi Obayashi; Ikuko Mizuta; Hirokazu Hara; Tetsuo Adachi; Mitsuhiro Ohta; Hisataka Tegoshi; Michiaki Fukui; Goji Hasegawa; Hirofumi Shigeta; Yoshihiro Kitagawa; Koji Nakano; Ryuji Kaji; Naoto Nakamura

    2003-01-01

    The human leukocyte antigen (HLA) class III region, located on chromosome 6p21, has been regarded as one of the susceptible loci for type 1 diabetes. Because it contains many genes related to inflammatory and immune responses, including tumor necrosis factor (TNF), lymphotoxin-? (LT-?), and allograft inflammatory factor 1 (AIF-1) genes, it is unclear which gene within the class III region

  10. Response to the dipeptidyl peptidase-4 inhibitors in Japanese patients with type 2 diabetes might be associated with a diplotype of two single nucleotide polymorphisms on the interleukin-6 promoter region under a certain level of physical activity

    PubMed Central

    Matsui, Mizue; Takahashi, Yoshihiko; Takebe, Noriko; Takahashi, Kazuma; Nagasawa, Kan; Honma, Hiroyuki; Oda, Tomoyasu; Ono, Mitsutaka; Nakagawa, Riyuki; Sasai, Takayoshi; Togashi, Hirobumi; Hangai, Mari; Kajiwara, Takashi; Taneichi, Haruhito; Ishigaki, Yasushi; Satoh, Jo

    2015-01-01

    Aims/Introduction Muscle-derived interleukin-6 (IL-6) has been reported to promote glucagon-like peptide-1 (GLP-1) secretion, and we explored the association of single nucleotide polymorphisms (SNPs) in the human IL-6 promoter region with the responsiveness to dipeptidyl peptidase-4 inhibitors (DPP-4Is), drugs that increase circulating GLP-1. Materials and Methods The present observational study enrolled Japanese patients with type 2 diabetes who took a DPP-4I over 3 months, and most of the clinical information was collected retrospectively. We defined non-responders as those having less than a 0.2% decrease of the glycated hemoglobin level at 3 or 4 months after starting DPP-4I treatment. Physical activity was retrospectively estimated by the Japanese short version of International Physical Activity Questionnaire. Results We studied 316 patients whose physical activity corresponding to the season of the DPP-4I administration was estimated. The non-responder rate was 29.7%. We analyzed rs1800796 and rs2097677, both are suggested to be functional in Japanese. Multivariate analysis for all patients showed that the adjusted odds ratio for the non-responder risk of the diplotype rs1800796 G/*–rs2097677 A/* against C/C-G/G (OR_G*A*) was 0.445 (P = 0.068). When patients were stratified by the International Physical Activity Questionnaire into low (n = 149) and moderate/high (n = 167) activity groups, however, OR_G*A* in each group was 1.58 (P = 0.615) and 0.153 (P = 0.003), respectively. Conclusions The diplotype rs1800796 G/*–rs2097677 A/* might contribute to responsiveness to DPP-4Is in Japanese patients with type 2 diabetes under a certain level of physical activity. However, further investigation is warranted to confirm this.

  11. Six-month multicentric, open-label, randomized trial of twice-daily injections of biphasic insulin aspart 30 versus multiple daily injections of insulin aspart in Japanese type 2 diabetic patients (JDDM 11).

    PubMed

    Hirao, Koichi; Arai, Keiko; Yamauchi, Mikio; Takagi, Hirofumi; Kobayashi, Masashi

    2008-01-01

    To evaluate glycemic control using convenience-oriented biphasic insulin analog compared with intensified insulin therapy, we conducted a 6-month multicentric, open-label, randomized trial in Japanese insulin-naive patients with type 2 diabetes mellitus. A total of 160 adult patients at 19 centers were randomized into two groups: those who received twice-daily injections of biphasic insulin aspart 30 and those on three-times-daily injections of insulin aspart with or without NPH insulin (multiple daily injections). At 6 months, mean HbA(1c) decreased by approximately 2.5% in both groups. Reduction of HbA(1c) on both regimens was better in patients whose prior therapy before starting the study was only diet and exercise (-5.0%) than in patients who were previously taking oral antidiabetic agents (-1.0%). No incidence of major hypoglycemia was observed in either regimen. These results suggest that convenience-oriented insulin therapy using biphasic insulin analog is as useful as intensified insulin therapy with insulin analog for the treatment of type 2 diabetes mellitus over 6 months. Furthermore, early induction of insulin therapy in individuals hitherto using only diet and exercise may provide good glycemic control. This study suggests that convenience-oriented biphasic insulin aspart 30 might be a useful option for the treatment of type 2 diabetes mellitus, especially for insulin-naive patients over 6 months, although it should be changed to another regimen when expected efficacy is not obtained. PMID:17919762

  12. Incidence and predictors of hypoglycemia in Japanese patients with type 2 diabetes treated by insulin glargine and oral antidiabetic drugs in real-life: ALOHA post-marketing surveillance study sub-analysis

    PubMed Central

    2014-01-01

    Background Add-on Lantus® to Oral Hypoglycemic Agents (ALOHA), an observational, non-interventional, 24-week post-marketing surveillance study in Japanese patients with type 2 diabetes (T2DM) having uncontrolled glycemic control, demonstrated that basal supported oral therapy (BOT) with insulin glargine was an effective and safe treatment in real-life clinical practice. We performed subgroup analysis to identify incidence and predictors associated with risk of hypoglycemia. Methods Among 4219 patients with T2DM, 3732 patients were insulin-naïve and 487 patients were insulin non-naïve who switched from other insulin to insulin glargine. All hypoglycemic episodes were counted by physicians’ documentation based on patients’ reports. Relationships between baseline patient characteristics and glargine-related hypoglycemic episodes were examined by univariate and multivariate analysis. Results Among 4219 patients, 44 (1.0%) patients experienced hypoglycemic episodes (41 insulin-naïve patients; 3 insulin non-naïve patients), with a rate of incidence 0.035 episodes/patient-years. Majority of patients with hypoglycemia (37 of 44) had just one hypoglycemic episode during study period. Among insulin-naïve patients, incidence of hypoglycemia differed significantly depending on age, diabetic complications, estimated glomerular filtration rate (eGFR), and postprandial plasma glucose (P <0.05). In a multivariate adjusted model, poor renal function (eGFR <60 mL/min/1.73 m2) was a statistically significant risk factor (P?patients with T2DM with inadequate glycemic control. Patients with low renal function might need a careful follow-up. PMID:24528773

  13. Historical chronology of basic and clinical research in diabetic nephropathy and contributions of Japanese scientists.

    PubMed

    Wada, Jun; Makino, Hirofumi

    2009-10-01

    The most problematic issue in clinical nephrology worldwide is the relentless and progressive increase in patients with end-stage renal disease (ESRD). Diabetic nephropathy has considerable impact on society in the areas of public health and social economy; many scientists are involved in research for the elucidation of the pathogenesis of diabetic nephropathy and for the prevention and cure of the disease. In contrast, diabetic nephropathy was a neglected or ignored disease in the historical era, and few dedicated physicians recognized the disease process of diabetic nephropathy. In this review, we look back on the history of basic and clinical research on diabetic nephropathy and survey the recent progress of the research, especially focusing on the contribution of Japanese scientists. PMID:19363645

  14. Impact of increased visceral adiposity with normal weight on the progression of arterial stiffness in Japanese patients with type 2 diabetes

    PubMed Central

    Bouchi, Ryotaro; Minami, Isao; Ohara, Norihiko; Nakano, Yujiro; Nishitani, Rie; Murakami, Masanori; Takeuchi, Takato; Akihisa, Momoko; Fukuda, Tatsuya; Fujita, Masamichi; Yoshimoto, Takanobu; Ogawa, Yoshihiro

    2015-01-01

    Objective Normal-weight abdominal obesity has been reported to be associated with poor mortality. We aimed to investigate the impact of increased visceral adiposity with normal weight (OB(?)VA(+)) on the progression of arterial stiffness in patients with type 2 diabetes. Methods This was a cross-sectional study of 414 patients with type 2 diabetes (mean age 64±12?years; 40.3% female). Visceral fat area (VFA, cm2) was measured by a dual bioelectrical impedance analyzer. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV, cm/s). Patients were divided into four groups by VFA and body mass index (BMI, kg/m2) as the following: BMI<25?kg/m2 and VFA<100?cm2 (obesity (OB)(?)visceral adiposity (VA)(?)), BMI?25?kg/m2 and VFA<100?cm2 (OB(+)VA(?)), BMI<25?kg/m2 and VFA?100?cm2 (OB(?)VA(+)), and BMI?25?kg/m2 and VFA?100?cm2 (OB(+)VA(+)). Multivariate linear regression analysis was done to determine the impact of OB(?)VA(+) on arterial stiffness. Results Among the patients, 7.2% were OB(?)VA(+) with higher baPWV levels (1956±444?cm/s) than those with OB(+)VA(?) (1671±416?cm/s, p=0.014), those with OB(+)VA(+) (1744±317?cm/s, p=0.048), and those with OB(?)VA(?) (1620±397?cm/s, p=0.024). In multivariate linear regression analysis, OB(?)VA(+) remained independently associated with baPWV (standardized ? 0.184, p=0.001). Conclusions This study provides evidence for the burden of arterial stiffness in OB(?)VA(+) patients with type 2 diabetes; therefore, evaluation of visceral adiposity is of clinical relevance for the better management of non-obese individuals as well as obese populations. PMID:25806115

  15. Genetic analysis of HLA class II alleles and susceptibility to Type 1 (insulin-dependent) diabetes mellitus in Japanese subjects

    Microsoft Academic Search

    T. Awatal; T. Kuzuyal; A. Matsuda; Y. Iwamoto; Y. Kanazawa

    1992-01-01

    Summary  Although HLA-DQB1 alleles encoding aspartic acid at position 57 (Asp-57) are protective against Type 1(insulin-dependent)\\u000a diabetes mellitus in Caucasians, most Japanese Type 1 diabetic patients carry at least one Asp-57 DQB1 allele. We analysed\\u000a the DRB1, DQA1 and DQB1 genes of 99 Japanese patients and 86 control subjects with polymerase chain reaction and sequence-specific\\u000a oligonucleotide hybridization. We found that (1)

  16. Efficacy and safety of canagliflozin alone or as add-on to other oral antihyperglycemic drugs in Japanese patients with type 2 diabetes: A 52-week open-label study

    PubMed Central

    Inagaki, Nobuya; Kondo, Kazuoki; Yoshinari, Toru; Kuki, Hideki

    2015-01-01

    Aims/Introduction Canagliflozin is a sodium–glucose cotransporter 2 inhibitor under development for the treatment of type 2 diabetes. Our aim was to examine its efficacy and safety as monotherapy or in combination with commonly used oral antihyperglycemic drugs in Japanese patients with type 2 diabetes. Materials and Methods Patients on diet/exercise alone or diet/exercise plus an oral antihyperglycemic drug (sulfonylurea, glinide, ?-glucosidase inhibitor, biguanide, thiazolidinedione or dipeptidyl peptidase-4 inhibitor) were randomized to either 100 or 200 mg canagliflozin while continuing prior therapy. Patients were treated for 52 weeks in an open-label manner. Results Canagliflozin significantly reduced hemoglobin A1c, fasting plasma glucose and bodyweight in all the study groups. Improvements were apparent by 4 weeks of treatment, and were maintained for 52 weeks. The reduction in hemoglobin A1c ranged from ?0.80 to ?1.06%, and from ?0.93 to ?1.26% in the 100 and 200 mg canagliflozin groups, respectively. Drug-related adverse events occurred in approximately one-third of patients, and included hypoglycemia/asymptomatic hypoglycemia and pollakiuria. Hypoglycemia/asymptomatic hypoglycemia was most common in patients treated with a sulfonylurea. Most adverse events were classified as mild or moderate in severity. Conclusions The results of the present study confirmed that treatment with canagliflozin resulted in significant reductions in glycemic control and bodyweight that were maintained for 52 weeks of treatment irrespective of whether it was administered as monotherapy or in combination with another oral antihyperglycemic drug. Canagliflozin was well tolerated, with a low incidence of drug-related adverse events. This trial was registered with ClinicalTrials.gov (no. NCT01387737). PMID:25802729

  17. Association of obesity and diabetes with serum prostate-specific antigen levels in Japanese males.

    PubMed

    Naito, Mariko; Asai, Yatami; Mori, Atsuyoshi; Fukada, Yuko; Kuwabara, Mayumi; Katase, Shiro; Hishida, Asahi; Morita, Emi; Kawai, Sayo; Okada, Rieko; Nishio, Kazuko; Tamakoshi, Akiko; Wakai, Kenji; Hamajima, Nobuyuki

    2012-08-01

    Patients with diabetes have been reported to be at an increased risk for cancers of the pancreas, liver, and colon; however, recent studies have suggested that men with diabetes are at a decreased risk for prostate cancer. Previous studies have found that obese men have lower serum prostate-specific antigen (PSA) concentrations than do non-obese men. Further understanding of how obesity and diabetes affect the PSA concentration may improve our ability to detect clinically relevant prostate tumors. This study examined the relationships among serum PSA level, obesity, and diabetes in apparently healthy Japanese males. We analyzed the baseline data from 2,172 Japanese males (age, 56.8 +/- 6.1 years [mean +/- SD]) who participated in the Japan Multi-Institutional Collaborative Cohort Study. Diabetes was defined as the presence of both a hemoglobin A1c (JDS) of > or = 6.1% and a fasting plasma glucose level of > or = 126 mg/dL, or a positive medical history. After adjusting for age, the PSA levels were elevated among males with a higher normal BMI (ranging from 23.0 to 24.9) and lowered among men with a BMI of > or = 25.0. In the stratified analysis, these significant differences in BMI categories were absent among diabetics. The mean PSA levels were significantly lower in diabetics than in non-diabetics among subjects aged 60 and over. Our findings suggest that the pre-overweight men had increased PSA levels, and the diabetes was associated with a reduction of PSA levels in elderly. PMID:23092101

  18. Hallux Ulceration in Diabetic Patients

    Microsoft Academic Search

    Mohamed ElMakki Ahmed; Abdulhakim O. Tamimi; Seif I. Mahadi; AbuBakr H. Widatalla; Mohamed A. Shawer

    2010-01-01

    We undertook a prospective cohort study to assess risk factors associated with hallux ulceration, and to determine the incidence of healing or amputation, in consecutive patients with diabetes mellitus who were treated over the observation period extending from September 2004 to March 2005, at the Jabir Abu Eliz Diabetic Centre, Khartoum City, Sudan. There were 122 diabetic patients in the

  19. Glutamic acid decarboxylase65 (GAD65) antibodies and insulin auto-antibodies in Japanese patients with non-insulin-dependent diabetes mellitus.

    PubMed

    Maruyama, T; Kasuga, A; Ozawa, Y; Nagata, A; Abiko, F; Suzuki, Y; Saruta, T

    1997-02-01

    To clarify whether glutamic acid decarboxylase65 antibodies (GAD65 Ab) and insulin autoantibodies (IAA) are good predictive markers for insulin-dependency in NIDDM, we studied GAD65 Ab and IAA in NIDDM patients treated with diet alone or in combination with oral hypoglycemic agents. GAD65 Ab were found in 12 or 29 (5.2%, P = 0.079 vs. control) NIDDM patients and IAA in 8 of 229 (3.5%). The frequency of GAD65 Ab and IAA positivity in NIDDM did not differ significantly from those of healthy controls (2/150, 1.3%, 2/150, 1.3%, respectively), but the frequency of patients who were positive for either GAD65 Ab or IAA, or both, was significantly higher than that of normal controls (17/229, 7.4% and 4/150, 2.7%, respectively, P < 0.05). In addition, the prevalences of GAD65 Ab and of IAA in those patients whose disease durations, since the diagnosis of diabetes, were less than one year were significantly higher than those of controls (4/30, 13.3%, P < 0.05, 4/30, 13.3%, P < 0.05, respectively). We found no differences between GAD65 Ab positive- and negative-patients in either BMI or serum C-peptide levels. Over a one to five year follow-up period (mean 2.0 yrs), serum C-peptide levels gradually decreased necessitating insulin treatment in three of the patients positive for GAD65 Ab and/or IAA (3/17, 17.6%; two were positive for both GAD65 Ab and IAA and one was positive for GAD65 Ab only). In contrast, only five patients negative for the two antibodies developed insulin requirement (5/212, 2.4%, P < 0.01). These results suggest that GAD65 Ab and IAA are good markers for predicting the development of insulin dependency in NIDDM patients and that the predictive value for insulin-dependency in NIDDM is enhanced by measuring both antibodies. PMID:9152613

  20. Liraglutide Versus Sitagliptin in a 24-week, Multicenter, Open-label, Randomized, Parallel-group Study in Japanese Type 2 Diabetes Mellitus Patients Responding Inadequately to a Sulfonylurea and/or One or Two Other Oral Antidiabetic Drugs (JDDM 33)

    PubMed Central

    Yokoyama, Hiroki; Hirao, Koichi; Yamaguchi, Kohei; Oishi, Mariko; Lee, Gendai; Yagi, Noriharu; Takamura, Hiroshi; Kashiwagi, Atsunori

    2014-01-01

    OBJECTIVE Liraglutide (glucagon-like peptide-1 [GLP-1] receptor agonist) and sitagliptin (dipeptidyl peptidase-4 inhibitor) are approved in Japan for treating type 2 diabetes mellitus (T2DM). We compared the efficacy and safety of adding liraglutide or sitagliptin to a sulfonylurea in Japanese T2DM patients. METHODS Patients aged 18 to <80 years with hemoglobin A1c (HbA1c; National Glycohemoglobin Standardization Program [NGSP]) of 6.9–9.4%, body mass index ?35 kg/m2, and treatment with a sulfonylurea and/or one or two non-sulfonylurea oral antidiabetic drugs for greater than or equal to eight weeks before enrollment were eligible. Patients were randomized in an open-label manner to either 0.9 mg/day liraglutide (n = 50) or 50–100 mg/day sitagliptin (n = 49) and were treated for 24 weeks. Non-sulfonylureas were discontinued before randomization. Patients using other oral antidiabetic drugs started sulfonylurea treatment. The primary endpoint was the change in HbA1c from baseline to Week 24. RESULTS HbA1c decreased in both groups, and the reduction was significantly greater throughout in the liraglutide group except for Week 24 (0.59 ± 0.80 vs. 0.24 ± 0.94%; P = 0.0525). Fasting plasma glucose (FPG) decreased significantly in the liraglutide group compared with the sitagliptin group (?21.15 ± 31.22 vs. +0.46 ± 39.39 mg/dL; P = 0.0014). Homeostasis model assessment of ? cell function and C-peptide increased significantly in the liraglutide group but not in the sitagliptin group. Hypoglycemic symptoms and adverse events occurred in four and nine patients, respectively, in the liraglutide group, and in two and five patients, respectively, in the sitagliptin group. CONCLUSION Treatment with liraglutide or sitagliptin together with a sulfonylurea improved HbA1c in Japanese T2DM patients in primary care. Both drugs were associated with low rates of adverse events and hypoglycemia. The improvement in ? cell function probably contributed to the improvement in glycemic control in the liraglutide group. PMID:25288908

  1. Japanese cases of acute onset diabetic ketosis without acidosis in the absence of glutamic acid decarboxylase autoantibody.

    PubMed

    Iwasaki, Yorihiro; Hamamoto, Yoshiyuki; Kawasaki, Yukiko; Ikeda, Hiroki; Honjo, Sachiko; Wada, Yoshiharu; Koshiyama, Hiroyuki

    2010-04-01

    We report consecutive Japanese patients presented with acute onset diabetic ketosis who had negative glutamic acid decarboxylase autoantibody (GADAb) to clarify the clinical characteristics of them. A total of consecutive 1,296 in-patients with newly diagnosed diabetes mellitus, who were admitted to our center from April 2003 to October 2008, were analyzed. Among them, 17 patients who presented with acute onset diabetic ketosis without acidosis, and found to be negative for GADAb, were included. They showed male preponderance (n = 15). Ten patients had history of excessive ingestion of sugar-containing soft drink. Patients who successfully withdrew insulin therapy by 6 months (n = 7) showed significantly higher insulin secretion capacity and higher body mass index at the time of diagnosis than those who continued insulin therapy at least for 6 months (n = 10). These findings suggest that some of Japanese patients who presented with acute onset diabetic ketosis and negative for GADAb share several clinical characteristics with atypical type 2 diabetes such as ketosis-prone diabetes and "soft-drink ketosis," but others do not. PMID:20960264

  2. Insulin secretion and insulin sensitivity in Japanese patients with type 2 diabetes: a cross-sectional study comparing the homeostasis model assessment-2 (HOMA2) indexes and indexes derived from the oral glucose tolerance test

    Microsoft Academic Search

    Ritsuko Yamamoto-HondaKeiichiro; Keiichiro Osame; Hiroji Kitazato; Michiko Shinkai-Goromaru; Akihiro Isogawa; Yoko Yoshida; Shoji Kawazu; Yasuo Akanuma; Mitsuhiko Noda

    2011-01-01

    We analyzed the results of a 75-g oral glucose tolerance test in 731 drug-naïve Japanese men with type 2 diabetes mellitus\\u000a (T2DM) with fasting plasma glucose values ranging between 126 and 199 mg\\/dl. We then determined the index of insulin sensitivity\\u000a and insulin secretion across the entire range of glucose loading. Next, we examined the correlation between these indexes\\u000a and the

  3. Applying Japanese management tips to patient accounts.

    PubMed

    Groenevelt, C J

    1990-04-01

    "Just in time," a Japanese management philosophy that has been applied successfully in manufacturing operations, also can be used to improve management of patient accounts departments. Under its principles, healthcare organizations would develop standardized procedures; involve workers in decision making; set up training and education programs aimed at creating a multi-skilled pool of workers; establish smooth production schedules; and foster cooperation and commitment to the philosophy throughout the organization. PMID:10145235

  4. Type 2 (non-insulin-dependent) diabetes mellitus associated with a mutation of the glucokinase gene in a Japanese family

    Microsoft Academic Search

    F. Shimada; H. Makino; N. Hashimoto; M. Taira; S. Seino; G. I. Bell; A. Kanatsuka; S. Yoshida

    1993-01-01

    Summary  Mutations were screened for in the glucokinase gene of 25 Japanese patients with Type 2 (non-insulin-dependent) diabetes mellitus. Each exon was scanned by electrophoresis of enzymatically amplified DNA segments under non-denaturing conditions and variants were sequenced. A variant pattern was detected in exon 5 of one patient. Direct sequencing of this exon revealed a single nucleotide substitution in codon 188

  5. JAMA Patient Page: Diabetic Foot Ulcers

    MedlinePLUS

    ... American Medical Association JAMA PATIENT PAGE Diabetic Foot Ulcers D iabetic foot ulcers are sores or wounds on the feet that ... preventing diabetic foot ulcers. WHAT CAUSES DIABETIC FOOT ULCERS? FOR MORE INFORMATION • National Diabetes Information Clearinghouse 1- ...

  6. Rheumatic manifestations in diabetic patients

    PubMed Central

    Serban, AL; Udrea, GF

    2012-01-01

    Diabetes mellitus (DM), a worldwide high prevalence disease, is associated with a large variety of rheumatic manifestations. For most of these affections, pathophysiologic correlations are not well established. Some of them, such as diabetic cheiroarthropathy, neuropathic arthritis, diabetic amyotrophy, diabetic muscle infraction, are considered intrinsic complications of DM. For others, like diffuse idiopathic skeletal hyperostosis or reflex sympathetic dystrophy, DM is considered a predisposing condition. In most cases, these affections cause pain and disability, affecting the quality of life of diabetic patients, but once correctly diagnosed, they often respond to the treatment, that generally requires a multidisciplinary team. This article reviews some epidemiological, clinical, diagnostic and therapeutic aspects of these conditions. PMID:23049626

  7. Prevalence of Type 2 (non-insulin-dependent) diabetes mellitus and impaired glucose tolerance in the Japanese general population: the Hisayama study

    Microsoft Academic Search

    T. Ohmura; K. Ueda; Y. Kiyohara; I. Kato; H. Iwamoto; K. Nakayama; K. Nomiyama; S. Ohmori; T. Yoshitake; A. Shinkawu; Y. Hasuo; M. Fujishima

    1993-01-01

    Summary  We determined the population-based prevalence of diabetes mellitus in members of the Japanese community, Hisayama aged 40–79 years old by a 75-g oral glucose tolerance test. The basic population used to calculate diabetic prevalence was 1,077 men (72.8% of the whole population in the same age range) and 1,413 women (80.8%) including ten diabetic patients on insulin therapy. In addition,

  8. Efficacy and safety of the dipeptidyl peptidase-4 inhibitor sitagliptin compared with alpha-glucosidase inhibitor in Japanese patients with type 2 diabetes inadequately controlled on metformin or pioglitazone alone (Study for an Ultimate Combination Therapy to Control Diabetes with Sitagliptin-1): A multicenter, randomized, open-label, non-inferiority trial

    PubMed Central

    Yokoh, Hidetaka; Kobayashi, Kazuki; Sato, Yasunori; Takemoto, Minoru; Uchida, Daigaku; Kanatsuka, Azuma; Kuribayashi, Nobuichi; Terano, Takashi; Hashimoto, Naotake; Sakurai, Kenichi; Hanaoka, Hideki; Ishikawa, Ko; Onishi, Shunichiro; Yokote, Koutaro

    2015-01-01

    Aims/Introduction To assess the efficacy and safety of sitagliptin compared with ?-glucosidase inhibitors in Japanese patients with type 2 diabetes inadequately controlled by metformin or pioglitazone alone. Materials and Methods In the present multicenter, randomized, open-label, parallel-group, active-controlled, non-inferiority trial, 119 patients aged 20–79 years with type 2 diabetes who had glycated hemoglobin 6.9–8.8% on stable metformin (500–1,500 mg/day) or pioglitazone (15–30 mg/day) alone were randomly assigned (1:1) to receive the addition of sitagliptin (50 mg/day) or an ?-glucosidase inhibitor (0.6 mg/day voglibose or 150 mg/day miglitol) for 24 weeks. The primary end-point was change in glycated hemoglobin from baseline to week 12. All data were analyzed according to the intention-to-treat principle. Results After 12 weeks, reductions in adjusted mean glycated hemoglobin from baseline were ?0.70% in sitagliptin and ?0.21% in the ?-glucosidase inhibitor groups respectively; between-group difference was ?0.49% (95% confidence interval ?0.66 to ?0.32, P < 0.0001), meeting the predefined non-inferiority criterion (0.25%) and showing statistical significance. This statistical significance also continued after 24 weeks. Although sitagliptin did not affect bodyweight, ?-glucosidase inhibitors decreased bodyweight significantly from baseline (?0.39 kg; P = 0.0079). Gastrointestinal disorders were significantly lower with sitagliptin than with an ?-glucosidase inhibitor (6 [10.3%] patients vs 23 [39.7%]; P = 0.0003). Minor hypoglycemia occurred in two patients (3.5%) in each group. Conclusions Sitagliptin showed greater efficacy and better tolerability than an ?-glucosidase inhibitor when added to stable doses of metformin or pioglitazone. These findings support the use of sitagliptin in Japanese patients with type 2 diabetes inadequately controlled by insulin-sensitizing agents. This trial was registered with UMIN (no. 000004675). PMID:25802726

  9. The diabetic patient in Ramadan

    PubMed Central

    Chamsi-Pasha, Hassan; Aljabri, Khalid S.

    2014-01-01

    During the month of Ramadan, all healthy, adult Muslims are required to fast from dawn to sunset. Fasting during Ramadan involves abstaining from food, water, beverages, smoking, oral drugs, and sexual intercourse. Although the Quran exempts chronically ill from fasting, many Muslims with diabetes still fast during Ramadan. Patients with diabetes who fast during the month of Ramadan can have acute complications. The risk of complications in fasting individuals with diabetes increases with longer periods of fasting. All patients with diabetes who wish to fast during Ramadan should be prepared by undergoing a medical assessment and engaging in a structured education program to undertake the fast as safely as possible. Although some guidelines do exist, there is an overwhelming need for better designed clinical trials which could provide us with evidence-based information and guidance in the management of patients with diabetes fasting Ramadan. PMID:24761380

  10. Gallbladder function in diabetic patients

    SciTech Connect

    Shreiner, D.P.; Sarva, R.P.; Van Thiel, D.; Yingvorapant, N.

    1986-03-01

    Gallbladder emptying and filling was studied in eight diabetic and six normal control patients. None of the patients had gallstones. Cholescintigraphy was performed using (/sup 99m/Tc)disofenin, and gallbladder emptying was studied using a 45-min i.v. infusion of the octapeptide of cholecystokinin (OP-CCK) 20 ng/kg X hr. The peak filling rate was greater in diabetic than in normal subjects; however, emptying of the gallbladder in response to OP-CCK was significantly less in the diabetic subjects (51.6 +/- 10.4% compared with 77.2 +/- 4.9%). When the diabetic group was subdivided into obese and nonobese diabetics, the obese diabetics had a much lower percentage of emptying than the nonobese diabetics (30.0 +/- 10.4% compared with 73.1 +/- 9.3%). These findings suggest that obese diabetics may have impaired emptying of the gallbladder even in the absence of gallstones. The more rapid rate of gallbladder filling in obesity may indicate hypotonicity of the gallbladder. The combination of these abnormalities may predispose the obese diabetic to the development of gallstones.

  11. Insomnia in Diabetic Hemodialysis Patients

    Microsoft Academic Search

    Sang-Youb Han; Jong-Woo Yoon; Sang-Kyung Jo; Jin-Ho Shin; Chol Shin; Jung-Bok Lee; Dae-Ryong Cha; Won-Yong Cho; Heui-Jung Pyo; Hyoung-Kyu Kim; Kyu-Bec Lee; Hyang Kim; Kyung-Wook Kim; Yong-Seop Kim; Jeong-Ho Lee; Sang-Eun Park; Chang-Soo Kim; Kyeong-So Wea; Kyung-Shik Oh; Tae-See Chung; Sang-Yeol Suh

    2002-01-01

    Background: Insomnia is one of the most common problems in dialysis patients, and likely to contribute impairment in quality of life, which has a positive correlation with patients’ survival. In diabetic patients, morbidity and mortality are substantially higher than in the nondiabetic counterparts, and also the incidence of sleep disturbances. However, there is no means to predict sleep disturbance in

  12. Diabetic education, special consideration of oriental patients

    Microsoft Academic Search

    Chanika Tuchinda; Nirun Vanaprapa; Suthida Nirapik; Ranoo Wongarn; Sathit Vannasaeng

    1989-01-01

    The important of patient education program in the management of diabetes has been widely recognized. We studied to find out\\u000a in general what the patients and their parents know about diabetes and their self-care by using a questionnaire. Then, the\\u000a diabetic education was given by one-to-one basis to every patient. Thirty four insulin-dependent diabetes mellitus attended\\u000a the diabetic the clinic

  13. How to revascularize patients with diabetes mellitus—

    Microsoft Academic Search

    Albrecht Elsässer; Helge Möllmann; Holger M. Nef; Christian W. Hamm

    2006-01-01

    Summary  The diabetic patient is at high risk for coronary artery disease. Incidence as well as severity of the disease is highly increased\\u000a in comparison to non–diabetic patients. The revascularization of the diabetic patient is a great challenge, since the longterm\\u000a results are disappointing when compared to non–diabetic patients. The success of coronary artery bypass grafting is limited\\u000a by increased perioperative

  14. [Japanese SUNCT patient responsive to gabapentin].

    PubMed

    Ito, Yasuhiro; Imai, Kazunori; Suzuki, Junichiro; Nishida, Suguru; Kato, Takashi; Yasuda, Takeshi

    2011-04-01

    We report a Japanese patient with short lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUCNT) responsive to gabapentin. A 29-year-old man presented with sudden-onset intermittent left-sided orbital headache, which was not accompanied by lacrimation and conjunctival injection. We diagnosed trigeminal neuralgia at first and administered carbamazepine and loxoprofen. However, these medications were entirely ineffective at all and 6 days later, autonomic symptoms including conjunctival injection and tearing appeared. Diagnosis of SUNCT was made and gabapentin was started at up to 800 mg per day. Soon after, the headache and autonomic symptoms disappeared. Gabapantin at 800 mg per day was continued for 3 months and then reduced to 400 mg per day. Soon he had only a slight headache without tearing and conjunctival injection. He has continued to take gabapenin at 400 mg per day until now. This case indicated that headache and autonomic symptoms in SUNCT did not always emerge simultaneously, but they sometimes appear with time lag. Furthermore, the long-term clinical course and therapeutic outcome in SUNCT remain unknown. A therapeutic strategy and optimal dosage of medications including gabapentin should be established for the treatment of SUNCT. PMID:21595298

  15. Outcomes of polytrauma patients with diabetes mellitus

    PubMed Central

    2014-01-01

    Background The impact of diabetes mellitus in patients with multiple system injuries remains obscure. This study was designed to increase knowledge of outcomes of polytrauma in patients who have diabetes mellitus. Methods Data from the Trauma Audit and Research Network was used to identify patients who had suffered polytrauma during 2003 to 2011. These patients were filtered to those with known outcomes, then separated into those with diabetes, those known to have other co-morbidities but not diabetes and those known not to have any co-morbidities or diabetes. The data were analyzed to establish if patients with diabetes had differing outcomes associated with their diabetes versus the other groups. Results In total, 222 patients had diabetes, 2,558 had no past medical co-morbidities (PMC), 2,709 had PMC but no diabetes. The diabetic group of patients was found to be older than the other groups (P <0.05). A higher mortality rate was found in the diabetic group compared to the non-PMC group (32.4% versus 12.9%), P <0.05). Rates of many complications including renal failure, myocardial infarction, acute respiratory distress syndrome, pulmonary embolism and deep vein thrombosis were all found to be higher in the diabetic group. Conclusions Close monitoring of diabetic patients may result in improved outcomes. Tighter glycemic control and earlier intervention for complications may reduce mortality and morbidity. PMID:25026864

  16. Periodontal health and diabetes awareness among Saudi diabetes patients

    PubMed Central

    Bahammam, Maha A

    2015-01-01

    Purpose This study aimed to examine diabetic patients in Jeddah, Saudi Arabia, regarding their general diabetic and oral health-related awareness and practices, their awareness of the association of diabetes with periodontal disease, and their sources of diabetes-related information. Methods Diabetic patients (n=454) who were receiving care at the diabetes clinic in King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from October 2013 to May 2014, completed a six-part questionnaire assessing their sociodemographic characteristics, general and oral health awareness and practices, and sources of diabetes-related information. Descriptive statistics were used to report the results. Results The responses indicated inadequate health-related practices in the surveyed group: 22.2% brushed their teeth twice daily, 73.6% never flossed their teeth, and while 80.2% visited a physician in the past year, only 12.6% visited a dentist during the same year. Of the respondents, 94.8% reported that they had never received advice on oral hygiene tasks in relation to diabetes from a health professional. Awareness about the diabetes and periodontal disease association was limited: 46.7% knew that diabetics have gum problems more often if their blood sugar stays very high, and only 21.8% knew that gum disease makes it harder to control blood sugar in diabetic patients. A significant association (P<0.05) was found between a higher level of education and greater general and oral awareness, as well as a significant association (P<0.05) between longer duration of disease, regular exercise, and regular visits to the physician and awareness about diabetes mellitus. Additionally, a significant association (P<0.05) was found between regular dental visits and both periodontal disease and diabetes awareness. Family and friends were the main source of diabetes-related information, and the Internet was the least likely source. Conclusion Customized educational programs should be planned for diabetic patients according to community needs. PMID:25673974

  17. Association of Cardiorespiratory Fitness and Overweight with Risk of Type 2 Diabetes in Japanese Men

    PubMed Central

    Kuwahara, Keisuke; Uehara, Akihiko; Kurotani, Kayo; Pham, Ngoc Minh; Nanri, Akiko; Yamamoto, Makoto; Mizoue, Tetsuya

    2014-01-01

    Objective Existing evidence is limited on what extent fitness can counterbalance type 2 diabetes mellitus (T2DM) risk associated with obesity. We investigated the joint association of weight status and estimated VO2max, a marker of fitness, with the risk of developing T2DM among Japanese men using haemoglobin A1c and fasting glucose criterion. Methods The present study included 3,523 male employees aged 18–61 years without diabetes who provided health check-up and fitness data in Japan in 2003–2005. We calculated hazard ratios and 95% confidence intervals for incident diabetes using the Cox regression model. Results During a mean follow-up of 6.0 years, 199 men developed diabetes. Multivariable-adjusted hazard ratios (95% confidence interval) of diabetes were 1.00 (reference), 1.44 (1.01–2.07), and 1.48 (1.03–2.13) for the highest through the lowest tertile of fitness (P for trend ?=?0.04). Additional adjustment for body mass index largely attenuated the association of fitness with diabetes. Joint analysis showed that adjusted hazard ratios of diabetes were 1.00, 1.32, 2.94, and 1.83 in normal weight high-fit men, normal weight low-fit men, overweight high-fit men, and overweight low-fit men, respectively. Conclusion The results suggest that weight control is more important than fitness in prevention of type 2 diabetes in Japanese men. PMID:24896640

  18. [Coronary angioplasty in diabetic patients].

    PubMed

    Steffenino, Giuseppe; La Scala, Eugenio; Riva, Lucilla; Menardi, Endrj

    2002-01-01

    Increased thrombogenicity, endothelial dysfunction, proliferation of both the cells and the matrix in the vessel walls, dislipidemia and insulin-resistance are the main metabolic alterations in the diabetic scenario, with possible implications in terms of vessel restenosis after coronary angioplasty. The outcome of balloon coronary angioplasty in diabetics is poor. This is due to both increased restenosis and a high incidence of medium/long-term cardiac events; the use of stents in these patients has substantially improved the results, but the recurrence rate has not been abated to the level observed in the general population. Abciximab may be a helpful adjunct to coronary angioplasty in these patients, while coronary artery bypass grafting may still be preferable--as at present--in case of multivessel coronary artery disease. This viewpoint is likely to be substantially modified in the near future, if the promise of "zero restenosis" devices is kept. PMID:11899579

  19. Therapeutic education of diabetic patients.

    PubMed

    Golay, A; Lagger, G; Chambouleyron, M; Carrard, I; Lasserre-Moutet, A

    2008-01-01

    Therapeutic patient education is a patient-centred approach, focussed on patients' needs, resources, values and strategies. It allows patients to improve their knowledge and skills not only concerning their illness but also their treatment. It brings a better quality of life, a greater therapeutic compliance and a reduction in complications. The most difficult part of therapeutic patient education occurs when patients must change their behaviour. Motivational interviewing and cognitive-behavioural approaches contribute greatly here and allow both the preparation and support of patients during progressive 'step by step' change. The work on resistance to change is fundamental, and ambivalence when faced with the choice of a new way of life must be measured, discussed and negotiated. Patients become partners and we become 'coaches'. The negotiation of objectives must allow patients to choose their own strategies, which normally should cost them the least possible, psychologically, and bring them the maximum benefit. The efficiency of therapeutic patient education no longer needs to be proved: 80% less amputations over 10 years in diabetic patients; 50% maintenance of weight loss over 5 years, etc. In conclusion, therapeutic education is part of a humanistic medical approach centred on patients; it allows them to be active participants in their own treatment with the aim of improving their quality of life and therapeutic compliance, as well as reducing potential complications. Thus, health care professionals teach, inform, train, negotiate with, motivate and accompany patients in the long-term follow-up of their illness. PMID:18229887

  20. Comparison of Potentially Preventable Hospitalizations Related to Diabetes Among Native Hawaiian, Chinese, Filipino, and Japanese Elderly Compared with Whites, Hawai‘i, December 2006–December 2010

    PubMed Central

    Ahn, Hyeong Jun; Juarez, Deborah T.; Tseng, Chien-Wen; Chen, John J.; Salvail, Florentina R.; Miyamura, Jill; Mau, Marjorie L.M.

    2013-01-01

    Introduction Approximately 25% of individuals aged 65 years or older in the United States have diabetes mellitus. Diabetes rates in this age group are higher for Asian American and Pacific Islanders (AA/PI) than for whites. We examined racial/ethnic differences in diabetes-related potentially preventable hospitalizations (DRPH) among people aged 65 years or older for Japanese, Chinese, Filipinos, Native Hawaiians, and whites. Methods Discharge data for hospitalizations in Hawai‘i for people aged 65 years or older from December 2006 through December 2010 were compared. Annual rates of DRPH by patient were calculated for each racial/ethnic group by sex. Rate ratios (RRs) were calculated relative to whites. Multivariable models controlling for insurer, comorbidity, diabetes prevalence, age, and residence location provided final adjusted rates and RRs. Results A total of 1,815 DRPH were seen from 1,515 unique individuals. Unadjusted RRs for DRPH by patient were less than1 in all AA/PI study groups compared with whites, but were highest among Native Hawaiians and Filipinos. In fully adjusted models accounting for higher diabetes prevalence in AA/PI groups, Native Hawaiian (adjusted rate ratio [aRR] = 1.59), Filipino (aRR = 2.26), and Japanese (aRR = 1.86) men retained significantly higher rates of diabetes-related potentially preventable hospitalizations than whites, as did Filipino women (aRR = 1.61). Conclusion Native Hawaiian, Filipino, and Japanese men and Filipino women aged 65 years or older have a higher risk than whites for DRPH. Health care providers and public health programs for elderly patients should consider effective programs to reduce potentially preventable hospitalizations among Native Hawaiian, Filipino, and Japanese men and Filipino women aged 65 years or older. PMID:23886042

  1. Hospital readmission of patients with diabetes.

    PubMed

    Rubin, Daniel J

    2015-04-01

    Hospital readmission is a high-priority health care quality measure and target for cost reduction. Despite broad interest in readmission, relatively little research has focused on patients with diabetes. The burden of diabetes among hospitalized patients, however, is substantial, growing, and costly, and readmissions contribute a significant portion of this burden. Reducing readmission rates of diabetic patients has the potential to greatly reduce health care costs while simultaneously improving care. Risk factors for readmission in this population include lower socioeconomic status, racial/ethnic minority, comorbidity burden, public insurance, emergent or urgent admission, and a history of recent prior hospitalization. Hospitalized patients with diabetes may be at higher risk of readmission than those without diabetes. Potential ways to reduce readmission risk are inpatient education, specialty care, better discharge instructions, coordination of care, and post-discharge support. More studies are needed to test the effect of these interventions on the readmission rates of patients with diabetes. PMID:25712258

  2. Use of the Japanese health insurance claims database to assess the risk of acute pancreatitis in patients with diabetes: comparison of DPP-4 inhibitors with other oral antidiabetic drugs.

    PubMed

    Yabe, D; Kuwata, H; Kaneko, M; Ito, C; Nishikino, R; Murorani, K; Kurose, T; Seino, Y

    2015-04-01

    This study was initiated to evaluate the association of acute pancreatitis (AP) with the use of dipeptidyl peptidase-4 (DPP-4) inhibitors among patients with diabetes in Japan. A retrospective cohort study of a large medical and pharmacy claims database was performed to compare the incidence of AP among those receiving DPP-4 inhibitors and those receiving other oral antidiabetic drugs. The incidence of all AP and hospitalizations for AP was similar between the two groups. Previous exposure to DPP-4 inhibitors did not affect occurrence of AP in patients on other oral antidiabetic drugs. The Kaplan-Meier curve for time to AP was similar between the two groups, and was not affected by previous exposure to DPP-4 inhibitors. The Cox proportional hazard models showed the incidence of AP was not significantly higher in those receiving DPP-4 inhibitors. Despite numerous, important limitations related to claims database-based analyses, our results indicate that there is no increased risk of AP with use of DPP-4 inhibitors among patients with diabetes in Japan. PMID:25146418

  3. Overtime Work and Prevalence of Diabetes in Japanese Employees: Japan Epidemiology Collaboration on Occupational Health Study

    PubMed Central

    Nishihara, Akiko; Nakagawa, Tohru; Yamamoto, Shuichiro; Honda, Toru; Miyamoto, Toshiaki; Kochi, Takeshi; Eguchi, Masafumi; Uehara, Akihiko; Kuroda, Reiko; Omoto, Daisuke; Kurotani, Kayo; Pham, Ngoc Minh; Nanri, Akiko; Kabe, Isamu; Mizoue, Tetsuya; Kunugita, Naoki; Dohi, Seitaro

    2014-01-01

    Objective Epidemiologic evidence on long working hour and diabetes has been conflicting. We examined the association between overtime work and prevalence of diabetes among Japanese workers. Methods The subjects were 40,861 employees (35,170 men and 5,691 women), aged 16 to 83 years, of 4 companies in Japan. Hours of overtime were assessed using self-reported questionnaires. Diabetes was defined as a fasting plasma glucose ?126 mg/dl (7.0 mmol/l), hemoglobin A1c ?6.5% (48 mmol/mol), or current use of anti-diabetic drug. Multiple logistic regression analysis was used to calculate odds ratio of diabetes for each category of overtime. Results After adjustment for age, sex, company, smoking, and BMI, there was a suggestion of U-shaped relationship between overtime work and prevalence of diabetes (P for quadratic trend?=?0.07). Compared with those who worked <45 hours of overtime per month, the adjusted odds ratios (95% confidence interval) of diabetes were 0.86 (0.77–0.94), 0.69 (0.53–0.89), and 1.03 (0.72–1.46) for those who worked 45–79, 80–99, and ?100 hours of overtime per month, respectively. In one company (n?=?33,807), where other potential confounders including shift work, job position, type of department, alcohol consumption, sleep duration, leisure time physical activity, and family history of diabetes was additionally adjusted for, similar result was obtained (P for quadratic trend?=?0.05). Conclusions Long hours of overtime work may not be associated with increased prevalence of diabetes among Japanese workers. PMID:24787995

  4. Association Between Diabetes and Increased Prevalence of Paranasal Sinus Disease: A Cross-Sectional Study in Japanese Adults

    PubMed Central

    Kabeya, Yusuke; Kato, Kiyoe; Tomita, Masuomi; Katsuki, Takeshi; Oikawa, Yoichi; Shimada, Akira

    2015-01-01

    Background The association between diabetes and paranasal sinus disease has not been thoroughly investigated. Methods We cross-sectionally investigated the association between diabetes and the presence of paranasal sinus disease, which was confirmed by a head MRI scan in 1350 adults who underwent a health screening program focusing on brain diseases and metabolic syndrome. Logistic regression, which was adjusted for age, sex, body mass index, waist-to-hip ratio, hypertension, smoking status, alcohol intake, and white blood cell count, was performed to calculate the odds ratio (OR) of having paranasal sinus disease among adults with diabetes in relation to those without. The dose-response relationship between hemoglobin A1c (HbA1c) levels and the presence of paranasal sinus disease was also investigated. Results Of the 1350 participants (mean age, 61.6 ± 10.0 years; 71.6% men), 220 diabetes cases were identified. Paranasal sinus disease was diagnosed in 151 adults. The adjusted OR of having paranasal sinus disease was 1.74 (95% confidence interval [CI], 1.12–2.71) in those with diabetes. The odds of having paranasal sinus disease increased with HbA1c levels. Compared to those with HbA1c of ?5.4%, those with HbA1c of 5.5%–6.4%, 6.5%–7.9%, and ?8.0% were more likely to have paranasal sinus disease, with adjusted ORs of 1.32 (95% CI, 0.88–1.98), 1.63 (95% CI, 0.86–3.09) and 2.71 (95% CI, 1.12–6.61), respectively (P for trend = 0.019). Conclusions Diabetes may be significantly associated with higher prevalence of paranasal sinus disease in Japanese adults. We should keep this increased risk in mind when a diabetic patient is suspected of having paranasal sinus disease. PMID:25728620

  5. Type 2 Diabetic Patient-Centered Care

    Microsoft Academic Search

    Somjit Prueksaritanond; Saisunee Tubtimtes; Kornthong Asavanich; Vasunee Tiewtranon

    Background : The prevalence of diabetes mellitus has increased worldwide including Thailand. Management of diabetes should be considered biological and psychosocial. Patient-centered care was applied in the present study. Patient-centered care is a process interaction between the clinician and the patient. It refers to the clinician's behavioral skill in the consultation. Patient-centered care customizes seeking and accepting the patient's ideas,

  6. CUTANEOUS DISORDERS IN 500 DIABETIC PATIENTS ATTENDING DIABETIC CLINIC

    PubMed Central

    Ragunatha, Shivanna; Anitha, Bhaktavatsalam; Inamadar, Arun C; Palit, Aparna; Devarmani, Shashidhar S

    2011-01-01

    Background: The metabolic complications and pathologic changes that occur in diabetes mellitus (DM) influence the occurrence of various dermatoses. Aim: To study the impact of control of diabetes on the pattern of cutaneous disorders. Materials and Methods: A cross-sectional descriptive study of patients attending diabetic clinic in a tertiary care hospital. A total of 500 consecutive patients were studied. Detailed history, clinical examination and relevant investigations were done to diagnose diabetic complications and cutaneous disorders. Dermatoses with or without known pathogenesis were correlated with age, gender, fasting plasma glucose (FPG), duration of diabetes, and complications of DM. Statistical analysis was carried out using Student “t” test and Chi-square test with 5% confidence interval (P value 0.05). Results: Majority of patients had well-controlled (FPG<130 mg/ml, 60%) type 2 DM (98.8%). No statistically significant difference (P>0.05) between the patients with or without DM specific cutaneous disorders was noticed with reference to age and gender distribution, duration of DM and FPG. Signs of insulin resistance, acrochordon (26.2%), and acanthosis nigricans (5%) were common, followed by fungal (13.8%) and bacterial (6.8%) infections. Eruptive xanthoma (0.6%), diabetic foot (0.2%), diabetic bulla (0.4%), diabetic dermopathy (0.2%), generalized granuloma annulare (0.2%), and insulin reactions (6.2%) and lipodystrophy (14%) were also seen. Conclusion: Well-controlled diabetes decreases the prevalence of DM-specific cutaneous disorders associated with chronic hyperglycemia. It is necessary to have a dermatologist in the diabetic clinic for early detection of potentially grave or predisposing conditions. PMID:21716540

  7. Association of genetic variants with chronic kidney disease in Japanese individuals with type 2 diabetes mellitus.

    PubMed

    Yoshida, Tetsuro; Kato, Kimihiko; Yokoi, Kiyoshi; Watanabe, Sachiro; Metoki, Norifumi; Yoshida, Hidemi; Satoh, Kei; Aoyagi, Yukitoshi; Nishigaki, Yutaka; Suzuki, Takao; Nozawa, Yoshinori; Yamada, Yoshiji

    2009-04-01

    Although diabetes mellitus has been recognized as a risk factor for chronic kidney disease (CKD), genetic factors for predisposition to CKD in individuals with diabetes mellitus remain elucidated. The purpose of the present study was to identify genetic variants that confer susceptibility to CKD among individuals with type 2 diabetes mellitus. The study population comprised 1742 Japanese individuals, including 636 subjects with CKD [estimated glomerular filtration rate (eGFR)<60 ml/min/1.73 m2] and 1106 controls (eGFR>or=60 ml/min/1.73 m2). The genotypes for 24 polymorphisms of 22 candidate genes were determined. An initial screen of allele frequencies by the Chi-square test revealed that four polymorphisms were significantly (false discovery rate<0.05) associated with the prevalence of CKD in individuals with type 2 diabetes mellitus. Subsequent multivariable logistic regression analysis with adjustment for covariates as well as a stepwise forward selection procedure revealed that the 8733T-->C polymorphism of ALOX5AP (rs3803278), the C-->T (Ser532Leu) polymorphism of IRAK1 (rs1059703), and the 2445G-->A (Ala54Thr) polymorphism of FABP2 (rs1799883) were significantly (P<0.05) associated with the prevalence of CKD. Our results suggest that ALOX5AP, IRAK1, and FABP2 are susceptibility loci for CKD among Japanese individuals with type 2 diabetes mellitus. PMID:19288030

  8. Dietary glycemic index and risk of type 2 diabetes mellitus in middle-aged Japanese men

    Microsoft Academic Search

    Masaru Sakurai; Koshi Nakamura; Katsuyuki Miura; Toshinari Takamura; Katsushi Yoshita; Yuko Morikawa; Masao Ishizaki; Teruhiko Kido; Yuchi Naruse; Yasushi Suwazono; Shuichi Kaneko; Satoshi Sasaki; Hideaki Nakagawa

    This cohort study investigated the association between dietary glycemic index (GI), glycemic load (GL), and the incidence of type 2 diabetes mellitus in middle-aged Japanese men, and the effect of insulin resistance and pancreatic B-cell function on the association. Participants were 1995 male employees of a metal products factory in Japan. Dietary GI and GL were assessed using a self-administered

  9. The importance of hypoglycemia in diabetic patients

    PubMed Central

    2012-01-01

    Hypoglycemia is one of the most important complications of diabetes treatment. The risk of severe hypoglycemia is higher in elderly patients, those having comorbidities such as vascular disease or renal failure, pregnant women and in children with type 1diabetes. Moreover, in type 2 diabetes, progressive insulin deficiency, longer duration of diabetes, and tight glycemic control increase the risk of hypoglycemia as much as type 1 diabetes.Episodes hypoglycemia may lead to impairment of counter-regulatory system, with the potential of development of hypoglycemia unawareness. So, hypoglycemia may increase the vascular events even death in addition to other possible detrimental effects. Glycemic control should be individualized based on patient characteristics with some degree of safety. Recognition of hypoglycemia risk factors, blood glucose monitoring, selection of appropriate regimens and educational programs for healthcare professionals and patients with diabetes are the major issues to maintain good glycemic control, minimize the risk of hypoglycemia, and prevent long- term complications. PMID:23497433

  10. Galectin-3 in diabetic patients.

    PubMed

    Pugliese, Giuseppe; Iacobini, Carla; Ricci, Carlo; Blasetti Fantauzzi, Claudia; Menini, Stefano

    2014-10-01

    Galectin-3 is a versatile molecule which exerts several and sometimes opposite functions in various pathophysiological processes. Recently, galectin-3 has gained attention as a powerful predictor of heart failure and mortality, thus becoming a useful prognostic marker in clinical practice. Moreover, though not specifically investigated in diabetic cohorts, plasma levels of galectin-3 correlated with the prevalence of diabetes and related metabolic conditions, thus suggesting that pharmacological blockade of this lectin might be successful for treating heart failure especially in subjects suffering from these disorders. Indeed, galectin-3 is considered not only as a marker of heart failure, but also as a mediator of the disease, due to its pro-fibrotic action, though evidence comes mainly from studies in galectin-3 deficient mice. However, these studies have provided contrasting results, with either attenuation or acceleration of organ fibrosis and inflammation, depending on the experimental setting and particularly on the levels of advanced glycation endproducts (AGEs)/advanced lipoxidation endproducts (ALEs), of which galectin-3 is a scavenging receptor. In fact, under conditions of increased AGE/ALE levels, galectin-3 ablation was associated with tissue-specific outcomes, reflecting the AGE/ALE-receptor function of this lectin. Conversely, in experimental models of acute inflammation and fibrosis, galectin-3 deficiency resulted in attenuation of tissue injury. There is a need for prospective studies in diabetic patients specifically investigating the relation of galectin-3 levels with complications and for further animal studies in order to establish the effective role of this lectin in organ damage before considering its pharmacological blockade in the clinical setting. PMID:24940712

  11. Circulating adiponectin levels and risk of type 2 diabetes in the Japanese

    PubMed Central

    Yamamoto, S; Matsushita, Y; Nakagawa, T; Hayashi, T; Noda, M; Mizoue, T

    2014-01-01

    Background: Adiponectin has anti-inflammatory and insulin-sensitizing properties. Prospective studies have consistently shown a lower risk of type 2 diabetes among those with higher circulating adiponectin levels. Objective: We examined prospectively the association between serum adiponectin levels and type 2 diabetes risk among Japanese workers, taking visceral fat mass into account. Subjects and methods: Subjects were 4591 Japanese employees who attended a comprehensive health screening in 2008; had biochemical data including serum adiponectin; were free of diabetes at baseline; and received health screening in 2011. Multiple logistic regression analysis was used to examine the association between adiponectin and incidence of diabetes among overall subjects, as well as subgroups. Stratified analyses were carried out according to variables including visceral fat area (VFA). Results: During 3 years of follow-up, 217 diabetic cases were newly identified. Of these, 87% had a prediabetes at baseline. Serum adiponectin level was significantly, inversely associated with incidence of diabetes, with odds ratios (95% confidence interval) adjusted for age, sex, family history, smoking, alcohol drinking, physical activity and body mass index (BMI) for the lowest through highest quartile of adiponectin of 1 (reference), 0.79 (0.55–1.12), 0.60 (0.41–0.88) and 0.40 (0.25–0.64), respectively (P-value for trend <0.01). This association was materially unchanged with adjustment for VFA instead of BMI. After further adjustment for both homeostasis model assessment of insulin resistance and hemoglobin A1c, however, the association became statistically nonsignificant (P-value for trend=0.18). Risk reduction associated with higher adiponectin levels was observed in both participants with and without obesity or insulin resistance at baseline. Conclusions: Results suggest that higher levels of circulating adiponectin are associated with a lower risk of type 2 diabetes, independently of overall and intra-abdominal fat deposition, and that adiponectin may confer a benefit in both persons with and without insulin resistance. PMID:25133442

  12. Cardiorespiratory fitness and the incidence of type 2 diabetes: a cohort study of Japanese male athletes

    PubMed Central

    2014-01-01

    Background In Japan, although the incidence of overweight (BMI???25) is still low compared with that in Europe and the United States, the prevalence of type 2 diabetes has increased over the last 15 years,. In both Japanese and Caucasian populations it has been reported that a high level of cardiorespiratory fitness protects against the development of type 2 diabetes. However, there are no reports focused specifically on athletes that investigate whether high cardiorespiratory fitness at a young age can prevent disease later in life. We examined the relationship between cardiorespiratory fitness at a young age and the development of type 2 diabetes in Japanese athletes using a cohort study. Methods The cardiorespiratory fitness of male alumni of the physical education department of Juntendo University, as measured by stored data of a 1,500-m endurance run in college (1971–1991) was compared with their incidence of type 2 diabetes as determined by follow-up questionnaires (2007–2009). This study used Cox’s proportional hazards models and adjusted for age, year of graduation, BMI, smoking, and sports club participation at college age. Results We collected data on cardiorespiratory fitness at college age and medical history survey data during 2007–2009 from 570 male alumni. The median follow-up period was 26 years (IQR: 23–29 years), and 22 men had developed type 2 diabetes. An inverse relationship was observed between incidence of type 2 diabetes and level of cardiorespiratory fitness at time of college after adjustment for age, year of graduation, BMI, smoking, and sports participation. The adjusted hazards ratio and 95% CI by category (low, medium, and high) were 1.00 (reference), 0.40 (0.14–1.13) and 0.26 (0.07–1.00) (p?=?0.03 for trend). Conclusions A high level of cardiorespiratory fitness at a young age can help prevent type 2 diabetes later in life. PMID:24885699

  13. Hereditary hemorrhagic telangiectasia in Japanese patients.

    PubMed

    Komiyama, Masaki; Ishiguro, Tomoya; Yamada, Osamu; Morisaki, Hiroko; Morisaki, Takayuki

    2014-01-01

    To describe clinical presentations of hereditary hemorrhagic telangiectasia (HHT) patients in Japan. There were 80 patients (40 men and 40 women, age 2-78, mean 39.4 years old), who were either genetically verified or genetically not identifiable but clinically definite HHT patients. Clinical presentations of these HHT patients were analyzed retrospectively. Radiological examinations, which included at least brain magnetic resonance imaging and lung computed tomography, were performed when indicated. Seventy-eight patients had either endoglin (ENG) or activin A receptor type II-like 1 (ACVRL1) mutation. They were 53 HHT1 patients with ENG mutation in 27 families and 25 HHT2 patients with ACVRL1 mutation in 17 families. Two other female patients were clinically definite HHT, but genetic mutation could not be identified. Nosebleeds were noted in 53/53 (100%) HHT1 and 24/25 (96%) HHT2 patients. Telangiectases were observed in 34/53 (64%) HHT1 and 18/25 (72%) HHT2 patients. Pulmonary arteriovenous malformations (AVMs) were noted in 33/52 HHT1 (63%) and 5/25 HHT2 patients (20%). Brain AVMs were detected in 12/51 HHT1 (24%) and 1/25 HHT2 (4%) patients. Hepatic AVMs were noted in 7/29 (24%) HHT1 and 16/20 (80%) HHT2 patients. The number of HHT1 patients was roughly twice as many as that of HHT2 patients in Japan. Pulmonary and brain AVMs were predominantly observed in HHT1 while hepatic AVMs were detected in HHT2. It seemed that ethnicity and regionality had minimal roles in the clinical presentation of HHT. PMID:24196379

  14. Influence of obesity on control in asthmatic Japanese patients defined by the Japanese definition of obesity.

    PubMed

    Youkou, Akira; Hasegawa, Takashi; Suzuki, Kazuo; Koya, Toshiyuki; Sakagami, Takuro; Toyabe, Shinichi; Arakawa, Masaaki; Gejyo, Fumitake; Narita, Ichiei; Suzuki, Eiichi

    2011-01-01

    BACKGROUND Despite the use of inhaled corticosteroid (ICS) becoming increasingly widespread, many problems related to asthma management still need to be addressed. One of them, obesity, has been reported to exert a harmful influence on asthma control. However, there have been few reports focusing not only on both obesity and its influence on Japanese asthma patients but also on the Japanese definition of obesity, as defined by the Japan Society for the Study of Obesity (JASSO). AIMS & METHODS The aim of this study was to confirm the influence of obesity, as defined by the JASSO, on asthma management in Japanese asthmatic patients. Using data from the Niigata Asthma Treatment Study Group 2008 questionnaire survey, differences between the "normal" group (18.5 kg/m(2) ? BMI <25 kg/m(2)) and the "obese" group (25 kg/m(2) ? BMI) were analyzed. RESULTS There was a significantly lower step 1 rate (19.4% v.s. 26.8%) and a higher proportion of patients using inhaled salmeterol (43.6% v.s. 35.8%) and leukotriene receptor antagonist (49.8% v.s. 40.8%) in the obese group relative to the normal group, although there were no significant differences in indicators of asthma control, including asthma control test scores. CONCLUSION This study investigated influences of JASSO-defined obesity on asthma severity and management in a clinical setting in Japan. It is possible that there are strong interactions between asthma and obesity, such as obesity causing decreased ICS therapy efficacy and leukotriene (LT)-related inflammation, although further investigation is necessary. PMID:21921368

  15. Genome-wide linkage analysis of type 2 diabetes mellitus reconfirms the susceptibility locus on 11p13–p12 in Japanese

    Microsoft Academic Search

    Hajime Nawata; Senji Shirasawa; Naoki Nakashima; Eiichi Araki; Jun Hashiguchi; Seibei Miyake; Teruaki Yamauchi; Kazuyuki Hamaguchi; Hironobu Yoshimatsu; Haruo Takeda; Hideo Fukushima; Takayuki Sasahara; Kohei Yamaguchi; Noriyuki Sonoda; Tomoko Sonoda; Masahiro Matsumoto; Yoshiya Tanaka; Hidekatsu Sugimoto; Hirotaka Tsubouchi; Toyoshi Inoguchi; Toshihiko Yanase; Nakayasu Wake; Kenziro Narazaki; Takashi Eto; Fumio Umeda; Mitsuhiro Nakazaki; Junko Ono; Takashi Asano; Yasuko Ito; Shoichi Akazawa; Iwaho Hazegawa; Nobuyuki Takasu; Moritsugu Shinohara; Takeshi Nishikawa; Seiho Nagafuchi; Toshimitsu Okeda; Katsumi Eguchi; Masanori Iwase; Mayuko Ishikawa; Masayuki Aoki; Naoto Keicho; Norihiro Kato; Kazuki Yasuda; Ken Yamamoto; Takehiko Sasazuki

    2004-01-01

    Type 2 diabetes mellitus is a heterogeneous disorder, and the development of type 2 diabetes mellitus is associated with both insulin secretion defect and insulin resistance. The primary metabolic defect leading to type 2 diabetes mellitus has been thought to be varied among populations, especially in Japanese and Caucasians. Here, we have done the genome-wide scan for type 2 diabetes

  16. [Pancreas transplantation in insulin dependent diabetic patients].

    PubMed

    Nakash, Richard; Ben Haim, Menachem; Katz, Paulina; Yahnin, Tatiana

    2004-12-01

    Successful transplantation of the pancreas as a whole organ, or as isolated islet cells, is the only treatment that achieves a stable normoglycemia as a result of insulin secretion and renewal of serum glucose levels control systems. Nowadays, one year patient survival after pancreas transplantation is above 90%, while functioning grafts are observed in 84% of combined pancreas kidney and in 70% of isolated pancreas transplantations. Type I insulin dependent diabetic patients aged 45 or less with severe diabetic nephropathy, without immediate life saving cardiovascular risk, highly motivated and well informed achieve the best results. Namely, these results include euglycemia without exogenous insulin, improvement of secondary complications of diabetes, protection of the kidney graft, and longer life expectancy with better quality of life, as compared to dialyzed diabetic patients. PMID:15666711

  17. Japanese neuropathy patients with peripheral myelin protein-22 gene aneuploidy

    SciTech Connect

    Lebo, R.V.; Li, L.Y.; Flandermeyer, R.R. [Univ. of California, San Francisco, CA (United States)] [and others

    1994-09-01

    Peripheral myelin protein (PMP-22) gene aneuploidy results in Charcot-Marie-Tooth disease Type 1A (CMT1A) and the Hereditary Neuropathy with Liability to Pressure Palsy (HNPP) in Japanese patients as well as Caucasian Americans. Charcot-Marie-Tooth disease (CMT), the most common genetic neuropathy, results when expression of one of at least seven genes is defective. CMT1A, about half of all CMT mutations, is usually associated with a duplication spanning the peripheral myelin protein-22 gene on distal chromosome band 17p11.2. Autosomal dominant HNPP (hereditary pressure and sensory neuropathy, HPSN) results from a deletion of the CMT1A gene region. Multicolor in situ hybridization with PMP-22 gene region probe characterized HNPP deletion reliably and detected all different size duplications reported previously. In summary, 72% of 28 Japanese CMT1 (HMSNI) patients tested had the CMT1A duplication, while none of the CMT2 (HMSNII) or CMT3 (HMSNIII) patients had a duplication. Three cases of HNPP were identified by deletion of the CMT1A gene region on chromosome 17p. HNPP and CMT1A have been reported to result simultaneously from the same unequal recombination event. The lower frequency of HNPP compared to CMT1A suggests that HNPP patients have a lower reproductive fitness than CMT1A patients. This result, along with a CMT1A duplication found in an Asian Indian family, demonstrates the broad geographic distribution and high frequency of PMP-22 gene aneuploidy.

