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. Factors responsible for the evolution of insulin resistance in Japanese type 2 diabetic patients: Association with atherosclerosis

    Microsoft Academic Search

    Ataru Taniguchi; Mitsuo Fukushima; Yoshikatsu Nakai; Akira Kuroe; Michihiro Ohya; Minako Ohgushi; Yutaka Seino

    2007-01-01

    Type 2 diabetes is a heterogeneous syndrome characterized by defective insulin secretion and\\/or insulin resistance. In distinct from Caucasian populations, Japanese type 2 diabetic patients are divided into two categories: one with insulin resistance and the other with normal insulin sensitivity. This unique feature allows us to explore the factors responsible for the evolution of insulin resistance in Japanese type

  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. Effects of liraglutide on postprandial insulin and glucagon responses in Japanese patients with type 2 diabetes

    PubMed Central

    Matsumoto, Shinobu; Yamazaki, Masahiro; Kadono, Mayuko; Iwase, Hiroya; Kobayashi, Kanae; Okada, Hiroshi; Fukui, Michiaki; Hasegawa, Goji; Nakamura, Naoto

    2013-01-01

    This study assessed the endocrine pancreatic responses to liraglutide (0.9 mg once a day) during normal living conditions in Japanese patients with type 2 diabetes. The study included 14 hospitalized patients with type 2 diabetes. Meal tests were performed after improvement of glycemic control achieved by two weeks of multiple insulin injection therapy and after approximately two weeks of liraglutide treatment. Continuous glucose monitoring was performed to compare daily variation in glycemic control between multiple insulin injection therapy and liraglutide treatment. Liraglutide reduced plasma glucose levels after the test meals (60–180 min; p<0.05), as a result of significant increases in insulin secretion (0–180 min; p<0.05) and decreases in the incremental ratio of plasma glucagon (15–60 min; p<0.05). Continuous glucose monitoring showed that liraglutide treatment was also associated with a decrease in glucose variability. We also demonstrated that optimal glycemic control seen as a reduction in 24-h mean glucose levels and variability was obtained only with liraglutide monotherapy. In conclusion, liraglutide treatment increases insulin secretion and suppresses glucagon secretion in Japanese patients with type 2 diabetes under normal living conditions. The main therapeutic advantages of liraglutide are its use as monotherapy and its ability to decrease glucose variability. PMID:23874074

  5. Predictors for Mild and Severe Hypoglycemia in Insulin-Treated Japanese Diabetic Patients

    PubMed Central

    Sonoda, Nao; Morimoto, Akiko; Ugi, Satoshi; Morino, Katsutaro; Sekine, Osamu; Nemoto, Ken-ichi; Godai, Kayo; Maegawa, Hiroshi; Miyamatsu, Naomi

    2015-01-01

    The objective of this study was to explore predictors, including social factors, lifestyle factors, and factors relevant to glycemic control and treatment, for mild and severe hypoglycemia in insulin-treated Japanese diabetic patients. This study included 123 insulin-treated diabetic patients who were referred to the diabetes clinic between January and July 2013 at Shiga University of Medical Science Hospital. After a survey examining the various factors, patients were followed for 6 months. During the follow-up period, blood glucose was self-monitored. Mild hypoglycemia was defined as blood glucose level 50–69 mg/dl, and severe hypoglycemia was defined as blood glucose level ?49 mg/dl. Multinomial logistic regression was used to estimate the adjusted odds ratio (OR) and 95% confidence interval (CI) of each factor for mild and severe hypoglycemia. During the 6-month follow-up period, 41 (33.3%) patients experienced mild hypoglycemia, and 20 (16.3%) experienced severe hypoglycemia. In multivariable-adjusted analyses, assistance from family members at the time of the insulin injection [presence/absence, OR (95% CI): 0.39 (0.16–0.97)] and drinking [current drinker/non- and ex-drinker, OR (95% CI): 4.89 (1.68–14.25)] affected mild hypoglycemia. Assistance from family members at the time of insulin injection [presence/absence, OR (95% CI): 0.19 (0.05–0.75)] and intensive insulin therapy [yes/no, OR (95% CI): 3.61 (1.06–12.26)] affected severe hypoglycemia. In conclusion, our findings suggest that not only a factor relevant to glycemic control and treatment (intensive insulin therapy) but also a social factor (assistance from family members) and a lifestyle factor (current drinking) were predictors for mild or severe hypoglycemia in Japanese insulin-treated diabetic patients. PMID:26102197

  6. Impact of Leisure-Time Physical Activity on Glycemic Control and Cardiovascular Risk Factors in Japanese Patients with Type 2 Diabetes Mellitus: The Fukuoka Diabetes Registry

    PubMed Central

    Kaizu, Shinako; Kishimoto, Hiro; Iwase, Masanori; Fujii, Hiroki; Ohkuma, Toshiaki; Ide, Hitoshi; Jodai, Tamaki; Kikuchi, Yohei; Idewaki, Yasuhiro; Hirakawa, Yoichiro; Nakamura, Udai; Kitazono, Takanari

    2014-01-01

    Aims/hypothesis The effects of leisure-time physical activity (LTPA) on glycemia and cardiovascular risk factors are not fully understood in Asian type 2 diabetic patients, who are typically non-obese. We studied associations between LTPA and glycemia and cardiovascular risk factors in Japanese type 2 diabetic patients. Methods A total of 4,870 Japanese type 2 diabetic patients aged ?20 years were divided into eight groups according to their LTPA. We investigated associations between the amount and intensity levels of physical activity (PA) and glycemic control, insulin sensitivity, cardiovascular risk factors, and low-grade systemic inflammation in a cross-sectional study. Results LTPA was dose-dependently associated with body mass index (BMI), waist circumference, hemoglobin A1c (HbA1c), fasting plasma glucose, homeostasis model assessment of insulin resistance, triglyceride, high density lipoprotein cholesterol, high sensitivity C-reactive protein, and prevalence of metabolic syndrome, but not with blood pressure, low density lipoprotein cholesterol or adiponectin. The amount of PA required to lower HbA1c was greater than that required to improve cardiovascular risk factors. LTPA was inversely associated with HbA1c in non-obese participants but not in obese participants after multivariate adjustments for age, sex, duration of diabetes, current smoking, current drinking, energy intake, cardiovascular diseases, depressive symptoms, and treatment of diabetes. Higher-intensity LTPA, not lower-intensity LTPA was associated with HbA1c after multivariate adjustments with further adjustment including BMI. Conclusions/interpretation LTPA was dose-dependently associated with better glycemic control and amelioration of some cardiovascular risk factors in Japanese type 2 diabetic patients. In addition, increased higher-intensity LTPA may be appropriate for glycemic control. PMID:24897110

  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. Hospitalization for Hypoglycemia in Japanese Diabetic Patients: A Retrospective Study Using a National Inpatient Database, 2008-2012.

    PubMed

    Sako, Akahito; Yasunaga, Hideo; Matsui, Hiroki; Fushimi, Kiyohide; Hamasaki, Hidetaka; Katsuyama, Hisayuki; Tsujimoto, Tetsuro; Goto, Atsushi; Yanai, Hidekatsu

    2015-06-01

    We aimed to elucidate the epidemiology, patient demographics, and clinical outcomes of hospitalization for hypoglycemia in diabetic patients using a Japanese large-scale database.We conducted a retrospective study using a national inpatient database of acute care hospitals in Japan. Diabetic patients ages ?15 years with hypoglycemia as a main diagnosis for hospitalization were eligible. We estimated the annual number of hospitalizations in Japan and compared the annual admission rate by age and treatment groups. We also analyzed the association between patient characteristics and in-hospital mortality.Among 22.7 million discharge records from July 2008 and March 2013, a total of 25,071 patients were eligible. The mean age was 73.4 years, and the mean body mass index (BMI) was 22.3?kg/m. The estimated annual hospitalization for hypoglycemia in Japan was ?20,000. Annual admission rates for hypoglycemia per 1000 diabetic patients and 1000 diabetic patients receiving insulin or oral hypoglycemic agents were 2.1 and 4.1, respectively. Patients <40 years and >70 years old were at a higher risk of hospitalization. In-hospital mortality was 3.8%, and risk factors associated with poor survival were male sex, older age, lower bed capacity, community hospital, low BMI, coma at admission, and higher Charlson Comorbidity Index.To prevent severe hypoglycemia that leads to death and complications, individualized and careful glycemic control are important, especially in very old or young patients and in those with comorbid conditions or low BMI. PMID:26107672

  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. The ?-glucosidase inhibitor miglitol decreases glucose fluctuations and inflammatory cytokine gene expression in peripheral leukocytes of Japanese patients with type 2 diabetes mellitus

    Microsoft Academic Search

    Takeshi Osonoi; Miyoko Saito; Kazuki Mochizuki; Nanae Fukaya; Takeshi Muramatsu; Seiya Inoue; Masahiro Fuchigami; Toshinao Goda

    2010-01-01

    In this study, we examined the effects of switching from acarbose or voglibose to miglitol in type 2 diabetes mellitus patients for 3 months on gene expression of inflammatory cytokines\\/cytokine-like factors in peripheral leukocytes and on glucose fluctuations. We enrolled 47 Japanese patients with type 2 diabetes mellitus, aged 26 to 81 years, with hemoglobin A1c levels ranging from 6.5%

  11. Efficacy and safety of liraglutide monotherapy compared with metformin in Japanese overweight/obese patients with type 2 diabetes.

    PubMed

    Tanaka, Kumiko; Saisho, Yoshifumi; Kawai, Toshihide; Tanaka, Masami; Meguro, Shu; Irie, Junichiro; Imai, Takatoshi; Shigihara, Toshikatsu; Morimoto, Jiro; Yajima, Ken; Atsumi, Yoshihito; Takei, Izumi; Itoh, Hiroshi

    2015-05-31

    There is little information on direct comparison between metformin and glucagon-like peptide-1 (GLP-1) receptor agonists in the Asian population. This study examined the efficacy and safety of liraglutide monotherapy compared with metformin monotherapy in overweight/obese Japanese patients with type 2 diabetes (T2DM). The study was a 24-week, open-labeled, randomized controlled study. Overweight or obese patients with T2DM aged 20-75 years with suboptimal glycemic control were randomized to liraglutide or metformin monotherapy. The primary endpoint was change in HbA1c at week 24. Secondary endpoints included changes in daily glycemic profile, body weight, incidence of hypoglycemia and other adverse events. The study, which was originally planned to enroll 50 subjects in each group, was ended with insufficient recruitment. A total of 46 subjects completed the study, and analysis was conducted in this cohort. Reduction in HbA1c at week 24 was comparable between the metformin (n = 24) and liraglutide (n = 22) groups (-0.95 ± 0.80% vs. -0.80 ± 0.88%, p = 0.77), while the liraglutide group reached maximal reduction more rapidly than did the metformin group. There was no significant difference in weight gain or incidence of hypoglycemia between the groups. Diarrhea was more frequent in the metformin group, while constipation was more frequent in the liraglutide group. There was no significant difference in treatment satisfaction between the groups. In conclusion, liraglutide and metformin monotherapy showed similar reduction in HbA1c during 24 weeks, with no difference in weight gain or incidence of hypoglycemia in overweight or obese Japanese patients with T2DM. PMID:25739726

  12. A long-term follow-up study of Japanese diabetic patients: Mortality and causes of death

    Microsoft Academic Search

    A. Sasaki; M. Uehara; N. Horiuchi; K. Hasagawa

    1983-01-01

    Summary  A systematic 20-year follow-up study of 1,221 diabetic patients was carried out in Osaka, Japan. The mean annual mortality rates were 2.55% for men and 1.64% for women. The ratios of observed to expected numbers of deaths were 1.50 for men and 1.39 for women, indicating an excess mortality for diabetic patients of both sexes, and higher mortality in men

  13. 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

  14. Low programmed cell death-1 (PD-1) expression in peripheral CD4(+) T cells in Japanese patients with autoimmune type 1 diabetes.

    PubMed

    Fujisawa, R; Haseda, F; Tsutsumi, C; Hiromine, Y; Noso, S; Kawabata, Y; Mitsui, S; Terasaki, J; Ikegami, H; Imagawa, A; Hanafusa, T

    2015-06-01

    Programmed cell death-1 (PD-1) is a co-stimulatory molecule that inhibits T cell proliferation. We aimed to clarify PD-1 expression in CD4(+) T cells and the association between PD-1 expression and the 7785C/T polymorphism of PDCD1, with a focus on the two subtypes of type 1 diabetes, type 1A diabetes (T1AD) and fulminant type 1 diabetes (FT1D), in the Japanese population. We examined 22 patients with T1AD, 15 with FT1D, 19 with type 2 diabetes (T2D) and 29 healthy control (HC) subjects. Fluorescence-activated cell sorting (FACS) and real-time PCR were utilized to analyse PD-1 expression quantitatively. Genotyping of 7785C/T in PDCD1 was performed using the TaqMan method in a total of 63 subjects (21 with T1AD, 15 with FT1D and 27 HC). FACS revealed a significant reduction in PD-1 expression in CD4(+) T cells in patients with T1AD (mean: 4·2 vs. 6·0% in FT1D, P?=?0·0450; vs. 5·8% in T2D, P = 0·0098; vs. 6·0% in HC, P?=?0·0018). PD-1 mRNA expression in CD4(+) T cells was also significantly lower in patients with T1AD than in the HC subjects. Of the 63 subjects, PD-1 expression was significantly lower in individuals with the 7785C/C genotype than in those with the C/T and T/T genotypes (mean: 4·1 vs. 5·9%, P?=?0·0016). Our results indicate that lower PD-1 expression in CD4(+) T-cells might contribute to the development of T1AD through T cell activation. PMID:25682896

  15. 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

  16. Lack of association between the heparan sulfate proteoglycan gene polymorphism and diabetic nephropathy in Japanese NIDDM with proliferative diabetic retinopathy.

    PubMed

    Fujita, H; Narita, T; Meguro, H; Ishii, T; Hanyu, O; Suzuki, K; Ito, S

    1999-11-01

    The development of diabetic nephropathy shows remarkable variation among individuals. Therefore, not only hyperglycemia but also genetic factors may contribute to the development of diabetic nephropathy Heparan sulfate proteoglycan (HSPG) is thought to play an important role as a component of the charge selectivity barrier in the glomerular basement membrane. Recently, a BamHI restriction fragment length polymorphism (RFLP) in the HSPG gene (HSPG2) was reported to be associated with diabetic nephropathy in Caucasian insulin-dependent diabetes mellitus (IDDM). The aim of the present study was to examine the contribution of the BamHI HSPG2 polymorphism to the development of diabetic nephropathy in Japanese non-insulin-dependent diabetes mellitus (NIDDM). For this purpose, we recruited 102 patients with diabetic nephropathy and 64 age-matched patients without diabetic nephropathy from Japanese NIDDM patients. Since all the subjects had proliferative diabetic retinopathy, it seems likely that they would be exposed to hyperglycemia for a long time. In the present study, the BamHI HSPG2 genotype and allele frequencies were not significantly different between the patients with nephropathy and the patients without nephropathy. Therefore, we conclude that the BamHI HSPG2 polymorphism is not associated with the development of diabetic nephropathy in Japanese NIDDM. PMID:10586428

  17. Efficacy and safety of canagliflozin in Japanese patients with type 2 diabetes: a randomized, double-blind, placebo-controlled, 12-week study†

    PubMed Central

    Inagaki, N; Kondo, K; Yoshinari, T; Maruyama, N; Susuta, Y; Kuki, H

    2013-01-01

    Aims We examined the efficacy, safety and tolerability of canagliflozin, a sodium glucose co-transporter 2 inhibitor, in Japanese patients with type 2 diabetes (T2DM) undergoing diet and exercise therapy. Methods Patients aged 20–80?years with T2DM diagnosed ?3?months previously, and HbA1c of 6.9–9.9% were randomized to 50, 100, 200 or 300?mg canagliflozin or placebo once daily for 12?weeks. The primary and secondary endpoints were changes in HbA1c, fasting plasma glucose (FPG), urinary glucose/creatinine and postprandial glycaemic parameters following a meal test. The safety assessments included adverse events (AEs) and clinical laboratory tests. Results Overall, 383 patients were randomized to receive either placebo (n?=?75), or 50?mg (n?=?82), 100?mg (n?=?74), 200?mg (n?=?77) or 300?mg canagliflozin (n?=?75). At week 12, significant reductions in HbA1c were observed in all canagliflozin groups relative to placebo (?0.61, –0.80, –0.79 and ?0.88% for 50, 100, 200 and 300?mg, respectively, versus +0.11% for placebo; all, p?Japanese patients with T2DM. Canagliflozin was well tolerated. PMID:23782594

  18. Anti-albuminuric effect of losartan versus amlodipine in hypertensive Japanese patients with type 2 diabetes mellitus: A prospective, open-label, randomized, comparative study

    PubMed Central

    Ohno, Yasuhiro; Nishimura, Akiyoshi; Iwai, Hiroshi; Hirota, Noriyuki; Yamauchi, Takaaki; Fujimoto, Mika; Miyatake, Toshiyuki; Arai, Hiroshi; Aoki, Norihiko

    2007-01-01

    Abstract Background The antiproteinuric effect of the angiotensin II receptor-antagonist losartan has been observed in patients with type 2 diabetes mellitus (T2DM). Proteinuria is considered to be a predictor of the progression of kidney disease. Objective The aims of the present study were to compare and examine the ability of losartan and amlodipine to ameliorate albuminuria in hypertensive Japanese patients (systolic blood pressure ?140 mm Hg or diastolic blood pressure ?90 mm Hg) with T2DM and whether the change in albuminuria was associated with a change in glomerular filtration rate (GFR). Methods This prospective, open-label, randomized, comparative study was conducted over 3 months at the Kinki University School of Medicine, Osaka-Sayama, Japan. Hypertensive patients with T2DM were enrolled and randomly assigned to 1 of 2 study groups receiving either losartan (25–100 mg/d) or the calcium channel-blocker amlodipine (2.5–5 mg/d). Urinary albumin excretion (UAE), creatinine clearance, and GFR were recorded at study initiation (baseline) and study end (month 3). The GFR was measured from the fractional renal accumulation of 99mTc-diethylenetriaminepentaacetic acid. Adverse events (AEs) were monitored by a clinical research nurse during the examination. Results Fifty patients were asked to enroll and 38 returned the informed written consent. Thirty-five Japanese patients were included in the final study analysis. Seventeen patients were assigned to the losartan group (male sex, 10 [58.8%]; mean [SD] age, 58.1 [8.2] years) and 18 were assigned to the amlodipine group (male sex, 10 [55.6%]; mean [SD] age, 57.4 [8.9] years); no significant between-group difference in demographics was observed. A significant decrease from baseline to month 3 of mean (SD) UAE was observed in the losartan group (352.5 [556.6] mg/d vs 275.7 [466.1] mg/d; P = 0.048). No significant difference in mean (SD) UAE was observed in the amlodipine group for the same time period (298.2 [416.6] mg/d vs 322.7 [415.4] mg/d). There was a statistically significant difference found in the mean (SD) percent change of UAE from baseline to month 3 in the losartan group compared with the amlodipine group (?23.52 [28.42] vs +27.90 [63.51]; P = 0.004). Neither group was associated with a significant change in GFR during the course of the study. No patient discontinued the study due to AEs that were considered, by the investigator, to be possibly or probably associated with study treatment. Conclusions Treatment with losartan, but not amlodipine, was associated with a reduction in albuminuria in these hypertensive Japanese patients with T2DM within a period as short as 3 months. Neither drug was associated with a significant change in GFR. Therefore, the reduction of UAE was independent of a change in the GFR. PMID:24678123