  18. Treating the elderly diabetic patient: special considerations

    PubMed Central

    Kezerle, Louise; Shalev, Leah; Barski, Leonid

    2014-01-01

    The prevalence of diabetes is rising in the >65 year-old group. The challenge of defining the goals of therapy arises from the heterogeneity of the aging process and the sparse clinical data in this patient population. In light of these challenges, the clinician should be aware of the pitfalls of caring for the older diabetic patient and prioritize an individualized treatment plan to ensure an optimal glycemic control, without placing the patient at unnecessary risk. We present a review of the current guidelines and literature that deal specifically with the treatment of the older diabetic patient in order to establish the principles of treatment in this age group and help the clinician make decisions regarding the care of these patients. PMID:25210468

  19. Treating the elderly diabetic patient: special considerations.

    PubMed

    Kezerle, Louise; Shalev, Leah; Barski, Leonid

    2014-01-01

    The prevalence of diabetes is rising in the >65 year-old group. The challenge of defining the goals of therapy arises from the heterogeneity of the aging process and the sparse clinical data in this patient population. In light of these challenges, the clinician should be aware of the pitfalls of caring for the older diabetic patient and prioritize an individualized treatment plan to ensure an optimal glycemic control, without placing the patient at unnecessary risk. We present a review of the current guidelines and literature that deal specifically with the treatment of the older diabetic patient in order to establish the principles of treatment in this age group and help the clinician make decisions regarding the care of these patients. PMID:25210468

  20. Data Standards in Diabetes Patient Registries

    PubMed Central

    Richesson, Rachel L

    2011-01-01

    Widespread adoption of electronic health records (EHRs) and expansion of patient registries present opportunities to improve patient care and population health and advance translational research. However, optimal integration of patient registries with EHR functions and aggregation of regional registries to support national or global analyses will require the use of standards. Currently, there are no standards for patient registries and no content standards for health care data collection or clinical research, including diabetes research. Data standards can facilitate new registry development by supporting reuse of well-defined data elements and data collection systems, and they can enable data aggregation for future research and discovery. This article introduces standardization topics relevant to diabetes patient registries, addresses issues related to the quality and use of registries and their integration with primary EHR data collection systems, and proposes strategies for implementation of data standards in diabetes research and management. PMID:21722563

  1. Association of the VEGF gene polymorphism with diabetic retinopathy in type 2 diabetes patients

    Microsoft Academic Search

    Monika Buraczynska; Piotr Ksiazek; Iwona Baranowicz-Gaszczyk; Lucyna Jozwiak

    2007-01-01

    Background. Diabetic microvascular complications are the major causes of morbidity and early mortality in diabetes. Vascular endothelial growth factor (VEGF) is a potent multifunctional cytokine which plays a key role in the pathogenesis of diabetic microvascular complications. We examined the possible association of the VEGF gene polymorphisms with diabetic nephropathy and retinopathy in type 2 diabetes patients. Methods. Genotyping of

  2. [Survey of newly diagnosed Japanese leprosy patients].

    PubMed

    Koba, Ai; Mori, Shuichi; Ishii, Norihisa

    2011-02-01

    We aimed to elucidate the patterns and trends of autochthonous leprosy in Japan from 1964 to 2009, to compare them with the findings from other studies of leprosy in decline. Data on registered leprosy cases in Japan in the period 1964-2009 were analysed with reference to trends in case detection, geographical distribution, age at diagnosis, sex, classification and family history. A consistent decline in leprosy case detection was observed in all areas of the country over the period 1964-2009. Highest incidence was consistently in Okinawa. Autochthonous leprosy has not been reported in anyone born in Japan since 1980. Increasing average age and a shift towards lower latitudes were demonstrated throughout the period. Analyses of data on autochthonous cases revealed patterns similar to those reported in other countries with declining leprosy. Okinawa has had the highest incidence of leprosy in all of Japan since the first national survey in 1900. Several possible explanations include the difference of leprosy control history between Okinawa and the rest of Japan, Okinawa's unique geographical condition, large-scale problem of stigma and discrimination against leprosy patients and delayed improvement of socio-economic conditions. PMID:21404591

  3. Diabetes education improves depressive state in newly diagnosed patients with type 2 diabetes

    PubMed Central

    Chen, Bin; Zhang, Xiyao; Xu, Xiuping; Lv, Xiaofeng; Yao, Lu; Huang, Xu; Guo, Xueying; Liu, Baozhu; Li, Qiang; Cui, Can

    2013-01-01

    Objectives: The prevalence of depression is relatively high in individuals with diabetes. However, screening and monitoring of depressive state in patients with diabetes is still neglected in developing countries and the treatment of diabetes-related depression is rarely performed in these countries. In this study, our aim was to study the role of diabetes education in the improvement of depressive state in newly diagnosed patients with type 2 diabetes. Methods: The Dutch version of the center for epidemiological studies depression scale (CES-D scale) and the problem areas in diabetes (PAID) questionnaire were used to assess depression and diabetes-specific emotional distress in 1200 newly diagnosed male adult patients with type 2 diabetes before and after a two-week diabetes education by professionally trained nurses. Pearson correlation and regression analysis were used to analyze the factors related to depression in patients with type 2 diabetes. Results: The incidence of depression in newly diagnosed patients with type 2 diabetes was 28%, and the rate of diabetes-specific emotional distress was 65.5%. High education levels, low income were correlated to depression in individuals with diabetes. After two weeks of diabetes education, the incidence of depression and diabetes-specific emotional distress decreased significantly to 20.5% (P < 0.05) and 11% (P < 0.001), respectively. Conclusions: The incidence of depression, especially diabetes-specific emotional distress, was relatively high in newly diagnosed patients with type 2 diabetes. The depression state could be improved by diabetes education. PMID:24353709

  4. Endocrinological Characteristics of 25 Japanese Patients with CHARGE Syndrome

    PubMed Central

    Shoji, Yasuko; Ida, Shinobu; Etani, Yuri; Yamada, Hiroyuki; Kayatani, Futoshi; Suzuki, Yasuhiro; Kosaki, Kenjiro; Okamoto, Nobuhiko

    2014-01-01

    Abstract CHARGE syndrome is a congenital disorder caused by mutation of the chromodomain helicase DNA binding protein 7 (CHD7) gene and is characterized by multiple anomalies including ocular coloboma, heart defects, choanal atresia, retarded growth and development, genital and/or urological abnormalities, ear anomalies, and hearing loss. In the present study, 76% of subjects had some type of endocrine disorder: short stature (72%), hypogonadotropic hypogonadism (60%), hypothyroidism (16%), and combined hypopituitarism (8%). A mutation in CHD7 was found in 80% of subjects. Here, we report the phenotypic spectrum of 25 Japanese patients with CHARGE syndrome, including their endocrinological features. PMID:24790386

  5. Hypoglycemia in Patients With Type 2 Diabetes Mellitus

    Microsoft Academic Search

    Christopher D. Miller; Lawrence S. Phillips; David C. Ziemer; Daniel L. Gallina; Curtiss B. Cook; Imad M. El-Kebbi

    2001-01-01

    Background: Although hypoglycemia is the most com- mon complication of intensive diabetes therapy, there is little information about risk factors for hypoglycemia in patients with type 2 diabetes mellitus. Objective: To determine the prevalence and predisposing factors for hypoglycemia in patients with type 2 diabetes. Methods: Retrospective, cross-sectional analysis set in an outpatient specialty diabetes clinic. We included those pa-

  6. OCT parameters in patients with diabetic maculopathy

    PubMed Central

    Serban, R; Cioboata, M; Chiotan, C; Corn?cel, C; Liora, R; Anghelie, A

    2014-01-01

    The treatment of the clinically significant macular edema in patients with diabetic maculopathy by the intravitreal administration of corticosteroids and antiangiogenic factors requires rapid and more accurate investigation methods aimed at following up the dynamic evolution of the structural parameters of the retina. The purpose of the study is to compare the outcome of OCT parameters for each group (Group A treated by intravitreal administered triamcinolone acetonide and Group B treated by intravitreal administered triamcinolone acetonide in combination with bevacizumab). Methods involved the selection of cases, dynamic measurements of the retina structures, so that, at the end, the data from the two groups of patients could be compared. The results showed a positive development in the short and medium term in both groups of patients. Abbreviations: OCT = optical coherence tomography, WESDR = epidemiological study of diabetic retinopathy Wisconsin, ETDRS = study early treatment of diabetic retinopathy, retinal thickness GRC = central-VMT total macular volume, VEGF, vascular endothelial growth factor

  7. Pharmacokinetics of gentamicin in hemodialysis patients: a comparative study between diabetic and non-diabetic patients

    Microsoft Academic Search

    Mohammed A. Al-Homrany; Yacoub M. Irshaid; Assem K. El Sherif; Haider A. Omar

    2009-01-01

    Diabetic nephropathy is one of the leading causes of end-stage renal disease (ESRD). There is some evidence that differences\\u000a in extracellular fluid volume and capillary permeability do exist between diabetic and non-diabetic patients. This may have\\u000a an impact on the gentamicin volume of distribution and clearance and thus dosing regimen. The pharmacokinetic parameters of\\u000a gentamicin [volume of distribution (Vd), clearance

  8. Primary Infrainguinal Subintimal Angioplasty in Diabetic Patients

    Microsoft Academic Search

    Irene Bargellini; Pasquale Petruzzi; Alessia Scatena; Roberto Cioni; Antonio Cicorelli; Claudio Vignali; Loredana Rizzo; Alberto Piaggesi; Carlo Bartolozzi

    2008-01-01

    The aim of this study was to prospectively evaluate technical and clinical results of infrainguinal subintimal angioplasty\\u000a in a series of diabetic patients with limb-threatening ischemia. From July 2003 to December 2007, 60 consecutive diabetic\\u000a patients (M\\/F = 41\\/19; mean age, 69.4 ± 9.4 years) with Fontaine stage IV critical limb ischemia, not suitable for surgical\\u000a recanalization, underwent primary infrainguinal subintimal angioplasty. The technical success,

  9. Prevalence and clinical characterization of Japanese diabetes mellitus with an A-to-G mutation at nucleotide 3243 of the mitochondrial tRNA{sup Leu (UUR)} gene

    SciTech Connect

    Odawara, Masato; Sasaki, Kayoko; Yamashita, Kamejiro [Univ. of Tsukuba (Japan)] [Univ. of Tsukuba (Japan)

    1995-04-01

    An A-to-G mutation at nucleotide position 3243 of the mitochondrial genome has been associated with insulin-dependent diabetes mellitus (IDDM) and with noninsulin-dependent diabetes mellitus (NIDDM) with deafness. We investigated the prevalence of this mutation in Japanese patients with IDDM, NIDDM, and impaired glucose tolerance (IGT) and in nondiabetic control individuals, and we identified it in 3 of 300 patients with NIDDM or IGT (1.0%). None of these individuals had significant sensorineural hearing loss. None of the 94 IDDM or the 115 nondiabetic control subjects was positive for this mutation. Oral glucose tolerance test revealed that a 57-yr-old male with this mutation was rather hyperinsulinemic in the fasting state. The insulin secretion in this patient decreased with age; he did not complain of any hearing disorder, although audiometry revealed a slight elevation of hearing threshold at high frequencies. In conclusion, we found that a mitochondrial gene mutation at nucleotide position 3243 was present in about 1% of NIDDM patients including those patients with IGT. The subtype of diabetes mellitus with this mutation may have a clinical profile similar to that found in patients with NIDDM commonly seen in outpatient clinics. 25 refs., 2 figs., 1 tab.

  10. Molecular characteristics in Japanese patients with lipidosis: Novel mutations in metachromatic leukodystrophy and Gaucher disease

    Microsoft Academic Search

    Yoshikatsu Eto; Hiroshi Kawame; Yoriyasu Hasegawa; Toya Ohashi; Hiroyuki Ida; Toshiharu Tokoro

    1993-01-01

    The characterization of mutations in Japanese patients with lipidosis, particularly in metachromatic leukodystrophy (MLD) and Gaucher disease has been studied in detail. Metachromatic leukodystrophy is characterized by an accumulation of sulfatide in nervous tissues and kidney due to a deficiency of arylsulfatase A (ASA). We analyzed the presence of three known mutant arylsulfatase A alleles in Japanese patients with MLD.

  11. Cysteinyldopa isomers and dopa in lesions and urine of Japanese patients with malignant melanoma

    Microsoft Academic Search

    Takafumi Morishima; Fumiko Tatsumi; Eishun Fukada; Mariko Saito; Mitsue Fujita; Noriyasu Nagashima; Shigeru Hanawa

    1983-01-01

    Cysteinyldopas and Dopa in the urine and tissues of Japanese melanoma patients were investigated quantitatively by means of high-performance liquid chromatography. Cysteinyldopa isomers were detected in the urine of eumelanic Japanese patients. The amount \\u000a

  12. Diabetic neuropathy in patients with “Latent Autoimmune Diabetes of the Adults” (LADA) compared with patients with type 1 and type 2 diabetes

    Microsoft Academic Search

    Petra Baum; Wieland Hermann; Hans-Jochen Verlohren; Armin Wagner; Tobias Lohmann; Friedrich Grahmann

    2003-01-01

    .   Objective: In previous studies, a lower incidence of diabetes-related complications such as diabetic neuropathy has been reported in\\u000a patients with early stages of type 1 diabetes compared with type 2 diabetes. The aim of this study was to compare the prevalence\\u000a of diabetic neuropathy in patients with manifestation of a slow onset type 1 diabetes in adulthood – latent

  13. A single-nucleotide polymorphism in ANK1 is associated with susceptibility to type 2 diabetes in Japanese populations.

    PubMed

    Imamura, Minako; Maeda, Shiro; Yamauchi, Toshimasa; Hara, Kazuo; Yasuda, Kazuki; Morizono, Takashi; Takahashi, Atsushi; Horikoshi, Momoko; Nakamura, Masahiro; Fujita, Hayato; Tsunoda, Tatsuhiko; Kubo, Michiaki; Watada, Hirotaka; Maegawa, Hiroshi; Okada-Iwabu, Miki; Iwabu, Masato; Shojima, Nobuhiro; Ohshige, Toshihiko; Omori, Shintaro; Iwata, Minoru; Hirose, Hiroshi; Kaku, Kohei; Ito, Chikako; Tanaka, Yasushi; Tobe, Kazuyuki; Kashiwagi, Atsunori; Kawamori, Ryuzo; Kasuga, Masato; Kamatani, Naoyuki; Nakamura, Yusuke; Kadowaki, Takashi

    2012-07-01

    To identify a novel susceptibility locus for type 2 diabetes, we performed an imputation-based, genome-wide association study (GWAS) in a Japanese population using newly obtained imputed-genotype data for 2 229 890 single-nucleotide polymorphisms (SNPs) estimated from previously reported, directly genotyped GWAS data in the same samples (stage 1: 4470 type 2 diabetes versus 3071 controls). We directly genotyped 43 new SNPs with P-values of <10(-4) in a part of stage-1 samples (2692 type 2 diabetes versus 3071 controls), and the associations of validated SNPs were evaluated in another 11 139 Japanese individuals (stage 2: 7605 type 2 diabetes versus 3534 controls). Combined meta-analysis using directly genotyped data for stages 1 and 2 revealed that rs515071 in ANK1 and rs7656416 near MGC21675 were associated with type 2 diabetes in the Japanese population at the genome-wide significant level (P < 5 × 10(-8)). The association of rs515071 was also observed in European GWAS data (combined P for all populations = 6.14 × 10(-10)). Rs7656416 was in linkage disequilibrium to rs6815464, which had recently been identified as a top signal in a meta-analysis of East Asian GWAS for type 2 diabetes (r(2) = 0.76 in stage 2). The association of rs7656416 with type 2 diabetes disappeared after conditioning on rs6815464. These results indicate that the ANK1 locus is a new, common susceptibility locus for type 2 diabetes across different ethnic groups. The signal of association was weaker in the directly genotyped data, so the improvement in signal indicates the importance of imputation in this particular case. PMID:22456796

  14. Prognostic stratification of diabetic patients by exercise echocardiography

    Microsoft Academic Search

    Abdou Elhendy; Adelaide M Arruda; Douglas W Mahoney; Patricia A Pellikka

    2001-01-01

    OBJECTIVESThe aim of this study was to assess the incremental value of exercise echocardiography for the risk stratification of diabetic patients.BACKGROUNDThere are currently insufficient outcome data in diabetic patients to define the role of stress echocardiography as a prognostic tool.METHODSWe studied the prognostic value of exercise echocardiography in 563 patients with diabetes mellitus (mean age 64 ± 11 years, 336

  15. Primary Infrainguinal Subintimal Angioplasty in Diabetic Patients

    SciTech Connect

    Bargellini, Irene, E-mail: irenebargellini@hotmail.com; Petruzzi, Pasquale [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy); Scatena, Alessia [University of Pisa, Department of Diabetology (Italy); Cioni, Roberto; Cicorelli, Antonio; Vignali, Claudio [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy); Rizzo, Loredana; Piaggesi, Alberto [University of Pisa, Department of Diabetology (Italy); Bartolozzi, Carlo [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy)

    2008-07-15

    The aim of this study was to prospectively evaluate technical and clinical results of infrainguinal subintimal angioplasty in a series of diabetic patients with limb-threatening ischemia. From July 2003 to December 2007, 60 consecutive diabetic patients (M/F = 41/19; mean age, 69.4 {+-} 9.4 years) with Fontaine stage IV critical limb ischemia, not suitable for surgical recanalization, underwent primary infrainguinal subintimal angioplasty. The technical success, perioperative morbidity and mortality, and clinical success (defined by ulcer healing) were evaluated. Kaplan-Meier life-table analysis was obtained for cumulative clinical success, limb salvage, and survival rates. The procedure was technically successful in 55 of 60 (91.7%) patients; in 5 cases we were not able to achieve a reentry. Periprocedural mortality was 5% (3 patients); three patients (5%) required major amputation periprocedurally. Mean follow-up was 23 months (range, 0-48 months). On an intention-to-treat basis, the limb salvage rate was 93.3% (56/60 patients); ulcer healing was observed in 45 of 60 (75%) patients and it was significantly (p < 0.05) associated with serum creatinine and HbA1c levels, diabetes duration, and infrapopliteal recanalization. One- and three-year cumulative survival rates were 91.5% and 83.1%, respectively; serum creatinine levels, patient age, and clinical success were significant predictors of survival. In conclusion, infrainguinal primary subintimal angioplasty is a safe and effective treatment in diabetic patients with limb-threatening ischemia not suitable for surgical recanalization. This procedure is aimed to create a 'temporary bypass' that facilitates ulcer healing.

  16. Maculopathy in patients with diabetes mellitus type 1 and type 2: associations with risk factors

    Microsoft Academic Search

    Eckhard Zander; Sabine Herfurth; Beate Bohl; Peter Heinke; Uwe Herrmann; Klaus-Dieter Kohnert; Wolfgang Kerner

    2000-01-01

    AIMTo examine possible relation between diabetic maculopathy and various risk factors for diabetic complications in patients with diabetes mellitus type 1 and type 2.METHODSCross sectional study of two cohorts of diabetic patients, comprising 1796 patients with type 1 diabetes (mean age 47 years, mean duration of diabetes 24 years) and 1563 patients with type 2 diabetes (mean age 62 years,

  17. Rhinocerebral zygomycosis in a diabetic patient.

    PubMed

    Cunha, Mirella Alves da; Nery, Andréia Ferreira; Lima, Francisco Pignataro; Diniz Junior, José; Maciel Neto, José; Calado, Nicácia Barbosa; Luz, Kleber Giovanni; Milan, Eveline Pipolo

    2011-01-01

    Rhinocerebral zygomycosis is the most frequent form of fungal infection caused by members of the Zygomycetes class. A fatal case of rhinocerebral zygomycosis caused by Rhizopus (oryzae) arrhizus with histopathological and mycological diagnosis is reported in a diabetic patient. PMID:21552748

  18. Psychosocial interventions for the diabetic patient

    PubMed Central

    Harvey, John N

    2015-01-01

    Diabetes usually requires substantial life-long self-management by the patient. Psychological factors and the patient’s health beliefs are important determinants of self-care behavior. Education has a modest influence on generating better self-care, but psychologically based interventions are clearly more effective. This review gives an overview of these interventions with some discussion of their basis in psychological theory. Some labels such as cognitive behavioral therapy and family therapy include a wide range of approaches. Randomized trials have generally produced improvement in measures of psychological well-being, but improved glycemic control has been more elusive. The influence on behavior can be very dependent on the individual therapist. Only a few trials have managed to sustain improvement in glycosylated hemoglobin beyond a year. Not all patients are prepared to engage and accept these forms of therapeutic intervention. We are still some way from moving psychological management from the trial situation into the diabetic clinic. PMID:25657590

  19. Anesthetic considerations in diabetic patients. Part II: intraoperative and postoperative management of patients with diabetes mellitus

    Microsoft Academic Search

    Yuji Kadoi

    2010-01-01

    Some studies have reported that tight glycemic control in diabetic patients undergoing major surgery improves perioperative\\u000a morbidity and mortality rates. Recently, however, large randomized studies have shown such control increases the mortality\\u000a rate, since aggressive glycemic control induces more frequent incidences of hypoglycemia. Diabetic patients have cerebral\\u000a complications during the perioperative period more often than their nondiabetic counterparts. Further, anesthetic

  20. Factors that influence the patient uptake of diabetic retinopathy screening

    Microsoft Academic Search

    E. Dervan; D. Lillis; L. Flynn; A. Staines; D. O’Shea

    2008-01-01

    Aim To assess whether patients were receiving regular diabetic retinopathy screening and to examine factors influencing screening uptake. Methods A questionnaire covering demographics, diabetic medical history and the knowledge of and attitudes to diabetic retinopathy was administered to all adults who were due to attend diabetes clinics in two centres in Dublin, Ireland over two months in 2001\\/2002. Results Of

  1. Clinical evaluation of fatigue in Japanese patients with Parkinson's disease

    PubMed Central

    Tanaka, Kenichiro; Wada-Isoe, Kenji; Yamamoto, Mikie; Tagashira, Shugo; Tajiri, Yuki; Nakashita, Satoko; Nakashima, Kenji

    2014-01-01

    Background Fatigue is a common nonmotor symptom of Parkinson's disease (PD). Although the causes of fatigue were estimated in the previous reports, fatigue is not fully understood. To determine the frequency of and factors related to fatigue in patients with PD, we carried out clinical assessments in our university hospital. Methods We used the Japanese version of the Parkinson Fatigue Scale (J-PFS). The J-PFS was administered to 110 patients with PD, and a cutoff point of 3.3 was used for the diagnosis of fatigue. Subsequently, demographic characteristics, clinical features, and medications utilized were evaluated to elucidate the factors related to fatigue. In particular, we focused on the relationship between fatigue and gait disorder assessed via the portable gait rhythmogram. Results The frequency of fatigue in patients with PD was 52.7%. Univariate analysis revealed that factors significantly associated with fatigue were many motor symptoms and nonmotor symptoms. In addition, multivariate analysis revealed that gait disorder and constipation were independent factors related to fatigue. Furthermore, short-step walking and bradykinesia in gait disorder had especially a relationship with fatigue. Conclusions More than half of our patients were judged having fatigue. Several factors, including motor and nonmotor symptoms, might be related to fatigue in patients with PD. PMID:25328841

  2. Treatment of Patients With Diabetic Gastroparesis

    PubMed Central

    Parkman, Henry P.; Fass, Ronnie; Foxx-Orenstein, Amy E.

    2010-01-01

    Gastroparesis, or chronic delayed gastric emptying without mechanical obstruction, affects about 40% of patients with type 1 diabetes and up to 30% of patients with type 2 diabetes. Diabetic gastroparesis (DGP) typically causes nausea, vomiting, early satiety, bloating, and postprandial fullness. These symptoms can be extremely troubling and result in poor quality of life. The diagnosis of DGP is made by documenting the presence of chronic upper gastrointestinal (GI) symptoms, ruling out mechanical obstruction, and demonstrating delayed gastric emptying. The usual treatment for DGP includes dietary modifications, prokinetic agents, and antiemetic agents. Although the majority of patients have mild-to-moderate disease that can be managed using these measures, a substantial percentage of patients have severe DGP that is characterized by inadequate oral intake, malnutrition, weight loss, and frequent hospitalizations. Optimal management of these patients presents a difficult challenge for the clinician, although emerging treatment options, such as gastric neurostimulation, are encouraging. Patients with DGP often present with gastric comorbidities, including gastroesophageal reflux disease, intestinal dysmotility, and fungal and bacterial infections of the GI tract. This monograph will present an overview of the pathophysiology of DGP, review diagnostic testing with a discussion of emerging technology, and present the latest research in treatment options for DGP. In addition, management strategies for refractory DGP and gastric comorbidities will be described. PMID:20733935

  3. Epidemiology of kidney failure in diabetic patients in Italy

    Microsoft Academic Search

    G. Greca; C. Catalano; R. Dell' Aquila; G. Erle; M. Milan; L. Fruner; D. Dissegna

    1992-01-01

    Chronic renal failure represent one of the more common complications of diabetes. End-stage renal disease develops in about 50% of type 1 (insulin-dependent) diabetic patients between 10 and 30 years from the onset of the disease, and in a consistent number of type 2 (non-insulin-dependent) diabetic patients. In the past, diabetic patients were not included in dialysis programmes, but in

  4. Self-Medication Practices among Diabetic Patients in Kuwait

    Microsoft Academic Search

    Abdelmoneim Awad; Shahd Al-Rabiy; Eman Abahussain

    2008-01-01

    Objectives: The aim of this study was to estimate the prevalence of self-medication with proprietary medicines and\\/or herbs among diabetic patients and evaluate factors associated with self-medication among diabetic patients. Subjects and Methods: A total of 104 diabetic patients were selected randomly from eight diabetic clinics from three governorates. Data were collected via face-to-face structured interview of the respondents in

  5. Psychosocial interventions for the diabetic patient.

    PubMed

    Harvey, John N

    2015-01-01

    Diabetes usually requires substantial life-long self-management by the patient. Psychological factors and the patient's health beliefs are important determinants of self-care behavior. Education has a modest influence on generating better self-care, but psychologically based interventions are clearly more effective. This review gives an overview of these interventions with some discussion of their basis in psychological theory. Some labels such as cognitive behavioral therapy and family therapy include a wide range of approaches. Randomized trials have generally produced improvement in measures of psychological well-being, but improved glycemic control has been more elusive. The influence on behavior can be very dependent on the individual therapist. Only a few trials have managed to sustain improvement in glycosylated hemoglobin beyond a year. Not all patients are prepared to engage and accept these forms of therapeutic intervention. We are still some way from moving psychological management from the trial situation into the diabetic clinic. PMID:25657590

  6. Aspirin for Primary Prevention in Patients With Diabetes Mellitus

    Microsoft Academic Search

    Kenneth X. Nguyen; Jacqueline S. Marinac; Chao Sun

    Background and Objectives: Evidence supports the routine use of low-dose aspirin (ASA) in the preven- tion of cardiovascular (CV) events in patients with diabetes mellitus (DM). In 1997, the American Diabetes Association (ADA) recommended ASA prophylaxis for all diabetic patients over the age of 30 with one additional risk factor for cardiovascular disease (CVD). Our objective was to determine the

  7. Treatment of dyslipidemia in patients with type 2 diabetes

    Microsoft Academic Search

    Krishnaswami Vijayaraghavan

    2010-01-01

    Type 2 diabetes is associated with significant cardiovascular morbidity and mortality. Although low-density lipoprotein cholesterol levels may be normal in patients with type 2 diabetes, insulin resistance drives a number of changes in lipid metabolism and lipoprotein composition that render low-density lipoprotein cholesterol and other lipoproteins more pathogenic than species found in patients without type 2 diabetes. Dyslipidemia, which affects

  8. Partnering with diabetes educators to improve patient outcomes

    PubMed Central

    Burke, Sandra D; Sherr, Dawn; Lipman, Ruth D

    2014-01-01

    Diabetes is a chronic, progressive disease that affects millions worldwide. The paradigm of diabetes management has shifted to focus on empowering the person with diabetes to manage the disease successfully and to improve their quality of life. Diabetes self-management education is a collaborative process through which people with diabetes gain the knowledge and skills needed to modify their behavior and to self-manage successfully the disease and its related conditions. Diabetes educators are health care professionals who apply in-depth knowledge and skills in the biological and social sciences, communication, counseling, and pedagogy to enable patients to manage daily and future challenges. Diabetes educators are integral in providing individualized education and promoting behavior change, using a framework of seven self-care behaviors known as the AADE7 Self-Care Behaviors™, developed by the American Association of Diabetes Educators. The iterative process of promoting behavior change includes assessment, goal setting, planning, implementation, evaluation, and documentation. Diabetes educators work as part of the patient’s health care team to engage with the patient in informed, shared decision making. The increasing prevalence of diabetes and the growing focus on its prevention require strategies for providing people with knowledge, skills, and strategies they need and can use. The diabetes educator is the logical facilitator of change. Access to diabetes education is critically important; incorporating diabetes educators into more and varied practice settings will serve to improve clinical and quality of life outcomes for persons with diabetes. PMID:24550679

  9. Calcium, vitamin D and dairy intake in relation to type 2 diabetes risk in a Japanese cohort

    Microsoft Academic Search

    K. Kirii; T. Mizoue; H. Iso; Y. Takahashi; M. Kato; M. Inoue; M. Noda; S. Tsugane

    2009-01-01

    Aims\\/hypothesis  Calcium and vitamin D have been implicated in the development of type 2 diabetes, but epidemiological evidence is limited.\\u000a We examined prospectively the relation of calcium and vitamin D intake to type 2 diabetes risk in a Japanese cohort.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Participants were 59,796 middle-aged and older men and women, who participated in the Japan Public Health Center-based Prospective\\u000a Study and had

  10. Factors Associated with Untreated Diabetes: Analysis of Data from 20,496 Participants in the Japanese National Health and Nutrition Survey

    PubMed Central

    Ikeda, Nayu; Noda, Hiroyuki; Shibuya, Kenji; Noda, Mitsuhiko

    2015-01-01

    Objective We aimed to examine factors associated with untreated diabetes in a nationally representative sample of the Japanese population. Research Design and Methods We pooled data from the Japanese National Health and Nutrition Survey from 2005 to 2009 (n = 20,496). Individuals aged 20 years and older were included in the analysis. We classified participants as having diabetes if they had HbA1c levels ?6.5% (?48 mmol/mol). People with diabetes who self-reported that they were not currently receiving diabetic treatment were considered to be untreated. We conducted a multinomial logistic regression analysis to determine factors associated with untreated diabetes relative to non-diabetic individuals. Results Of 20,496 participants who were included in the analysis, untreated diabetes was present in 748 (3.6%). Among participants with untreated diabetes, 48.3% were previously diagnosed with diabetes, and 46.5% had HbA1c levels ?7.0% (?53 mmol/mol). Participants with untreated diabetes were significantly more likely than non-diabetic participants to be male, older, and currently smoking, have lower HDL cholesterol levels and higher BMI, non-HDL cholesterol levels, and systolic blood pressure. Conclusions A substantial proportion of people in Japan with untreated diabetes have poor glycemic control. Targeting relevant factors for untreated diabetes in screening programs may be effective to enhance the treatment and control of diabetes. PMID:25756183

  11. Cancer risk in patients with diabetes mellitus

    Microsoft Academic Search

    Hans-Olov Adami; Joseph McLaughlin; Anders Ekbom; Christian Berne; Debra Silverman; David Hacker; Ingemar Persson

    1991-01-01

    Cancer incidence was ascertained in a population-based cohort of 51,008 patients in Uppsala, Sweden, who were given a discharge diagnosis of diabetes mellitus during 1965–83. Complete follow-up through 1984 with exclusion of the first year of observation showed that the observed number of cancers in females (1,294) was eight percent higher than expected (relative risk [RR]=1.1, 95 percent confidence interval

  12. Diabetes Stories: Use of Patient Narratives of Diabetes to Teach Patient-Centered Care

    ERIC Educational Resources Information Center

    Kumagai, Arno K.; Murphy, Elizabeth A.; Ross, Paula T.

    2009-01-01

    A critical component to instituting compassionate, patient-centered diabetes care is the training of health care providers. Our institution developed the Family Centered Experience (FCE), a comprehensive 2-year preclinical program based on longitudinal conversations with patients about living with chronic illness. The goal of the FCE is to explore…

  13. Impairment of Bone Status in Patients with Central Diabetes Insipidus

    Microsoft Academic Search

    ROSARIO PIVONELLO; ANNAMARIA COLAO; CAROLINA DI SOMMA; GIUSEPPINA FACCIOLLI; MICHELE KLAIN; ANTONGIULIO FAGGIANO; MARCO SALVATORE; GAETANO LOMBARDI

    The aim of the current study was to evaluate the biochemical parameters of bone metabolism and the bone mineral density (BMD) in patients with central diabetes insipidus, either treated or not treated with endonasal desmopressin. Eighteen patients with central diabetes insipidus and 18 sex- and age-matched healthy subjects entered the study. The patients were divided into 2 groups: patients who

  14. A cross-sectional analysis of quality of life in Japanese acne patients using the Japanese version of Skindex-16.

    PubMed

    Hayashi, Nobukazu; Higaki, Yuko; Kawamoto, Kyoko; Kamo, Toshiko; Shimizu, Satoru; Kawashima, Makoto

    2004-12-01

    We measured the quality of life of Japanese patients with acne using the Japanese version of Skindex-16, a semantically equivalent and validated translation of the original version produced by Chren et al. A total of 210 acne patients were enrolled in this study. The results showed that patients with acne experienced more severe emotional effects from their skin disease than functional or symptomatic effects. The scores for emotional aspects were related to the severity of the patients' acne following a prescribed scale, but the scores were high even when the patients only had a few comedones. Akaike's information criterion showed that the scores for symptoms were related to the severity of the patients' acne, and the patients' emotions were related to the interval between clinic visits. To improve patients' quality of life, treatment of comedones should be fully respected. In addition, dermatologists should encourage patients to visit clinics regularly to help them improve the emotional aspects of their quality of life. PMID:15801260

  15. STUDY ON ST-SEGMENT ELEVATION ACUTE MYOCARDIAL INFARCTION (STEMI) IN DIABETIC AND NON-DIABETIC PATIENTS

    Microsoft Academic Search

    M. Javed Iqbal; M. Azhar; M. Tariq Javed; Ifaat Tahira

    2008-01-01

    Objective: To compare some epidemiological and other parameters between diabetic and non-diabetic subjects admitted with STEMI. Methodology: Two hundred and forty patients were included in the study, 76 (32%) were diabetic, and 164 (68%) were non-diabetic. Results: Among diabetic patients 11\\/76 were newly diagnosed. The male to female ratio in diabetic was 1.5:1 (P=0.02), while in non-diabetic it was 5.8:1

  16. Benefits of coronary revascularisation in diabetic and non-diabetic patients with ischaemic cardiomyopathy: Role of myocardial viability

    Microsoft Academic Search

    Vittoria Rizzello; Don Poldermans; Elena Biagini; Arend F. L. Schinkel; Eric Boersma; Abdou Elhendy; Fabiola B. Sozzi; Alexander Maat; Jos R. T. C. Roelandt; Jeroen J. Bax

    2006-01-01

    Background: Diabetes mellitus in patients with coronary artery disease is associated with poor outcome. In this study, the relation between myocardial viability, diabetes, coronary revascularisation and outcome was evaluated. Methods: 129 patients (31 diabetic, 98 non-diabetic) with ischaemic cardiomyopathy underwent dobutamine stress echocardiography to assess myocardial viability. Patients with 4 viable segments were defined as viable and patients with <4

  17. Criterion and Construct Validity of the CogState Schizophrenia Battery in Japanese Patients with Schizophrenia

    PubMed Central

    Yoshida, Taisuke; Eguchi, Satoshi; Lin, Crystal; Yoshida, Sumiko; Ishikawa, Masanori; Higuchi, Yuko; Seo, Tomonori; Ueoka, Yoshinori; Tomotake, Masahito; Kaneda, Yasuhiro; Darby, David; Maruff, Paul; Iyo, Masaomi; Kasai, Kiyoto; Higuchi, Teruhiko; Sumiyoshi, Tomiki; Ohmori, Tetsuro; Takahashi, Kiyohisa; Hashimoto, Kenji

    2011-01-01

    Background The CogState Schizophrenia Battery (CSB), a computerized cognitive battery, covers all the same cognitive domains as the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery but is briefer to conduct. The aim of the present study was to evaluate the criterion and construct validity of the Japanese language version of the CSB (CSB-J) in Japanese patients with schizophrenia. Methodology/Principal Findings Forty Japanese patients with schizophrenia and 40 Japanese healthy controls with matching age, gender, and premorbid intelligence quotient were enrolled. The CSB-J and the Brief Assessment of Cognition in Schizophrenia, Japanese-language version (BACS-J) were performed once. The structure of the CSB-J was also evaluated by a factor analysis. Similar to the BACS-J, the CSB-J was sensitive to cognitive impairment in Japanese patients with schizophrenia. Furthermore, there was a significant positive correlation between the CSB-J composite score and the BACS-J composite score. A factor analysis showed a three-factor model consisting of memory, speed, and social cognition factors. Conclusions/Significance This study suggests that the CSB-J is a useful and rapid automatically administered computerized battery for assessing broad cognitive domains in Japanese patients with schizophrenia. PMID:21637776

  18. Impact and characteristics of quality of life in Japanese patients with multiple sclerosis

    Microsoft Academic Search

    Hiromi KikuchiNobuhiro; Nobuhiro Mifune; Masaaki Niino; Sadayoshi Ohbu; Jun-ichi Kira; Tatsuo Kohriyama; Kohei Ota; Masami Tanaka; Hirofumi Ochi; Shunya Nakane; Masaji Maezawa; Seiji Kikuchi

    2011-01-01

    Purpose  To evaluate health-related quality of life (HRQOL) in Japanese patients with multiple sclerosis (MS) and investigate associations\\u000a between the results of these QOL assessments and disease severity.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  One-hundred sixty-three Japanese MS patients completed a questionnaire battery comprising the Functional Assessment of MS\\u000a (FAMS), the Nottingham Adjustment Scale-Japanese version (NAS-J), and the European QOL scale (EQ-5D). Additional five factors\\u000a affecting QOL

  19. [Therapeutic education of the diabetic patient].

    PubMed

    Golay, A; Lagger, G; Chambouleyron, M; Lasserre-Moutet, A

    2005-01-01

    Therapeutic education is a patient centred approach focused on patients' needs, values and strategies. It allows not only to increase patients' knowledge and skills on the disease, but also on their treatments. It brings a better quality of life, an increased therapeutic compliance, and decreases complications. The most difficult part of therapeutic education occurs when patients must change their behaviour. Motivational interviewing techniques are of great support and allow to prepare and support patients in "step by step" progressive changes. It is essential to work on resistance to change. The ambivalence in the choice of a new lifestyle must be measured, discussed and negotiate. Patients become partners and health care providers become coaches. To negotiate objectives must allow patients to choose their own strategies which should cost them minimum psychological efforts and bring them maximum benefits. The efficacy of therapeutic education has not to be proved any more: 80% less of amputations at 10 years in diabetic patients, 50% of stable body weight after weight loss at 5 years, etc. In conclusion, therapeutic education is part of a humanist medicine centred on patients which allow them to take care of their own treatment, in order to improve their quality of life, therapeutic compliance and potential complications. The health care providers teach, train, negotiate, motivate and accompany their patients in the long-term follow-up of their diseases. PMID:16035335

  20. Effect of eating vegetables before carbohydrates on glucose excursions in patients with type 2 diabetes

    PubMed Central

    Imai, Saeko; Fukui, Michiaki; Kajiyama, Shizuo

    2014-01-01

    The aim of this review was to evaluate whether eating vegetables before carbohydrates could reduce the postprandial glucose, insulin, and improve long-term glycemic control in Japanese patients with type 2 diabetes. We studied the effect of eating vegetables before carbohydrates on postprandial plasma glucose, insulin, and glycemic control for 2.5 y in patients with type 2 diabetes. The postprandial glucose and insulin levels decreased significantly when the patients ate vegetables before carbohydrates compared to the reverse regimen, and the improvement of glycemic control was observed for 2.5 y. We also compared the postprandial glucose and glucose fluctuations assessed by continuous glucose monitoring system for 72-h in patients with type 2 diabetes and subjects with normal glucose tolerance when subjects ate vegetables before carbohydrates and carbohydrates before vegetables in a randomized crossover design. The glycemic excursions and incremental glucose peak were significantly lower when the subjects ate vegetables before carbohydrates compared to the reverse regimen. This evidence supports the effectiveness of eating vegetables before carbohydrates on glucose excursions in the short-term and glycemic control in the long-term in patients with type 2 diabetes. PMID:24426184

  1. Diabetic retinopathy and endothelial dysfunction in patients with type 2 diabetes mellitus

    Microsoft Academic Search

    J. S. Yun; S. H. Ko; J. H. Kim; K. W. Moon; Y. M. Park; K. D. Yoo; Y. B. Ahn

    2013-01-01

    BACKGROUND: We investigated the relationship between endothelial dysfunction and diabetic retinopathy (DR) in patients with type 2 diabetes. METHODS: We used a cross-sectional design to examine 167 patients with type 2 diabetes mellitus. All patients underwent biochemical and ophthalmological examination. We assessed endothelial dysfunction by a flow-mediated vasodilation method of the brachial artery. Changes in vasodilation (flow-mediated vasodilatation, %FMD) were

  2. Zinc Status in Type 2 Diabetic Patients: Relation to the Progression of Diabetic Nephropathy

    PubMed Central

    Sulieman, Dhia M; Hussen, Kajeen R.

    2014-01-01

    Background and Objectives: Zinc deficiency often occurs in patients with diabetes. Therefore, the relationship between zinc status and progression of nephropathy in diabetes has been explored. Materials and Methods: Total 300 diabetic patients and 100 non-diabetic healthy subjects (age matched) were selected followed by informed consent and divided into five groups as I: non-diabetic normotensive control; II: diabetic normotensive; III: diabetic hypertensive; IV: diabetic normotensive with microalbuminuria; V: diabetic hypertensive with microalbuminuria. The blood samples of all subjects were collected and analyzed for serum zinc, serum creatinine, and estimated-glomerular filtration rate (e-GFR). Urine zinc, creatinine and microalbuminuria concentrations were determined. Results: The serum zinc levels were low (p<0.01) in diabetic patients as compared to non-diabetic control subjects. The lower levels (p<0.001) of serum zinc were observed in Group IV and V as compared to group I-III. Significantly low levels of e-GFR (p<0.05) and high levels of microalbuminuria (p<0.001) were observed in diabetic patients with low serum zinc level as compared to normal serum zinc level. Serum zinc level in diabetic patients was inversely correlated with serum creatinine(r=-0.331, p<0.001), microalbuminuria (r=-0.587, p<0.001) and positively with e-GFR (r=0.194, p<0.01). Conclusion: It is evident from this study that advancing diabetic nephropathy represented by decreasing GFR and increasing microalbuminuria is associated with lower serum zinc levels. It thus indicates the need for determining serum zinc levels and the effectiveness of zinc supplementation in diabetic patients, particularly during the assessment of kidney damage. PMID:25584209

  3. Pharmacokinetics and penetration of moxifloxacin into infected diabetic foot tissue in a large diabetic patient cohort

    Microsoft Academic Search

    Jolanta Majcher-Peszynska; Marko Sass; Sora Schipper; Viktor Czaika; Andreas Gussmann; Ralf Lobmann; Ralf G. Mundkowski; Christoph Luebbert; Peter Kujath; Bernhard R. Ruf; Horst Koch; Wolfgang Schareck; Ernst Klar; Bernd Drewelow

    2011-01-01

    Objectives  Physiological changes occurring in patients with diabetes may affect the pharmacokinetics and penetration of antimicrobial\\u000a agents into peripheral tissue. We examined the pharmacokinetics and the penetration of moxifloxacin into perinecrotic tissue\\u000a of diabetic foot lesions in patients with diabetic foot infections (DFI).\\u000a \\u000a \\u000a \\u000a \\u000a Patients and methods  Adult patients suffering from type 2 diabetes mellitus and hospitalized for DFI (Texas classification of at

  4. Improving depression care in patients with diabetes and multiple complications

    Microsoft Academic Search

    Leslie S. Kinder; Wayne J. Katon; Evette Ludman; Joan Russo; Greg Simon; Elizabeth H. B. Lin; Paul Ciechanowski; Michael Von Korff; Bessie Young

    2006-01-01

    BACKGROUND: Depression is common in patients with diabetes, but it is often inadequately treated within primary care. Competing clinical\\u000a demands and treatment resistance may make it especially difficult to improve depressive symptoms in patients with diabetes\\u000a who have multiple complications.\\u000a \\u000a \\u000a OBJECTIVE: To determine whether a collaborative care intervention for depression would be as effective in patients with diabetes who\\u000a had

  5. Monosodium Glutamate Affects Mealtime Food Selection in Diabetic Patients

    Microsoft Academic Search

    F. BELLISLE; A. M. DALIX; A. S. CHAPPUIS; F. ROSSI; P. FIQUET; V. GAUDIN; M. ASSOUN; G. SLAMA

    1996-01-01

    Lunch intake was followed in 31 matched pairs of hospitalized diabetic patients over four consecutive days. Pairs of patients were matched for type and duration of diabetes, gender, age and body mass index. Lunches were composed of appetizer, meat, vegetables, starch, cheese, bread and dessert; water, coffee, tea and lemon were available. One patient per pair was randomly ascribed to

  6. Aspirin resistance in patients with type II diabetes mellitus

    PubMed Central

    Toptas, Tayfur; Demir, Cengiz; Esen, Ramazan; Atmaca, Murat

    2014-01-01

    Background Diabetic patients exhibit platelet hyperreactivity, which renders them resistant to antithrombotic treatments. We aimed to investigate the prevalence and predictors of aspirin resistance in diabetic patients. Material and methods A total of 93 diabetic and 37 non-diabetic participants were included into the study. Aspirin resistance was measured with a whole-blood desktop platelet function analyzer (PFA-100) with an epinephrine agonist. Results Altogether 41.9% patients with DM were aspirin non-responders. Aspirin resistance was observed in 43.2% of non-diabetic patients (p = 0.89). Presence of diabetes mellitus had no effect on aspirin response (RR 0.95 (95% CI 0.44–2.05), p = 0.89) in the whole study population. Hypercholesterolemia was the only predictor of aspirin resistance in multivariate analysis in diabetic patients (RR 3.09 (95% CI 1.17–8.16), p = 0.023). Conclusion The prevalence of aspirin resistance is comparable in diabetic and non-diabetic patients. Hypercholesterolemia is the only independent predictor of aspirin resistance in diabetic patients. PMID:24236750

  7. An interpretable rule-based diagnostic classification of diabetic nephropathy among type 2 diabetes patients

    PubMed Central

    2015-01-01

    Background The prevalence of type 2 diabetes is increasing at an alarming rate. Various complications are associated with type 2 diabetes, with diabetic nephropathy being the leading cause of renal failure among diabetics. Often, when patients are diagnosed with diabetic nephropathy, their renal functions have already been significantly damaged. Therefore, a risk prediction tool may be beneficial for the implementation of early treatment and prevention. Results In the present study, we developed a decision tree-based model integrating genetic and clinical features in a gender-specific classification for the identification of diabetic nephropathy among type 2 diabetic patients. Clinical and genotyping data were obtained from a previous genetic association study involving 345 type 2 diabetic patients (185 with diabetic nephropathy and 160 without diabetic nephropathy). Using a five-fold cross-validation approach, the performance of using clinical or genetic features alone in various classifiers (decision tree, random forest, Naïve Bayes, and support vector machine) was compared with that of utilizing a combination of attributes. The inclusion of genetic features and the implementation of an additional gender-based rule yielded better classification results. Conclusions The current model supports the notion that genes and gender are contributing factors of diabetic nephropathy. Further refinement of the proposed approach has the potential to facilitate the early identification of diabetic nephropathy and the development of more efficient treatment in a clinical setting. PMID:25707942

  8. What the radiologist needs to know about the diabetic patient

    Microsoft Academic Search

    Athanasios E. Raptis; Konstantinos P. Markakis; Maria C. Mazioti; Sotirios A. Raptis; George D. Dimitriadis

    2011-01-01

    Diabetes mellitus (DM) is recognised as a major health problem. Ninety-nine percent of diabetics suffer from type 2 DM and\\u000a 10% from type 1 and other types of DM. The number of diabetic patients worldwide is expected to reach 380 millions over the\\u000a next 15 years. The duration of diabetes is an important factor in the pathogenesis of complications, but other

  9. Prevalence of Diabetes Mellitus among Tuberculosis Patients in Urban Puducherry

    PubMed Central

    Raghuraman, Soundararajan; Vasudevan, Kavita P; Govindarajan, S; Chinnakali, Palanivel; Panigrahi, Krishna Chandra

    2014-01-01

    Background: Diabetes and Tuberculosis often present together and complicate each other at many levels. A collaborative framework for care and control of diabetes and tuberculosis developed by World Health Organisation and International Union against Tuberculosis and Lung Diseases emphasizes routine bi-directional screening for the two diseases. Aims: The study was to assess the prevalence of diabetes in tuberculosis patients currently on treatment. Materials and Methods: This facility-based cross-sectional study was undertaken in four randomly selected peripheral health institutions providing directly observed treatment short-course, treatment for tuberculosis patients. All cases of tuberculosis, more than 18 years of age were screened for diabetes. Risk factors like age, sex, family history of diabetes, alcohol, smoking and obesity were assessed. Results: The prevalence of diabetes in tuberculosis patients was found to be 29% (known diabetics - 20.7%, new Diabetes cases - 8.3%). Diabetes was significantly associated with older age, family history of diabetes, consumption of alcohol and sputum positivity. Conclusions: Screening patients with Tuberculosis for fasting blood sugar estimation will help in early detection of diabetes PMID:24678474

  10. Noise-Enhanced Vibrotactile Sensitivity in Older Adults, Patients With Stroke, and Patients With Diabetic Neuropathy

    E-print Network

    Collins, James J.

    With Diabetic Neuropathy Wen Liu, PhD, Lewis A. Lipsitz, MD, Manuel Montero-Odasso, MD, Jonathan Bean, MD, D, and patients with diabetic neuropathy. Arch Phys Med Rehabil 2002;83: 171-6. Objective: To test the hypothesis that vibrotactile detection thresholds in older adults, patients with stroke, and patients with diabetic neuropathy

  11. Diabetic retinopathy in type 1 diabetes—a contemporary analysis of 8,784 patients

    Microsoft Academic Search

    H. P. Hammes; W. Kerner; S. Hofer; O. Kordonouri; K. Raile; R. W. Holl

    2011-01-01

    Aims\\/hypothesis  The aim of this study was to analyse the risk profile for diabetic retinopathy under real-life conditions in a large cohort\\u000a of patients with type 1 diabetes.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Patients (n?=?18,891) with childhood, adolescent or adult onset of type 1 diabetes from the prospective German Diabetes Documentation\\u000a System survey were analysed. A total of 8,784 patients fulfilled the inclusion criterion, which was

  12. Japanese diagnostic criteria for mixed connective tissue disease in Caucasian patients.

    PubMed

    Doria, A; Ghirardello, A; de Zambiasi, P; Ruffatti, A; Gambari, P F

    1992-02-01

    Preliminary Japanese diagnostic criteria for the classification of mixed connective tissue disease (MCTD) were tested in a group of 32 Caucasian patients with this disease. Many clinical and laboratory similarities were found between Caucasian and Japanese patients. However, polyarthritis was more frequent in the Caucasians, while finger and hand swelling, DLCO reduction and muscle involvement were more frequent in the Japanese. In Caucasians the sensitivity of this criteria set was 87%, very similar to that found in the Japanese group (88%), and the specificity was 94%, higher than that of Japanese (87%). The difference resulted from the higher specificity of anti-nRNP antibody positivity in the Caucasian patients, probably due to the use of counterimmunoelectrophoresis in the detection of this antibody. The Japanese criteria seem more useful than others because they allow the use of techniques other than passive hemagglutination in detecting the anti-nRNP antibody. In our experience, such criteria also contribute to a better definition of MCTD in Caucasian patients. PMID:1629824

  13. Dental implant survival in diabetic patients; review and recommendations

    PubMed Central

    Dubey, Rajendra Kumar; Gupta, Deepesh Kumar; Singh, Amit Kumar

    2013-01-01

    Rising population of diabetic individuals across the world has become a big concern to the society. The persistent hyperglycemia may affect each and every tissue and consequently results in morbidity and eventually mortality in diabetic patients. A direct negative response of diabetes has been observed on oral tissues with few contradictions however, little are known about effect of diabetes on dental implant treatment and the consequent results. Many studies concerned with osteointegration and prognosis of dental implant in diabetic patients have been conducted and published since 1994. These studies have been critically reviewed to understand the impact of diabetes on the success of dental implant and the factors to improve osseointegration and consequently survival of dental implant in diabetic patients. Theoretical literatures and studies in diabetic animals substantiate high failure rate of implants but most of clinical studies indicated statistically insignificant failure of dental implants even in moderately uncontrolled diabetic patients. Success of dental implant in well and fairly controlled diabetic patients with proper treatment planning, prophylactic remedies and adequate postsurgical maintenance appears as good as normal individuals. PMID:24665167

  14. Cytokine Profile of Peripheral Blood in Type 2 Diabetes Mellitus Patients with Diabetic Retinopathy

    Microsoft Academic Search

    Jong-Han Lee; Woonhyung Lee; Oh Hun Kwon; Jeong-Ho Kim; Oh Woong Kwon; Kyung Hwan Kim; Jong-Baeck Lim

    2008-01-01

    To evaluate the usefulness of cytokine levels of peripheral blood in diabetic retinopathy (DR), demographic and biochemical parameters including low-density lipoprotein (LDL) diameter as well as cytokine profiles were analyzed in 74 patients with type 2 diabetes mellitus (DM), with DR (n = 46) or without DR (n = 28). DM duration was longer in the patients with DR than

  15. The lethargic diabetic: cerebral edema in pediatric patients in diabetic ketoacidosis.

    PubMed

    Gee, Samantha W

    2015-01-01

    Diabetic ketoacidosis (DKA) is the leading cause of hospitalizations for pediatric patients with diabetes mellitus. The most severe complication of DKA is cerebral edema that may lead to brain herniation. We present a case report that highlights the subclinical presentation of DKA-related cerebral edema in a pediatric patient and review the acute care management of suspected cerebral edema during transport. PMID:25733118

  16. Cardiovascular comorbidities among public health clinic patients with diabetes: the Urban Diabetics Study

    Microsoft Academic Search

    Jessica M Robbins; David A Webb; Christopher N Sciamanna

    2005-01-01

    BACKGROUND: We sought to determine the frequency and distribution of cardiovascular comorbidities in a large cohort of low-income patients with diabetes who had received primary care for diabetes at municipal health clinics. METHODS: Outpatient data from the Philadelphia Health Care Centers was linked with hospital discharge data from all Pennsylvania hospitals and death certificates. RESULTS: Among 10,095 primary care patients

  17. Japanese version of the Dermatology Life Quality Index: validity and reliability in patients with acne

    Microsoft Academic Search

    Natsuko Takahashi; Yoshimi Suzukamo; Motonobu Nakamura; Yoshiki Miyachi; Joseph Green; Yukihiro Ohya; Andrew Y Finlay; Shunichi Fukuhara

    2006-01-01

    BACKGROUND: Patient-reported quality of life is strongly affected by some dermatologic conditions. We developed a Japanese version of the Dermatology Life Quality Index (DLQI-J) and used psychometric methods to examine its validity and reliability. METHODS: The Japanese version of the DLQI was created from the original (English) version, using a standard method. The DLQI-J was then completed by 197 people,

  18. Proliferative diabetic retinopathy in long-term diabetic patients with and without clinical osteoarthritis

    PubMed Central

    Skolik, S A; Caspers, L E

    2013-01-01

    Objective To determine whether some long-term diabetic patients with coexisting clinical osteoarthritis (OA) are less likely to develop diabetic retinopathy (DR) than other diabetic patients and whether there is a relation between the timing of the clinical OA onset and DR. Design, setting, and participants Retrospective case–control study of 85 osteoarthritic patients with 20 years or more diabetes (A/DM) control group and of 85 non-osteoarthritic diabetic patients (NoA/DM) matched for age, race, duration, and type of diabetes. Digital fundus photographs were graded for retinopathy in masked manner. Results Glycosylated hemoglobin, hypertension, and smoking showed no significant difference. Twelve out of 85 patients (12.9%) in A/DM group developed proliferative diabetic retinopathy (PDR) whereas 79/85 (92.9%) NoA/DM patients developed PDR (P<0.001). The onset of OA symptoms was known in 80/85 of the A/D patients, including 47 patients with onset before or at the same year as DM and 33 patients with relative onset after the year of DM. All the 10 patients with PDR (10/33) developed OA subsequent to their initiation for diabetic treatment while 0/47 A/DM patients with the onset of osteoarthritic symptoms present before or the same year as their onset of diabetes developed PDR (P<0.001). Conclusion Our study suggests that in long-term DM, PDR was significantly associated with the absence of concomitant clinical OA. This observation was highly significant if the onset of the arthritis was the same year or before the onset of the diabetes. PMID:23154491

  19. APPROACH TO ARTERIAL HYPERTENSION IN PATIENTS WITH DIABETES MELLITUS

    Microsoft Academic Search

    Lea Duvnjak; Krishna Mohan Sepuri

    2004-01-01

    SUMMARY In diabetic patients, the presence of hypertension implies an increased risk of cardiovascular disease. Approximately two- thirds of such patients die from cardiovascular complications. Over the last decade extensive randomized trials showing a clinically significant benefit in outcomes with lowering of blood pressure levels have led to a revision of the definition of hypertension in diabetic population. According to

  20. Regular physical exercise in patients with type II diabetes mellitus

    Microsoft Academic Search

    C. Nakhanakhup; P. Moungmee; H. J. Appell; J. A. Duarte

    2006-01-01

    It is widely accepted that regular physical exercise helps diabetic patients control blood glucose, reduce cardiovascular risk factors, and prevent other related complications. In spite of the undoubted benefits of regular physical exercise, diabetic patients with chronic complications should be aware of potential hazards of practicing exercise. To avoid some harmful consequences of acute exercise, it is necessary to adopt

  1. NUTRITION THERAPY FOR THE HOSPITALIZED PATIENT WITH DIABETES

    Microsoft Academic Search

    Carrie S. Swift; Jackie L. Boucher

    2006-01-01

    Objective: To summarize recommendations for medi- cal nutrition therapy (MNT), including how to implement it to achieve glycemic control targets for hospitalized patients with diabetes. ? Methods:? The MNT goals for hospitalized patients with diabetics are reviewed, and suggestions are made for attaining these goals. Emphasis is placed on the importance of proper screening and referral of inpatients to MNT

  2. Helicobacter pylori infection in patients with diabetes mellitus.

    PubMed

    Stanciu, Oana Gabriela; Trifan, Anca; Sfarti, C; Cojocariu, Camelia; Stanciu, C

    2003-01-01

    Data concerning the prevalence of Helicobacter pylori (H. pylori) in diabetic patients are scanty and controversial. The aim of this study was to evaluate the prevalence of H. pylori infection in patients with diabetes mellitus (DM), and to assess whether the presence of bacterium was associated with severity of dyspeptic symptoms and endoscopic findings in such patients. The study involved 42 patients (19 men, 23 women; mean age 55 years, range 34-75 years) with DM and dyspeptic symptoms. Sixteen patients (38%) were classified as having type 1 diabetes and 26 (62%) patients as having type 2 diabetes. All patients had chronic dyspepsia, and each patient has completed a self-report questionnaire to obtain information concerning the presence and severity of upper gastrointestinal tract symptoms. H. pylori status was confirmed by 13C-urea breath test (13C-UBT), and diabetic patients underwent upper gastrointestinal endoscopy. Twenty-six (61.9%) of patients with DM were positive for 13C-UBT. There were no statistically significant differences in the infection rate between patients with type 1 and type 2 diabetes, and the prevalence of H. pylori infection was not associated with the known duration of diabetes. There was no significant difference in the symptoms score between H. pylori-positive and H. pylori-negative diabetic patients, and endoscopic findings in patients with DM were in the same range with those found in dyspeptic subjects from the same region. In conclusion, H. pylori infection is not associated with DM, duration of diabetes, or severity of dyspeptic symptoms in patients with DM. PMID:14755971

  3. Diabetic Foot Syndrome as a Possible Cardiovascular Marker in Diabetic Patients

    PubMed Central

    Tuttolomondo, Antonino; Maida, Carlo; Pinto, Antonio

    2015-01-01

    Diabetic foot ulcerations have been extensively reported as vascular complications of diabetes mellitus associated with a high degree of morbidity and mortality; in fact, some authors showed a higher prevalence of major, previous and new-onset, cardiovascular, and cerebrovascular events in diabetic patients with foot ulcers than in those without these complications. This is consistent with the fact that in diabetes there is a complex interplay of several variables with inflammatory metabolic disorders and their effect on the cardiovascular system that could explain previous reports of high morbidity and mortality rates in diabetic patients with amputations. Involvement of inflammatory markers such as IL-6 plasma levels and resistin in diabetic subjects confirmed the pathogenetic issue of the “adipovascular” axis that may contribute to cardiovascular risk in patients with type 2 diabetes. In patients with diabetic foot, this “adipovascular axis” expression in lower plasma levels of adiponectin and higher plasma levels of IL-6 could be linked to foot ulcers pathogenesis by microvascular and inflammatory mechanisms. The purpose of this review is to focus on the immune inflammatory features of DFS and its possible role as a marker of cardiovascular risk in diabetes patients.

  4. A Single Nucleotide Polymorphism within the Acetyl-Coenzyme A Carboxylase Beta Gene Is Associated with Proteinuria in Patients with Type 2 Diabetes

    PubMed Central

    Maeda, Shiro; Kobayashi, Masa-aki; Araki, Shin-ichi; Babazono, Tetsuya; Freedman, Barry I.; Bostrom, Meredith A.; Cooke, Jessica N.; Toyoda, Masao; Umezono, Tomoya; Tarnow, Lise; Hansen, Torben; Gaede, Peter; Jorsal, Anders; Ng, Daniel P. K.; Ikeda, Minoru; Yanagimoto, Toru; Tsunoda, Tatsuhiko; Unoki, Hiroyuki; Kawai, Koichi; Imanishi, Masahito; Suzuki, Daisuke; Shin, Hyoung Doo; Park, Kyong Soo; Kashiwagi, Atsunori; Iwamoto, Yasuhiko; Kaku, Kohei; Kawamori, Ryuzo; Parving, Hans-Henrik; Bowden, Donald W.; Pedersen, Oluf; Nakamura, Yusuke

    2010-01-01

    It has been suggested that genetic susceptibility plays an important role in the pathogenesis of diabetic nephropathy. A large-scale genotyping analysis of gene-based single nucleotide polymorphisms (SNPs) in Japanese patients with type 2 diabetes identified the gene encoding acetyl-coenzyme A carboxylase beta (ACACB) as a candidate for a susceptibility to diabetic nephropathy; the landmark SNP was found in the intron 18 of ACACB (rs2268388: intron 18 +4139 C > T, p?=?1.4×10?6, odds ratio?=?1.61, 95% confidence interval [CI]: 1.33–1.96). The association of this SNP with diabetic nephropathy was examined in 9 independent studies (4 from Japan including the original study, one Singaporean, one Korean, and two European) with type 2 diabetes. One case-control study involving European patients with type 1 diabetes was included. The frequency of the T allele for SNP rs2268388 was consistently higher among patients with type 2 diabetes and proteinuria. A meta-analysis revealed that rs2268388 was significantly associated with proteinuria in Japanese patients with type 2 diabetes (p?=?5.35×10?8, odds ratio?=?1.61, 95% Cl: 1.35–1.91). Rs2268388 was also associated with type 2 diabetes–associated end-stage renal disease (ESRD) in European Americans (p?=?6×10?4, odds ratio?=?1.61, 95% Cl: 1.22–2.13). Significant association was not detected between this SNP and nephropathy in those with type 1 diabetes. A subsequent in vitro functional analysis revealed that a 29-bp DNA fragment, including rs2268388, had significant enhancer activity in cultured human renal proximal tubular epithelial cells. Fragments corresponding to the disease susceptibility allele (T) had higher enhancer activity than those of the major allele. These results suggest that ACACB is a strong candidate for conferring susceptibility for proteinuria in patients with type 2 diabetes. PMID:20168990

  5. Characterization of lipid parameters in diabetic and non-diabetic atherosclerotic patients

    PubMed Central

    Ali, Fatima; Jamil, Hassan; Anwar, Sanam Saiqa; Wajid, Nadia

    2015-01-01

    Background & Objective The relationship between lipid profile perturbation and diabetes associated complications has long been an area of interest. Dyslipidemia is a potent predictor of cardiovascular morbidity and mortality in diabetic patients. The aim of present study was to investigate relationship between aging and lipid profiles in diabetic and non-diabetic atherosclerotic patients. Methods Five hundred and seventy six individuals (45–75 year age) participated in this study. Among these, 192 were having history of diabetes mellitus and atherosclerosis. Individuals are categorized on the base of health (normal, non-diabetic atherosclerosis, diabetic atherosclerosis) and age (45–55 years, 56–65 years, and 66–75 years). All the participants were subjected to the procedures like a detailed history, biochemical analysis for fasting blood sugar, hemoglobin A1c, total cholesterol (TC), triglycerides (TG), low-density lipoprotein-(LDL), very low-density lipoprotein (VLDL) and high-density lipoprotein (HDL). All these parameters were compared between diabetic and non-diabetic atherosclerotic patients of all three age groups. TC/HDL and LDL/HDL were also calculated. Results Diabetic atherosclerotic individuals (both males and females) had high level of TC, TG, LDL, VLDL and low level of HDL in comparison to non-diabetic atherosclerotic and normal control individuals. Among all three age groups, lipoprotein abnormality was observed to be more frequent in females than males. There was a significant increase in TC/HDL and LDL/HDL ratio in diabetic atherosclerotic subjects compared to age and sex matched non-diabetic atherosclerotic and normal control. Conclusions Degree of dyslipidemia increases with increase in age in both genders. Female are more prone to diabetic dyslipidemia and hence have more risk of developing atherosclerosis with increasing age. PMID:25678903

  6. Comparitive Angiographic Profile in Diabetic and Non-Diabetic Patients with Acute Coronary Syndrome

    PubMed Central

    Mallesh, P.; Yeli, S.M.; Gadad, Veeranna M.; M., Giri Punja

    2014-01-01

    Background: Cardiac adversity is by far the commonest cause of mortality in patients with diabetes. Cardiac involvement in diabetes commonly manifest as coronary artery disease (CAD). Definitive diagnosis,precise assessment and anatomic severity of CAD requires invasive diagnostic modality like coronary angiography. Aims and Objectives: To study angiographic extents, type of vessels, number of vessels, severity involving coronary artery and its branches in patients with acute coronary syndrome(ACS).Compare the same in diabetics and non diabetics with ACS. Materials and Methods: Hundred patients with ACS,50 diabetics and 50 nondiabetics admitted in Bapuji Hospital ICCU attached to J.J.M. Medical College were selected randomly during a period of approximately one and half years formed the study group. RBS, FBS was done in all 100 pateints, HbA1c in all diabetics. All subjects with ACS were taken up for coronary angiography. Statistical Analysis: Chi-square test was used to determine any significant difference between two groups. p-value of less than 0.05 was considered significant. Results: In our study 22 (44%) out of 50 diabetic patients had triple or multi-vessel disease compared to 8 (16%) out of 50 non diabetics. Hundred patients with ACS, number of vessels involved were 199, of which 61.3% in diabetics and 38.6% in non diabetics, 23(46%) of 50 diabetic patients required CABG as treatment outcome. HbA1c levels of >8.5%, 69.2% had triple / multi vessel disease and 19 (73.1%) of 23 patients who had to undergo CABG had HbA1c levels >8.5%, 24% of diabetics were in third decade, 40% were in fourth decade as compared to 10% and 26% of non-diabetics of similar age group. Interpretation and Conclusion: This study showed that ACS in diabetic patients presented much earlier in life, the severity and extent of CAD and incidence of triple/multi vessel disease was significantly high in diabetics when compared to nondiabetics with ACS. Diabetics with high HbA1c had more number of coronary vessel involvement and the mode of treatment required in them was CABG. PMID:25386473

  7. [Screening and management of coronary artery disease in diabetic patients].

    PubMed

    Kraiem, Sondos; Abassi, Chedly; Annabi, Nizar; Smaali, Ibtissem; Issaa, Inès; Wali, Mouin; Malou, Monia; Hannachi, Sofiane; Longo, Selma; Battikh, Kaies; Slimane, Mohamed Lotfi

    2006-10-01

    Diabetes represents as independent risk factor for coronary artery disease (CAD) and the prognosis in term of survival rates is worse for diabetic patients who have CAD with report to those with CAD but no diabetes. The coronary artery disease in diabetes has specificities and, in particular, more extensive atherosclerosis. Diabetic patients are also more frequently asymptomatic. Due to the extreme complexity of ischemic vascular disease in patients with diabetes, an optimal therapeutic strategy is based on the correction of elevated blood glucose and lipid levels, of blood pressure, of platelet and coagulation abnormalities. Diabetic patients benefit from secondary prevention by drug therapy(aspirin, lipid lowering with statines, beta blocker and ACE inhibitors) to the same extent as, or more than, non-diabetic patients. Both percutaneous and surgical myocardial revascularization have been proved equally effective for CAD treatment in diabetes. A recent randomized trial has shown a significantly improved outcome after surgical revascularization. But, the effects of drug-eluting stents, which dramatically decrease the incidence of re-stenosis, seem promising. PMID:17193866

  8. Effect of hope therapy on the hope of diabetic patients

    PubMed Central

    Ghazavi, Zahra; Khaledi-Sardashti, Firouz; Kajbaf, Mohamad Bagher; Esmaielzadeh, Mojtaba

    2015-01-01

    Background: Hope is the most important factor in diabetic patients’ life. The level of hope may be changing among these individuals as a result of chronic nature of diabetes and its complications. When the level of hope increases among these patients, they can resist against physical and psychological complications of diabetes more, accept the treatment better, enjoy life more, and adapt with their situations more efficiently. This study aimed to define the efficacy of hope therapy on hope among diabetic patients. Materials and Methods: This was a quasi-experimental study conducted on 38 diabetic patients referring to Sedigheh Tahereh Research and Treatment Center affiliated to Isfahan University of Medical Sciences in Iran in 2012. The subjects were selected based on the goals and inclusion criteria of the study and then were randomly assigned to study and control groups. Herth Hope Index (HHI) was completed by both groups before, after, and 1 month after intervention. In the study group, 120-min sessions of hope therapy were held twice a week for 4 weeks. Descriptive and inferential statistical tests were adopted to analyze the data through SPSS version 12. Results: Comparison of the results showed that hope therapy significantly increased hope in diabetic patients after intervention in the study group compared to control (P < 0.001). Conclusions: The results showed that hope therapy increased hope among diabetic patients. This method is suggested to be conducted for diabetic patients. PMID:25709694

  9. Ambulatory blood pressure in microalbuminuric type 1 diabetic patients

    Microsoft Academic Search

    Klavs W Hansen; Cramer K Christensen; Per H Andersen; Margrethe Mau Pedersen; Jens S Christiansen; Carl Erik Mogensen

    1992-01-01

    Ambulatory blood pressure in microalbuminuric type 1 diabetic patients. Twenty-four-hour ambulatory blood pressure (AMBP) was performed in microalbuminuric (micro.) type 1 diabetic patients, with the aim of comparison with a matched group of normoalbuminuric patients (normo.) and healthy controls. Thirty-four patients without antihypertensive medication were investigated in each group. Urinary albumin excretion (UAE) for micro, was (geometric mean, tolerance factor

  10. Retinal Blood Vessel Test in Young-Onset Diabetic Patients

    Microsoft Academic Search

    Guido Kluxen; Elke Wilden

    1987-01-01

    136 patients with insulin-dependent diabetes mellitus (IDDM) were shown the entoptic blood vessel figure. All patients were examined independently by retinal fluorescein angiography and ophthalmoscopy. 34 patients had no retinopathy, none of them believed to see alterations. 102 patients had different phases of diabetic retinopathy. If there were 1–5 microaneurysms within the 15° meridian surrounding the central fovea, 55% of

  11. Sequence variations of the pancreatic islet/liver glucose transporter (GLUT2) gene in Japanese subjects with noninsulin dependent diabetes mellitus

    SciTech Connect

    Matsubara, Atsushi; Tanizawa, Yukio; Matsutani, Akira [Yamaguchi Univ. School of Medicine (Japan)] [and others] [Yamaguchi Univ. School of Medicine (Japan); and others

    1995-10-01

    To assess the genetic susceptibility to noninsulin-dependent diabetes mellitus (NIDDM) in Japanese subjects, we investigated the role of GLUT2 gene defects in patients with NIDDM. When the allelic frequency of a simple tandem repeat polymorphism in the GLUT2 gene was compared, the allele with 155 base pairs was more common in NIDDM patients (n = 99) than in controls (n = 89; 5.1% v. 0.6%; P = 0.0118, by Fisher`s exact test), whereas this was not significant after the correction for multiple comparisons. To directly identify mutations, we then analyzed each of 11 exons by the polymerase chain reaction-single strand conformation polymorphism analysis in 60 NIDDM patients. We found 2 missense mutations in exon 3: CCC{r_arrow}CTC (Pro{sup 68}{r_arrow}Leu) in 1 patient and ACT{r_arrow}ATT (Thr{sup 110}{r_arrow}Ile) in 3 patients, all in the heterozygous state. These mutations were found in 60 control subjects. To evaluate the significance of the Pro{sup 68}{r_arrow}Leu mutation, the family members of the proband were studied. The mutation did not appear to be associated with the disease or other clinical parameters including change in immunoreactive insulin/change in plasma glucose or oral glucose load. The other mutation (Thr{sup 110}{r_arrow}Ile) is known to be functionally insignificant. We identified 4 additional nucleotide changes, all of which appeared to be silent. We concluded that the mutations in the GLUT2 gene were not major determinants of genetic susceptibility to NIDDM in Japanese. 34 refs., 2 figs., 3 tabs.

  12. Frequency of odontogenic periradicular lesions in diabetic patients

    PubMed Central

    Mesgarani, Abbas; Haghanifar, Sina; Eshkevari, Narges; Ehsani, Maryam; Khafri, Soraya; Nafarzade, Shima; Damankesh, Zahra

    2014-01-01

    Background: Diabetic patients are more prone to oral infections and periradicular lesions due to changes in their immune system and qualitative and quantitative changes in normal flora of their mouth. The aim of this study was to evaluate the frequency of periradicular lesions in diabetic patients in Babol, North of Iran. Methods: From October 2011 to March 2012, 135 diabetic patients who referred to the Iranian Diabetes Society - Babol Branch and Endocrinology Clinic of Babol University of Medical Sciences were studied. The demographic features as well as the duration of the diagnosis of diabetes (> 48 months was called long term and < 48 months short term) is the quality of control of their diabetes. For all the patients, panoramic and periapical radiography were performed for the presence of any radicular radiolucent lesions. Vitality test has been done for the recorded teeth except for the root treated ones and periodontal involvement necrotic teeth. The data were collected and analyzed. Results: Periradicular lesions were seen on 90.37% of the patients. The frequency of periradicular lesions in long term patients was 85 (94.4%) and in short term was 37 (82.2%) (p=0.023). The mean of teeth with periradicular lesions in long and short term diabetic patients was 2.63±2.23 and 2.11±1.79, respectively (p=0.174). Conclusion: The results show that the frequency of periradicular lesions in diabetic patients is higher in long-term diabetic patients than the short-term diabetic patients. PMID:24490009

  13. Ocular Disease, Knowledge, and Technology Applications in Patients with Diabetes

    PubMed Central

    Threatt, Jennifer; Williamson, Jennifer Faye; Huynh, Kyle; Davis, Richard M.

    2013-01-01

    An estimated 25.8 million children and adults in the United States, approximately 8.3% of the population, have diabetes. Diabetes prevalence varies by race and ethnicity. African Americans have the highest prevalence (12.6%), followed closely by Hispanics (11.8%), Asian Americans (8.4%), and Whites (7.1%). The purpose of this article is to discuss the ocular complications of diabetes, the cultural and racial differences in diabetes knowledge, and the role of telemedicine as a means to reach the undeserved who are at risk of complications. Information on the pathophysiology of ocular disease in patients with diabetes and the role of telemedicine in diabetes care was derived from a literature review. National Institutes of Health (NIH) on-line resources were queried to present data on the racial and cultural understandings of diabetes and diabetes-related complications. The microvascular ocular complications of diabetes are discussed for retinopathy, cataracts, glaucoma and ocular surface disease. Racial and cultural differences in knowledge of recommended self-care practices are presented. These differences in part, may explain health disparities and the increased risk of diabetes and its complications in rural minority communities. Finally, advances in telemedicine technology are discussed that show improvements in metabolic control and cardiovascular risk in adults with type 2 diabetes. Improving provider and patient understanding of diabetes complications may improve management and self care practices that are important for diabetes control. Telemedicine may improve access to diabetes specialists and may improve self-management education and diabetes control particularly in rural and underserved communities. PMID:23531956

  14. Effects of Candesartan on Cardiovascular Outcomes in Japanese Hypertensive Patients

    Microsoft Academic Search

    Hiromichi Suzuki; Yoshihiko Kanno

    2005-01-01

    In recent years, angiotensin receptor blockers (ARBs) have begun to represent a markedly larger percentage of the antihypertensive agents used in Japan. However, it remains uncertain whether ARBs are effective for protecting against hypertension-related organ damage in the general Japanese population. In the present report, we describe the results of a single blind, randomized, prospective study conducted in 1999–2002 and

  15. Identifying knowledge deficits of food insecure patients with diabetes

    PubMed Central

    Ejebe, Ifna H.

    2015-01-01

    The purpose of this project was to identify the self-care needs of adults with diabetes who experience food insecurity. A cross-sectional study design and methodology were used to attain the study data. We invited 153 adults with diabetes who utilized the St Vincent de Paul Food Pantry to complete the diabetes knowledge test. The reliability of the sample was calculated using Cronbach's coefficient ?. To determine validity, differences in test scores were examined by diabetes type and treatment, educational attainment, and receipt of diabetes education. Results The coefficient ? for the general test and the insulin-use subscale indicated that both were moderately reliable, ? > 0.60. General test scores were significantly associated with educational attainment (p<0.01) and prior diabetes education (p<0.05). We found that participants who attained education beyond high school or previously received diabetes education scored significantly higher on the test compared to those with less than high school education or not receiving diabetes education (p<0.05). Adults with type 1 diabetes had higher general and insulin use scores compared to adults with type 2 diabetes, however the difference was not statistically significant. While general knowledge about diabetes is not a predictor of self-care behavior, it is needed to perform daily self-care activities. Health care providers should assess diabetes knowledge in low income patients who experience food insecurity regularly to identify any gaps in knowledge that can compromise self-care behaviors. PMID:25418712

  16. Noise-Enhanced Balance Control in Patients with Diabetes and Patients with Stroke

    E-print Network

    Collins, James J.

    ,8 and James J. Collins, PhD1 Objective: Somatosensory function declines with diabetic neuropathy and often-standing balance control in 15 patients with diabetic neuropathy and 15 patients with stroke. Sway data of 12 reduction in each of the eight sway parameters in the subjects with diabetic neuropathy, the subjects

  17. Seborrheic Area Erythema as a Common Skin Manifestation in Japanese Patients with Dermatomyositis

    Microsoft Academic Search

    N. Okiyama; H. Kohsaka; N. Ueda; T. Satoh; I. Katayama; K. Nishioka; H. Yokozeki

    2008-01-01

    Background: Although dermatomyositis (DM)-associated facial erythema was noted in the nasolabial folds of Japanese patients, DM-associated facial erythema other than heliotrope rash has drawn little attention in previous studies. Objectives: To characterize phenotypical features and frequencies of erythema, especially those in the seborrheic area of the head, in DM patients. Methods: A retrospective study on skin manifestations in 33 DM

  18. Treatment of hyperphosphatemia with bixalomer in Japanese patients on long-term hemodialysis with gastrointestinal symptoms.

    PubMed

    Ito, Kae; Takeshima, Akiko; Shishido, Kanji; Wakasa, Mikio; Kumata, Chiaki; Matsuzaka, Kantaro; Nakajima, Yutaka; Ogata, Hiroaki

    2014-06-01

    Bixalomer (Bix) is an amine-functional polymer, non-calcium-containing phosphate (P) binder, and has been clinically available in Japan recently. Bix is expected to cause fewer gastrointestinal (GI) side-effects as compared with sevelamer hydrochloride (SH), because of less expansion of Bix in the GI tract. In this prospective observational study, we evaluated changes in GI symptoms by the Gastrointestinal Symptom Rating Scale (GSRS) score in long-term hemodialysis (HD) outpatients with SH-associated GI symptoms who switched to Bix from SH. A total of 114 patients (age 63.7±10.8 year (mean±SD), female 65.5%, HD vintage 11.2±8.6 years, diabetes mellitus 27.4%) were enrolled. The GSRS score was checked at 0 and 12 weeks after the start of Bix. Bix was started at the initial dose of 750?mg/day, and then was titrated. Serum albumin, P and corrected calcium levels did not significantly change during Bix treatment. However, serum low-density lipoprotein-cholesterol and bicarbonate levels significantly increased during Bix treatment (P<0.001). In GSRS scores, total and domain-specific scores, including constipation, diarrhea, reflux and abdominal pain were significantly reduced at 0, 4, 12 and 24 weeks as compared with those at 0 weeks (P<0.05). This study shows that Bix was well tolerated and managed hyperphosphatemia effectively after switching from SH in Japanese patients on long-term HD. In addition, Bix might be less often associated with GI symptoms as compared with SH. PMID:24975891

  19. Skin and nail mycoses in patients with diabetic foot.

    PubMed

    Papini, M; Cicoletti, M; Fabrizi, V; Landucci, P

    2013-12-01

    Diabetes mellitus affects all socioeconomic and age groups and its incidence is rapidly increasing worldwide. The diabetic foot complication represents one of the most complex and serious complications in these patients. Fungal infections can also contribute to the severity of the diabetic foot. The aim of the present study was to evaluate the prevalence of foot skin and toenail mycosis in a group of 75 patients with diabetic foot complication and in a matched control group. Diabetic patients showed onychomycosis in 53.3% and foot skin mycosis in 46.7% of the cases, with a prevalence of both fungal infections significantly higher than that observed in the control group. At least one type of these fungal infections was present in 69.3% of diabetic subjects with a highly significant difference compared to control group (P<0.001). Trichophyton rubrum and Trichophyton interdigitale were the most common species responsible of both nail and skin infections. Candida spp, Fusarium spp, Aspergillus spp and other moulds. were found in about 1/3 onychomycosis. Previous toe amputation was significantly associated with both skin and nail mycosis. The present study confirms that both tinea pedis and onychomycosis have a high prevalence in subjects suffering from diabetic foot complication, and that the problem of fungal infections of the foot in diabetic subjects is still highly underestimated. Consequently, there is an important clinical rationale for careful mycological examination of diabetic foot and an adequate treatment tailored for each individual patient according to the fungal species involved. PMID:24442040

  20. JAMA Patient Page: Weight and Diabetes

    MedlinePLUS

    ... blood sugar levels. The bodies of individuals with type 1 diabetes , which usually starts by the early teen years, ... the May 15, 2002, issue; and one on type 1 diabetes was published in the October 22/29, 2003, ...

  1. Simple self-reported behavioral or psychological characteristics as risk factors for future type 2 diabetes in Japanese individuals: Toranomon Hospital Health Management Center Study 14

    PubMed Central

    Heianza, Yoriko; Arase, Yasuji; Kodama, Satoru; Tsuji, Hiroshi; Fujihara, Kazuya; Saito, Kazumi; Hara, Shigeko; Sone, Hirohito

    2015-01-01

    Aims/Introduction Depression, anger, sleep disorders and cognitive impairment are regarded as presenting a high risk for diabetes. We investigated whether responses to single statements on a self-report questionnaire on the presence of each of these four factors were associated with the development of type 2 diabetes. Materials and Methods We investigated 3,211 Japanese individuals without diabetes. Cumulative incidence rate and hazard ratios (HRs) for future type 2 diabetes over 7–13 years were evaluated according to the presence of lack of perseverance, anger, memory loss or sleep disorders. Results Results of Cox regression analysis showed that lack of perseverance (age- and sex-adjusted HR 1.41, 95% confidence interval 1.07–1.84), anger, (HR 1.51, 95% confidence interval 1.07–2.12) or memory loss (HR 1.47, 95% confidence interval 1.14–1.90) was predictive of the development of diabetes. Even after adjustment for metabolic factors including glycemic measurements, anger was significantly associated with an increased risk of future diabetes. Individuals with both anger and memory loss had a 1.94-fold (95% confidence interval 1.19–3.15) increased risk of type 2 diabetes than those without those two symptoms. Conclusions Responses to a simple self-report questionnaire as to whether individuals were aware of anger or memory loss were associated with the development of type 2 diabetes independent of traditional risk factors for diabetes in this cohort of Japanese individuals.

  2. Nutritional Intervention for a Patient with Diabetic Nephropathy

    PubMed Central

    2014-01-01

    In recent years, several studies have reported that the prevalence of diabetes mellitus is increasing every year, and also the acute and chronic complications accompanying this disease are increasing. Diabetic nephropathy is one of chronic complications of diabetes mellitus, and food intake which is burden to kidney function should be limited. At the same time, diet restriction could deteriorate quality of life of patient with diabetic nephropathy. According to the results of previous studies, the aggressive management is important for delaying of the progression to diabetic nephropathy. Also, the implementation of a personalized diet customized to individuals is an effective tool for preservation of kidney function. This is a case report of a patient with diabetic nephropathy who was introduced to a proper diet through nutrition education to prevent malnutrition, uremia and to maintain blood glucose levels. PMID:24527422

  3. Nrf2 and Redox Status in Prediabetic and Diabetic Patients

    PubMed Central

    Jiménez-Osorio, Angélica S.; Picazo, Alejandra; González-Reyes, Susana; Barrera-Oviedo, Diana; Rodríguez-Arellano, Martha E.; Pedraza-Chaverri, José

    2014-01-01

    The redox status associated with nuclear factor erythroid 2-related factor-2 (Nrf2) was evaluated in prediabetic and diabetic subjects. Total antioxidant status (TAS) in plasma and erythrocytes, glutathione (GSH) and malondialdehyde (MDA) content and activity of antioxidant enzymes were measured as redox status markers in 259 controls, 111 prediabetics and 186 diabetic type 2 subjects. Nrf2 was measured in nuclear extract fractions from peripheral blood mononuclear cells (PBMC). Nrf2 levels were lower in prediabetic and diabetic patients. TAS, GSH and activity of glutamate cysteine ligase were lower in diabetic subjects. An increase of MDA and superoxide dismutase activity was found in diabetic subjects. These results suggest that low levels of Nrf2 are involved in the development of oxidative stress and redox status disbalance in diabetic patients. PMID:25383674

  4. Nrf2 and redox status in prediabetic and diabetic patients.

    PubMed

    Jiménez-Osorio, Angélica S; Picazo, Alejandra; González-Reyes, Susana; Barrera-Oviedo, Diana; Rodríguez-Arellano, Martha E; Pedraza-Chaverri, José

    2014-01-01

    The redox status associated with nuclear factor erythroid 2-related factor-2 (Nrf2) was evaluated in prediabetic and diabetic subjects. Total antioxidant status (TAS) in plasma and erythrocytes, glutathione (GSH) and malondialdehyde (MDA) content and activity of antioxidant enzymes were measured as redox status markers in 259 controls, 111 prediabetics and 186 diabetic type 2 subjects. Nrf2 was measured in nuclear extract fractions from peripheral blood mononuclear cells (PBMC). Nrf2 levels were lower in prediabetic and diabetic patients. TAS, GSH and activity of glutamate cysteine ligase were lower in diabetic subjects. An increase of MDA and superoxide dismutase activity was found in diabetic subjects. These results suggest that low levels of Nrf2 are involved in the development of oxidative stress and redox status disbalance in diabetic patients. PMID:25383674

  5. Impact of metabolic disturbances and malnutrition-inflammation on 6-year mortality in Japanese patients undergoing hemodialysis.

    PubMed

    Nakagawa, Naoki; Matsuki, Motoki; Yao, Naoyuki; Hirayama, Tomoya; Ishida, Hironori; Kikuchi, Kenjiro; Hasebe, Naoyuki

    2015-02-01

    Metabolic syndrome confers an increased risk of cardiovascular disease (CVD) in the general population. The relationship between adiponectins, and clinical outcomes in patients undergoing hemodialysis remains controversial. We investigated whether adiponectins, biomarkers of inflammation, nutrition status and clinical features predict the mortality of patients undergoing hemodialysis for 6 years. We measured baseline plasma total and high-molecular-weight (HMW) adiponectins, tumor necrosis factor (TNF)-?, serum high sensitivity C-reactive protein (hsCRP), and clinical characteristics including visceral fat area (VFA) and the Geriatric Nutritional Risk Index (GNRI) in 133 patients undergoing chronic hemodialysis. Forty-one of the 133 patients died during follow-up. The deceased patients were significantly older, had more prior CVD and diabetes, higher TNF-? and hsCRP levels but lower GNRI. VFA, and total and HMW adiponectin did not significantly differ between the two groups. TNF-? and hsCRP levels and GNRI score were significant for predicting all-cause and cardiovascular mortality in receiver operating curve analyses. When stratified by a GNRI score of 96, Cox proportional hazards analyses identified TNF-? as a significant predictor of all-cause mortality (hazard ratio [HR] 1.23; P?=?0.038) and hsCRP as a significant predictor of all-cause and cardiovascular mortality (HR, 2.32, P?=?0.003; HR 2.30, P?=?0.012, respectively) after adjusting for age, sex, diabetes mellitus, and prior CVD, only in malnourished patients. These results demonstrate that malnutrition and the inflammatory markers TNF-? and hsCRP, but not metabolic markers, including VFA and adiponectins have a significant impact on 6-year all-cause and cardiovascular mortality in Japanese patients undergoing hemodialysis. PMID:25196142

  6. Assessment of Diabetic Polyneuropathy and Plantar Pressure in Patients with Diabetes Mellitus in Prevention of Diabetic Foot

    PubMed Central

    Skopljak, Amira; Sukalo, Aziz; Batic-Mujanovic, Olivera; Muftic, Mirsad; Tiric-Campara, Merita; Zunic, Lejla

    2014-01-01

    Introduction: Risk assessment for development foot ulcer in diabetics is a key aspect in any plan and program for prevention of non-traumatic amputation of lower extremities. Material and methods: In the prospective research to assessed diabetic neuropathy in diabetic patients, to determined the dynamic function of the foot (plantar pressure), by using pedobarography (Group I), and after the use of orthopedic insoles with help of pedobarography, to determined the connection between the risk factors: deformity of the foot, limited joint movements, diabetic polyneuropathy, plantar pressure in effort preventing changes in the diabetic foot. Results: Out of 1806 patients, who are registered in one Team of family medicine examined 100 patients with diabetes mellitus Type 2. The average age of subjects was 59.4, SD11.38. The average HbA1c was 7.78% SD1.58. Combining monofilament and tuning fork tests, the diagnosis of polyneuropathy have 65% of patients. Comparing Test Symptom Score individual parameters between the first and second measurement, using pedobarography, in Group I, statistically significant difference was found for all of the assessed parameters: pain, burning sensation, paresthesia and insensitivity (p<0,05). The measurements of peak pressure, both first and the second measurement, for all of the subjects in Group I(45) show values above 200kPa. That’s a level of pressure that needs to be corrected. The study finds correlation between the foot deformation, diabetic polyneuropathy and plantar pressure (p>0,05). Conclusion: A detail clinical exam of diabetic food in a family doctor office equipped with pedobarography (plantar pressure measurements), use of orthopedic insoles, significantly reduces clinical symptoms of diabetic polyneuropathy in patients with diabetes. PMID:25650237

  7. Presenilin-2 mutation and polymorphism in Japanese Alzheimer disease patients

    Microsoft Academic Search

    Hitoshi Tanimukai; Ichiro Tsujio; Ryota Hashimoto; Takashi Kudo; Koujin Kamino; Koujn Kamino; Masatoshi Takeda

    1999-01-01

    The Asn141Ile mutation of the presenilin 2 gene is responsible for familial early-onset Alzheimer disease found in Volga-German kindreds. However, the genetic influence of presenilin 2 gene on sporadic Alzheimer disease remains unknown. In this study, the frequency of the mutation and genetic association with the presenilin 2 locus were investigated in Japanese sporadic cases. The Asn141Ile mutation was not

  8. Production of superoxide anion by polymorphonuclear leukocytes from diabetic patients with or without diabetic retinopathy

    Microsoft Academic Search

    Ahmed M. Abu El-Asrar; Rafik T. Soliman; Saleh A. Al-Amro; Fahad J. Al-Shammary

    1995-01-01

    Oxygen free radicals have been implicated in the pathogenesis of diabetic microangiopathy. The production of superoxide anion (O2-.) by polymorphonuclear leukocytes (PMNs) from 45 insulin-dependent diabetes mellitus patients in the resting state and in response to a soluble stimulus (phorbol myristate acetate) was measured spectrophotometrically and compared with that of 15 age and sex matched controls. The resting superoxide anion

  9. Beneficios del ejercicio físico en los pacientes con diabetes Benefits of exercise in patients with diabetes

    Microsoft Academic Search

    Á. Caballero Figueroa; M. Hernández García

    Physical exercise has important health benefi ts. Physical inactivity is as- sociated with an increased risk of chronic diseases like type 2 diabetes mellitus. In contrast, moderate levels of physical exercise produce con- siderable benefi ts in diabetic patients, especially in those with type 2 dia- betes mellitus. At the onset of the disease, modifi cation of lifestyle, with improvements

  10. EFFECT OF DIABETIC PATIENT EDUCATION IN THE MANAGEMENT OF DIABETES MELLITUS

    Microsoft Academic Search

    Mani UV; Srivastava R; Parekh A; Shah V; Mehta NC; Patel HR; Dosi M

    Diabetic Patient Education (DPE) was imparted for a period of 30 days to 31 maturity onset diabetics. The DPE included knowledge about the disease, types, symptoms, complications and ways of achieving a good control with major emphasis on diet and exercise. The education was imparted using visual aids, printed pamphlets and oral com- munication. The efficacy of DPE was moni-

  11. Management of type 2 diabetes: evolving strategies for the treatment of patients with type 2 diabetes

    Microsoft Academic Search

    Ebenezer A. Nyenwe; Terri W. Jerkins; Guillermo E. Umpierrez; Abbas E. Kitabchi

    2011-01-01

    The prevalence of type 2 diabetes continues to increase at an alarming rate around the world, with even more people being affected by prediabetes. Although the pathogenesis and long-term complications of type 2 diabetes are fairly well known, its treatment has remained challenging, with only half of the patients achieving the recommended hemoglobin A1c target. This narrative review explores the

  12. The role of oral dryness in interdialytic weight gain by diabetic and non-diabetic haemodialysis patients

    Microsoft Academic Search

    Junne-Ming Sung; Shih-Chen Kuo; Shu-Fen Chuang; Szu-Yuan Lee; Jeng-Jong Huang

    Background. Factors influencing the percentage of daily interdialytic weight gain (IDWG%) and their interactions in haemodialysis (HD) patients have not been well-defined, especially in diabetic patients. We analysed contributing factors for the increase of IDWG%, particularly xerostomia (oral dryness), among diabetic and non-diabetic HD patients. Methods. We collected 3 month prospective data in 184 stable HD patients (116 non-diabetic and

  13. Diabetic retinopathy in newly diagnosed middle-aged and elderly diabetic patients. Prevalence and interrelationship with microalbuminuria and triglycerides

    Microsoft Academic Search

    Niels de Fine Olivarius; Niels Vesti Nielsen; Anne Helms Andreasen

    2001-01-01

    Background: The exact role of factors such as serum lipids, body mass index and (micro-)albuminuria as possible determinants of diabetic retinopathy remains to be determined. We have scrutinized the prevalence of diabetic retinopathy and its concomitants in terms of risk factors and other diabetic complications in newly diagnosed diabetic patients. Methods: A population-based sample of 1,251 newly diagnosed diabetic patients

  14. Abnormalities of thyroid function in Japanese patients with metastatic renal cell carcinoma treated with sorafenib: A prospective evaluation

    Microsoft Academic Search

    Hideaki Miyake; Toshifumi Kurahashi; Kazuki Yamanaka; Yutaka Kondo; Mototsugu Muramaki; Atsushi Takenaka; Taka-aki Inoue; Masato Fujisawa

    2010-01-01

    The objective of this study was to characterize features of thyroid dysfunction in Japanese patients with metastatic renal cell carcinoma (RCC) who were treated with sorafenib. We performed a prospective observational study including 69 Japanese patients who were diagnosed as having metastatic RCC refractory to cytokine therapy and subsequently treated with sorafenib for at least 12 weeks. Thyroid function was

  15. Predictive Properties of Plasma Amino Acid Profile for Cardiovascular Disease in Patients with Type 2 Diabetes

    PubMed Central

    Kume, Shinji; Araki, Shin-ichi; Ono, Nobukazu; Shinhara, Atsuko; Muramatsu, Takahiko; Araki, Hisazumi; Isshiki, Keiji; Nakamura, Kazuki; Miyano, Hiroshi; Koya, Daisuke; Haneda, Masakazu; Ugi, Satoshi; Kawai, Hiromichi; Kashiwagi, Atsunori; Uzu, Takashi; Maegawa, Hiroshi

    2014-01-01

    Prevention of cardiovascular disease (CVD) is an important therapeutic object of diabetes care. This study assessed whether an index based on plasma free amino acid (PFAA) profiles could predict the onset of CVD in diabetic patients. The baseline concentrations of 31 PFAAs were measured with high-performance liquid chromatography-electrospray ionization-mass spectrometry in 385 Japanese patients with type 2 diabetes registered in 2001 for our prospective observational follow-up study. During 10 years of follow-up, 63 patients developed cardiovascular composite endpoints (myocardial infarction, angina pectoris, worsening of heart failure and stroke). Using the PFAA profiles and clinical information, an index (CVD-AI) consisting of six amino acids to predict the onset of any endpoints was retrospectively constructed. CVD-AI levels were significantly higher in patients who did than did not develop CVD. The area under the receiver-operator characteristic curve of CVD-AI (0.72 [95% confidence interval (CI): 0.64–0.79]) showed equal or slightly better discriminatory capacity than urinary albumin excretion rate (0.69 [95% CI: 0.62–0.77]) on predicting endpoints. A multivariate Cox proportional hazards regression analysis showed that the high level of CVD-AI was identified as an independent risk factor for CVD (adjusted hazard ratio: 2.86 [95% CI: 1.57–5.19]). This predictive effect of CVD-AI was observed even in patients with normoalbuminuria, as well as those with albuminuria. In conclusion, these results suggest that CVD-AI based on PFAA profiles is useful for identifying diabetic patients at risk for CVD regardless of the degree of albuminuria, or for improving the discriminative capability by combining it with albuminuria. PMID:24971671

  16. Clinical Characteristics of Diabetic Patients Transferred to Korean Referral Hospitals

    PubMed Central

    Oh, Min Young; Kim, Sang Soo; Lee, In Kyu; Baek, Hong Sun; Lee, Hyoung Woo; Chung, Min Young

    2014-01-01

    Background We evaluated the disease profile and clinical management, including the status of both glycemic control and complications, in patients with diabetes who were transferred to referral hospitals in Korea. Methods Patients referred to 20 referral hospitals in Gyeongsangnam/Gyeongsangbuk-do and Jeollanam/Jeollabuk-do with at least a 1-year history of diabetes between January and June 2011 were retrospectively reviewed using medical records, laboratory tests, and questionnaires. Results A total of 654 patients were enrolled in the study. In total, 437 patients (67%) were transferred from clinics and 197 (30%) patients were transferred from hospitals. A total of 279 patients (43%) visited higher medical institutions without a written medical request. The main reason for the referral was glycemic control in 433 patients (66%). Seventy-three patients (11%) had received more than one session of diabetic education. Only 177 patients (27%) had been routinely self-monitoring blood glucose, and 146 patients (22%) were monitoring hemoglobin A1c. In addition, proper evaluations for diabetic complications were performed for 74 patients (11%). The most common complication was neuropathy (32%) followed by nephropathy (31%). In total, 538 patients (82%) had been taking oral hypoglycemic agents. A relatively large number of patients (44%) had been taking antihypertensive medications. Conclusion We investigated the clinical characteristics of diabetic patients and identified specific problems in diabetic management prior to the transfer. We also found several problems in the medical system, which were divided into three medical institutions having different roles in Korea. Our findings suggested that the relationships among medical institutions have to be improved, particularly for diabetes. PMID:25349826

  17. Treatment of specific macrovascular beds in patients with diabetes mellitus

    Microsoft Academic Search

    Allison M Petznick; Jay H Shubrook

    2010-01-01

    In 2007, over 23 million people had diabetes in the United States and death from cardiovascular disease is estimated to occur in 80% of those Americans. Risk factor reduction is the most important therapy for primary and secondary prevention of macrovascular disease in patients with and without diabetes mellitus. Despite this, presentation and response to therapy is often different for

  18. Hyporeninemic Hypoaldosteronism in Diabetic Patients with Chronic Renal Failure

    Microsoft Academic Search

    J. Grande Villoria; J. F. Macias Nunez; J. M. Miralles; S. De Castro del Pozo; J. M. Tabernero Romo

    1988-01-01

    Plasma renin activity, plasma aldosterone levels and renal tubular capacity to excrete hydrogen ions were studied in 13 patients suffering from diabetes mellitus with a creatinine clearance of less than 40 ml\\/min. The results were compared with those obtained in a control group, in a group of nondiabetic subjects with chronic renal failure (CRF) and in a group of diabetic

  19. Altered redox status in patients with Diabetes Mellitus type I

    Microsoft Academic Search

    Lizette Gil-del Valle; Lazara de la C. Milian; Arturo Toledo; Nora Vilaró; Rolando Tápanes; Maria A. Otero

    2005-01-01

    Diabetes mellitus is a complex metabolic disorder characterized by a disturbance in glucose metabolism. Recent evidences suggest that increased oxidative damage as well as deficits in antioxidants defence systems could be related to the complications in Diabetes patients’ type I. The aim of this study was to investigate an extensive array of redox status indices: glutathione (GSH), malondialdehyde (MDA), peroxidation

  20. Cystoid macular oedema following cataract extraction in patients with diabetes

    Microsoft Academic Search

    A. Pollack; H. Leiba; A. Bukelman; M. Oliver

    1992-01-01

    The course of cystoid macular oedema (CMO) following extracapsular cataract extraction with posterior chamber intraocular lens implantation was prospectively studied in 44 eyes of 44 consecutive diabetic patients without preoperative CMO. In 50% of eyes CMO was observed 6 weeks after surgery and in 25% was still present at 1 year. The preoperative presence of diabetic retinopathy significantly affected the

  1. Diabetes in Patients With Idiopathic Parkinson’s Disease

    E-print Network

    Claudia Becker; Gunnar P. Brobert; Christoph R. Meier

    OBJECTIVE — Previous observational studies reported inconsistent results on the association between diabetes and Parkinson’s disease, and data on the risk of developing incident diabetes in relation to Parkinson’s disease are scarce. We aimed at comparing the diabetes prevalence between patients with or without Parkinson’s disease and at exploring the risk of developing incident diabetes associated with Parkinson’s disease. RESEARCH DESIGN AND METHODS — We used the U.K.-based General Practice Research Database (GPRD) to 1) compare the diabetes prevalence between Parkinson’s disease cases and a matched comparison group free of Parkinson’s disease between 1994 and 2005 and to 2) conduct a follow-up study with a nested case-control analysis to quantify the risk of developing new-onset diabetes in association with Parkinson’s disease. RESULTS — The diabetes prevalence was similar in patients with and without Parkinson’s disease (adjusted odds ratio [OR] 0.95 [95 % CI 0.80–1.14]). In the cohort analysis (incidence rate ratio [IRR] 0.55 [95 % CI 0.38–0.81]) and in the nested case-control analysis (adjusted OR 0.53 [95 % CI 0.33–0.87]), the risk of developing diabetes was lower in patients with Parkinson’s disease than in subjects without. The adjusted OR for patients with Parkinson’s disease who were

  2. Oral Health Related Quality of Life in Diabetic Patients

    PubMed Central

    Sadeghi, Rokhsareh; Taleghani, Ferial; Farhadi, Sareh

    2014-01-01

    Background and aims. Diabetic patients display an increased risk of oral disorders, and oral health related quality of life (OHRQL) might affect their management and treatment modalities. The aim of the present study was to determine OHRQL and associated parameters in patients with diabetes. Materials and methods. In this study two hundred patients were recruited from the diabetes clinic in Mustafa Khomeini Hospital in Tehran, Iran. OHRQL was assessed using Oral Health Impact Profile Questionnaire (OHIP-20). Also, another questionnaire was designed which contained questions regarding participants’ knowledge about oral complications of diabetes and oral health behavior. OHRQL was categorized as low and good. Data were analyzed using logistic regression at P = 0.05. Results. Of the diabetic patients assessed, 77.5% were in good and 22.5% were in low categories of OHRQL. This quality was significantly associated with age (OR = 4.03, 95% CI = 1.63-11.29), knowledge about diabetes oral complications (OR = 18.17 95% CI = 4.42-158.6), educational level (OR = 26.31 95% CI = 4.2-1080.3), referred for dental visit by physician (OR = 3.16 95% CI = 1.48-6.69), frequency of brushing (OR = 10.29 95% CI = 3.96-31.2) and length of time diagnosed with diabetes (OR = 6.21 95% CI = 2.86-13.63). Conclusion. Oral health related quality of life was not negatively affected by diabetes mellitus in the assessed sample. PMID:25587385

  3. PERIPHERAL VASCULAR DISEASE IN DIABETIC PERITONEAL DIALYSIS PATIENTS

    Microsoft Academic Search

    Heikki H. T. Saha; Yrjö K. J. Leskinen; Juha P. Salenius; Jorma T. Lahtela

    In the present article, we review current knowledge of the epidemiology, diagnosis, and treatment of peripheral vascular disease in patients with end-stage renal disease. The main focus is placed on diabetic patients receiving peri- toneal dialysis, but studies on patients receiving hemodi- alysis are also reviewed, because most reports involve this patient group, and the number of reports on peripheral

  4. Gustometry of diabetes mellitus patients and obese patients.

    PubMed

    Stolbová, K; Hahn, A; Benes, B; Andel, M; Treslová, L

    1999-01-01

    The sensation of adequate taste detection can be associated with satisfaction of food intake. The impairment of taste detection may be associated with the development of obesity. Taste detection is determined hereditarily, but it can be influenced also by the occurrence of neuropathy. To find an explanation for these phenomena, we investigated 73 patients with diabetes mellitus (DM) 2 (i.e., non-insulin-dependent DM); 11 patients with DM 1 (i.e., insulin-dependent DM); 12 obese patients (body-mass index >30) without DM; and 29 control patients. All subjects underwent electrogustometric examination with Hortmman's electrogustometer. During this examination, we obtained electrical thresholds of taste by stimulating appropriate parts of the tongue. We stimulated the apex, middle, and near tongue radix areas on both sides. The resulting value is the average on the left and right sides of the mentioned areas. We considered a value of less than 40 microA to be normal. Values in excess of 100 microA are considered as hypogeusia. Values between 40 and 100 microA are taken as borderline, and ageusia is in excess of 500 microA. According to these criteria, in the DM 2 group, we found 40% of patients with hypogeusia, whereas in the DM 1 group, we found 33% of patients; 25% of patients were in the obese group. Among normal subjects (people without obesity or DM), no hypogeusia was found. We found ageusia in 5% of patients with DM 2, in 3% of patients with DM 1, and in 14% of obese patients. Among normal subjects, we found no ageusia. These results support the hypothesis that diminished taste detection can evoke hyperphagia and later obesity. PMID:10753433

  5. Determinants of sexual dysfunction among clinically diagnosed diabetic patients

    Microsoft Academic Search

    William KBA Owiredu; Nafiu Amidu; Huseini Alidu; Charity Sarpong; Christian K Gyasi-Sarpong

    2011-01-01

    Background  Diabetes mellitus is a chronic disease that can result in various medical, psychological and sexual dysfunctions (SD) if not\\u000a properly managed. SD in men is a common under-appreciated complication of diabetes. This study assessed the prevalence and\\u000a determinants of SD among diabetic patients in Tema, Greater Accra Region of Ghana.\\u000a \\u000a \\u000a \\u000a \\u000a Method  Sexual functioning was determined in 300 consecutive diabetic men (age

  6. Prevention of type 2 diabetes in a primary healthcare setting: Three-year results of lifestyle intervention in Japanese subjects with impaired glucose tolerance

    Microsoft Academic Search

    Naoki Sakane; Juichi Sato; Kazuyo Tsushita; Satoru Tsujii; Kazuhiko Kotani; Kokoro Tsuzaki; Makoto Tominaga; Shoji Kawazu; Yuzo Sato; Takeshi Usui; Isao Kamae; Toshihide Yoshida; Yutaka Kiyohara; Shigeaki Sato; Hideshi Kuzuya

    2011-01-01

    BACKGROUND: A randomized control trial was performed to test whether a lifestyle intervention program, carried out in a primary healthcare setting using existing resources, can reduce the incidence of type 2 diabetes in Japanese with impaired glucose tolerance (IGT). The results of 3 years' intervention are summarized. METHODS: Through health checkups in communities and workplaces, 304 middle-aged IGT subjects with

  7. Heart rate variability in diabetic patients during orthostatic load — A spectral analytic approach

    Microsoft Academic Search

    F. Weise; F. Heydenreich; W. Gehrig; U. Runge

    1990-01-01

    Summary Spectral analysis of heart rate variability (HRV) was used to assess the autonomic nervous control of cardiac function during orthostatic load in insulin-dependent diabetic patients and healthy subjects. The diabetic patients were divided into three groups: diabetics without neuropathy (group 1), diabetics with peripheral neuropathy (group 2), and diabetics with peripheral and autonomic neuropathy (group 3). Resting mid-frequency (MF,

  8. Musculoskeletal manifestations in diabetic patients at a tertiary center

    PubMed Central

    Attar, Suzan M.

    2012-01-01

    Objectives Diabetes mellitus is a major public health problem worldwide. Most diabetic patients will develop functional disabilities due to multiple factors, including musculoskeletal (MSK) manifestations. The purpose of this study was to determine the frequency of MSK in diabetic patients and to examine the possible predictors for its development. Methods We performed a cross-sectional study from June 1, 2010, to June 30, 2011, to evaluate MSK manifestations in adult diabetic patients at an outpatient clinic of King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Baseline variables were examined to determine predictors for the development of MSK complications. Analyses were carried out using the Statistical Package for Social sciences. Results We included 252 diabetic patients; 45 (17.9%) had MSK manifestations. Of these 45 patients, 41 (91.1%) had type 2 diabetes. The most common manifestations were carpal tunnel syndrome (n=17, 6.7%), shoulder adhesive capsulitis (n=17, 6.7%), and diabetic amyotrophy (n=12, 4.8%). A significant association was found between the development of MSK manifestations and manual labor, overweight, and vascular complications. On logistic regression analysis, the presence of vascular complications in general (B-coefficient=1.27, odds ratio=3.57, P<0.05, 95% confidence interval=1.31–9.78), and retinopathy in particular (B-coefficient=1.17, odds ratio=3.21, P<0.05, 95% confidence interval=1.47–7.02) can predict the development of MSK manifestations in about 82% of the cases. Conclusion Musculoskeletal manifestations are under recognized in adult diabetic patients, occurring in 18% of the cases. Physicians should consider examining the periarticular region of the joints in the hands and shoulders whenever a diabetic patient presents with MSK symptoms. PMID:23115579

  9. Chromium level in prediction of diabetes in pre-diabetic patients

    PubMed Central

    Rafiei, Rahmatollah; Habyby, Zahra; Fouladi, Lootfollah; Najafi, Somayeh; Asgary, Sedigheh; Torabi, Zahra

    2014-01-01

    Background: Chromium supplementations (Cr) have been shown to exert beneficial effects in the management of type-2 diabetes. Prevalence of Cr deficiency in pre-diabetic patients is not well-understood, therefore, the aim of this study was to evaluate the extent of this prevalence. Materials and Methods: In this cross-sectional descriptive study, 132 pre-diabetic patients were recruited. The participants were randomly selected from those who referred to the Shariati Hospital in Isfahan, Iran. Blood samples are collected for measurement of Cr, insulin, fasting blood sugar (FBS), and two-hour post-load plasma glucose. The body mass index (BMI) was calculated. Determination of Cr was carried out by atomic absorption spectrometry. Results: Thirty-four (31.5%) patients had Cr deficiency and 74 (68.5%) patients had normal Cr. There was no significant difference between sex, age groups (<50 years and ?50 years) and between patients with and without a family history of diabetes in both the groups. No significant differences in age, BMI, FBS or insulin were observed between two groups. In the group with a normal level of Cr, there was a significant reversed correlation between the Cr level and age, but no significant correlation existed between the Cr level and other factors in both groups. Conclusion: The levels of Cr deficiency are relatively common in patients with pre-diabetes, and it is necessary to screen patients with diabetes and pre-diabetes according to the American Diabetes Association guidelines, with regard to the Cr level and action should be taken to eliminate the Cr deficiency in these patients. PMID:25538921

  10. Diabetic foot risk factors in type 2 diabetes patients: a cross-sectional case control study

    PubMed Central

    2014-01-01

    Background Diabetic foot is a serious condition in patients with a long lasting diabetes mellitus. Diabetic foot treated improperly may lead not only to delayed ulceration healing, generalized inflammation, unnecessary surgical intervention, but also to the lower limb amputation. The aim of this study was to compare diabetic foot risk factors in population with type 2 diabetes and risk factors for diabetes in healthy subjects. Methods The study included 900 subjects: 145 with diabetic foot, 293 with type 2 diabetes without diabetic foot and 462 healthy controls matched in terms of mean age, gender structure and cardiovascular diseases absence. Study was conducted in Gastroenterology and Metabolic Diseases Department, Medical University of Warsaw, Poland. In statistical analysis a logistic regression model, U Mann-Whitney’s and t-Student test were used. Results The binomial logit models analysis showed that the risk of diabetic foot in patients with type 2 diabetes was decreased by patient’s age (odds ratio [OR] = 0.94; 95% confidence interval [CI]: 0.92-0.96; p = 0.00001) and hyperlipidaemia (OR = 0.54; 95% CI: 0.36-0.81; p = 0.01). In contrast, male gender (OR = 2.83; 95% CI: 1.86-4.28; p = 0.00001) diabetes duration (OR = 1.04; 95% CI: 1.03-1.06; p = 0.0003), weight (OR = 1.04; 95% CI: 1.03-1.06; p = 0.00001), height (OR = 1.08; 95% CI: 1.05-1.11; p = 0.00001) and waist circumference (OR = 1.028; 95% CI: 1.007-1.050; p = 0.006) increase the risk of diabetic foot. The onset of type 2 diabetes in healthy subjects was increased by weight (OR = 1.035; 95% CI: 1.024-1.046; p = 0.00001), WC (OR = 1.075; 95% CI: 1.055-1.096; p = 00001), hip circumference (OR = 1.03; 95% CI: 1.01-1.05; p = 0.005), overweight defined with body mass index (BMI) above 24,9 kg/m2 (OR = 2.49; 95% CI: 1.77-3.51; p = 0.00001) and hyperlipidaemia (OR = 3.53; 95% CI: 2.57-4.84; p = 0.00001). Conclusions Risk factors for Type 2 diabetes and diabetic foot are only partially common. Study proved that patients who are prone to developing diabetic foot experience different risk factors than patients who are at risk of diabetes. Identification of relationship between diabetic foot and diabetes risk factors in appropriate groups may help clinicians to focus on certain factors in diabetic foot prevention. PMID:25114882

  11. Hyporeninemic hypoaldosteronism in diabetic patients with chronic renal failure.

    PubMed

    Grande Villoria, J; Macias Nunez, J F; Miralles, J M; De Castro del Pozo, S; Tabernero Romo, J M

    1988-01-01

    Plasma renin activity, plasma aldosterone levels and renal tubular capacity to excrete hydrogen ions were studied in 13 patients suffering from diabetes mellitus with a creatinine clearance of less than 40 ml/min. The results were compared with those obtained in a control group, in a group of nondiabetic subjects with chronic renal failure (CRF) and in a group of diabetic patients without CRF. Twelve of the thirteen diabetic patients with CRF had data characteristic of hyporeninemic hypoaldosteronism associated with type IV renal tubular acidosis. On comparing the results with those of the other two groups of patients, it was observed that the manifestations of the latter two groups considered separately were different from those of the problem group, although in the diabetic patients with normal glomerular filtration rate (GFR) hyporeninism but not hypoaldosteronism was present accompanied by a lower net acid excretion (p less than 0.001) due to a lower excretion of NH4 (p less than 0.05) and titratable acid (p less than 0.001) when the patients were challenged with an NH4Cl overload. We believe that a conjunction of diabetes and renal failure is necessary for the diabetic patients with a decrease in GFR to show hyporeninemic hypoaldosteronism and type IV tubular acidosis. PMID:3394721

  12. Coronary Artery Revascularization in Patients with Diabetes Mellitus

    MedlinePLUS

    Coronary Artery Revascularization in Patients With Diabetes Mellitus David H. Fitchett , MD ; Milan Gupta , MD ; Michael E. Farkouh , MD, ... at}smh.ca Next Section What Is Coronary Artery Disease? Atherosclerosis is the disease process that narrows ...

  13. Diabetes Drug Metformin Safe for Patients with Kidney Disease: Review

    MedlinePLUS

    ... JavaScript. Diabetes Drug Metformin Safe for Patients With Kidney Disease: Review Alternative medications more costly, have more side ... medication, is usually not prescribed for people with kidney disease, a new analysis shows the drug may be ...

  14. A toll-like receptor 3 single nucleotide polymorphism in Japanese patients with sarcoidosis.

    PubMed

    Ikezoe, K; Handa, T; Tanizawa, K; Kubo, T; Ito, I; Sokai, A; Nakatsuka, Y; Nagai, S; Izumi, T; Mishima, M

    2015-03-01

    Toll-like receptor 3 (TLR3) may be associated with T helper 1 immune response. This study aimed to investigate the role of a functional TLR3 single nucleotide polymorphism (SNP) in sarcoidosis. We genotyped 220 Japanese patients with sarcoidosis and 140 controls for TLR3 SNP rs3775291 to analyze its association with susceptibility to sarcoidosis and assessed its relationship to clinical features in 172 patients over 2?years. The TLR3 rs3775291 genotype was not significantly associated with disease susceptibility. However, patients with cardiac sarcoidosis (CS) significantly more frequently had the TT genotype (p?patients without CS. We conclude that TLR3 SNP rs3775291 may affect cardiac involvement in Japanese patients with sarcoidosis. PMID:25720507

  15. Periodontal status among patients with diabetes in Nuuk, Greenland

    PubMed Central

    Schjetlein, Amanda Lamer; Jørgensen, Marit Eika; Lauritzen, Torsten; Pedersen, Michael Lynge

    2014-01-01

    Background Diabetes is becoming more common in the Greenlandic population. Patients with diabetes are more prone to periodontal disease. Periodontal status may have an effect on metabolic control. Objective The aim of this study was to estimate the prevalence of periodontitis amongst patients with diabetes in Nuuk, Greenland, and secondly, to observe if dental care was associated with improved periodontal status and metabolic control. Study design Observational cross-sectional study and a pilot study of a dental care intervention. Methods Sixty-two Greenlandic patients with diabetes were included in the study. Data were collected from the Electronic Medical Records (EMR), in addition to a telephone interview. Patients were offered 3 dental examinations with a 3-month interval. The dental examinations consisted of a full-mouth assessment of number of remaining teeth and assessment of periodontal status. Patients received scaling and root planing, together with information and instructions on oral hygiene. Information on glycated haemoglobin (HbA1C) values was collected from the EMR at each dental examination. Results In this study, 21.0% (13/62) of patients with diabetes had periodontitis. About 42% had less than 20 teeth. The association between diabetes and periodontitis was known by 20 out of the 62 patients. Over half of the patients had been to a dental examination within the last year. The prevalence of periodontitis decreased significantly from 21.0 to 0% (p<0.001) after 3 dental examinations. No change in HbA1C levels was observed (p=0.440). Conclusion Periodontitis was common among patients with diabetes in Nuuk. Dental health status based on Periodontal Screening Index (PSI) and bleeding on probing (BOP) seemed to improve after dental health care, indicating a need for increased awareness among patients and health care professionals. HbA1C levels were not improved among the patients. PMID:25498562

  16. Rosiglitazone Monotherapy Is Effective in Patients with Type 2 Diabetes

    Microsoft Academic Search

    HAROLD E. LEBOVITZ; JO F. DOLE; RITA PATWARDHAN; ELIZABETH B. RAPPAPORT; MARTIN I. FREED; SmithKline Beecham

    2010-01-01

    This study evaluated the efficacy and safety of rosiglitazone mono- therapy in patients with type 2 diabetes. After a 4-week placebo run-in period, 493 patients with type 2 diabetes were randomized to receive rosiglitazone (2 or 4 mg twice daily (bd)) or placebo for 26 weeks. The primary end point was change in hemoglobin A1c; other variables assessed included fasting

  17. Thailand Diabetes Registry Project: Prevalence and Risk Factors of Stroke in Thai Diabetic Patients

    Microsoft Academic Search

    Nattachet Plengvidhya

    2006-01-01

    Results: The prevalence of stroke in the patients studied was 3.5%. Most of the patients were type 2 diabetes and had ischemic stroke. One of the risk factors associated with stroke was age greater than 60 years, and the risk appeared to be highest if the patients' age was greater than 70 years (adjust OR = 3.29, p = 0.012).

  18. Endogenous endophthalmitis in a patient with diabetes and foot osteomyelitis.

    PubMed

    Mavrakanas, Thomas A; de Haller, Raoul; Philippe, Jacques

    2015-02-01

    Endogenous endophthalmitis is a rare condition caused by the hematogenous spread of microorganisms from a remote infection site to the eye. Common predisposing conditions are intravenous drug abuse, diabetes, malignancy, immunosuppression, chronic renal failure, parenteral nutrition or invasive medical procedures. We describe a case of endogenous endophthalmitis in the setting of foot osteomyelitis in a patient with diabetes. A high index of clinical suspicion is required to diagnose this condition early in a patient with diabetes because visual symptoms commonly may be misattributed to retinopathy. Early diagnosis is important. PMID:25444679

  19. Antithrombotic therapy in diabetic patients with coronary artery disease.

    PubMed

    Lemesle, G; Bauters, A; Bauters, C

    2015-06-01

    In case of coronary artery disease (CAD), diabetic patients are at higher risk than their non-diabetic counterparts. Antithrombotics are therefore of key importance to decrease the risk of ischemic complications. A careful assessment of the benefit-risk balance is however needed to limit the risk of bleeding. Diabetic CAD patients are characterized by a pro-thrombotic milieu and by an impaired response to both aspirin and P2Y12 receptor inhibitors, especially to clopidogrel. When combined with aspirin, the new P2Y12 receptor inhibitors prasugrel and ticagrelor provide superior efficacy for the diabetic patients with acute coronary syndromes. In stable CAD, antiplatelet monotherapy (aspirin) remains for the time being the reference treatment for diabetic as well as for non-diabetic patients; further studies are however ongoing to test whether the antithrombotic strategy should be reinforced, particularly in case of diabetes mellitus. Finally, although chronic oral anticoagulation is rarely indicated for CAD management in itself, it is often prescribed for the concomitant treatment of atrial fibrillation. The combination of anticoagulation and antiplatelet therapy is associated with a high risk of bleeding and should only be prescribed for limited periods of time when the estimated benefits exceed the risks. PMID:25585230

  20. Comparison of the Hospital Arrival Time and Differences in Pain Quality between Diabetic and Non-Diabetic STEMI Patients

    PubMed Central

    Gradišer, Marina; Dilber, Dario; Cmre?njak, Jasna; Ostri?ki, Branko; Bili?-?ur?i?, Ines

    2015-01-01

    The aim of our study was to determine whether diabetic ST segment elevation myocardial infarction (STEMI) patients arrive in the emergency room (ER) later than non-diabetics, compare the differences in pain quality and quantity between those groups, and measure differences in the outcome after an index hospitalization. A total of 266 patients with first presentation of STEMI were included in our study during a period of two years, 62 with diabetes and 204 without diabetes type 2. Pain intensity and quality at admission were measured using a McGill short form questionnaire. Diabetic patients did not arrive significantly later than non-diabetic (?2; p = 0.105). Most diabetic patients described their pain as “slight” or “none” (?2; p < 0.01), while most non-diabetic patients graded their pain as “moderate” or “severe” (?2; p < 0.01). The quality of pain tended to be more distinct in non-diabetic patients, while diabetic patients reported mainly shortness of breath (?2; p < 0.01). Diabetic patients were more likely to suffer a multi-vessel disease (?2; p < 0.01), especially in the late arrival group. Therefore, cautious evaluation of diabetic patients and adequate education of target population could improve overall survival while well-organized care like a primary PCI Network program could significantly reduce CV mortality. PMID:25633029

  1. Lipoprotein(a) Serum Levels in Diabetic Patients with Retinopathy

    PubMed Central

    Malaguarnera, Giulia; Gagliano, Caterina; Vacante, Marco; Malaguarnera, Michele; Leonardi, Daniela Giovanna; Motta, Massimo; Drago, Filippo; Avitabile, Teresio

    2013-01-01

    Background. Atherogenic lipoproteins, such as total cholesterol, LDL cholesterol, oxidized low density lipoprotein, and triglycerides, are associated with progression of retinopathy. Aim. To evaluate the relationship between lipoprotein(a) and retinopathy in patients with type 2 diabetes mellitus. Materials and Methods. We enrolled 145 diabetic consecutive patients (82 females, 63 males; mean age 66.8 ± 12 years, mean duration of diabetes 9.4 ± 6.8 years). Presence and severity of retinopathy were evaluated. Serum lipid profile, including Lp(a) level, was assessed. Results. High Lp(a) levels have been observed in 54 (78.3%) subjects and normal levels in 13 (18.85%) subjects as regards diabetic patients with retinopathy. Lp(a) levels were high in 15 subjects (21.75%) and normal in 63 subjects (91.35%) as regards patients without retinopathy. Conclusions. Lp(a) levels are increased in a significant percentage of patients with retinopathy compared to diabetic patients without retinopathy. The impact of Lp(a) levels on diabetic retinopathy needs to be further investigated. PMID:23862162

  2. Health Information in Japanese (???): MedlinePlus

    MedlinePLUS

    ... ??? (Japanese) Bilingual PDF Health Information Translations GTT (Glucose Tolerance Test) GTT (????????) - ??? (Japanese) Bilingual PDF Health Information Translations Two Reasons I Find Time to Prevent Diabetes: My Future and Theirs ??? (Japanese) PDF National ...

  3. "Throw your hammer!" the essence of patient empowerment in diabetes.

    PubMed

    Okazaki, Kentaro

    2015-01-01

      The empowerment approach to patients with diabetes is a philosophy that was introduced by Robert M. Anderson and Martha M. Funnell of Michigan Diabetes Research and Training Center in the 1990s. This approach is based on the observation that more than 98% of diabetes care is performed by patients themselves. Dr. Anderson, Ms. Funnell, and their colleagues found that every patient has a right and an ability to solve his/her own problem in his/her own diabetes. Therefore healthcare providers should provide support for patients own endeavors. Empowerment has three essential elements: 1) the patient is centered, they make a final decision of their daily self-management, and are responsible for those decisions and the results; 2) patient support is the main role of healthcare providers; and 3) patient and healthcare providers should collaborate. In this author's opinion, it is important for healthcare providers to improve their communication skills to use the empowerment approach to help patients change their behaviors in the real world. To encourage empowerment, we created a unique learning program for healthcare providers, named "Diabetes Theater". This program is an interactive workshop comprising two parts: drama and discussion. PMID:25759041

  4. Retinopathy Identifies Marked Restriction of Coronary Flow Reserve in Patients With Diabetes Mellitus

    Microsoft Academic Search

    Takashi Akasaka; Kiyoshi Yoshida; Takeshi Hozumi; Tsutomu Takagi; Shuichiro Kaji; Takahiro Kawamoto; Shigefumi Morioka; Junichi Yoshikawa

    1997-01-01

    Objectives. This study sought to assess the differences in coronary flow reserve in patients with and without diabetic retinopathy.Background. Microvascular abnormalities throughout the body and impairment of coronary flow reserve have been described in patients with diabetes mellitus. However, the relation between diabetic retinopathy and coronary microvascular disease has not been investigated.Methods. The study included 29 patients with diabetes mellitus

  5. Combined Clozapine and Electroconvulsive Therapy in a Japanese Schizophrenia Patient: A Case Report

    PubMed Central

    Ozaki, Yuki; Kawasoe, Koichiro; Ochi, Shinichiro; Niiya, Takanori; Sonobe, Naomi; Matsumoto, Teruhisa; Ueno, Shu-ichi

    2014-01-01

    Clozapine is well-known for successful use in schizophrenic patients treatment resistant to other antipsychotics. However, even with clozapine, 25% of schizophrenic patients are not in remission. Recently, as adjunctive treatment with clozapine, electroconvulsive therapy has been reported to be an effective and safe adjunctive treatment. We report a Japanese schizophrenic woman who was not in remission with clozapine alone but with both clozapine and electroconvulsive therapy. PMID:25191508

  6. Effects of enzyme replacement therapy in thirteen Japanese paediatric patients with Gaucher disease

    Microsoft Academic Search

    Hiroyuki Ida; Owen M. Rennert; Masahisa Kobayashi; Yoshikatsu Eto

    2001-01-01

    To determine treatment effects in the unique and previously internationally unreported Japanese paediatric patient population\\u000a with Gaucher disease (GD), we analysed six response parameters among 13 patients given enzyme replacement therapy (ERT). Also\\u000a to obtain insights into optimising maintenance dosing, through subgroup analysis we retrospectively examined effects of three\\u000a ERT dose reduction schedules from a starting regimen of 60 U\\/kg

  7. Patient Web Portals to Improve Diabetes Outcomes: A Systematic Review

    Microsoft Academic Search

    Chandra Y. Osborn; Lindsay Satterwhite Mayberry; Shelagh A. Mulvaney; Rachel Hess

    2010-01-01

    Patient web portals (PWPs), defined as the integration of electronic medical records and patient health records, have been\\u000a related to enhanced patient outcomes. A literature review was conducted to characterize the design and evaluation of PWPs\\u000a to improve health care processes and outcomes in diabetes. A summary of 26 articles revealed the positive impact PWPs have\\u000a on patient outcomes, patient-provider

  8. Diabetic Foot Syndrome and Corneal Subbasal Nerve Plexus Changes in Congolese Patients with Type 2 Diabetes

    PubMed Central

    Schober, Hans-Christof; Stachs, Oliver; Baltrusch, Simone; Bambi, Marie Therese; Kilangalanga, Janvier; Winter, Karsten; Kundt, Guenther; Guthoff, Rudolf F.

    2015-01-01

    Background To study the severity of diabetic neuropathy, diabetic retinopathy and grades of diabetic foot syndrome for correlations with corneal subbasal nerve plexus (SBP) changes in Congolese patients with type 2 diabetes. Methodology/Principal Findings Twenty-eight type 2 diabetes patients with diabetes-related foot ulceration were recruited in a diabetic care unit in Kinshasa, Democratic Republic of Congo. Corneal SBP was investigated by confocal laser-scanning microscopy to analyse nerve fibre density (NFD) [µm/ µm²], number of branches [n] and number of connectivity points [n]. Foot ulceration was graded using the Wagner ulcer classification. Corneal sensitivity (Cochet-Bonnet), Neuropathy Symptom Score (NSS), Neuropathy Disability Score (NDS), ankle-brachial index (ABI) and ophthalmological status were evaluated. Foot ulceration was ranked as mild (Wagner 0-1: 13 patients/46.4%), moderate (Wagner 2-3: 10 patients/35.7%) and severe (Wagner 4-5: 5 patients/17.9%). The correlation between Wagner Score and NFD (p=0.017, r = - 0,454), NDS and NFD (p=0,039, r = - 0.400) as well as Wagner Score and HbA1c (p=0,007, r = - 0.477) was stated. Significant differences in confocal SBP parameters were observed between Wagner 0-1 and Wagner 4 5 (number of branches (p=0.012), number of connectivity points (p=0.001), nerve fibre density (p=0.033)) and ABI (p=0.030), and between Wagner 2-3 and Wagner 4-5 (number of branches (p=0.003), number of connectivity points (p=0.005) and nerve fibre density (p=0.014)). Differences in NDS (p=0.001) and corneal sensation (p=0.032) were significant between Wagner 0-1 and Wagner 2-3. Patients with diabetic retinopathy had significantly longer diabetes duration (p=0.03) and higher NDS (p=0.01), but showed no differences in SBP morphology or corneal sensation. Conclusions/Significance While confirming the diabetic aetiology of foot ulceration due to medial arterial calcification, this study indicates that the grade of diabetic foot syndrome correlates with corneal SBP changes and corneal sensation in patients in sub-Saharan Africa. PMID:25811186

  9. Estimation of Salivary Amylase in Diabetic Patients and Saliva as a Diagnostic Tool in Early Diabetic Patients

    PubMed Central

    Malathi, L.; Masthan, K.M.K.; Balachander, N.; Babu, N. Aravindha; Rajesh, E.