  19. Burns in diabetic patients

    PubMed Central

    Maghsoudi, Hemmat; Aghamohammadzadeh, Naser; Khalili, Nasim

    2008-01-01

    CONTEXT AND AIMS: Diabetic burn patients comprise a significant population in burn centers. The purpose of this study was to determine the demographic characteristics of diabetic burn patients. MATERIALS AND METHODS: Prospective data were collected on 94 diabetic burn patients between March 20, 2000 and March 20, 2006. Of 3062 burns patients, 94 (3.1%) had diabetes; these patients were compared with 2968 nondiabetic patients with burns. Statistical analysis was performed using the statistical analysis software SPSS 10.05. Differences between the two groups were evaluated using Student's t-test and the chi square test. P < 0.05 was considered as significant. RESULTS: The major mechanism of injury for the diabetic patients was scalding and flame burns, as was also the case in the nondiabetic burn patients. The diabetic burn patients were significantly older, with a lower percentage of total burn surface area (TBSA) than the nondiabetic burn population. There was significant difference between the diabetic and nondiabetic patients in terms of frequency of infection. No difference in mortality rate between diabetic and nondiabetic burn patients was observed. The most common organism in diabetic and nondiabetic burn patients was methicillin-resistant staphylococcus. Increasing %TBSA burn and the presence of inhalation injury are significantly associated with increased mortality following burn injury. CONCLUSIONS: Diabetics have a higher propensity for infection. Education for diabetic patients must include caution about potential burn mishaps and the complications that may ensue from burns. PMID:19902035

  20. Effects of metabolic and myocardial microcirculatory abnormalities on the pathogenesis of cardiac autonomic neuropathy in type 2 diabetes mellitus: A prospective study in Japanese patients*

    PubMed Central

    Komori, Hiromi

    2005-01-01

    Background: In diabetic patients, cardiac autonomic neuropathy is an important factor affecting prognosis. Whether this condition in diabetic patients is caused directly by neurovisceral metabolic disorder and/or indirectly by micro circulation remains to be clarified. Objective: The aim of this study was to determine whether cardiac sympathetic nerve dysfunction can be detected using adenosine triphosphate (ATP) testing, while also investigating the effects of metabolic and/or myocardial microcirculatory abnormalities on the pathogenesis of cardiac autonomic nerve dysfunction in patients with type 2 diabetes mellitus (DM-2) in Japan. Methods: This prospective study was performed at the Division of Diabetology Department of Internal Medicine, Toho University, Ohashi Hospital, Tokyo, Japan. Patients aged ? 18 years with DM-2 with no abnormalities on electrocardiography (ECG) or echocardiography were enrolled. An ATP thallium (Tl)-201 myocardial scintigraphy test (ATP test) and iodine (I)-123 metaiodobenzylguanidine (MIBG) scintigraphy were performed. ATP was administered by continuous IV infusion over 6 minutes at 0.16 mg/kg · min. Five minutes after the ATP infusion was started, T1-201 111 MBq IV was administered. Single-photon emission computed tomography (SPECT) imaging was begun immediately after the end of ATP infusion and was completed 3 hours after stress to show washout from stress to rest. I-123 MIBG 111 MBq IV was administered. A planar image from the front side and a SPECT image (early phase) was obtained 15 to 30 minutes later. After 3 hours, a planar image from the front side and a SPECT image (late phase) were obtained to show washout from stress to rest. The mean TI washout rate (ATP-WR) and heart-to-mediastinum (H/M) ratio in the late-phase scintigraphic images and the washout rate of MIBG (MIBG-WR) in the left ventricle was determined. The correlations of these measurements with the mean values of glycosylated hemoglobin (HbA1c) and fasting plasma glucose obtained from monthly measurements over the previous 6 and 24 months were determined. Results: A total of 25 patients were enrolled (13 men, 12 women; mean [SD] age, 59.86 [8.28] years). Significant negative correlations between both ATP-WR and MIBG-WR and HbA1c were found (r = -0.52 [P = 0.02] and ?0.47 [P = 0.03], respectively). Although no correlation was found between ATP-WR values and the early phase H/M ratio, a significant positive correlation was observed between ATP-WR and H/M ratio (r = 0.54; P = 0.02). Conclusions: In the present study in Japanese diabetic patients without subjective signs of coronary artery disease and without abnormalities on ECG or echocardiography, ATP-WR, an indicator of myocardial blood flow, was correlated with myocardial sympathetic nerve dysfunction and 24-month glycemic control. However, sympathetic nerve dysfunction was not correlated with 24-month glycemic control. PMID:24678078

  1. 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

  2. Rehabilitation in diabetic patients.

    PubMed

    Zdrenghea, D; Pop, Dana; Penciu, Oana; Zdrenghea, V; Zdrenghea, M

    2009-01-01

    Physical activity is very important for diabetic patients. In normal subjects physical activity postpones diabetes mellitus and in diabetic patients postpones the cardiovascular complications. In diabetic patients with cardiovascular disease, physical training increases exercise capacity, decreases complications and prolongs survival. Physical activity can be applied in diabetic patients as physical activity counseling or physical training, the second being recommended to be ambulatory and supervised but, sometimes, also home rehabilitation can be useful. Aerobic exercises, but also resistance exercises will be applied for a 30-60 min duration at least 3x/ week, recommended 5x/ week, and optimal every day. Some specific aspects of diabetic patients as hyper or hypoglycemia, autonomic or peripheral neuropathy, retinopathy, have to be considered during physical rehabilitation and sometimes physical training has to be modulated according to them. In conclusion, physical activity and training represent a real chance for every diabetic patient and has to be recommended and applied in all of them. PMID:21179912

  3. 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

  4. Association between subclinical hypothyroidism and diabetic nephropathy in patients with type 2 diabetes mellitus.

    PubMed

    Furukawa, Shinya; Yamamoto, Shin; Todo, Yasuhiko; Maruyama, Kotatsu; Miyake, Teruki; Ueda, Teruhisa; Niiya, Tetsuji; Senba, Takatoshi; Torisu, Masamoto; Kumagi, Teru; Miyauchi, Syozo; Sakai, Takenori; Minami, Hisaka; Miyaoka, Hiroaki; Matsuura, Bunzo; Hiasa, Yoichi; Onji, Morikazu; Tanigawa, Takeshi

    2014-01-01

    Subclinical hypothyroidism (SCH) has been associated with type 2 diabetes mellitus. However, it is unknown whether common complications of type 2 diabetes, such as diabetic nephropathy, are also present with SCH. Here, we investigated the association between SCH and diabetic nephropathy among Japanese patients with type 2 diabetes mellitus. In this multicenter cross-sectional study, we recruited 414 such patients who had no previous history of thyroid disease. Serum thyroid hormone levels and the urinary albumin:creatinine ratio were measured. SCH was defined as an elevated thyroid-stimulating hormone (TSH) level (>4.0 mIU/L), and diabetic nephropathy was defined as urinary albumin/creatinine ratio ?300 mg/g. The prevalence of SCH was 8.7% (n = 36) among patients with type 2 diabetes mellitus. The SCH group had a higher prevalence of dyslipidemia (p = 0.008) and diabetic nephropathy (p = 0.014) than the euthyroid group. Multivariate analysis identified significant positive associations between diabetic nephropathy and SCH (odds ratio [OR], 3.51; 95% confidence interval [CI], 1.10-10.0; p = 0.034), hypertension (OR, 4.56; 95% CI, 1.69-14.7; p = 0.001), and smoking (OR, 3.02; 95% CI, 1.14-7.91; p = 0.026). SCH may be independently associated with diabetic nephropathy in Japanese patients with type 2 diabetes mellitus. PMID:25100149

  5. 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)

  6. A Single Nucleotide Polymorphism in KCNQ1 Is Associated With Susceptibility to Diabetic Nephropathy in Japanese Subjects With Type 2 Diabetes

    PubMed Central

    Ohshige, Toshihiko; Tanaka, Yasushi; Araki, Shin-ichi; Babazono, Tetsuya; Toyoda, Masao; Umezono, Tomoya; Watada, Hirotaka; Suzuki, Daisuke; Iwamoto, Yasuhiko; Kawamori, Ryuzo; Nakamura, Yusuke; Maeda, Shiro

    2010-01-01

    OBJECTIVE Genetic factors have been considered to contribute to the development and progression of diabetic nephropathy. The KCNQ1 gene (potassium voltage-gated channel, KQT-like subfamily, member 1) was originally identified as a strong susceptibility gene for type 2 diabetes in two Japanese genome-wide association studies. In this study, we examined the association of single nucleotide polymorphisms (SNPs) within KCNQ1 with diabetic nephropathy in Japanese subjects with type 2 diabetes. RESEARCH DESIGN AND METHODS We genotyped 33 SNPs in KCNQ1 using 754 type 2 diabetic patients with overt nephropathy and 558 control subjects (an initial study), and we further examined the association of a candidate SNP using three other independent Japanese populations (replications 1–3). RESULTS We found that five SNPs were nominally associated with diabetic nephropathy, and the association of rs2237897 was the strongest. We also found that the T allele frequencies of rs2237897 were consistently higher in the nephropathy groups than in the control groups for all study populations (initial study: 0.33 vs. 0.27; replication 1: 0.32 vs. 0.30; replication 2: 0.33 vs. 0.28; and replication 3: 0.32 vs. 0.28), although the individual associations did not reach statistically significant levels. Combined analysis by a meta-analysis revealed that the T allele of rs2237897 was significantly associated with susceptibility to diabetic nephropathy in Japanese subjects with type 2 diabetes (odds ratio 1.22 [95% CI 1.10–1.34], P = 3.1 × 10–4, corrected P = 0.01). CONCLUSIONS These results suggest that KCNQ1 is a new candidate gene for conferring susceptibility to diabetic nephropathy. PMID:20056949

  7. Daily Physical Activity Assessed by a Triaxial Accelerometer Is Beneficially Associated with Waist Circumference, Serum Triglycerides, and Insulin Resistance in Japanese Patients with Prediabetes or Untreated Early Type 2 Diabetes

    PubMed Central

    Hamasaki, Hidetaka; Noda, Mitsuhiko; Moriyama, Sumie; Yoshikawa, Reo; Katsuyama, Hisayuki; Sako, Akahito; Mishima, Shuichi; Kakei, Masafumi; Ezaki, Osamu; Yanai, Hidekatsu

    2015-01-01

    Aim. To investigate the association between daily physical activity and metabolic risk factors in Japanese adults with prediabetes or untreated early type 2 diabetes (T2D). Methods. Daily physical activity level was measured using a triaxial accelerometer. We assessed correlations between physical activity level and waist circumference, blood pressure, fasting levels of plasma glucose, serum triglycerides, and insulin and homeostasis model assessment-insulin resistance (HOMA-IR). Results. A total of 80 patients were studied. After adjustment for age and body mass index, in all subjects, physical activity level was negatively associated with waist circumference (? = ?0.124, P = 0.018) and fasting serum triglycerides (? = ?0.239, P = 0.035), insulin (? = ?0.224, P = 0.022). In men, physical activity level was negatively associated with systolic blood pressure (? = ?0.351, P = 0.044), fasting plasma glucose (? = ?0.369, P = 0.025) and insulin (? = ?0.362, P = 0.012), and HOMA-IR (? = ?0.371, P = 0.011). No significant associations were found between physical activity level and metabolic risk factors in women. Conclusion. Objectively measured daily physical activity is beneficially associated with waist circumference, serum triglycerides, and insulin resistance in individuals with prediabetes or untreated early T2D. (This trial is registered with UMIN000015774.)

  8. The diabetic patient in Ramadan.

    PubMed

    Chamsi-Pasha, Hassan; Aljabri, Khalid S

    2014-04-01

    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

  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. [Communication during hospitalization of Japanese immigrant patients].

    PubMed

    Chubaci, Rosa Yuka Sato; Merighi, Miriam Aparecida Barbosa

    2002-01-01

    Communication--verbal or non-verbal--during hospitalization is an important tool to provide a new way of looking and acting to nursing professionals. Based on the consideration that the understanding about the disease and hospitalization can be impaired due to the difficulty in understanding the Portuguese language, the authors carried out the present study aiming at evaluating the importance of the communication during hospitalization. In order to unveil the experience of these subjects, the authors developed a qualitative investigation with a phenomenological approach. Authors interviewed 17 Japanese immigrants at a hospital in the city of São Paulo. Results showed that the difficulty in speaking Portuguese interfered in the patients' understanding about the disease, its treatment and the relationship with the health team, enhancing the feeling of insecurity and demonstrating that culture does play an important role on these patients' behavior and attitudes concerning the disease and hospitalization. PMID:12696552

  13. CARBOPLATIN DOSING FOR ADULT JAPANESE PATIENTS

    PubMed Central

    ANDO, YUICHI; SHIMOKATA, TOMOYA; YASUDA, YOSHINARI; HASEGAWA, YOSHINORI

    2014-01-01

    ABSTRACT Carboplatin is a platinum-based anticancer drug that has been long used to treat many types of solid cancer. Because the clearance of carboplatin strongly correlates with the glomerular filtration rate (GFR), its dosage is calculated with the Calvert formula on the basis of the patient’s GFR to achieve the target area under the plasma drug concentration-time curve (AUC) for each patient. However, many lines of evidence from previous clinical studies should be interpreted with caution because different methods were used to estimate drug clearance and derive the dosage of carboplatin. There is a particularly high risk of carboplatin overdosing when the dosage is determined on the basis of standardized serum creatinine values. When deciding the dose of carboplatin for adult Japanese patients, preferred methods to assess renal function instead of directly measuring GFR include (1) 24-h urinary collection-based creatinine clearance adjusted by adding 0.2 mg/dl to the serum creatinine concentration measured by standardized methods, and (2) equation-based GFR (eGFR) with a back calculation to units of ml/min per subject. Given the limitations of serum creatinine-based GFR estimations, the GFR or creatinine clearance should be directly measured in each patient whenever possible. To ensure patient safety and facilitate a medical-team approach, the single most appropriate method available at each institute or medical team should be consistently used to calculate the dose of carboplatin with the Calvert formula. PMID:25129986

  14. 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

  15. Association of severe hypoglycemia with depressive symptoms in patients with type 2 diabetes: the Fukuoka Diabetes Registry

    PubMed Central

    Kikuchi, Yohei; Iwase, Masanori; Fujii, Hiroki; Ohkuma, Toshiaki; Kaizu, Shinako; Ide, Hitoshi; Jodai, Tamaki; Idewaki, Yasuhiro; Nakamura, Udai; Kitazono, Takanari

    2015-01-01

    Objective Although many studies have investigated the clinical characteristics of patients with diabetes with depression in Western populations, there is a lack of information regarding other ethnicities. We studied the association between clinical characteristics and depressive symptoms in Japanese patients with type 2 diabetes. Methods A total of 4218 Japanese patients with type 2 diabetes who were not taking antidepressants were divided into four groups according to the Center for Epidemiologic Studies Depression Scale (CES-D) score. The relationship between the severity of depressive symptoms and clinical parameters was examined cross-sectionally. Results After multivariate adjustments, the severity of depressive symptoms was significantly associated with body mass index, leisure-time physical activity, current smoking, sleep duration, sucrose intake, skipping breakfast, insulin use, severe hypoglycemia, dysesthesia of both feet, history of foot ulcer, photocoagulation, ischemic heart disease, and stroke. ORs for severe hypoglycemia increased significantly with the CES-D score in 2756 sulfonylurea and/or insulin-treated patients after multivariate adjustment including age, sex, duration of diabetes, glycated hemoglobin, insulin use, self-monitoring of blood glucose, leisure-time physical activity, skipping breakfast, dysesthesia of both feet, ischemic heart disease, and stroke (CES-D score ?9, referent; 10–15, OR 1.64; 16–23, OR 2.09; ?24, OR 3.66; p for trend <0.01). Conclusions Severe hypoglycemia was positively associated with the severity of depressive symptoms in Japanese patients with type 2 diabetes independent of glycemic control, insulin therapy, lifestyle factors, and diabetic complications. As both severe hypoglycemia and depression are known risk factors for morbidity and mortality in patients with diabetes, clinicians should be aware of this association. UMIN Clinical Trial Registry 000002627. PMID:26019877

  16. The Influence of a Single Nucleotide Polymorphism within CNDP1 on Susceptibility to Diabetic Nephropathy in Japanese Women with Type 2 Diabetes

    PubMed Central

    Kurashige, Mahiro; Imamura, Minako; Araki, Shin-ichi; Suzuki, Daisuke; Babazono, Tetsuya; Uzu, Takashi; Umezono, Tomoya; Toyoda, Masao; Kawai, Koichi; Imanishi, Masahito; Hanaoka, Kazushige; Maegawa, Hiroshi; Uchigata, Yasuko; Hosoya, Tatsuo; Maeda, Shiro

    2013-01-01

    Background Several linkage analyses have mapped a susceptibility locus for diabetic nephropathy to chromosome 18q22–23, and polymorphisms within the carnosine dipeptidase 1 gene (CNDP1), located on 18q22.3, have been shown to be associated with diabetic nephropathy in European subjects with type 2 diabetes. However, the association of this locus with diabetic nephropathy has not been evaluated in the Japanese population. In this study, we examined the association of polymorphisms within the CNDP1/CNDP 2 locus with diabetic nephropathy in Japanese subjects with type 2 diabetes. Methodology/Principal Findings We genotyped a leucine repeat polymorphism (D18S880) that is within CNDP1 along with 29 single nucleotide polymorphisms (SNPs) in the CNDP1/CNDP2 locus for 2,740 Japanese subjects with type 2 diabetes (1,205 nephropathy cases with overt nephropathy or with end-stage renal disease [ESRD], and 1,535 controls with normoalbuminuria). The association of each polymorphism with diabetic nephropathy was analysed by performing logistic regression analysis. We did not observe any association between D18S880 and diabetic nephropathy in Japanese subjects with type 2 diabetes. None of the 29 SNPs within the CNDP1/CNDP2 locus were associated with diabetic nephropathy, but a subsequent sex-stratified analysis revealed that 1 SNP in CNDP1 was nominally associated with diabetic nephropathy in women (rs12604675-A; p?=?0.005, odds ratio [OR]?=?1.76, 95% confidence interval [CI], 1.19?2.61). Rs12604675 was associated with overt proteinuria (p?=?0.002, OR?=?2.18, 95% CI, 1.32?3.60), but not with ESRD in Japanese women with type 2 diabetes. Conclusions/Significance Rs12604675-A in CNDP1 may confer susceptibility to overt proteinuria in Japanese women with type 2 diabetes. PMID:23342076

  17. 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

  18. Association between new onset diabetic retinopathy and monocyte chemoattractant protein-1 (MCP-1) polymorphism in Japanese type 2 diabetes.

    PubMed

    Ninomiya, Hiroyo; Katakami, Naoto; Osonoi, Takeshi; Saitou, Miyoko; Yamamoto, Yuichi; Takahara, Mitsuyoshi; Kawamori, Dan; Matsuoka, Taka-Aki; Yamasaki, Yoshimitsu; Shimomura, Iichiro

    2015-06-01

    We longitudinally evaluated the association between monocyte chemoattractant protein-1 (MCP-1) A-2518G polymorphism and new onset of diabetic retinopathy in 758 type 2 diabetic patients. The new onset of retinopathy increased with the increase of the number of G alleles, even after adjustment for age, HbA1c levels, and duration of diabetes. PMID:25913234

  19. Circulating betatrophin is elevated in patients with type 1 and type 2 diabetes.

    PubMed

    Yamada, Hodaka; Saito, Tomoyuki; Aoki, Atsushi; Asano, Tomoko; Yoshida, Masashi; Ikoma, Aki; Kusaka, Ikuyo; Toyoshima, Hideo; Kakei, Masafumi; Ishikawa, San-E

    2015-05-31

    There is evidence that betatrophin, a hormone derived from adipose tissue and liver, affects the proliferation of pancreatic beta cells in mice. The aim of this study was to examine circulating betatrophin concentrations in Japanese healthy controls and patients with type 1 and type 2 diabetes. A total of 76 subjects (12 healthy controls, 34 type 1 diabetes, 30 type 2 diabetes) were enrolled in the study. Circulating betatrophin was measured with an ELISA kit and clinical parameters related to betatrophin were analyzed statistically. Circulating betatrophin (Log transformed) was significantly increased in patients with diabetes compared with healthy subjects (healthy controls, 2.29 ± 0.51; type 1 diabetes, 2.94 ± 0.44; type 2 diabetes, 3.17 ± 0.18; p<0.001, 4.1 to 5.4 times in pg/mL order). Age, HbA1c, fasting plasma glucose and Log triglyceride were strongly associated with Log betatrophin in all subjects (n=76) in correlation analysis. In type 1 diabetes, there was a correlation between Log betatrophin and Log CPR. These results provide the first evidence that circulating betatrophin is significantly elevated in Japanese patients with diabetes. The findings of this pilot study also suggest a possibility of association between the level of betatrophin and the levels of glucose and triglycerides. PMID:25753914

  20. Symptomatic diabetic and non-diabetic neuropathies in a series of 100 diabetic patients.

    PubMed

    Lozeron, Pierre; Nahum, Laurence; Lacroix, Catherine; Ropert, Angèle; Guglielmi, Jean-Marc; Said, Gérard

    2002-05-01

    We have reviewed the clinical and pathological data of a series of 100 consecutive diabetic patients with symptomatic neuropathy in order to learn more about the causes of neuropathy in this population and on the signs and symptoms that could suggest another cause than diabetes in this setting. After diagnostic procedures, patients were assigned one (at most two) of a final total of 18 different causes of neuropathy. Diabetes accounted for 74 % of the neuropathies in the whole group of patients and for 79 % of those with a fiber length dependent pattern of neuropathy. One third of patients had a neuropathy unrelated to diabetes. As a group, 71 % of the patients presented either a length dependent diabetic polyneuropathy (LDDP) or a proximal diabetic neuropathy (PDN). The LDDP group was biased towards more severely affected patients owing to our specialization. Conversely, most patients with proximal diabetic neuropathy had usual features. Chronic inflammatory demyelinating neuropathy that was diagnosed in 9 % of the patients was the most common non-diabetic cause of neuropathy in this population. We conclude that a short interval between diagnosis of diabetes and the onset of the neuropathy, early motor deficit, markedly asymmetrical deficit and generalized areflexia, which are all uncommon in the LDDP, argue in favor of a non diabetic origin of the neuropathy and should lead to further investigation. PMID:12021947

  1. Clinical features and visual outcomes of Japanese patients with scleritis

    Microsoft Academic Search

    H. Keino; T. Watanabe; W. Taki; C. Nakashima; A. A. Okada

    2010-01-01

    PurposeTo analyse clinical features, systemic associations, treatment and visual outcomes in Japanese patients with scleritis.MethodsClinical records of 83 patients with scleritis who presented between 1998 and 2008 to the Ocular Inflammation Service of the Kyorin Eye Center, Tokyo, were reviewed.ResultsOf the 83 patients, 57 (69%) had diffuse anterior scleritis, 9 (11%) had nodular anterior scleritis, 8 (10%) had necrotising anterior

  2. Helicobacter pylori Infection and Coronary Heart Disease in Japanese Patients

    Microsoft Academic Search

    Hiroyuki Osawa; Masanobu Kawakami; Mikihisa Fujii; Norifumi Kubo; Hisakazu Iwanaka; Wari Yamamoto; Muneyasu Saitoh; Toshio Yaginuma; Kentaro Sugano

    2001-01-01

    Although several independent studies have claimed a link between Helicobacter pylori infection and coronary heart disease (CHD), this association has not been established conclusively. The aim was to determine whether an association between H. pylori infection and CHD can be demonstrated in Japanese patients. Three-hundred and four patients who underwent consecutive coronary arteriography were investigated. Ninety-four patients had single-vessel coronary

  3. Optimal Hemoglobin A1c Levels for Screening of Diabetes and Prediabetes in the Japanese Population

    PubMed Central

    Shimodaira, Masanori; Okaniwa, Shinji; Hanyu, Norinao; Nakayama, Tomohiro

    2015-01-01

    The aim of this study was to evaluate the utility of hemoglobin A1c (HbA1c) to identify individuals with diabetes and prediabetes in the Japanese population. A total of 1372 individuals without known diabetes were selected for this study. A 75?g oral glucose tolerance test (OGTT) was used to diagnose diabetes and prediabetes. The ability of HbA1c to detect diabetes and prediabetes was investigated using receiver operating characteristic (ROC) analysis. The kappa (?) coefficient was used to test the agreement between HbA1c categorization and OGTT-based diagnosis. ROC analysis demonstrated that HbA1c was a good test to identify diabetes and prediabetes, with areas under the curve of 0.918 and 0.714, respectively. Optimal HbA1c cutoffs for diagnosing diabetes and prediabetes were 6.0% (sensitivity 83.7%, specificity 87.6%) and 5.7% (sensitivity 60.6%, specificity 72.1%), respectively, although the cutoff for prediabetes showed low accuracy (67.6%) and a high false-negative rate (39.4%). Agreement between HbA1c categorization and OGTT-based diagnosis was low in diabetes (? = 0.399) and prediabetes (? = 0.324). In Japanese subjects, the HbA1c cutoff of 6.0% had appropriate sensitivity and specificity for diabetes screening, whereas the cutoff of 5.7% had modest sensitivity and specificity in identifying prediabetes. Thus, HbA1c may be inadequate as a screening tool for prediabetes. PMID:26114121

  4. Hypothyroidism Complicating Nephropathy in a Diabetes Patient

    PubMed Central

    Veerappan, Ilangovan; Abraham, Anila; Hariharan, Somasundaram

    2012-01-01

    We describe a patient with type 2 diabetes mellitus and autoimmune hypothyroidism who presented with elevated serum creatinine possibly due to subclinical rhabdomyolysis induced by hypolipidemic drug therapy in the background of diabetic nephropathy. Both hypothyroidism and rhabdomyolysis were asymptomatic in this case as evidenced by lack of classical clinical features of hypothyroidism despite elevated serum TSH and absent pigment cast in renal biopsy. The combination of diabetes mellitus and hypothyroidism is common in the general population and should not be forgotten in patients with diabetes and kidney disease. PMID:23304572

  5. Japanese doctor-patient discourse : an investigation into cultural and institutional influences on patient-centred communication. 

    E-print Network

    Holst, Mark Anthony

    2010-10-06

    This thesis investigates how Japanese doctors create and maintain patient-centred consultations through their verbal interaction with patients, and the extent to which features of Japanese interpersonal communication ...

  6. Analysis of mitochondrial DNA variants in Japanese patients with schizophrenia

    Microsoft Academic Search

    Hitomi Ueno; Yutaka Nishigaki; Qing-Peng Kong; Noriyuki Fuku; Shuji Kojima; Nakao Iwata; Norio Ozaki; Masashi Tanaka

    2009-01-01

    To test the hypothesis that mitochondrial DNA (mtDNA) variants contribute to the susceptibility to schizophrenia, we sequenced the entire mtDNAs from 93 Japanese schizophrenic patients. Three non-synonymous homoplasmic variants in subunit six of the ATP synthase (MT-ATP6) gene that were detected only in patients but not in controls were suggested to be slightly deleterious, because (1) their original amino acid

  7. Evaluation of foot ulcers in diabetic patients.

    PubMed

    Quddus, M A; Uddin, M J

    2013-07-01

    This is a prospective observational study of 50 cases of diabetic foot ulcer conducted from June 2010 to May 2011 in the Department of Surgery of Shaheed Ziaur Rahman Medical College Hospital and the Diabetic Hospital, Bogra. This study revealed that diabetic foot ulcers are not uncommon complication in our country. The purpose of the study was to undergo a thorough evaluation of diabetic foot ulcers for better management as well as better outcome of patients. The maximum age group of this study was 41-50 years; mean±SD age was 55±15 years and male to female ratio was 1.4:1. This study showed that diabetic foot ulcers were more common in low-socio-economic group, among smokers, among poor glycemic controlled group and long duration of diabetics. In this series, 92% patients had peripheral neuropathy, 22% had foot deformity and 70% patients had vascular insufficiency in the foot and legs. In this series, 68% patients presented early diabetic complication i.e. 44% patients belonged to grade '0' and 24% patients belonged to Grade 1, which were suitable for safety of the limb or reducing major amputation if treated properly. PMID:23982544

  8. Lipid control in patients with diabetes mellitus

    Microsoft Academic Search

    D. John Betteridge

    2011-01-01

    Patients with diabetes mellitus are at increased risk of cardiovascular disease (CVD). Dyslipidemia, an important component of the insulin resistance syndrome and type 2 diabetes, is strongly related to CVD risk and is open to therapeutic intervention. Statins have proved to be safe, very-well tolerated, and highly effective in reducing the levels of LDL cholesterol and apolipoprotein B. Primary and

  9. Osteoporosis in patients with diabetes mellitus.

    PubMed

    Hofbauer, Lorenz C; Brueck, Carolin C; Singh, Shiv K; Dobnig, Harald

    2007-09-01

    Demographic trends with longer life expectancy and a lifestyle characterized by low physical activity and high-energy food intake contribute to an increasing incidence of diabetes mellitus and osteoporosis. Diabetes mellitus is a risk factor for osteoporotic fractures. Patients with recent onset of type 1 diabetes mellitus may have impaired bone formation because of the absence of the anabolic effects of insulin and amylin, whereas in long-standing type 1 diabetes mellitus, vascular complications may account for low bone mass and increased fracture risk. Patients with type 2 diabetes mellitus display an increased fracture risk despite a higher BMD, which is mainly attributable to the increased risk of falling. Strategies to improve BMD and to prevent osteoporotic fractures in patients with type 1 diabetes mellitus may include optimal glycemic control and aggressive prevention and treatment of vascular complications. Patients with type 2 diabetes mellitus may additionally benefit from early visual assessment, regular exercise to improve muscle strength and balance, and specific measures for preventing falls. PMID:17501667

  10. Insulin use in elderly diabetic patients.

    PubMed

    Ober, Scott K; Watts, Sharon; Lawrence, Renée H

    2006-01-01

    The prevalence of type 2 diabetes is increasing among older adults as is their diabetes-related mortality rate. Studies suggest that tighter glucose control reduces complications in elderly patients. However, too low a glycosylated hemoglobin (HbA1c) value is associated with increased hypoglycemia. Moreover, the appropriateness of most clinical trial data and standards of care related to diabetes management in elderly patients is questionable given their heterogeneity. Having guidelines to safely achieve glycemic control in elderly patients is crucial. One of the biggest challenges in achieving tighter control is predicting when peak insulin action will occur. The clinician's options have increased with new insulin analogs that physiologically match the insulin peaks of the normal glycemic state, enabling patients to achieve the tighter diabetes control in a potentially safer way. We discuss the function of insulin in managing diabetes and how the new insulin analogs modify that state. We offer some practical considerations for individualizing treatment for elderly patients with diabetes, including how to incorporate these agents into current regimens using several methods to help match carbohydrate intake with insulin requirements. Summarizing guidelines that focus on elderly patients hopefully will help reduce crises and complications in this growing segment of the population. PMID:18044107

  11. Diabetes patient management by pharmacists during Ramadan

    PubMed Central

    2014-01-01

    Background Many Muslim diabetes patients choose to participate in Ramadan despite medical advice to the contrary. This study aims to describe Qatar pharmacists’ practice, knowledge, and attitudes towards guiding diabetes medication management during Ramadan. Methods A cross-sectional descriptive study was performed among a convenience sample of 580 Qatar pharmacists. A web-based questionnaire was systematically developed following comprehensive literature review and structured according to 4 main domains: subject demographics; diabetes patient care experiences; knowledge of appropriate patient care during Ramadan fasting; and attitudes towards potential pharmacist responsibilities in this regard. Results In the 3 months prior to Ramadan (July 2012), 178 (31%) pharmacists responded to the survey. Ambulatory (103, 58%) and inpatient practices (72, 41%) were similarly represented. One-third of pharmacists reported at least weekly interaction with diabetes patients during Ramadan. The most popular resources for management advice were the internet (94, 53%) and practice guidelines (80, 45%); however only 20% were aware of and had read the American Diabetes Association Ramadan consensus document. Pharmacist knowledge scores of appropriate care was overall fair (99, 57%). Pharmacists identified several barriers to participating in diabetes management including workload and lack of private counseling areas, but expressed attitudes consistent with a desire to assume greater roles in advising fasting diabetes patients. Conclusion Qatar pharmacists face several practical barriers to guiding diabetes patient self-management during Ramadan, but are motivated to assume a greater role in such care. Educational programs are necessary to improve pharmacist knowledge in the provision of accurate patient advice. PMID:24606885

  12. 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

  13. Prescribing Exercise for Patients with Diabetes

    Microsoft Academic Search

    Dalynn T. Badenhop

    Exercise prescription for patients with diabetes follows guidelines regarding frequency, intensity, duration, and mode of\\u000a exercise established for patients participating in a medically supervised exercise program. Physicians and health care professionals\\u000a should devise an exercise care plan that maximizes the benefits and minimizes the risks for each patient. The distinction\\u000a between prescribing exercise for patients with T1DM and patients with

  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. [Constipation in patients with diabetes mellitus].

    PubMed

    Rossol, Siegbert

    2007-11-01

    Up to 60% of the patients with diabetes mellitus suffer from gastrointestinal tract symptoms that arise pathogenetically from a disturbance of the autonomous nervous system. Patient age, disease duration and poor control of diabetes mellitus correlate positively with the presence of gastrointestinal symptoms. Chronic constipation, in addition to diarrhoea, gall bladder dysfunction and incontinence, is increasingly regarded as a serious problem and for the first time, is now considered in the current guidelines of the professional societies. Modern diagnosis and treatment facilitate systematic control of the symptoms. Treatment necessitates long-term intake of laxatives, proper diabetes control and other accompanying general measures such as adequate amounts of liquids, dietary fibre and exercise. Motility and secretion-stimulating, osmotically active or locally applied laxatives are used. Slow transit constipation, which is typically observed in diabetics, can be best controlled with polyethylene glycol, bisacodyl or sodium picosulphate. PMID:18078169

  16. Safety of fondaparinux versus enoxaparin after TKA in Japanese patients.

    PubMed

    Hosaka, Kunihiro; Saito, Shu; Ishii, Takao; Sumino, Takanobu; Ryu, Keinosuke; Suzuki, Gen; Suzuki, Takashi; Tokuhashi, Yasuaki

    2013-04-01

    Fondaparinux and enoxaparin are useful for preventing venous thromboembolism after total knee arthroplasty (TKA), but both drugs have associated complications. The purpose of this study was to clarify the risks associated with use of these drugs in Japanese patients who underwent TKA.A total of 575 patients (935 knees) underwent TKA and were retrospectively reviewed; 277 patients (454 knees) were treated with fondaparinux and 298 patients (481 knees) were treated with enoxaparin. The authors investigated the incidences of deep venous thrombosis of the lower limbs and pulmonary embolism to evaluate venous thromboembolism, knee enlargement compared with the preoperative size, incidence of subcutaneous knee hematoma, and other complications. No significant differences were observed between the 2 drugs regarding the incidences of deep venous thrombosis and pulmonary embolism. However, fondaparinux use resulted in knee enlargement (P<.0005) and subcutaneous hematoma of the knee (P=.035) significantly more often than enoxaparin use. Conversely, enoxaparin use significantly caused the elevation of alanine aminotransferase (one of the liver enzymes) at a higher rate than fondaparinux (30.1% vs 8.3%, respectively; P<.0001). However, the increased alanine aminotransferase levels were transient, and no patient exhibited symptoms of abnormal liver function, such as jaundice or cutaneous pruritus.Fondaparinux and enoxaparin were both effective in preventing venous thromboembolism in Japanese patients undergoing elective TKA. However, both drugs had some adverse effects. It is important to be aware of these potential risks when prescribing these drugs. PMID:23590781

  17. Urodynamic Findings in Patients With Diabetic Cystopathy

    Microsoft Academic Search

    Steven A. Kaplan; Alexis E. Te; Jerry G. Blaivas; Edward J. McGuire

    1995-01-01

    To ascertain the relationship between voiding dysfunction associated with diabetes and bladder and sphincter behavior, the video urodynamic studies of 182 patients were retrospectively analyzed. Patients were classified based on urodynamic diagnosis and the presence or absence of signs of sacral cord involvement. Urodynamic findings were classified as either detrusor hyperreflexia, impaired detrusor contractility, detrusor areflexia, indeterminate and normal. The

  18. Myroides odoratimimus bacteremia in a diabetic patient

    PubMed Central

    Endicott-Yazdani, Tiana R.; Dhiman, Neelam; Benavides, Raul

    2015-01-01

    Myroides species are a rare source of human infection. Though not part of the human microbiota, Myroides species are commonly found in the environment. Myroides infections are typically attributed to contact with contaminated water; the most common presentation is in immunocompromised patients. We present a patient with a diabetic foot ulcer who subsequently developed Myroides odoratimimus bacteremia and bone abscess.