    2013-01-01

    Aim: The aim of this study was to estimate the salivary amylase levels in non-insulin dependent diabetes mellitus patients and to correlate these findings with those in normal individuals, in order to provide salivary amylase level as a bio-chemical indicator for diagnosing and monitoring the glucose levels. Material and Methods: The study samples consisted of 60 individuals. Both males and females participated in the study. Thirty non-insulin dependent diabetes mellitus patients of age group of 30 to 60 years and healthy individuals of same number and age group were included in this study. The data obtained in this study were statistically analyzed by using Student’s t–test. Results: In estimation of salivary amylase levels, the comparison of mean and standard deviation showed the highest mean score (2739.48 +1525.20) among the diabetic patients and lowest mean score (1740.38 + 638.51) among the non-diabetic patients. The p-value obtained was less than 0.01. Hence, a highly significant difference in the mean scores regarding salivary amylase (u/l) was found among the two groups. Conclusion: The mean scores of age, fasting blood sugar, post prandial blood sugar, HbA1c and salivary amylase levels were greater in diabetic patients than in non-diabetic patients. PMID:24392426

  10. Causative anti-diabetic drugs and the underlying clinical factors for hypoglycemia in patients with diabetes

    PubMed Central

    Yanai, Hidekatsu; Adachi, Hiroki; Katsuyama, Hisayuki; Moriyama, Sumie; Hamasaki, Hidetaka; Sako, Akahito

    2015-01-01

    Recent clinical trials indicated that the intensive glycemic control do not reduce cardiovascular disease mortality among diabetic patients, challenging a significance of the strict glycemic control in diabetes management. Furthermore, retrospective analysis of the Action to Control Cardiovascular Risk in Diabetes study demonstrated a significant association between hypoglycemia and mortality. Here, we systematically reviewed the drug-induced hypoglycemia, and also the underlying clinical factors for hypoglycemia in patients with diabetes. The sulfonylurea use is significantly associated with severe hypoglycemia in patients with type 2 diabetes. The use of biguanide (approximately 45%-76%) and thiazolidinediones (approximately 15%-34%) are also highly associated with the development of severe hypoglycemia. In patients treated with insulin, the intensified insulin therapy is more frequently associated with severe hypoglycemia than the conventional insulin therapy and continuous subcutaneous insulin infusion. Among the underlying clinical factors for development of severe hypoglycemia, low socioeconomic status, aging, longer duration of diabetes, high HbA1c and low body mass index, comorbidities are precipitating factors for severe hypoglycemia. Poor cognitive and mental functions are also associated with severe hypoglycemia. PMID:25685276

  11. Causative anti-diabetic drugs and the underlying clinical factors for hypoglycemia in patients with diabetes.

    PubMed

    Yanai, Hidekatsu; Adachi, Hiroki; Katsuyama, Hisayuki; Moriyama, Sumie; Hamasaki, Hidetaka; Sako, Akahito

    2015-02-15

    Recent clinical trials indicated that the intensive glycemic control do not reduce cardiovascular disease mortality among diabetic patients, challenging a significance of the strict glycemic control in diabetes management. Furthermore, retrospective analysis of the Action to Control Cardiovascular Risk in Diabetes study demonstrated a significant association between hypoglycemia and mortality. Here, we systematically reviewed the drug-induced hypoglycemia, and also the underlying clinical factors for hypoglycemia in patients with diabetes. The sulfonylurea use is significantly associated with severe hypoglycemia in patients with type 2 diabetes. The use of biguanide (approximately 45%-76%) and thiazolidinediones (approximately 15%-34%) are also highly associated with the development of severe hypoglycemia. In patients treated with insulin, the intensified insulin therapy is more frequently associated with severe hypoglycemia than the conventional insulin therapy and continuous subcutaneous insulin infusion. Among the underlying clinical factors for development of severe hypoglycemia, low socioeconomic status, aging, longer duration of diabetes, high HbA1c and low body mass index, comorbidities are precipitating factors for severe hypoglycemia. Poor cognitive and mental functions are also associated with severe hypoglycemia. PMID:25685276

  12. Thyroid Cancer Risk Is Not Increased in Diabetic Patients

    PubMed Central

    Tseng, Chin-Hsiao

    2012-01-01

    Objective This study evaluated thyroid cancer risk with regards to diabetes status and diabetes duration, and with the use of anti-diabetic drugs including sulfonylurea, metformin, insulin, acarbose, pioglitazone and rosiglitazone, by using a population-based reimbursement database in Taiwan. Methods A random sample of 1,000,000 subjects covered by the National Health Insurance was recruited. After excluding patients with type 1 diabetes, 999730 subjects (495673 men and 504057 women) were recruited into the analyses. Logistic regression estimated the odds ratios (OR) and their 95% confidence intervals (CI) for independent variables including age, sex, diabetes status/duration, anti-diabetic drugs, other medications, comorbidities, living regions, occupation and examinations that might potentially lead to the diagnosis of thyroid cancer in various models. Results The diabetic patients had a significantly higher probability of receiving potential detection examinations (6.38% vs. 5.83%, P<0.0001). After multivariable-adjustment, the OR (95% CI) for diabetes status was 0.816 (0.652–1.021); and for diabetes duration <1 year, 1–3 years, 3–5 years and ?5 years vs. non-diabetes was 0.071 (0.010–0.507), 0.450 (0.250–0.813), 0.374 (0.203–0.689) and 1.159 (0.914–1.470), respectively. Among the anti-diabetic agents, only sulfonylurea was significantly associated with thyroid cancer, OR (95% CI): 1.882 (1.202–2.947). The OR (95% CI) for insulin, metformin, acarbose, pioglitazone and rosiglitazone was 1.701 (0.860–3.364), 0.696 (0.419–1.155), 0.581 (0.202–1.674), 0.522 (0.069–3.926) and 0.669 (0.230–1.948), respectively. Furthermore, patients with benign thyroid disease or other cancer, living in Kao-Ping/Eastern regions, or receiving potential detection examinations might have a significantly higher risk; and male sex, hypertension, dyslipidemia, chronic obstructive pulmonary disease, vascular complications or use of statin, aspirin or non-steroidal anti-inflammatory drugs might be associated with a significantly lower risk. Conclusions There is a lack of an overall association between diabetes and thyroid cancer, but patients with diabetes duration <5 years have a significantly lower risk. Sulfonylurea may increase the risk of thyroid cancer. PMID:23300866

  13. Metformin in Diabetic Patients with Heart Failure: Safe and Effective?

    PubMed Central

    Ekeruo, Ijeoma Ananaba; Solhpour, Amirreza; Taegtmeyer, Heinrich

    2013-01-01

    Management of diabetic patients with heart failure is a complex endeavor. The initial reluctance to use metformin in these patients has given way to a broader acceptance after clinical trials and meta-analyses have revealed that some of the insulin-sensitizing agents lead to adverse cardiovascular events. We have proposed that an increase of substrate uptake by the insulin-resistant heart is detrimental because the heart is already flooded with fuel. In light of this evidence, metformin offers a unique safety profile in the patient with diabetes and heart failure. Our article expands on the use of metformin in patients with heart failure. We propose that the drug targets both the source as well as the destination (in this case the heart) of excess fuel. We consider treatment of diabetic heart failure patients with metformin both safe and effective. PMID:24466358

  14. MPV may reflect subcinical platelet activation in diabetic patients with and without diabetic retinopathy.

    PubMed

    Citirik, M; Beyazyildiz, E; Simsek, M; Beyazyildiz, O; Haznedaroglu, I C

    2015-03-01

    PurposeTo search subclinical platelet activation via detecting three important platelet activation parameters; mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) in diabetic retinopathy (DR) in comparison with those in healthy adults as controls.MethodsThis prospective study included 140 patients who were followed-up at the Ankara Ulucanlar Eye Education and Research Hospital, and 40 normal subjects. All patients and control subjects underwent complete ophthalmologic evaluation. Of patients with type 2 diabetes, 43 cases with diabetes mellitus (DM) have no DR (Group 1), 45 cases with DM have nonproliferative DR (NPDR) (Group 2), and 52 cases with DM have proliferative DR (PDR) (Group 3). In addition, 40 age- and sex-matched healthy controls (Group 4) were included into the study. MPV, PDW, and PCT were measured in the studied groups.ResultsThe MPV levels were significantly altered in Group 1, Group 2, and Group 3 patients when compared with those in the controls (P<0.05), whereas PDW and PCT levels were not significantly changed among groups (P>0.05).ConclusionThe data provided a significant association between MPV levels and DM. Diabetic patients have increased MPV values compared with healthy subjects, but MPV levels were not altered together with the DR stage. Diabetic and DR patients have no different PDW and PCT values compared with healthy subjects. MPV may be a clue for the reflection of subclinical platelet activation in DM regardless of the DR stage. PMID:25523200

  15. Plantar Pressure as a Risk Assessment Tool for Diabetic Foot Ulceration in Egyptian Patients with Diabetes

    PubMed Central

    Fawzy, Olfat A; Arafa, Asmaa I; El Wakeel, Mervat A; Abdul Kareem, Shaimaa H

    2014-01-01

    BACKGROUND Diabetic foot ulceration is a preventable long-term complication of diabetes. In the present study, peak plantar pressures (PPP) and other characteristics were assessed in a group of 100 Egyptian patients with diabetes with or without neuropathy and foot ulcers. The aim was to study the relationship between plantar pressure (PP) and neuropathy with or without ulceration and trying to clarify the utility of pedobarography as an ulceration risk assessment tool in patients with diabetes. SUBJECTS AND METHODS A total of 100 patients having diabetes were selected. All patients had a comprehensive foot evaluation, including assessment for neuropathy using modified neuropathy disability score (MNDS), for peripheral vascular disease using ankle brachial index, and for dynamic foot pressures using the MAT system (Tekscan). The studied patients were grouped into: (1) diabetic control group (DC), which included 37 patients who had diabetes without neuropathy or ulceration and MNDS ?2; (2) diabetic neuropathy group (DN), which included 33 patients who had diabetes with neuropathy and MNDS >2, without current or a history of ulceration; and (3) diabetic ulcer group (DU), which included 30 patients who had diabetes and current ulceration, seven of those patients also gave a history of ulceration. RESULTS PP parameters were significantly different between the studied groups, namely, forefoot peak plantar pressure (FFPPP), rearfoot peak plantar pressure (RFPPP), forefoot/rearfoot ratio (F/R), forefoot peak pressure gradient (FFPPG) rearfoot peak pressure gradient (RFPPG), and forefoot peak pressure gradient/rearfoot peak pressure gradient (FFPPG/RFPPG) (P < 0.05). FFPPP and F/R were significantly higher in the DU group compared to the DN and DC groups (P < 0.05), with no significant difference between DN and DC. FFPPG was significantly higher in the DU and DN groups compared to the DC group (P < 0.05). RFPPP and FFPPG/RFPPG were significantly higher in the DU and DN groups compared to the DC group (P < 0.05) with no significant difference between the DN and DU groups (P > 0.05). FFPPP, F/R ratio, FFPPG, and FFPPG/RFPPG correlated significantly with the severity of neuropathy according to MNDS (P < 0.05). These same variables as well as MNDS were also significantly higher in patients with foot deformity compared to those without deformity (P < 0.05). Using the receiver operating characteristic analysis, the optimal cut-point of PPP for ulceration risk, as determined by a balance of sensitivity, specificity, and accuracy was 335 kPa and was found at the forefoot. Multivariate logistical regression analysis for ulceration risk was statistically significant for duration of diabetes (odds ratio [OR] = 0.8), smoking (OR = 9.7), foot deformity (OR = 8.7), MNDS (OR = 1.5), 2-h postprandial plasma glucose (2 h-PPG) (OR = 0.9), glycated hemoglobin (HbA1c) (OR = 2.1), FFPPP (OR = 1.0), and FFPPG (OR = 1.0). CONCLUSION In conclusion, persons with diabetes having neuropathy and/or ulcers have elevated PPP. Risk of ulceration was highly associated with duration of diabetes, smoking, severity of neuropathy, glycemic control, and high PP variables especially the FFPPP, F/R, and FFPPG. We suggest a cut-point of 355 kPa for FFPPP to denote high risk for ulceration that would be more valid when used in conjunction with other contributory risk factors, namely, duration of diabetes, smoking, glycemic load, foot deformity, and severity of neuropathy. PMID:25520564

  16. Novel and emerging diabetes mellitus drug therapies for the type 2 diabetes patient

    PubMed Central

    Rochester, Charmaine D; Akiyode, Oluwaranti

    2014-01-01

    Type 2 diabetes mellitus is a metabolic disorder of deranged fat, protein and carbohydrate metabolism resulting in hyperglycemia as a result of insulin resistance and inadequate insulin secretion. Although a wide variety of diabetes therapies is available, yet limited efficacy, adverse effects, cost, contraindications, renal dosage adjustments, inflexible dosing schedules and weight gain significantly limit their use. In addition, many patients in the United States fail to meet the therapeutic HbA1c goal of < 7% set by the American Diabetes Association. As such new and emerging diabetes therapies with different mechanisms of action hope to address some of these drawbacks to improve the patient with type 2 diabetes. This article reviews new and emerging classes, including the sodium-glucose cotransporter-2 inhibitors, 11?-Hydroxysteroid dehydrogenase type 1 inhibitors, glycogen phosphorylase inhibitors; protein tyrosine phosphatase 1B inhibitors, G Protein-Coupled receptor agonists and glucokinase activators. These emerging diabetes agents hold the promise of providing benefit of glucose lowering, weight reduction, low hypoglycemia risk, improve insulin sensitivity, pancreatic ? cell preservation, and oral formulation availability. However, further studies are needed to evaluate their safety profile, cardiovascular effects, and efficacy durability in order to determine their role in type 2 diabetes management. PMID:24936252

  17. Attenuated Purinergic Receptor Function in Patients With Type 2 Diabetes

    PubMed Central

    Thaning, Pia; Bune, Laurids T.; Hellsten, Ylva; Pilegaard, Henriette; Saltin, Bengt; Rosenmeier, Jaya B.

    2010-01-01

    OBJECTIVE Extracellular nucleotides and nucleosides are involved in regulation of skeletal muscle blood flow. Diabetes induces cardiovascular dysregulation, but the extent to which the vasodilatatory capacity of nucleotides and nucleosides is affected in type 2 diabetes is unknown. The present study investigated 1) the vasodilatatory effect of ATP, uridine-triphosphate (UTP), and adenosine (ADO) and 2) the expression and distribution of P2Y2 and P2X1 receptors in skeletal muscles of diabetic subjects. RESEARCH DESIGN AND METHODS In 10 diabetic patients and 10 age-matched control subjects, leg blood flow (LBF) was measured during intrafemoral artery infusion of ATP, UTP, and ADO, eliciting a blood flow equal to knee-extensor exercise at 12 W (?2.6 l/min). RESULTS The vasodilatatory effect of the purinergic system was 50% lower in the diabetic group as exemplified by an LBF increase of 274 ± 37 vs. 143 ± 26 ml/?mol ATP × kg, 494 ± 80 vs. 234 ± 39 ml/?mol UTP × kg, and 14.9 ± 2.7 vs. 7.5 ± 0.6 ml/?mol ADO × kg in control and diabetic subjects, respectively, thus making the vasodilator potency as follows: UTP control subjects (100) > ATP control subjects (55) > UTP diabetic subjects (47) > ATP diabetic subjects (29) > ADO control subjects (3) > ADO diabetic subjects (1.5). The distribution and mRNA expression of receptors were similar in the two groups. CONCLUSIONS The vasodilatatory effect of the purinergic system is severely reduced in type 2 diabetic patients. The potency of nucleotides varies with the following rank order: UTP > ATP > ADO. This is not due to alterations in receptor distribution and mRNA expression, but may be due to differences in receptor sensitivity. PMID:19808895

  18. Only three mutations account for almost all defective alleles causing adenine phosphoribosyltransferase deficiency in Japanese patients.

    PubMed

    Kamatani, N; Hakoda, M; Otsuka, S; Yoshikawa, H; Kashiwazaki, S

    1992-07-01

    We analyzed mutant alleles of adenine phosphoribosyltransferase (APRT) deficiency in Japanese patients. Among 141 defective APRT alleles from 72 different families, 96 (68%), 30 (21%), and 10 (7%) had an ATG to ACG missense mutation at codon 136 (APRT*J allele), TGG to TGA nonsense mutation at codon 98, and duplication of a 4-bp sequence in exon 3, respectively. The disease-causing mutations of only four (3%) of all the alleles among Japanese remain to be elucidated. Thus, a diagnosis can be made for most of the Japanese APRT-deficient patients by identifying only three disease-causing mutations. All of the different alleles with the same mutation had the same haplotype, except for APRT*J alleles, thereby suggesting that alleles with the same mutation in different families were derived from the same ancestral gene. Evidence for a crossover or gene conversion event within the APRT gene was observed in an APRT*J mutant allele. Distribution of mutant alleles encoding APRT deficiency among the Japanese was similar to that seen in cystic fibrosis genes among Caucasians and Tay-Sachs genes among the Ashkenazi Jews. PMID:1353080

  19. Quantitative estimation of antioxidant therapy efficiency in diabetes mellitus patients

    NASA Astrophysics Data System (ADS)

    Gurfinkel, Youri I.; Ishunina, Angela M.; Ovsyannickov, Konstantin V.; Strokov, Igor A.

    2000-11-01

    The aim of this work was to find out to which degree Tanakan affects the microcirculation parameters and the malonic dialdehyde level as a parameter of intense lipid peroxidation in insulin-independent diabetes patients with different disease durations. We used computerized capillaroscope GY-0.04 designed by the Centre for Analysis of Substances, Russia for the non-invasive measurement of capillary blood velocity as well as the size of the perivascular zone and density of blood aggregates and lipid inclusions. The microcirculation parameters were studied in two groups of insulin-independent diabetes patients. The basic group included 58 patients (61+/-9,0 years, disease duration 14,7+/-7,8 years). The patients had late diabetic complications as retinopathy and nephrophathy, neuropathy, confirmed by clinical and tool investigation. In this group we also studied the level of serum malonic dialdehyde, as a parameter of intense lipid peroxidation. The reference group included 31 patients (57+/-1,3 years, disease duration 3,6+/-0,6 years) with minimum diabetic complication. We show that Tanakan in daily dosage 120 mg for 2 months reduces the malonic dialdehyde level in the blood serum and the erythrocyte membranes of type II diabetes patients and improves the microcirculation parameters. There are correspondences between the density of lipid inclusions as determined with computerized capillaroscopy and the lipid exchange parameters as determined using a routing blood test. Thus, noninvasive blood lipid quantification is feasible and reliable.

  20. Safety and tolerance of sorafenib in Japanese patients with advanced hepatocellular carcinoma

    Microsoft Academic Search

    Sadahisa OgasawaraFumihiko; Fumihiko Kanai; Shuntaro Obi; Shinpei Sato; Taketo Yamaguchi; Ryosaku Azemoto; Hideaki Mizumoto; Youhei Koushima; Naoki Morimoto; Nobuto Hirata; Takeshi Toriyabe; Yusuke Shinozaki; Yoshihiko Ooka; Rintaro Mikata; Tetsuhiro Chiba; Shinichiro Okabe; Fumio Imazeki; Masaharu Yoshikawa; Osamu Yokosuka

    Purpose  Sorafenib provides a survival benefit for patients with advanced hepatocellular carcinoma (HCC). However, there has been little\\u000a experience with it in Japan. This study evaluated the safety and tolerance of sorafenib in Japanese patients with HCC.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Clinical data for patients given sorafenib for advanced HCC were captured from eight institutions. All patients were classified\\u000a as Child-Pugh A and the treatment

  1. Improvements in Care and Reduced Self-Management Barriers Among Rural Patients With Diabetes

    ERIC Educational Resources Information Center

    Dettori, Nancy; Flook, Benjamin N.; Pessl, Erich; Quesenberry, Kim; Loh, Johnson; Harris, Colleen; McDowall, Janet M.; Butcher, Marcene K.; Helgerson, Steven D.; Gohdes, Dorothy; Harwell, Todd S.

    2005-01-01

    Improved preventive care and clinical outcomes among patients with diabetes can reduce complications and costs; however, diabetes care continues to be suboptimal. Few studies have described effective strategies for improving care among rural populations with diabetes. In 2000, the Park County Diabetes Project and the Montana Diabetes Control…

  2. Diabetes

    MedlinePLUS

    ... version of this page please turn Javascript on. Diabetes What is Diabetes? Too Much Glucose in the Blood Diabetes means ... high, causing pre-diabetes or diabetes. Types of Diabetes There are three main kinds of diabetes: type ...

  3. The quality of life of elderly diabetic patients

    Microsoft Academic Search

    Per E Wändell; Jonas Tovi

    2000-01-01

    The objective of this study was to evaluate the health-related quality of life (HRQoL) of elderly diabetic patients. A cross-sectional, questionnaire survey of diabetic subjects aged 65–84 years (n=177 respondents) from three community health centers in Stockholm County. The HRQoL was assessed by the Swedish Health-Related Quality of Life Survey (SWED-QUAL), a generic HRQoL questionnaire adapted from the Medical Outcomes

  4. Pharmacological interventions on critical limb ischemia in diabetic patients.

    PubMed

    Parekh, N; Nanjundappa, A; Dieter, R S

    2012-02-01

    Peripheral arterial disease is highly prevalent in patients with diabetes mellitus. Critical limb ischemia is an important component of this disease entity. Early diagnosis, identification of risk factors, and appropriate therapeutic management strategies are needed to aggresively treat this disease. This paper reviews risk factors for critical limb ischemia and discusses updates on pharmacologic therapies with a specific focus on the diabetic population. PMID:22231528

  5. Severe hyperkalemia in two patients with diabetes after cosyntropin administration.

    PubMed

    Feuerstein, B L; Lebowitz, M R; Blumenthal, S A; Weinstock, R S

    1992-01-01

    Some patients with diabetes mellitus are at increased risk for the development of hyperkalemia. Included in this group are patients with glucose-induced hyperkalemia who may have renal insufficiency, hyporeninemic hypoaldosteronism, or other impediments to the release or action of aldosterone. In an unusual demonstration of this abnormality, two patients with diabetes, who form the basis of our report, became markedly hyperglycemic and hyperkalemic after cosyntropin administration. To our knowledge, this complication of adrenocorticotropic hormone (ACTH) stimulation testing has not been previously reported. It should therefore be emphasized that the use of cosyntropin as a diagnostic agent can provoke severe hyperglycemia and hyperkalemia in a susceptible subgroup of patients with diabetes mellitus. PMID:1472747

  6. Management of patients with type 1 diabetes in the hospital.

    PubMed

    Yogi-Morren, Divya; Lansang, M Cecilia

    2014-02-01

    Managing a patient with type 1 diabetes mellitus can be challenging to the inpatient medical team. These patients require a continuous supply of exogenous insulin, and the omission of even a single dose can result in severe hyperglycemia and diabetic ketoacidosis. This article aims to equip the inpatient medical team with the knowledge and expertise required to care for these patients in the hospital, including transitioning from home to hospital, transitioning from the intravenous insulin infusion to the subcutaneous route, subcutaneous insulin dosing including the insulin pump, and transitioning back to home. PMID:24398661

  7. Visual acuity outcome in patients with diabetic maculopathy

    PubMed Central

    Serban, R; Cioboata, M; Chiotan, C; Corn?cel, C; Liora, R; Anghelie, A

    2014-01-01

    The purpose of this study is to follow up visual acuity in patients diagnosed with clinically significant macular edema and treated by an intravitreal injection of triamcinolone acetonide or in combination with bevacizumab. The working method: based on the selectivity criteria we involved 295 patients (460 eyes), divided into 2 groups according to the treatment administered and one control group. The results showed a better preservation of the functional parameter for the group of patients treated with intravitreal injection of triamcinolone acetonide and bevacizumab. Abbreviations: VA = visual acuity, VA0 = visual acuity at study entry, WESDR = Wisconsin epidemiological study of diabetic retinopathy, ETDRS = Early treatment diabetic retinopathy study, OCT = optical coherence tomography

  8. Glycemic control and diabetes management in hospitalized patients in Brazil

    PubMed Central

    2013-01-01

    Background The importance of tight blood glucose control among outpatients with diabetes mellitus is well established, however, the management of diabetes in the hospital setting is generally considered secondary in importance. This study sought to assess glycemic control and diabetes management in adult patients admitted to hospitals in Brazil. Methods A cross-sectional and nationwide survey was conducted from July 2010 to January 2012. Eligible cases were 18 years of age or older, had a diagnosis of diabetes and a hospitalization length of stay ?72 hours. Socio-demographic information, hospitalization details, and data on diabetes diagnosis, management and treatment were collected for all patients by chart review. Information on all blood glucose (BG) readings for a maximum of 20 consecutive days of hospitalization was recorded for each patient. Results Overall, 2,399 patients were surveyed in 24 hospitals located in 13 cities from all five Brazilian regions. The prevalence of patients presenting hyperglycemic (BG >180 mg/dL) or hypoglycemic (BG <70 mg/dL) events was 89.4% and 30.9% in patients in general wards, and 88.2% and 27.7% in those in Intensive Care Units (ICUs), respectively. In addition, a BG measure >180 mg/dL was recorded in two-thirds of the patient-days. A high proportion of patients were treated with sliding-scale insulin regimen alone in the general wards (52.0%) and in the ICUs (69.2%), and only 35.7% and 3.9% received appropriate insulin therapy in general wards (basal + bolus insulin) and in ICUs (continuous IV insulin), respectively. Conclusions Inpatient glycemic control and diabetes management needs improvement. Opportunities to improve care in Brazilian hospitals include expanded use of intravenous insulin and subcutaneous basal-bolus insulin protocols, avoiding use of sliding-scale insulin alone, increased frequency of blood glucose monitoring, and institution wide quality improvement efforts targeting both physician and nursing behavior. PMID:24499564

  9. [Distal revascularization in diabetic patients with chronic limb ischemia].

    PubMed

    Courtois, M-C; Sapoval, M; Del Giudice, C; Ducloux, R; Mirault, T; Messas, E

    2015-02-01

    Diabetes mellitus is an independent risk factor for peripheral artery disease. Life expectancy is 41 months for diabetic patients with an ischemic ulcer. The characteristics of diabetic arteriopathy make its treatment more difficult than in non-diabetic patients. Few data are available about the surgical treatment of arteriopathy in diabetic patients (including angioplasty or bypass), especially in case of distal arteriopathy. The choice of the procedure depends on multiple factors such as the disease localization, its extent, distal blood flow and vascular disease-related surgical risk. The principal aim of revascularisation is to restore direct flow to the foot in order to ensure wound healing and limb salvage. With percutaneous endoluminal angioplasty, limb salvage can be achieved in more than 80 % of patients at 1-3 years. The percutaneous procedure is less invasive than open surgery, there are fewer complications, and morbidity and mortality rates are reduced; moreover, a second procedure remains possible in the future. With bypass surgery, the rate of limb salvage exceeds 80 % at five years. Nevertheless, peri-operative mortality reaches 3 % and arterial anatomy, patient-related risks factors or venous graft availability may be limitations. New endovascular techniques especially designed for the distal arteries of the lower limbs enable very distal revascularization with morbidity and mortality rates lower than with surgery. PMID:25596672

  10. Novel USH2A mutations in Japanese Usher syndrome type 2 patients: marked differences in the mutation spectrum between the Japanese and other populations.

    PubMed

    Nakanishi, Hiroshi; Ohtsubo, Masafumi; Iwasaki, Satoshi; Hotta, Yoshihiro; Usami, Shin-Ichi; Mizuta, Kunihiro; Mineta, Hiroyuki; Minoshima, Shinsei

    2011-07-01

    Usher syndrome (USH) is an autosomal recessive disorder characterized by retinitis pigmentosa and hearing loss. USH type 2 (USH2) is the most common type of USH and is frequently caused by mutations in USH2A. In a recent mutation screening of USH2A in Japanese USH2 patients, we identified 11 novel mutations in 10 patients and found the possible frequent mutation c.8559-2A>G in 4 of 10 patients. To obtain a more precise mutation spectrum, we analyzed further nine Japanese patients in this study. We identified nine mutations, of which eight were novel. This result indicates that the mutation spectrum for USH2A among Japanese patients largely differs from Caucasian, Jewish and Palestinian patients. Meanwhile, we did not find the c.8559-2A>G in this study. Haplotype analysis of the c.8559-2G (mutated) alleles using 23 single nucleotide polymorphisms surrounding the mutation revealed an identical haplotype pattern of at least 635?kb in length, strongly suggesting that the mutation originated from a common ancestor. The fact that all patients carrying c.8559-2A>G came from western Japan suggests that the mutation is mainly distributed in that area; indeed, most of the patients involved in this study came from eastern Japan, which contributed to the absence of c.8559-2A>G. PMID:21593743

  11. Motivations of Patients with Diabetes to Participate in Research

    PubMed Central

    Geppert, Cynthia; Candilis, Philip; Baker, Stephen; Lidz, Charles; Appelbaum, Paul; Fletcher, Kenneth

    2014-01-01

    Background Research on the motivations of research participants has focused primarily on vulnerable populations at risk of exploitation, and there is little research on the motivations and reasons of general medical patients participating in research. Given a significant increase in research studies recruiting participants with diabetes, we sought to better understand the motivations of patients with diabetes considering a general medical research protocol. Methods The analyses presented here compare the reasoning and willingness to participate in a hypothetical research study of medically ill subjects (patients with diabetes, n=51) with non-ill (n=57) subjects. Responses on the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) were correlated with demographic variables and scores on the Mini-Mental State Examination (MMSE) and Short-Form-36 (SF-36). Results Overall, 44% of the group with diabetes and 56% of the comparison group indicated a willingness to participate in the research study. The reasons diabetic and comparison groups offered for willingness or unwillingness to participate in research did not differ significantly. 75% mentioned reasons related to treatment, 63% altruism; none mentioned money. Of those patients with diabetes who would not participate in research, 94% cited risk, and 89% expressed an aversion to research. Conclusions The present study suggests that when research is not related to their diagnosis, persons with diabetes do not differ significantly from non-ill comparison subjects in their motivations to participate in research. Given the similarity of our subjects’ motivations to those of other medically ill populations, it may be that investigators can now focus more closely on the decision-making characteristics of their patients involved in clinical research rather than their diagnoses. PMID:25419533

  12. Yogic practice and diabetes mellitus in geriatric patients

    PubMed Central

    Beena, Rani K; Sreekumaran, E

    2013-01-01

    Background: Stress has negative effect on health and type 2 diabetes patients may be at an increased risk. Abnormally high levels of free radicals and the simultaneous decline of antioxidant defense mechanisms can increase lipid peroxidation and insulin resistance. The objective of the present study was to demonstrate the efficacy of yogic practice in geriatric patients with type 2 diabetes mellitus and also to compare the efficacy with the state of glycaemic control. Materials and Methods: Seventy three (73) healthy elderly patients of type 2 diabetes mellitus in the age group of 60 to 70 years with a history of diabetes for 5 to 10 years and with poor glycaemic control (HbA1c >8 %) residing in Kozhikode district were recruited for the study. The subjects were divided into three groups according to their glycaemic control. Group I with HbA1c 8.6–9.7 %, group II with HbA1c 9.8–10.7 % and group III with HbA1c 10.8–12.7 %. Participants did yogic practice under the supervision of experienced trainer, daily 90 minutes and for three months. Biochemical estimation of HbA1c, glucose, lipid profile, cortisol, ferritin, malondialdehyde (MDA) and catalase activity were carried out on 0 day and 90th day. Seventy patients participated in a comparable control session. Results: The participants in the test group showed statistically significant (P < 0.001) decrease in glucose, HbA1c, lipids, cortisol, ferritin, MDA and significant increase in catalase activity after yogic practice. Conclusions: Yoga may improve risk profiles induced by stress in geriatric patients with type 2 diabetes and may have promise for the prevention or delay in diabetes complications. And at all stages of the disease a significant improvement can be achieved by yogic practice in geriatric diabetes. PMID:23440675

  13. Fluorescence lifetime imaging ophthalmoscopy in type 2 diabetic patients who have no signs of diabetic retinopathy.

    PubMed

    Schweitzer, Dietrich; Deutsch, Lydia; Klemm, Matthias; Jentsch, Susanne; Hammer, Martin; Peters, Sven; Haueisen, Jens; Müller, Ulrich A; Dawczynski, Jens

    2015-06-01

    The time-resolved autofluorescence of the eye is used for the detection of metabolic alteration in diabetic patients who have no signs of diabetic retinopathy. One eye from 37 phakic and 11 pseudophakic patients with type 2 diabetes, and one eye from 25 phakic and 23 pseudophakic healthy subjects were included n the study. After a three-exponential fit of the decay of autofluorescence, histograms of lifetimes ?(i), amplitudes ?(i), and relative contributions Q(i) were statistically compared between corresponding groups in two spectral channels (490 < ch1 < 560 nm, 560 < ch2 < 700 nm). The change in single fluorophores was estimated by applying the Holm–Bonferroni method and by calculating differences in the sum histograms of lifetimes. Median and mean of the histograms of ?(2), ?(3), and ?(3) in ch1 show the greatest differences between phakic diabetic patients and age-matched controls (p < 0.000004). The lack of pixels with a ?(2) of ?360 ps, the increased number of pixels with ?(2) > 450 ps, and the shift of ?(3) from ?3000 to 3700 ps in ch1 of diabetic patients when compared with healthy subjects indicate an increased production of free flavin adenine dinucleotide, accumulation of advanced glycation end products (AGE), and, probably, a change from free to protein-bound reduced nicotinamide adenine inucleotide at the fundus. AGE also accumulated in the crystalline lens. PMID:25769278

  14. Potential Effect of Opium Consumption on Controlling Diabetes and Some Cardiovascular Risk Factors in Diabetic Patients

    PubMed Central

    Rahimi, Najmeh; Gozashti, Mohamad Hossain; Najafipour, Hamid; Shokoohi, Mostafa; Marefati, Hamid

    2014-01-01

    Background Due to this belief that opium may have beneficial effects on diabetes or cardiovascular risk factors, the present study aimed to assess the potential and possible effects of opium consumption on diabetes control and some cardiovascular risk factors in diabetic patients. Methods This study enrolled 374 diabetic subjects from diabetes care centers in Kerman, Iran, including opium user group (n = 179) and a non-opium user group (n = 195). The data were collected through a questionnaire completed by interviewing, physical examination and laboratory assessment. Findings Opium did not show any statistically significant effect on blood glucose, glycated hemoglobin (HbA1C), fasting blood sugar (FBS), low-density lipoprotein (LDL) and diastolic blood pressure. However, systolic blood pressure (SBP) and prevalence of high SBP were significantly higher in opium user group (P < 0.050). In addition, lower serum high-density lipoprotein (HDL) and frequency of lower HDL was significantly higher in opium user group (P < 0.001). Conclusion According to this study, opium does not seem to have beneficial effects on diabetes control or cardiovascular risk factors. Therefore, it would not be advisable to consume opium as an anti-diabetes or cardioprotective agent. PMID:25140211

  15. Prevalence of microalbuminuria, arterial hypertension, retinopathy, and neuropathy in patients with insulin dependent diabetes

    Microsoft Academic Search

    Hans-Henrik Parving; Eva Hommel; Elisabeth Mathiesen; Peter Skøtt; Berit Edsberg; Mogens Bahnsen; Mogens Lauritzen; Philip Hougaard; Erik Lauritzen

    1988-01-01

    Diabetic nephropathy is the main cause of the increased morbidity and mortality in patients with insulin dependent diabetes. The prevalence of microalbuminuria was determined in adults with insulin dependent diabetes of five or more years' duration that had started before the age of 41. All eligible patients (n=982) attending a diabetes clinic were asked to collect a 24 hour urine

  16. Relationship between pigment epithelium-derived factor (PEDF) and renal function in patients with diabetic retinopathy

    Microsoft Academic Search

    Kayako Matsuyama; Nahoko Ogata; Masato Matsuoka; Chieko Shim; Mitsumasa Wada; Nobuo Jo; Miyo Matsumura

    Purpose: Diabetic retinopathy and nephropathy are microvascular complications in patients with diabetes that are considered to be related. Pigment epithelium-derived factor (PEDF), a strong inhibitor of angiogenesis, is significantly elevated in the blood of diabetic patients, especially those with proliferative diabetic retinopathy (PDR). The level of PEDF in the blood, on the other hand, is reported to be low in

  17. Re-amputation after minor foot amputation in diabetic patients: Risk factors leading to limb loss

    PubMed Central

    Nerone, Vincent S.; Springer, Kevin D.; Atway, Said

    2014-01-01

    Burn injury in diabetic patients has been a recent topic of interest in published studies. Previous studies have shown increased complications in diabetic patients compared with nondiabetic controls who have sustained these injuries. A paucity of research has been devoted to foot-specific diabetic burn injury. We present a case series evaluating the mechanisms and complications of diabetic foot burns. PMID:23419696

  18. Angina and exertional myocardial ischemia in diabetic and nondiabetic patients: assessment by exercise thallium scintigraphy

    SciTech Connect

    Nesto, R.W.; Phillips, R.T.; Kett, K.G.; Hill, T.; Perper, E.; Young, E.; Leland, O.S. Jr.

    1988-02-01

    Patients with diabetes mellitus and coronary artery disease are thought to have painless myocardial ischemia more often than patients without diabetes. We studied 50 consecutive patients with diabetes and 50 consecutive patients without diabetes, all with ischemia, on exercise thallium scintigraphy to show the reliability of angina as a marker for exertional ischemia. The two groups had similar clinical characteristics, treadmill test results, and extent of infarction and ischemia, but only 7 patients with diabetes compared with 17 patients without diabetes had angina during exertional ischemia. In diabetic patients the extent of retinopathy, nephropathy, or peripheral neuropathy was similar in patients with and without angina. Angina is an unreliable index of myocardial ischemia in diabetic patients with coronary artery disease. Given the increased cardiac morbidity and mortality in such patients, periodic objective assessments of the extent of ischemia are warranted.

  19. Homocysteine Serum Levels in Diabetic Patients with Non Proliferative, Proliferative and without Retinopathy

    PubMed Central

    Gagliano, Caterina; Giordano, Maria; Vacante, Marco; Caraci, Filippo; Drago, Filippo; Avitabile, Teresio; Motta, Massimo

    2014-01-01

    Homocysteine has been associated with extracellular matrix changes. The diabetic retinopathy is a neurovascular complication of diabetes mellitus and it is the leading cause of vision loss among working adults worldwide. In this study, we evaluate the role of homocysteine in diabetic retinopathy analyzing the plasma levels of homocysteine in 63 diabetic type 2 patients with nonproliferative retinopathy (NPDR), 62 patients with proliferative diabetic retinopathy (PDR), 50 healthy subjects used as control group, and 75 randomly selected patients. PMID:24877066

  20. Homocysteine serum levels in diabetic patients with non proliferative, proliferative and without retinopathy.

    PubMed

    Malaguarnera, Giulia; Gagliano, Caterina; Giordano, Maria; Salomone, Salvatore; Vacante, Marco; Bucolo, Claudio; Caraci, Filippo; Reibaldi, Michele; Drago, Filippo; Avitabile, Teresio; Motta, Massimo

    2014-01-01

    Homocysteine has been associated with extracellular matrix changes. The diabetic retinopathy is a neurovascular complication of diabetes mellitus and it is the leading cause of vision loss among working adults worldwide. In this study, we evaluate the role of homocysteine in diabetic retinopathy analyzing the plasma levels of homocysteine in 63 diabetic type 2 patients with nonproliferative retinopathy (NPDR), 62 patients with proliferative diabetic retinopathy (PDR), 50 healthy subjects used as control group, and 75 randomly selected patients. PMID:24877066

  1. A new single base substitution in a Japanese phenylketonuria (PKU) patient.

    PubMed

    Shirahase, W; Oya, N; Shimada, M

    1991-07-01

    DNA analysis on phenylalanine hydroxylase (PAH) gene was performed in four Japanese PKU patients. By the Southern analysis, three patients were confirmed to be homozygous for haplotype 4, and the other one was homozygous for haplotype 2. Sequence analysis on the mutant PAH gene of this haplotype 2 patient, who was born to first-cousin parents, disclosed it to be a C-to-T transition in exon 7. This transition causes the substitution of Arg261 codon to a termination codon. PMID:1683521

  2. A qualitative study of mindfulness-based meditation therapy in Japanese cancer patients

    Microsoft Academic Search

    Michiyo Ando; Tatsuya Morita; Tatsuo Akechi; Yuka Ifuku

    2011-01-01

    Purpose  The primary objective of the study was to examine mindfulness-based meditation therapy qualitatively. A secondary goal was\\u000a to examine the differences in themes selected by Japanese and Western patients receiving this therapy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The subjects were 28 patients who were undergoing anti-cancer treatment. The subjects participated in two sessions of mindfulness-based\\u000a meditation therapy, including breathing, yoga movement, and meditation. Each patient

  3. Treatment of 153 Japanese patients with Q-switched alexandrite laser

    Microsoft Academic Search

    Shinji Kagami; Akihiko Asahina; Rei Watanabe; Yoshihiro Mimura; Akira Shirai; Naoko Hattori; Takahiro Watanabe; Kunihiko Tamaki

    2007-01-01

    We have recently used Q-switched alexandrite laser for the treatment of various kinds of pigmented skin lesions. We retrospectively\\u000a compared therapeutic outcomes of 153 Japanese patients who consulted our department. This approach was not very efficient\\u000a for nevus spilus\\/café-au-lait spots, which seemed laser-resistant, especially when the pigmentation had appeared after 1 year\\u000a of age, was treated after 5 years of age, was

  4. Increased frequency of specific alleles of the cHa ras gene in Japanese cancer patients

    Microsoft Academic Search

    Kazuo Honda; Kanji Ishizaki; Mituo Ikenaga; Junya Toguchida; Takashi Inamoto; Kouichi Tanaka; Kazue Ozawa

    1988-01-01

    We have examined the c-Ha-ras locus in 145 cancer patients of a mixed group and 164 normal individuals in Japan for restriction fragment length polymorphisms and compared the allele distributions in normal and cancer populations. The c-Ha-ras gene is highly polymorphic in Japanese as previously reported in Caucasians. Two rare alleles were found to be present with increased frequencies in

  5. Phase II Study to Investigate the Efficacy, Safety, and Pharmacokinetics of Sorafenib in Japanese Patients with Advanced Renal Cell Carcinoma

    Microsoft Academic Search

    Hideyuki Akaza; Taiji Tsukamoto; Masaru Murai; Keiko Nakajima; Seiji Naito

    2007-01-01

    Objective: Sorafenib (Nexavarw) is an oral multi-kinase inhibitor that targets tumor growth and angiogenesis. This phase II study investigated efficacy, safety, and pharmacokinetics of sorafenib in Japanese patients with advanced renal cell carcinoma (RCC). Methods: Nonrandomized, open-label study in Japanese patients with metastatic renal cell carcinoma who had received nephrectomy and failed ? 1 cytokine-containing therapy. The primary endpoint was

  6. Urinary tract infections in patients with diabetes

    Microsoft Academic Search

    Ann Stapleton

    2002-01-01

    Results of various epidemiologic studies suggest that bacteriuria and urinary tract infection (UTI) occur more commonly in women with diabetes than in women without this disease. Similar findings have been demonstrated for asymptomatic bacteriuria (ASB), with ASB being a risk factor for pyelonephritis and subsequent decline in renal function. Although ASB is not associated with serious health outcomes in healthy

  7. Lifestyle intervention for type 2 diabetes patients – trial protocol of The Copenhagen Type 2 Diabetes Rehabilitation Project

    Microsoft Academic Search

    Eva S Vadstrup; Anne Frølich; Hans Perrild; Eva Borg; Michael Røder

    2009-01-01

    BACKGROUND: Current guidelines recommend education, physical activity and changes in diet for type 2 diabetes patients, yet the composition and organization of non-pharmacological care are still controversial. Therefore, it is very important that programmes aiming to improve non-pharmacological treatment of type 2 diabetes are developed and evaluated. The Copenhagen Type 2 Diabetes Rehabilitation Project aims to evaluate the effectiveness of

  8. Early prediction of blonanserin response in Japanese patients with schizophrenia

    PubMed Central

    Kishi, Taro; Matsuda, Yuki; Fujita, Kiyoshi; Iwata, Nakao

    2014-01-01

    Background Blonanserin is a second-generation antipsychotic used for the treatment of schizophrenia in Japan and Korea. The present study aimed to examine early prediction of blonanserin in patients with schizophrenia. Methods An 8-week, prospective, single-arm, flexible-dose clinical trial of blonanserin in patients with schizophrenia was conducted under real-world conditions. The inclusion criteria were antipsychotic naïve, and first-episode schizophrenia patients or schizophrenia patients with no consumption of any antipsychotic medication for more than 4 weeks before enrollment in this study. The positive predictive value, negative predictive value, sensitivity, specificity, and predictive power were calculated for the response status at week 4 to predict the subsequent response at week 8. Results Thirty-seven patients were recruited (56.8% of them had first-episode schizophrenia), and 28 (75.7%) completed the trial. At week 8, blonanserin was associated with a significant improvement in the Positive and Negative Syndrome Scale (PANSS) total score (P<0.0001) and in positive (P<0.0001), negative (P<0.0001), and general subscale scores (P<0.0001). In terms of percentage improvement of PANSS total scores from baseline to week 8, 64.9% of patients showed a ?20% reduction in the PANSS total score and 48.6% showed a ?30% reduction. However, 8.1% of patients experienced at least one adverse event. Using the 20% reduction in the PANSS total score at week 4 as a definition of an early response, the negative predictive values for later responses (ie, reductions of ?30 and ?40 in the PANSS total scores) were 88.9% and 94.1%, respectively. The specificities were 80.0% and 51.6%, respectively. Conclusion Our results suggest that the blonanserin response at week 4 could predict the later response at week 8. PMID:25285009

  9. Novel USH2A mutations in Japanese Usher syndrome type 2 patients: marked differences in the mutation spectrum between the Japanese and other populations

    Microsoft Academic Search

    Hiroshi Nakanishi; Masafumi Ohtsubo; Satoshi Iwasaki; Yoshihiro Hotta; Shin-ichi Usami; Kunihiro Mizuta; Hiroyuki Mineta; Shinsei Minoshima

    2011-01-01

    Usher syndrome (USH) is an autosomal recessive disorder characterized by retinitis pigmentosa and hearing loss. USH type 2 (USH2) is the most common type of USH and is frequently caused by mutations in USH2A. In a recent mutation screening of USH2A in Japanese USH2 patients, we identified 11 novel mutations in 10 patients and found the possible frequent mutation c.8559-2A>G

  10. Diabetic Neuropathy: A Clinical and Neuropathological Study of 107 Patients

    PubMed Central

    Younger, David S.

    2010-01-01

    One hundred seven patients were retrospectively studied from 1992 to 2002 with diabetic neuropathy that underwent peripheral nerve biopsy. Nerve biopsy revealed the underlying histopathology, including cell and humoral-mediated immunological lesions in the majority of patients. When combined with clinical and laboratory studies, nerve biopsy has the potential to assist in the selection of patients who may benefit from immunomodulatory therapy. PMID:21152210

  11. Monocyte chemoattractant protein-1 promoter ?2518 polymorphism is associated with post-challenge insulin and glucose levels in non-diabetic Japanese subjects

    Microsoft Academic Search

    Noriko Maruyama-Furuta; Yutaka Yano; Esteban C. Gabazza; Mina Suematsu; Kazutaka Matsumoto; Hajime Akatsuka; Nelson E. Bruno; Rika Araki; Akira Katsuki; Yasuhiro Sumida

    2007-01-01

    We investigated that the association of MCP-1 polymorphism at position ?2518 with insulin sensitivity and insulin secretion by measuring the fasting and post-challenge glucose and insulin levels during 75g OGTT in 409 non-diabetic Japanese subjects. The blood sampling was performed before glucose loading and after 30 and 120min. Polymorphism was evaluated by PCR-RFLP method by genomic DNA isolated from peripheral

  12. A Japanese case series of 12 patients with esophageal eosinophilia

    Microsoft Academic Search

    Yasuhiko AbeKatsunori; Katsunori Iijima; Shuichi Ohara; Tomoyuki Koike; Nobuyuki Ara; Kaname Uno; Naoki Asano; Akira Imatani; Katsuaki Kato; Daisuke Shibuya; Tooru Shimosegawa

    2011-01-01

    Background  Eosinophilic esophagitis (EoE) has been a rarely recognized condition in Asian populations, and its clinical manifestation\\u000a is rarely documented. Our aim was to describe clinically, endoscopically, and pathologically the features of patients with\\u000a esophageal eosinophilia, including EoE.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Twelve patients histologically proven to have esophageal eosinophilia were investigated. The histological diagnostic cutoff\\u000a value was defined as a peak of ?15 eosinophils\\/high-power

  13. Long-term outcome of immunosuppressive therapy for Japanese patients with lower-risk myelodysplastic syndromes.

    PubMed

    Hata, Tomoko; Tsushima, Hideki; Baba, Maki; Imaizumi, Yoshitaka; Taguchi, Jun; Imanishi, Daisuke; Nagai, Kazuhiro; Tomonaga, Masao; Miyazaki, Yasushi

    2013-12-01

    To investigate the long-term usefulness of immunosuppressive therapy (IST) for Japanese patients with lower-risk myelodysplastic syndromes, we retrospectively analyzed 29 MDS patients who were treated with cyclosporine A alone or with anti-thymocyte globulin at a single institute in Japan. A total of 58.6 % of patients showed hematological response to IST. Overall survival of all patients was 74.5 % at 5 years and 48.3 % at 10 years. The major adverse event was the elevation of creatinine level (grade 1 and 2). Eleven patients were still on IST at the time of analysis with, at least, some clinical benefits. Pneumonia was the most frequent cause of death (eight of 12 deaths), followed by bleeding (three of 12); most of the patients who died were non-responders. The presence of paroxysmal nocturnal hemoglobinuria-type cells was significantly associated with both response to IST and long-term survival by univariate analysis. The 10-year overall survival of responders (72.2 %) was significantly superior to that of non-responders (15.6 %, P < 0.0001). These results suggest that IST using cyclosporine A provides long-term benefit for Japanese patients with lower-risk MDS. PMID:24254637

  14. Scleredema Diabeticorum in a Patient with Type 2 Diabetes Mellitus

    PubMed Central

    Martín, C.; Requena, L.; Manrique, K.; Manzarbeitia, F. D.; Rovira, A.

    2011-01-01

    Background. Scleredema adultorum, a connective tissue disorder of unknown aetiology, is characterized by a thickening of the reticular dermis in the upper back of the body that may decrease the mobility of the affected tissues. It has been reported in diabetic patients with poor metabolic control. Therapeutic options are limited with generally poor results. Case Report. 53-year-old white male with type 2 diabetes mellitus was referred to our department for evaluation of incipient nephropathy and retinopathy. On examination, he presented erythematous, indurated, painless and ill-defined plaque on the skin of the upper back with limited movement of shoulders. A biopsy was done revealing scleredema. PUVA treatment and physiotherapy were started with the amelioration of mobility and acquiring some elasticity of the upper back. Discussion. The development of scleredema in diabetic patients has been related to prolonged exposure to chronic hyperglycaemia. Our patient has had diabetes for 20 years with an acceptable glucose control, however he developed the scleredema 10 years ago. Conclusions. Scleredema is a rare connective disorder that seems to appear most frequently in diabetic subjects. Good metabolic control seems not to preclude its development. PUVA treatment and physiotherapy are therapeutic options that seem to be of some help. PMID:22937286

  15. Pulmonary multinodular mucormycosis in type 1 diabetic patient with diabetic ketoacidosis.

    PubMed

    Kebapci, N; Efe, B; Alata?, F; Açikalin, M; Kiraz, N

    2007-03-01

    We report a case of pulmonary multinodular mucormycosis in a Type 1 diabetic patient with diabetic ketoacidosis. He had a history of 20-pack-year tobacco use. The initial chest roentgenogram and thorax tomography (after the treatment of diabetic ketoacidosis) revealed multiple nodular lesions with cavitation in the upper lobes of pulmonary parenchyma. Resection of three nodular lesion demonstrated cheesy necrotic mass in the cavitating lesions. The diagnosis of pulmonary multinodular mucormycosis was made depending on the histopathologic examination yielding nonseptated right angle branching-shaped hyphae typical of mucormycosis. The patient was started on liposomal amphotericin B and discharged at the sixth week of therapy with a scheduled therapy of amphotericin B. When he came back after 33 months, he was metabolically unregulated under the insulin therapy. He confessed that he had been smoking heroin besides tobacco for the last 5 years. A new thorax computerized tomography showed that pulmonary nodules were slightly regressed but not resolved. PMID:17505160

  16. Prevention of type 2 diabetes by lifestyle intervention: a Japanese trial in IGT males

    Microsoft Academic Search

    Kinori Kosaka; Mitsuihiko Noda; Takeshi Kuzuya

    2005-01-01

    Prevention of type 2 diabetes by intensive lifestyle intervention designed to achieve and maintain ideal body weight was assessed in subjects with impaired glucose tolerance (IGT). Male subjects with IGT recruited from health-screening examinees were randomly assigned in a 4:1 ratio to a standard intervention group (control group) and intensive intervention group (intervention group). The final numbers of subjects were

  17. Diabetes Patients Lax with Meds If Diagnosed with Cancer, Study Finds

    MedlinePLUS

    ... features on this page, please enable JavaScript. Diabetes Patients Lax With Meds If Diagnosed With Cancer, Study ... new study included more than 16,000 diabetes patients, average age 68, taking drugs to lower their ...

  18. Age Differences in Visits to Office-Based Physicians by Patients with Diabetes: United States, 2010

    MedlinePLUS

    ... Differences in Visits to Office-based Physicians by Patients With Diabetes: United States, 2010 On This Page ... the number of office-based physician visits by patients with diabetes increase between 2005 and 2010? Overall ...

  19. Mastication and Risk for Diabetes in a Japanese Population: A Cross-Sectional Study

    PubMed Central

    Yamazaki, Toru; Yamori, Masashi; Asai, Keita; Nakano-Araki, Ikuko; Yamaguchi, Akihiko; Takahashi, Katsu; Sekine, Akihiro; Matsuda, Fumihiko; Kosugi, Shinji; Nakayama, Takeo; Inagaki, Nobuya; Bessho, Kazuhisa

    2013-01-01

    Background Associations between mastication and insufficient nutrient intake, obesity, and glucose metabolism have been shown in previous studies. However, the association between mastication and diabetes has not been clarified. Our objective was to examine the association between mastication, namely masticatory performance or rate of eating, and diabetes in a population-based cohort. Methods We conducted a cross-sectional study of the association between mastication and diabetes in the Nagahama Prospective Cohort Study, an ongoing study which recruits citizens of Nagahama City in Shiga Prefecture, central Japan. 2,283 male and 4,544 female residents aged 40–74 years were enrolled from July 2009 to November 2010. Masticatory performance was evaluated by spectrophotometric measurement of color changes after masticating color-changeable chewing gum. Categorical rate of eating (fast, intermediate or slow) was self-assessed using a questionnaire. Results 177 males (7.7%) and 112 (2.4%) females were diagnosed with diabetes. We divided participants into four groups by quartile of masticatory performance, namely Q1 (lowest), 2, and 3 and 4 (highest). Compared to the lowest performance group, the multivariable adjusted odds ratio (OR) of diabetes was 0.91 (95% confidence interval (CI), 0.58–1.4) in Q2, 0.77 (95% CI, 0.48–1.2) in Q3, and 0.53 (95% CI, 0.31–0.90) in the highest group in males, and 1.2 (95% CI, 0.73–2.0), 0.95 (95% CI, 0.54–1.6) and 0.56 (95% CI, 0.30–1.0) in females. We also estimated ORs of diabetes by rate of eating. Compared to the fast eating group, ORs in males were 0.87 (95% CI, 0.61–1.2) in the intermediate group and 0.38 (95% CI, 0.16–0.91) in the slow group, and ORs in females were 0.92 (95% CI, 0.59–1.4) and 1.5 (95% CI, 0.73–3.0). Conclusions These findings support the hypothesis that higher masticatory performance and slow eating prevent the occurrence of diabetes. PMID:23755114

  20. Urinary angiotensinogen is a marker for tubular injuries in patients with type 2 diabetes

    PubMed Central

    Terami, Takahiro; Wada, Jun; Inoue, Kentaro; Nakatsuka, Atsuko; Ogawa, Daisuke; Teshigawara, Sanae; Murakami, Kazutoshi; Katayama, Akihiro; Eguchi, Jun; Makino, Hirofumi

    2013-01-01

    Purpose Urinary angiotensinogen has been reported as a marker for the activation of intrarenal renin–angiotensin system (RAS) in various kidney diseases. To investigate the importance of urinary angiotensinogen in diabetic nephropathy, we compared the urinary levels of angiotensinogen, albumin, and ?1-microglobulin. Materials and methods Japanese patients with type 2 diabetes at various stages of nephropathy (n=85) were enrolled, and we measured albumin/creatinine ratio (ACR) and urinary excretion of angiotensinogen and ?1-microglobulin. We also compared the clinical data of the patients treated with or without angiotensin II receptor blockers or angiotensin-converting enzyme inhibitors (RAS inhibitors [+], n=51; RAS inhibitors [?], n=34). Results Urinary angiotensinogen levels positively correlated with ACR (r=0.367, P=3.84×10?4) and urinary ?1-microglobulin (r=0.734, P=1.32 × 10?15), while they negatively correlated with estimated glomerular filtration ratio (eGFR) (r=?0.350, P=1.02 × 10?3) and high-density lipoprotein cholesterol (r=?0.216, P=0.049). Multiple regression analysis was carried out to predict urinary angiotensinogen levels by employing eGFR, ACR, and urinary ?1-microglobulin as independent variables; only urinary ?1-microglobulin entered the regression equation at a significant level. Although ACR was higher in the RAS inhibitors (+) group, urinary ?1-microglobulin and angiotensinogen did not show significant increase in the RAS inhibitors (+) group. Conclusion Urinary angiotensinogen is well correlated with urinary ?1-microglobulin and reflected the tubular injuries which may be associated with the intrarenal RAS activation in patients with type 2 diabetes. PMID:24174882

  1. Is tetrahydrobiopterin a therapeutic option in diabetic hypertensive patients?

    PubMed

    Rubio-Guerra, Alberto Francisco; Vargas-Robles, Hilda; Ramos-Brizuela, Luz Maria; Escalante-Acosta, Bruno Alfonso

    2010-01-01

    Nitric oxide (NO) is an important regulator of vascular tone, and is also an antithrombotic, anti-inflammatory, antiproliferative, and antiatherogenic factor. Endothelial function is altered in patients with coronary artery disease, stroke, and peripheral artery disease, and endothelial dysfunction correlates with the risk factor profile for a patient. Hypertension and type 2 diabetes are risk factors for vascular disease, and are both pathologies characterized by loss of NO activity. Indeed, endothelial dysfunction is usually present in diabetic and/or hypertensive patients. Tetrahydrobiopterin is an essential cofactor for the NO synthase enzyme, and insufficiency of this cofactor leads to uncoupling of the enzyme, release of superoxide, endothelial dysfunction, progression of hypertension, and finally, proatherogenic effects. Tetrahydrobiopterin is also an important mediator of NO synthase regulation in type 2 diabetes and hypertension, and may be a rational therapeutic target to restore endothelial function and prevent vascular disease in these patients. The aim of this paper is to review the rationale for therapeutic strategies directed to biopterins as a target for vascular disease in type 2 diabetic hypertensive patients. PMID:21949628

  2. Bevacizumab in Japanese patients with malignant glioma: from basic research to clinical trial

    PubMed Central

    Takano, Shingo; Ishikawa, Eiichi; Nakai, Kei; Matsuda, Masahide; Masumoto, Tomohiko; Yamamoto, Tetsuya; Matsumura, Akira

    2014-01-01

    An antiangiogenic approach is especially suitable for the treatment of malignant gliomas. Recently, two large clinical trials in newly diagnosed glioblastoma (the Avastin in Glioblastoma study and Radiation Therapy Oncology Group 0825 study) showed a 3- to 4-month prolongation of progression-free survival (PFS) with bevacizumab, but no significant effect on overall survival (OS). Japan is the first, and so far only, country to approve the use of bevacizumab in newly diagnosed glioblastoma in combination with radiotherapy and temozolomide chemotherapy. The drug is also approved for use as monotherapy for recurrent glioblastoma and certain other types of high-grade glioma after previous therapy. The effectiveness of bevacizumab on Japanese malignant glioma patients was reviewed. The Phase II clinical trial demonstrated that the PFS with bevacizumab alone was 34% at 6 months and 3.3 months at median for 32 patients with recurrent malignant gliomas. In the Avastin in Glioblastoma study, 44 Japanese patients were registered from Japan. PFS and OS for bevacizumab combined with standard temozolomide and radiotherapy were 12.2 months and 29.2 months at median, respectively, for the patients with newly diagnosed glioblastoma. PFS and OS tended to be longer for those treated with bevacizumab than for those not treated with the drug. In addition, biomarkers of bevacizumab effectiveness were investigated in Japanese patients. Vascular endothelial growth factor concentration, matrix metalloproteinase 9 activities in urine, and apparent diffusion coefficient values on magnetic resonance imaging may be biomarkers that predict patient prognosis. Finally, novel experiments for vascular endothelial growth factor antibody action were described; these include the induction of glioma cell apoptosis, an antibody treatment failure model, and a study of the synergistic effect with chemotherapeutic agents. PMID:25228814

  3. Psychological characteristics of Japanese patients with chronic pain assessed by the Rorschach test

    PubMed Central

    2010-01-01

    Background The increasing number of patients with chronic pain in Japan has become a major issue in terms of the patient's quality of life, medical costs, and related social problems. Pain is a multi-dimensional experience with physiological, affective, cognitive, behavioral and social components, and recommended to be managed via a combination of bio-psycho-social aspects. However, a biomedical approach is still the dominant method of pain treatment in Japan. The current study aimed to evaluate comprehensive psychological functions and processes in Japanese chronic pain patients. Methods The Rorschach Comprehensive System was administered to 49 in-patients with non-malignant chronic pain. Major variables and frequencies from the test were then compared to normative data from non-patient Japanese adults by way of the t-test and chi-square test. Results Patients exhibited high levels of emotional distress with a sense of helplessness with regard to situational stress, confusion, and ambivalent feelings. These emotions were managed by the patients in an inappropriate manner. Cognitive functions resulted in moderate dysfunction in all stages. Information processing tended to focus upon minute features in an inflexible manner. Mediational dysfunction was likely to occur with unstable affective conditions. Ideation was marked by pessimistic and less effective thinking. Since patients exhibited negative self-perception, their interpersonal relationship skills tended to be ineffective. Originally, our patients displayed average psychological resources for control, stress tolerance, and social skills for interpersonal relationships. However, patient coping styles were either situation- or emotion-dependent, and patients were more likely to exhibit emotional instability influenced by external stimuli, resulting in increased vulnerability to pain. Conclusions Data gathered from the Rorschach test suggested psychological approaches to support chronic pain patients that are likely to be highly beneficial, and we thus recommend their incorporation into the course of current pain treatments. PMID:21110860

  4. Low frequency of PAX8-PPAR? rearrangement in follicular thyroid carcinomas in Japanese patients.

    PubMed

    Mochizuki, Kunio; Kondo, Tetsuo; Oishi, Naoki; Tahara, Ippei; Inoue, Tomohiro; Kasai, Kazunari; Nakazawa, Tadao; Okamoto, Takahiro; Shibata, Noriyuki; Katoh, Ryohei

    2015-05-01

    Paired-box gene 8 (PAX8)-peroxisome proliferator-activated receptor-? (PPAR?) gene fusion has been identified at significant frequency in follicular thyroid carcinomas (FTCs) with cytogenetically detectable translocation t(2;3)(q13;p25). This represents a possible specific molecular marker for follicular carcinoma. In this study, we examined PAX8-PPAR? rearrangement in 24 FTC samples from Japanese patients by reverse transcribed-polymerase chain reaction (RT-PCR) using two upstream PAX8 primers located in exons 7 and 8 and a downstream primer in exon 1 of PPAR?. The fusion gene was detected in only one of 24 FTCs (4%). The FTC with PAX8-PPAR? rearrangement from a 56-year-old man showed a product consistent with fusion between exon 8 of PAX8 and exon 1 of PPAR?. It was confirmed by direct sequencing. This FTC was histologically encapsulated, composed of trabeculae and small follicles and had complete penetration of the capsule by tumor tissues (minimally invasive type). The frequency of the fusion gene in this study was much lower than the 29-63% noted in reports from other countries suggesting that FTCs in Japanese patients may have a special genetic background, and that the high iodine intake from a typical Japanese diet might influence the frequency of the fusion gene in FTCs. PMID:25708358

  5. HLA class I markers in Japanese patients with carbamazepine-induced cutaneous adverse reactions.

    PubMed

    Ikeda, Hiroko; Takahashi, Yukitoshi; Yamazaki, Etsuko; Fujiwara, Tateki; Kaniwa, Nahoko; Saito, Yoshiro; Aihara, Michiko; Kashiwagi, Mariko; Muramatsu, Masaaki

    2010-02-01

    Carbamazepine (CBZ) is frequently used for treating epilepsy, but this drug causes cutaneous adverse drug reactions (cADRs) that may range from mild to severe. It is reported recently that the human leukocyte antigen HLA-B*1502 is associated with Stevens-Johnson syndrome (SJS) induced by CBZ in Han Chinese. We examined HLA class I in 15 Japanese patients who fulfilled the diagnostic criteria for CBZ-induced cADRs (mild in 10 and severe = SJS in 5). HLA-B*1518, HLA-B*5901 and HLA-C*0704 alleles showed higher relative risks (above 10.0) for severe cADRs. The haplotype (HLA-A*2402-B*5901-C*0102) had high relative risk (16.09) for severe cADRs. In patients with severe cADRs, frequencies of HLA-A*1101, HLA-A*3303, HLA-B*1501, HLA-B*4403, HLA-B*5101, HLA-B*5201, HLA-C*0702, and HLA-C*1202 alleles are relatively lower than in the Japanese population. These data may suggest that HLA-B*5901 is one of the candidate markers for CBZ-induced SJS in Japanese. PMID:19694795

  6. Balneotherapy and platelet glutathione metabolism in type II diabetic patients

    NASA Astrophysics Data System (ADS)

    Ohtsuka, Yoshinori; Yabunaka, Noriyuki; Watanabe, Ichiro; Noro, Hiroshi; Agishi, Yuko

    1996-09-01

    Effects of balneotherapy on platelet glutathione metabolism were investigated in 12 type II (non-insulin-dependent) diabetic patients. Levels of the reduced form of glutathione (GSH) on admission were well correlated with those of fasting plasma glucose (FPG; r=0.692, P<0.02). After 4 weeks of balneotherapy, the mean level of GSH showed no changes; however, in well-controlled patients (FPG <150 mg/dl), the level increased ( P<0.01) and in poorly controlled patients (FPG >150 mg/dl), the value decreased ( P<0.05). There was a negative correlation between glutathione peroxidase (GPX) activities and the levels of FPG ( r=-0.430, P<0.05). After balneotherapy, the activity increased in 5 patients, decreased in 3 patients and showed no changes (alteration within ±3%) in all the other patients. From these findings in diabetic patients we concluded: (1) platelet GSH synthesis appeared to be induced in response to oxidative stress; (2) lowered GPX activities indicated that the antioxidative defense system was impaired; and (3) platelet glutathione metabolism was partially improved by 4 weeks balneotherapy, an effect thought to be dependent on the control status of plasma glucose levels. It is suggested that balneotherapy is beneficial for patients whose platelet antioxidative defense system is damaged, such as those with diabetes mellitus and coronary heart disease.