  19. Effect of the 2004 Mid Niigata Prefecture earthquake on glycemic control in type 1 diabetic patients

    Microsoft Academic Search

    Kyuzi Kamoi; Midori Tanaka; Tomoo Ikarashi; Masashi Miyakoshi

    2006-01-01

    At 5:56 p.m. on October 23, 2004, a major earthquake of magnitude 6.8 on the Richter scale struck the Chuetsu district of Niigata Prefecture, Japan, a rural area with mountain villages. Strong aftershocks of grade 5–6 on the Japanese Intensity Scale continued for 2 months. We investigated changes in the HbA1c levels of 65 type 1 diabetic patients with insulin

  20. Anesthetic considerations in diabetic patients. Part I: preoperative considerations of patients with diabetes mellitus

    Microsoft Academic Search

    Yuji Kadoi

    2010-01-01

    Diabetes mellitus is an increasingly common disease that affects people of all ages, resulting in significant morbidity and\\u000a mortality. Diabetic patients require perioperative care more frequently than their nondiabetic counterparts. The major risk\\u000a factors for diabetics undergoing surgery are the associated end-organ diseases: cardiovascular disease, autonomic neuropathy,\\u000a joint collagen tissue, and immune deficiency. Physicians need to pay extra attention to

  1. Population pharmacokinetic analysis of fexofenadine in Japanese pediatric patients.

    PubMed

    Martinez, Jean-Marie; Khier, Sonia; Morita, Shigemichi; Rauch, Clémence; Fabre, David

    2014-04-01

    A population pharmacokinetic analysis was conducted to characterize the pharmacokinetics of fexofenadine in Japanese pediatric patients (6 months through 16 years) with perennial allergic rhinitis or atopic dermatitis. The dataset was composed of 515 patients (including 109 adults), for a total of 1,080 concentration-time points. The analysis was performed with NONMEM using the SAEM method. Several structural models and residual error models were evaluated. The relationship between the individual estimates and the potential covariates was then investigated: demographic and pathophysiologic characteristics were tested as potential model covariates (forward selection method). The qualification of the model was performed using visual predictive check and bootstrap. A two-compartment disposition model with first-order absorption best fitted the data. The inter-individual variability was modeled through an exponential error model for all parameters (except for ka for which no inter-individual term could be estimated), while a proportional error model was used to model the residual variability. The final model included two covariates on elimination clearance and one on the intercompartmental clearance. CL/F was related to BSA and patient's age (expressed in months) Q/F was also related to BSA. Once the model was correctly qualified, exposure parameters such as Cmax and AUC? were computed and compared between each age sub-group and between Japanese and Caucasians patients. These comparisons did not reveal any major difference (less than 50 %) between subgroups. PMID:24633780

  2. Diabetes mellitus and Ramadan in elderly patients.

    PubMed

    Azzoug, Said; Mahgoun, Souad; Chentli, Farida

    2015-05-01

    Worldwide, the proportion of people above 60 years old represents 15% of the whole population. Diabetes mellitus is more frequent in this age group, and is associated with increased risk of morbidities and premature mortality. Aged Muslim people with diabetes insist on fasting during Ramadan, for many reasons. Elderly people, especially frail patients, who fast are at increased risk for many complications such as hypoglycaemia, hyperglycaemia and metabolic decompensation including hyperosmolar coma, diabetic ketoacidosis, dehydration and thrombosis. Therefore it is important to assess functional capacity, cognition, mental health and comorbidities in elderly people with diabetes in order to evaluate the risk of fasting, individualize the therapy, and adapt care to their needs. PMID:26013782

  3. Sympathetic nerve hyperactivity in non-diabetic offspring of patients with type 2 diabetes mellitus

    Microsoft Academic Search

    R. J. Huggett; A. J. Hogarth; A. F. Mackintosh; D. A. S. G. Mary

    2006-01-01

    Aims\\/hypothesis  Type 2 diabetes mellitus with hyperinsulinaemia is a state of sympathetic nerve hyperactivity, which can develop subsequently in non-diabetic first-degree offspring of patients with type 2 diabetes. Although both type 2 diabetes and sympathetic activation are major cardiovascular risk factors, the level of sympathetic nerve activity is as yet unknown in offspring of type 2 diabetic patients who are ostensibly

  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. Elevation of Cerebrospinal Fluid Protein in Patients with Diabetes Mellitus Is Associated with Duration of Diabetes

    Microsoft Academic Search

    Hiroshi Kobessho; Kenichi Oishi; Hirotoshi Hamaguchi; Fumio Kanda

    2008-01-01

    We investigated the relationships between total cerebrospinal fluid (CSF) protein in diabetic patients and the clinical characteristics of diabetes mellitus. The subjects comprised 16 diabetic patients (median age = 60.5 years, range = 47–71) who were studied retrospectively. Patients with diseases known to be associated with increases in total CSF protein were excluded as far as possible. The median total

  6. High incidence of Aggregatibacter actinomycetemcomitans infection in patients with cerebral infarction and diabetic renal failure: a cross-sectional study

    PubMed Central

    2013-01-01

    Background Recent epidemiological studies suggest that periodontitis is a major risk factor for renal failure and cerebral infarction. The aim of this study was to evaluate the association among periodontitis, renal failure, and cerebral infarction, focusing on microbiological and immunological features. Methods Twenty-one patients treated with hemodialysis (HD) were enrolled in this study. They were 8 with diabetic nephropathy and 13 with non-diabetic nephropathy. Blood examination, periodontal examination, brain magnetic resonance image (MRI), and dental radiography were performed on all patients. Subgingival plaque, saliva, and blood samples were analyzed for the periodontal pathogens, Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), and Prevotella intermedia (P. intermedia) using quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA). Results We found that the patients with diabetic nephropathy had more A. actinomycetemcomitans compared with non-diabetic nephropathy (P?=?0.038) in dental plaque. Furthermore, the patients with diabetic nephropathy showed a significantly higher incidence of cerebral infarction compared with those with non-diabetic nephropathy (P?=?0.029). Clinical oral and radiographic scores tended to be higher among patients in the diabetic nephropathy group than in the non-diabetic nephropathy group. Conclusions Periodontal pathogens, particularly A. actinomycetemcomitans, may play a role, at least a part, in the development of cerebral infarction in Japanese HD patients with diabetic nephropathy. PMID:24267704

  7. Exploration Mining in Diabetic Patients Databases: Findings and Conclusions

    E-print Network

    Lee, Mong Li "Janice"

    Exploration Mining in Diabetic Patients Databases: Findings and Conclusions Wynne Hsu Mong Li Lee-life application that we have done is on the diabetic patients databases. Valuable lessons are learnt from application. In this paper, we shall discuss how we carry out knowledge discovery on this diabetic patient

  8. 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.

  9. 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

  10. Analysis of mitochondrial DNA variants in Japanese patients with schizophrenia.

    PubMed

    Ueno, Hitomi; Nishigaki, Yutaka; Kong, Qing-Peng; Fuku, Noriyuki; Kojima, Shuji; Iwata, Nakao; Ozaki, Norio; Tanaka, Masashi

    2009-11-01

    To test the hypothesis that mitochondrial DNA (mtDNA) variants contribute to the susceptibility to schizophrenia, we sequenced the entire mtDNAs from 93 Japanese schizophrenic patients. Three non-synonymous homoplasmic variants in subunit six of the ATP synthase (MT-ATP6) gene that were detected only in patients but not in controls were suggested to be slightly deleterious, because (1) their original amino acid residues (AA) were highly conserved and (2) the physicochemical differences between the original and altered AA were relatively high. In addition, we detected three novel heteroplasmic variants that were potentially pathogenic. Although functional analysis is needed, rare variants in the mtDNA may convey susceptibility to schizophrenia. PMID:19563917

  11. Diabetic striatopathy in a patient with hemiballism.

    PubMed

    Özgür, An?l; Esen, Kaan; Kalea?as?, Hakan; Y?lmaz, Arda; Kara, Engin

    2015-06-01

    Diabetic striatopathy is a rare and life-threatening manifestation of diabetes mellitus. The disease commonly affects individuals of Asian descent, females, and the elderly. Patients usually present with hemiballism-hemichorea caused by nonketotic hyperglycemia. Hemiballism-hemichorea is defined as involuntary continuous random appearing movement involving one side of the body. This movement disorder may develop secondary to stroke, diabetic striatopathy, neoplasm, infection, Wilson's disease, and thyrotoxicosis. Despite being rare, prompt recognition of a hyperglycemia-induced hemiballism-hemichorea is essential because the symptoms are reversible with correction of hyperglycemia. Diagnosis is possible based on blood analysis and neuroimaging findings. Laboratory tests reveal raised blood glucose and hemoglobin A1C levels which indicate poorly controlled diabetes. Neuroimaging provides suggestive findings of diabetic striatopathy which are hyperattenuation on computed tomography and hyperintensity on T1-weighted magnetic resonance imaging in the basal ganglia. In this case report, our aim is to present neuroimaging findings in an adult man with sudden onset of hemiballism associated with nonketotic hyperglycemia. PMID:25763569

  12. Insulin resistance and metabolic parameters in type 2 diabetic patients

    Microsoft Academic Search

    W Metzler; S Fischer; C Köhler; F Pistrosch; B Kindel; M Hanefeld

    2002-01-01

    Background: The importance of insulin resistance in type 2 diabetes mellitus has been generally accepted. Only very few data about the degree of insulin resistance in a representative group of type 2 diabetic patients are available. The aim of this study was to ascertain the degree of insulin resistance and its relation to metabolic parameters in type 2 diabetic patients.

  13. Recognizing and treating depression in patients with diabetes

    Microsoft Academic Search

    Richard R. Rubin; Paul Ciechanowski; Leonard E. Egede; Elizabeth H. B. Lin; Patrick J. Lustman

    2004-01-01

    Diabetes doubles the risk for depression, which in turn may interfere with effective diabetes self-management, and is associated\\u000a with hyperglycemia and with increased risk for diabetes complications. Despite its relevance to the course of diabetes and\\u000a its chronic character, depression is recognized and treated appropriately in fewer than 25% of depressed diabetic patients.\\u000a The authors discuss the use of screening

  14. Rhino-orbito-cerebral mucormycosis in patients with diabetic ketoacidosis.

    PubMed

    Gen, Ramazan; Horasan, Elif ?ahin; Vayso?lu, Yusuf; Arpaci, Rabia Bozdo?an; Ersöz, Gülden; Özcan, Cengiz

    2013-03-01

    Mucormycosis is a life-threatening fungal infection that occurs in immunocompromised patients. The most common predisposing risk factor for mucormycosis is diabetes mellitus. Rhino-orbito-cerebral mucormycosis is the most common form in diabetic patients and is characterized by paranasal sinusitis, ophthalmoplegia with blindness, and unilateral proptosis with cellulitis, facial pain with swelling, headache, fever, rhinitis, granular or purulent nasal discharge, nasal ulceration, epistaxis, hemiplegia or stroke, and decreased mental function. Diabetic ketoacidosis is the most common and serious acute complication of diabetic patients. We herein report 2 cases of fatal rhino-orbito-cerebral mucormycosis in a patient with diabetic ketoacidosis. PMID:23524816

  15. Medial arterial calcification in the feet of diabetic patients and matched non-diabetic control subjects

    Microsoft Academic Search

    M. J. Young; J. E. Adams; G. F. Anderson; A. J. M. Boulton; P. R. Cavanagh

    1993-01-01

    Summary  The prevalence and distribution of medial arterial calcification was assessed in the feet of four subject groups; 54 neuropathic diabetic patients with previous foot ulceration (U), median age 60.5 (50.5–67 interquartile range) years, duration of diabetes 19.5 (9.9–29.9) years; 40 neuropathic diabetic patients without a foot ulcer history (N), age 68 (62–73) years, duration of diabetes 14.0 (8.0–28.0) years; 43

  16. Replication Study for the Association Between Four Loci Identified by a Genome-Wide Association Study on European American Subjects With Type 1 Diabetes and Susceptibility to Diabetic Nephropathy in Japanese Subjects With Type 2 Diabetes

    PubMed Central

    Maeda, Shiro; Araki, Shin-ichi; Babazono, Tetsuya; Toyoda, Masao; Umezono, Tomoya; Kawai, Koichi; Imanishi, Masahito; Uzu, Takashi; Watada, Hirotaka; Suzuki, Daisuke; Kashiwagi, Atsunori; Iwamoto, Yasuhiko; Kaku, Kohei; Kawamori, Ryuzo; Nakamura, Yusuke

    2010-01-01

    OBJECTIVE Genetic factors are believed to contribute to the development and progression of diabetic nephropathy. Recently, a genome-wide association study for diabetic nephropathy revealed four novel candidate loci in European American subjects with type 1 diabetes. In this study, we determined the association of the four loci with diabetic nephropathy in Japanese subjects with type 2 diabetes. RESEARCH DESIGN AND METHODS We genotyped 11 singlenucleotide polymorphisms (SNPs) in four distinct loci (rs39059 and rs39075 in the CPVL/CHN2, rs1888747 and rs10868025 in FRMD3, rs739401 and rs451041 in CARS, and rs1041466, rs1411766, rs6492208, rs7989848, and rs9521445 in a chromosome 13q locus) in four independent Japanese populations. RESULTS Six SNPs were nominally associated with diabetic nephropathy in one of the four Japanese populations (P < 0.05; rs451041 in study 1; rs39059 and rs1888747 in study 3; rs1411766 in studies 1 and 4; and rs7989848 and rs9521445 in study 4); however, no significant association was observed for any SNP after correction for multiple testing errors in the individual populations. Nevertheless, a meta-analysis performed for the data obtained from all four populations revealed that one SNP (rs1411766) in chromosome 13q was significantly associated with diabetic nephropathy in the Japanese populations (nominal P = 0.004, corrected P = 0.04, odds ratio 1.26 [95% CI = 1.07–1.47]). CONCLUSIONS Our results suggest that the rs1411766 locus may be commonly involved in conferring susceptibility to diabetic nephropathy among subjects with type 1 or type 2 diabetes across different ethnic groups. PMID:20460425

  17. 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

  18. 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…

  19. Rapid onset of syndrome of inappropriate antidiuretic hormone secretion induced by duloxetine in an elderly type 2 diabetic patient with painful diabetic neuropathy.

    PubMed

    Kamei, Shinji; Kaneto, Hideaki; Tanabe, Akihito; Irie, Shintaro; Hirata, Yurie; Shimoda, Masashi; Kohara, Kenji; Mune, Tomoatsu; Kaku, Kohei

    2015-05-01

    Diabetic neuropathy is the most common diabetic complication. Duloxetine, a serotonin noradrenaline reuptake inhibitor (SNRI), is widely used for the treatment of diabetic painful neuropathy (DPN) because of the efficacy and safety profile. Syndrome of inappropriate antidiuretic hormone secretion, which is strongly associated duloxetine, is a rare but occasionally life-threatening adverse effect. Here, we report a case of syndrome of inappropriate antidiuretic hormone secretion that rapidly developed after starting duloxetine in an elderly Japanese female type 2 diabetes mellitus patient. Furthermore, we discuss the possible relationship between the onset of syndrome of inappropriate antidiuretic hormone secretion and the gene polymorphism of cytochrome P450 isoform 1A2 and 2D6, both of which are responsible for duloxetine metabolism. PMID:25969720

  20. Glycometabolic Control and Fibrinolysis in Diabetic Patients

    Microsoft Academic Search

    J. W. J. van Wersch; L. W. J. J. M. Westerhuis; W. J. R. R. Venekamp

    1990-01-01

    We investigated 148 diabetic patients with regard to their relationship between fibrinolysis (D-dimer and plasminogen activator inhibitor; PAI) and glycometabolic control (HbA1c, HbA1 and fructosamine). The percentage of moderately controlled patients as indicated by HbA1c, HbA1 and fructosamine is relatively high (29.7, 41.7 and 30.4%, respectively). Simultaneously, the D-dimer and PAI levels turned out to be enhanced in 30.8 and

  1. 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

  2. Advanced glycation end-products in senile diabetic and non-diabetic patients with cardiovascular complications

    Microsoft Academic Search

    Anjuman Gul; M. Ataur Rahman; Asmat Salim; Shabana U. Simjee

    2008-01-01

    Advanced glycation end products (AGEs) have been reported to contribute to aging and cardiovascular complications. In the\\u000a present study, the immunoreactivity of AGEs in human serum samples of healthy older subjects (n?=?31), senile diabetic patients without cardiovascular complications (n?=?33), senile diabetic patients with cardiovascular complications (n?=?32), senile non-diabetic patients with cardiovascular complications (n?=?30) ,and healthy young subjects (n?=?31) were investigated.

  3. Screening, prevention, and ambitious management of diabetic macular edema in patients with type 1 diabetes.

    PubMed

    Tarantola, Ryan M; Maturi, Raj K; Kushal, Shalesh; Gupta, Sunil

    2013-10-01

    Diabetic macular edema results from progressive retinopathy related to chronic hyperglycemic and inflammatory vascular damage. Loss of vision secondary to diabetic macular edema is the most common cause of vision loss in patients with diabetes. Blood glucose control remains the main means of preventing progression of retinopathy and macular edema. Recent advancements allowing more efficient mechanisms for screening patients and emerging treatments for macular edema have led to improved visual outcomes in this group of patients. PMID:23959793

  4. Macular microcirculation in cystoid maculopathy of diabetic patients.

    PubMed Central

    Arend, O; Remky, A; Harris, A; Bertram, B; Reim, M; Wolf, S

    1995-01-01

    BACKGROUND--In patients with diabetic macular oedema and central cysts ischaemia of the retina appears to be an important contributing factor in the pathogenesis of cysts. This study was performed to further elucidate the role of the inner retinal microcirculation in diabetic cystoid macular oedema (CMO). METHODS--Video fluorescein angiography allows visualisation of the macular microvasculature and measurements of the capillary blood velocity (CBV), foveal avascular zone (FAZ), and perifoveal intercapillary area (PIA, characterising capillary density). RESULTS--Twenty three diabetic subjects with CMO, matched diabetic patients without macular oedema (n = 23), and healthy subjects (n = 23) were included. CBV, PIA, and FAZ did not differ significantly among diabetic groups regardless of presence of cystoid changes. CBV was significantly reduced (p < 0.0001) and PIA was more than doubled in both diabetic groups (p < 0.0001) when compared with healthy subjects. Furthermore, FAZ showed a nearly doubled size in diabetic patients without macular oedema (p < 0.01) and a less pronounced enlargement (by 29%) in diabetics with CMO (p < 0.05). CONCLUSION--The results indicate that the retinal microcirculation in diabetic patients is markedly altered when compared with healthy subjects, regardless of CMO presence. In CMO patients the microcirculatory changes are similar to those of diabetic patients without macular oedema. Thus inner retinal perfusion does not contribute to tissue ischaemia leading to cystoid formations in diabetic maculopathy. Images PMID:7662623

  5. Analysis of tumor necrosis factor-alpha promoter polymorphism in type 1 diabetes: HLA-B and -DRB1 alleles are primarily associated with the disease in Japanese.

    PubMed

    Hamaguchi, K; Kimura, A; Seki, N; Higuchi, T; Yasunaga, S; Takahashi, M; Sasazuki, T; Kusuda, Y; Okeda, T; Itoh, K; Sakata, T

    2000-01-01

    Polymorphisms in the 5'-flanking region of the tumor necrosis factor (TNF)-alpha gene were examined to study the genetic background of type 1 diabetes in Japanese. Five different biallelic polymorphisms were examined in 136 type 1 diabetic patients and 300 control subjects. The frequencies of individuals carrying TNF-alpha-857T allele (designated as TNFP-D allele) or -863A/-1,031C allele (designated as TNFP-B allele) were significantly increased in the patients as compared with the controls. Since these TNF-alpha alleles are in linkage disequilibria with certain DRB1 and HLA-B alleles, two-locus analyses were carried out. The TNFP-D allele did not increase the risk in either the presence or absence of the DRB1*0405 or HLA-B54 allele, while the DRB1*0405 and HLA-B54 alleles per se could confer susceptibility in both the TNFP-D allele-positive and -negative populations. Moreover, an odds ratio was remarkably elevated in the population carrying both DRB1*0405 and HLA-B54. Similarly, the TNFP-B allele did not show significant association with the disease in either the HLA-B61-positive or -negative population, while the HLA-B61 allele could significantly increase the risk in the TNFP-B allele-positive population. These data suggest that the associations of TNFP-D and -B alleles may be secondary to their linkage disequilibria with the susceptible HLA class I and class II alleles. Because HLA-B and DRB1 genes were independently associated, both of these genes may be contributed primarily to the pathogenesis of type 1 diabetes in Japanese. PMID:10703602

  6. Providing Secure Access to Confidential Patient Information Detailing Diabetic Condition

    E-print Network

    Kent, University of

    Providing Secure Access to Confidential Patient Information Detailing Diabetic Condition Dr. D +44 161 295 5351 Fax +44 161 745 8169 Email: d.w.chadwick@salford.ac.uk 2 Diabetes and Endocrinology testing Introduction "There are nearly 1.5 million people in the United Kingdom with diabetes

  7. Psychological Adjustment and Neuropsychological Performance in Diabetic Patients.

    ERIC Educational Resources Information Center

    Skenazy, Judy A.; Bigler, Erin D.

    1985-01-01

    Compared diabetic (N=39) with nondiabetic chronic illness patients (N=20) and healthy controls (N=24). The chronic illness and the diabetic groups had significant elevations on the Hypochondriasis, Depression, and Hysteria scales of the Feschingbauer Abbreviated MMPI. For diabetics, results demonstrated a negligible effect of poor adjustment on…

  8. Impact of the atherosclerotic process in patients with diabetes

    Microsoft Academic Search

    R. W. Nesto; M. K. Rutter

    2002-01-01

    Between 120 and 140 million people suffer from diabetes mellitus (type 1 and type 2) worldwide, and this number may well double by the year 2025. Patients with diabetes are at increased risk of atherosclerosis and its clinical sequelae: coronary, peripheral vascular, and cerebrovascular diseases. Concurrently, the most common cause of death in persons with diabetes is myocardial infarction. The

  9. Learning Difficulties of Diabetic Patients: A Survey of Educators.

    ERIC Educational Resources Information Center

    Bonnet, Caroline; Gagnayre, Remi; d'Ivernois, Jean-Francois

    1998-01-01

    Surveys 85 health care professionals on the learning difficulties of diabetic patients. Results show that educators find it easy to teach techniques: patients master procedures well and make few mistakes. In contrast, diabetic patients seem to have problems learning skills, such as insulin dose adjustment, that require complex problem-solving.…

  10. Decreased Gastric Motility in Type II Diabetic Patients

    PubMed Central

    Chen, Jung-Fu; Wu, Keng-Liang; Chou, Yeh-Pin; Tai, Wei-Chen; Hu, Ming-Luen

    2014-01-01

    Background. To differentiate gastric motility and sensation between type II diabetic patients and controls and explore different expressions of gastric motility peptides. Methods. Eleven type II diabetic patients and health volunteers of similar age and body mass index were invited. All underwent transabdominal ultrasound for gastric motility and visual analogue scales. Blood samples were taken for glucose and plasma peptides (ghrelin, motilin, and glucacon-like peptides-1) by ELISA method. Results. Gastric emptying was significantly slower in diabetic patients than controls (T50: 46.3 (28.0–52.3)?min versus 20.8 (9.6–22.8)?min, P ? 0.05) and less antral contractions in type II diabetic patients were observed (P = 0.02). Fundus dimensions did not differ. There were a trend for less changes in gastrointestinal sensations in type II diabetic patients especially abdomen fullness, hunger, and abdominal discomfort. Although the serum peptides between the two groups were similar a trend for less serum GLP-1in type II diabetic patients was observed (P = 0.098). Conclusion. Type II diabetic patients have delayed gastric emptying and less antral contractions than controls. The observation that there were lower serum GLP-1 in type II diabetic patients could offer a clue to suggest that delayed gastric emptying in diabetic patients is not mainly influenced by GLP-1. PMID:25147821

  11. Diabetes Remission after Nonsurgical Intensive Lifestyle Intervention in Obese Patients with Type 2 Diabetes

    PubMed Central

    Mottalib, Adham; Sakr, Mahmoud; Shehabeldin, Mohamed; Hamdy, Osama

    2015-01-01

    Partial or complete remission from type 2 diabetes was recently observed after bariatric surgeries. Limited data is available about the possibility of inducing diabetes remission through intensive weight reduction. We retrospectively evaluated diabetes remissions after one year of the Weight Achievement and Intensive Treatment (Why WAIT) program, a 12-week intensive program for diabetes weight management in real-world clinical practice. Among 120 obese patients with type 2 diabetes who completed the program, 88 patients returned for follow-up at one year. Nineteen patients (21.6%) had major improvement in their glycemic control, defined as achieving an A1C <6.5% after one year. Four patients (4.5%) achieved either partial or complete diabetes remission defined as A1C <6.5% and <5.7%, respectively, on no antihyperglycemic medications for one year; 2 achieved partial remission (2.3%) and 2 achieved complete remission (2.3%). At the time of intervention, patients who achieved diabetes remission had shorter diabetes duration (<5 years) and lower A1C (<8%) and were treated with fewer than 2 oral medications. They achieved a weight reduction of >7% after 12 weeks. These results indicate that a subset of obese patients with type 2 diabetes is appropriate for intensive lifestyle intervention with the aim of inducing diabetes remission.

  12. 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

  13. [Immunologic autoagression in patients with diabetic retinopathy under type I diabetes mellitus].

    PubMed

    Teplinskaia, L E; Iastrebova, N E; Vetrov, Iu D; Vaneeva, N P

    2006-01-01

    Presence of IgG autoantibodies to broad spectrum of tissues' antigens in patients with diabetic retinopathy under type I diabetes mellitus was studied. Increased levels of antibodies to different antigens were observed in 56% of patients. Increased levels of antibodies to hypophysis, denaturated DNA, and myelin basic protein were detected most frequently. Correlation in presence of autoantibodies of different specificity with diabetes length as well as with frequency of respiratory infections was established. There was relation between level of antibodies to DNA and increased permeability of microvascular network of retina as well as between presence of autoantibodies to myelin basic protein and encephalopathy in patients with type I diabetes mellitus. PMID:17297882

  14. Candida Colonization on the Denture of Diabetic and Non-diabetic Patients

    PubMed Central

    Lotfi-Kamran, Mohammad Hossein; Jafari, Abbas Ali; Falah-Tafti, Abbas; Tavakoli, Ehsan; Falahzadeh, Mohammad Hossein

    2009-01-01

    Background: Oral candidiasis is a common opportunistic infection in diabetic patients. Presence of denture in the oral cavity of diabetic patients can promote Candida colonization and results in the higher incidence of oral and systemic candidiasis. The general purpose of the present study was to evaluate and compare Candida colonization in denture of diabetic patients and non-diabetic control group. Methods: In current case-control study, samples for mycological examinations were collected from the palatal impression surface of maxillary dentures from 92 edentulous patients including 46 dia-betic and 46 non-diabetic denture wearers. All samples were cultured directly on sabouraud agar me-dium and isolated colonies were counted and identified based on specific tests. Data were statistically analyzed using Mann-Whitney and Spearman correlation tests. Results: The higher density of isolated colonies was seen in diabetic group in compare with control group (P = 0.0001). There was a statistically significant correlation between the blood glucose level (P = 0.0001) and the duration of denture usage (P = 0.022) with the colonization of Candida on denture of diabetic patients. C. albicans was the most common isolated Candida species in both groups, though diabetic patients with dentures had more non-albicans Candida isolated from their dentures compared to non-diabetic patients. Conclusions: Mycological findings from the present study revealed that diabetes mellitus can in-crease colonization of Candida in denture and mouth. By elimination of local and systemic factors in diabetic patients and improving their oral health care, Candida colonization and the risk of oral and systemic candidiasis will be decreased. PMID:21528026

  15. Inhaled insulin for controlling blood glucose in patients with diabetes

    PubMed Central

    Silverman, Bernard L; Barnes, Christopher J; Campaigne, Barbara N; Muchmore, Douglas B

    2007-01-01

    Diabetes mellitus is a significant worldwide health problem, with the incidence of type 2 diabetes increasing at alarming rates. Insulin resistance and dysregulated blood glucose control are established risk factors for microvascular complications and cardiovascular disease. Despite the recognition of diabetes as a major health issue and the availability of a growing number of medications designed to counteract its detrimental effects, real and perceived barriers remain that prevent patients from achieving optimal blood glucose control. The development and utilization of inhaled insulin as a novel insulin delivery system may positively influence patient treatment adherence and optimal glycemic control, potentially leading to a reduction in cardiovascular complications in patients with diabetes. PMID:18200813

  16. MAJOR AMPUTATION INCIDENCE DECREASE SB OTH IN NON-DIABETIC AND IN DIABETIC PATIENTS IN HELSINKI

    Microsoft Academic Search

    E. Eskelinen; A. E skelinen; A. Albäck; M. Lepäntalo

    Background an dA ims: The aim of the study was to assess the changes in diabetes-related lower extremity amputation sa nd to compare it with the development of amputations for critica ll eg ischaemia in patients without diabetes. Material and Methods: Clinical records of 1094 patients undergoing major lower limb amputations for vascular disease in the town of Helsinki during

  17. Predictive value of ambulatory blood pressure in diabetic patients

    Microsoft Academic Search

    Robert Zweiker; Andrea Siebenhofer; Johannes Plank; Peter Baeck; Thomas Pieber

    2002-01-01

    Background: Arterial hypertension represents one of the most important risk factors in diabetes. It was the aim of this study evaluate the power of ambulatory blood pressure values in the prediction of cardio- and cerebrovascular events as well as end stage renal disease in type-I and type-II diabetic patients.Methods: We incuded 107 diabetic patients, in whom an ambulatory blood pressure

  18. Screening for Diabetic Retinopathy and Nephropathy in Patients with Diabetes: A Nationwide Survey in Korea

    PubMed Central

    Byun, Sang-Ho; Ma, Seung Hyun; Jun, Jae Kwan; Jung, Kyu-Won; Park, Boyoung

    2013-01-01

    This study was performed to identify factors associated with screening for diabetic retinopathy and nephropathy. Data from the Korean National Health and Nutrition Examination Survey between 2007 and 2009 were analyzed. Of 24,871 participants, 1,288 patients diagnosed with diabetes at ?30 years of age were included. 36.3% received screening for diabetic retinopathy, and 40.5% received screening for diabetic nephropathy during the previous year. Patients living in rural areas, those with less education, those who had not received education about diabetes care, and those who did not receive medical care for diabetes were screened less often for retinopathy or nephropathy. Patients with poorer self-reported health status were screened more often. Occupation, smoking status, and diabetes duration were associated with retinopathy screening. Lower family income was associated with decreased nephropathy screening. Receiving education about diabetes care and receiving medical care for diabetes were significant factors in patients with a shorter duration of diabetes (the significant odds ratio [OR] of not receiving education varied between 0.27 and 0.51, and that of not receiving medical care varied between 0.34 and 0.42). Sociodemographic factors and health-related factors as well as education and medical care influenced screening for diabetic complications among those with a longer duration of diabetes (for retinopathy and nephropathy, the significant OR of living in a rural area varied between 0.56 and 0.61; for retinopathy, the significant OR of current smokers was 0.55, and the p-trend of subjective health status was <0.001; for nephropathy, the significant OR of a monthly household income of <3000 dollars was 0.61 and the p-trends of education and subjective health status were 0.030 and 0.007, respectively). Efforts to decrease sociodemographic disparities should be combined with education about diabetes care to increase the screening, especially for those with a longer duration of diabetes. PMID:23667557

  19. A cohort study of diabetic patients and diabetic foot ulceration patients in China.

    PubMed

    Jiang, Yufeng; Wang, Xuemei; Xia, Lei; Fu, Xiaobing; Xu, Zhangrong; Ran, Xingwu; Yan, Li; Li, Qiu; Mo, Zhaohui; Yan, Zhaoli; Ji, Qiuhe; Li, Qiang

    2015-03-01

    To determine the annual incidence and clinically relevant risk factors for foot ulceration in a large cohort study of diabetic foot ulcer (DFU) patients and diabetes mellitus (DM) patients in China. To investigate a cohort of 1,333 patients comprising 452 DFU patients and 881 DM patients, who underwent foot screening, physical examination, and laboratory tests in eight hospitals. The patients were assessed at baseline in terms of their demographic information, medical and social history, peripheral neuropathy disease (PND) screening, periphery artery disease (PAD) screening, assessment of nutritional status, and diabetic control. One year later, the patients were followed up to determine the incidence of new foot ulcers, amputation, and mortality. By univariate analysis, statistically significant differences were found in age, location, gender, living alone (yes/no), occupation, smoking, hypertension, PND, PAD, nephropathy, retinopathy, cataracts, duration of diabetes, Glycosylated hemoglobin A (HbA1c), fasting plasma glucose level, postprandial blood glucose level, insulin level, blood urea nitrogen, creatinine, cholesterol, triglyeride, high density lipoprotein (HDL), serum albumin, white blood cell, and body mass index. A binary logistic regression model was used to examine which of these risk factors were independent risk factors for foot ulceration. A total of 687 (51.5%) of the 1,333 patients were followed up for an average of 12 months; there were 458 DM patients and 229 DFU patients. A total of 46 patients died during the follow-up period; 13 were DM patients, and 33 were DFU patients. Of the 641 patients, 445 (69.4%) patients were DM patients, and 196 (30.6%) were DFU patients. At follow-up, 36/445 DM patients (8.1%), and 62/196 DFU patients (31.6%), developed new ulcers; 10/196 DFU patients underwent an amputation. The annual incidence of ulceration for DM patients and amputation for DFU patients were 8.1 and 5.1%, respectively. The annual mortality of the DM patients and DMF patients were 2.8 and 14.4%, respectively. A binary logistic regression model was used to examine which risk factors were independent risk factors for foot ulceration during the follow-up period, and the final results showed that nephropathy (odds ratio 2.32), insulin level (odds ratio 3.136, 2.629), and decreased HDL (odds ratio 0.427) were associated with increased risks for foot ulceration. Complications of diabetes affecting the feet represent a serious problem in China. The incidence of foot ulcers and amputation are much higher than that of Western countries. More intensive surveillance and aggressive care following a diagnosis of DFU and earlier referral to specialty care might improve the patient outcome. PMID:25682850

  20. Management and prognosis of atrial fibrillation in the diabetic patient.

    PubMed

    Pallisgaard, Jannik Langtved; Lindhardt, Tommi Bo; Olesen, Jonas Bjerring; Hansen, Morten Lock; Carlson, Nicholas; Gislason, Gunnar Hilmar

    2015-06-01

    The global burden of atrial fibrillation and diabetes mellitus (diabetes) is considerable, and prevalence rates are increasing. Diabetes is associated with an increased risk of developing atrial fibrillation; however, diabetes also influences the management and prognosis of atrial fibrillation. In the following article, the authors describe the association between diabetes and atrial fibrillation; specifically, the significance of diabetes on the risk of atrial fibrillation, ischemic stroke and bleeding complications associated with anticoagulation. In addition, the authors evaluate the risks and outcomes of heart failure and the success rates of both ablation and cardioversion in atrial fibrillation patients with diabetes. Finally, this article describes the association of HbA1c levels with the management and prognosis of atrial fibrillation patients. PMID:26000562

  1. Subclinical hyperthyroidism in patients with type 2 diabetes.

    PubMed

    Díez, Juan J; Iglesias, Pedro

    2012-08-01

    Both subclinical hyperthyroidism and type 2 diabetes (T2D) have been associated with an increase in cardiovascular disease risk and mortality. We aimed to assess the prevalence of newly diagnosed subclinical hyperthyroidism in a cohort of patients with T2D, and also to analyse the relationships between diabetes-related characteristics and the presence of subclinical hyperthyroidism. 933 diabetic patients without previous history of thyroid disease (45.4% females, mean age 66.3 years, median duration of diabetes 10 years) were evaluated. A sample of 911 non-diabetic subjects without known thyroid dysfunction was studied as control group. Serum concentrations of thyrotropin were measured in all subjects. Subclinical hyperthyroidism was present in 4.3% of female and 3.5% of male diabetic patients. Relative risk was significant only for the female gender (OR 3.69, 95% CI 1.56-8.71). In comparison with diabetic patients without thyroid hyperfunction, patients with subclinical hyperthyroidism were older, had longer duration of diabetes, showed lower fasting glucose levels, had greater proportion of goitre and diet therapy, and had lower proportion of treatment with oral agents. Logistic regression analysis showed that age and the presence of goitre were significantly related to subclinical hyperthyroidism in patients with T2D. The risk for subclinical hyperthyroidism is increased in women with T2D. Advanced age and the presence of goitre are significantly and independently related with the presence of subclinical hyperthyroidism in diabetic population. PMID:22327927