  7. The Association between Serum GGT Concentration and Diabetic Peripheral Polyneuropathy in Type 2 Diabetic Patients

    PubMed Central

    2010-01-01

    Background Diabetic peripheral polyneuropathy (DPP) is one of the common complications of diabetes mellitus (DM) and can lead to foot ulcers or amputation. The pathophysiology of DPP includes several factors such as metabolic, vascular, autoimmune, oxidative stress and neurohormonal growth-factor deficiency and recent studies have suggested the use of serum gamma-glutamyl transferase (GGT) as an early marker of oxidative stress. Therefore, we investigated whether serum GGT may be useful in predicting DPP. Methods We assessed 90 patients with type 2 DM who were evaluated for the presence of DPP using clnical neurologic examinations including nerve conduction velocity studies. We evaluated the association between serum GGT and the presence of DPP. Results The prevalence of DPP was 40% (36 cases) according to clinical neurological examinations. The serum GGT concentration was significantly elevated in type 2 diabetic patients with DPP compared to patients without DPP (P < 0.01). There were other factors significantly associated with DPP including smoking (P = 0.019), retinopathy (P = 0.014), blood pressure (P < 0.05), aspartate aminotransferase (P = 0.022), C-reactive protein (P = 0.036) and urine microalbumin/creatinine ratio (P = 0.004). Serum GGT was independently related with DPP according to multiple logistic analysis (P < 0.01). Conclusion This study shows that increased levels of serum GGT may have important clinical implications in the presence of DPP in patients with type 2 diabetes. PMID:20548843

  8. Identification of KCNJ15 as a Susceptibility Gene in Asian Patients with Type 2 Diabetes Mellitus

    PubMed Central

    Okamoto, Koji; Iwasaki, Naoko; Nishimura, Chisa; Doi, Kent; Noiri, Eisei; Nakamura, Shinko; Takizawa, Miho; Ogata, Makiko; Fujimaki, Risa; Grarup, Niels; Pisinger, Charlotta; Borch-Johnsen, Knut; Lauritzen, Torsten; Sandbaek, Annelli; Hansen, Torben; Yasuda, Kazuki; Osawa, Haruhiko; Nanjo, Kishio; Kadowaki, Takashi; Kasuga, Masato; Pedersen, Oluf; Fujita, Toshiro; Kamatani, Naoyuki; Iwamoto, Yasuhiko; Tokunaga, Katsushi

    2010-01-01

    Recent advances in genome research have enabled the identification of new genomic variations that are associated with type 2 diabetes mellitus (T2DM). Via fine mapping of SNPs in a candidate region of chromosome 21q, the current study identifies potassium inwardly-rectifying channel, subfamily J, member 15 (KCNJ15) as a new T2DM susceptibility gene. KCNJ15 is expressed in the ? cell of the pancreas, and a synonymous SNP, rs3746876, in exon 4 (C566T) of this gene, with T allele frequency among control subjects of 3.1%, showed a significant association with T2DM affecting lean individuals in three independent Japanese sample sets (p = 2.5 × 10?7, odds ratio [OR] = 2.54, 95% confidence interval [CI] = 1.76–3.67) and with unstratified T2DM (p = 6.7 × 10?6, OR = 1.76, 95% CI = 1.37–2.25). The diabetes risk allele frequency was, however, very low among Europeans in whom no association between this variant and T2DM could be shown. Functional analysis in human embryonic kidney 293 cells demonstrated that the risk allele of the synonymous SNP in exon 4 increased KCNJ15 expression via increased mRNA stability, which resulted in the higher expression of protein as compared to that of the nonrisk allele. We also showed that KCNJ15 is expressed in human pancreatic ? cells. In conclusion, we demonstrated a significant association between a synonymous variant in KCNJ15 and T2DM in lean Japanese patients with T2DM, suggesting that KCNJ15 is a previously unreported susceptibility gene for T2DM among Asians. PMID:20085713

  9. Dominant risk factors for retinopathy at clinical diagnosis in patients with type II diabetes mellitus

    Microsoft Academic Search

    Hung T. Nguyen; Stephen D. Luzio; John Dolben; James West; Lyn Beck; Philip A. Coates; David R. Owens

    1996-01-01

    A study of 270 newly presenting, previously untreated, type II diabetic patents revealed that 38 patients (14%) had already developed diabetic retinopathy (DR). Among this group, 26 patients had lesions of background diabetic retinopathy and 12 patients already had maculopathy or preproliferative changes. The aim of this study was to determine the risk factors influencing susceptibility to retinopathy, and to

  10. Relationship Between Diurnal Blood Pressure Variation and Diurnal Blood Glucose Levels in Type 2 Diabetic Patients

    Microsoft Academic Search

    Frank Pistrosch; Eva Reissmann; Jan Wildbrett; Carsta Koehler; Markolf Hanefeld

    2007-01-01

    Background: Hypertension and hyperglycemia are established risk factors for progression of microangiopathies and macroangiopathies in type 2 diabetes mellitus. Cardiovascular risk is even more increased in diabetic patients with nocturnal nondipping or postprandial hyperglycemia. We therefore investigated the relationship between diurnal hyperglycemia and diurnal blood pressure (BP) variation in patients.Methods: One hundred seven hypertensive type 2 diabetic patients received a

  11. Continuous ambulatory peritoneal dialysis in insulin-dependent diabetic patients: A 40-month experience

    Microsoft Academic Search

    Jacques Rottembourg; Yassim el Shahat; Athanasios Agrafiotis; Yvette Thuillier; François de Groc; Claude Jacobs; Marcel Legrain

    1983-01-01

    Diabetic nephropathy is becoming a major and growing cause of endstage renal disease (ESRD) in all industrialized countries [1, 2]. In Europe, the number of patients with diabetic nephropathy and ESRD that have been put on renal replacement therapy has increased rapidly during the last years. By the end of 1980, diabetic patients accounted for 3% of all patients alive

  12. Mutations of carnitine palmitoyltransferase II (CPT II) in Japanese patients with CPT II deficiency.

    PubMed

    Yasuno, T; Kaneoka, H; Tokuyasu, T; Aoki, J; Yoshida, S; Takayanagi, M; Ohtake, A; Kanazawa, M; Ogawa, A; Tojo, K; Saito, T

    2008-05-01

    Carnitine palmitoyltransferase II (CPT II) deficiency is an inherited disorder involving beta-oxidation of long-chain fatty acids. CPT II deficiency is a wide-spectrum disorder that includes a lethal neonatal form, an infantile form, and an adult-onset form. However, the ethnic characteristics and the relationship between genotype and clinical manifestation are not well understood. We investigated three non-consanguineous Japanese patients with CPT II deficiency and examined cell lines from 4 unrelated patients and 50 healthy donors. The CPT 2 gene was typed by direct DNA sequencing of polymerase chain reaction-amplified gene products. Case 1 (infantile form) was heterozygous for a phenylalanine to tyrosine substitution at position 383 (p.F383Y) and a novel valine to leucine substitution at 605 (p.V605L). Cases 2, 4, and 5 (infantile form) and case 3 (adult-onset form) were heterozygous for a single mutation at F383Y. Case 6 (adult-onset form) was compound heterozygous at the CPT 2 locus, with deletion of cytosine and thymine at residue 408, resulting in a stop signal at 420 (p.Y408fsX420), and an arginine to cysteine substitution at position 631 (p.R631C). Case 7 (adult-onset form) was homozygous for the p.F383Y mutation. In conclusion, we identified p.F383Y mutations in six of seven patients with CPT II deficiency and two novel variants of the coding gene: p.Y408fsX420 and p.V605L. These mutations differ from those in Caucasian patients, who commonly harbor p.S113L, p.P50H, and p.Q413fsX449 mutations; therefore, our data and those of other Japanese groups suggest that the p.F383Y mutation is significant in Japanese patients with CPT II deficiency. PMID:18363739

  13. Multiorgan dysfunctions in diabetic patients: the role of functional imaging.

    PubMed

    Shah, S; Win, Z; Al-Nahhas, A

    2009-09-01

    Functional imaging plays a central role in the evaluation of some of the clinical problems faced by diabetic patients. In cardiovascular disease, myocardial perfusion imaging, particularly when complemented by gated SPECT, is a powerful tool not only for establishing the diagnosis of coronary artery disease, but also for providing prognostic information in both the general and diabetic populations. Although promising, its role in screening of asymptomatic diabetic patients is yet to be established, and its role as a potential 'one-stop shop' also needs further study. PET is currently the gold standard for viability assessment, and also provides prognostic data, but its widespread use is limited by cost and availability. Hybrid imaging with PET/CT is promising, and could revolutionise cardiac imaging by combining functional and anatomic information. In the investigation of the diabetic foot, labelled leukocyte imaging is the nuclear medicine test of choice to diagnose osteomyelitis. It is likely that SPECT/CT will further improve diagnostic accuracy, but more studies are needed. Combined leukocyte and bone marrow imaging is of value in distinguishing osteomyelitis from neuropathic osteoarthropathy in the diabetic foot; PET and PET/CT may also be of value in these cases, but their wider role is currently inconclusive. The value of bone scintigraphy in the diabetic foot, even as a screening test, is questionable. Functional imaging methods can also be employed in the evaluation of other diabetic complications, including the assessment of left ventricular function, renal scarring and gastric emptying, but these methods are not widely used in current clinical practice. PMID:19859045

  14. Duloxetine vs. placebo in patients with painful diabetic neuropathy

    Microsoft Academic Search

    David J. Goldstein; Yili Lu; Michael J. Detke; Thomas C. Lee; Smriti Iyengar

    2005-01-01

    The aim of this study was to examine the efficacy and safety of duloxetine, a balanced and potent dual reuptake inhibitor of serotonin and norepinephrine, in the management of diabetic peripheral neuropathic pain. Serotonin and norepinephrine are thought to inhibit pain via descending pain pathways. In a 12-week, multicenter, double-blind study, 457 patients experiencing pain due to polyneuropathy caused by

  15. Oxidative protein damage in early stage Type 1 diabetic patients

    Microsoft Academic Search

    Ay?egül Telci; Ufuk Çakatay; Serpil Salman; ?lhan Satman; Ahmet Sivas

    2000-01-01

    To examine the influence of oxidative stress on oxidative protein damage, we studied 51 young Type 1 diabetic patients clinically free of complications and 48 healthy normolipidaemic age-matched controls. We determined: (1) plasma carbonyl (PCO), plasma total thiol (T-SH), and nitrotyrosine (NT) levels as markers of oxidative protein damage; (2) plasma lipid hydroperoxide (LHP), and nitric oxide (NO) levels as

  16. Supporting shared care for diabetes patients. The synapses solution.

    PubMed Central

    Toussaint, P. J.; Kalshoven, M.; Ros, M.; van der Kolk, H.; Weier, O.

    1997-01-01

    In this paper we discuss the construction of a Federated Health Care Record server within the context of the European R&D project Synapses. We describe the system using the five ODP viewpoints. From an analysis of the business process to be supported by the distributed system (the shared care for diabetes patients) requirements for the server are derived. PMID:9357655

  17. Ibudilast May Improve Retinal Circulation in Patients with Diabetes mellitus

    Microsoft Academic Search

    Ryo Suzuki; Itsuko Sugihara; Takeshi Ishibashi; Shinji Kurimoto

    1992-01-01

    Ibudilast selectively vasodilates cerebral vessels without reducing blood pressure. We investigated the effect of the drug on retinal circulation in 8 patients with diabetes mellitus, using the video-densitometric image analysis of fluorescein angiography. We compared the build up time, the time constant of washout rate and the mean circulation time (MCT) before and after oral therapy with ibudilast. After 2

  18. Physician support for diabetes patients and clinical outcomes

    PubMed Central

    Gensichen, Jochen; Von Korff, Michael; Rutter, Carolyn M; Seelig, Michelle D; Ludman, Evette J; Lin, Elizabeth HB; Ciechanowski, Paul; Young, Bessie A; Wagner, Edward H; Katon, Wayne J

    2009-01-01

    Background Physician practical support (e.g. setting goals, pro-active follow-up) and communicative support (e.g., empathic listening, eliciting preferences) have been hypothesized to influence diabetes outcomes. Methods In a prospective observational study, patients rated physician communicative and practical support using a modified Health Care Climate Questionnaire. We assessed whether physicians' characteristic level of practical and communicative support (mean across patients) and each patients' deviation from their physician's mean level of support was associated with glycemic control outcomes. Glycosylated haemoglobin (HbA1c) levels were measured at baseline and at follow-up, about 2 years after baseline. Results We analysed 3897 patients with diabetes treated in nine primary care clinics by 106 physicians in an integrated health plan in Western Washington, USA. Physicians' average level of practical support (based on patient ratings of their provider) was associated with significantly lower HbA1c at follow-up, controlling for baseline HbA1c (p = .0401). The percentage of patients with "optimal" and "poor" glycemic control differed significantly across different levels of practical support at follow (p = .022 and p = .028). Communicative support was not associated with differences in HbA1c at follow-up. Conclusion This observational study suggests that, in community practice settings, physician differences in practical support may influence glycemic control outcomes among patients with diabetes. PMID:19788726

  19. Biophoton emission from blood serum of diabetic patients

    NASA Astrophysics Data System (ADS)

    Van Wijk, R.; Wiegant, F. A. C.; Popp, Fritz A.; Storms, G. E. M. G.

    1994-12-01

    The concept that free radicals mediate vascular abnormalities in diabetes has been debated. This study examines the relationship between serum free radical activity and glycaemic regulation. A cross-sectional assessment is presented of the chemiluminescence of blood serum, long term glycaemic control (HbAlc, fructosamine) and blood glucose concentrations in patients with type-1 (n equals 114) and patients with type-2 (n equals 112) diabetes. The average value of serum chemiluminescence of type-1 patients is higher than that of type-2 patients (p equals 0.014). Spectral analysis suggests that different sources of free radical activity are responsible in different ratios for chemiluminescence in type-1 and type-2 sera. Serum chemiluminescence values of type-1 patients strongly correspond with blood glucose levels (p < 0.001). Chemiluminescence values were higher, although not significant (p equals 0.082) in the 'poorly' controlled group characterized by high values of HbAlc and/or fructosamine in comparision with the group of 'good' glycaemic control with lower values of HbAlc and/or fructosamine. Serum chemeluminescence values of type-2 patients neither correspond to their long tern glycaemic status nor to their blood glucose levels. It is concluded that changes in glucose metabolism and changes in chemiluminescence are coordinated for type-1 but not for type-2 patients. This strongly indicates the relevance of ther free radical connection to diabetes type-1 complications.

  20. [Clinicopathological study on 100 Japanese patients with peritoneal mesothelioma in Japan].

    PubMed

    Naka, H; Naka, A

    1984-01-01

    We report a clinicopathological study on 100 japanese patients with peritoneal mesothelioma encountered between 1911 and 1982. Fifty-six were males and 44 were females, they ranged in age from 10 months to 83 years. As the inducement materials, asbestos was reported in 5 and thorium in 2 patients. Clinical symptoms were abdominal distension in 56 and abdominal pain in 50 patients. Thrombocytosis and hypoglycemia were observed in 7 and 3 patients, respectively. Macroscopically, the peritoneal mesothelioma was localized in 7, diffuse in 86 and not described in 7 patients. The pathological classification was benign in 5 and malignant in 77 cases. According to Stout's classification, the peritoneal mesothelioma was tubular in 43 mixed in 25 and fibrous type in 11 cases. Based on our findings we suggest that peritoneal mesotheliomas are on the increase in Japan. PMID:6230471

  1. Adherence and rehospitalizations in patients with schizophrenia: evidence from Japanese claims data

    PubMed Central

    Kuwabara, Hiroyo; Saito, Yoshimichi; Mahlich, Jörg

    2015-01-01

    Background The aim of this study is to analyze if there is a relationship between adherence to antipsychotic medication and rehospitalization for patients diagnosed with schizophrenia in Japan. Methods Based on Japanese claims data, we constructed three patient groups based on their medication possession ratio (MPR). Controlling for potential confounders, a Cox proportional hazard model was employed to assess if medication adherence affects the risk of rehospitalization. Results Patients with good adherence (MPRs from 0.8–1.1) had the lowest rates of admission. Both poor adherence (MPRs <0.8) and overadherence (MPRs >1.1) were associated with a significant higher risk of rehospitalization with hazard ratios of 4.7 and 2.0, respectively. Conclusion The results of this study support the notion that good adherence to antipsychotic medication reduces the risk of rehospitalization of schizophrenia patients. Appropriate measures should be taken to improve adherence of schizophrenia patients. PMID:25897229

  2. Exocrine Pancreatic Insufficiency in Diabetic Patients: Prevalence, Mechanisms, and Treatment

    PubMed Central

    Piciucchi, Matteo; Capurso, Gabriele; Archibugi, Livia; Delle Fave, Martina Maria; Capasso, Marina; Delle Fave, Gianfranco

    2015-01-01

    Pancreas is a doubled-entity organ, with both an exocrine and an endocrine component, reciprocally interacting in a composed system whose function is relevant for digestion, absorption, and homeostasis of nutrients. Thus, it is not surprising that disorders of the exocrine pancreas also affect the endocrine system and vice versa. It is well-known that patients with chronic pancreatitis develop a peculiar form of diabetes (type III), caused by destruction and fibrotic injury of islet cells. However, less is known on the influence of diabetes on pancreatic exocrine function. Pancreatic exocrine insufficiency (PEI) has been reported to be common in diabetics, with a prevalence widely ranging, in different studies, in both type I (25–74%) and type II (28–54%) diabetes. A long disease duration, high insulin requirement, and poor glycemic control seem to be risk factors for PEI occurrence. The impact of pancreatic exocrine replacement therapy on glycemic, insulin, and incretins profiles has not been fully elucidated. The present paper is aimed at reviewing published studies investigating the prevalence of PEI in diabetic patients and factors associated with its occurrence.

  3. Three novel ZBTB24 mutations identified in Japanese and Cape Verdean type 2 ICF syndrome patients.

    PubMed

    Nitta, Hirohisa; Unoki, Motoko; Ichiyanagi, Kenji; Kosho, Tomoki; Shigemura, Tomonari; Takahashi, Hiroshi; Velasco, Guillaume; Francastel, Claire; Picard, Capucine; Kubota, Takeo; Sasaki, Hiroyuki

    2013-07-01

    Immunodeficiency, centromeric instability and facial anomalies (ICF) syndrome is a rare autosomal recessive disorder that shows DNA hypomethylation at pericentromeric satellite-2 and -3 repeats in chromosomes 1, 9 and 16. ICF syndrome is classified into two groups: type 1 (ICF1) patients have mutations in the DNMT3B gene and about half of type 2 (ICF2) patients have mutations in the ZBTB24 gene. Besides satellite-2 and -3 repeats, ?-satellite repeats are also hypomethylated in ICF2. In this study, we report three novel ZBTB24 mutations in ICF2. A Japanese patient was homozygous for a missense mutation (C383Y), and a Cape Verdean patient was compound heterozygous for a nonsense mutation (K263X) and a frame-shift mutation (C327W fsX54). In addition, the second Japanese patient was homozygous for a previously reported nonsense mutation (R320X). The C383Y mutation abolished a C2H2 motif in one of the eight zinc-finger domains, and the other three mutations caused a complete or large loss of the zinc-finger domains. Our immunofluorescence analysis revealed that mouse Zbtb24 proteins possessing a mutation corresponding to either C383Y or R320X are mislocalized from pericentrometic heterochromatin, suggesting the importance of the zinc-finger domains in proper intranuclear localization of this protein. We further revealed that the proper localization of wild-type Zbtb24 protein does not require DNA methylation. PMID:23739126

  4. Evaluation of Patients' Education on Foot Self-Care Status in Diabetic Patients

    PubMed Central

    Kafaie, Parichehr; Noorbala, Mohamad Taghi; Soheilikhah, Sedigheh; Rashidi, Maryam

    2012-01-01

    Background Skin problems caused by neuropathy and antipathy are common manifestations of diabetes. The most serious about such problem is the diabetic foot, which may lead to eventual ulceration and amputation, and will decrease a patient’s quality of life dramatically. Objectives The aim of this study is to assess the level of foot self-care and foot conditions in diabetic patients, and to demonstrate the role of self-care education in diabetic foot care. Patients and Methods A total of 80 diabetic patients were included in the study, all of whom had referred to "Yazd Diabetic Research Center." The levels of their foot self-care were recorded in pre-test questionnaires, and then all of the patients were visited and educated by a Dermatologist for their foot self-care on a monthly basis, after which their post-test results were recorded through a second administration of the same questionnaire. Eventually, data from the pre and post-test questionnaires were analyzed to identify the possible effects of education. Results A total of 80 diabetic patients (34 males, 46 females) with a mean average age of 53.53 ± 10.19 and mean average duration of diabetes 12.42 ± 6.73 years were assessed. A significant increase in foot self-care through education was observed (baseline 27.06 ± 8.77, vs. post education 43.12 ± 8.77; P = 0.0001). After education, foot and nail lesions improved completely in 84% and 62.8%. Moreover, 77.8% of patients had suitable shoes and 79.6% had suitable socks. Conclusions Our findings showed that foot self-care education could improve knowledge and performance of patients about various foot problems, and was significantly important in preventing ulcers. PMID:23482390

  5. Ephrin-B2–Activated Peripheral Blood Mononuclear Cells From Diabetic Patients Restore Diabetes-Induced Impairment of Postischemic Neovascularization

    PubMed Central

    Broquères-You, Dong; Leré-Déan, Carole; Merkulova-Rainon, Tatiana; Mantsounga, Chris S.; Allanic, David; Hainaud, Patricia; Contrères, Jean-Olivier; Wang, Yu; Vilar, José; Virally, Marie; Mourad, Jean-Jacques; Guillausseau, Pierre-Jean; Silvestre, Jean-Sébastien; Lévy, Bernard I.

    2012-01-01

    We hypothesized that in vitro treatment of peripheral blood mononuclear cells (PB-MNCs) from diabetic patients with ephrin-B2/Fc (EFNB2) improves their proangiogenic therapeutic potential in diabetic ischemic experimental models. Diabetes was induced in nude athymic mice by streptozotocin injections. At 9 weeks after hyperglycemia, 105 PB-MNCs from diabetic patients, pretreated by EFNB2, were intravenously injected in diabetic mice with hindlimb ischemia. Two weeks later, the postischemic neovascularization was evaluated. The mechanisms involved were investigated by flow cytometry analysis and in vitro cell biological assays. Paw skin blood flow, angiographic score, and capillary density were significantly increased in ischemic leg of diabetic mice receiving EFNB2-activated diabetic PB-MNCs versus those receiving nontreated diabetic PB-MNCs. EFNB2 bound to PB-MNCs and increased the adhesion and transmigration of PB-MNCs. Finally, EFNB2-activated PB-MNCs raised the number of circulating vascular progenitor cells in diabetic nude mice and increased the ability of endogenous bone marrow MNCs to differentiate into cells with endothelial phenotype and enhanced their proangiogenic potential. Therefore, EFNB2 treatment of PB-MNCs abrogates the diabetes-induced stem/progenitor cell dysfunction and opens a new avenue for the clinical development of an innovative and accessible strategy in diabetic patients with critical ischemic diseases. PMID:22596048

  6. Management of Blood Pressure in Patients With Diabetes

    Microsoft Academic Search

    Ehud Grossman; Franz H. Messerli

    2011-01-01

    Hypertension is a major modifiable risk factor for cardiovascular morbidity and mortality in patients with diabetes. Lowering blood pressure (BP) to 135\\/85 mm Hg is the main goal of treatment. A nonpharmcologic approach is recommended in all patients. If BP levels remain above the target despite nonpharmacologic treatment, drug therapy should be initiated. Blockers of the renin–angiotensin–aldosterone system (RAAS) represent

  7. Impact of Generalist Care Managers on Patients with Diabetes

    PubMed Central

    Dorr, David A; Wilcox, Adam; Donnelly, Steven M; Burns, Laurie; Clayton, Paul D

    2005-01-01

    Objective To determine how the addition of generalist care managers and collaborative information technology to an ambulatory team affects the care of patients with diabetes. Study Setting Multiple ambulatory clinics within Intermountain Health Care (IHC), a large integrated delivery network. Study Design A retrospective cohort study comparing diabetic patients treated by generalist care managers with matched controls was completed. Exposure patients had one or more contacts with a care manager; controls were matched on utilization, demographics, testing, and baseline glucose control. Using role-specific information technology to support their efforts, care managers assessed patients' readiness for change, followed guidelines, and educated and motivated patients. Data Collection Patient data collected as part of an electronic patient record were combined with care manager-created databases to assess timely testing of glycosylated hemoglobin (HbA1c) and low-density lipoprotein (LDL) levels and changes in LDL and HbA1c levels. Principal Findings In a multivariable model, the odds of being overdue for testing for HbA1c decreased by 21 percent in the exposure group (n=1,185) versus the control group (n=4,740). The odds of being tested when overdue for HbA1c or LDL increased by 49 and 26 percent, respectively, and the odds of HbA1c <7.0 percent also increased by 19 percent in the exposure group. The average HbA1c levels decreased more in the exposure group than in the controls. The effect on LDL was not significant. Conclusions Generalist care managers using computer-supported diabetes management helped increase adherence to guidelines for testing and control of HbA1c levels, leading to improved health status of patients with diabetes. PMID:16174140

  8. Airway inflammation in Japanese COPD patients compared with smoking and nonsmoking controls

    PubMed Central

    Ishikawa, Nobuhisa; Hattori, Noboru; Kohno, Nobuoki; Kobayashi, Akihiro; Hayamizu, Tomoyuki; Johnson, Malcolm

    2015-01-01

    Purpose To assess the importance of inflammation in chronic obstructive pulmonary disease (COPD) by measuring airway and systemic inflammatory biomarkers in Japanese patients with the disease and relevant control groups. Patients and methods This was the first study of its type in Japanese COPD patients. It was a non-treatment study in which 100 participants were enrolled into one of three groups: nonsmoking controls, current or ex-smoking controls, and COPD patients. All participants underwent standard lung function assessments and provided sputum and blood samples from which the numbers of inflammatory cells and concentrations of biomarkers were measured, using standard procedures. Results The overall trends observed in levels of inflammatory cells and biomarkers in sputum and blood in COPD were consistent with previous reports in Western studies. Increasing levels of neutrophils, interleukin 8 (IL-8), surfactant protein D (SP-D), and Krebs von den Lungen 6 (KL-6) in sputum and clara cell 16 (CC-16), high-sensitivity C-reactive protein (hs-CRP), and KL-6 in serum and plasma fibrinogen were seen in the Japanese COPD patients compared with the non-COPD control participants. In sputum, significant correlations were seen between total cell count and matrix metalloproteinase 9 (MMP-9; P<0.001), neutrophils and MMP-9 (P<0.001), macrophages and KL-6 (P<0.01), total cell count and IL-8 (P<0.05), neutrophils and IL-8 (P<0.05), and macrophages and MMP-9 (P<0.05). Significant correlations were also observed between some inflammatory cells in sputum and biomarkers in serum, with the most significant between serum CC-16 and both total cell count (P<0.005) and neutrophils (P<0.005) in sputum. Conclusion These results provide evidence for the first time that COPD in Japanese patients is a multicomponent disease, involving both airway and systemic inflammation, in addition to airway obstruction. Therefore, intervention with anti-inflammatory therapy may provide additional benefit in disease management of COPD in Japan. PMID:25670894

  9. Molecular Cloning of the Human Hepatitis C Virus Genome From Japanese Patients with NonA, Non-B Hepatitis

    Microsoft Academic Search

    Nobuyuki Kato; Makoto Hijikata; Yuko Ootsuyama; Masanori Nakagawa; Showgo Ohkoshi; Takashi Sugimura; Kunitada Shimotohno

    1990-01-01

    The nucleotide sequence of the Japanese type of hepatitis C virus (HCV-J) genome, consisting of 9413 nucleotides, was determined by analyses of cDNA clones from plasma specimens from Japanese patients with chronic hepatitis. HCV-J genome contains a long open reading frame that can encode a sequence of 3010 amino acid residues. Comparison of HCV-J with the American isolate of HCV

  10. Correlation between diabetic lower-extremity arterial disease and diabetic neuropathy in patients with type II diabetes: an exploratory study

    PubMed Central

    Sun, Peng; Guo, Jianchao; Xu, Na

    2015-01-01

    The lower-extremity vascular injuries and neuropathy are the most salient complications of diabetes which could lead to the poor prognosis, especially for the type II diabetes. The lower extremity vascular injuries and neuropathy usually coexist, yet their correlation in the pathogenesis of lower extremity lesions has received little attention in previous studies. To investigate the correlation between the degree of lower-extremity arterial injuries and lower-extremity neurological functional status in patients with type II diabetes, 32 patients with type II diabetes were examined for the mean flow velocity of the femoral artery and popliteal artery of lower extremeties, while the motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) of the bilateral common peroneal nerve, sural nerve and posterior tibial nerve were simultaneously examined. Results showed that there was moderate correlation between the mean flow velocity of lower-extremity arteries and MCV/SCV. In particular, the MCV of the right tibial nerve was strongly correlated with the average velocity of the right popliteal artery (P < 0.05). PMID:25785144

  11. Insulin secretory capacity and the regulation of glucagon secretion in diabetic and non-diabetic alcoholic cirrhotic patients

    Microsoft Academic Search

    Yolanta T. Kurszynska; Spiros Goulas; Nigel Wollen; Neil McIntyre

    1998-01-01

    Background\\/Aims: Insulin secretion is increased in cirrhotic patients without diabetes but decreased in cirrhotic patients with diabetes. Increased glucagon secretion is found in both groups. Our aim was to determine: 1) whether alterations in insulin secretion are due to changes in maximal secretory capacity or altered islet B-cell sensitivity to glucose, and 2) whether regulation of glucagon secretion by glucose

  12. Phase II study of FOLFIRINOX for chemotherapy-naïve Japanese patients with metastatic pancreatic cancer.

    PubMed

    Okusaka, Takuji; Ikeda, Masafumi; Fukutomi, Akira; Ioka, Tatsuya; Furuse, Junji; Ohkawa, Shinichi; Isayama, Hiroyuki; Boku, Narikazu

    2014-10-01

    The FOLFIRINOX combination of chemotherapy drugs had not been fully evaluated for Japanese pancreatic cancer patients. Therefore, we carried out a phase II study to examine the efficacy and safety of FOLFIRINOX in chemotherapy-naïve Japanese patients with metastatic pancreatic cancer. FOLFIRINOX (i.v. infusion of 85 mg/m(2) oxaliplatin, 180 mg/m(2) irinotecan, and 200 mg/m(2) l-leucovorin, followed by a bolus of 400 mg/m(2) fluorouracil and a 46-h continuous infusion of 2400 mg/m(2) fluorouracil) was given every 2 weeks. The primary endpoint was the response rate. The 36 enrolled patients received a median of eight (range, 1-25) treatment cycles. The response rate was 38.9% (95% confidence interval [CI], 23.1-56.5); median overall survival, 10.7 months (95% CI, 6.9-13.2); and median progression-free survival, 5.6 months (95% CI, 3.0-7.8). Major grade 3 or 4 toxicities included neutropenia (77.8%), febrile neutropenia (22.2%), thrombocytopenia (11.1%), anemia (11.1%), anorexia (11.1%), diarrhea (8.3%), nausea (8.3%), elevated alanine aminotransferase levels (8.3%), and peripheral sensory neuropathy (5.6%). Febrile neutropenia occurred only during the first cycle. There were no treatment-related deaths. FOLFIRINOX can be a standard regimen showing favorable efficacy and acceptable toxicity profile in chemotherapy-naïve Japanese patients with metastatic pancreatic cancer. PMID:25117729

  13. TNF-? and Microalbuminuria in Patients with Type 2 Diabetes Mellitus

    PubMed Central

    Lampropoulou, I.-Th.; Stangou, M.; Papagianni, A.; Didangelos, T.; Iliadis, F.; Efstratiadis, G.

    2014-01-01

    Aim. Recent evidence suggests that chronic subclinical inflammation plays a key role in the pathogenesis and progression of diabetic nephropathy. Aim of the present study was to investigate possible correlation between the presence and degree of microalbuminuria and markers of inflammation in patients with type 2 diabetes mellitus (DM). Patients-Methods. Eighty patients were enrolled and clinical and laboratory data were recorded. Albumin-creatinine ratio (ACR) was calculated in first-morning urine samples. Serum and urinary tumor necrosis factor-? (TNF-?) levels were determined by ELISA. Results. Forty-five patients had normoalbuminuria, 33 microalbuminuria, and 2 macroalbuminuria. Patients with microalbuminuria were older, with higher glycosylated hemoglobin levels (HbA1c) and they more frequently had diabetic retinopathy, neuropathy, and cardiovascular disease and were on treatment with angiotensin converting enzyme inhibitors (ACEi) and/or angiotensin receptor blockers (ARBs). ACR was significantly correlated with the presence of cardiovascular disease, hypertension, and HbA1c levels and the administration of clopidogrel and ACEi or ARBs. ACR was not correlated with C-reactive protein, fibrinogen, or serum TNF-? levels but had a strong correlation with urinary TNF-? levels. Conclusions. In patients with type 2 DM, urinary, but not serum, TNF-? levels are associated with the presence and severity of microalbuminuria. PMID:25587544

  14. Serum chromogranin A is a useful marker for Japanese patients with pancreatic neuroendocrine tumors.

    PubMed

    Hijioka, Masayuki; Ito, Tetsuhide; Igarashi, Hisato; Fujimori, Nao; Lee, Lingaku; Nakamura, Taichi; Jensen, Robert T; Takayanagi, Ryoichi

    2014-11-01

    Although chromogranin A (CGA) is a useful marker for pancreatic neuroendocrine tumors (pNET) in the West, its usefulness in Japanese populations is unclear. To assess this, we evaluated the serum CGA levels in 189 patients with various pancreatic diseases, including proven pNET (n = 69), pancreatic cancer (PC) (n = 50), chronic pancreatitis (CP) (n = 50) and autoimmune pancreatitis (AIP) (n = 20), and 112 normal controls (controls) using an ELISA kit. The mean CGA level of patients with pNET was significantly higher than any of the other groups (407.8 ± 984.6 ng/mL [pNET] vs 91.8 ± 101.8 ng/mL [PC], 93.6 ± 57.5 ng/mL [CP], 69.9 ± 52.4 ng/mL [AIP] and 62.5 ± 48.3 ng/mL [controls]). Limiting the analysis to patients not using proton pump inhibitors (PPI), the CGA level of patients with PC or CP was not significantly different compared with the controls. Discriminant analysis revealed that the best cut-off value of CGA to distinguish patients with pNET from the controls was 78.7 ng/mL, with a sensitivity and specificity of 53.6% and 78.6%, respectively. In patients with pNET, significant factors associating with elevated CGA levels were tumor classification, tumor size, and the presence of liver metastases in univariate analysis as well as PPI use and the presence of liver metastases in multivariate analysis. We show that CGA is a useful marker for diagnosing pNET in Japanese populations and for distinguishing patients with pNET from patients with other pancreatic diseases. The increased use of CGA in Japan will likely be a helpful tool in managing these patients, as found in the West. PMID:25220535

  15. Factors affecting high-sensitivity cardiac troponin T elevation in Japanese metabolic syndrome patients

    PubMed Central

    Hitsumoto, Takashi; Shirai, Kohji

    2015-01-01

    Purpose The blood concentration of cardiac troponin T (ie, high-sensitivity cardiac troponin T [hs-cTnT]), measured using a highly sensitive assay, represents a useful biomarker for evaluating the pathogenesis of heart failure or predicting cardiovascular events. However, little is known about the clinical significance of hs-cTnT in metabolic syndrome. The aim of this study was to examine the factors affecting hs-cTnT elevation in Japanese metabolic syndrome patients. Patients and methods We enrolled 258 metabolic syndrome patients who were middle-aged males without a history of cardiovascular events. We examined relationships between hs-cTnT and various clinical parameters, including diagnostic parameters of metabolic syndrome. Results There were no significant correlations between hs-cTnT and diagnostic parameters of metabolic syndrome. However, hs-cTnT was significantly correlated with age (P<0.01), blood concentrations of brain natriuretic peptide (P<0.01), reactive oxygen metabolites (markers of oxidative stress, P<0.001), and the cardio–ankle vascular index (marker of arterial function, P<0.01). Furthermore, multiple regression analysis revealed that these factors were independent variables for hs-cTnT as a subordinate factor. Conclusion The findings of this study indicate that in vivo oxidative stress and abnormality of arterial function are closely associated with an increase in hs-cTnT concentrations in Japanese metabolic syndrome patients.

  16. Chronic ulcers: MATRIDERM® system in smoker, cardiopathic, and diabetic patients

    PubMed Central

    Gentile, Pietro; Agovino, Annarita; Migner, Alessia; Orlandi, Fabrizio; Delogu, Pamela; Cervelli, Valerio

    2013-01-01

    Diabetic ulcers and pressure ulcers represent a more frequent cause of chronic wounds in aging populations. It is estimated that approximately 15% of the diabetic population will develop diabetic ulcers during their life and over half of these patients develop an infection, often osteomyelitis, with 20% requiring amputation. The authors report a case of a 65-year-old woman affected by a post-traumatic loss of substance due to road accidents with soft tissue exposure (comprising muscle tendon) of the left knee combined with the fracture of the right fibula previously subjected to surgery and reconstruction of muscle tendon. The patient was affected by diabetes type II, hypertension, and ischemic heart disease. In 2008, she underwent a double bypass surgery and coronary angioplasty. Initially, the patient was treated with cycles of advanced dressings, with fibrinolytic ointments, hydrocolloid, and subsequently, when the bottom began granulated with fibrinolytic and idrocellulosa, Hydrofibra-Ag, and Ag-alginate, three times a week for 30 days. In the second step, the authors decided to treat the ulcer with the MATRIDERM system and auto skin graft. Following the first treatment, 7 days after the procedure, the authors found the reduction of the loss of substance until its complete closure. The wound’s infection was evaluated by a buffer negative confirmation performed every 2 weeks four times. We obtained decrease of limb edema and full functional rehabilitation. The skin appeared renovated, with volume restoration and an improvement of the texture. PMID:24020011

  17. Subclinical Ulnar Neuropathy at the Elbow in Diabetic Patients

    PubMed Central

    Jang, Ji Eun; Kim, Yun Tae; Park, Byung Kyu; Cheong, In Yae

    2014-01-01

    Objective To demonstrate the prevalence and characteristics of subclinical ulnar neuropathy at the elbow in diabetic patients. Methods One hundred and five patients with diabetes mellitus were recruited for the study of ulnar nerve conduction analysis. Clinical and demographic characteristics were assessed. Electrodiagnosis of ulnar neuropathy at the elbow was based on the criteria of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM1 and AANEM2). The inching test of the ulnar motor nerve was additionally performed to localize the lesion. Results The duration of diabetes, the existence of diabetic polyneuropathy (DPN) symptoms, the duration of symptoms, and HbA1C showed significantly larger values in the DPN group (p<0.05). Ulnar neuropathy at the elbow was more common in the DPN group. There was a statistically significant difference in the number of cases that met the three diagnostic criteria between the no DPN group and the DPN group. The most common location for ulnar mononeuropathy at the elbow was the retrocondylar groove. Conclusion Ulnar neuropathy at the elbow is more common in patients with DPN. If the conduction velocities of both the elbow and forearm segments are decreased to less than 50 m/s, it may be useful to apply the AANEM2 criteria and inching test to diagnose ulnar neuropathy. PMID:24639928

  18. [Plausible solution to prevent major amputation in diabetic foot patients].

    PubMed

    Laginja, Stanislava; Seremet, Jasmina; Spehar, Branka; Marinovi?, Marin

    2014-10-01

    Diabetes mellitus is one of the leading public health problems in the world. Complications of diabetes mellitus include cardiovascular diseases, retinopathy, neuropathy and diabetic foot, which can in turn lead to lower extremity amputations. This is the main cause of mortality and the biggest expenditure for health system. Treatment is long and frustrating for the patient and also for medical staff. Amputations are becoming more frequent, while the quality of life after amputation is greatly reduced. Healing of postoperative infection is long lasting and demands a lot of hard work from the surgeon and the rest of medical staff, while causing severe suffering for the patient. Progression of infection increases mortality. Negative pressure therapy after minor foot amputations greatly reduces healing time. Negative Pressure Wound Therapy (NPWT) was applied after surgical treatment. All necrotic tissue and fibrin deposits were removed. Initial therapy was administered continuously with 125 mm Hg of vacuum. The NPWT was continued intermittently. Additionally, all patients underwent additional hyperbaric treatment and local hemoglobin administration. In conclusion, in all cases presented, combined NPWT, hyperbaric and topical hemoglobin therapy proved to be a highly effective therapeutic option in preventing pending major amputation following minor diabetic foot amputation. PMID:25326996

  19. Effective Nurse Communication With Type 2 Diabetes Patients: A Review.

    PubMed

    Mulder, Bob C; Lokhorst, Anne Marike; Rutten, Guy E H M; van Woerkum, Cees M J

    2014-04-22

    Many type 2 diabetes mellitus patients have difficulties reaching optimal blood glucose control. With patients treated in primary care by nurses, nurse communication plays a pivotal role in supporting patient health. The twofold aim of the present review is to categorize common barriers to nurse-patient communication and to review potentially effective communication methods. Important communication barriers are lack of skills and self-efficacy, possibly because nurses work in a context where they have to perform biomedical examinations and then perform patient-centered counseling from a biopsychosocial approach. Training in patient-centered counseling does not seem helpful in overcoming this paradox. Rather, patient-centeredness should be regarded as a basic condition for counseling, whereby nurses and patients seek to cooperate and share responsibility based on trust. Nurses may be more successful when incorporating behavior change counseling based on psychological principles of self-regulation, for example, goal setting, incremental performance accomplishments, and action planning. PMID:24757047

  20. Optimizing the medical management of diabetic patients undergoing surgery.

    PubMed

    Tamai, Doris; Awad, Aymen Alian; Chaudhry, Humayun J; Shelley, Kirk H

    2006-01-01

    Patients with diabetes are prone to metabolic derangements because of their lack of effective insulin. Comorbid conditions, such as coronary artery disease, nephropathy, and autonomic neuropathy warrant preoperative assessment to ensure safety in the perioperative period. Preoperative evaluation must include assessment of chronic complications of diabetes. A thorough history and physical should guide preoperative testing which should be aimed at detecting correctable abnormalities and assessing the extent of end-organ disease. Surgery poses special challenges to patients with diabetes because the stress response, interruption of food intake, altered consciousness, and circulatory alterations all lead to unpredictable glucose and electrolyte levels. The management of insulin perioperatively depends on the preparation normally taken by the patient, and the glucose level on the morning of surgery. The goal is to avoid hypoglycemia and extreme hyperglycemia. Oral hypoglycemic agents should be held on the morning of surgery. Metformin should be discontinued 48 hours prior to and subsequent to surgery in order to reduce the risk of lactic acidosis. The avoidance of hypoglycemia and excessive hyperglycemia intraoperatively is best achieved with frequent monitoring of blood glucose and treating abnormalities according to patients' preoperative regimen and current condition. Maintaining blood glucose levels below 110 mg/dL reduces morbidity and mortality in critically ill patients. Measure blood glucose immediately following surgery because progression of the stress response postoperatively, in addition to possible nausea and vomiting, can complicate the patient's management. Precautions should be taken to prevent damage to peripheral nerves while diabetics are on the operating table because their nerves and limbs are already vulnerable to pressure and stretch injuries secondary to neurologic and vascular disease. With thorough and careful management, metabolic control in the perioperative period is a goal that is attainable for most patients. PMID:17190391

  1. Chelation Shows Benefit in Diabetic Patients After Heart Attack, But Findings Do Not Support Its Routine Use

    MedlinePLUS

    ... external links Menu Chelation Shows Benefit in Diabetic Patients After Heart Attack, But Findings Do Not Support ... marked reduction in cardiovascular events and death in patients with diabetes but not in those without diabetes. ...

  2. Cognitive Dysfunction Survey of the Japanese Patients with Moyamoya Disease (COSMO-JAPAN Study): Study Protocol.

    PubMed

    Takagi, Yasushi; Miyamoto, Susumu

    2015-03-15

    Moyamoya disease is a cerebrovascular occlusive disease characterized by progressive stenosis or by occlusion at the terminal portion of the bilateral internal carotid arteries. The unusual vascular network (moyamoya vessels) at the base of the brain with this disease as collateral channels is developed in this disease. Social independence because of cognitive impairment has recently been recognized as an important unsolved social issue with adult moyamoya disease. The patients with cognitive impairment have difficulty in proving their status because the standard neuroradiological and neuropsychological methods to define cognitive impairment with moyamoya disease are not determined. These patients with cognitive impairment should be supported by social welfare as psychologically handicapped persons. Thus Cognitive Dysfunction Survey of the Japanese Patients with Moyamoya Disease (COSMO-JAPAN study) is planned. In this study, we want to establish a standard finding of the cognitive impairment in patients with moyamoya disease. PMID:25739435

  3. Circulating endothelin-1 levels in type 2 diabetic patients with ischaemic heart disease

    Microsoft Academic Search

    M. Donatelli; E. Hoffmann; I. Colletti; G. Andolina; V. Russo; M. L. Bucalo; T. M. L. Valenti; V. Compagno; M. G. Cataldo; M. L. Morici

    1996-01-01

    To investigate whether circulating endothelin-1 (Et-1) may be related to the increased incidence and severity of ischaemic heart disease in type 2 diabetes mellitus, we compared the concentrations in type 2 diabetic patients and in non-diabetic patients with coronary artery disease (CAD) angiographically documented. Plasma levels of Et-1 were determined in 34 type 2 diabetic patients with CAD (16 with

  4. Newly diagnosed diabetes mellitus patients presenting with proliferative diabetic retinopathy as an initial sign

    PubMed Central

    Park, Hoon; Kim, Young Gyun; Lee, Jong Wook; Park, Jong Seok

    2014-01-01

    AIM To investigate the clinical features of newly diagnosed diabetes mellitus (NDM) patients showing proliferative diabetic retinopathy (PDR) as an initial sign. METHODS As a retrospective case series, the medical records of a total of four hundred and thirty-two patients who underwent a vitrectomy due to PDR were reviewed to find the subjects. Of 432 patients, six cases of NDM patients showing PDR as an initial sign were included and analyzed with their systemic and ocular features. Main outcome measures: the systemic features and ocular features [preoperative and postoperative best corrected visual acuity (BCVA), intraoperative findings]. RESULTS The mean onset age of visual symptoms was 36.3 years old. The mean serum insulin and C-peptide titer was below the normal range. The mean fasting plasma glucose was 178mg/dL and the mean postprandial 2h plasma glucose was 306mg/dL. The mean HbA1c at diagnosis was 11.02%. In all cases, an acute progressive fibrovascular proliferation was observed. Intraoperative retinal tears were found in three cases of six. The mean preoperative BCVA was +0.67±0.58 logMAR and the mean BCVA at postoperative 6 months was +0.20±0.30 logMAR. CONCLUSION All patients were considered to have latent autoimmune diabetes in adults (LADA). A rapid deterioration of kidney function as well as poor diabetic control status at diagnosis was observed in all six cases. The ocular features of the patients showed acute progressive fibrovascular proliferation and relatively favorable postoperative visual acuity. PMID:24634886

  5. Ascending infection of foot tendons in diabetic patients.

    PubMed

    Mismar, Ayman; Yousef, Mohammad; Badran, Darwish; Younes, Nidal

    2013-12-01

    Bone and soft tissue infection in the foot of diabetic patients is a well-described issue in the literature. A sound anatomical knowledge of the foot anatomy and compartments is mandatory to understand the mechanisms of infection spread. We describe four cases of diabetic foot infection complicated by long ascending infection. All did not respond initially to antibiotic treatment and the usual surgical debridement and were cured only after excision of the infected tendons. We highlight a rare but serious complication of the diabetic foot disease not commonly seen by the surgical community. We hope that this report raises the awareness of this condition so that a prompt diagnosis is made and appropriate treatment started, thereby reducing the risk of major lower limb amputations. PMID:24043670

  6. Risk of Bladder Cancer Among Diabetic Patients Treated With Pioglitazone

    PubMed Central

    Lewis, James D.; Ferrara, Assiamira; Peng, Tiffany; Hedderson, Monique; Bilker, Warren B.; Quesenberry, Charles P.; Vaughn, David J.; Nessel, Lisa; Selby, Joseph; Strom, Brian L.

    2011-01-01

    OBJECTIVE Some preclinical in vivo studies and limited human data suggest a possible increased risk of bladder cancer with pioglitazone therapy. This is an interim report of an ongoing cohort study examining the association between pioglitazone therapy and the risk of bladder cancer in patients with diabetes. RESEARCH DESIGN AND METHODS This study includes 193,099 patients in the Kaiser Permanente Northern California diabetes registry who were ?40 years of age between 1997 and 2002. Those with prior bladder cancer were excluded. Ever use of each diabetes medication (defined as two or more prescriptions within 6 months) was treated as a time-dependent variable. Cox regression–generated hazard ratios (HRs) compared pioglitazone use with nonpioglitazone use adjusted for age, sex, race/ethnicity, diabetes medications, A1C, heart failure, household income, renal function, other bladder conditions, and smoking. RESULTS The group treated with pioglitazone comprised 30,173 patients. There were 90 cases of bladder cancer among pioglitazone users and 791 cases of bladder cancer among nonpioglitazone users. Overall, ever use of pioglitazone was not associated with risk of bladder cancer (HR 1.2 [95% CI 0.9–1.5]), with similar results in men and women (test for interaction P = 0.8). However, in the a priori category of >24 months of therapy, there was an increased risk (1.4 [1.03–2.0]). Ninety-five percent of cancers diagnosed among pioglitazone users were detected at early stage. CONCLUSIONS In this cohort of patients with diabetes, short-term use of pioglitazone was not associated with an increased incidence of bladder cancer, but use for more than 2 years was weakly associated with increased risk. PMID:21447663

  7. Exercise thallium imaging in patients with diabetes mellitus. Prognostic implications

    SciTech Connect

    Felsher, J.; Meissner, M.D.; Hakki, A.H.; Heo, J.; Kane-Marsch, S.; Iskandrian, A.S.

    1987-02-01

    We used exercise thallium 201 imaging in 123 patients with diabetes mellitus (77 men and 46 women, aged 56 +/- 8 years), 75% of whom had angina pectoris (typical or atypical). During exercise testing, 18 patients (15%) had angina pectoris, 28 (23%) had ischemic ST changes, and 69 (56%) had abnormal thallium images. During follow-up (up to 36 months), there were 12 cardiac events; four patients died of cardiac causes and eight had nonfatal acute myocardial infarction. Univariate and multivariate survival analysis identified two independent predictors of cardiac events: the event rate was significantly less in patients with normal images and exercise heart rate over 120 beats per minute than in patients with abnormal images and exercise heart rate of 120 beats per minute or less (0% vs 22%). The patients with abnormal images or exercise heart rate of 120 beats per minute or less had an intermediate event rate (11.5%). Furthermore, two of the 54 patients with normal images and ten of 69 patients with abnormal images had subsequent cardiac events. Thus, exercise thallium imaging is useful in risk stratification in patients with diabetes mellitus.

  8. Psychological aspects of diabetes care: Effecting behavioral change in patients

    PubMed Central

    Chew, Boon-How; Shariff-Ghazali, Sazlina; Fernandez, Aaron

    2014-01-01

    Patients with diabetes mellitus (DM) need psychological support throughout their life span from the time of diagnosis. The psychological make-up of the patients with DM play a central role in self-management behaviors. Without patient’s adherence to the effective therapies, there would be persistent sub-optimal control of diseases, increase diabetes-related complications, causing deterioration in quality of life, resulting in increased healthcare utilization and burden on healthcare systems. However, provision of psychosocial support is generally inadequate due to its challenging nature of needs and demands on the healthcare systems. This review article examines patient’s psychological aspects in general, elaborates in particular about emotion effects on health, and emotion in relation to other psychological domains such as cognition, self-regulation, self-efficacy and behavior. Some descriptions are also provided on willpower, resilience, illness perception and proactive coping in relating execution of new behaviors, coping with future-oriented thinking and influences of illness perception on health-related behaviors. These psychological aspects are further discussed in relation to DM and interventions for patients with DM. Equipped with the understanding of the pertinent nature of psychology in patients with DM; and knowing the links between the psychological disorders, inflammation and cardiovascular outcomes would hopefully encourages healthcare professionals in giving due attention to the psychological needs of patients with DM. PMID:25512782

  9. Empowering patients: how to implement a diabetes passport in hospital care

    Microsoft Academic Search

    Rob Dijkstra; Jozé Braspenning; Richard Grol

    2002-01-01

    The purpose was to ascertain the views of patients with diabetes and patient care teams on the introduction of a recently developed diabetes passport in order to plan effective implementation. A semi-qualitative study by eight semi-structured focus group discussions with patient care teams and patients in four Dutch hospitals was organised. In total 29 patients participated (range five to nine

  10. Analysis of psoriasis patients registered with the Japanese Society for Psoriasis Research from 2002-2008.

    PubMed

    Takahashi, Hidetoshi; Nakamura, Koichiro; Kaneko, Fumio; Nakagawa, Hidemi; Iizuka, Hajime

    2011-12-01

    A survey of psoriasis patients from 1982-2001 has been reported by the Japanese Society for Psoriasis Research. The aim of this study is to analyze psoriasis patients in Japan registered from 2002-2008. A total of 11 631 cases were registered from 152 dermatological institutions in Japan. Males (7738 cases, 66.5%) were predominant over females (3893 cases, 33.5%). The clinical types of psoriasis were psoriasis vulgaris (88.5%), guttate psoriasis (3.9%), psoriasis arthropathica (3.3%), generalized pustular psoriasis (1.3%), psoriatic erythroderma (1.2%), localized pustular psoriasis (0.9%) and infantile psoriasis (0.1%). Topical corticosteroids (85.4%) and vitamin D(3) (59.7%) products were the main previous topical agents. Previous systemic treatments included etretinate (8.8%), cyclosporin (8.3%) and methotrexate (2.0%). Use of topical vitamin D(3) and systemic cyclosporin therapies has been increasing during the past 7 years. Topical psoralen and ultraviolet A therapy (PUVA) (7.6%) was the predominant phototherapy followed by UV-B (7.3%) and systemic PUVA (4.7%). Use of UV-B phototherapy has been increasing during the past 5 years. The survey of Japanese psoriasis patients during 2002-2008 disclosed that psoriasis arthropathica is more prevalent (1%) than that of the previous survey during 1982-2001. Use of topical vitamin D(3) and systemic cyclosporin has been increasing during the past 7 years. PMID:21951304

  11. Functional health literacy and the quality of physician–patient communication among diabetes patients

    Microsoft Academic Search

    Dean Schillinger; Andrew Bindman; Frances Wang; Anita Stewart; John Piette

    2004-01-01

    While patients with poor functional health literacy (FHL) have difficulties reading and comprehending written medical instructions, it is not known whether these patients also experience problems with other modes of communication, such as face-to-face encounters with primary care physicians. We enrolled 408 English- and Spanish-speaking diabetes patients to examine whether patients with inadequate FHL report worse communication than patients with

  12. Functional health literacy and the quality of physician-patient communication among diabetes patients

    Microsoft Academic Search

    Dean Schillinger; Andrew Bindmana; Frances Wang; Anita Stewart; John Piette

    2003-01-01

    While patients with poor functional health literacy (FHL) have difficulties reading and comprehending written medical instructions, it is not known whether these patients also experience problems with other modes of communication, such as face-to-face encounters with primary care physicians. We enrolled 408 English- and Spanish-speaking diabetes patients to examine whether patients with inadequate FHL report worse communication than patients with

  13. Total Mortality by Elevated Transferrin Saturation in Patients With Diabetes

    PubMed Central

    Ellervik, Christina; Andersen, Henrik Ullits; Tybjærg-Hansen, Anne; Frandsen, Merete; Birgens, Henrik; Nordestgaard, Børge G.; Mandrup-Poulsen, Thomas

    2013-01-01

    OBJECTIVE It is not known to what extent iron overload predicts prognosis in patients with diabetes after diagnosis or whether iron overload is a risk factor independent of the HFE genotype. We investigated total and cause-specific mortality according to increased transferrin saturation (?50 vs. <50%), whether mortality is driven by the HFE genotype, and whether early measurement of transferrin saturation helps to predict mortality outcome. RESEARCH DESIGN AND METHODS Cohort 1 included patients with late-onset type 1 diabetes (n = 716) with a cross-sectional measurement of transferrin saturation and HFE genotype. Cohort 2 included consecutively recruited patients with any diabetes (n = 6,120), transferrin saturation measurement at referral, and HFE genotype if transferrin saturation was above 50%. RESULTS In cohort 1, the hazard ratio for total mortality was 2.3 (95% CI 1.3–3.9; P = 0.002) and for cause-specific mortality by neoplasms was 5.8 (2.4–14; P = 0.00007) in patients with transferrin saturation ?50 vs. <50%. Excluding genotypes C282Y/C282Y and C282Y/H63D gave similar results. The hazard ratio for total mortality was 4.0 (1.2–13; P = 0.01) and for cause-specific mortality by neoplasms was 13 (3.6–49; P = 0.0001) in patients with C282Y/C282Y versus wild type. In cohort 2, total mortality was not different in patients with transferrin saturation ?50 vs. <50%. In patients with late-onset type 1 diabetes and transferrin saturation ?50%, the hazard ratio for total mortality was 0.4 (0.2–0.9; P = 0.03) in cohort 2 versus cohort 1. CONCLUSIONS Increased transferrin saturation and HFE genotype C282Y/C282Y predict total mortality in patients with late-onset type 1 diabetes, and increased transferrin saturation after diagnosis is an independent risk factor. Early measurement of transferrin saturation in these patients leading to early intervention improves life expectancy. PMID:23801727

  14. Assessment of sensory neuropathy in patients with diabetic foot problems

    PubMed Central

    Nather, Aziz; Keng Lin, Wong; Aziz, Zameer; HJ Ong, Christine; MC Feng, Bernard; B Lin, Clarabelle

    2011-01-01

    Our aim of this study was to compare the accuracy of three different modalities for testing sensory neuropathy in diabetic patients with and without diabetic foot problems. The three devices used included the pin-prick testing using the Neurotip® (PPT), the Semmes–Weinstein 5.07/10 g monofilament testing (SWMT), and the rapid-current perception threshold (R-CPT) measurements using the Neurometer® testing. Our study population consisted of 54 patients (108 feet) with diabetic foot problems treated at the National University Hospital in Singapore by our multi-disciplinary diabetic foot care team. Our results showed no difference in sensory neuropathy detected by PPT and 5.07/10 g SWMT in both the pathological and normal foot. In the pathological foot, there was significant increase in sensory neuropathy detected by the Neurometer® device at both the big toe and ankle sites as compared to PPT and 5.07/10 g SWMT. In the normal foot, there was a significant increase in sensory neuropathy detected by the Neurometer® device at the big toe site only as compared to PPT and 5.07/10 g SWMT. Finally, the Neurometer® measurements detected a statistically higher proportion of feet with sensory neuropathy as compared to detection by the PPT or 5.07/10 g SWMT. PMID:22396819

  15. Cardiac autonomic neuropathy in patients with diabetes mellitus.

    PubMed

    Dimitropoulos, Gerasimos; Tahrani, Abd A; Stevens, Martin J

    2014-02-15

    Cardiac autonomic neuropathy (CAN) is an often overlooked and common complication of diabetes mellitus. CAN is associated with increased cardiovascular morbidity and mortality. The pathogenesis of CAN is complex and involves a cascade of pathways activated by hyperglycaemia resulting in neuronal ischaemia and cellular death. In addition, autoimmune and genetic factors are involved in the development of CAN. CAN might be subclinical for several years until the patient develops resting tachycardia, exercise intolerance, postural hypotension, cardiac dysfunction and diabetic cardiomyopathy. During its sub-clinical phase, heart rate variability that is influenced by the balance between parasympathetic and sympathetic tones can help in detecting CAN before the disease is symptomatic. Newer imaging techniques (such as scintigraphy) have allowed earlier detection of CAN in the pre-clinical phase and allowed better assessment of the sympathetic nervous system. One of the main difficulties in CAN research is the lack of a universally accepted definition of CAN; however, the Toronto Consensus Panel on Diabetic Neuropathy has recently issued guidance for the diagnosis and staging of CAN, and also proposed screening for CAN in patients with diabetes mellitus. A major challenge, however, is the lack of specific treatment to slow the progression or prevent the development of CAN. Lifestyle changes, improved metabolic control might prevent or slow the progression of CAN. Reversal will require combination of these treatments with new targeted therapeutic approaches. The aim of this article is to review the latest evidence regarding the epidemiology, pathogenesis, manifestations, diagnosis and treatment for CAN. PMID:24567799

  16. Importance of maternal history of non-insulin dependent diabetic patients

    Microsoft Academic Search

    J C Alcolado; R Alcolado

    1991-01-01

    OBJECTIVE--To assess the family history of diabetes in non-insulin dependent diabetes mellitus with particular emphasis on parental phenotype. DESIGN--Family histories were obtained from an existing computerised database and supplemented by postal questionnaires. SETTING--Diabetic service of a provincial teaching hospital. SUBJECTS--A total of 1326 patients with non-insulin dependent diabetes who had been referred to diabetic clinics over the past 10 years

  17. A Neural Network Approach in Predicting the Blood Glucose Level for Diabetic Patients

    Microsoft Academic Search

    Zarita Zainuddin; Ong Pauline; Cemal Ardil

    2009-01-01

    ? Abstract—Diabetes Mellitus is a chronic metabolic disorder, where the improper management of the blood glucose level in the diabetic patients will lead to the risk of heart attack, kidney disease and renal failure. This paper attempts to enhance the diagnostic accuracy of the advancing blood glucose levels of the diabetic patients, by combining principal component analysis and wavelet neural

  18. The cognitive orientation of compliance in short- and long-term type 2 diabetic patients

    Microsoft Academic Search

    Klara Nurymberg; Shulamith Kreitler; Kineret Weissler

    1996-01-01

    Previous research showed that providing diabetic patients with information about diabetes is mostly insufficient for compliance. The purpose was to develop a new model for studying and promoting compliance in diabetes based on the theory of cognitive orientation (Kreitler & Kreitler), which assumes that in addition to knowledge it is necessary to consider the patient's goals, values and self image.

  19. Renal long-term effects of calcium antagonist treatment in patients with diabetes mellitus

    Microsoft Academic Search

    E. Jungmann; K. H. Usadel

    1992-01-01

    Although calcium antagonists have long been introduced into antihypertensive treatment, little is known of their renal long-term action in patients with diabetes mellitus, diabetic nephropathy, or hypertension. Much of the current information concerning this issue is from short-term studies. While urinary albumin excretion, a major indicator of glomerular damage in patients with diabetes mellitus, remains unchanged or even increases during

  20. Emphysematous pyelonephritis in a diabetic patient with obstructed kidney

    PubMed Central

    Konecki, Tomasz; Jab?onowski, Zbigniew

    2014-01-01

    Emphysematous pyelonephritis (EPN) is an acute, rare, inflammatory disease, which typically occurs in patients who suffer from diabetes mellitus. We report the case of a patient who was admitted to the Department of Urology with septic signs, in whom, after performing computed tomography, the diagnosis of EPN was established. The patient underwent organ–preserving treatment, which consisted of pyelolithotomy with nephrostomy, and the insertion of a double J catheter into the left ureter. The importance of the classification of EPN is also discussed. The need for individualized procedures is highlighted. PMID:25147731

  1. Dietary glycemic index, glycemic load and incidence of type 2 diabetes in Japanese men and women: the Japan public health center-based prospective study

    PubMed Central

    2013-01-01

    Background Japanese diets contain a relatively high amount of carbohydrates, and its high dietary glycemic index and glycemic load may raise the risk of diabetes in the Japanese population. The current study evaluated the associations between the dietary glycemic index, glycemic load, and the risk of type 2 diabetes in a population based cohort in Japan. Methods We observed 27,769 men and 36,864 women (45–75 y) who participated in the second survey of the Japan Public Health Center-based Prospective Study. The dietary glycemic index and glycemic load were estimated using a food-frequency questionnaire. The development of diabetes was reported in a questionnaire administered five years later, and the associations were analyzed using logistic regression after controlling for age, area, total energy intake, smoking status, family history of diabetes, physical activity, hypertension, BMI, alcohol intake, magnesium, calcium, dietary fiber and coffee intake, and occupation. Results The dietary glycemic load was positively associated with the risk of diabetes among women: the multivariable-adjusted odds ratio comparing the highest vs. the lowest quartile was 1.52 (95% CI, 1.13-2.04; P-trend?=?0.01). The association was implied to be stronger among women with BMI?diabetes among men with a high intake of total fat: the multivariable-adjusted odds ratio comparing the highest vs. the lowest quartile was 1.46 (95% CI, 0.94-2.28; P-trend?=?0.04). Among women with a high total fat intake, those in the first and second quartiles of the dietary glycemic index had a significant reduced risk of diabetes, compared with those in the first quartile who had a lower total fat level (multivariable-adjusted odds ratio?=?0.59 with 95% CI, 0.37-0.94, and odds ratio?=?0.63 with 95% CI, 0.40-0.998 respectively). Conclusions The population-based cohort study in Japan indicated that diets with a high dietary glycemic load increase the risk of type 2 diabetes among women. Total fat intake may modify the association between the dietary glycemic index and the risk of type 2 diabetes among men and women. PMID:24370346

  2. PLASMA FIBRINOGEN AS A MARKER OF MAJOR ADVERSE CARDIAC EVENTS IN PATIENTS OF TYPE 2 DIABETES WITH UNSTABLE ANGINA

    Microsoft Academic Search

    V. S. Sahashrabhojney; R. G. Salkar

    Unstable angina patients with type 2 diabetes have higher mortality and morbidity. The present study aimed at determining the differences i n the inflammatory status between non-diabetic and diabetic patients with unstable angina, and evaluating fibrinogen concentration as predictor of in hospital major adverse cardiac events in diabetic patients. 142 cases of unstable angina were analyzed. 37 patients were found

  3. Oncoplastic surgery for Japanese patients with breast cancer of the lower pole.

    PubMed

    Kijima, Yuko; Yoshinaka, Heiji; Hirata, Munetsugu; Mizoguchi, Tadao; Ishigami, Sumiya; Nakajo, Akihiro; Arima, Hideo; Ueno, Shinichi; Natsugoe, Shoji

    2011-10-01

    This report presents the results of oncoplastic surgery in three Japanese patients with breast cancer lesions involving the lower pole of the breast. Their breasts were ptotic, and their lesions were considered to be suitable for breast conservation surgery. There were treated with partial mastectomy resection using vertical-scar mammaplasty, with reduction surgery and recentralization of the nipple-areola complex. Two patients underwent a mirror-image biopsy on the contralateral breasts to determine the symmetry. The remaining patient had periareolar incision mastopexy without reduction added for the contralateral breast. A large surgical margin was used to remove excessive skin and parenchymal tissue. Ideal symmetry was achieved by performing reduction and/or mastopexy on the contralateral breast. PMID:21922380

  4. [Treatment of patients with proliferative diabetic retinopathy and serotonin insufficiency].

    PubMed

    Korzenkova, L V; Fedorova, N V; Mukha, A I

    2003-01-01

    30 patients (19--female and 11--male) with proliferative diabetic retinopathy (DR) were examined. The age of patients and of the controls ranged from 25 to 72 years. The duration of diabetes mellitus amounted on the average to 16.4 +/- 4.1 years. The cause of diabetes mellitus was evaluated for the moment of examination as of mean severity and in the stage of subcompensation. Ophthalmologically, relapsing hemophthalmias and extensive preretinal hemorrhages in the eye fundus were typical for this group of patients. Standard techniques were used to determine the index of erythrocytes deformability and the concentration of serotonin in the blood plasma. All patients were prescribed intramuscular injections of 1% ATP solution, 2 ml daily during 2 weeks. Pentoxifillin was prescribed perorally, 0.2 g x 3 times per day during 30 days, enterogel--15 g x 3 times per day during 7 days. The simultaneous administration of pentoxifylline and enterogel normalized the erythrocytes elasticity and the concentration of serotonin in the blood plasma. Clinically, it led to an improvement of visual acuity (0.18 +/- 0.008) and to resorption of hemorrhages in the eye fundus. The obtained results are indicative of the advisability to use simultaneously pentoxifylline, enterogel and ATP in a comprehensive medication treatment of proliferative DR with chronic serotonin insufficiency. PMID:13678006

  5. The Japanese version of Skindex-16: a brief quality-of-life measure for patients with skin diseases.

    PubMed

    Higaki, Yuko; Kawamoto, Kyoko; Kamo, Toshiko; Horikawa, Naoshi; Kawashima, Makoto; Chren, Mary-Margaret

    2002-11-01

    A practical quality-of-life measure applicable to patients with skin diseases is necessary. Recently developed dermatological quality-of-life measures must be translated and adapted for use in cultures other than the ones in which they were created. In this study, we translated and adapted culturally into Japanese a skin-disease-specific, brief quality-of-life measure, Skindex-16, and studied its reliability and validity. Forward-and back-translations of Skindex-16 were carried out. Six doubtful items as well as the term "skin condition" required a second forward- and back-translation to reach satisfactory agreement with the original instrument. Cross-cultural adaptation and cross-sectional questionnaire studies were then performed to evaluate the reliability and validity of the instrument. One hundred patients and 30 healthy adults responded to the Japanese version. The internal-consistency reliability of the final Japanese version of Skindex-16 was high (range of Cronbach's alpha for each scale, symptoms, emotions, and functioning, was 0.83-0.92). The Japanese version showed construct and content validity. As hypothesized, scores for dermatological patients were higher than those for healthy persons (mean global scores 36 +/- 23 vs 1 +/- 2, p < 0.001) and scores for patients with inflammatory diseases were higher than those for patients with isolated skin lesions (mean global scores 48 +/- 21 vs 22 +/- 17, p < 0.001), indicating a poorer quality of life. Most patients' responses to an open-ended question about their skin disease were similar to those of the American responders and were addressed according to the items. In conclusion, we have developed a semantically equivalent translation of Skindex-16 into Japanese. It is a reliable and valid measure of the effects of skin disease on the quality of life in Japanese patients. PMID:12484430

  6. Effect of azilsartan versus candesartan on morning blood pressure surges in Japanese patients with essential hypertension.

    PubMed

    Rakugi, Hiromi; Kario, Kazuomi; Enya, Kazuaki; Sugiura, Kenkichi; Ikeda, Yoshinori

    2014-06-01

    Morning blood pressure (BP) surge is reported as a risk factor for cardiovascular events and end-organ damage independent of the 24-h BP level. Controlling morning BP surge is therefore important to help prevent onset of cardiovascular disease. We compared the efficacy of azilsartan and candesartan in controlling morning systolic BP (SBP) surges by analyzing relevant ambulatory BP monitoring data in patients with/without baseline BP surges. As part of a 16-week randomized, double-blind study of azilsartan (20-40 mg once daily) and candesartan (8-12 mg once daily) in Japanese patients with essential hypertension, an exploratory analysis was carried out using ambulatory BP monitoring at baseline and week 14. The effects of study drugs on morning BP surges, including sleep trough surge (early morning SBP minus the lowest night-time SBP) and prewaking surge (early morning SBP minus SBP before awakening), were evaluated. Patients with sleep trough surge of at least 35 mmHg were defined by the presence of a morning BP surge (the 'surge group'). Sleep trough surge and prewaking surge data were available at both baseline and week 14 in 548 patients, 147 of whom (azilsartan 76; candesartan 71) had a baseline morning BP surge. In surge group patients, azilsartan significantly reduced both the sleep trough surge and the prewaking surge at week 14 compared with candesartan (least squares means of the between-group differences -5.8 mmHg, P=0.0395; and -5.7 mmHg, P=0.0228, respectively). Once-daily azilsartan improved sleep trough surge and prewaking surge to a greater extent than candesartan in Japanese patients with grade I-II essential hypertension. PMID:24710336

  7. Effect of azilsartan versus candesartan on morning blood pressure surges in Japanese patients with essential hypertension

    PubMed Central

    Kario, Kazuomi; Enya, Kazuaki; Sugiura, Kenkichi; Ikeda, Yoshinori

    2014-01-01

    Morning blood pressure (BP) surge is reported as a risk factor for cardiovascular events and end-organ damage independent of the 24-h BP level. Controlling morning BP surge is therefore important to help prevent onset of cardiovascular disease. We compared the efficacy of azilsartan and candesartan in controlling morning systolic BP (SBP) surges by analyzing relevant ambulatory BP monitoring data in patients with/without baseline BP surges. As part of a 16-week randomized, double-blind study of azilsartan (20–40 mg once daily) and candesartan (8–12 mg once daily) in Japanese patients with essential hypertension, an exploratory analysis was carried out using ambulatory BP monitoring at baseline and week 14. The effects of study drugs on morning BP surges, including sleep trough surge (early morning SBP minus the lowest night-time SBP) and prewaking surge (early morning SBP minus SBP before awakening), were evaluated. Patients with sleep trough surge of at least 35 mmHg were defined by the presence of a morning BP surge (the ‘surge group’). Sleep trough surge and prewaking surge data were available at both baseline and week 14 in 548 patients, 147 of whom (azilsartan 76; candesartan 71) had a baseline morning BP surge. In surge group patients, azilsartan significantly reduced both the sleep trough surge and the prewaking surge at week 14 compared with candesartan (least squares means of the between-group differences ?5.8 mmHg, P=0.0395; and ?5.7 mmHg, P=0.0228, respectively). Once-daily azilsartan improved sleep trough surge and prewaking surge to a greater extent than candesartan in Japanese patients with grade I–II essential hypertension. PMID:24710336

  8. Assessment of Japanese stimulant control law offenders using the Addiction Severity Index--Japanese version: comparison with patients in treatment settings.

    PubMed

    Watanabe, Takashi; Ogai, Yasukazu; Koga, Takehiro; Senoo, Eiichi; Nakamura, Kazuhiko; Mori, Norio; Ikeda, Kazutaka

    2009-12-01

    The present study assessed problems in Japanese prisoners (inmates) who abused methamphetamine. Fifty-two male inmates were assessed in 2005-2007 using the Addiction Severity Index-Japanese version and compared with 55 male methamphetamine abusers in hospitals and recovery centers. The chi(2) and Mann-Whitney-Wilcoxon tests showed that the inmates had a significantly lower education level, more frequently had full-time jobs, had more experience living with a sexual partner, and more frequently had a history of juvenile delinquency and criminal records than patients. Although psychiatric symptoms, such as depression, anxiety, and hallucinations, were not common among inmates, suicidal behavior and trouble controlling violence were common in both groups. PMID:20049245

  9. Diabetic myonecrosis in a patient with hepatitis B-induced liver cirrhosis.

    PubMed

    Park, Su Min; Kim, You Jeong; Kim, Seung Man; Han, Na; Lee, Eun Ju; Kim, Tae Kyoon; Kim, Tae Nyun; Kwon, Min Jeong; Kim, Mi Kyung; Lee, Soon Hee; Park, Jeong Hyun; Rhee, Byung Doo; Kim, Bo Mi; Lee, Sun Joo

    2015-02-01

    Diabetic myonecrosis-a rare complication of long-standing, poorly controlled diabetes mellitus-typically presents with acute-onset muscle pain, is self-limiting, and responds well to conservative management. We report a case of diabetic myonecrosis in a 33-year-old man with hepatitis B-induced liver cirrhosis and type 2 diabetes who presented with abdominal distension and pain in the left thigh. Diabetic myonecrosis was diagnosed based on clinical presentation, radiological findings, magnetic resonance imaging and histopathological investigations; he was successfully treated conservatively with insulin and analgesics. Diabetic myonecrosis should be considered in the differential diagnosis of muscle pain in patients with diabetes. PMID:25305801

  10. Metabolic control and diabetic retinopathy in patients with diabetes type 2

    Microsoft Academic Search

    N. Kosanovi?-Jakovi?; V. Dimitrijevi?-Sre?kovi?; M. Vukosavljevi?; S. Milenkovi?; E. ?olak; D. Risovi?; S. Avramovi?; F. Canovi?

    2010-01-01

    \\u000a Zusammenfassung  ZIELSETZUNG: Die Bewertung der Korrelation zwischen Wechselstoffkontrolle und Präsenz und Schweregrad der diabetischen Retinopathie\\u000a (DR) bei Patienten mit Typ-2-Diabetes. METHODEN: Diese Querschnittstudie umfasste 80 Patienten, die in vier Gruppen eingeordnet\\u000a wurden, nach der Dauer der Krankheit: de novo; bis zu 10 Jahren; 11 bis 20 Jahre; und über 20 Jahre. Um die Stoffwechselkontrolle zu bewerten wurden bei jedem Patient\\u000a die

  11. Evaluation of immunological parameters in diabetic patients: are these patients immunodeficient?

    PubMed

    Moazezi, Zoleikha; Hosseinian, Azam; Ahmad Moazam, Ensiyeh; Eslami, Mohamed Bagher; Mosavi, Ezatollah; Akhavan-Niaki, Haleh; Bijani, Ali; Schloot, Nanette; Mostafazadeh, Amrollah

    2014-04-01

    It has been widely thought that diabetic patients are prone to infections due to hyperglycemia induced immunodeficiency; the present study was designed to examine this opinion. In diabetic patients and normal control groups T-cell reactivity to hsp-60 molecule, tetanus toxoid recall antigen (TT) and phytohemagglutinin-A (PHA) mitogen were evaluated The number of circulating IFN-?, IL-10 and IL-13 cytokine producing cells stimulated with above antigens or mitogen as well as the serum levels of Th1/Th2 type cytokines were determined. Total serum immunoglobulins (IgG, IgA, IgM), C3, C4 and CH50 were also measured. Diabetic patients showed a positive circulating T-cell reactivity to human recombinant hsp60 However, this reactivity was significantly lower in comparison to control group (p<0.001). All other examined factors were not significantly different between diabetic and normal subjects except for the number of IFN-? and IL-13 producing cells in response to PHA stimulation, which was higher in control gtroup (p=0.006, 0.018, respectively). The mean serum concentration of IgA in diabetic patients was 245.86 ± 115.05 mg/dl versus 192.96 ± 105.33 mg/dl in healthy control group (p<0.018). We were not able to demonstrate any substantial mitigation in cellular arms of immune reaction to some prominent T-cell antigens and mitogens, as well as, in main parameters of humoral immunity of diabetic patients, thus, the common notion of believing that patients with diabetes suffering from immunodeficiency should be revised. It is much more appropriate that "altered immunity" is applied instead of "immunodeficiency" to explain the immunity condition in this group of patients. PMID:24338256

  12. Psychological aspects of diabetes care: Effecting behavioral change in patients.

    PubMed

    Chew, Boon-How; Shariff-Ghazali, Sazlina; Fernandez, Aaron

    2014-12-15

    Patients with diabetes mellitus (DM) need psychological support throughout their life span from the time of diagnosis. The psychological make-up of the patients with DM play a central role in self-management behaviors. Without patient's adherence to the effective therapies, there would be persistent sub-optimal control of diseases, increase diabetes-related complications, causing deterioration in quality of life, resulting in increased healthcare utilization and burden on healthcare systems. However, provision of psychosocial support is generally inadequate due to its challenging nature of needs and demands on the healthcare systems. This review article examines patient's psychological aspects in general, elaborates in particular about emotion effects on health, and emotion in relation to other psychological domains such as cognition, self-regulation, self-efficacy and behavior. Some descriptions are also provided on willpower, resilience, illness perception and proactive coping in relating execution of new behaviors, coping with future-oriented thinking and influences of illness perception on health-related behaviors. These psychological aspects are further discussed in relation to DM and interventions for patients with DM. Equipped with the understanding of the pertinent nature of psychology in patients with DM; and knowing the links between the psychological disorders, inflammation and cardiovascular outcomes would hopefully encourages healthcare professionals in giving due attention to the psychological needs of patients with DM. PMID:25512782

  13. Anakinra treatment in patients with gout and type 2 diabetes.

    PubMed

    Vitale, Antonio; Cantarini, Luca; Rigante, Donato; Bardelli, Marco; Galeazzi, Mauro

    2015-05-01

    We report three Caucasian patients affected by gout and type 2 diabetes, who were treated with the recombinant nonglycosylated human interleukin-1 receptor antagonist anakinra (100 mg/day subcutaneously) after an unsatisfactory or incomplete response to urate-lowering therapy, colchicine, nonsteroidal anti-inflammatory drugs, and prednisone. The remarkable clinical improvement in joint symptoms within 24 h and in glycemic control during a 6-month period gives anakinra a potential therapeutic role in the management of gout and type 2 diabetes. When anakinra was discontinued, a gout attack occurred within 3-25 days in all three patients. The contribution of anakinra in the treatment of such syndromes is encouraging, but requires further studies to establish its long-term efficacy. PMID:24733251

  14. Pharmacokinetics and safety of voriconazole intravenous-to-oral switch regimens in immunocompromised Japanese pediatric patients.

    PubMed

    Mori, Masaaki; Kobayashi, Ryoji; Kato, Koji; Maeda, Naoko; Fukushima, Keitaro; Goto, Hiroaki; Inoue, Masami; Muto, Chieko; Okayama, Akifumi; Watanabe, Kenichi; Liu, Ping

    2015-02-01

    The aim of this study was to investigate the pharmacokinetics, safety, and tolerability of voriconazole following intravenous-to-oral switch regimens used with immunocompromised Japanese pediatric subjects (age 2 to <15 years) at high risk for systemic fungal infection. Twenty-one patients received intravenous-to-oral switch regimens based on a recent population pharmacokinetic modeling; they were given 9 mg/kg of body weight followed by 8 mg/kg of intravenous (i.v.) voriconazole every 12 h (q12h), and 9 mg/kg (maximum, 350 mg) of oral voriconazole q12h (for patients age 2 to <12 or 12 to <15 years and <50 kg) or 6 mg/kg followed by 4 mg/kg of i.v. voriconazole q12h and 200 mg of oral voriconazole q12h (for patients age 12 to <15 years and ?50 kg). The steady-state area under the curve over the 12-h dosing interval (AUC0-12,ss) was calculated using the noncompartmental method and compared with the predicted exposures in Western pediatric subjects based on the abovementioned modeling. The geometric mean (coefficient of variation) AUC0-12,ss values for the intravenous and oral regimens were 51.1 ?g · h/ml (68%) and 45.8 ?g·h/ml (90%), respectively; there was a high correlation between AUC0-12,ss and trough concentration. Although the average exposures were higher in the Japanese patients than those in the Western pediatric subjects, the overall voriconazole exposures were comparable between these two groups due to large interindividual variability. The exposures in the 2 cytochrome P450 2C19 poor metabolizers were among the highest. Voriconazole was well tolerated. The most common treatment-related adverse events were photophobia and abnormal hepatic function. These recommended doses derived from the modeling appear to be appropriate for Japanese pediatric patients, showing no additional safety risks compared to those with adult patients. (This study has been registered at ClinicalTrials.gov under registration no. NCT01383993.). PMID:25451051

  15. Patient-centered diabetes self-management education

    Microsoft Academic Search

    Geoffrey C. Williams; Allan Zeldman

    2002-01-01

    Diabetes self-management education (DSME) has been shown to improve health outcomes. Yet, relatively little is known about\\u000a how DSME has its effects. Literature reviewed from the past 3 years indicates that if DSME is to become more effective interventions\\u000a need to be theory-based, to increase patient involvement in their care, and to encompass a broader array of evidenced-based\\u000a outcomes. Outcomes

  16. Obesity and type 2 diabetes: which patients are at risk?

    PubMed

    Garber, A J

    2012-05-01

    An estimated 72.5 million American adults are obese, and the growing US obesity epidemic is responsible for substantial increase in morbidity and mortality, as well as increased health care costs. Obesity results from a combination of personal and societal factors, but is often viewed as a character flaw rather than a medical condition. This leads to stigma and discrimination towards obese individuals and decreases the likelihood of effective intervention. Conditions related to obesity are increasingly common, such as metabolic syndrome, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), all of which indicate high risk for type 2 diabetes (T2DM). This paper reviews the progression from obesity to diabetes, identifying physiological changes that occur along this path as well as opportunities for patient identification and disease prevention. Patients with prediabetes (defined as having IFG, IGT or both) and/or metabolic syndrome require interventions designed to preserve insulin sensitivity and ?-cell function, both of which start to deteriorate prior to T2DM diagnosis. Lifestyle modification, including both healthy eating choices and increased physical activity, is essential for weight management and diabetes prevention. Although sustained weight loss is often considered by patients and physicians as being impossible to achieve, effective interventions do exist. Specifically, the Diabetes Prevention Program (DPP) and programs modelled along its parameters have shown repeated successes, even with long-term maintenance. Recent setbacks in the development of medications for weight loss further stress the importance of lifestyle management. By viewing obesity as a metabolic disorder rather than a personal weakness, we can work with patients to address this increasingly prevalent condition and improve long-term health outcomes. PMID:22074144

  17. Direct Diabetes-Related Costs in Young Patients with Early-Onset, Long-Lasting Type 1 Diabetes

    PubMed Central

    Straßburger, Klaus; Flechtner-Mors, Marion; Hungele, Andreas; Beyer, Peter; Placzek, Kerstin; Hermann, Ulrich; Schumacher, Andrea; Freff, Markus; Stahl-Pehe, Anna

    2013-01-01

    Objective To estimate diabetes-related direct health care costs in pediatric patients with early-onset type 1 diabetes of long duration in Germany. Research Design and Methods Data of a population-based cohort of 1,473 subjects with type 1 diabetes onset at 0–4 years of age within the years 1993–1999 were included (mean age 13.9 (SD 2.2) years, mean diabetes duration 10.9 (SD 1.9) years, as of 31.12.2007). Diabetes-related health care services utilized in 2007 were derived from a nationwide prospective documentation system (DPV). Health care utilization was valued in monetary terms based on inpatient and outpatient medical fees and retail prices (perspective of statutory health insurance). Multiple regression models were applied to assess associations between direct diabetes-related health care costs per patient-year and demographic and clinical predictors. Results Mean direct diabetes-related health care costs per patient-year were €3,745 (inter-quartile range: 1,943–4,881). Costs for glucose self-monitoring were the main cost category (28.5%), followed by costs for continuous subcutaneous insulin infusion (25.0%), diabetes-related hospitalizations (22.1%) and insulin (18.4%). Female gender, pubertal age and poor glycemic control were associated with higher and migration background with lower total costs. Conclusions Main cost categories in patients with on average 11 years of diabetes duration were costs for glucose self-monitoring, insulin pump therapy, hospitalization and insulin. Optimization of glycemic control in particular in pubertal age through intensified care with improved diabetes education and tailored insulin regimen, can contribute to the reduction of direct diabetes-related costs in this patient group. PMID:23967077

  18. Pilot study using mobile health to coordinate the diabetic patient, diabetologist, and ophthalmologist.

    PubMed

    Tsui, Irena; Drexler, Andrew; Stanton, Annette L; Kageyama, Jennie; Ngo, Elaine; Straatsma, Bradley R

    2014-07-01

    In the United States, more than 25 million adults have diabetes, 40% of diabetics have diabetic retinopathy, and diabetes is the leading cause of blindness in people 20 to 74 years of age. Clinical trials have shown that strict control of blood glucose level and other risk factors delays diabetic retinopathy onset, progression, and vision loss. Patients with Type 1 or Type 2 diabetes mellitus, access to an Apple iPhone or iPad, and no psychological or medical condition that would interfere with the study participated in a nonrandomized clinical trial using SightBook™, a free mobile app that enables self-measurement of visual function and creates a password-protected web account for each patient. Sixty patients enrolled in the clinical trial over a 6 month period. Twenty-six participants were men and 34 were women, with ages from 23 to 72 years (mean 45 ± 15) and diabetes duration of 1.5 to 50 years (mean 15.5 ± 11.5). Thirty-nine (65%) patients reported Type 1 diabetes and 21 (35%) patients reported Type 2 diabetes. Every patient established a personal web account on SightBook and invited participation of treating physicians; 51 (85%) patients completed the validated self-reported outcome assessments. Diabetologist examinations of 49 (82%) patients demonstrated systolic hypertension (?140 mgHg) in 20% and hemoglobin A1c ? 7.0% in 56%. Ophthalmology examinations of 45 patients showed visual acuity in the worse-seeing eye of < 20/40 in 18% and diabetic retinopathy in 42% of patients. This clinical trial used a mobile health app to incorporate diabetic patient self-measurement of vision and coordinate the diabetic patient, diabetologist, and ophthalmologist for control of diabetes and diabetic retinopathy risk factors. PMID:24876413

  19. Pancreas transplant alone has beneficial effects on retinopathy in type 1 diabetic patients

    Microsoft Academic Search

    R. Giannarelli; A. Coppelli; M. S. Sartini; M. del Chiaro; F. Vistoli; G. Rizzo; M. Barsotti; S. Del Prato; F. Mosca; U. Boggi; P. Marchetti

    2006-01-01

    Aims\\/hypothesis  The effects of successful pancreas transplant alone (PTA) on chronic complications of diabetes, in particular diabetic retinopathy, remain disputed. We prospectively studied the course of diabetic retinopathy in PTA recipients and in non-transplanted (non-PTA) type 1 diabetic patients.Methods  The PTA and non-PTA groups consisted respectively of 33 (follow-up: 30?±?11 months) and 35 patients (follow-up: 28?±?10 months). Best corrected visual acuity, slit lamp examination,

  20. Corneal Changes After Small-Incision Cataract Surgery in Patients With Diabetes Mellitus

    Microsoft Academic Search

    Soichi Morikubo; Yoshihiro Takamura; Eri Kubo; Shosai Tsuzuki; Yoshio Akagi

    2004-01-01

    Objective:Toevaluatefunctionalimpairmentinthecor- neal endothelium of eyes in patients with diabetes melli- tus, after small-incision cataract surgery. Methods: Evaluation was performed in 93 eyes in pa- tients with type 2 diabetes mellitus (diabetic group) and 93 eyes in patients without diabetic mellitus (nondia- betic group) who underwent cataract surgery. Using a topography system, the corneal thickness in the central areawasmeasuredbeforesurgeryand1day,1week,and 1 month

  1. Corneal Changes After Small-Incision Cataract Surgery in Patients With Diabetes Mellitus

    Microsoft Academic Search

    Soichi Morikubo; Yoshihiro Takamura; Eri Kubo; Shosai Tsuzuki; Yoshio Akagi

    Objective:Toevaluatefunctionalimpairmentinthecor- neal endothelium of eyes in patients with diabetes melli- tus, after small-incision cataract surgery. Methods: Evaluation was performed in 93 eyes in pa- tients with type 2 diabetes mellitus (diabetic group) and 93 eyes in patients without diabetic mellitus (nondia- betic group) who underwent cataract surgery. Using a topography system, the corneal thickness in the central areawasmeasuredbeforesurgeryand1day,1week,and 1 month

  2. Underuse of an invasive strategy for patients with diabetes with acute coronary syndrome: a nationwide study

    PubMed Central

    Gustafsson, Ida; Hvelplund, Anders; Hansen, Kim Wadt; Galatius, Søren; Madsen, Mette; Jensen, Jan Skov; Tilsted, Hans-Henrik; Terkelsen, Christian Juhl; Jensen, Lisette Okkels; Jørgensen, Erik; Madsen, Jan Kyst; Abildstrøm, Steen Zabell

    2015-01-01

    Background Guidelines recommend an early invasive strategy for patients with diabetes with acute coronary syndromes (ACS). We investigated if patients with diabetes with ACS are offered coronary angiography (CAG) and revascularisation to the same extent as patients without diabetes. Methods and results The study is a nationwide cohort study linking Danish national registries containing information on healthcare. The study population comprises all patients hospitalised with first-time ACS in Denmark during 2005–2007 (N=24?952). Diabetes was defined as claiming of a prescription for insulin and/or oral hypoglycaemic agents within 6?months prior to the ACS event. Diabetes was present in 2813 (11%) patients. Compared with patients without diabetes, patients with diabetes were older (mean 69 vs 67?years, p<0.0001), less often males (60% vs 64%, p=0.0001) and had more comorbidity. Fewer patients with diabetes underwent CAG: cumulative incidence 64% vs 74% for patients without diabetes, HR=0.72 (95% CI 0.69 to 0.76, p<0.0001); adjusted for age, sex, previous revascularisation and comorbidity HR=0.78 (95% CI 0.74 to 0.82, p<0.0001). More patients with diabetes had CAG showing two-vessel or three-vessel disease (53% vs 38%, p<0.0001). However, revascularisation after CAG revealing multivessel disease was less likely in patients with diabetes (multivariable adjusted HR=0.76, 95% CI 0.68 to 0.85, p<0.0001). Conclusions In this nationwide cohort of patients with incident ACS, patients with diabetes were found to be less aggressively managed by an invasive treatment strategy. The factors underlying the decision to defer an invasive strategy in patients with diabetes are unclear and merit further investigation. PMID:25685362

  3. Prevalence of metabolic syndrome among Nepalese type 2 diabetic patients.

    PubMed

    Tamang, H K; Timilsina, U; Thapa, S; Singh, K P; Shrestha, S; Singh, P; Shrestha, B

    2013-03-01

    This study was carried out to establish the prevalence of metabolic syndrome among the type 2 diabetic patients in Nepal. Two hundred twenty one participants aged 26-90 (mean age 53.41 +/- 13.30) years with established type 2 diabetes visiting Kathmandu Model Hospital, Kathmandu, Nepal from August 2011 to November 2011 were included in the study. National Cholesterol Education Adult Treatment Panel III (NCEP ATPIII) definition of the metabolic syndrome with ethnic threshold on abdominal obesity was used. 170 (76.9%) participants were found to have metabolic syndrome. Thirty two (14.5%) participants fulfilled all 5 criteria for metabolic syndrome, 63 (28.5%) participants had four criteria while three criteria were fulfilled by 75 (33.9%) of the participants. Among the patients having metabolic syndrome, hypertension was seen in 89 (52.35%) participants, raised serum triglyceride levels were found in 144 (84.70%) subjects, decreased serum HDL cholesterol levels were found in 119 (70%) participants while in 108 (63.35%) participants increased waist circumference was found. There was a higher frequency of metabolic syndrome in obese (81.58%) and in overweight (79.49%) subjects. This study indicates significant prevalence of metabolic syndrome among type 2 diabetic patients with strong association of obesity. PMID:24592795

  4. Patient-Centered Outcomes of Diabetes Self-Care Associations with Satisfaction and General Health in a Community Clinic Setting

    Microsoft Academic Search

    Roger T. Anderson; Rajesh Balkrishnan; Fabian Camacho; Ronny Bell; Vanessa Duren-Winfield; David Goff

    Background: Despite the recognition of strategies for diabetes care management, information systems that screen patient diabetes self-care problems are not commonplace, especially among low-income patients. This study examined correlates of three patient- centered outcomes of diabetes self-care (awareness of self-care components, difficulties in diabetes self-care, and adherence to self- care) among low-income diabetic patients. Methods: Clinical and patient survey data

  5. Seven-year mortality in heart failure patients with undiagnosed diabetes: an observational study

    PubMed Central

    2011-01-01

    Background Patients with type 2 diabetes mellitus and heart failure have adverse clinical outcomes, but the characteristics and prognosis of those with undiagnosed diabetes in this setting has not been established. Methods In total, 400 patients admitted consecutively with acute heart failure were grouped in three glycaemic categories: no diabetes, clinical diabetes (previously reported or with hypoglycaemic treatment) and undiagnosed diabetes. The latter was defined by the presence of at least two measurements of fasting plasma glycaemia ? 7 mmol/L before or after the acute episode.Group differences were tested by proportional hazards models in all-cause and cardiovascular mortality during a 7-year follow-up. Results There were 188 (47%) patients without diabetes, 149 (37%) with clinical diabetes and 63 (16%) with undiagnosed diabetes. Patients with undiagnosed diabetes had a lower prevalence of hypertension, dyslipidaemia, peripheral vascular disease and previous myocardial infarction than those with clinical diabetes and similar to that of those without diabetes. The adjusted hazards ratios for 7-year total and cardiovascular mortality compared with the group of subjects without diabetes were 1.69 (95% CI: 1.17-2.46) and 2.45 (95% CI: 1.58-3.81) for those with undiagnosed diabetes, and 1.48 (95% CI: 1.10-1.99) and 2.01 (95% CI: 1.40-2.89) for those with clinical diabetes. Conclusions Undiagnosed diabetes is common in patients requiring hospitalization for acute heart failure. Patients with undiagnosed diabetes, despite having a lower cardiovascular risk profile than those with clinical diabetes, show a similar increased mortality. PMID:21569580

  6. Attainment of Canadian Diabetes Association recommended targets in patients with type 2 diabetes

    PubMed Central

    McCrate, Farah; Godwin, Marshall; Murphy, Laura

    2010-01-01

    OBJECTIVE To examine the degree to which targets for diabetes (blood pressure [BP], glycated hemoglobin [HbA1c], and low-density lipoprotein cholesterol [LDL-C]) are achieved in family practices and how these results compare with family physicians’ perceptions of how well targets are being achieved. DESIGN Chart audit and physician survey. SETTING Newfoundland and Labrador. PARTICIPANTS Patients with type 2 diabetes and their family physicians. INTERVENTIONS The charts of 20 patients with type 2 diabetes were randomly chosen from each of 8 family physician practices in St John’s, Nfld, and data were abstracted. All family physicians in the province were surveyed using a modified Dillman method. MAIN OUTCOME MEASURES The most recent HbA1c, LDL-C, and BP measurements listed in each audited chart; surveyed family physicians’ knowledge of the recommended targets for HbA1c, LDL-C, and BP and their estimates of what percentage of their patients were at those recommended targets. RESULTS The chart audit revealed that 20.6% of patients were at the recommended target for BP, 48.1% were at the recommended target for HbA1c, and 17.5% were at the recommended target for LDL-C. When targets were examined collectively, only 2.5% of patients were achieving targets in all 3 areas. The survey found that most family physicians were aware of the recommended targets for BP, LDL-C, and HbA1c. However, their estimates of the percentages of patients in their practices achieving these targets appeared high (59.3% for BP, 58.2% for HbA1c, and 48.4% for LDL-C) compared with the results of the chart audit. CONCLUSION The findings of the chart audit are consistent with other published reports, which have illustrated that a large majority of patients with diabetes fall short of reaching recommended targets for BP, blood glucose, and lipid levels. Although family physicians are knowledgeable about recommended targets, there is a gap between knowledge and clinical outcomes. The reasons for this are likely multifactorial. Further investigation is needed to better understand this phenomenon as well as to understand the foundation for physicians’ optimistic estimates of how many of their patients with diabates were reaching target values. PMID:20090056

  7. The prevention of fragility fractures in diabetic patients.

    PubMed

    Gonnelli, Stefano; Caffarelli, Carla; Giordano, Nicola; Nuti, Ranuccio

    2015-04-01

    Patients with diabetes mellitus (DM) are at greater risk of fractures mostly due to not only extraskeletal factors, such as propensity to falls, but also to bone quality alteration, which reduces bone strength. In people with DM, insulin deficit and hyperglycemia seem to play a role in determining bone formation alteration by AGE accumulation which directly influences osteoblast activity. Although there are conflicting data in the literature, adequate glycemic control with hypoglycemic treatment may be an important element in preventing bone tissue alterations in both type 1 and type 2 DM. Diabetes status is a predictive of future hip and major osteoporosis fractures independently of BMD and FRAX probability. Attention should be paid to the use of thiazolidinediones, especially in older women, because the direct negative effect on bone could exceed the positive effect of glycemic control. Systematic screening for complications and fall prevention efforts, along with calcium and vitamin D repletion and adequate physical activity, represents the mainstay of fracture prevention in DM patients. All anticatabolic drugs (raloxifene, bisphosphonates, denosumab) seem to be effective in DM patients. On the basis of pathophysiological evidence that suggests low bone formation in DM patients, osteoanabolic therapies such as teriparatide might represent an important therapeutic option for DM patients with severe osteoporosis and/or multiple fractures. The search for better methods for the identification of fragility fracture risk in the growing population of adult and elderly subjects with DM might be considered a clinical priority which could improve the prevention of fracture in DM patients. PMID:25059454

  8. Levetiracetam add-on therapy in Japanese patients with refractory partial epilepsy.

    PubMed

    Tanaka, Shigeya; Tanaka, Tatsuya

    2013-06-01

    The aim of this observational study was to obtain information regarding efficacy and safety of add-on levetiracetam (LEV; n=32) in Japanese patients with refractory partial seizures in an everyday clinical setting, relative to control AEDs (n=30). This is the first study of LEV add-on therapy conducted in Japan since approval was made. The medical charts of patients were retrospectively reviewed. The efficacy variables were seizure freedom and ?50% reduction in seizure frequency. A significantly higher response to LEV was demonstrated in patients with all seizure types at baseline, relative to control AEDs. In patients with a duration of epilepsy of at least 10 years, significant effects in response to LEV were demonstrated with regards to efficacy variables, relative to control AEDs, thus providing meaningful results. Only two patients (6.2%) discontinued LEV treatment due to worsening of seizures, but no discontinuation was reported due to adverse events. LEV as add-on therapy to other AEDs is a promising useful treatment option for patients with refractory partial seizures without notable effects on safety, indicating that this treatment regimen might be recommended for such patients. PMID:23774199

  9. Normal parathyroid hormone levels in a diabetic patient with parathyroid adenoma

    Microsoft Academic Search

    Nese Ersoz Gulcelik; Fani Bozkurt; Gaye Güler Tezel; Volkan Kaynaroglu; Tomris Erbas

    2009-01-01

    Objective The incidence of diabetes mellitus in patients with primary hyperparathyroidism and, conversely, primary hyperparathyroidism\\u000a in diabetic patients are approximately threefold higher than the respective expected prevalence in the general populace. The\\u000a diagnosis is straightforward when the patient presents hypercalcemia and inappropriately elevated serum parathyroid hormone\\u000a (PTH) levels. We report a case of parathyroid adenoma in a diabetic patient with

  10. Aqueous humor levels of cytokines are related to vitreous levels and progression of diabetic retinopathy in diabetic patients

    Microsoft Academic Search

    Hideharu Funatsu; Hidetoshi Yamashita; Hidetaka Noma; Tatsuya Mimura; Shinko Nakamura; Kumi Sakata; Sadao Hori

    2005-01-01

    Background Cytokine levels are elevated in the ocular fluid of diabetic patients. It is unclear whether aqueous humor levels of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) are related to the vitreous fluid levels of these substances and to the progression of diabetic retinopathy. Methods Aqueous humor and vitreous fluid samples were obtained during cataract and vitreous surgery from

  11. Intrinsic and extrinsic factors affecting patient engagement in diabetes self-management: perspectives of a certified diabetes educator.

    PubMed

    Rodriguez, Kellie M

    2013-02-01

    Patients with diabetes are responsible for the vast majority of management requirements of their condition. However, their ability and motivation to engage in required self-management behaviors may be mitigated by multiple intrinsic and extrinsic factors. Intrinsic barriers include attitudes and health beliefs, limited diabetes knowledge and technical skill, reduced functional health literacy, and inadequate self-efficacy to promote positive behavior change. Extrinsic barriers include financial considerations, inadequate family and community support systems, ineffective clinical relationships, and limited access to effective diabetes health care delivery. Diabetes providers have opportunities for enhancing patient engagement with clinical recommendations and diabetes self-management through effective communication, including efforts to contextually assess patients' perceptions of diabetes and how the condition fits within the context of their changing lives. This article provides a conceptual framework for establishing and building an effective clinical alliance with patients with the goal of empowering them to take more control of their diabetes and reduce their risks for poor diabetes outcomes. PMID:23411000

  12. Concepts of diabetes self-management in Mexican American and African American low-income patients with diabetes.

    PubMed

    Lynch, E B; Fernandez, A; Lighthouse, N; Mendenhall, E; Jacobs, E

    2012-10-01

    The goal of the study was to explore low-income minority patients' concepts of diabetes self-management and assess the extent to which patient beliefs correspond to evidence-based recommendations. African American and Mexican American patients with type 2 diabetes were recruited from safety net clinics that serve the uninsured and under-insured in Chicago and San Francisco to participate in focus group discussions. Grounded theory was used to identify themes related to diabetes self-management. Strategies participants mentioned for diabetes self-care were medication use, diet, weight loss and exercise. Eating more fruit and vegetables and consuming smaller portions were the most commonly mentioned dietary behaviors to control diabetes. African Americans expressed skepticism about taking medications. Mexican Americans discussed barriers to acquiring medications and use of herbal remedies. Mexican Americans frequently mentioned intentional exercise of long duration as a management strategy, whereas African Americans more frequently described exercise as regular activities of daily living. Blood glucose self-monitoring and reducing risks of diabetes complications were rarely mentioned as diabetes self-management behaviors. African American and Mexican American patients have different concepts of diabetes self-management, especially with regard to medication use and physical activity. Consideration of these differences may facilitate design of effective self-management interventions for these high-risk populations. PMID:22641792

  13. Molecular genetic testing of patients with monogenic diabetes and hyperinsulinism.

    PubMed

    Bennett, James T; Vasta, Valeria; Zhang, Min; Narayanan, Jaya; Gerrits, Peter; Hahn, Si Houn

    2015-03-01

    Genetic sequencing has become a critical part of the diagnosis of certain forms of pancreatic beta cell dysfunction. Despite great advances in the speed and cost of DNA sequencing, determining the pathogenicity of variants remains a challenge, and requires sharing of sequence and phenotypic data between laboratories. We reviewed all diabetes and hyperinsulinism-associated molecular testing done at the Seattle Children's Molecular Genetics Laboratory from 2009 to 2013. 331 probands were referred to us for molecular genetic sequencing for Neonatal Diabetes (NDM), Maturity-Onset Diabetes of the Young (MODY), or Congenital Hyperinsulinism (CHI) during this period. Reportable variants were identified in 115 (35%) patients with 91 variants in one of 6 genes: HNF1A, GCK, HNF4A, ABCC8, KCNJ11, or INS. In addition to identifying 23 novel variants, we identified unusual mechanisms of inheritance, including mosaic and digenic MODY presentations. Re-analysis of all reported variants using more recently available databases led to a change in variant interpretation from the original report in 30% of cases. These results represent a resource for molecular testing of monogenic forms of diabetes and hyperinsulinism, providing a mutation spectrum for these disorders in a large North American cohort. In addition, they highlight the importance of periodic review of molecular testing results. PMID:25555642

  14. Does Diabetes Really Impact on Postoperative Survival in Patients with Colorectal Cancer?

    E-print Network

    J Korean; Soc Coloproctol; Hungdai Kim

    According to a recent cohort study, diabetic patients had a significantly greater risk of colorectal cancer (CRC) than non-diabetic patients [1]. This study went one-step further and analyzed the postoperative survival difference between diabetic and nondiabetic patients with comorbid colorectal cancer. The authors found that no relationship existed between the presence of diabetes and the recurrence of or the survival rate for colorectal cancer. However, many other studies have reported that diabetes significantly and negatively impacts overall survival (OS) and that the cancer-specific survival (CSS) and prognostic impact of diabetes on OS and CSS were particularly significant in patients with stage II colon cancer [2]. However, many articles report results different from what we know. For instance, in patients undergoing colorectal cancer surgery, those with diabetes had a 23 % lower in hospital mortality and fewer postoperative

  15. Patient profiling in diabetes and role of canagliflozin

    PubMed Central

    Amblee, Ambika

    2014-01-01

    Background Physicians attempt to achieve glycemic goals in patients with type 2 diabetes mellitus (T2DM) through various means, including glucose-lowering medications. There is interindividual variability in response to medications, which can be partially explained by the presence of genetic polymorphisms that affect drug metabolism. Pharmacogenomics studies the hereditary basis of interpatient variations in drug response and aims to identify subgroups of patients whose drug management could be tailored accordingly. The aim of this review is to explore patient profiling in the management of T2DM with a focus on the sodium glucose transporter inhibitor canagliflozin. Methods The PubMed database was searched using the terms “pharmacogenomics” and “diabetes” through May 31, 2014. Published articles and abstracts presented at national/international meetings were considered. Results and conclusion Genome-wide association studies have opened the door for patient profiling and research into genetic variants in multifactorial T2DM. Clinically, it may be possible to tailor the type of medication used based on the presence or absence of the various genetic variants. However, the polymorphisms studied may only explain some of the variability in response to T2DM drugs and needs further validation to ensure its authenticity. There are still unidentified factors which appear to play a role in the interindividual variability seen in clinical practice. The potential exists for pharmacogenomics to promote efficacious, safe, and cost-effective individualized diabetes management. Pharmacogenomics is still in its early stages, and the idea of defining patients genetically to predict individual responses to drugs and obtain safe and effective T2DM management is promising, in spite of existing barriers. Currently, clinical profiling of patients with T2DM and using an individualized approach with most drugs, including canagliflozin, based on comorbid conditions still remains the most accepted approach for the management of T2DM. PMID:25540592

  16. Gómez-López-Hernández syndrome in a Japanese patient: A case report.

    PubMed

    Kobayashi, Yu; Kawashima, Hideshi; Magara, Shinichi; Akasaka, Noriyuki; Tohyama, Jun

    2015-03-01

    Gómez-López-Hernández syndrome (GLHS) is a rare neurocutaneous syndrome characterized by the triad of rhombencephalosynapsis, trigeminal anesthesia, and bilateral parieto-occipital alopecia. We herein describe the first Japanese patient with GLHS characterized by the standard triad with typical craniofacial anomaly including hypertelorism, brachyturricephaly and midface retrusion, and a short stature. This female patient had also exhibited fever-induced convulsive seizures and psychomotor developmental delay since infancy. Brain magnetic resonance imaging showed severe rhombencephalosynapsis, supratentorial abnormalities (aplasia of the septum pellucidum, severe ventricular enlargement, and hypoplasia of the corpus callosum), and hippocampus atrophy. Bilateral ectopic cerebellums were also observed. This report describes the long-term clinical outcome of GLHS and a new neuroradiological finding regarding rhombencephalosynapsis. PMID:24856766

  17. [Clinical features in a Japanese patient with autosomal dominant lateral temporal epilepsy having LGI1 mutation].

    PubMed

    Fujita, Youshi; Ikeda, Akio; Kadono, Kentaro; Kawamata, Jun; Tomimoto, Hidekazu; Fukuyama, Hidenao; Takahashi, Ryosuke

    2009-04-01

    We described a clinical feature of autosomal dominant lateral temporal epilepsy (ADLTE) in a Japanese patient having LGI1 mutation. The patient was a 27-year-old woman who had her first seizure at the age of 10 years, a nocturnal generalized seizure. She then had partial seizures manifesting auditory symptoms with or without anxiety, panic attack, déjà vu, sensory aphasia and visual symptoms. Repeated EEGs were normal. Brain MRI showed small left superior temporal gyrus. 18F-deoxyglucose positron emission tomography (PDG-PET) demonstrated glucose hypometabolism in the left lateral temporal lobe. Sequencing of the LGI1 revealed a single base substitution in exon 8 (1642C-->T) causing missense mutation at residue 473 of the LGI1 protein (S473 L). When one demonstrates ictal symptoms arising from the lateral temporal to occipital area with psychotic symptoms, ADLTE should be suspected and a detailed family history is warranted. PMID:19462817

  18. [Effectiveness of physical exercise programs in patients with diabetes mellitus].

    PubMed

    Cano-De La Cuerda, Roberto; Aguila-Maturana, Ana María; Miangolarra-Page, Juan Carlos

    2009-02-14

    Clinical studies with methodological rigor have shown that the strategies for lifestyle modification and drug therapies can prevent or at least delay the development of type 2 diabetes mellitus (DM) in individuals at high risk. Combination of regular physical exercise and diet is more effective than each one separately to achieve modest weight loss and improve metabolic control in patients with DM. Our objective is to describe the role of exercise in patients with DM and the exercise programs in relation to the previous considerations, taking into account the intensity of the exercise, components of the program, duration, frequency and precautions. PMID:19211086

  19. Molecular and Clinical Studies in 138 Japanese Patients with Silver-Russell Syndrome

    PubMed Central

    Fuke, Tomoko; Mizuno, Seiji; Nagai, Toshiro; Hasegawa, Tomonobu; Horikawa, Reiko; Miyoshi, Yoko; Muroya, Koji; Kondoh, Tatsuro; Numakura, Chikahiko; Sato, Seiji; Nakabayashi, Kazuhiko; Tayama, Chiharu; Hata, Kenichiro; Sano, Shinichiro; Matsubara, Keiko; Kagami, Masayo; Yamazawa, Kazuki; Ogata, Tsutomu

    2013-01-01

    Background Recent studies have revealed relative frequency and characteristic phenotype of two major causative factors for Silver-Russell syndrome (SRS), i.e. epimutation of the H19-differentially methylated region (DMR) and uniparental maternal disomy 7 (upd(7)mat), as well as multilocus methylation abnormalities and positive correlation between methylation index and body and placental sizes in H19-DMR epimutation. Furthermore, rare genomic alterations have been found in a few of patients with idiopathic SRS. Here, we performed molecular and clinical findings in 138 Japanese SRS patients, and examined these matters. Methodology/Principal Findings We identified H19-DMR epimutation in cases 1–43 (group 1), upd(7)mat in cases 44–52 (group 2), and neither H19-DMR epimutation nor upd(7)mat in cases 53–138 (group 3). Multilocus analysis revealed hyper- or hypomethylated DMRs in 2.4% of examined DMRs in group 1; in particular, an extremely hypomethylated ARHI-DMR was identified in case 13. Oligonucleotide array comparative genomic hybridization identified a ?3.86 Mb deletion at chromosome 17q24 in case 73. Epigenotype-phenotype analysis revealed that group 1 had more reduced birth length and weight, more preserved birth occipitofrontal circumference (OFC), more frequent body asymmetry and brachydactyly, and less frequent speech delay than group 2. The degree of placental hypoplasia was similar between the two groups. In group 1, the methylation index for the H19-DMR was positively correlated with birth length and weight, present height and weight, and placental weight, but with neither birth nor present OFC. Conclusions/Significance The results are grossly consistent with the previously reported data, although the frequency of epimutations is lower in the Japanese SRS patients than in the Western European SRS patients. Furthermore, the results provide useful information regarding placental hypoplasia in SRS, clinical phenotypes of the hypomethylated ARHI-DMR, and underlying causative factors for idiopathic SRS. PMID:23533668

  20. Efficacy of methotrexate and tumor necrosis factor inhibitors in Japanese patients with active psoriatic arthritis.

    PubMed

    Mori, Yu; Kuwahara, Yoshiyuki; Chiba, Shinpei; Itoi, Eiji

    2014-10-01

    Objective. The aim of this study was to assess the efficacy of oral methotrexate and tumor necrosis factor inhibitors in Japanese patients with active psoriatic arthritis. Methods. We retrospectively investigated 51 patients who fulfilled the ClASsification criteria for Psoriatic ARthritis (CASPAR) criteria for the efficacy of tumor necrosis factor inhibitors and methotrexate. We assessed the visual analog scale score, psoriasis area and severity index score, C-reactive protein-based disease activity score in 28 joints (DAS28), swollen joint count (0-66), tender joint count (0-68), health assessment questionnaire score, C-reactive protein level, erythrocyte sedimentation rate, and matrix metalloproteinase 3, at both baseline and week 24. Results. Of the 51 patients, 34 were male and 17 were female, with a mean age of 50.3 ± 13.2 years. The duration of psoriasis to onset of arthritis was 10.2 ± 9.1 years. At week 24, in the group treated with the tumor necrosis factor inhibitor plus methotrexate, the tender joint count declined from 6.05 ± 5.84 to 0.43 ± 1.03, the swollen joint count declined from 6.42 ± 4.36 to 0.00 ± 0.00, and the DAS28 declined from 4.35 ± 0.82 to 2.04 ± 0.68. In the group treated with methotrexate alone, the tender joint count declined from 3.70 ± 1.76 to 0.60 ± 0.86, the swollen joint count declined from 5.26 ± 4.00 to 0.27 ± 0.70, and the DAS28 declined from 3.91 ± 0.82 to 1.94 ± 0.53. There were no significant differences in the mean reduction in clinical measurements between the two groups. Conclusion. Our study demonstrated that methotrexate and tumor necrosis factor inhibitors are effective for the treatment of active psoriatic arthritis in Japanese patients. PMID:25295919

  1. Short- and Long-Term Mortality After Myocardial Infarction in Patients With and Without Diabetes

    PubMed Central

    Nauta, Sjoerd T.; Deckers, Jaap W.; Akkerhuis, K. Martijn; van Domburg, Ron T.

    2012-01-01

    OBJECTIVE To study temporal trends in short- and long-term outcome after myocardial infarction (MI) according to diabetes status. RESEARCH DESIGN AND METHODS We included all 14,434 consecutive patients admitted for ST-segment elevation MI or non–ST-segment elevation MI at our center between 1985 and 2008. The study patients were compared according to prevalent diabetes. Temporal trend analyses were performed by comparing decades of admission (1985–1989 vs. 1990–1999 vs. 2000–2008). RESULTS A total of 2,015 (14%) of the patients had prevalent diabetes. The risk of presenting with diabetes increased from 8 to 17% from 1985 to 2008. Diabetic patients presented with a higher prevalence of cardiovascular risk factors. With time, the use of evidence-based therapies increased in both patients with and without diabetes. Diabetes is associated with a 1.5-fold increased risk of mortality at the 20-year follow-up. Ten-year mortality decreased over time in patients with diabetes, from 53% in 1985–1989 to 39% in 2000–2008 (adjusted hazard ratio 0.56 [95% CI 0.43–0.73]), and in those without diabetes, from 38% in 1985–1989 to 29% in 2000–2008 (0.66 [0.60–0.73]; P interaction = 0.83). Patients with diabetes benefitted from a higher 30-day and 10-year absolute survival increase. CONCLUSIONS Temporal mortality reductions after MI between 1985 and 2008 were at least as high in patients with diabetes compared with those without diabetes. However, long-term mortality remained higher in diabetic patients. Awareness of the high-risk profile of diabetic patients is warranted and might stimulate optimal medical care and outcome. PMID:22815296

  2. Erectile Dysfunction and Other Sexual Activity Dysfunctions among Saudi Type 2 Diabetic Patients

    PubMed Central

    AlMogbel, Turki Abdullah

    2014-01-01

    Objectives The aim of the study is to determine the prevalence of Erectile Dysfunction (ED) in Type 2 diabetic Saudi patients, to determine the effect of Type 2 diabetic on other sexual activities (intercourse satisfaction, orgasmic function, sexual desire, overall satisfaction), and to assess whether glycemic control and duration of diabetes have an influence on sexual activities or not. Methods A cross-sectional study was conducted among 376 of Type 2 diabetic male Saudi patients. Erectile dysfunction and other sexual activities dysfunctions were evaluated using the International Index of Erectile Function (IIEF) by a fill coded questionnaire. Additionally, the level of glycosylated hemoglobin was measured to classify the diabetes control status in patients. Results Erectile Dysfunction was reported by 83% of male Saudi diabetic patients. The results show that there was a significant association between the presence of ED and both the age and the duration of diabetes. Family income, occupation, and educational level of the patients show a significant association between them and erectile dysfunction (ED). Moreover, glycemic control did not show a significant association with ED in our sample. Conclusion The findings showed that prevalence of ED among male Saudi diabetic patients is high. It increases with age and duration of diabetes. Also, the study showed that the glycemic control did not correlate with ED. It is recommended that the family physician and diabetologist should ask routinely for this complication in patients with diabetes just like any other diabetes complication. PMID:25780354

  3. Adherence of Healthcare Professionals to American Diabetes Association 2004 guidelines for the care of patients with type 2 diabetes at Peripheral Diabetes Clinics in Karachi, Pakistan

    PubMed Central

    Muzaffar, Farzana; Fatima, Nimra; Fawwad, Asher; Riaz, Mussarat

    2013-01-01

    Objective: To observe the adherence of Healthcare Professionals to American Diabetes Association (ADA) 2004 guidelines for the care of patients with type 2 diabetes at Peripheral Diabetes Clinics (PDCs) in Karachi, Pakistan. Methodology: The study was conducted using a retrospective medical chart review of patients with type 2 diabetes at four PDCs in four townships of Karachi district from January 2005 to December 2006. Entire medical records of patients were evaluated for the evidence of documentation of testing and treatment. Results: Medical records of 691 patients (332 males and 359 females) with type 2 diabetes were reviewed. Mean age of the patients was 50.79 ± 10.75 years. Deficiencies were observed in most areas of diabetes care. Blood pressure was documented in 85.81% patients, whereas, serum creatinine, HbA1c and lipid profile were noted in 56%, 44.57% and 40.08% of the patients respectively. Similarly, lower leg examination was registered in 44% patients, while in 30.53% of the patients fundoscopic examination was recorded. Co-morbid conditions like hypertension and hyperlipidemia were documented in 92.7% and 84.6% patients respectively. HbA1c < 7% was achieved by 59.04% patients, while 27.50% of the patients attained the recommended level of serum cholesterol. Likewise, ADA recommended goal for blood pressure and LDL was achieved by13.02% and 12.16% patients respectively. Conclusions: The study showed that adherence of healthcare professionals to ADA guidelines was suboptimal. Moreover, insufficient documentation of medical records reflected inadequate care of patients with type 2 diabetes. PMID:24353559

  4. Glucometric assessment of gingival crevicular blood in diabetic and non-diabetic patients: A randomized clinical trial

    PubMed Central

    Debnath, Puja; Govila, Vivek; Sharma, Mona; Saini, Ashish; Pandey, Suraj

    2015-01-01

    Background Diabetes mellitus is one of the most incessant metabolic afflictions with high prevalence rate in Indians. Diagnosis of diabetics in the initial stage helps to prevent its long term complications that are responsible for high morbidity and mortality. The aim of the present study was to assess whether glucometric analysis using Gingival Crevicular Blood (GCB) can be used for screening of diabetic patients in dental chair. Materials and methods Present study was a double blinded randomized controlled trial. A total of 50 patients, 25 diabetic and 25 non-diabetic with chronic periodontitis were enrolled in the study. Blood oozing from the gingival crevices after periodontal pocket probing of anterior teeth and Finger Prick Blood (FPB) was taken and analysed by glucometer. Result Mean ± S.D was 195.84 ± 27.19 and 138.78 ± 29.95 for GCB and FPB respectively in diabetic group. For non-diabetic group Mean ± S.D was 103.84 ± 12.56 and 84.36 ± 10.36 respectively for GCB and FPB. A Karl Pearson correlation coefficient value of r = +0.735 for diabetic and r = +0.802 for non-diabetic group comparing GCB and FPB. Conclusion GCB cannot be used for screening blood glucose during periodontal examination. PMID:25853040

  5. Characteristics of pediatric diabetic ketoacidosis patients in Saudi Arabia

    PubMed Central

    Naeem, Mohammed A.; Al-Alem, Hala A.; Al-Dubayee, Mohammed S.; Al-Juraibah, Fahad N.; Omair, Amir; Al-Ruwaili, AbdulKarim S.; Al-Saleh, Abdullah M.

    2015-01-01

    Objectives: To evaluate the clinical and biochemical characteristics of children with diabetic ketoacidosis (DKA). Methods: In this retrospective study conducted between June 2012 and November 2013 at the King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, we evaluated pediatric DKA admissions from 1995-2008 (Phase 1). From the case files, we obtained information related to patients’ age, gender, weight, presenting complaints, serum biochemical profile, and management. Results: This study included 373 DKA admissions with a median age of 11 years (interquartile range [IQR]:8-13). The patients in the subgroup of age more than 10 years old had the highest proportion of admissions (n=250, 67%, p<0.000). The median duration of diagnosis of diabetes mellitus (DM) was 3 years (IQR:2-6). New-onset DM was 47%. Predominant precipitating cause was acute illness, mostly viral syndrome in 22% of all cases, and non-compliance to insulin regimen was in 79% of the diagnosed diabetic cases. Blood glucose, pH, anion gap, serum osmolality, serum potassium, and serum phosphate showed the highest change during the initial 6 hours of management, while trends of serum bicarbonate and blood urea nitrogen demonstrated a predominant change in the initial 12 hours. Conclusion: The notable findings in this study, such as, higher mean age of presentation, high rate of non-compliance to insulin as the cause of precipitation, and a high prevalence of abdominal pain at presentation should be followed up with further comparative studies. PMID:25630000

  6. Type 1 diabetes developed in a type 2 diabetic patient with severe insulin resistance.

    PubMed

    Suehiro, Tadashi; Osaki, Fumiaki; Ikeda, Yukio; Arii, Kaoru; Nakayama, Fumi; Ota, Kikuko; Hashimoto, Kozo

    2005-12-01

    We report a 38-year-old female with severe insulin resistance who developed type 1 diabetes after being diagnosed with type 2 diabetes. At the initial examination, BMI was 31.8 kg/m(2) and HbA1c 10.8%. Her insulin secretion was sufficient (urinary CPR 80 microg/day) and the GAD antibody was negative. Following treatment with insulin and glimepiride, HbA1c decreased to 6.3%, though diabetic control deteriorated after 1 year (HbA1c, 11.0%) and her body weight was reduced in a short period, from 78 to 67 kg. Re-examination revealed that the GAD antibody was high (1870 U/mL, normal <1.5) and the anti-islet cell antibody positive, and insulin secretion decreased (urinary CPR 18 microg/day). Further, a hyperinsulinemic-euglycemic cramp study using an artificial pancreas showed that the patient had severe insulin resistance [glucose infusion rate 1.8 mg/(min kg); normal, 7.4+/-2.4 (mean+/-S.D.)]. An HLA-analysis showed that she was a homozygote of haplotype DRB1*0901-DQB1*0303. In spite of strict insulin therapy, glucose control was not improved. Pioglitazone could not be used because of side effects, however, metformin was effective for glucose control. The accumulation of case reports of patients with type 1 diabetes and insulin resistance is important for studying the relationship between the onset of the disease and insulin resistance, and for developing an effective treatment strategy. PMID:15955587

  7. Characterization of the ?c chain among 27 unrelated Japanese patients with X-linked severe combined immunodeficiency (X-SCID)

    Microsoft Academic Search

    Satoru Kumaki; Naoto Ishii; Masayoshi Minegishi; Yoshiyuki Ohashi; Ikuko Hakozaki; Shigeaki Nonoyama; Kohsuke Imai; Tomohiro Morio; Ikuya Tsuge; Yukio Sakiyama; Akihiko Miyanoshita; Jun-ichi Miura; Mitsuhumi Mayumi; Toshio Heike; Kenji Katamura; Hidetoshi Takada; Isho Izumi; Junji Kamizono; Shigeyoshi Hibi; Hiroshi Sasaki; Mitsuaki Kimura; Atsushi Kikuta; Yukiji Date; Masahiro Sako; Haruki Tanaka; Kimihiko Sano; Kazuo Sugamura; Shigeru Tsuchiya

    2000-01-01

    X-linked severe combined immunodeficiency (X-SCID) is a rare fatal disease that is caused by mutations in the gene encoding the %c chain. In this study, 27 unrelated Japanese patients with X-SCID were examined in terms of their genetic mutations and surface expression of the %c chain. Among 25 patients examined, excluding two patients with large deletions, 23 different mutations were

  8. Patient-provider interaction from the perspectives of type 2 diabetes patients in Muscat, Oman: a qualitative study

    Microsoft Academic Search

    Nadia Abdulhadi; Mohammed Al Shafaee; Solveig Freudenthal; Claes-Göran Östenson; Rolf Wahlström

    2007-01-01

    BACKGROUND: Patients' expectations and perceptions of the medical encounter and interactions are important tools in diabetes management. Some problems regarding the interaction during encounters may be related to a lack of communication skills on the part of either the physician or the patient. This study aimed at exploring the perceptions of type 2 diabetes patients regarding the medical encounters and

  9. Japanese version of the Dermatology Life Quality Index: validity and reliability in patients with acne

    PubMed Central

    Takahashi, Natsuko; Suzukamo, Yoshimi; Nakamura, Motonobu; Miyachi, Yoshiki; Green, Joseph; Ohya, Yukihiro; Finlay, Andrew Y; Fukuhara, Shunichi

    2006-01-01

    Background Patient-reported quality of life is strongly affected by some dermatologic conditions. We developed a Japanese version of the Dermatology Life Quality Index (DLQI-J) and used psychometric methods to examine its validity and reliability. Methods The Japanese version of the DLQI was created from the original (English) version, using a standard method. The DLQI-J was then completed by 197 people, to examine its validity and reliability. Some participants completed the DLQI-J a second time, 3 days later, to examine the reproducibility of their responses. In addition to the DLQI-J, the participants completed parts of the SF-36 and gave data on their demographic and clinical characteristics. Their physicians provided information on the location and clinical severity of the skin disease. Results The participants reported no difficulties in answering the DLQI-J items. Their mean age was 24.8 years, 77.2% were female, and 78.7% had acne vulgaris. The mean score of DLQI was 3.99(SD: 3.99). The responses were found to be reproducible and stable. Results of principal-component and factor analysis suggested that this scale measured one construct. The correlations of DLQI-J scores with sex or age were very poor, but those with SF-36 scores and with clinical severity were high. Conclusion The DLQI-J provides valid and reliable data despite having only a small number of items. PMID:16884543

  10. Development and evaluation of a self-efficacy instrument for Japanese sleep apnea patients receiving continuous positive airway pressure treatment.

    PubMed

    Saito, Ayako; Kojima, Shigeko; Sasaki, Fumihiko; Hayashi, Masamichi; Mieno, Yuki; Sakakibara, Hiroki; Hashimoto, Shuji

    2015-01-01

    The purpose of this study was to develop and evaluate a self-efficacy instrument for Japanese obstructive sleep apnea (OSA) patients treated with continuous positive airway pressure (CPAP). Analyzed subjects were 653 Japanese OSA patients (619 males and 34 females) treated with CPAP at a sleep laboratory in a respiratory clinic in a Japanese city. Based on Bandura's social cognitive theory, the CPAP Self-Efficacy Questionnaire for Sleep Apnea in Japanese (CSESA-J) was developed by a focus group of experts, using a group interview of OSA patients for the items of two previous self-efficacy scales for Western sleep apnea patients receiving CPAP treatment. CSESA-J has two subscales, one for self-efficacy and the other for outcome expectancy, and consists of a total of 15 items. Content validity was confirmed by the focus group. Confirmatory factor analysis showed that the factor loadings of self-efficacy and outcome expectancy were 0.47-0.76 and 0.41-0.92, respectively, for the corresponding items. CSESA-J had a significant but weak positive association with the General Self-Efficacy Scale, and a strong positive association with "Self-efficacy scale on health behavior in patients with chronic disease." Cronbach's alpha coefficient was 0.85 for the self-efficacy subscale and 0.89 for the outcome expectancy subscale. The intraclass correlation coefficient using data from the first and second measurements with CSESA-J for a subset of 130 subjects was 0.93 for the self-efficacy and outcome expectancy subscales. These results support CSESA-J as a reliable and valid instrument for measuring the self-efficacy of Japanese OSA patients treated with CPAP. Further studies are warranted to confirm validity for female OSA patients and generalizability. PMID:25678832

  11. Development and evaluation of a self-efficacy instrument for Japanese sleep apnea patients receiving continuous positive airway pressure treatment

    PubMed Central

    Saito, Ayako; Kojima, Shigeko; Sasaki, Fumihiko; Hayashi, Masamichi; Mieno, Yuki; Sakakibara, Hiroki; Hashimoto, Shuji

    2015-01-01

    The purpose of this study was to develop and evaluate a self-efficacy instrument for Japanese obstructive sleep apnea (OSA) patients treated with continuous positive airway pressure (CPAP). Analyzed subjects were 653 Japanese OSA patients (619 males and 34 females) treated with CPAP at a sleep laboratory in a respiratory clinic in a Japanese city. Based on Bandura’s social cognitive theory, the CPAP Self-Efficacy Questionnaire for Sleep Apnea in Japanese (CSESA-J) was developed by a focus group of experts, using a group interview of OSA patients for the items of two previous self-efficacy scales for Western sleep apnea patients receiving CPAP treatment. CSESA-J has two subscales, one for self-efficacy and the other for outcome expectancy, and consists of a total of 15 items. Content validity was confirmed by the focus group. Confirmatory factor analysis showed that the factor loadings of self-efficacy and outcome expectancy were 0.47–0.76 and 0.41–0.92, respectively, for the corresponding items. CSESA-J had a significant but weak positive association with the General Self-Efficacy Scale, and a strong positive association with “Self-efficacy scale on health behavior in patients with chronic disease.” Cronbach’s alpha coefficient was 0.85 for the self-efficacy subscale and 0.89 for the outcome expectancy subscale. The intraclass correlation coefficient using data from the first and second measurements with CSESA-J for a subset of 130 subjects was 0.93 for the self-efficacy and outcome expectancy subscales. These results support CSESA-J as a reliable and valid instrument for measuring the self-efficacy of Japanese OSA patients treated with CPAP. Further studies are warranted to confirm validity for female OSA patients and generalizability. PMID:25678832

  12. Health-related quality of life in diabetic patients and controls without diabetes in refugee camps in the Gaza strip: a cross-sectional study

    Microsoft Academic Search

    Ashraf Eljedi; Rafael T Mikolajczyk; Alexander Kraemer; Ulrich Laaser

    2006-01-01

    BACKGROUND: Prevalence of diabetes mellitus is increasing in developed and developing countries. Diabetes is known to strongly affect the health-related quality of life (HRQOL). HRQOL is also influenced by living conditions. We analysed the effects of having diabetes on HRQOL under the living conditions in refugee camps in the Gaza strip. METHODS: We studied a sample of 197 diabetic patients

  13. Investigation of auditory thresholds in type 2 diabetic patients compared to non-diabetic cases

    PubMed Central

    Kiakojouri, Keivan; Monadi, Mohsen; Sheikhzadeh, Mahboobeh; Taghinejad Omran, Pouria; Bayani, Mohammad Ali; Khafri, Soraya

    2014-01-01

    Background: Hearing loss is one of the common complaints of diabetics. The aim of this study was to evaluate the hearing status of diabetic patients in Babol, North of Iran. Methods: The hearing status of 50 type 2 diabetic patients (case group) and 50 healthy individuals (control group) were evaluated from October 2011 to September 2012. Audiometry was done with the frequencies of 250, 500, 1000, 2000, 4000, 6000, 8000 HZ and speech tests like SRT (speech reception threshold), SDS (speech discrimination score) were performed. The data were collected and analyzed. Results: The mean age of case group was 50.1±3 and in control group was 49.9±3.2 years. Hearing thresholds were 10.55.6, 10.76.1, 15.27.1, 169.6, 21.213.5, 26.416.5, 28.32 db in the right ear of the case group and 11.25.3, 9.74.9, 127.1, 14.29.4, 20.913.3, 25.115.6, 27.620.2 db in control group with different frequencies (p<0.05). Similar results were obtained in the left ear of both groups. The mean SRT in the right ear of the case group was 15.77.7 and control group was 9.24.8 and 13.56.9 in case and 9.14 in the left ear of case group (P=0.0001). SDS was 94.33.7 and in 96.23.3 in the right ear for the case and control group, respectively (P=0.0001). For the left ear, these values were 94.44.4 and 95.93.2, respectively (P=0.023). Conclusion: The results show that hearing loss in different frequencies and speech reception threshold were higher in diabetic group but speech discrimination score was higher in normal individuals. Audiological monitoring is recommended in diabetic patients during therapy. PMID:24778785

  14. Current Status of Diabetic Peripheral Neuropathy in Korea: Report of a Hospital-Based Study of Type 2 Diabetic Patients in Korea by the Diabetic Neuropathy Study Group of the Korean Diabetes Association

    PubMed Central

    Won, Jong Chul; Kim, Sang Soo; Cha, Bong-Yun

    2014-01-01

    Diabetic peripheral neuropathy (DPN) is the most common complication associated with diabetes. DPN can present as a loss of sensation, may lead to neuropathic ulcers, and is a leading cause of amputation. Reported estimates of the prevalence of DPN vary due to differences in study populations and diagnostic criteria. Furthermore, the epidemiology and clinical characteristics of DPN in Korean patients with type 2 diabetes mellitus (T2DM) are not as well understood as those of other complications of diabetes such as retinal and renal disease. Recently, the Diabetic Neuropathy Study Group of the Korean Diabetes Association (KDA) conducted a study investigating the impact of DPN on disease burden and quality of life in patients with T2DM and has published some data that are representative of the nation. This review investigated the prevalence and associated clinical implications of DPN in Korean patients with diabetes based on the KDA study. PMID:24627824

  15. Various adiposity measures show similar positive associations with type 2 diabetes in Caucasians, native hawaiians, and Japanese americans: the multiethnic cohort.