  2. Glycometabolic control and fibrinolysis in diabetic patients.

    PubMed

    van Wersch, J W; Westerhuis, L W; Venekamp, W J

    1990-01-01

    We investigated 148 diabetic patients with regard to their relationship between fibrinolysis (D-dimer and plasminogen activator inhibitor; PAI) and glycometabolic control (HbA1c, HbA1 and fructosamine). The percentage of moderately controlled patients as indicated by HbA1c, HbA1 and fructosamine is relatively high (29.7, 41.7 and 30.4%, respectively). Simultaneously, the D-dimer and PAI levels turned out to be enhanced in 30.8 and 22.4% of the patients. There was a positive nonsignificant correlation between D-dimer and HbA1c, a highly significant negative correlation between D-dimer and HbA1 and a nonsignificant negative correlation between D-dimer and fructosamine. According to the upper limits of the distinct reference ranges for HbA1c, HbA1 and fructosamine, we splitted up the D-dimer results and calculated the mean D-dimer values belonging to each category. Comparing the D-dimer means for each parameter, we separately obtained significant differences of the D-dimer means between the lower and higher HbA1 and fructosamine groups, whereas in the case of HbA1c the mean D-dimer values of the categories under and over 9% showed no significant difference. For PAI, we found only weak nonsignificant positive correlations to D-dimer and fructosamine and weak but highly significant correlations to HbA1c. These results are indicative for an increase of PAI with diminished glycometabolic control as measured with the HbA1c and fructosamine level. Both D-dimer and PAI showed positive, highly significant correlations to the age of the diabetic patients, whereas HbA1c and fructosamine were age independent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2242825

  3. Difficulties of Diabetic Patients in Learning about Their Illness.

    ERIC Educational Resources Information Center

    Bonnet, Caroline; Gagnayre, Remi; d'Ivernois, Jean Francois

    2001-01-01

    Examines the difficulties experienced by diabetic patients in learning about their illness. Diabetic people (N=138) were questioned by means of a closed answer questionnaire. Results reveal that patients easily acquired manual skills, yet numerous learning difficulties were associated with the skills required to solve problems and make decisions,…

  4. Prolonged Mechanical Noise Restores Tactile Sense in Diabetic Neuropathic Patients

    Microsoft Academic Search

    Rachel Cloutier; Samuel Horr; James B. Niemi; Susan DAndrea; Christina Lima; Jason D. Harry; Aristidis Veves

    2009-01-01

    Acute application of stochastic resonance (SR), defined as a subsensory level of mechanical noise presented directly to sensory neurons, improves the vibration and tactile perception in diabetic patients with mild to moderate neuropathy. This study examined the effect of 1 hour of continuous SR stimulation on sensory nerve function. Twenty diabetic patients were studied. The effect of stimulation was measured

  5. Barriers to diabetes management: Patient and provider factors

    Microsoft Academic Search

    Soohyun Nam; Catherine Chesla; Nancy A. Stotts; Lisa Kroon; Susan L. Janson

    2011-01-01

    Despite significant advances in diagnosis and treatment, the persistence of inadequate metabolic control continues. Poor glycemic control may be reflected by both the failure of diabetes self-management by patients as well as inadequate intervention strategies by clinicians. The purpose of this systematic review is to summarize existing knowledge regarding various barriers of diabetes management from the perspectives of both patients

  6. Electrophysiological findings of acute peripheral facial palsy in diabetic and non-diabetic patients.

    PubMed

    Kiziltan, Meral E; Uluduz, Derya; Yaman, Mehmet; Uzun, Nurten

    2007-05-18

    The aim of this study is to investigate the role of diabetes mellitus on the clinical and electrophysiological findings of peripheral facial palsy (PFP), the effect of the diabetes duration and polyneuropathy on the electrophysiological parameters. A total of 32 diabetic and 40 non-diabetic patients with peripheral facial palsy were included. All patients were divided into two subgroups based on the time of electrophysiological examinations: within the first 15 days versus within 16-30 days. Neuropathy symptoms and the results of neurological examinations and electrophysiological findings were recorded. The findings of electroneurography (EnoG), blink reflex (BR) evaluation, and needle electromyography (EMG) indicated statistically significant blink reflex abnormalities in diabetic patients compared to non-diabetics. Delay in the latency was more remarkable in the R2 component than in the R1 (p<0.001). The delay in the R1 latency was also observed in the non-affected side for diabetic patients. The longer duration of the diabetes caused significant delay on the blink reflex latency on both the affected and non-affected sides for R1 component (p=0.019, p=0.041, respectively). In contrary, neither the diabetes duration nor the age of the patients correlated with the clinical severity of facial palsy, fiber loss, fibular nerve compound muscle action potential amplitudes, and the nerve conduction velocities. PMID:17400385

  7. 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. PMID:25883983

  8. Fatal Bacillus cereus bacteremia in a patient with diabetes.

    PubMed

    Orrett, F A

    2000-04-01

    This report describes a fatal case of Bacillus cereus septicemia in a patient with uncontrolled diabetes and re-emphasizes the potential seriousness of Bacillus infections in patients with compromised immune function. PMID:10976178

  9. Efficacy of sildenafil as the first-step therapeutic tool for Japanese patients with erectile dysfunction

    Microsoft Academic Search

    A Ochiai; Y Naya; J Soh; Y Ishida; Y Mizutani; A Kawauchi; T Fujiwara; T Miki

    2005-01-01

    The aim of this study was to assess the efficacy of sildenafil as the first-step tool for erectile dysfunction (ED) in Japanese males. Between March 1999 and March 2003, 281 patients were prescribed five tablets of sildenafil (50 mg) as the first step in the therapeutic management of ED. Of the 281 patients, 206 were evaluable patients. The overall success

  10. 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

  11. Lower-extremity amputation in diabetic patients: age at amputation is not different from that in non-diabetic controls

    Microsoft Academic Search

    P. Diem; B. Beck; L. Käser

    1992-01-01

    To assess whether diabetic patients undergo lower-extremity amputations (LEA) at an earlier age than non-diabetic patients, and whether there is a relationship between duration of diabetes mellitus and the age at which such amputations occur, we performed a retrospective analysis of data on 289 consecutive diabetic and 484 consecutive non-diabetic patients who underwent LEA for macrovascular disease. The mean age

  12. 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

  13. Glycemic control in diabetic dialysis patients and the burnt-out diabetes phenomenon.

    PubMed

    Park, Jongha; Lertdumrongluk, Paungpaga; Molnar, Miklos Z; Kovesdy, Csaba P; Kalantar-Zadeh, Kamyar

    2012-08-01

    Diabetes mellitus (DM) is the most common cause of end-stage kidney disease and a major risk of morbidity and mortality. It is not clear whether medical management of DM has any significant beneficial effect on clinical outcomes at the end-stage of diabetic nephropathy with full-blown micro- and macro-angiopathic complications. Both loss of kidney function and dialysis treatment interfere with glucose homeostasis and confound glycemic control. Given the unique nature of uremic milieu and dialysis therapy related alterations, there have been some debates about reliance on the conventional measures of glycemic control, in particular the clinical relevance of hemoglobin A1c and its recommended target range of <7 % in diabetic dialysis patients. Moreover, a so-called burnt-out diabetes phenomenon has been described, in that many diabetic dialysis patients experience frequent hypoglycemic episodes prompting cessation of their anti-diabetic therapies transiently or even permanently. By reviewing the recent literature we argue that the use of A1c for management of diabetic dialysis patients should be encouraged if appropriate target ranges specific for these patients (e.g. 6 to 8 %) are used. We also argue that "burnt-out diabetes" is a true biologic phenomenon and highly prevalent in dialysis patients with established history and end-stage diabetic nephropathy and explore the role of protein-energy wasting to this end. Similarly, the J- or U-shaped associations between A1c or blood glucose concentrations and mortality are likely biologically plausible phenomena that should be taken into consideration in the management of diabetic dialysis patients to avoid hypoglycemia and its fatal consequences in diabetic dialysis patients. PMID:22638938

  14. HOMA-IR Values are Associated With Glycemic Control in Japanese Subjects Without Diabetes or Obesity: The KOBE Study

    PubMed Central

    Hirata, Takumi; Higashiyama, Aya; Kubota, Yoshimi; Nishimura, Kunihiro; Sugiyama, Daisuke; Kadota, Aya; Nishida, Yoko; Imano, Hironori; Nishikawa, Tomofumi; Miyamatsu, Naomi; Miyamoto, Yoshihiro; Okamura, Tomonori

    2015-01-01

    Background Several studies have reported that insulin resistance was a major risk factor for the onset of type 2 diabetes mellitus in individuals without diabetes or obesity. We aimed to clarify the association between insulin resistance and glycemic control in Japanese subjects without diabetes or obesity. Methods We conducted a community-based cross-sectional study including 1083 healthy subjects (323 men and 760 women) in an urban area. We performed multivariate regression analyses to estimate the association between the homeostasis model assessment of insulin resistance (HOMA-IR) values and markers of glycemic control, including glycated haemoglobin (HbA1c), 1,5-anhydroglucitol (1,5-AG), and fasting plasma glucose (FPG) levels, after adjustment for potential confounders. Results Compared with the lowest tertile of HOMA-IR values, the highest tertile was significantly associated with HbA1c and FPG levels after adjustment for potential confounders, both in men (HbA1c: ? = 1.83, P = 0.001; FPG: ? = 0.49, P < 0.001) and women (HbA1c: ? = 0.82, P = 0.008; FPG: ? = 0.39, P < 0.001). The highest tertile of HOMA-IR values was inversely associated with 1,5-AG levels compared with the lowest tertile (? = ?18.42, P = 0.009) only in men. Conclusions HOMA-IR values were associated with markers of glycemic control in Japanese subjects without diabetes or obesity. Insulin resistance may influence glycemic control even in a lean, non-diabetic Asian population. PMID:26005064

  15. Impact of diabetes in patients with pulmonary hypertension

    PubMed Central

    Abernethy, Abraham D.; Stackhouse, Kathryn; Hart, Stephen; Devendra, Ganesh; Bashore, Thomas M.; Dweik, Raed

    2015-01-01

    Abstract Diabetes complicates management in a number of disease states and adversely impacts survival; how diabetes affects patients with pulmonary hypertension (PH) has not been well characterized. With insulin resistance having recently been demonstrated in PH, we sought to examine the impact of diabetes in these patients. Demographic characteristics, echo data, and invasive hemodynamic data were prospectively collected for 261 patients with PH referred for initial hemodynamic assessment. Diabetes was defined as documented insulin resistance or treatment with antidiabetic medications. Fifty-five patients (21%) had diabetes, and compared with nondiabetic patients, they were older (mean years ± SD, 61 ± 13 vs. 56 ± 16; ), more likely to be black (29% vs. 14%; ) and hypertensive (71% vs. 30%; ), and had higher mean (±SD) serum creatinine levels (1.1 ± 0.5 vs. 1.0 ± 0.4; ). Diabetic patients had similar World Health Organization functional class at presentation but were more likely to have pulmonary venous etiology of PH (24% vs. 10%; ). Echo findings, including biventricular function, tricuspid regurgitation, and pressure estimates were similar. Invasive pulmonary pressures and cardiac output were similar, but right atrial pressure was appreciably higher (14 ± 8 mmHg vs. 10 ± 5 mmHg; ). Despite similar management, survival was markedly worse and remained so after statistical adjustment. In summary, diabetic patients referred for assessment of PH were more likely to have pulmonary venous disease than nondiabetic patients with PH, with hemodynamics suggesting greater right-sided diastolic dysfunction. The markedly worse survival in these patients merits further study. PMID:25992276

  16. [Macroangiopathic complications in type 2 diabetic patients seen at an Italian diabetes center].

    PubMed

    Maggini, Marina; Spila Alegiani, Stefania; Raschetti, Roberto

    2003-01-01

    A large multicenter cohort study, the DAI study, is being performed on patients with type 2 diabetes mellitus who are followed by diabetic care units in Italy, to study the prevalence and incidence of macrovascular complications. The reference population consists of all patients visited at the participating units in the period September 1998-June 1999. Patients were randomly chosen so as to create a sample representative of the diabetic population visited at the units. Overall, 201 Italian diabetic care units participated in the study and 19,570 patients were included in the study. The prevalence of macrovascular complications in Italian type 2 diabetics is 15.6% (17.2% in males and 14.0% in females). Acute miocardial infarction was the most prevalent (7.6%) complication among males, while angina was more frequent (9.3%) among females. PMID:14587214

  17. Disordered eating behaviors in type 1 diabetic patients

    PubMed Central

    Larrañaga, Alejandra; Docet, María F; García-Mayor, Ricardo V

    2011-01-01

    Patients with type 1 diabetes mellitus are at high risk for disordered eating behaviors (DEB). Due to the fact that type 1 diabetes mellitus is one of the most common chronic illnesses of childhood and adolescence, the coexistence of eating disorders (ED) and diabetes often affects adolescents and young adults. Since weight management during this state of development can be especially difficult for those with type 1 diabetes, some diabetics may restrict or omit insulin, a condition known as diabulimia, as a form of weight control. It has been clearly shown that ED in type 1 diabetics are associated with impaired metabolic control, more frequent episodes of ketoacidosis and an earlier than expected onset of diabetes-related microvascular complications, particularly retinopathy. The management of these conditions requires a multidisciplinary team formed by an endocrinologist/diabetologist, a nurse educator, a nutritionist, a psychologist and, frequently, a psychiatrist. The treatment of type 1 diabetes patients with DEB and ED should have the following components: diabetes treatment, nutritional management and psychological therapy. A high index of suspicion of the presence of an eating disturbance, particularly among those patients with persistent poor metabolic control, repeated episodes of ketoacidosis and/or weight and shape concerns are recommended in the initial stage of diabetes treatment, especially in young women. Given the extent of the problem and the severe medical risk associated with it, more clinical and technological research aimed to improve its treatment is critical to the future health of this at-risk population. PMID:22087355

  18. 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,

  19. Evaluation of subjective symptoms of Japanese patients with multiple chemical sensitivity using QEESI ©

    Microsoft Academic Search

    Sachiko Hojo; Kou Sakabe; Satoshi Ishikawa; Mikio Miyata; Hiroaki Kumano

    2009-01-01

    Objectives  The Quick Environment Exposure Sensitivity Inventory (QEESI©) has been used as a questionnaire to evaluate subjective symptoms of patients with multiple chemical sensitivity (MCS), also\\u000a known as idiopathic environmental intolerance, in Japan. However, no cutoff value for Japanese subjects has yet been established.\\u000a We designed this study to establish a cutoff value for Japanese subjects using QEESI© for screening of

  20. Medical Nutrition Therapy in Hospitalized Patients with Diabetes

    PubMed Central

    Gosmanov, Aidar R.

    2013-01-01

    Medical nutrition therapy (MNT) plays an important role in management of hyperglycemia in hospitalized patients with diabetes mellitus. The goals of inpatient MNT are to optimize glycemic control, to provide adequate calories to meet metabolic demands, and to create a discharge plan for follow-up care. All patients with and without diabetes should undergo nutrition assessment on admission with subsequent implementation of physiologically sound caloric support. The use of a consistent carbohydrate diabetes meal-planning system has been shown to be effective in facilitating glycemic control in hospitalized patients with diabetes. This system is based on the total amount of carbohydrate offered rather than on specific calorie content at each meal, which facilitates matching the prandial insulin dose to the amount of carbohydrate consumed. In this article, we discuss general guidelines for the implementation of appropriate MNT in hospitalized patients with diabetes. PMID:21997598

  1. Lipid Management in Patients with Type 2 Diabetes

    PubMed Central

    Daniel, Marsha J.

    2011-01-01

    Background Diabetes is correlated with a high risk for cardiovascular disease (CVD). The management of diabetic dyslipidemia, a well-recognized and modifiable risk factor, is a key element in the multifactorial approach to preventing CVD in patients with type 2 diabetes. Diabetic dyslipidemia is characterized by elevated triglyceride levels, decreased high-density lipoprotein cholesterol levels, and elevated low-density lipoprotein cholesterol (LDL-C) levels. Objectives To describe the effective approach to the management of dyslipidemia in patients with diabetes to allow providers and payers to become familiar with the treatment goals for all the components of lipoproteins, to correctly initiate appropriate lipid-lowering medications based on treatment goals and lipid-lowering capability, and to apply the data presented in lipid clinical trials to the treatment of patients with diabetes. Summary Diabetes is associated with a 2- to 4-fold increase in risk for CVD. The risk factors for coronary artery disease (CAD) include hypertension, dyslipidemia, obesity, and smoking. Therefore, prioritizing and managing diabetic patients with CVD risk factors is vital. Conclusion LDL-C appears to have the greatest role in premature and early atherosclerosis and the development of CAD and must be treated as aggressively as hyperglycemia to reduce CAD risk. Becoming familiar with lipid treatment goals and the many therapies available today can help providers and payers implement the appropriate approach to managing diabetic dyslipidemia risk factors and reduce the burden of this disease. PMID:25126359

  2. [Nursing diagnoses for diabetic patients using insulin].

    PubMed

    Becker, Tânia Alves Canata; Teixeira, Carla Regina de Souza; Zanetti, Maria Lúcia

    2008-01-01

    This is a descriptive study with a qualitative approach that has as objective to identify the nursing diagnoses of diabetic patients using insulin, having as inquiry method the study of multiple cases. The data were obtained by the researcher by means of physical examination and the technique of interview directed in the instrument based on the Orem's Self-Care Theory. After data collection, the diagnostic indentification was proceeded from the nominated nursing diagnoses of NANDA Taxonomy II, using Risner's reasoning diagnostic process. The identified nursing diagnoses with a higher frequency than 50% were six: impaired skin integrity (100%), risk for infection (100%), behavior of health search (57,2%), disturbed sleep (57,2%), chronic pain (57,2%) and risk for peripheral neurovascular dysfunction (57,2%). The application of the nursing process based in Orem and the importance of the identified diagnostic for clients nursing care were evidenced. PMID:19142391

  3. Abdominal Pathology in Patients With Diabetes Ketoacidosis.

    PubMed

    Pant, Nicole; Kadaria, Dipen; Murillo, Luis C; Yataco, Jose C; Headley, Arthur S; Freire, Amado X

    2012-01-20

    INTRODUCTION: The objective is to describe the incidence and nature of significant abdominal pathologies in patients with diabetes ketoacidosis (DKA) and abdominal pain. METHODS: Retrospective chart review (N = 86) of patients with DKA from January 1, 2005, to January 31, 2010, was performed. Data included demographics, comorbidities, compliance, chief complaints and physical findings, blood count, metabolic profile, lactic acid, glycosylated hemoglobin (HbA1C), amylase, lipase, anion gap, arterial gases, imaging and final diagnosis. Continuous variables were described as mean ± standard deviation and compared with the Student's t test. Categorical variables were expressed as percentages (%) and compared with the Mantel-Haenszel ? test. Univariate analysis was conducted among patients with and without significant abdominal pain and also with and without significant abdominal pathology. Two lipase strata were created at 400 U. Multivariate model to identify limits (confidence interval) of the estimated risk imposed by the predictor found significant in univariate analysis. A P value of ?0.05 was considered significant. Stat View 5.0 (SAS Institute, Cary, NC) was used for the statistical analysis. RESULTS: In patients with abdominal pain, 17% had significant abdominal pathology mainly acute pancreatitis (AP). Serum amylase and lipase level were found to be an indicator of significant underlying pathology (both P values ?0.001). The logistic model created showed that patients with lipase level ?400 U have a 7% increased risk of having AP with confidence interval of 0.01 to 0.6. CONCLUSIONS: Patients with DKA and abdominal pain with lipase >400 U have an increased risk of significant underlying abdominal pathology (AP). PMID:22270401

  4. Adequacy of Oral Health Information for Patients with Diabetes

    PubMed Central

    Yuen, Hon K.; Mountford, William K.; Magruder, Kathryn M.; Bandyopadhyay, Dipankar; Hudson, Pemra L.; Summerlin, Lisa M.; Salinas, Carlos F.

    2009-01-01

    Objective We investigated the perception of dental hygienists regarding their adequacy of providing diabetics with diabetes-related oral health preventive education. Methods A one-page questionnaire printed on both sides was mailed to 2,237 licensed registered dental hygienists with a South Carolina (SC) mailing address. In addition to the dental hygienists’ background and practice characteristics, the survey queried their perception of adequacy for educating patients with diabetes on various diabetes-related oral health topics and reasons for inadequate coverage of materials. Results After two follow-up mailings, 995 completed and usable surveys were returned. About 60% of respondents reported not covering all essential materials related to oral health when educating diabetic patients. The three most common reasons were: (1) insufficient time (60.1%), (2) patient disinterest (41.2%), and (3) insufficient information on oral care and diabetes (39.7%). Respondents reporting insufficient information were less likely to adequately address the effect of periodontal disease on diabetes (P < 0.001), effect of uncontrolled diabetes on periodontal disease (P < 0.001), and dry mouth management (P = 0.03). Conclusion This study indicates that SC dental hygienists do not routinely provide patient education on diabetes-related oral health and healthy lifestyle topics. Lack of time, patient disinterest, and insufficient information were the three main reasons for respondents not covering essentials. A practical method for improving dental hygienists’ comprehensive service to patients with diabetes is to offer more continuing education on diabetes and oral health to supplement their knowledge, skills, and confidence to educate this growing population. PMID:19192104

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

    PubMed

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

    2011-04-01

    Diabetes mellitus (DM) is recognised as a major health problem. Ninety-nine percent of diabetics suffer from type 2 DM and 10% from type 1 and other types of DM. The number of diabetic patients worldwide is expected to reach 380 millions over the next 15 years. The duration of diabetes is an important factor in the pathogenesis of complications, but other factors frequently coexisting with type 2 DM, such as hypertension, obesity and dyslipidaemia, also contribute to the development of diabetic angiopathy. Microvascular complications include retinopathy, nephropathy and neuropathy. Macroangiopathy mainly affects coronary arteries, carotid arteries and arteries of the lower extremities. Eighty percent of deaths in the diabetic population result from cardiovascular incidents. DM is considered an equivalent of coronary heart disease (CHD). Stroke and peripheral artery disease (PAD) are other main manifestations of diabetic macroangiopathy. Diabetic cardiomyopathy (DC) represents another chronic complication that occurs independently of CHD and hypertension. The greater susceptibility of diabetic patients to infections completes the spectrum of the main consequences of DM. The serious complications of DM make it essential for physicians to be aware of the screening guidelines, allowing for earlier patient diagnosis and treatment. PMID:22347947

  6. A Phase 2 Clinical Trial of Panitumumab Monotherapy in Japanese Patients with Metastatic Colorectal Cancer

    Microsoft Academic Search

    Kei Muro; Takayuki Yoshino; Toshihiko Doi; Kuniaki Shirao; Hiroya Takiuchi; Yasuo Hamamoto; Hiroyuki Watanabe; Bing-Bing Yang; Daisuke Asahi

    Objective: Panitumumab, a fully human monoclonal antibody targeting epidermal growth factor receptor (EGFR), has antitumor activity and an acceptable safety profile in patients with metastatic colorectal cancer (mCRC). This Phase 2 study evaluated efficacy, pharmaco- kinetics and safety of panitumumab in Japanese patients with mCRC who developed pro- gressive disease during or after fluoropyrimidine, irinotecan and oxaliplatin chemotherapy. Methods: Eligible

  7. Excessive daytime sleepiness and sleep episodes in Japanese patients with Parkinson's disease

    Microsoft Academic Search

    Keisuke Suzuki; Tomoyuki Miyamoto; Masayuki Miyamoto; Yasuyuki Okuma; Nobutaka Hattori; Satoshi Kamei; Fumihito Yoshii; Hiroya Utsumi; Yasuo Iwasaki; Mutsumi Iijima; Koichi Hirata

    2008-01-01

    In Parkinson's disease (PD), sudden unexpected sleep episodes and excessive daytime sleepiness (EDS) while driving and engaging in social activities are important problems. We conducted a multi-center study to clarify the prevalence and contributing factor of EDS and sleep episodes in Japanese patients with PD. We evaluated 188 patients with PD (85 men, 103 women) and 144 age-matched controls for

  8. Daily omega-3 fatty acid intake and depression in Japanese patients with newly diagnosed lung cancer

    Microsoft Academic Search

    S Suzuki; T Akechi; M Kobayashi; K Taniguchi; K Goto; S Sasaki; S Tsugane; Y Nishiwaki; H Miyaoka; Y Uchitomi

    2004-01-01

    The aim of the present study was to examine the association between daily omega-3 fatty acid intake and depression in Japanese cancer patients. Omega-3 fatty acid intake in 771 patients with newly diagnosed primary lung cancer was evaluated using a food-frequency questionnaire, and the prevalence of depression was examined using the cutoff values for the depression subscale included in the

  9. 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

  10. 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

  11. 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

  12. [Safe exercises for elderly diabetic patients with chronic complications].

    PubMed

    Bai, Yu-Ling; Chiou, Chou-Ping

    2012-12-01

    Medical complications impair the ability of elderly diabetic patients to exercise independently, which often leads to increased medical costs. Detailed exercise guidance, in addition to encouragement, can help sustain and improve independent exercise abilities in this vulnerable population. Prior to adopting a exercise regimen, diabetic patients should receive a full physical examination and consider possible complications. Disease stage-appropriate exercise information can help patients self-manage their disease and exercise to achieve long-term benefits. This paper is a literature review that focuses on pre-exercise evaluation methodologies, exercise suggestions, and exercises recommended for diabetic patients with chronic complications. This review may serve as a reference for medical professionals responsible to provide exercise advice to elderly diabetic patients. PMID:23212258

  13. Pancreas and islet transplantation for patients with diabetes

    Microsoft Academic Search

    R. PAUL ROBERTSON; CONNIE DAVIS; JENNIFER LARSEN; ROBERT STRATTA; DAVID E. R. SUTHERLAND

    2000-01-01

    i s t o r i c a l l y, patients with diabetes have expended tremendous eff o rt in pursuing a re t u rn to norm o g l y c e m i a . The relatively recent results of the Diabetes C o n t rol and Complications Trial (DCCT), demonstrating an approximate 50% re

  14. Benefit of Blood Pressure Control in Diabetic Patients.

    PubMed

    Kintscher, Ulrich

    2015-07-01

    The coexistence of arterial hypertension and diabetes represents a devastating partnership for cardiovascular health. Thus, blood pressure and blood glucose control are essential therapeutic goals to reduce cardiovascular risk and other diabetes-related endpoints in these patients. The major benefit of blood pressure lowering in diabetes comes from a marked reduction of cardiovascular and renal endpoints. New target blood pressure values to achieve maximum cardiovascular and renal protection will be discussed. In addition to the reduction of macrovascular endpoints, blood pressure lowering therapy in diabetic patients has also been discussed to improve microvascular diseases during diabetes, in particular microalbuminuria or diabetic retinopathy. However, current clinical trial evidence is less robust than for macrovascular disease. Clinical studies showed controversial results, and will be discussed. Finally, new data from the ADVANCE-ON study about the long-term, sustained benefit of blood pressure lowering in hypertensive, diabetic patients has been recently published, and will be evaluated in the context of previous evidence. In summary, the present article will discuss selected new topics in the field of hypertension and diabetes focusing on the benefits achieved by blood pressure lowering in these patients. PMID:26068653

  15. Analysis of diabetic patient's breath with conducting polymer sensor array

    Microsoft Academic Search

    Joon-Boo Yu; Hyung-Gi Byun; Myung-Suk So; Jeung-Soo Huh

    2005-01-01

    A portable gas analyzing system has been developed using conducting polymer (polypyrrole) sensor array that can be possible to analyze diabetic patient's breath. The expired breathe of diabetics often smells like decaying apples, which give off acetone. The polypyrrole thin film sensors with different thickness, which had been synthesized by chemical polymerization, were employed to detect acetone. Baseline was calibrated

  16. 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

  17. Approach to the Patient with Gestational Diabetes after Delivery

    PubMed Central

    Page, Kathleen A.

    2011-01-01

    The diagnosis of gestational diabetes mellitus (GDM) identifies patients with a pancreatic ?-cell defect. In some patients, the defect is transient or stable, but in most it is progressive, imparting a high risk of diabetes for at least a decade after the index pregnancy. The ?-cell defects in GDM can result from many causes, including genetic variants typical of monogenic forms of diabetes and autoimmunity typical of evolving type 1 diabetes. No specific disease-modifying therapies are available for those patients. The majority of women with GDM have clinical characteristics indicating a risk for type 2 diabetes (T2D). Available evidence indicates that T2D can be prevented or delayed by intensive lifestyle modification and by medications, particularly those that ameliorate insulin resistance. Clinical management should include assessment of glucose tolerance in the postpartum period to detect diabetes or assess diabetes risk. Women who don't have diabetes should be advised about their risk and participate in family planning to prevent subsequent pregnancies with undiagnosed hyperglycemia. All patients should be monitored for rising glycemia indicative of progressive ?-cell deterioration. We suggest a combination of fasting glucose and glycosylated hemoglobin measurements for this purpose. Monitoring should be initiated at least annually and should be intensified if glycemia is rising and/or impaired. Lifestyle modification is advised to reduce the risk for T2D. Like monitoring, lifestyle modification should be intensified for rising glycemia and/or development of impaired glucose levels. At present, there is insufficient evidence to recommend medications to prevent T2D. Close follow-up and monitoring will allow initiation of pharmacological treatment as soon as diabetes develops. Children of women with GDM are at increased risk for obesity and diabetes. They should receive education, monitoring, and lifestyle advice to minimize obesity and diabetes risk. PMID:22143829

  18. 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

  19. Retinopathy and microalbuminuria in type II diabetic patients

    PubMed Central

    Manaviat, Masoud R; Afkhami, Mohammad; Shoja, Mohammad R

    2004-01-01

    Background The aim of this study was to identify risk factors for the development of retinopathy and microalbuminuria and their correlation in type II diabetic patients. Methods In this cross-sectional study 590 patients suffering from diabetis type II were examined. Fundoscopy was performed by practising ophthalmologist. The ratio of urinary albumin to creatinine was assessed by clinitek 100 (Bayer corporation–USA). HbA1C, height and weight also were measured. Results The overall prevalence of retinopathy was 39.3% (232 patients), 5.4% of which showed to be prolifrative diabetic retinopathy (PDR). The diabetic retinopathy had significant inverse correlation with body mass index (BMI) (P = 0.02). HbA1C was higher in patients with PDR (mean = 10.5%) than in patients with no signs of retinopathy (mean = 9.5%) and this difference was statistically significant (P = 0.001). The prevalence of microalbuminuria was 25.9% while 14.5% of the patients revealed to have macroalbuminuria. As expected, diabetic retinopathy and renal involvement were highly positively correlated. (P = 0.001). Conclusion Microalbuminuria is associated with diabetic retinopathy in type II diabetic patients and is a reliable marker of retinopathy. PMID:15228626

  20. New Drug May Help Diabetic Kidney Disease Patients

    MedlinePLUS

    New Drug May Help Diabetic Kidney Disease Patients Patiromer appears to keep potassium levels in check, researchers ... 2015 TUESDAY, July 14, 2015 (HealthDay News) -- A new drug decreases dangerously high levels of potassium in ...

  1. Relationship Between Retinal Blood Flow and Renal Function in Patients With Type 2 Diabetes and Chronic Kidney Disease

    PubMed Central

    Nagaoka, Taiji; Yoshida, Akitoshi

    2013-01-01

    OBJECTIVE To study the relationship between retinal microcirculation and renal function in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Using a laser Doppler velocimetry system, we obtained the retinal blood flow (RBF) values by simultaneously measuring the retinal vessel diameter and blood velocity. To determine if the RBF is affected in the presence of renal dysfunction, we also evaluated the renal function using the estimated glomerular filtration rate calculated by age and serum creatinine level. RESULTS We recruited 169 eyes of 169 consecutive Japanese patients with type 2 diabetes, no or minimal diabetic retinopathy, and normo/microalbuminuria (mean age ± SD, 59.0 ± 11.1 years). We divided the patients into four groups based on the stage of chronic kidney disease (CKD) (non-CKD, n = 99; CKD stage 1, n = 22; stage 2, n = 27; stage 3, n = 21). We found significant (P = 0.035) decreases in RBF with decreased vessel diameter (P = 0.017) but no difference in blood velocity (P = 0.54) in stage 3 CKD compared with the non-CKD group. Multiple regression analysis showed that the CKD stage was significantly (P = 0.02) and independently associated with decreased RBF. CONCLUSIONS Our results indicated that the vessel diameter and RBF in the retinal arterioles decrease in patients with type 2 diabetes with stage 3 CKD, suggesting that impaired renal function might be associated with decreased RBF, probably via constriction of the retinal arterioles, in early-phase diabetic retinopathy. PMID:23204249

  2. 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

  3. An Analysis, Using Concept Mapping, of Diabetic Patients' Knowledge, before and after Patient Education.

    ERIC Educational Resources Information Center

    Marchand, C.; d'Ivernois, J. F.; Assal, J. P.; Slama, G.; Hivon, R.

    2002-01-01

    Assesses whether concept maps used with diabetic patients could describe their cognitive structure, before and after having followed an educational program. Involves 10 diabetic patients and shows that concept maps can be a suitable technique to explore the type and organization of the patients' prior knowledge and to visualize what they have…

  4. 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

  5. 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

  6. Increased Incidence of Non-Insulin Dependent Diabetes Mellitus Among Japanese Schoolchildren Correlates with an Increased Intake of Animal Protein and Fat

    Microsoft Academic Search

    Teruo Kitagawa; Misao Owada; Tatsuhiko Urakami; Kuniaki Yamauchi

    1998-01-01

    Non-insulin dependent diabetes (NIDDM) was diagnosed in 188 of more than 7 million Tokyo schoolchildren tested between 1974 and 1994 for glycosuria followed by oral glucose tolerance testing. The incidence rate of NIDDM in youth has continued to increase since 1976. While the daily energy intake has not changed significantly, the consumption of animal protein and fat by the Japanese

  7. The prognosis of diabetic retinopathy in patients with type 2 diabetes since 1996-1998: the Skaraborg Diabetes Register.

    PubMed

    Garberg, Grete; Lövestam-Adrian, Monica; Nasic, Salmir; Boström, Kristina Bengtsson

    2015-08-01

    Diabetes mellitus is the main reason for visual impairment among patients of working ages. The aim of this paper was to investigate the prognosis of eye complications in patients with diabetes during 10 years of follow-up and contributing risk factors. Data from ophthalmological records (occurrence of retinopathy and laser treatment and visual acuity), and clinical data (blood pressure, glycosylated hemoglobin (HbA1c), body mass index (BMI), and antihypertensive treatment) from the Skaraborg Diabetes Register were retrieved in the Skaraborg Screening Program of 1,258 patients diagnosed during 1996-1998. Kaplan Meyer survival analysis and Log Rank test were used to analyze eye complications in 773 patients with type 2 diabetes and ?70 years at diagnosis. Visual acuity was above the limit for driving license in 96 % of 548 patients and only nineteen patients were treated by laser. At diagnosis of diabetes, mean HbA1c was 6.7 ± 1.7 % (59 ± 7.1 mmol/mol), and systolic blood pressure was 142.9 ± 0.7 mmHg; neither changed significantly during follow-up. Retinopathy appeared about 1 year, and maculopathy 2 years earlier, if HbA1c ? 7 % (63 mmol/mol) at diagnosis (p < 0.001 and p < 0.006). Antihypertensive treatment, higher BMI, and higher age at diagnosis were associated with less retinopathy during follow-up. Most patients with diabetes develop little retinopathy for the first 10 years after diagnosis. High HbA1c at baseline was associated with retinopathy and maculopathy during follow-up. Antihypertensive treatment, probably a proxy for regular controls and early detection of diabetes, was associated with less retinopathy. PMID:25143261

  8. Central nervous system impairment in diabetic patients.

    PubMed

    Kolev, O I; Milanov, I

    1999-12-01

    The aims of this study were to investigate the function of the central motor control system in interaction with the vestibular and auditory systems (measured by H-reflex changes in response to vestibular and acoustic stimulations) in diabetics without clinical data for CNS impairment, in order to establish whether the disease affects these CNS mechanisms; and to assess this approach in detecting subclinical CNS diabetic pathology. The results show the same mode of change of H-reflex amplitude in response to acoustic and vestibular stimulations in diabetics as in normal subjects. However the degree of facilitation and inhibition was significantly (p < 0.001) higher in diabetics which indicates subclinical CNS dysfunction. Therefore it was concluded that the test is useful in early diagnosis of the diabetic CNS impairment. PMID:10627933

  9. Diabetes therapies in hemodialysis patients: Dipeptidase-4 inhibitors

    PubMed Central

    Nakamura, Yuya; Hasegawa, Hitomi; Tsuji, Mayumi; Udaka, Yuko; Mihara, Masatomo; Shimizu, Tatsuo; Inoue, Michiyasu; Goto, Yoshikazu; Gotoh, Hiromichi; Inagaki, Masahiro; Oguchi, Katsuji

    2015-01-01

    Although several previous studies have been published on the effects of dipeptidase-4 (DPP-4) inhibitors in diabetic hemodialysis (HD) patients, the findings have yet to be reviewed comprehensively. Eyesight failure caused by diabetic retinopathy and aging-related dementia make multiple daily insulin injections difficult for HD patients. Therefore, we reviewed the effects of DPP-4 inhibitors with a focus on oral antidiabetic drugs as a new treatment strategy in HD patients with diabetes. The following 7 DPP-4 inhibitors are available worldwide: sitagliptin, vildagliptin, alogliptin, linagliptin, teneligliptin, anagliptin, and saxagliptin. All of these are administered once daily with dose adjustments in HD patients. Four types of oral antidiabetic drugs can be administered for combination oral therapy with DPP-4 inhibitors, including sulfonylureas, meglitinide, thiazolidinediones, and alpha-glucosidase inhibitor. Nine studies examined the antidiabetic effects in HD patients. Treatments decreased hemoglobin A1c and glycated albumin levels by 0.3% to 1.3% and 1.7% to 4.9%, respectively. The efficacy of DPP-4 inhibitor treatment is high among HD patients, and no patients exhibited significant severe adverse effects such as hypoglycemia and liver dysfunction. DPP-4 inhibitors are key drugs in new treatment strategies for HD patients with diabetes and with limited choices for diabetes treatment. PMID:26131325