    PubMed

    Steinbrecher, Astrid; Heak, Sreang; Morimoto, Yukiko; Grandinetti, Andrew; Kolonel, Larry N; Maskarinec, Gertraud

    2015-03-01

    The authors evaluated the association of body mass index (BMI), waist circumference (WC) and hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) with diabetes in Caucasians, Native Hawaiians, and Japanese Americans aged 45 to 75 years in the Multiethnic Cohort. Diabetes cases were obtained from self-reports and by linkages with health insurance plans. The authors estimated adjusted prevalence odds ratios (PORs) and compared the area under the receiver operating characteristic curves (AUC). All measures were positively associated with diabetes prevalence; the PORs were 1.25 to 1.64 in men and 1.52 to 1.83 in women. In all 3 ethnic groups, the AUCs in men were greater for BMI than for the other measures, whereas in women, the AUCs were greater for combined models than for BMI alone, but the differences were small and not clinically significant. It does not appear that one anthropometric measure best reflects diabetes prevalence or performs better in one ethnic group than in another. PMID:22500038

  16. JAMA Patient Page: Starting Insulin Treatment for Diabetes

    MedlinePLUS

    ... 2 diabetes will need treatment with insulin. The Importance of Insulin in Treating Type 2 Diabetes Diabetes is ... Starting insulin is in no way a sign of personal failure in controlling diabetes. Diabetes is by nature a progressive disease. The longer someone lives with ...

  17. Metabolic syndrome and incidence of type 2 diabetes in patients with manifest vascular disease

    Microsoft Academic Search

    Annemarie Mj Wassink; Yolanda Van Der Graaf; Sabita S Soedamah-Muthu; Wilko Spiering; Frank Lj Visseren

    2008-01-01

    Risk reduction in patients with clinically manifest vascular disease focuses on preventing new vascular events and not on prevention of type 2 diabetes. However, given the common pathophysiological pathways involved in the development of atherosclerosis and type 2 diabetes, it is probable that people with atherosclerotic vascular disease have an elevated risk of type 2 diabetes. The present prospective cohort

  18. Metabolic syndrome and incidence of type 2 diabetes in patients with manifest vascular disease

    Microsoft Academic Search

    ANNEMARIE MJ WASSINK; YOLANDA VAN DER GRAAF; SABITA S SOEDAMAH-MUTHU; WILKO SPIERING; LJ VISSEREN

    2010-01-01

    R isk reduction in patients with clinically manifest vas- cular disease focuses on preventing new vascular events and not on prevention of type 2 diabetes. However, given the common pathophysiological pathways involved in the development of atherosclerosis and type 2 diabetes, it is probable that people with atherosclerotic vas- cular disease have an elevated risk of type 2 diabetes. The

  19. Applying the Transtheoretical Model to Investigate Behavioural Change in Type 2 Diabetic Patients

    ERIC Educational Resources Information Center

    Lin, Shu-Ping; Wang, Ming-Jye

    2013-01-01

    Background: Long-term behaviour change in type 2 diabetic patients may provide effective glycemic control. Purpose: To investigate the key factors that promote behaviour change in diabetic subjects using the transtheoretical model. Methods: Subjects were selected by purposive sampling from type 2 diabetes outpatients. Self-administered…

  20. Insulin Therapy and Colorectal Cancer Risk Among Type 2 Diabetes Mellitus Patients

    E-print Network

    Hennessy, Sean

    Insulin Therapy and Colorectal Cancer Risk Among Type 2 Diabetes Mellitus Patients YU­XIAO YANG: Endogenous hyperinsulinemia in the context of type 2 diabetes mellitus is potentially associated of colorectal cancer among type 2 diabetes mellitus pa- tients. Methods: We conducted a retrospective cohort

  1. Autoantibodies to thyroid peroxidase in patients with type 1 diabetes in Taiwan

    Microsoft Academic Search

    Ching-Chung Chang; Chien-Ning Huang; Lee-Ming Chuang

    1998-01-01

    Objective: Type 1 diabetes mellitus is frequently associated with autoimmune thyroid disease (ATD). Genetic susceptibility to autoantibody formation in association with ATD and type 1 diabetes mellitus has been described with varying frequencies, but there is still debate about the situation in the Chinese population. We have, therefore, investigated the prevalence of anti-thyroid peroxidase (anti-TPO) in type 1 diabetic patients,

  2. Prevalence of Hypomagnesaemia among Obese Type 2 Diabetic Patients Attending the National Center for Diabetes, Endocrinology and Genetics (NCDEG)

    PubMed Central

    Hyassat, Dana; Al Sitri, Ebtihaj; Batieha, Anwar; EL-Khateeb, Mohammed; Ajlouni, Kamel

    2014-01-01

    Background: Some observations suggested that magnesium supplementation could be helpful in the treatment of diabetic patients by improving glycemic control and preventing the development of diabetes-related complications. Objectives: To estimate the prevalence of hypomagnesaemia among obese patients with type 2 diabetes attending the National Center for Diabetes, Endocrinology and Genetics (NCDEG) in Amman, Jordan. Patients and Methods: A cross-sectional study was carried out at the National Center for diabetes, Endocrinology and Genetics (NCDEG) in Amman-Jordan. A total of 1105 patients with type 2 diabetes (51.9% females and 48.1% males) who attended this center between first of October 2011and end of February 2012 were included in the study. The mean age and duration of diabetes were 57.1 years and 5.1 years, respectively and the mean value of HbA1c was 7.9%. Our study also performed a comparison of the prevalence of hypomagnesaemia between our studied sample and 3600 individuals enrolled in the National Vitamin D study completed in Jordan in 2009. The obtained data included patients’ age, gender, smoking history, HbA1c level, comorbid history including hypertension, dyslipidemia, and presence of neuropathy and retinopathy. Results: Out of 1105 patients with type 2 diabetes, 210 patients (19%) (95% CI, 16.8%-21.4%) were hypomagnesaemic. Female gender, hypertension, statin therapy, HbA1c between 7-7.9% or ? 9% and patients with diabetes duration more than five years were independent risk factors for hypomagnesaemia. No association between hypomagnesaemia and age distribution, smoking history, neuropathy and retinopathy was found. In comparison with individuals enrolled in the National Vitamin D study, diabetic patients in this study had a much higher prevalence of hypomagnesaemia (19% vs. 0.7%) with odd’s ratio of 32 (95% CI, 21-48.2). Conclusions: As the prevalence of hypomagnesaemia among patients with type 2 diabetes treated at the NCDEG was found to be 19% (95% CI, 16.8%-21.4%), we recommend periodic determination of magnesium level and appropriate magnesium replacement therapy particularly among the above defined groups. PMID:25237327

  3. Prevalence and causes of albuminuria in non-insulin-dependent diabetic patients

    Microsoft Academic Search

    Hans-Henrik Parving; Mari-Anne Gall; Peter Skøtt; Hans E Jørgensen; Hans Løkkegaard; Finn Jørgensen; Bent Nielsen; Svend Larsen

    1992-01-01

    Prevalence and causes of albuminuria in non-insulin-dependent diabetic patients. A prospective study of the prevalence and causes of persistent albuminuria (>300 mg\\/24 hr) was conducted in non-insulin-dependent diabetic (NIDDM) patients, age <66 years, attending a diabetic clinic during 1987. All eligible patients (N = 370) were asked to collect at least one 24-hour urine sample for albumin analysis. Urine collection

  4. The role of sleep disturbance and depression in patients with type 2 diabetes

    Microsoft Academic Search

    Akiko YagiYoshihiko; Yoshihiko Nishio; Satoshi Ugi; Hiromichi Kawai; Takashi Uzu; Makoto Imai; Naoto Yamada; Masako Okawa; Atsunori Kashiwagi; Hiroshi Maegawa

    2011-01-01

    The importance of sleep disturbance and depression in patients with type 2 diabetes is unclear. Our objective was to evaluate\\u000a their effects on the quality of life (QOL) of patients with type 2 diabetes. For the study, 270 patients were recruited from\\u000a the Shiga Prospective Observational Follow-up Study for Diabetic Complications. Depressive symptoms, sleep disturbance, and\\u000a QOL were assessed by

  5. Organizational safety climate differently affects on patient safety behavior of nurses according to the hospital scale in Japanese private hospitals

    Microsoft Academic Search

    Takayasu Inoue; Risuke Karima

    Introduction: The aim of this study is to elucidate how patient safety behavior of nurses is associated with organizational safety climate and nurse's individual factors by covariance structure analysis of the results of the questionnaires, such as professional awareness and job- satisfaction, in 10 Japanese private hospitals. Methodology: In this study, the questionnaire was developed including organizational factors (organizational safety

  6. Change of aging males' symptoms (AMS) rating scale in Japanese late-onset hypogonadism (LOH) patients administered androgen replacement therapy

    Microsoft Academic Search

    Hisanori Taniguchi; Gen Kawa; Hidefumi Kinoshita; Tadashi Matsuda

    2011-01-01

    BackgroundWe examined changes in the Aging Males' Symptoms (AMS) rating scale in Japanese late-onset hypogonadism (LOH) patients during the administration of androgen replacement therapy (ART), and evaluated whether the AMS rating scale is a useful tool for the diagnosis of LOH or the determination of ART efficacy.

  7. Dobutamine stress echocardiography and the effect of revascularization on outcome in diabetic and non-diabetic patients with chronic ischaemic left ventricular dysfunction

    Microsoft Academic Search

    Lauro Cortigiani; Rosa Sicari; Alessandro Desideri; Riccardo Bigi; Francesco Bovenzi; Eugenio Picano

    2007-01-01

    Aim: To evaluate the interaction between prognostic effect of revascularization and viability in diabetic and non-diabetic patients with ischaemic left ventricular dysfunction. Methods: 612 patients with angiographically proven coronary artery disease and left ventricular ejection fraction b35% underwent dobutamine stress echocardiography to assess viability (peak-rest wall motion score index N0.4). 262 patients (75 diabetics, 187 non- diabetics) underwent revascularization and

  8. Patients' willingness to pay for diabetes disease state management services in Australian community pharmacies

    Microsoft Academic Search

    Andrew Hanna; Lesley White; Venkata Yanamandram

    2010-01-01

    Purpose – The purpose of this paper is to determine whether and how much patients would be willing to pay for diabetes disease state management (DSM) services in community pharmacies, and also to determine the relationships between willingness to pay (WTP) and different clinical\\/socio\\/demographic characteristics of patients. Design\\/methodology\\/approach – A sample of 130 diabetic patients recruited from 14 pharmacies across

  9. Issues of Cause and Control in Patient Accounts of Type 2 Diabetes

    ERIC Educational Resources Information Center

    Parry, O.; Peel, E.; Douglas, M.; Lawton, J.

    2006-01-01

    Patients experience considerable difficulties in making and sustaining health-related lifestyle changes. Many Type 2 diabetes patients struggle to follow disease risk-management advice even when they receive extensive information and support. Drawing on a qualitative study of patients with Type 2 diabetes, the paper uses discourse analysis to…

  10. A Ringdown Breath Analyzer for Diabetes Monitoring: Breath Acetone in Diabetic Patients.

    NASA Astrophysics Data System (ADS)

    Wang, Chuji; Mbi, Armstrong; Shepherd, Mark

    2008-03-01

    It is highly desirable for millions of diabetic patients to have a non-blood, non-invasive, point-of-care device for monitoring daily blood glucose (BG) levels and the adequacy of diabetic treatment and control. Cavity ringdown spectroscopy, due to its unique capability of high sensitivity, fast-response, and relatively low cost for instrumentation, has the potential for medical application through non-invasive analysis of breath biomarkers. We report the first ringdown acetone breath analyzer for clinic testing with diabetic outpatients. The instrument was set in a clinic center and 34 outpatients (24 T1D and 10 T2D) were tested during a four-day period. 10 T1D subjects and 15 nondiabetic persons were tested in our laboratory. Three juvenile-onset T1D subjects were selected for a 24-hr monitoring on the variations of breath acetone and simultaneous BG level. In this talk, we present our research findings including the correlations of breath acetone with BG level and A1C.

  11. Isotopic test of capillary permeability to albumin in diabetic patients: effects of hypertension, microangiopathy, and duration of diabetes

    SciTech Connect

    Valensi, P.; Attali, J.R.; Behar, A.; Sebaoun, J.

    1987-09-01

    Capillary permeability to albumin (CPA) was studied by performing an isotopic noninvasive test with venous compression on 87 nonselected diabetics with no edema, no cardiac failure, and no peripheral vascular disease. Excessive albumin retention (AR greater than or equal to 8%) ten minutes after removal of the compression was found in 27 patients (31%). The radioactivity disappearance curve was then analyzed using the Fast Fourier Transform (FFT). An abnormal isotopic CPA test was thus found in at least 45 out of the 87 patients. The prevalence of an abnormal test was not different in type 1 and type 2 diabetics. We studied the independent effects of hypertension, presence of specific clinical signs of microangiopathy (retinopathy and/or significant proteinuria), and duration of diabetes. Among diabetics free of specific clinical signs of microangiopathy, the prevalence of an AR greater than or equal to 8% was significantly higher in those with hypertension (11/19) than in those with normal blood pressure (2/28) and in nondiabetic hypertensive patients (0/16). Among normotensive diabetics, the prevalence of an abnormal test was higher, but not significantly, in patients with specific clinical signs of microangiopathy (8/11) than in those free of them (7/18). Seven normotensive diabetics without specific clinical signs of microangiopathy had an abnormal test; five of them had had diabetes for more than five years. The prevalence of diabetes of more than five years duration was significantly higher in patients with an abnormal test (35/45) than in normotensive diabetics free of specific clinical signs of microangiopathy with a normal test (4/11).

  12. Diabetes treatment patterns and goal achievement in primary diabetes care (DiaRegis) - study protocol and patient characteristics at baseline

    Microsoft Academic Search

    Peter Bramlage; Christiane Binz; Anselm K Gitt; Michael Krekler; Tanja Plate; Evelin Deeg; Diethelm Tschöpe

    2010-01-01

    BACKGROUND: Patients with type 2 diabetes are at an increased risk for disease and treatment related complications after the initial approach of oral mono\\/dual antidiabetic therapy has failed. Data from clinical practice with respect to this patient group are however scarce. Therefore we set up a registry in primary care documenting the course and outcomes of this patient group. METHODS:

  13. Mild Clinical Course of Severe Fever with Thrombocytopenia Syndrome Virus Infection in an Elderly Japanese Patient

    PubMed Central

    Ohagi, Yuko; Nakamoto, Chiaki; Nakamoto, Hiromichi; Saijo, Masayuki; Shimojima, Masayuki; Nakano, Yoshio; Fujimoto, Tokuzo

    2014-01-01

    Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious and hemorrhagic disease recently described in China and western Japan. A 71-year-old healthy Japanese woman noticed a tick biting her after harvesting in an orchard and removed it herself. She developed diarrhea, anorexia, and chills eight days later. Because these symptoms continued, she visited a primary care physician 6 days after the onset. Laboratory data revealed thrombocytopenia, leukocytopenia, and elevated liver enzymes. She was then referred to our hospital. Although not completely fulfilling the diagnostic criteria used in a retrospective study in Japan, SFTS was suspected, and we detected SFTS virus in the patient's blood using RT-PCR. However, she recovered without intensive treatment and severe complications 13 days after the onset. In this report, we present a mild clinical course of SFTS virus infection in Japan in detail. PMID:25574405

  14. Osteomyelitis or Charcot neuro-osteoarthropathy? Differentiating these disorders in diabetic patients with a foot problem

    PubMed Central

    Ertugrul, Bulent M.; Lipsky, Benjamin A.; Savk, Oner

    2013-01-01

    Both osteomyelitis and Charcot neuro-osteoarthropathy (CN) are potentially limb-threatening complications of diabetic neuropathy, but they require quite different treatments. Almost all bone infections in the diabetic foot originate from an infected foot ulcer while diabetic osteoarthropathy is a non-infectious process in which peripheral neuropathy plays the critical role. Differentiating between diabetic foot osteomyelitis and CN requires careful evaluation of the patient, including the medical history, physical examination, selected laboratory findings, and imaging studies. Based on available studies, we review the approaches to the diagnostic differentiation of osteomyelitis from CN of the foot in diabetic patients. PMID:24205433

  15. Osteomyelitis or Charcot neuro-osteoarthropathy? Differentiating these disorders in diabetic patients with a foot problem.

    PubMed

    Ertugrul, Bulent M; Lipsky, Benjamin A; Savk, Oner

    2013-01-01

    Both osteomyelitis and Charcot neuro-osteoarthropathy (CN) are potentially limb-threatening complications of diabetic neuropathy, but they require quite different treatments. Almost all bone infections in the diabetic foot originate from an infected foot ulcer while diabetic osteoarthropathy is a non-infectious process in which peripheral neuropathy plays the critical role. Differentiating between diabetic foot osteomyelitis and CN requires careful evaluation of the patient, including the medical history, physical examination, selected laboratory findings, and imaging studies. Based on available studies, we review the approaches to the diagnostic differentiation of osteomyelitis from CN of the foot in diabetic patients. PMID:24205433

  16. Psychometric Properties of the Questionnaire on Stress in Patients With Diabetes—Revised (QSD–R)

    Microsoft Academic Search

    Peter Herschbach; Gabriele Duran; Sabine Waadt; Angela Zettler; Christoph Amm; Birgit Marten-Mittag; Friedrich Strian

    1997-01-01

    This study reports the psychometric properties of a 45-item diabetes-specific questionnaire, the Questionnaire on Stress in Patients with Diabetes—Revised (QSD–R), a modified and shortened version of the QSD (G. Duran, P. Herschbach, S. Waadt, A. Zettler, & F. Strian, 1995). The QSD–R was filled out by 1, 930 individuals with insulin-dependent diabetes mellitus and noninsulin-dependent diabetes mellitus. Eight consistent scales

  17. Platelets from patients with diabetes mellitus have impaired ability to mediate vasodilation

    Microsoft Academic Search

    Helgi J. Oskarsson; Timothy G. Hofmeyer

    1996-01-01

    Objectives. The purpose of this study was to examine vasomotor responses mediated by platelets from patients with diabetes mellitus.Background. Diabetes mellitus is associated with increased cardiovascular morbidity and mortality, which in part may be due to a variety of abnormalities reported in diabetic platelets. However, the effects of diabetic platelets on vasomotor tone have not been characterized.Methods. We compared platelet-mediated

  18. Haptoglobin Polymorphism and Association with Complications in Ghanaian Type 2 Diabetic Patients

    Microsoft Academic Search

    Michael B. Adinortey; Ben A. Gyan; Jonathan P. Adjimani; Philomena E. Nyarko; Charity Sarpong; Francis Y. Tsikata; Alexander K. Nyarko

    There is scanty information on the role of genetic factors, especially those relating to haptoglobin (Hp) phenotypes in the\\u000a expression of complications among diabetes mellitus patients in Ghana. In this study, we investigated whether there is any\\u000a association between Hp phenotypes and diabetic complications and to determine if association of the Hp phenotypes with diabetic\\u000a complications in Ghanaian diabetics differ

  19. Mutation analysis of the IL36RN gene in 14 Japanese patients with generalized pustular psoriasis.

    PubMed

    Farooq, Muhammad; Nakai, Hiroyuki; Fujimoto, Atsushi; Fujikawa, Hiroki; Matsuyama, Asako; Kariya, Naoyuki; Aizawa, Atsuko; Fujiwara, Hiroshi; Ito, Masaaki; Shimomura, Yutaka

    2013-01-01

    Generalized pustular psoriasis (GPP) is a rare, potentially life threatening, and aggressive form of psoriasis, which is characterized by sudden onset with repeated episodic skin inflammation leading to pustule formation. Familial GPP is known to be caused by recessively inherited mutations in the IL36RN gene, which encodes interleukin 36 receptor antagonist (IL-36Ra). In this article, we performed mutation analysis of the IL36RN gene in 14 Japanese patients with GPP, and identified mutations in two of these patients analyzed. One patient was compound heterozygous for mutations c.115+6T>C and c.368C>G (p.Thr123Arg), whereas the other carried compound heterozygous mutations c.28C>T (p.Arg10*) and c.115+6T>C in the IL36RN gene. Expression studies using total RNA from the patients' skin revealed that the mutation c.115+6T>C resulted in skipping of exon 3, leading to a frameshift and a premature termination codon (p.Arg10Argfs*1). The protein structure analysis suggested that the missense mutation p.Thr123Arg caused misfolding and instability of IL-36Ra protein. In vitro studies in cultured cells showed impaired expression of the p.Thr123Arg mutant IL-36Ra protein, which failed to antagonize the IL-36 signaling pathway. Our data further underscore the critical role of IL36RN in pathogenesis of GPP. PMID:22903787

  20. Seasonal Trends in the Incidence of Hip Osteoarthritis in Japanese Patients

    PubMed Central

    Nagamine, Satomi; Sonohata, Motoki; Kitajima, Masaru; Kawano, Syunsuke; Ogawa, Kenji; Mawatari, Masaaki; Hotokebuchi, Takao

    2011-01-01

    Purpose: There is an association between winter birth and developmental dysplasia of the hip, formerly termed congenital dislocation of the hip. The purpose of this study was to clarify the relationship between the month and season of birth and hip osteoarthritis in Japanese patients who had undergone total hip arthroplasty or transpositional osteotomy of the acetabulum. Methods: One thousand eight hundred and 52 female patients that presented for the surgical treatment of hip osteoarthritis between 1999 and 2005 were included in this study. Female out-patients who were seen at the initial visit during same period were used as controls to correct the bias of the month of birth. Results: There was a significant deviation of the observed number of births from the expected values calculated on a monthly basis (p<0.001). A comparison by seasons (periods of 3 months) revealed more births than expected in winter (p<0.001). The risk of hip osteoarthritis was significantly associated with the month of birth. Namely, it was highest for births in January (p<0.001). Conclusions: These data clearly revealed that the prevalence of hip osteoarthritis was significantly higher in those patients born in winter. The seasonal trend in hip osteoarthritis might be due to the winter prevalence of congenital dislocation of the hip in childhood. PMID:21584203

  1. A Spectrum of Clinical Presentations in Seven Japanese Patients with Vitamin D Deficiency

    PubMed Central

    Kubota, Takuo; Kotani, Tomoo; Miyoshi, Yoko; Santo, Yoko; Hirai, Haruhiko; Namba, Noriyuki; Shima, Masaaki; Shimizu, Kazuo; Nakajima, Shigeo; Ozono, Keiichi

    2006-01-01

    Recently, the reemergence of vitamin D deficiency in developed countries has been pointed out. Vitamin D deficiency is diagnosed based on the serum 25-hydroxyvitamin D (25OHD) level. However, its normal range is still controversial, making the diagnosis of vitamin D deficiency difficult. Here, we present seven Japanese patients diagnosed with vitamin D deficiency. Three patients complained of leg bowing, and the other four of tetany. The patients with leg bowing were toddlers. Radiographic surveys demonstrated evidence of rickets. Laboratory findings showed decreased levels of serum inorganic phosphorus and increased levels of alkaline phosphatase (ALP) and intact-parathyroid hormone (iPTH). The serum levels of 25OHD were relatively low, ranging from 13 to 15.2 ng/ml. Of the patients with tetany, three were young infants. Laboratory findings showed decreased levels of serum calcium and increased levels of ALP and iPTH. The serum levels of 25OHD were markedly decreased (below 8 ng/ml). Thus, these results indicate that relatively low levels of 25OHD can cause rickets, a symptom of vitamin D deficiency, and that clinicians should therefore carefully evaluate the levels of 25OHD. PMID:24790316

  2. Low-Carbohydrate Diet and Type 2 Diabetes Risk in Japanese Men and Women: The Japan Public Health Center-Based Prospective Study

    PubMed Central

    Nanri, Akiko; Mizoue, Tetsuya; Kurotani, Kayo; Goto, Atsushi; Oba, Shino; Noda, Mitsuhiko; Sawada, Norie; Tsugane, Shoichiro

    2015-01-01

    Objective Evidence is sparse and contradictory regarding the association between low-carbohydrate diet score and type 2 diabetes risk, and no prospective study examined the association among Asians, who consume greater amount of carbohydrate. We prospectively investigated the association of low-carbohydrate diet score with type 2 diabetes risk. Methods Participants were 27,799 men and 36,875 women aged 45–75 years who participated in the second survey of the Japan Public Health Center-Based Prospective Study and who had no history of diabetes. Dietary intake was ascertained by using a validated food-frequency questionnaire, and low-carbohydrate diet score was calculated from total carbohydrate, fat, and protein intake. The scores for high animal protein and fat or for high plant protein and fat were also calculated. Odds ratios of self-reported, physician-diagnosed type 2 diabetes over 5-year were estimated by using logistic regression. Results During the 5-year period, 1191 new cases of type 2 diabetes were self-reported. Low-carbohydrate diet score for high total protein and fat was significantly associated with a decreased risk of type 2 diabetes in women (P for trend <0.001); the multivariable-adjusted odds ratio of type 2 diabetes for the highest quintile of the score were 0.63 (95% confidence interval 0.46–0.84), compared with those for the lowest quintile. Additional adjustment for dietary glycemic load attenuated the association (odds ratio 0.75, 95% confidence interval 0.45–1.25). When the score separated for animal and for plant protein and fat, the score for high animal protein and fat was inversely associated with type 2 diabetes in women, whereas the score for high plant protein and fat was not associated in both men and women. Discussion Low-carbohydrate diet was associated with decreased risk of type 2 diabetes in Japanese women and this association may be partly attributable to high intake of white rice. The association for animal-based and plant-based low-carbohydrate diet warrants further investigation. PMID:25695497

  3. Safety and efficacy of rosiglitazone in the elderly diabetic patient.

    PubMed

    Viljoen, Adie; Sinclair, Alan

    2009-01-01

    Diabetes is an important health condition for the aging population; at least 20% of patients over the age of 65 years have diabetes, and this number can be expected to grow rapidly in the coming decades. Rosiglitazone, a drug in the thiazolidinedione class which targets insulin resistance, was approved by drug regulatory bodies based on its ability to improve glycemic control nearly ten years ago. The greatest long-term risk in diabetes is cardiovascular disease with macrovascular disease being the cause of as much as 80% of mortality. More recently the cardiovascular safety of rosiglitazone was brought to center stage following several meta-analyses and the unplanned interim analysis of the RECORD trial. As opposed to pioglitazone, current evidence points to rosiglitazone having a greater risk of myocardial ischemic events than placebo, metformin, or sulfonylureas. A thiazolidinedione class effect however seems apparent with respect to the increased risk for fractures and congestive heart failure. Clinical trial evidence on rosiglitazone therapy in the elderly is limited. The available evidence is mainly related to observational cohort studies. Most of the trial evidence relates to a younger population and therefore these data can not be directly extrapolated to an older population. The effects of the thiazolidinedione drug class remain incompletely understood. PMID:19475776

  4. Novel treatment approaches in hypertensive type 2 diabetic patients

    PubMed Central

    Castro Torres, Yaniel; Katholi, Richard E

    2014-01-01

    Type 2 diabetes mellitus (T2DM) and hypertension represent two common conditions worldwide. Their frequent association with cardiovascular diseases makes management of hypertensive patients with T2DM an important clinical priority. Carvedilol and renal denervation are two promising choices to reduce plasma glucose levels and blood pressure in hypertensive patients with T2DM to reduce future complications and improve clinical outcomes and prognosis. Pathophysiological mechanisms of both options are under investigation, but one of the most accepted is an attenuation in sympathetic nervous system activity which lowers blood pressure and improves insulin sensitivity. Choice of these therapeutic approaches should be individualized based on specific characteristics of each patient. Further investigations are needed to determine when to consider their use in clinical practice. PMID:25126399

  5. A multinational, open-label, phase 2 study of ruxolitinib in Asian patients with myelofibrosis: Japanese subset analysis.

    PubMed

    Oritani, Kenji; Okamoto, Shinichiro; Tauchi, Tetsuzo; Saito, Shigeki; Ohishi, Kohshi; Handa, Hiroshi; Takenaka, Katsuto; Gopalakrishna, Prashanth; Amagasaki, Taro; Ito, Kazuo; Akashi, Koichi

    2015-03-01

    Ruxolitinib is a potent Janus kinase (JAK) 1/JAK2 inhibitor that has demonstrated rapid and durable improvements in splenomegaly and symptoms and a survival benefit in 2 phase 3 trials in patients with myelofibrosis. Ruxolitinib was well tolerated and effectively reduced splenomegaly and symptom burden in Asian patients with myelofibrosis in the Asian multinational, phase 2 Study A2202. We present a subset analysis of Japanese patients (n = 30) in Study A2202. At data cutoff, 22 patients were ongoing; 8 discontinued, mainly due to adverse events (n = 4). At week 24, 33 % of patients achieved ?35 % reduction from baseline in spleen volume; 56.0 % achieved ?50 % reduction from baseline in total symptom score, as measured by the 7-day Myelofibrosis Symptom Assessment Form v2.0. The most common adverse events were anemia (63 %), thrombocytopenia (40 %), nasopharyngitis (37 %), decreased platelet counts (30 %), and diarrhea (30 %). Dose reductions or interruptions due to hemoglobin decreases were more frequent in Japanese patients; no loss of efficacy and no discontinuations due to hematologic abnormalities were observed. Ruxolitinib was well tolerated in Japanese patients and provided substantial reductions in splenomegaly and myelofibrosis-related symptoms similar to those observed in the overall Asian population and phase 3 COMFORT studies. PMID:25638222

  6. Utilizing Information Technologies for Lifelong Monitoring in Diabetes Patients

    PubMed Central

    Capozzi, Davide; Lanzola, Giordano

    2011-01-01

    Background Information and communication technologies have long been acknowledged to support information sharing along the whole chain of care, from the clinic to the homes of patients and their relatives. Thus they are increasingly being considered for improving the delivery of health care services also in light of clinical and technological achievements that propose new treatments requiring a tighter interaction among patients and physicians. Methods The multiagent paradigm has been utilized within an architecture for delivering telemedicine services to chronic outpatients at their domiciles and enforcing cooperation among patients, caregivers, and different members of the health care staff. The architecture sees each communication device such as a palmtop, smart phone, or personal digital assistant as a separate agent upon which different services are deployed, including telemetry, reminders, notifications, and alarms. Decoupling services from agents account for a highly configurable environment applicable to almost any context that can be customized as needed. Results The architecture has been used for designing and implementing a prototypical software infrastructure, called LifePhone, that runs on several communication devices. A basic set of services has been devised with which we were able to configure two different applications that address long-term and short-term monitoring scenarios for diabetes patients. The long-term scenario encompasses telemetry and reminder services for patients undergoing peritoneal dialysis, which is a treatment for chronic renal failure, a diabetes complication. The short-term scenario incorporates telemetry and remote alarms and is applicable for training patients to use an artificial pancreas. Conclusions Our experiments proved that an infrastructure such as LifePhone can be used successfully for bridging the interaction gap that exists among all the components of a health care delivery process, improving the quality of service and possibly reducing the overall costs of health care. Furthermore, the modularity of services allows for more complex scenarios encompassing data analysis or even involving actors at multiple institutions in order to better support the overall health care organization. PMID:21303625

  7. Fatigue and cognitive symptoms in patients with diabetes: relationship with disease phenotype and insulin treatment.

    PubMed

    Lasselin, Julie; Layé, Sophie; Barreau, Jean-Baptiste; Rivet, Alice; Dulucq, Marie-Josée; Gin, Henri; Capuron, Lucile

    2012-09-01

    Neurobehavioral symptoms are frequently reported in patients with diabetes. Nevertheless, the characterization of the specific symptom dimensions that develop in diabetic patients with respect to disease phenotype and treatment status remains obscure. This study comparatively assessed fatigue symptoms and cognitive performance using a dimensional approach in 21 patients with insulin-treated type 1 diabetes, 24 type 2 diabetic patients either insulin-free or undergoing insulin treatment for at least six months, and 15 healthy subjects. Specific dimensions of fatigue were assessed using the Multidimensional-Fatigue-Inventory (MFI). Cognitive performance on tests of choice reaction time, pattern recognition memory and spatial planning was evaluated using the Cambridge-Neuropsychological-Automated-Battery (CANTAB). Body mass index (BMI) and glycated-hemoglobin (HbA1C) concentrations were collected, as well as information on diabetes complications and disease duration. Patients with type 2 diabetes, regardless of insulin treatment status, exhibited higher scores of fatigue, primarily in the dimensions of general and physical fatigue as well as reduced activity. Cognitive alterations, in the form of longer reaction times and impaired spatial planning, were also detected in type 2 diabetic patients treated with insulin. These alterations were overall unrelated to glucose control, as reflected in HbA1C levels, and were not explained by complications and duration of diabetes. No specific alteration was measured in type 1 diabetic patients who exhibited fatigue scores and cognitive performance comparable to healthy participants. While associated with fatigue, increased BMI did not significantly account for the relationship of type 2 diabetes with general fatigue and physical fatigue. BMI, however, modulated the association of type 2 diabetes with reduced activity and the association of insulin-treated type 2 diabetes with psychomotor slowing. These findings reveal specific fatigue and cognitive symptoms in patients with type 2 diabetes and suggest the involvement of differential pathophysiological processes. PMID:22370460

  8. Family history, body mass index and survival in Japanese patients with stomach cancer: a prospective study.

    PubMed

    Minami, Yuko; Kawai, Masaaki; Fujiya, Tsuneaki; Suzuki, Masaki; Noguchi, Tetsuya; Yamanami, Hideaki; Kakugawa, Yoichiro; Nishino, Yoshikazu

    2015-01-15

    Family history and nutritional status may affect the long-term prognosis of stomach cancer, but evidence is insufficient and inconsistent. To clarify the prognostic factors of stomach cancer, we conducted a prospective study of 1,033 Japanese patients with histologically confirmed stomach cancer who were admitted to a single hospital between 1997 and 2005. Family history of stomach cancer and pretreatment body mass index (BMI) were assessed using a self-administered questionnaire. Clinical data were retrieved from a hospital-based cancer registry. All patients were completely followed up until December, 2008. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated according to family history in parents and siblings and BMI category. During a median follow-up of 5.3 years, 403 all-cause and 279 stomach cancer deaths were documented. Although no association with family history was observed in the patients overall, analysis according to age group found an increased risk of all-cause death associated with a history in first degree relatives (HR = 1.61, 95% CI: 0.93-2.78, p = 0.09) and with a parental history (HR = 1.86, 95% CI: 1.06-3.26) among patients aged under 60 years at diagnosis. BMI was related to all-cause and stomach cancer death among patients aged 60 and over, showing a J-shaped pattern (HR of all-cause death = 2.28 for BMI < 18.5; HR = 1.61 for 25 ? vs. ? 23.0 to < 25.0 kg/m(2)). A family history of stomach cancer, especially parental history, may affect mortality among younger stomach cancer patients, whereas nutritional status may be a prognostic factor in older patients. PMID:24890283

  9. Pemphigus: use of the Japanese severity index in 56 Moroccan patients

    PubMed Central

    Benchikhi, Hakima; Nani, Samira; Baybay, Hanane; Amal, Said; Mernissi, Fatim-Zahra

    2013-01-01

    Introduction In pemphigus, there still is no consensus on parameters mesuring clinically the disease severity. The aim of this study is to use the Japanese severity index in Moroccan patients with pemphigus. Methods Multicenter prospective study from September 2007 to September 2009 including consecutive patients with confirmed pemphigus. We used the Japenese severity index for pemphigus. For each patient, the score was calculated at diagnosis and at 6 months of follow-up and correlated to type of pemphigus; mean dosage of corticosteroids and clinical statuts at 6 months: dead or not. Results Fifty six patients were included, 20 men and 36 women, mean age 46.62 ± 15.9 years. At diagnosis, the mean initial score was 7.7 + 2.36; at six months, it was 1.61 + 1.83. The score variation at 6 months and inclusion was 6.19 ± 2.18 for deep pemphigus and 5.43 ± 2.85 for superficial pemphigus (p = 0,3 non significant). At six months, 4 patients were dead: their initial score was 11 + 1.41 while the initial score in the 52 patients was 7.4±2.03 (p = 0,001, significant). Data showed no correlation between initial severity scores and cumulative dosage of corticosteroids at 6 months (Pearson coefficient of correlation 0.144; p = 0.580). Conclusion In this study, initial severity scores for pemphigus were high and decreased at 6 months of treatment. Both deep pemphigus and superficial pemphigus were severe as their score variation was similar. Japenese severity score is useful for Moroccan patients with pemphigus. PMID:24772225

  10. Patient-Perceived Barriers to the Psychological Care of Japanese Patients with Lung Cancer

    Microsoft Academic Search

    Chiharu Endo; Tatsuo Akechi; Toru Okuyama; Takashi Seto; Masashi Kato; Nobuhiko Seki; Kenji Eguchi; Takashi Hosaka; Toshiaki A. Furukawa

    2008-01-01

    Objective: Although cancer patients frequently experience psychological distress, few cancer patients with psychological distress receive appropriate psychological care. The purpose of this study was to investigate the type and frequency of barriers to receive psychological care in patients with lung cancer. Methods: Randomly selected ambulatory patients with lung cancer participated in the study. A self-administered questionnaire developed for this study

  11. Intraocular surgery in a large diabetes patient population: risk factors and surgical results.

    PubMed

    Ostri, Christoffer

    2014-05-01

    The prevalence of diabetes is on the increase in developed countries. Accordingly, the prevention and treatment of vision-threatening diabetic eye complications is assuming greater importance. The overall aim of this thesis is to analyse risk factors for intraocular surgery in a large diabetes population and to report surgical results. The specific objectives are to (1) estimate the incidence of diabetic vitrectomy and analyse risk factors (Study I), (2) report long-term results, prognostic factors and incidence of cataract surgery after diabetic vitrectomy (Study II), (3) report results and prognostic factors after cataract surgery in diabetes patients (Study III) and (4) analyse risk factors for diabetic papillopathy with emphasis on metabolic control variability (Study IV). All studies are based on a close-to-complete national surgery register and a large, closely followed diabetic retinopathy screening population. Study I (cohort study, 3980 type 1 diabetes patients) illustrates that diabetic vitrectomy is rarely required in a diabetes patient population with varying degrees of diabetic retinopathy. The risk of reaching diabetic vitrectomy increases fourfold with poor metabolic control, defined as glycosylated haemoglobin A1c > 75 mmol/mol (~9%), which points to good metabolic control as an important preventive measure. Study II (cohort study, 167 diabetes patients) shows that most diabetic vitrectomy patients stand to gain visual acuity ?0.3 after surgery. Visual acuity is stable after 1 year, and the stability is maintained through 10 years of follow-up. The use of silicone oil for endotamponade is a consistent long-term predictor of low vision after surgery. The risk of requiring cataract surgery after diabetic vitrectomy is substantial, and the risk increases if silicone oil is used. Study III (cohort study, 285 diabetes patients) shows, on the other hand, that diabetes patients can expect a significant improvement in visual acuity after cataract surgery, regardless of the degree of diabetic retinopathy. Poor preoperative visual acuity, a high degree of diabetic retinopathy and advanced age are predictors of a poor visual acuity after surgery. The risk of diabetic macular oedema after surgery is 4%. Finally, Study IV (case-control study, 2066 type 1 diabetes patients) demonstrates that diabetic papillopathy shares characteristics with diabetic retinopathy. The risk of experiencing diabetic papillopathy increases markedly with a drastic, recent reduction in glycosylated haemoglobin A1c and a small optic disc. This lends support to the theory that diabetic eye complications may occur in anatomically predisposed patients in response to metabolic control variability. Overall, results after intraocular surgery in diabetes patients are favourable. Surgery, however, is associated with costs to society, patient discomfort and risk of complications. This thesis provides an analysis of risk factors for intraocular surgery and identifies prognostic factors for visual acuity after surgery, which can be used for preventive purposes, surgical decision-making and patient counselling. PMID:24809766

  12. Prevalence of and risk factors for low bone mineral density in Japanese female patients with systemic lupus erythematosus

    Microsoft Academic Search

    Makio FurukawaChikako; Chikako Kiyohara; Hiroshi Tsukamoto; Hiroki Mitoma; Yasutaka Kimoto; Ayumi Uchino; Misato Nakagawa; Kensuke Oryoji; Terufumi Shimoda; Koichi Akashi; Mine Harada; Takahiko Horiuchi

    2011-01-01

    To examine the prevalence of and risk factors for low bone mineral density (BMD) (osteoporosis or osteopenia) in Japanese\\u000a female patients with systemic lupus erythematosus (SLE). We performed BMD measurements by dual X-ray absorptiometry at the\\u000a lumbar spine and the hip and collected basic and lifestyle-related, clinical and treatment characteristics among 58 SLE patients.\\u000a Odds ratios (ORs) and their 95%

  13. Submicroscopic deletion of chromosome region 16p13.3 in a Japanese patient with Rubinstein-Taybi syndrome

    SciTech Connect

    Masuno, Mitsuo; Imaizumi, Kiyoshi; Kurosawa, Kenji; Makita, Yoshio; Kuroki, Yoshikazu [Kanagawa Children`s Medical Center, Yokohama (Japan); Petrij, F.; Dauwerse, H.G.; Breuning, M.H. [Leiden Univ. (Netherlands)

    1994-12-01

    In a series of 25 Japanese patients with Rubinstein-Taybi syndrome, we screened, by high-resolution GTG banding and fluorescence in situ hybridization of a cosmid probe (RT1, D16S237), for microdeletions associated with this syndrome. In one patient, a microdeletion was demonstrated by in situ hybridization, but none were detected by high-resolution banding. 11 refs., 2 figs.

  14. Vorapaxar in Patients With Diabetes Mellitus and Previous Myocardial Infarction

    PubMed Central

    Cavender, Matthew A.; Scirica, Benjamin M.; Bonaca, Marc P.; Angiolillo, Dominick J.; Dalby, Anthony J.; Dellborg, Mikael; Morais, Joao; Murphy, Sabina A.; Ophuis, Ton Oude; Tendera, Michal; Braunwald, Eugene

    2015-01-01

    Background— Vorapaxar reduces cardiovascular death, myocardial infarction (MI), or stroke in patients with previous MI while increasing bleeding. Patients with diabetes mellitus (DM) are at high risk of recurrent thrombotic events despite standard therapy and may derive particular benefit from antithrombotic therapies. The Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events-TIMI 50 trial was a randomized, double-blind, placebo-controlled trial of vorapaxar in patients with stable atherosclerosis. Methods and Results— We examined the efficacy of vorapaxar in patients with and without DM who qualified for the trial with a previous MI. Because vorapaxar is contraindicated in patients with a history of stroke or transient ischemic attack, the analysis (n=16 896) excluded such patients. The primary end point of cardiovascular death, MI, or stroke occurred more frequently in patients with DM than in patients without DM (rates in placebo group: 14.3% versus 7.6%; adjusted hazard ratio, 1.47; P<0.001). In patients with DM (n=3623), vorapaxar significantly reduced the primary end point (11.4% versus 14.3%; hazard ratio, 0.73 [95% confidence interval, 0.60–0.89]; P=0.002) with a number needed to treat to avoid 1 major cardiovascular event of 29. The incidence of moderate/severe bleeding was increased with vorapaxar in patients with DM (4.4% versus 2.6%; hazard ratio, 1.60 [95% confidence interval, 1.07–2.40]). However, net clinical outcome integrating these 2 end points (efficacy and safety) was improved with vorapaxar (hazard ratio, 0.79 [95% confidence interval, 0.67–0.93]). Conclusions— In patients with previous MI and DM, the addition of vorapaxar to standard therapy significantly reduced the risk of major vascular events with greater potential for absolute benefit in this group at high risk of recurrent ischemic events. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00526474. PMID:25681464

  15. Diabetes

    MedlinePLUS

    ... prevent or delay the start of type 2 diabetes. Type 1 diabetes cannot be prevented. ... Elsevier; 2011:chap 31. Eisenbarth GS, Buse JB. Type 1 diabetes mellitus. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen ...

  16. Evaluation of Serum & Salivary IgA in Patients with Type 1 Diabetes

    PubMed Central

    Ahmadiafshar, Akefeh; Mohsenifard, Mahmood Reza; Mazloomzadeh, Saeideh

    2015-01-01

    Background Diabetes mellitus is a common immune mediated disorder. The aim of the present study is to evaluate the level of serum and salivary IgA levels in patients with Type 1 diabetes. Material and Method In this case control study, serum and salivary IgA levels of patients with diabetes type 1 and similar non diabetes subjects were measured. Age, gender, duration of diabetes and the last HbA1c level of diabetic patients were also studied. Data was analyzed by SPSS software. Results Two hundred and fifty subjects (126 diabetics and 124 non diabetics) were enrolled in the study. The mean value of serum IgA in patients with Type 1 Diabetes and controls was 1.77± 1.55 g/lit and 2.39± 1.52 g/lit, respectively. The mean salivary IgA level in diabetics and controls was 276 ± 162.5 40 ?g/ml and 129 ± 112.2 40 ?g/ml, respectively. Selective IgA deficiency was detected in two (1.6%) and three(2.4%)cases of diabetic and control group; respectively (p=0.68). We found low salivary IgA level in 44.4% diabetic and 33.9% control (p=0.08). There was no significant correlation between serum and salivary IgA level. There was also significant association between serum IgA levels with age. Salivary IgA was significantly correlated with HbA1c level. But considering gender, duration of diabetes we didn’t find any association. Conclusion We didn't find any significant difference in serum and salivary IgA level among diabetic and non diabetics and also, no association between serum and salivary IgA levels. PMID:25875365

  17. Interrelation between Patient Satisfaction and Patient-Provider Communication in Diabetes Management

    PubMed Central

    Cinar, Ayse Basak; Schou, Lone

    2014-01-01

    The present study aims to assess how patient satisfaction with medical provider-patient communication can affect oral health, diabetes, and psychobehavioural measures among type 2 diabetes (T2DM) patients. It is part of a prospective intervention study among randomly selected T2DM patients, in Turkey. The data analyzed were Community Periodontal Need Index (CPI), HbA1c, patient satisfaction with communication, and psychobehavioural variables. Data was collected initially and at the end of the intervention. The participants were allocated to either health coaching (HC) or health education (HE). At baseline, there were no statistical differences between the HC and the HE groups on any of the measures (P > 0.05). Patients in both the HC and the HE groups had low satisfaction with communication. At postintervention, the increase in patient satisfaction with communication in the HC group was significantly higher than that in the HE group (P = 0.001). Principal component analysis revealed that patient satisfaction with communication shared the same cluster with clinical measures (CPI and HbA1c) and quality of life in the HC group. In conclusion, the present study showed, to our knowledge for the first time, that overall patient satisfaction with medical care provider-patient communication, empowered by HC approach, was interrelated with well-being of T2DM patients, in terms of psychobehavioural and clinical measures. PMID:25614885

  18. Patient confidentiality, data security, and provider liabilities in diabetes management.

    PubMed

    Albisser, A Michael; Albisser, Jeremy B; Parker, Louise

    2003-01-01

    From inception, the electronic patient record has raised issues of data protection and patient confidentiality. These privacy issues have become more complicated with the introduction of electronic links to patient information held in databases sited on local and wide area networks. The first purpose of this paper is to review, from the provider's perspective, the issues surrounding patient confidentiality, data security, and consequential provider liabilities. The second is to propose possible immediate strategies and long-term solutions. Clinical procedures in diabetes practice create patient data from confidential information. This information is owned by the patient, received by the provider, enriched by a professional interpretation, and merged with other data into health records. Ownership, privacy, accountability, and responsibility issues are raised. Consequential data security and patient privacy are easily met by storage in a locked box or file cabinet. Conversion of such records into digital data in databases on local and wide area networks markedly increases the provider's exposure to liabilities. Current methods for securing remote data exist. These involve user authentication and secure transmission, but remote data storage is far less secure than a locked box. New tools for the secure storage of patient data are outlined. These involve encryption and decryption by the provider alone. A suite of computer protocols is presented that can restore security equivalent to a "locked box" and thus reduce liabilities for the provider. Providers should protect the privacy of their patients by encrypting all data that are stored in remote repositories. The tools to do this are urgently needed. A standardized digital protocol for verifying user identities, preserving patient confidentiality, and controlling data security by encryption will fully mitigate provider liabilities. Standardization and economies of scale promise future cost containment. PMID:14511418

  19. Diminished serum levels of free IGF-I in patients with diabetic retinopathy

    Microsoft Academic Search

    Berit Feldmann; Gabriele E. Lang; Angèle Arnavaz; Peter M. Jehle; Bernhard O. Böhm; Gerhard K. Lang

    1999-01-01

      \\u000a \\u000a Background: Growth factors like IGF-I have been implicated in the pathogenesis of diabetic retinopathy. To investigate the role and bioavailability\\u000a of IGF-I we measured not only total but also free serum levels of IGF-I in diabetic patients.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: A total of 159 patients with and without diabetic retinopathy were investigated (60 diabetic patients without and 99 with\\u000a clinically and

  20. In-patient management of diabetes: Controversies and guidelines.

    PubMed

    Korytkowski, Mary T

    2013-12-01

    Hyperglycemia is associated with adverse outcomes in hospitalized patients with and without previously known diabetes. Some therapies that are used in the in-patient setting, including glucocorticoids, enteral and parenteral nutrition are associated with new onset hyperglycemia even in previously normoglycemic patients. Current guidelines advise that fasting and premeal blood glucose (BG) be maintained at < 140 mg/dl, with maximal random BG < 180 mg/dl in non-critically ill-patients. In critically ill-patients, intravenous (IV) insulin infusion therapy with BG targets of 140-180 effectively maintains glycemic control with a low risk for hypoglycemia. Protocols targeting "tight" glycemic control, defined as BG 80-110 mg/dl, are no longer recommended due to the high frequency of severe hypoglycemia. Rational use of basal bolus insulin (BBI) regimens in non-critical care and IV insulin infusions in critical care settings has been demonstrated to effectively achieve and maintain recommended BG targets with low risk for hypoglycemia. The safety of BBI relies upon provider awareness of prescribing recommendations for initiating and adjusting insulin regimens according to changes in overall clinical and nutritional status, as well as careful review of daily BG measurements. Smooth transition of care to the out-patient setting is facilitated by providing oral and written instructions regarding the timing and dosing of insulin as well as education in basic skills for home management. PMID:24910825

  1. Diabetes, Prediabetes and the Survival of Nasopharyngeal Carcinoma: A Study of 5,860 Patients

    PubMed Central

    OuYang, Pu-Yun; Su, Zhen; Tang, Jie; Lan, Xiao-Wen; Mao, Yan-Ping

    2014-01-01

    Background The incidence of diabetes is increasing. But the impact of diabetes and prediabetes on survival of patients with nasopharyngeal carcinoma (NPC) has received little evaluation. Methods In a cohort of 5,860 patients, we compared the disease specific survival (DSS), locoregional relapse-free survival (LRFS) and distant metastasis-free survival (DMFS) of patients with diabetes, prediabetes and normoglycemia defined by pretreatment fasting plasma glucose (FPG) using Kaplan–Meier method, log-rank test and Cox proportional hazards model. Results Comparing to normoglycemic patients, the diabetic and the prediabetic were generally older, fatter, had hypertension, heart diseases and hyperlipaemia and usually received radiotherapy alone. But both the diabetic and the prediabetic had similar DSS, LRFS and DMFS to normoglycemic patients, even adjusting for such important factors as age, gender, smoking, drinking, hypertension, heart diseases, body mass index, hyperlipaemia, titer of VCA-IgA and EA-IgA, pathology, T-stage, N-stage, chemotherapy and radiotherapy (P>0.05 for all). Additionally, the findings remained unchanged in sensitivity analysis by excluding patients with known diabetes history and in subgroups of the various factors. Conclusions The diabetic and prediabetic NPC patients had similar survival to normoglycemic NPC patients. These data, in the largest reported cohort, are the first to evaluate the association between diabetes, prediabetes and the survival in NPC. The findings are relevant to patient management and provided evidence of the effect on this disease exerted by comorbidities. PMID:25350747

  2. Patient-centered outcomes of a value-based insurance design program for patients with diabetes.

    PubMed

    Elliott, Daniel J; Robinson, Edmondo J; Anthony, Karen B; Stillman, Paula L

    2013-04-01

    Value-based insurance design (VBID) initiatives have been associated with modest improvements in adherence based on evaluations of administrative claims data. The objective of this prospective cohort study was to report the patient-centered outcomes of a VBID program that eliminated co-payments for diabetes-related medications and supplies for employees and dependents with diabetes at a large health system. The authors compared self-reported values of medication adherence, cost-related nonadherence, health status, and out-of-pocket health care costs for patients before and 1 year after program implementation. Clinical metrics and satisfaction with the program also are reported. In all, 188 patients completed the follow-up evaluation. Overall, patients reported a significant reduction in monthly out-of-pocket costs (P<0.001), which corresponded to a significant reduction in cost-related nonadherence from 41% to 17.5% (P<0.001). Self-reported medication adherence increased for hyperglycemic medications (P=0.011), but there were no apparent changes in glycemic control. Overall, 89% of participants agreed that the program helped them take better care of their diabetes. The authors found that a VBID program for employees and dependents with diabetes was associated with self-reported reductions in cost-related nonadherence and improvements in medication adherence. Importantly, the program was associated with high levels of satisfaction among participants and strongly perceived by participants to facilitate medication utilization and self-management for diabetes. These findings suggest that VBID programs can accomplish the anticipated goals for medication utilization and are highly regarded by participants. Patient-centered outcomes should be included in VBID evaluations to allow decision makers to determine the true impact of VBID programs on participants. PMID:23405873

  3. Slowing the progression of kidney disease in patients with diabetes

    Microsoft Academic Search

    Ellen Burgess

    2008-01-01

    Diabetic nephropathy is a leading cause of renal failure requiring replacement therapy. Diabetic nephropathy is typically characterized by persistent microalbuminuria progressing to nephrotic syndrome, a progressive decline in glomerular filtration rate, and hypertension. Diabetic nephropathy prevention strategies may involve early angiotensin-converting enzyme (ACE) inhibitor treatment and the control of diabetes to reduce glomerular hypertension and hyperfiltration. Treatment strategies include the

  4. The Wired Patient: Patterns of Electronic Patient Portal Use Among Patients With Cardiac Disease or Diabetes

    PubMed Central

    Weiner, Jonathan P; Shah, Nirav R; Stewart, Walter F

    2015-01-01

    Background As providers develop an electronic health record–based infrastructure, patients are increasingly using Web portals to access their health information and participate electronically in the health care process. Little is known about how such portals are actually used. Objective In this paper, our goal was to describe the types and patterns of portal users in an integrated delivery system. Methods We analyzed 12 months of data from Web server log files on 2282 patients using a Web-based portal to their electronic health record (EHR). We obtained data for patients with cardiovascular disease and/or diabetes who had a Geisinger Clinic primary care provider and were registered “MyGeisinger” Web portal users. Hierarchical cluster analysis was applied to longitudinal data to profile users based on their frequency, intensity, and consistency of use. User types were characterized by basic demographic data from the EHR. Results We identified eight distinct portal user groups. The two largest groups (41.98%, 948/2258 and 24.84%, 561/2258) logged into the portal infrequently but had markedly different levels of engagement with their medical record. Other distinct groups were characterized by tracking biometric measures (10.54%, 238/2258), sending electronic messages to their provider (9.25%, 209/2258), preparing for an office visit (5.98%, 135/2258), and tracking laboratory results (4.16%, 94/2258). Conclusions There are naturally occurring groups of EHR Web portal users within a population of adult primary care patients with chronic conditions. More than half of the patient cohort exhibited distinct patterns of portal use linked to key features. These patterns of portal access and interaction provide insight into opportunities for electronic patient engagement strategies. PMID:25707036

  5. Computer-Assisted Intervention Improves Patient-Centered Diabetes Care by Increasing Autonomy Support

    Microsoft Academic Search

    Geoffrey C. Williams; Martin Lynch; Russell E. Glasgow

    2007-01-01

    Objective: To determine if a patient-centered, computer-assisted diabetes care intervention increased perceived autonomy support, perceived competence (from self-determination theory), and if these constructs mediated the effect of the intervention on ADA\\/NCQA recommended diabetes care outcomes. Design: A randomized controlled trial of 866 adult type 2 diabetes patients in heterogeneous primary care settings in Colorado. Main Outcome Measures: Perceived autonomy support,

  6. Impaired nitric oxide-mediated vasodilation in patients with non-insulin-dependent diabetes mellitus

    Microsoft Academic Search

    Stephen B. Williams; Jorge A. Cusco; Mary-Anne Roddy; Michael T. Johnstone; Mark A. Creager

    1996-01-01

    Objectives. This study sought to determine whether nitric oxide-mediated vasodilation is abnormal in patients with non-insulin-dependent diabetes mellitus.Background. Multiple investigations, both in experimental models and in patients with insulin-dependent diabetes mellitus, demonstrate impaired endothelium-dependent vasodilation. Decreased availability of endothelium-derived nitric oxide may contribute to the high prevalence of vascular disease in diabetes.Methods. Vascular reactivity was measured in the forearm resistance

  7. The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study

    Microsoft Academic Search

    A. Veves; H. J. Murray; M. J. Young; A. J. M. Boulton

    1992-01-01

    Summary  Foot ulceration results in substantial morbidity amongst diabetic patients. We have studied prospectively the relationship between high foot pressures and foot ulceration using an optical pedobarograph. A series of 86 diabetic patients, mean age 53.3 (range 17–77) years, mean duration of diabetes 17.1 (range 1–36) years, were followed-up for a mean period of 30 (range 15–34) months. Clinical neuropathy was

  8. Impaired Mitochondrial Activity in the Insulin-Resistant Offspring of Patients with Type 2 Diabetes

    Microsoft Academic Search

    Kitt Falk Petersen; Sylvie Dufour; Douglas Befroy; Rina Garcia; Gerald I. Shulman

    2010-01-01

    background Insulin resistance appears to be the best predictor of the development of diabetes in the children of patients with type 2 diabetes, but the mechanism responsible is unknown. methods We performed hyperinsulinemic-euglycemic clamp studies in combination with infu- sions of (6,6- 2 H 2 )glucose in healthy, young, lean, insulin-resistant offspring of patients with type 2 diabetes and insulin-sensitive

  9. Elevation of serum apelin-13 associated with proliferative diabetic retinopathy in type 2 diabetic patients

    PubMed Central

    Du, Jun-Hui; Li, Xia; Li, Rong; Xu, Lin; Ma, Ran-Ran; Liu, Song-Fang; Zhang, Zhong; Sun, Hong-Zhi

    2014-01-01

    AIM To compare apelin-13, a ligand of G-protein-coupled receptor which has been shown to be involved in retinal angiogenesis, and vascular endothelial growth factor (VEGF) serum levels in type 2 diabetes mellitus (T2DM) with or without retinopathy, and to investigate the relationship between the serum concentration of apelin-13 and diabetes retinopathy. METHODS Sixty-nine patients with T2DM were enrolled. Of the 69 patients, 16 had proliferative diabetic retinopathy (PDR group), 23 had non-PDR (NPDR group) and 30 had no retinopathy (T2DM group). Subjects' information, including demographics, medical history, and use of medications were recorded. Their serum samples were collected for measuring the levels of C-reactive protein (CRP), serum lipid and glycosylated hemoglobin. Apelin-13 and VEGF serum levels were measured by enzyme-linked immunosorbent assay. Kruskal-Wallis test and one-way ANOVA were used to compare the differences among these groups. Chi-square test was used to assess categorical variables. Correlations between variables were investigated by Spearman rho correlation test and stepwise regression analysis. All statistical analyses were performed through SPSS 17.0 software. RESULTS Sex, age, body mass index (BMI), blood pressure, CRP, hemoglobin A1c (HbA1c) have no significantly difference in the three groups. Serum level of apelin-13 was significantly elevated in PDR group as compared with T2DM group (P=0.041). Differences of VEGF serum concentration in the three groups were statistically significant (P=0.007, P=0.007 and P<0.001, respectively). Spearman rho correlation test showed that serum apelin-13 was positively correlated with BMI, serum triglycerides, VEGF, but not with age, duration of diabetes, blood pressure, CRP, HbA1c and total-cholesterol. Stepwise regression analysis showed that BMI also significantly associated with serum apelin-13 (P=0.002), while VEGF and serum triglycerides were irrelevant. CONCLUSION This study elucidated a positive association of apelin-13 serum level with PDR, but not with VEGF. Apelin-13 may influence the promotion of PDR but unrelated with VEGF. PMID:25540748

  10. Monitoring for proteinuria in patients with type 2 diabetes mellitus

    PubMed Central

    Liang, Huifang; Kennedy, Caroline; Manne, Sudhakar; Lin, Jennifer Hsiang-Ling; Dolin, Paul

    2015-01-01

    Objective The UK National Institute for Health and Care Excellence (NICE) guideline on diabetes recommends at least annual monitoring of patients with type 2 diabetes mellitus (T2DM) for proteinuria. To date, little has been published on the frequency of proteinuria monitoring in T2DM, and its association with risk factors for renal complications. We aimed to describe proteinuria monitoring in patients with T2DM. Design This study identified patients with T2DM aged 40?years or older with the first antidiabetic drug use in 2007–2012 (cohort entry) in the UK Clinical Practice Research Datalink. At least 1?year of registration before and after cohort entry was required. A test was considered undertaken if a medical or laboratory code indicated a urinary albumin or protein test. The percentage of patients with at least one test performed was obtained in 1?year after cohort entry and any time during follow-up. A Cox proportional hazards model was used to estimate the HRs of patients having the first screening test while adjusting for baseline covariates. Results 65?790 patients (mean age 63.0?years, men 57.5%, mean follow-up 41.0?months) were included, of whom 49?707 (75.6%) patients had at least one test in 1?year after antidiabetic drug initiation and 59?400 (90.3%) had at least one test any time during follow-up. Proteinuria monitoring decreased with time since initiation of antidiabetic drug therapy and with number of treatment changes and was independently associated with age, sex, smoking status, and year of antidiabetic drug initiation. 12.3% of patients with T2DM tested had a positive proteinuria test for the first screening performed in 1?year after initiation of antidiabetic drug therapy. Conclusions The findings suggested suboptimal compliance with the NICE guideline on proteinuria monitoring in patients with T2DM and that level of monitoring appeared to depend on multiple clinical factors.

  11. Analysis of microsatellite polymorphisms within the GLC1F locus in Japanese patients with normal tension glaucoma

    PubMed Central

    Murakami, Kaori; Ota, Masao; Shiota, Tomoko; Nomura, Naoko; Kashiwagi, Kenji; Mabuchi, Fumihiko; Iijima, Hiroyuki; Kawase, Kazuhide; Yamamoto, Tetsuya; Nakamura, Makoto; Negi, Akira; Sagara, Takeshi; Nishida, Teruo; Inatani, Masaru; Tanihara, Hidenobu; Aihara, Makoto; Araie, Makoto; Fukuchi, Takeo; Abe, Haruki; Higashide, Tomomi; Sugiyama, Kazuhisa; Kanamoto, Takashi; Kiuchi, Yoshiaki; Iwase, Aiko; Ohno, Shigeaki; Inoko, Hidetoshi; Mizuki, Nobuhisa

    2010-01-01

    Purpose To investigate whether the GLC1F locus is associated with normal tension glaucoma (NTG) in Japanese patients. Methods We recruited 242 unrelated Japanese subjects, including, 141 NTG patients and 101 healthy controls. The patients exhibiting a comparatively early onset were selected as they suggest that genetic factors may show stronger involvement. Genotyping and assessment of allelic diversity was performed on 11 highly polymorphic microsatellite markers in and around the GLC1F locus. Results Individuals carrying the 163 allele of D7S1277i had a statistically significant increased risk of NTG (p=0.0013, pc=0.016, OR=2.47, 95%CI=1.42–4.30). None of the other markers identified significant loci (pc>0.05) after Bonferroni’s correction. Conclusions These findings suggested that the genes in the GLC1F locus may be associated with the pathogenesis of NTG. PMID:20309402

  12. Diabetic gangrene in multiple fingers and toes after a dog bite in an elderly patient with type 2 diabetes.

    PubMed

    Oya, Junko; Hanai, Ko; Miura, Junnosuke; Maruyama, Satoko; Ishii, Akiko; Syono, Kazu; Shinjo, Takamichi; Iwamoto, Yasuhiko

    2011-01-01

    A 78-year-old diabetic woman experienced multiple sites of gangrene not only in fingers that were directly bitten by a dog but also in fingers and toes that had not beenbitten. Her glycemic control was fair and microvascular complications were mild. There were no clinical findings related to angitis, collagenosis or severe infection. The fingers and toes with gangrene were amputated. The pathological diagnosis was diabetic gangrene. This report presents a case of multiple sites of gangrene of the fingers and toes after a dog bite in an elderly patient with type 2 diabetes. PMID:21673466

  13. Facilitators and barriers of adaptation to diabetes: experiences of Iranian patients

    PubMed Central

    2014-01-01

    Background Diabetes mellitus is one of the most challenging and burdensome chronic diseases of the 21st century and More than 1% of the Iranian urban population older than 20 years develops Type 2 diabetes each year. Living with diabetes mellitus has been described as a dynamic personal transitional adaptation, based on restructuring of the illness perceived experience and management of the self. Adaptation to Type 2 Diabetes mellitus is an integral part of diabetes care. This study explored the experiences of facilitators and barriers adaptation to Type 2 Diabetes by Iranian patients. Methods This study was conducted by using qualitative content analysis. Data were collected via in-depth, semi-structured and face to face interviews with 15 patients with type2 diabetes. Results Three themes emerged from collected data, including a) individual context with Beliefs, personal background, and previous experience subthemes. b) supportive system with Family, Society and Health organizations subthemes and c) self-comparison with comparison with other diabetes and comparison with other diseases subthemes. Conclusions Identifying and managing Facilitators and Barriers adaptation to Type 2 Diabetes mellitus are an integral part of diabetes care. This study provides a better understanding of the factors from perspective of patients and it can be utilized by health care providers to adapt their health care and education contents to better meet the needs of people with diabetes. PMID:24401490

  14. Dose- and Time-Dependent Association of Smoking and Its Cessation with Glycemic Control and Insulin Resistance in Male Patients with Type 2 Diabetes Mellitus: The Fukuoka Diabetes Registry

    PubMed Central

    Ohkuma, Toshiaki; Iwase, Masanori; Fujii, Hiroki; Kaizu, Shinako; Ide, Hitoshi; Jodai, Tamaki; Kikuchi, Yohei; Idewaki, Yasuhiro; Hirakawa, Yoichiro; Nakamura, Udai; Kitazono, Takanari

    2015-01-01

    Objective Cigarette smoking is an important modifiable risk factor for cardiovascular diseases. However, the effect of smoking and its cessation on glycemic control in diabetic patients has not been fully examined yet. The aim of the present study was to examine the association of smoking status with glycemic level and markers of insulin resistance and secretion in patients with type 2 diabetes mellitus. Research Design and Methods A total of 2,490 Japanese male patients with type 2 diabetes mellitus aged ?20 years were divided according to smoking status, amount of cigarettes smoked and years since quitting. The associations with glycemic level and markers of insulin resistance and secretion were examined cross-sectionally. Results HbA1c levels increased progressively with increases in both number of cigarettes per day and pack-years of cigarette smoking compared with never smokers (P for trend = 0.001 and <0.001, respectively), whereas fasting plasma glucose did not. On the other hand, HbA1c, but not fasting plasma glucose, decreased linearly with increase in years after smoking cessation (P for trend <0.001). These graded relationships persisted significantly after controlling for the confounders, including total energy intake, current drinking, regular exercise, depressive symptoms, and BMI. In addition, a homeostasis model assessment of insulin resistance and high-sensitivity C-reactive protein also showed similar trends. Conclusions Smoking and its cessation showed dose- and time-dependent relationship with glycemic control and insulin resistance in patients with type 2 diabetes mellitus. These findings may highlight the importance of smoking cessation in the clinical management of diabetes mellitus. PMID:25822499

  15. Pharmacokinetics, efficacy and safety profiles of etanercept monotherapy in Japanese patients with rheumatoid arthritis: review of seven clinical trials.

    PubMed

    Takeuchi, Tsutomu; Miyasaka, Nobuyuki; Kawai, Shinichi; Sugiyama, Naonobu; Yuasa, Hirotoshi; Yamashita, Noriaki; Sugiyama, Noriko; Wagerle, Lorin Craig; Vlahos, Bonnie; Wajdula, Joseph

    2015-03-01

    Abstract Conventional synthetic disease-modifying anti-rheumatic drugs, including methotrexate, may not be tolerated by all patients with rheumatoid arthritis (RA), and limited international data for etanercept (ETN) monotherapy are available. The aim of this review was to summarize the clinical program for ETN monotherapy in Japanese patients with RA, which has included a pharmacokinetic study, clinical trials for registration, long-term studies, and once-weekly dosing studies. Pharmacokinetic results showed that serum concentrations of ETN were linear with dose levels and were similar to other international studies. Across interventional studies, 652 Japanese patients with active RA were treated with ETN. In the registration studies, ETN treatment led to consistent improvement in American College of Rheumatology 20/50/70 scores, European League Against Rheumatism Good Response, Disease Activity Score 28 erythrocyte sedimentation rate remission, and Health Assessment Questionnaire disability index. In the long-term studies, efficacy was maintained for up to 180 weeks. Similar results were seen in the once-weekly studies. Across the studies, more than 870 patient-years of exposure to ETN were recorded. Discontinuations owing to lack of efficacy or adverse events were modest and no new safety signals were recorded. These studies demonstrated that ETN monotherapy is efficacious and well-tolerated in Japanese patients with RA. PMID:24842477

  16. Interferon treatment for Japanese patients with favorable-risk metastatic renal cell carcinoma in the era of targeted therapy

    PubMed Central

    Nihei, Naoki; Nakamura, Kazuyoshi; Sakamoto, Shinichi; Fukasawa, Satoshi; Komaru, Atsushi; Ueda, Takeshi; Igarashi, Tatsuo; Ichikawa, Tomohiko

    2015-01-01

    Purpose Single-agent interferon (IFN) is no longer regarded as a standard option for first-line systemic treatment of metastatic renal cell carcinoma (RCC) in Western countries. However, some patients with favorable-risk RCC may still achieve complete and long-lasting remission in response to IFN treatment. The present study compared favorable-risk Japanese patients with metastatic RCC Japanese patients who had been treated with IFN or tyrosine kinase inhibitor (TKI) therapy as a first-line systemic therapy. Materials and Methods From 1995 to 2014, a total of 48 patients with favorable risk as defined by the Memorial Sloan Kettering Cancer Center criteria who did not receive adjuvant systemic therapy were retrospectively enrolled in this study. We assessed the tumor response rate, progression-free survival (PFS), and overall survival (OS). Results The objective response rate for first-line therapy was 29% in the IFN group and 47% in the TKI group, but this difference did not reach the level of statistical significance. Median OS for IFN and TKI was 71 and 47 months, respectively (p=0.014). Median first-line PFS for IFN and TKI was 20 and 16 months, respectively (no significant difference). First-line IFN therapy did not prove inferior to TKI therapy in terms of OS according to metastatic sites. Conclusions IFN is associated with a survival benefit in Japanese patients with favorable-risk metastatic RCC in the era of targeted therapy. Further prospective study is needed. PMID:25763124

  17. Endothelial nitric oxide synthase genotype and haplotype are not associated with diabetic retinopathy in diabetes type 2 patients

    Microsoft Academic Search

    Roger W. C. de Syllos; Valeria C. Sandrim; Hugo R. K. Lisboa; Glaucia S. Tres; Jose E. Tanus-Santos

    2006-01-01

    Polymorphisms in the endothelial nitric oxide synthase (eNOS) gene have been associated with the development of diabetic retinopathy (DR) in patients with type 1 diabetes mellitus (T1DM), but not with T2DM. However, no previous study has analyzed combinations of genetic markers (haplotypes), which can be more informative. We studied three eNOS genetic polymorphisms: a single nucleotide polymorphism in the promoter

  18. Vitamin D Insufficiency Is Associated with Lower Physical Function in Patients with Heart Failure and Diabetes

    PubMed Central

    Lopes, M. R.; Ribeiro, Paula A. B.; Souza, Gabriela C.; Clausell, Nadine; Schaan, Beatriz D.

    2014-01-01

    Vitamin D deficiency is frequent among patients with heart failure (HF) and diabetes, disorders associated with exercise intolerance and muscle weakness. This study aims to search for associations between vitamin D sufficiency and physical function indexes in patients with HF and diabetes. A cross-sectional study of 146 HF patients, 39.7% with diabetes, at a Brazilian tertiary outpatient clinic was performed. Patients underwent clinical evaluation, 6-minute walk test (6?MWT), handgrip strength, physical activity level (IPAQ), and biochemical evaluations including serum 25-hydroxyvitamin D. Classification was done according to vitamin D status (?30?ng/dL, sufficient) and presence/absence of diabetes in vitamin sufficient, no diabetes (DS-C, n = 25), vitamin sufficient, diabetes (DS-DM, n = 18), vitamin deficient, no diabetes (DD-C, n = 63), and vitamin deficient, diabetes (DD-DM, n = 40). Patients age was 55.4 ± 8 yrs; 70.5% had vitamin D deficiency. Clinical characteristics were similar among groups. Total time expended in physical activity was similar among groups (P = 0.26). DS-C covered higher distances in the 6?MWT (392 ± 60 m) versus DD-DM (309 ± 116?m); P = 0.024. Handgrip strength was similar among groups but tended to lower levels in DD-DM (P = 0.074) even after being adjusted to physical activity (P = 0.069). Vitamin D deficiency can influence physical function in HF diabetic patients. PMID:25243195

  19. Predictive Control of Blood Glucose Concentration in Type I Diabetic Patients

    Microsoft Academic Search

    Surekha Kamath; V. I. George; Sudha Vidyasagar

    Maintaining the glucose concentration in normoglycemic range in Type I diabetic patients is challenging. In this study H? control is applied for the insulin delivery to prevent the hyperglycemic levels in a type I diabetic patient. From a control theory point of view, the blood glucose regulation problem is reformulated as a tracking one. A glucose tolerance curve (GTC) validated

  20. Autoantibodies and endothelial dysfunction in well-controlled, uncomplicated insulin-dependent diabetes mellitus patients

    Microsoft Academic Search

    M. V. Ciarla; A. Bocciarelli; S. Di Gregorio; A. Tordi; P. Cotroneo; G. Marra; G. Ghirlanda; R. Strom

    2001-01-01

    Patients with insulin-dependent diabetes mellitus (IDDM) are well known to be at high risk of vascular disease, and dysfunction of vascular endothelium is considered as an early step in the development of diabetic complications. Because of the involvement of autoimmunity in the pathogenesis of IDDM, our aim was to assess, in 45 IDDM patients without clinically evident vascular complications, whether

  1. Diabetes Distress and Depressive Symptoms: A Dyadic Investigation of Older Patients and Their Spouses

    ERIC Educational Resources Information Center

    Franks, Melissa M.; Lucas, Todd; Stephens, Mary Ann Parris; Rook, Karen S.; Gonzalez, Richard

    2010-01-01

    In this dyadic study, we examined diabetes distress experienced by male and female patients and their spouses (N = 185 couples), and its association with depressive symptoms using the Actor-Partner Interdependence Model. Diabetes-related distress reported by both patients and spouses was associated with each partner's own depressive symptoms…

  2. Zinc levels after intravenous administration of zinc sulphate in insulin-dependent diabetes mellitus patients

    Microsoft Academic Search

    A. Maldonado Martín; B. Gil Extremera; M. Fernfindez Soto; M. Ruiz Martínez; A. González Jiménez; A. Guijarro Morales; J. de Dios Luna del Castillo

    1991-01-01

    Summary Diabetic patients commonly have increased urinary excretion of zinc, although blood concentrations may be normal, lowered, or raised. We analyzed zinc levels in plasma and urine after an intravenous overload of zinc sulphate (8 mg) in 22 patients with insulin-dependent diabetes mellitus (IDDM) and 22 healthy individuals. No significant differences were found in basal levels of serum zinc in

  3. Elevated vitreous nitric oxide levels in patients with proliferative diabetic retinopathy

    Microsoft Academic Search

    Gürsel Yilmaz; Peter Esser; Norbert Kociek; Pinar Aydin; Klaus Heimann

    2000-01-01

    PURPOSE: The aim of this study was to determine nitric oxide levels in the vitreous of patients with proliferative diabetic retinopathy.METHODS: Using the spectrophotometric method based on Griess reaction, we measured levels of nitrite, the stable product of nitric oxide, in the vitreous of 21 eyes of 21 patients who underwent vitrectomy for the treatment of proliferative diabetic retinopathy with

  4. Invasive rhino-orbito-cerebral mucormycosis in a diabetic patient – the need for prompt treatment

    PubMed Central

    Chow, Vanessa; Khan, Sheema; Balogun, Adeola; Mitchell, David; Mühlschlegel, Fritz A.

    2014-01-01

    Mucormycosis is a rare life threatening fungal infection predominately seen in immunocompromised or diabetic patients. The following case is of a known type II diabetic patient who presented with sepsis and sudden unilateral loss of vision secondary to infective rhino-orbito-cerebral mucormycosis. Treatment of the condition required extensive surgical intervention and medical management for a life saving outcome.

  5. Predicting foot ulcers in patients with diabetes: a systematic review and meta-analysis

    Microsoft Academic Search

    F. Crawford; M. Inkster; J. Kleijnen; T. Fahey

    2006-01-01

    Summary Clinical guidelines recommend that all patients with diabetes should be screened annually to establish their risk of foot ulceration. The aim of this systematic review was to quantify the predictive value of diagnostic tests, physical signs and ele- ments from the patient's history in relation to diabetic foot ulcers. Observational studies were identified from: electronic databases (MEDLINE, EMBASE and

  6. Managing Activity in Patients Who Have Diabetes. Practical Ways to Incorporate Exercise into Lifestyle.

    ERIC Educational Resources Information Center

    Taunton, Jack E.; McCargar, Linda

    1995-01-01

    Diabetes control involves the appropriate balance of exercise, diet, and medication. Regular exercise has many benefits for people with diabetes. Physicians can educate patients about ways to regulate and monitor blood glucose before, during, and after workouts. Patients need to understand the effects of exercise and diet on insulin requirements.…

  7. Localized primary renal aspergillosis in a diabetic patient following lithotripsy – a case report

    Microsoft Academic Search

    Jalaluddin A Haq; Mohammad AM Khan; Nazma Afroze; Tahniyah Haq

    2007-01-01

    BACKGROUND: Primary renal aspergillosis is rare in diabetic patients. Diagnosis of localized primary renal Aspergillus infection in diabetic patients requires careful investigations due to its benign presentation and lack of associated systemic clinical features. There is also paucity of information on the role of conservative treatment of such localized infection with antifungal agents only. Here, we describe a case of

  8. Efficacy of Indapamide SR Compared With Enalapril in Elderly Hypertensive Patients With Type 2 Diabetes

    Microsoft Academic Search

    Juan Garcia Puig; Michel Marre; Franciszek Kokot; Margarita Fernandez; György Jermendy; Lionel Opie; Valentin Moyseev; André Scheen; Constantin Ionescu-Tirgoviste; M. Helena Saldanha; Aaron Halabe; Bryan Williams; Decio Mion; Maximino Ruiz; Kjeld Hermansen; Jaakko Tuomilehto; Bartolomé Finizola; Yves Gallois; Philippe Amouyel; Jean-Pierre Ollivier; Roland Asmar

    2007-01-01

    Background: Blood pressure control is the main influential variable in reducing microalbuminuria in patients with type 2 diabetes. In this subanalysis of the Natrilix SR versus Enalapril Study in hypertensive Type 2 diabetics with micrOalbuminuRia (NESTOR) study, we have compared the effectiveness of indapamide sustained release (SR) and enalapril in reducing blood pressure and microalbuminuria in patients ?65 years of

  9. Efficacy of Indapamide SR Compared With Enalapril in Elderly Hypertensive Patients With Type 2 Diabetes

    Microsoft Academic Search

    Juan Garcia Puig; Michel Marre; Franciszek Kokot; Margarita Fernandez; György Jermendy; Lionel Opie; Valentin Moyseev; André Scheen; Constantin Ionescu-Tirgoviste; Helena Saldanha; Aaron Halabe; Bryan Williams; Decio Mion Jr; Maximino Ruiz; Kjeld Hermansen; Jaakko Tuomilehto; Bartolomé Finizola; Yves Gallois; Philippe Amouyel; Jean-Pierre Ollivier; Roland Asmar

    Background: Blood pressure control is the main in- fluential variable in reducing microalbuminuria in patients with type 2 diabetes. In this subanalysis of the Natrilix SR versus Enalapril Study in hypertensive Type 2 diabetics with micrOalbuminuRia (NESTOR) study, we have com- pared the effectiveness of indapamide sustained release (SR) and enalapril in reducing blood pressure and mi- croalbuminuria in patients

  10. Outcome of Coronary Bypass Surgery Versus Coronary Angioplasty in Diabetic Patients With Multivessel Coronary Artery Disease

    Microsoft Academic Search

    William S Weintraub; Bernardo Stein; Andrzej Kosinski; John S Douglas; Ziyad M. B Ghazzal; Ellis L Jones; Douglas C Morris; Robert A Guyton; Joseph M Craver; Spencer B King

    1998-01-01

    Objectives. This study sought to compare the outcome of percutaneous transluminal coronary angioplasty (PTCA) (n = 834) and coronary artery bypass graft surgery (CABG) (n = 1805) in diabetic patients with multivessel coronary disease from an observational database.Background. There is concern about selection of revascularization in diabetic patients with multivessel coronary artery disease.Methods. Data were collected prospectively and entered into

  11. Effect of sulphated glycosaminoglycans on albuminuria in patients with overt diabetic (type 1) nephropathy

    Microsoft Academic Search

    J. T. Tamsma; F. J. van der Woude; H. H. P. J. Lemkes

    Decreased expression of heparan sulphate has been shown in the glomerular basement membrane of patients with overt diabetic nephropathy. Low- molecular-weight heparin (LMWH) is a highly sulphated glycosaminoglycan with strong structural and functional similarities to heparan sulphate. In a first study, we set out to assess if LMWH could decrease the urinary albumin excretion rate (AER) in diabetic patients with

  12. CHROMIUM SUPPLEMENTATION SHORTENS QTC INTERVAL DURATION IN PATIENTS WITH TYPE 2 DIABETES

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We investigated the potential effects of chromium supplementation on QTc interval duration in patients with type 2 diabetes. Sixty patients with type 2 diabetes mellitus were randomly assigned to two groups. Group A received 1000 'g of chromium as chromium picolinate (CrPic) daily for 3 months, fo...

  13. Invasive rhino-orbito-cerebral mucormycosis in a diabetic patient - the need for prompt treatment.

    PubMed

    Chow, Vanessa; Khan, Sheema; Balogun, Adeola; Mitchell, David; Mühlschlegel, Fritz A

    2015-06-01

    Mucormycosis is a rare life threatening fungal infection predominately seen in immunocompromised or diabetic patients. The following case is of a known type II diabetic patient who presented with sepsis and sudden unilateral loss of vision secondary to infective rhino-orbito-cerebral mucormycosis. Treatment of the condition required extensive surgical intervention and medical management for a life saving outcome. PMID:25750854

  14. Nonenzymatic glycation of epidermal proteins of the stratum corneum in diabetic patients

    Microsoft Academic Search

    I. Mfirovti; J. Záhejský; H. Sehnalovfi

    1995-01-01

    A selected group of diabetic patients showed a statistically significant increase in levels of glycated proteins in the stratum corneum compared with a control group. The values of glycated proteins correlated with those of glycohaemoglobin (GHb), and in diabetic patients also with serum glucose concentrations. The values of glycated proteins (and GHb) exhibited a positive correlation with age both in

  15. Intermediate Monocytes Lead to Enhanced Myocardial Remodelling in STEMI Patients With Diabetes.

    PubMed

    Lu, Wenbin; Zhang, Ziwei; Fu, Cong; Ma, Genshan

    2015-01-21

    This study aimed to evaluate the potential associations of intermediate monocytes (CD14(++)CD16(+)) with myocardial remodelling in ST segment elevation myocardial infarction (STEMI) patients with diabetes.A total of 67 STEMI patients with diabetes were enrolled. The control group consisted of 65 STEMI patients without diabetes. All patients received emergency medical services for reperfusion therapy in less than 12 hours after onset of AMI. Blinded to patient clinical characteristics, monocyte subset analysis was performed using flow cytometry immediately after admission. mRNA of Chemokine Decoy Receptor D6 in each subset of monocytes was validated by Q-PCR. Expression of CCL2 in patient plasma was determined with an Elisa kit. Infarct size and left ventricular ejection fraction (LVEF) were measured using 3-dimensional echocardiography 3 days and 6 months after AMI. The incidences of recurrent cardiovascular events and death in each group were measured using the Kaplan-Meier estimator in follow-up during the next 24 months. Cox proportional-hazard models were further used to analyze the relationship of monocyte cell counts and event-free survival after adjusting for confounding factors.The number of circulating intermediate monocytes was significantly correlated with LVEF% and infarct size (r = -0.32; P = 0.008; r = 0.57, P < 0.001) in STEMI patients with diabetes compared with those without diabetes 6 months after AMI. Chemokine Decoy Receptor D6 transcript levels were lower in intermediate monocytes of STEMI patients with diabetes compared to the subsets in STEMI patients without diabetes (P < 0.001). Higher levels of CCL2 (pg/mL) were observed in STEMI patients with diabetes compared to STEMI patients without diabetes (P < 0.001). During a mean follow-up period of 24 ± 1 month, recurrent cardiovascular events or death occurred in 23 patients belonging to the STEMI with diabetes group and 10 belonging to the control group. Univariate Kaplan-Meier analysis revealed that counts of the intermediate monocytes according to median showed statistical significance in STEMI patients with diabetes (P = 0.010). After full adjustment for confounding factors, the cells were found to remain independently related to recurrent cardiovascular events or death in this group (P = 0.004, 95% CI: 1.62-12.49).Intermediate monocytes were associated with LV remodelling in STEMI patients with diabetes. The cells were predictive for recurrent cardiovascular events or death in these patients. A low level of D6 mRNA in the intermediate monocytes of STEMI patients with diabetes and high level of CCL2 in these patients may partially explain the causality. PMID:25503660

  16. FOXG1 mutations in Japanese patients with the congenital variant of Rett syndrome.

    PubMed

    Takahashi, S; Matsumoto, N; Okayama, A; Suzuki, N; Araki, A; Okajima, K; Tanaka, H; Miyamoto, A

    2012-12-01

    Rett syndrome (RTT) is a severe neurodevelopmental disorder characterized by microcephaly, psychomotor regression, seizures and stereotypical hand movements. Recently, deletions and inactivating mutations in FOXG1, encoding a brain-specific transcription factor that is critical for forebrain development, have been found to be associated with the congenital variant of RTT. Here we report the clinical features and molecular characteristics of two cases of the congenital variant of RTT. We conducted mutation screenings of FOXG1 in a cohort of 15 Japanese patients with a clinical diagnosis of atypical RTT but without MECP2 and CDKL5 mutations. Two unrelated female patients had heterozygous mutations (c.256dupC, p.Gln86ProfsX35 and c.689G>A, pArg230His). Both showed neurological symptoms from the neonatal period, including hypotonia, irritability and severe microcephaly. Further, their psychomotor development was severely impaired, as indicated by their inability to sit unaided or acquire speech sounds, and they had a hyperkinetic movement disorder, because both displayed hand stereotypies and jerky movements of the upper limbs. Brain magnetic resonance imaging scans revealed delayed myelination with hypoplasia of the corpus callosum and frontal lobe. These cases confirm the involvement of FOXG1 in the molecular etiology of the congenital variant of RTT and show the characteristic features of FOXG1-related disorder. PMID:22129046

  17. Fondaparinux prevents venous thromboembolism after joint replacement surgery in Japanese patients

    PubMed Central

    Fujita, Satoru; Ochi, Takahiro

    2007-01-01

    Venous thromboembolism (VTE) is an important complication of major orthopaedic surgery of the lower limbs. Fondaparinux, a synthetic pentasaccharide and highly selective inhibitor of activated Factor Xa, is the first in a new class of antithrombotic agents. To determine the optimal dose in Japanese patients, double-blind, placebo-controlled, dose-ranging studies of fondaparinux were conducted in patients undergoing total knee replacement (TKR) or total hip replacement (THR) surgery. Patients were randomly assigned to receive a once-daily subcutaneous injection of fondaparinux (0.75, 1.5, 2.5, or 3.0 mg) or placebo in Study 1 (TKR) and Study 2 (THR). In Study 1, the incidence of VTE was 65.3% in the placebo group and was 34.2%, 21.3%, 16.2%, and 9.5% in the groups receiving 0.75, 1.5, 2.5, and 3.0 mg fondaparinux respectively. In Study 2, the incidence of VTE was 33.8% in the placebo group and was 24.2%, 4.6%, 7.4%, and 14.4% in the 0.75, 1.5, 2.5, and 3.0 mg fondaparinux groups respectively. Dose–response effects were observed in both studies; however, no statistically significant differences in major bleeding events were found among any groups. Fondaparinux proved to be a potent anticoagulant with a favourable benefit-to-risk ratio in the prevention of VTE in these study patients. PMID:17468868

  18. BRAF V600 mutations and pathological features in Japanese melanoma patients

    PubMed Central

    Tanaka, Ryota; Tsutsumida, Arata; Namikawa, Kenjiro; Eguchi, Hironobu; Omata, Wataru; Oashi, Kohei; Ogawa, Toru; Hayashi, Amiko; Nakamura, Noriyuki; Tsuta, Koji

    2015-01-01

    Ultraviolet radiation is a risk factor for BRAF V600 mutations frequently found in melanomas that cause constitutive BRAF activation. Primary sites of melanoma and the frequency of BRAF mutations might differ between races. Melanoma is rare in Japan (1500–2000 cases/year compared with 132?000/year worldwide) and the frequency and distribution of BRAF V600 mutations are unknown. We aimed to investigate the frequency of BRAF V600 mutations in a cohort of Japanese patients with melanoma and determine the relationship between mutations and clinical/pathologic features. DNA was extracted from 80 formalin-fixed, paraffin-embedded tumours from individuals diagnosed with melanoma. BRAF V600 mutations were detected using the Cobas 4800 System with z480 Analyzer and Cobas 4800 BRAF V600 Mutation Test reagents. BRAF V600 mutations were detected in 41.8% of tested tumours, with an invalid rate of 1.3%. The mutation rate was more than 60% in patients aged less than 60 years and more than 36% in patients with stage III/IV disease. No sex difference in the mutation rate was observed. BRAF V600 mutations were detected in 18.8% of acral lentiginous melanomas (ALMs), 64.7% of superficial spreading melanomas, 50.0% of lentigo maligna melanomas and 20.0% of nodular melanomas. Although the mutation rate was low in ALMs, 36.4% were mutation positive at stage III/IV compared with 9.5% at stage I/II. This study confirmed associations among BRAF V600 mutations, pathological features and subtypes of melanoma. BRAF V600 mutations were more frequent in late-stage ALMs than in early-stage ALMs. Superficial spreading melanomas had similar mutation rates at all stages. These insights suggest improved treatment predictions for stage III/IV melanoma patients. PMID:25051202

  19. Discontinuation of BCG Vaccination Precedes Significant Drop in Type 2 Diabetes in Japanese Children. Role of Inflammation and Cortisol Activity as a Cause of Type 2 Diabetes

    Microsoft Academic Search

    John B. Classen

    2008-01-01

    BCG immunization was routinely given to elementary and junior high school students in Japan until it was abruptly discontinued after 2002. Data on the incidence of type 2 diabetes was analyzed to see if there was a change fol- lowing discontinuation of BCG. The incidence of type 2 diabetes dropped by over 50% in children from Tokyo following discontinuation of

  20. Diabetes - Multiple Languages: MedlinePlus

    MedlinePLUS

    ... ??? (Japanese) Bilingual PDF Health Information Translations GTT (Glucose Tolerance Test) GTT (????????) - ??? (Japanese) Bilingual PDF Health Information Translations Two Reasons I Find Time to Prevent Diabetes: My Future and Theirs ??? (Japanese) PDF National ...

  1. Visual functions and disability in diabetic retinopathy patients

    PubMed Central

    Shrestha, Gauri Shankar; Kaiti, Raju

    2013-01-01

    Purpose This study was undertaken to find correlations between visual functions and visual disabilities in patients with diabetic retinopathy. Method A cross-sectional study was carried out among 38 visually impaired diabetic retinopathy subjects at the Low Vision Clinic of B.P. Koirala Lions Centre for Ophthalmic Studies, Kathmandu. The subjects underwent assessment of distance and near visual acuity, objective and subjective refraction, contrast sensitivity, color vision, and central and peripheral visual fields. The visual disabilities of each subject in their daily lives were evaluated using a standard questionnaire. Multiple regression analysis between visual functions and visual disabilities index was assessed. Result The majority of subjects (42.1%) were of the age group 60–70 years. Best corrected visual acuity was found to be 0.73 ± 0.2 in the better eye and 0.93 ± 0.27 in the worse eye, which was significantly different at p = 0.002. Visual disability scores were significantly higher for legibility of letters (1.2 ± 0.3) and sentences (1.4 ± 0.4), and least for clothing (0.7 ± 0.3). Visual disability index for legibility of letters and sentences was significantly correlated with near visual acuity and peripheral visual field. Contrast sensitivity was also significantly correlated with the visual disability index, and total scores. Conclusion Impairment of near visual acuity, contrast sensitivity, and peripheral visual field correlated significantly with different types of visual disability. Hence, these clinical tests should be an integral part of the visual assessment of diabetic eyes. PMID:24646899

  2. Increased Risk of Myocardial Infarction in Depressed Patients With Type 2 Diabetes

    PubMed Central

    Scherrer, Jeffrey F.; Garfield, Lauren D.; Chrusciel, Timothy; Hauptman, Paul J.; Carney, Robert M.; Freedland, Kenneth E.; Owen, Richard; True, William R.; Lustman, Patrick J.

    2011-01-01

    OBJECTIVE To investigate major depressive disorder (MDD), which complicates the course of type 2 diabetes and is associated with an increased risk of cardiovascular disease and death. This risk may be due to a greater susceptibility for myocardial infarction (MI) in depressed patients with type 2 diabetes compared with nondepressed patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Veterans Administration electronic medical records were analyzed to identify a cohort free of cardiovascular disease in fiscal years 1999 and 2000, aged 25 to 80 years. ICD-9-CM codes were used to create a four-level risk group indicating 1) neither diabetes nor MDD (n = 214,749), 2) MDD alone (n = 77,568), 3) type 2 diabetes alone (n = 40,953), and 4) comorbid MDD and type 2 diabetes (n = 12,679). Age-adjusted Cox proportional hazards models were computed before and after adjusting for baseline sociodemographic and time-dependent covariates. RESULTS After adjusting for covariates, patients with type 2 diabetes alone and patients with MDD alone were at ?30% increased risk for MI, and patients with type 2 diabetes and MDD were at 82% increased risk for MI (hazard ratio 1.82 [95% CI 1.69–1.97]) compared with patients without either condition. CONCLUSIONS Compared with patients with only diabetes or only MDD, individuals with type 2 diabetes and MDD are at increased risk for new-onset MI. Monitoring cardiovascular health in depressed patients with type 2 diabetes may reduce the risk of MI in this especially high-risk group. PMID:21680721

  3. A comparison of cerebral vasomotor reactivity in diabetic and nondiabetic Iranian patients

    PubMed Central

    Moghaddasi, Mehdi; Mamarabadi, Mansoureh; Habibi, Amir Hosein

    2010-01-01

    BACKGROUND: Cerebral microangiopathy is one of the most important complications in diabetes. It may interfere with cerebral vasomotor reactivity (VMR) which may lead to disability, stroke or even death. The aim of the present study was to determine and compare VMR changes in diabetic and non- diabetic patients. METHODS: Fifty three diabetic and 51 non- diabetic patients (with no other vascular abnormality) were recruited. Vasomotor reactivity was evaluated with Trans- Cranial Doppler (TCD) before and after CO2 inhalation. RESULTS: There were 69 (66.30%) males. The mean age was 41.53 ± 17.80 years. The general average of VMR was 5.79 ± 3.00%, the figures in diabetic and nondiabetic patients were 5.31 ± 2.60% and 6.62 ± 2.00%, respectively (p = 0.02). The average of flow velocity (FV) change was 42.47± 29.00 in diabetics and 53.34 ±16.70 in non- diabetic patients (p = 0.04). CONCLUSIONS: It is recommended that such non- invasive method is necessary for evaluation of cerebral vasculature in diabetic patients for better prevention. PMID:21526058

  4. Prefrontal myo-inositol concentration and visuospatial functioning among diabetic depressed patients.

    PubMed

    Haroon, Ebrahim; Watari, Kecia; Thomas, Albert; Ajilore, Olusola; Mintz, Jim; Elderkin-Thompson, Virginia; Darwin, Christine; Kumaran, Senthil; Kumar, Anand

    2009-01-30

    Patients with diabetes mellitus are reported to be at higher risk for developing neuropsychiatric disorders such as dementia and depression. Myo-inositol (mI), a neuronal/glial metabolite associated with multiple functions in the brain, has been shown to be increased in cognitive disorders, depression and diabetes. This study examined whether elevations in dorsolateral (DL) mI of diabetic patients with depression were associated with visuospatial deficits. Diabetic and depressed patients (n=18) were matched with patients with diabetes but without depression (n=20) and control subjects (n=19). Subjects were scored on both the recall and recognition tasks of the Rey-Osterreith Complex Figure (ROCF). Proton magnetic spectroscopy spectra from bilateral prefrontal white matter voxels were used to obtain concentrations of mI. Controls showed negative correlations between mI in right DL white matter and recall and recognition subtests. No correlation was observed for depressed diabetic patients. Correlations for diabetic controls fell midway between the comparison and depressed diabetic groups. The expected pattern of association between mI and visuospatial impairment in the right DL prefrontal region was seen among healthy controls. Progressive weakening of this association across both diabetic groups might be related to progressive changes in neural activity that underlies visuospatial function. PMID:19097871

  5. Central Corneal Thickness and Corneal Endothelial Cell Changes Caused by Contact Lens Use in Diabetic Patients

    PubMed Central

    Leem, Hyun Sung; Lee, Koon Ja; Shin, Ki Cheul

    2011-01-01

    Purpose To analyze the effects of soft contact lenses on central corneal thickness and morphologic characteristics of the corneal endothelium in diabetic patients. Materials and Methods Ultrasound pachymetry and noncontact specular microscopy were performed on 26 diabetic patients who regularly use soft contact lenses (group 1), 27 diabetic patients who do not use soft contact lenses (group 2) and 30 normal subjects (group 3). We compared the values in each group using the Mann-Whitney test. Results The central cornea was found to be thicker in diabetic patients, both those who use and do not use contact lenses, than in the normal control group. The central corneal thickness was significantly higher in group 1 (564.73 ± 35.41 µm) and group 2 (555.76 ± 45.96 µm) than in the control group (534.05 ± 27.02 µm), but there was no statistically significant difference between groups 1 and 2. Endothelial cell density was significantly different between the groups, and was smallest in the group of diabetic patients using contact lenses. The coefficient of variation of cell size was significantly higher and the percentage of hexagonal cells was significantly lower in contact lens using diabetic patients than in non-contact lens using diabetic patients and in the control group. Conclusion Central corneal thickness and endothelial cell density is more affected by diabetes mellitus, and corneal endothelial cell morphology is more affected by contact lens use, when compared with normal subjects. PMID:21319353

  6. Rehabilitation and quality of life in diabetic patients after successful pancreas-kidney transplantation

    Microsoft Academic Search

    Ø. H. Bentdal; P. Fauchald; I. B. Brekke; H. Holdaas; A. Hartmann

    1991-01-01

    Summary  Twenty-seven Type I diabetic patients in end-stage renal failure were followed after combined pancreas-kidney transplantation. All patients received duct-occluded segmental pancreas grafts. Clinical progression of extrarenal diabetic complications was studied in 11 patients with long-term functioning pancreatic and renal transplants (Group 1), and in 16 patients who had lost pancreatic graft function, but retained renal graft function (Group 2). Pretransplant,

  7. Glycemic control and major depression in patients with type 1 and type 2 diabetes mellitus

    Microsoft Academic Search

    Mary de Groot; ALAN M. JACOBSON; JACQUELINE A. SAMSON; Garry Welch

    1999-01-01

    The current study evaluated the association of glycemic control and major depression in 33 type 1 and 39 type 2 diabetes mellitus patients. Type 1 patients with a lifetime history of major depression showed significantly worse glycemic control than patients without a history of psychiatric illness (t=2.09; df=31, p<0.05). Type 2 diabetes patients with a lifetime history of major depression

  8. Lung abscess without sepsis in a patient with diabetes with refractory episodes of spontaneous hypoglycemia: a case report and review of the literature

    PubMed Central

    2014-01-01

    Introduction Hypoglycemia is a cause of considerable morbidity. Although hypoglycemia has been documented in the setting of septic shock and has been associated with higher mortality, hypoglycemia in infection without sepsis has not been reported in the literature. Case presentation A 72-year-old Japanese woman treated with high-dose glucocorticoids for autoimmune hemolytic anemia, as well as intensive insulin therapy for type 2 diabetes, presented with severe hypoglycemia. A lung abscess was diagnosed by imaging studies and treated with intravenous antibiotics. Hypoglycemia spontaneously recurred during lung abscess exacerbations, despite appropriate de-escalation of antidiabetic therapy. Only mild sporadic episodes of hypoglycemia occurred after the lung abscess was controlled. Infection accompanied with malnutrition and immunosuppression, although in the absence of sepsis, may have contributed to hypoglycemia. Conclusions Caution is warranted in the management of hypoglycemia in patients with diabetes with the conditions described here, that is malnutrition and immunosuppression, as infection may be a contributing factor. PMID:24524438

  9. Successful Treatment of a Patient With Complicated Diabetic Foot Wound: A Case Report.

    PubMed

    Zheng, Yurong; Wang, Xingang; Zhang, Liping; You, Chuangang; Feng, Zhanzeng; Han, Chunmao

    2014-04-16

    Foot ulceration is one of the most serious complications of diabetes mellitus and may lead to amputation of the lower extremity. Timely prophylaxis and treatment of diabetic foot ulceration are important to maintain a good quality of life. This article reports a complicated diabetic patient with severe limb-threatening necrotizing infection. We successfully applied endovascular stent insertion, digit amputation, negative pressure wound therapy, and advanced dressings in different wound phases to achieve definitive wound healing after 12 months of treatment. Based on this case report, we would like to emphasize the importance of combined multiple therapies and patient compliance for severe diabetic foot ulcers. PMID:24743750

  10. Variant ALDH2 is associated with accelerated progression of bone marrow failure in Japanese Fanconi anemia patients

    PubMed Central

    Hira, Asuka; Yabe, Hiromasa; Yoshida, Kenichi; Okuno, Yusuke; Shiraishi, Yuichi; Chiba, Kenichi; Tanaka, Hiroko; Miyano, Satoru; Nakamura, Jun; Kojima, Seiji; Ogawa, Seishi; Matsuo, Keitaro

    2013-01-01

    Fanconi anemia (FA) is a severe hereditary disorder with defective DNA damage response and repair. It is characterized by phenotypes including progressive bone marrow failure (BMF), developmental abnormalities, and increased occurrence of leukemia and cancer. Recent studies in mice have suggested that the FA proteins might counteract aldehyde-induced genotoxicity in hematopoietic stem cells. Nearly half of the Japanese population carries a dominant-negative allele (rs671) of the aldehyde-catalyzing enzyme ALDH2 (acetaldehyde dehydrogenase 2), providing an opportunity to test this hypothesis in humans. We examined 64 Japanese FA patients, and found that the ALDH2 variant is associated with accelerated progression of BMF, while birth weight or the number of physical abnormalities was not affected. Moreover, malformations at some specific anatomic locations were observed more frequently in ALDH2-deficient patients. Our current data indicate that the level of ALDH2 activity impacts pathogenesis in FA, suggesting the possibility of a novel therapeutic approach. PMID:24037726

  11. A randomised controlled trial for the evaluation of risk for type 2 diabetes in hypertensive patients receiving thiazide diuretics: Diuretics In the Management of Essential hypertension (DIME) study

    PubMed Central

    Ueda, Shinichiro; Morimoto, Takeshi; Ando, Shin-ichi; Takishita, Shu-ichi; Kawano, Yuhei; Shimamoto, Kazuaki; Ogihara, Toshio; Saruta, Takao

    2014-01-01

    Objectives Thiazide diuretics are one of the first choice antihypertensives but not optimally utilised because of concerns regarding their adverse effects on glucose metabolism. The Diuretics In the Management of Essential hypertension (DIME) study was designed, for the first time, to assess the risk for type 2 diabetes mellitus in patients with essential hypertension during antihypertensive treatment with low-dose thiazide diuretics compared to those not treated with diuretics. Design Multicentre, unblinded, pragmatic, randomised, controlled trial with blinded assessment of end points and intention-to-treat analysis that was started in 2004 and finished in 2012. Setting Hypertension clinics at 106 sites in Japan, including general practitioners’ offices and teaching hospitals. Participants Non-diabetic patients with essential hypertension. Interventions Antihypertensive treatment with low-dose thiazide diuretics at 12.5?mg/day of hydrochlorothiazide or equivalent (Diuretics group) or that without thiazide diuretics (No-diuretics group). Main outcome The primary outcome was new onset of type 2 diabetes diagnosed according to WHO criteria and the criteria of Japanese Society of Diabetes. Results 1130 patients were allocated to Diuretics (n=544) or No-diuretics group (n=586). Complete end point information was collected for 1049 participants after a median follow-up of 4.4?years. Diabetes developed in 25 (4.6%) participants in the Diuretics group, as compared with 29 (4.9%) in the No-diuretics group (HR 0.93; 95% CI 0.55 to 1.58; p=0.800). Conclusions Antihypertensive treatment with thiazide diuretics at low doses may not be associated with an increased risk for new onset of type 2 diabetes. This result might suggest safety of use of low doses of thiazide diuretics. Trial registration number ClinicalTrials.gov NCT00131846. PMID:25031188

  12. Increased plasma soluble endoglin levels as an indicator of cardiovascular alterations in hypertensive and diabetic patients

    PubMed Central

    2010-01-01

    Background Endoglin is involved in the regulation of endothelial function, but there are no studies concerning its relation with hypertension- and diabetes-associated pathologies. Thus, we studied the relationship between plasma levels of soluble endoglin and cardiovascular alterations associated with hypertension and diabetes. Methods We analyzed 288 patients: 64 with type 2 diabetes, 159 with hypertension and 65 healthy patients. We assessed the relationship of soluble endoglin plasma levels measured by enzyme-linked immunosorbent assay with basal glycemia, glycosylated hemoglobin, blood pressure, endothelial dysfunction (assessed by pressure wave velocity), hypertensive retinopathy (by Keith-Wagener classification), left ventricular hypertrophy (by Cornell and Sokolow indexes), cardiovascular risk and target organ (heart, vascular, kidney) damage. Results There are significant correlations between endoglin and glycemia, systolic blood pressure, pulse pressure, pressure wave velocity and electrocardiographically assessed left ventricular hypertrophy. Endoglin levels were significantly higher in patients with diabetes who had nondipper and extreme dipper circadian blood pressure patterns than in dipper circadian patterns, in patients with hypertension and diabetes who had riser pattern than in the other patients, and in patients with diabetes but not hypertension who had extreme dipper pattern than in dipper, nondipper and riser groups. There was also a significant correlation between plasma-soluble endoglin and lower levels of systolic night-day ratio. Higher endoglin levels were found in patients with diabetes who had retinopathy, in patients with diabetes who had a high probability of 10-year cardiovascular risk, and in patients with diabetes and hypertension who had three or more damaged target organs (heart, vessels, kidney) than in those with no organs affected. Conclusions This study shows that endoglin is an indicator of hypertension- and diabetes-associated vascular pathologies as endothelial dysfunction and cardiovascular damage. PMID:21171985

  13. Antiviral effects of peginterferon alpha-2b and ribavirin following 24-week monotherapy of telaprevir in Japanese hepatitis C patients

    Microsoft Academic Search

    Itaru OzekiJun; Jun Akaike; Yoshiyasu Karino; Tomohiro Arakawa; Yasuaki Kuwata; Takumi Ohmura; Takahiro Sato; Naohiro Kamiya; Ichimaro Yamada; Kazuaki Chayama; Hiromitsu Kumada; Joji Toyota

    Background\\/aims  Anemia is commonly observed as a side effect in a treatment with protease inhibitors combined with peginterferon alpha and\\u000a ribavirin for hepatitis C virus infection. This study assessed the safety, tolerability, viral kinetics, and selection of\\u000a variants in telaprevir monotherapy for 24 weeks, and outcomes of the off-study treatment with peginterferon alpha-2b and ribavirin\\u000a among Japanese female patients at a median

  14. Mitochondrial DNA sequence variation in Finnish patients with matrilineal diabetes mellitus

    PubMed Central

    2012-01-01

    Background The genetic background of type 2 diabetes is complex involving contribution by both nuclear and mitochondrial genes. There is an excess of maternal inheritance in patients with type 2 diabetes and, furthermore, diabetes is a common symptom in patients with mutations in mitochondrial DNA (mtDNA). Polymorphisms in mtDNA have been reported to act as risk factors in several complex diseases. Findings We examined the nucleotide variation in complete mtDNA sequences of 64 Finnish patients with matrilineal diabetes. We used conformation sensitive gel electrophoresis and sequencing to detect sequence variation. We analysed the pathogenic potential of nonsynonymous variants detected in the sequences and examined the role of the m.16189?T>C variant. Controls consisted of non-diabetic subjects ascertained in the same population. The frequency of mtDNA haplogroup V was 3-fold higher in patients with diabetes. Patients harboured many nonsynonymous mtDNA substitutions that were predicted to be possibly or probably damaging. Furthermore, a novel m.13762?T>G in MTND5 leading to p.Ser476Ala and several rare mtDNA variants were found. Haplogroup H1b harbouring m.16189?T?>?C and m.3010?G?>?A was found to be more frequent in patients with diabetes than in controls. Conclusions Mildly deleterious nonsynonymous mtDNA variants and rare population-specific haplotypes constitute genetic risk factors for maternally inherited diabetes. PMID:22780954

  15. Bradykinin-forming components in Kuwaiti patients with type 2 diabetes.

    PubMed

    Sharma, J N; Al-Shoumer, K A S; Matar, K M; Al-Gharee, H Y; Madathil, N V

    2013-01-01

    Diabetes is the most common risk factor in inducing hypertension, nephropathy and retinopathy. The bradykinin (BK)-forming system has been proposed to protect cardiovascular and renal functions. We therefore evaluated urinary active and proactive kallikrein, total kininogen, plasma tissue kallikrein, plasma creatinine, plasma glucose and plasma HbA1c in newly diagnosed untreated type 2 diabetic patients and healthy subjects. In diabetic patients, urinary and plasma tissue kallikrein concentrations were significantly increased. In addition, plasma prekallikrein levels were also significantly higher. However, urinary kininogen values were significantly reduced in diabetic patients when compared with healthy subjects. This is the first investigation among Kuwaiti Arab patients with type 2 diabetes showing abnormal activities in the BK-forming system. High levels of plasma prekallikrein may be a risk factor for developing high blood pressure as well as nephropathy. The urinary and plasma tissue kallikrein concentrations were higher in diabetic patients, which could indicate the hyperactivities of these components, and may result in increased levels of plasma glucose to induce diabetes. Furthermore, the urinary kininogen levels were reduced in diabetic patients. These alterations might reflect the utilization of urinary kininogen to form BK, a potent inflammatory agent. However, this hypothesis needs further investigation. PMID:24067466

  16. Psoriasis and type 2 diabetes risk among psoriatic patients in a Spanish population.

    PubMed

    Armesto, Susana; Santos-Juanes, Jorge; Galache-Osuna, Cristina; Martinez-Camblor, Pablo; Coto, Eliecer; Coto-Segura, Pablo

    2012-05-01

    There is accumulating evidence showing a relationship between psoriasis and an increased risk of developing cardiovascular risk factors, including diabetes mellitus type 2 and ischemic heart disease. Our aim was to investigate if there is any difference in the diabetes risk profile among psoriatic patients based on clinical findings. To test this, we carried out a prospective and descriptive hospital-based study. Our results suggest that the highest risk of suffering from diabetes mellitus type 2 among psoriatic patients is in patients suffering from non-familial and late-onset disease and in patients suffering from psoriatic arthritis. PMID:22571562

  17. Patient-provider interaction from the perspectives of type 2 diabetes patients in Muscat, Oman: a qualitative study

    PubMed Central

    Abdulhadi, Nadia; Al Shafaee, Mohammed; Freudenthal, Solveig; Östenson, Claes-Göran; Wahlström, Rolf

    2007-01-01

    Background Patients' expectations and perceptions of the medical encounter and interactions are important tools in diabetes management. Some problems regarding the interaction during encounters may be related to a lack of communication skills on the part of either the physician or the patient. This study aimed at exploring the perceptions of type 2 diabetes patients regarding the medical encounters and quality of interactions with their primary health-care providers. Methods Four focus group discussions (two women and two men groups) were conducted among 27 purposively selected patients (13 men and 14 women) from six primary health-care centres in Muscat, Oman. Qualitative content analysis was applied. Results The patients identified some weaknesses regarding the patient-provider communication like: unfriendly welcoming; interrupted consultation privacy; poor attention and eye contact; lack of encouraging the patients to ask questions on the providers' side; and inability to participate in medical dialogue or express concerns on the patients' side. Other barriers and difficulties related to issues of patient-centeredness, organization of diabetes clinics, health education and professional competency regarding diabetes care were also identified. Conclusion The diabetes patients' experiences with the primary health-care providers showed dissatisfaction with the services. We suggest appropriate training for health-care providers with regard to diabetes care and developing of communication skills with emphasis on a patient-centred approach. An efficient use of available resources in diabetes clinics and distributing responsibilities between team members in close collaboration with patients and their families seems necessary. Further exploration of the providers' work situation and barriers to good interaction is needed. Our findings can help the policy makers in Oman, and countries with similar health systems, to improve the quality and organizational efficiency of diabetes care services. PMID:17925030

  18. Prevalence of diabetes mellitus and impaired fasting blood glucose in patients with Lichen Planus

    PubMed Central

    Majedi, Mehrdad; Peyghambari, Shadi; Ghourchian, Shadi

    2012-01-01

    Background The relationship between Lichen Planus (LP) and diabetes was studied previously, but the results were in conflict. The aim of this study was to find the prevalence of diabetes mellitus (DM) in patients with LP among Iranian patients. Methods In this study, 80 patients with LP were enrolled. They referred to dermatology clinic of our hospital during one year. A self-designed checklist for the study included duration of the disease, the pattern of the distribution of lichenoid lesions and fasting blood sugar (FBS). Results From 80 patients with LP, 16 (20%) had diabetes. Also, 14 patients (17.5%) had impaired fasting glucose. The mean age of diabetic patients was significantly higher than non-diabetic group (p=0.039). In addition, the duration of LP in patients with DM was significantly higher than non-diabetic patients (p=0.024). Conclusion In our study, we saw a high prevalence of DM among patients with LP. Comparing our findings with the overall prevalence of DM in Iran, there was a significant difference between the prevalence of DM among patients with LP and the overall prevalence (p=0.001). Regarding our findings screening for FBS in patients with LP is required in Iran. PMID:23482842

  19. von Willebrand factor and early diabetic retinopathy: no evidence for a relationship in patients with Type 1 (insulin-dependent) diabetes mellitus and normal urinary albumin excretion

    Microsoft Academic Search

    C. D. A. Stehouwer; P. Zellenrath; B. C. P. Polak; G. S. Baarsma; J. J. P. Nauta; A. J. M. Donker; G. J. H. den Ottolander

    1992-01-01

    Summary  High plasma levels of von Willebrand factor, an indicator of endothelial cell dysfunction, have been reported in both diabetic retinopathy and nephropathy. It is unclear, however, whether von Willebrand factor is related to diabetic retinopathy in the absence of diabetic nephropathy. The relationship between retinal status and plasma von Willebrand factor concentration was investigated in a cohort of 17 patients

  20. Fulminant type 1 diabetes in Korea: high prevalence among patients with adult-onset type 1 diabetes

    Microsoft Academic Search

    Y. M. Cho; J. T. Kim; K. S. Ko; B. K. Koo; S. W. Yang; M. H. Park; H. K. Lee; K. S. Park

    2007-01-01

    Aims\\/hypothesis  The aim of this study was to investigate the prevalence of fulminant type 1 diabetes and the clinical characteristics of the\\u000a disease among newly diagnosed Korean patients.\\u000a \\u000a \\u000a \\u000a Methods  Using data retrieved from the Seoul National University Hospital database, we identified all patients newly diagnosed with\\u000a type 1 diabetes from 1 January 1999 to 31 July 2006. Information on clinical manifestations and

  1. Mutation analysis of the MYO7A and CDH23 genes in Japanese patients with Usher syndrome type 1.

    PubMed

    Nakanishi, Hiroshi; Ohtsubo, Masafumi; Iwasaki, Satoshi; Hotta, Yoshihiro; Takizawa, Yoshinori; Hosono, Katsuhiro; Mizuta, Kunihiro; Mineta, Hiroyuki; Minoshima, Shinsei

    2010-12-01

    Usher syndrome (USH) is an autosomal recessive disorder characterized by retinitis pigmentosa and hearing loss. USH type 1 (USH1), the second common type of USH, is frequently caused by MYO7A and CDH23 mutations, accounting for 70-80% of the cases among various ethnicities, including Caucasians, Africans and Asians. However, there have been no reports of mutation analysis for any responsible genes for USH1 in Japanese patients. This study describes the first mutation analysis of MYO7A and CDH23 in Japanese USH1 patients. Five mutations (three in MYO7A and two in CDH23) were identified in four of five unrelated patients. Of these mutations, two were novel. One of them, p.Tyr1942SerfsX23 in CDH23, was a large deletion causing the loss of 3 exons. This is the first large deletion to be found in CDH23. The incidence of the MYO7A and CDH23 mutations in the study population was 80%, which is consistent with previous findings. Therefore, mutation screening for these genes is expected to be a highly sensitive method for diagnosing USH1 among the Japanese. PMID:20844544

  2. Associations of HLA class I alleles in Japanese patients with Crohn's disease.

    PubMed

    Oryoji, D; Hisamatsu, T; Tsuchiya, K; Umeno, J; Ueda, S; Yamamoto, K; Matsumoto, T; Watanabe, M; Hibi, T; Sasazuki, T

    2015-01-01

    Previous studies have suggested that the human leukocyte antigen (HLA) is involved in the etiology of Crohn's disease (CD); however, few reports are available on the association between HLA class I antigens and CD in Japan. In this study, we performed association analysis of HLA class I antigens in CD using 208 Japanese patients and 384 healthy controls. We identified novel positive associations between CD and HLA-A*02:01 (odds ratio (OR)=1.64, P=0.016) and HLA-A*02:07 (OR=2.31, P=0.0067) and confirmed previously reported positive associations between CD and HLA-Cw*14:02 (OR=2.18, P=0.0021) and HLA-B*51:01 (OR=1.70, P=0.033). We also identified novel negative associations between CD and HLA-A*24:02 (OR=0.60, P=0.0047) and HLA-B*07:02 (OR=0.38, P=0.0041). Although the associations were not significant after full Bonferroni correction, we suggested that HLA class I genes have dual functions, susceptibility and resistance in controlling the development of CD. PMID:25373727

  3. Case Reports That Illustrate the Efficacy of SGLT2 Inhibitors in the Type 1 Diabetic Patient

    PubMed Central

    Bell, David S. H.

    2015-01-01

    SGLT2 inhibitors are only approved for use in adults with type 2 diabetes. However, because SGLT2 inhibitors have a mechanism of action that does not require the presence of endogenous insulin, these drugs should also be efficacious in type 1 diabetes where endogenous insulin production is greatly reduced or absent. Herein, I present five cases which illustrate the benefits of utilizing an SGLT2 inhibitor with type 1 diabetes. In these cases the use of SGLT2 inhibitors resulted not only in better glycemic control in most patients but also in some patients' less hypoglycemia, weight loss, and decreased doses of insulin. In type 1 diabetes Candida albicans vaginitis and balanitis may occur more frequently than in type 2 diabetes. These cases show that a large randomized clinical trial of SGLT2 inhibitors in type 1 diabetes needs to be performed.

  4. Potentials of Web 2.0 for Diabetes Education of Adolescent Patients

    NASA Astrophysics Data System (ADS)

    Shabestari, Omid; Roudsari, Abdul

    Diabetes is a very common chronic disease which produces compli-cations in almost all body organs and consumes a huge amount of the health budget. Although education has proved to be useful in diabetes management, there is a great need to improve the availability of these courses for the increasing number of diabetic patients. E-learning can facilitate this service, but the current education system should be tailored towards e-learning standards. Amongst diabetic patients, adolescents as computer natives are suggested as the best target to e-learning diabetes education. With regards to its features, Web 2.0 can be a very good technology to build a framework for diabetes education and consequent evaluation of this education.

  5. LIPID PEROXIDATION AND ANTIOXIDANT STATUS IN PATIENTS WITH DIABETIC RETINOPATHY

    Microsoft Academic Search

    MADHUR M. GUPTA; SURESH CHARI

    Non Insulin Dependent Diabetes Mellitus is responsible for 60% cases of retinopathy in the population and is one of the common cause of blindness. Oxidative stress as measured by the levels of malondialdehyde, superoxide dismutase (SOD), glutathione peroxidase (GPx) and vitamin C was measured in 50 normal controls, 40 diabetics without complications, 22 diabetics with proliferative and 20 with nonproliferative

  6. Analysis of some predictive factors of quality of life among type 2 diabetic patients

    PubMed Central

    Tol, Azar; Sharifirad, Gholamreza; Eslami, Ahmadali; Shojaeizadeh, Davoud; Alhani, Fatemeh; Tehrani, Mohamadreza Mohajeri

    2015-01-01

    Introduction: Considering the chronic nature of diabetes and its significant effect on quality of life of patients, the present study was conducted to evaluate predictors of quality of life in these patients in order to facilitate planning health promotion intervention programs. Materials and Methods: The present study was designed as a cross-sectional study on 140 type 2 diabetic patients of Om-ol-Banin Diabetes Center of Isfahan. Data collection tool was a multidimensional questionnaire including demographic and disease related data (12 items), the standard scale for diabetes distress (17 items), the standard scale for self-efficacy in diabetic patients (8 items), and standard scale for specific quality of life of diabetic patients (15 items). Collected data were evaluated by SPSS version 11.5 using the Chi-square test, Independent T-test, ANOVA, Pearson correlation and multivariate regression analysis. Results: Results showed that the quality of life of diabetic patients had a statistically significant correlation with diabetes distress variable (P < 0.001) and self-efficacy variable (P < 0.001). In this study R2 (predictive power) was 0.66. Multivariate regression model indicated diabetes distress (? = -0.277, P = 0.01) and self-efficacy (? = -0.161, P < 0.001) as variables influencing adjusted self-management for other variables. Conclusion: The result of the present study urges that in planning health promotion interventions in the field of diabetes, more attention be paid to self-efficacy and diabetes distress variables in order to improve the efficiency and effectiveness of the interventions carried out.

  7. Antipsychotics Associated with the Development of Type 2 Diabetes in Antipsychotic-Naïve Schizophrenia Patients

    PubMed Central

    Nielsen, Jimmi; Skadhede, Søren; Correll, Christoph U

    2010-01-01

    Diabetes mellitus occurs in schizophrenia patients at higher rates than in the general population. Reasons for this elevated risk are poorly understood and have not been examined prospectively in antipsychotic-naïve, first-episode patients. This study aims to determine which antipsychotics are associated with diabetes development in antipsychotic-naïve schizophrenia patients. All antipsychotic-naïve patients diagnosed with schizophrenia in Denmark between 01 January 1997 and 31 December 2004, followed until 31 December 2007, allowing for ?3 years follow-up, unless death or diabetes onset occurred. Risk factors for the time to diabetes onset were assessed, including antipsychotics taken for at least 180 defined daily doses in the first year after first antipsychotic prescription (‘initial treatment'). Risk factors for diabetes incidence were assessed, including antipsychotic use within 3 months before diabetes onset or study end (‘current treatment'). Of 7139 patients, followed for 6.6 years (47?297 patient years), 307 developed diabetes (annual incidence rate: 0.65%). Time to diabetes onset was significantly shorter in patients with higher age (hazard ratio (HR): 1.03, confidence interval (CI): 1.02–1.03) and those with ‘initial' treatment of olanzapine (HR: 1.41, CI: 1.09–1.83), mid-potency first-generation antipsychotics (FGAs) (HR: 1.60, CI: 1.07–2.39), antihypertensive (HR: 1.87, CI: 1.13–3.09), or lipid-lowering drugs (HR: 4.67, CI: 2.19–10.00). Significant factors associated with diabetes within 3 month of its development included treatment with low-potency FGAs (odds ratio (OR): 1.52, CI: 1.14–2.02), olanzapine (OR: 1.44, CI: 1.98–1.91), and clozapine (OR: 1.67, CI: 1.14–2.46), whereas aripiprazole was associated with lower diabetes risk (OR: 0.51, CI: 0.33–0.80). In addition to general diabetes risk factors, such as age, hypertension, and dyslipidemia, diabetes is promoted in schizophrenia patients by initial and current treatment with olanzapine and mid-potency FGAs, as well as by current treatment with or low-potency first-generation antipsychotics and clozapine, whereas current aripiprazole treatment reduced diabetes risk. Patients discontinuing olanzapine or mid-potency FGA had no increased risk of diabetes compared with patient not treated with the drugs at anytime. PMID:20520598

  8. High Prevalence of Lower Extremity Peripheral Artery Disease in Type 2 Diabetes Patients with Proliferative Diabetic Retinopathy

    PubMed Central

    Zhao, Dong; Yu, Cai-Guo; Xin, Zhong; Cao, Xi; Shi, Jing; Yang, Guang-Ran; Yuan, Ming-Xia; Yang, Jin-Kui

    2015-01-01

    Little is known about the relationship between lower extremity peripheral arterial disease (PAD) and proliferative diabetic retinopathy (PDR) in type 2 diabetes (T2D). Here, we explored the relationship between sight-threatening PDR and PAD. We screened for diabetic retinopathy (DR) and PAD in hospitalized patients with T2D. Patients with a diabetic duration of more than 10 years, HbA1c ?7.5%, eGFR ?60mL/min/1.73m2 and with PDR or with no diabetic retinopathy (NDR) were eligible for this cross-sectional study. Severities of DR were graded by digital retinal photographs according to the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. We assessed PAD by measuring Ankle Brachial Index (ABI), Toe Brachial Index (TBI) and Doppler ultrasound. Statistical analyses were performed using SPSS 17.0 software. Of the 1544 patients, 169 patients with extreme eye (57 PDR and 112 NDR) phenotypes met the inclusion criteria. Patients with PDR had a significantly higher proportion of low ABI (?0.99) and high ABI (?1.3) than patients with NDR (28.1% and 15.8% vs. 14.3% and 6.2% respectively, P<0.05). PDR patients also had lower TBI than NDR patients (0.56±0.09 vs. 0.61±0.08, P<0.01). The proportion of patients with abnormal duplex ultrasound was higher in PDR than in NDR (21.1% vs. 9.8%, P<0.001). This showed that PDR associated with PAD could be defined in multiple ways: abnormal ABI (?0.9) (OR = 3.61, 95% CI: 1.15–11.26), abnormal TBI (OR = 2.84, 95% CI: 1.19–6.64), abnormal duplex (OR = 3.28, 95% CI: 1.00–10.71), and critical limb ischemia (OR = 5.52, 95% CI: 2.14–14.26). Moreover, PDR was a stronger independent correlation factor for PAD than a diabetic duration of 10 years. In conclusion, PAD is more common in PDR than in NDR. It implies that PDR and PAD are mostly concomitant in T2D. We should focus on screening PAD in patients with PDR in clinical practice. PMID:25822410

  9. Real Life Cancer Comorbidity in Greek Patients with Diabetes Mellitus Followed Up at a Single Diabetes Center: An Unappreciated New Diabetes Complication

    PubMed Central

    Thanopoulou, Anastasia; Pectasides, Demetrios

    2014-01-01

    We determined cancer comorbidity in patients with diabetes followed up at a single Greek academic clinic and investigated the potential related factors. Cancer comorbidity was prospectively recorded for all patients with type 2 (T2DM, n = 759) or type 1 (T1DM, n = 134) diabetes of at least 10-year duration examined during one year. Patient characteristics, diabetes age of onset, duration, treatment, control, and complication rates were compared between subjects with and without cancer. Moreover, a retrospective collection of data from similar patients examined for the first time during the last 25 years, but lost to follow-up, after at least one-year's regular visits, was performed. In regularly followed-up T2DM patients cancer comorbidity was 12.6%. Patients with cancer were older and more frequently smokers. Prostate cancer was the most frequent (24.0%) type. In T1DM cancer comorbidity was 3.0%. Similar rates of comorbidity and types of cancer were observed in lost to follow-up patients. In conclusion, our patients with T2DM of at least 10-year' duration show high cancer comorbidity. No specific characteristics discriminate patients with cancer. Therefore presymptomatic cancer detection and prevention strategies may have to be incorporated into the annual systematic evaluation of our patients. PMID:25136643

  10. Japanese; Japanese Songs.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This supplementary textbook for students of Japanese presents a collection of 43 songs--folk songs, nursery songs, lullabies, love songs, wedding songs, graduation songs, the national anthem, drinking songs, school songs, and Christmas carols. With the exception of the carols, the musical scores are presented with their Japanese lyrics. The…

  11. Lifestyle and glycemic control in Japanese adults receiving diabetes treatment: an analysis of the 2009 Japan Society of Ningen Dock database.

    PubMed

    Takahashi, Eiko; Moriyama, Kengo; Yamakado, Minoru

    2014-05-01

    We investigated the level of glycemic control in 7020 patients treated with diabetes medications. We found that the overall mean HbA1c was 7.3% (56 mmol/mol). Over half had HbA1c levels ?7.0% (53 mmol/mol) and poorer glycemic control was associated with unhealthy lifestyle habits. PMID:24598264

  12. Is there enough information about foot care among patients with diabetes?

    PubMed

    Basu, Subrata; Hadley, Julie; Tan, Rebecca Marie; Williams, Jenny; Shearman, C P

    2004-06-01

    The United Kingdom has a diabetic population of approximately 1.2 million. It is estimated that approximately 15% of all patients with diabetes will develop a foot ulcer in their lifetime. Twenty-five percent of all patients with foot ulcers will have a major amputation. There have been several publications demonstrating a reduction in foot ulcer and amputation rate through a range of active educational programs and ways of improving patient awareness of the problem. The authors' study attempted to establish the amount of information patients with diabetes have about care of their feet. Of 110 patients recruited, 37 (33%) claimed they had never received any information about foot care. Of those who had received advice, approximately half had received information or had access to information over the previous 10 years. In the majority of cases, information had been given once only. In conclusion, 33% of patients with diabetes did not recall receiving any information about foot care. PMID:15866791

  13. Effects of long-term zinc treatment in Japanese patients with Wilson disease: efficacy, stability, and copper metabolism.

    PubMed

    Shimizu, Norikazu; Fujiwara, Junko; Ohnishi, Shin; Sato, Mari; Kodama, Hiroko; Kohsaka, Takao; Inui, Ayano; Fujisawa, Tomoo; Tamai, Hiroshi; Ida, Shinobu; Itoh, Susumu; Ito, Michinori; Horiike, Norio; Harada, Masaru; Yoshino, Makoto; Aoki, Tsugutoshi

    2010-12-01

    Wilson disease is an autosomal recessive disorder with copper metabolism. In Japan, the standard treatment is the administration of copper chelating agents, such as D-penicillamine and trientine. In this study, the authors used zinc acetate to treat Japanese patients with Wilson disease and investigated its efficacy. The 37 patients that comprise this study were found to have Wilson disease using clinical and biochemical tests and were administrated zinc acetate for 48 weeks. The authors followed the clinical symptoms and laboratory findings of the patients by assessing their complete blood counts, biochemical findings, as well as the results of urinalysis and special laboratory tests for copper and zinc metabolism. We also examined side effects of the treatment. Zinc acetate did not aggravate the hepatic or neurological symptoms of any of the patients. Blood biochemical analysis also did not reveal elevation of alanine aminotransferase, aspartate aminotransferase, and ?-glutamyltranspeptidase levels. Zinc treatment did not aggravate the patients' clinical signs and/or laboratory findings. However, it did improve some clinical symptoms of the Wilson disease patients. Although this agent had some side effects, none of them were severe. The authors measured spot urinary copper excretion, which gave an indication of the efficacy of treatment and of the sufficient dosage of zinc. We recommend maintaining a spot urinary copper excretion less than 0.075-?g/mg creatinine. The authors conclude that zinc acetate is an effective and safe treatment for Japanese patients with Wilson disease. PMID:21078496

  14. Pancreatic exocrine function in patients with type 1 and type 2 diabetes mellitus

    Microsoft Academic Search

    P. D. Hardt; A. Krauss; L. Bretz; M. Porsch-Özcürümez; H. Schnell-Kretschmer; E. Mäser; R. G. Bretzel; T. Zekorn; H. U. Klör

    2000-01-01

    Reduced exocrine pancreatic function has been observed in a high percentage of patients with type 1 diabetes in the past.\\u000a There are only few data for type 2 diabetes available and they are contradictory. In this study we investigated exocrine pancreatic\\u000a function in 105 controls and 114 with type 1 or type 2 diabetes mellitus by means of an indirect

  15. Antidiabetic effect of Pycnogenol® French maritime pine bark extract in patients with diabetes type II

    Microsoft Academic Search

    Ximing Liu; Junping Wei; Fengsen Tan; Shengming Zhou; Gudrun Würthwein; Peter Rohdewald

    2004-01-01

    A double-blind, placebo-controlled, randomized, multi-center study was performed with 77 diabetes type II patients to investigate anti-diabetic effects of the French maritime pine bark extract, Pynogenol®. Supplementation with 100 mg Pycnogenol® for 12 weeks, during which a standard anti-diabetic treatment was continued, significantly lowered plasma glucose levels as compared to placebo. HbA1c was also lowered; however, the difference as compared

  16. Diabetes mellitus increases risk for colorectal adenomas in younger patients

    PubMed Central

    Vu, Hongha T; Ufere, Nneka; Yan, Yan; Wang, Jean S; Early, Dayna S; Elwing, Jill E

    2014-01-01

    AIM: To determine if diabetes mellitus (DM) is associated with increased risk of colorectal adenomas in younger subjects. METHODS: This was a retrospective cohort study of 375 patients undergoing index colonoscopy at a single tertiary care center in the United States. Three cohorts of patients matched for exam date and gender were compared: (1) ages 40-49 years with DM; (2) ages 40-49 years without DM; and (3) ages 50-59 years without DM. Data collected included demographics, co-morbidities, colonoscopy and pathology results. Adenoma detection rates (ADR) were calculated and compared. Conditional logistic regression analysis was performed to determine the association between each cohort and ADR. RESULTS: One hundred and twenty-five patients ages 40-49 with DM met study eligibility criteria. Patients in the other two cohorts were r