  10. Endothelial Progenitor Cells in Long-Standing Asymptomatic Type 1 Diabetic Patients with or without Diabetic Nephropathy

    Microsoft Academic Search

    Henrik Reinhard; Peter Karl Jacobsen; Maria Lajer; Lise Tarnow; Anne Sofie Astrup; Won Yong Kim; Nadja Pedersen; Nils Billestrup; Thomas Mandrup-Poulsen; Hans-Henrik Parving; Peter Rossing

    2011-01-01

    A decrease in the number and dysfunction of endothelial progenitor cells (EPC) may increase the risk for progression of cardiovascular disease (CVD) in type 1 diabetic patients with diabetic nephropathy (DN). Our aim was to evaluate EPC numbers in asymptomatic CVD type 1 diabetic patients with or without DN and to study the effect of CVD and medication on EPC

  11. Insulinoma in a patient with type 2 diabetes mellitus.

    PubMed

    Ghafoori, Shahnaz; Lankarani, Mahnaz

    2015-05-01

    Insulinoma in a patient with pre-existing diabetes is extremely rare (1). Only a small number of cases have been reported all over the world (2). We report a case of insulinoma in a patient with type 2 diabetes. A 63-year-old female was diagnosed to have diabetes mellitus six years ago, she was given metformin and sulphonylurea to control her glycemia, she had adequate glycemic control for many years, but thereafter, the patient has experienced hypoglycemia after cessation of the treatment since 8 months ago and was hospitalized for further examination, endogenous hypoglycemia was confirmed and the level of serum insulin and C-peptide were elevated. Endoscopic ultrasound showed a heterogeneous lesion in the head of the pancreas. Head pancreatectomy was done. In the postoperative period diabetes again developed and required oral agents for control. PMID:26024708

  12. SESAM-DIABETE, an expert system for insulin-requiring diabetic patient education.

    PubMed

    Levy, M; Ferrand, P; Chirat, V

    1989-10-01

    SESAM-DIABETE is an interactive educational expert system that provides personalized advice and therapeutic recommendations for insulin-requiring diabetic patients. Because of its sophisticated explanation facilities, this system is intended to complete the more traditional educational tools for diabetic patients. It has been developed using an original essential expert system, namely SESAM, itself implemented in an upper-layer of Lisp, MBX. Its control structure uses a top-down strategy to solve a problem; i.e., it decomposes the current problem into subproblems easier to solve, this method being recursively applied to each subproblem. All information about patients is kept in a Patient Medical Record, which allows their follow-up. This system is currently available from their home for selected patients through the French telematic network TELETEL and is under clinical evaluation. PMID:2776447

  13. 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

  14. 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

  15. Hospitalized cardiovascular events in patients with diabetic macular edema

    PubMed Central

    2012-01-01

    Background Microvascular and macrovascular complications in diabetes stem from chronic hyperglycemia and are thought to have overlapping pathophysiology. The aim of this study was to investigate the incidence rate of hospitalized myocardial infarctions (MI) and cerebrovascular accidents (CVA) in patients with diabetic macular edema (DME) compared with diabetic patients without retinal diseases. Methods This was a retrospective cohort study of a commercially insured population in an administrative claims database. DME subjects (n?=?3519) and diabetes controls without retinal disease (n?=?10557) were matched by age and gender. Healthcare claims were analyzed for the study period from 1 January 2002 to 31 December 2005. Incidence and adjusted rate ratios of hospitalized MI and CVA events were then calculated. Results The adjusted rate ratio for MI was 2.50 (95% CI: 1.83-3.41, p?diabetes controls. Predictors of MI events were heart disease, history of acute MI, and prior use of antiplatelet or anticoagulant drugs. The adjusted rate ratio for CVA was 1.98 (95% CI: 1.39-2.83, p?diabetes controls. Predictors of CVA events were cardiac arrhythmia, Charlson comorbidity scores, history of CVA, hyperlipidemia, and other cerebrovascular diseases. Conclusion Event rates of MI or CVA were higher in patients with DME than in diabetes controls. This study is one of few with sufficient sample size to accurately estimate the relationship between DME and cardiovascular outcomes. PMID:22646811

  16. The serum vaspin levels are reduced in Japanese chronic hemodialysis patients

    PubMed Central

    2012-01-01

    Background Visceral adipose tissue-derived serine proteinase inhibitor (vaspin) is an adipokine identified in genetically obese rats that correlates with insulin resistance and obesity in humans. Recently, we found that 7% of the Japanese population with the minor allele sequence (A) of rs77060950 exhibit higher levels of serum vaspin. We therefore evaluated the serum vaspin levels in Japanese chronic hemodialysis patients. Methods Healthy Japanese control volunteers (control; n?=?95, 49.9±6.91?years) and Japanese patients undergoing hemodialysis therapy (HD; n?=?138, 51.4±10.5?years) were enrolled in this study, and serum samples were subjected to the human vaspin RIA system. Results The measurement of the serum vaspin levels demonstrated that a fraction of control subjects (n?=?5) and HD patients (n?=?11) exhibited much higher levels (> 10?ng/ml; VaspinHigh group), while the rest of the population exhibited lower levels (< 3?ng/ml; VaspinLow group). By comparing the patients in the VaspinLow group, the serum vaspin levels were found to be significantly higher in the control subjects (0.87±0.24?ng/ml) than in the HD patients (0.32±0.15?ng/ml) (p?Japanese HD patients in the VaspinLow group. PMID:23206815

  17. High Prevalence of Multiple Human Papillomavirus Infection in Japanese Patients with Invasive Uterine Cervical Cancer

    Microsoft Academic Search

    Hidemichi Watari; Rie Michimata; Motoaki Yasuda; Akihiro Ishizu; Utano Tomaru; Ying Xiong; Mohamed K. Hassan; Noriaki Sakuragi

    2011-01-01

    Objective: Multiple human papillomavirus (HPV) infection of the uterine cervix has been suggested as a risk factor for persistent HPV infection, resulting in the development of invasive cervical cancer. The aim of this study was to reveal the actual state of multiple HPV infection in Japanese patients with invasive cervical cancer. Methods: Sixty fresh-frozen invasive cervical cancer tissues were examined

  18. Immunoglobulin allotypes in caucasian and Chinese myasthenia gravis: differences from Japanese patients.

    PubMed Central

    Chiu, H C; de Lange, G G; Willcox, N; Vincent, A; Newsom-Davis, J; Hsieh, K H; Hung, T P

    1988-01-01

    The G2m(n) allotype was significantly increased in Chinese female and high autoantibody cases, and in caucasians with pure ocular myasthenia, or undetectable autoantibody. In contrast to the strong Glm(x) association reported in Japanese, no overall Gm haplotype, or Am or Km allotype association was found in 90 (Taiwan) Chinese and 181 caucasian myasthenia gravis patients. PMID:3346685

  19. Postmarketing surveillance of rabeprazole in upper gastrointestinal peptic lesions in Japanese patients with coexisting hepatic disorders

    Microsoft Academic Search

    Isao Makino; Kimihide Nakamura; Yoichi Sato; Yuzuru Sato; Shuichi Sezai; Yusei Ikeda; Wahei Shinmura; Hajime Watahiki; Hideaki Yamamoto; Yayuki Hioki; Masao Suzuki; Takashi Kumada; Takashi Honda; Tomoo Rikitoku; Yasuhiro Hisanaga; Hiroshi Fukui; Junichi Yamao; Hironaka Kawasaki; Akihide Hosoda; Morikazu Onji; Hidetaka Matsui; Michio Sata; Takuji Torimura; Kazuhiko Oho; Ryuichiro Maekawa; Yoshiyuki Takagi; Satoshi Shakado; Masafumi Nakayama; Kazuhisa Gondo; Hirofumi Fukushima; Taku Kusaba; Hirohito Tsubouchi; Katsuhiro Hayashi; Takeshi Hori; Yozo Iida; Kouki Yutoku; Noboru Maetani; Yoshitsugu Kubo; Yoshifumi Miyata

    2006-01-01

    Background:Many Japanese patients with hepatic disorders confirmed on diagnostic imaging and coexisting upper gastrointestinal (GI) peptic lesions receive treatment with proton pump inhibitors. Some pharmacotherapies used to treat peptic ulcers have been associated with adverse drug reactions (ADRs), including elevated liver enzyme levels.

  20. [Causes of emergency hospitalization of elderly diabetic patients].

    PubMed

    Horikawa, Shunji; Kajitani, Shinya; Kawakami, Keiko; Tadasa, Nobuko; Ito, Akihiko

    2013-01-01

    In recent years there has been a rise in the number of diabetic patients in Japan, with the increase in elderly diabetic patients becoming a serious problem. This study looked at 488 elderly type 2 diabetes patients who were admitted as emergency cases to the Department of Internal Medicine, JA Yoshida General Hospital, Akitakada City, Japan. All patients were classified by age into three groups: <70, 70-80 and >80. The most common cause of emergency hospitalization in each of the three age groups was infection. This was significantly higher in the >80 group in comparison with<70 (p<0.05). The most common infection among the three groups was respiratory infection, followed by urinary tract infection. The number of emergency hospitalization cases due to hypoglycemia was much higher in the over 80 group, particularly in comparison with<70-80 (p<0.05). The incidence of hypoglycemia in our patients could be explained mainly by reduced energy intake. Most cases were treated with oral administration of hypoglycemic drugs. As elderly diabetic patients have a number of underlying illnesses that are prone to aggravation and may lead to unfavorable prognosis, early medical examination and disease detection are considered to be important. Pharmacists are required to educate patients, home-visit nursing care personnel on sick-day rule, and provide diabetes care. PMID:23546590

  1. 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

  2. Characteristics of Patients With Diabetes Having Normal Coronary Arteries.

    PubMed

    Binbrek, Azan Salim; Ali, Sameera Mohamed; Baslaib, Fahad Omar; Ali, Alawi Al Sheikh

    2015-07-01

    We evaluated the association between risk variables in diabetic patients with normal and diseased coronary arteries in a retrospective cohort study conducted at Rashid Hospital, Dubai. A total of 4446 patients underwent coronary angiography due to various indications; 43% had type 2 diabetes mellitus (T2DM). Among the diabetic patients, 94% had diseased coronary arteries and the remaining 6% had absolutely normal arteries. The normal coronary group had significantly lower low-density lipoprotein cholesterol (LDL-C) and a higher high-density lipoprotein cholesterol (HDL-C) levels than the diseased group. Patients with normal coronaries were more likely to be females, have T2DM for a shorter duration, and were nonsmokers and non-South Asians. They also had lower levels of LDL, hemoglobin A1c, and fasting glucose and higher levels of HDL-C. Apart from these variables, genetic or environmental factors could protect these patients from atherosclerosis. PMID:25092679

  3. 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

  4. Acquired dyslexia in three writing systems: study of a Portuguese-Japanese bilingual aphasic patient.

    PubMed

    Senaha, Mirna Lie Hosogi; de Mattos Pimenta Parente, Maria Alice

    2012-01-01

    The Japanese language is represented by two different codes: syllabic and logographic while Portuguese employs an alphabetic writing system. Studies on bilingual Portuguese-Japanese individuals with acquired dyslexia therefore allow an investigation of the interaction between reading strategies and characteristics of three different writing codes. The aim of this study was to examine the differential impact of an acquired brain lesion on the reading of the logographic, syllabic and alphabetic writing systems of a bilingual Portuguese-Japanese aphasic patient (PF). Results showed impaired reading in the logographic system and when reading irregularly spelled Portuguese words but no effects on reading regular words and nonwords in syllabic and alphabetic writing systems. These dissociations are interpreted according to a multi-route cognitive model of reading assuming selective damage in the lexical route can result in acquired dyslexia across at least three different writing codes. PMID:22713387

  5. Effectiveness of repeated intragastric balloon therapy in a morbidly obese Japanese patient.

    PubMed

    Sekino, Yusuke; Iida, Hiroshi; Endo, Hiroki; Sakamoto, Yasunari; Yoneda, Masato; Koide, Tomoko; Takahashi, Hirokazu; Tokoro, Chikako; Abe, Yasunobu; Nakajima, Atsushi; Maeda, Shin; Takihata, Masahiro; Terauchi, Yasuo; Inamori, Masahiko

    2011-01-01

    A 19-year-old Japanese male with a BMI of 55.4 kg/m(2) who also had liver dysfunction, dyslipidemia and hyperuricemia underwent repeated intragastric balloon therapy. The percent excess weight loss was 22.5% at the first balloon removal and 28.6% at the second balloon removal. The hepatic dysfunction resolved after the second balloon therapy, however, the dyslipidemia and hyperuricemia did not improve. The Japanese population is regarded as a high-risk race for obesity-related diseases at lower BMI values, and morbidly obese Japanese patients may need more serious weight reduction protocols to improve the comorbidities than similarly obese Americans or Europeans. PMID:21245633

  6. Effective management of patients with diabetes foot ulcers: outcomes of an Interprofessional Diabetes Foot Ulcer Team.

    PubMed

    Ogrin, Rajna; Houghton, Pamela E; Thompson, G William

    2015-08-01

    A longitudinal observational study on a convenience sample was conducted between 4 January and 31 December of 2010 to evaluate clinical outcomes that occur when a new Interprofessional Diabetes Foot Ulcer Team (IPDFUT) helps in the management of diabetes-related foot ulcers (DFUs) in patients living in a small urban community in Ontario, Canada. Eighty-three patients presented to the IPDFUT with 114 DFUs of average duration of 19·5 ± 2·7 weeks. Patients were 58·4 ± 1·4 years of age and 90% had type 2 diabetes, HbA1c of 8·3 ± 2·0%, with an average diabetes duration of 22·3 ± 3·4 years; in 69% of patients, 78 DFUs healed in an average duration of 7·4 ± 0·7 weeks, requiring an average of 3·8 clinic visits. Amputation of a toe led to healing in three patients (4%) and one patient required a below-knee amputation. Six patients died and three withdrew. Adding a skilled IPDFUT that is trained to work together resulted in improved healing outcomes. The rate of healing, proportion of wounds closed and complication rate were similar if not better than the results published previously in Canada and around the world. The IPDFUT appears to be a successful model of care and could be used as a template to provide effective community care to the patients with DFU in Ontario, Canada. PMID:23834390

  7. 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 ...

  8. Proteomic Biomarkers for Acute Interstitial Lung Disease in Gefitinib-Treated Japanese Lung Cancer Patients

    Microsoft Academic Search

    Fredrik Nyberg; Atsushi Ogiwara; Chris G. Harbron; Takao Kawakami; Keiko Nagasaka; Sachiko Takami; Kazuya Wada; Hsiao-Kun Tu; Makiko Otsuji; Yutaka Kyono; Tae Dobashi; Yasuhiko Komatsu; Makoto Kihara; Shingo Akimoto; Ian S. Peers; Marie C. South; Tim Higenbottam; Masahiro Fukuoka; Koichiro Nakata; Yuichiro Ohe; Shoji Kudoh; Ib Groth Clausen; Toshihide Nishimura; György Marko-Varga; Harubumi Kato

    2011-01-01

    Interstitial lung disease (ILD) events have been reported in Japanese non-small-cell lung cancer (NSCLC) patients receiving EGFR tyrosine kinase inhibitors. We investigated proteomic biomarkers for mechanistic insights and improved prediction of ILD. Blood plasma was collected from 43 gefitinib-treated NSCLC patients developing acute ILD (confirmed by blinded diagnostic review) and 123 randomly selected controls in a nested case-control study within

  9. HLA class II genes associated with anticentromere antibody in Japanese patients with systemic sclerosis (scleroderma)

    Microsoft Academic Search

    M Kuwana; Y Okano; J Kaburaki; H Inoko

    1995-01-01

    OBJECTIVE--To define further HLA class II gene associations with anticentromere antibody (ACA), a major serum antinuclear antibody in patients with systemic sclerosis (SSc). METHODS--HLA class II genes were determined using polymerase chain reaction\\/restriction fragment length polymorphisms in 94 Japanese patients with SSc (22 ACA positive and 72 ACA negative) and 50 race matched normal control subjects. RESULTS--Frequency of DQB1*0501 was

  10. HLA and Chinese patients with juvenile onset diabetes mellitus.

    PubMed

    Yeo, P P; Chan, S H; Lui, K F; Wee, G B; Lun, K C; Cheah, J S; Wong, H B; Lim, P

    1985-04-01

    The HLA profile of 147 Chinese patients with juvenile onset diabetes mellitus was studied. There were HLA associations related to different age of onset of the disease. The patients who presented during the first decade of life had strong linkages with AW 33, B 17 and BW 22 (BW 54/55) but a weak association with DR 4. In contrast, patients whose age of onset ranged from 31 to 39 years had increased frequency of BW 46. Patients with diabetic complications (retinopathy, nephropathy, neuropathy and peripheral vascular disease) which were present singly or in combination were associated with HLA AW 33 and B 17. It would appear that genetic factor may be related to both the age of onset of diabetes as well as to the development of complications. PMID:3876053

  11. Managing patients with type 2 diabetes and obesity.

    PubMed

    Wilding, John

    2015-01-01

    Diabetes risk increases exponentially with increasing BMI particularly if fat accumulates centrally and/or in the skeletal muscle, liver and other organs such as the pancreas. Those with diabetes and co-existing obesity, particularly if it is severe, are also at risk of other obesity-related conditions, such as cardiovascular disease, obstructive sleep apnoea, joint pain, many cancers and depression. In people with impaired glucose tolerance, modest weight loss can reduce the development of overt diabetes by 50% or more over four years. Once diabetes has developed weight loss can also be of benefit. Supporting patients to lose weight should be considered a key goal of diabetes care for all overweight and obese patients with type 2 diabetes. Increased physical activity improves insulin sensitivity and can help weight loss maintenance. Metformin is the first-line therapy and is generally considered weight neutral. Of the oral therapies available second line, DPP-IV inhibitors are weight neutral and the newer SGLT2 inhibitors can produce 2-3 kg of weight loss on average. Insulin often causes weight gain and patients should be counselled about this. Adjunctive treatment with metformin, SGLT2 inhibitors, DPP-IV inhibitors and GLP-1 analogues can help keep insulin doses lower and limit weight gain. Currently in the UK, obesity pharmacotherapy in type 2 diabetes is limited to orlistat which has been shown to improve glucose control. NICE recommends bariatric surgery as a clinically and cost effective option for obese patients with type 2 diabetes, particularly those with severe obesity. It typically results in 20-30% of body weight loss. PMID:25726618

  12. Retinopathy and microalbuminuria in type II diabetic patients

    Microsoft Academic Search

    Masoud R Manaviat; Mohammad Afkhami; Mohammad R Shoja

    2004-01-01

    BACKGROUND: The aim of this study was to identify risk factors for the development of retinopathy and microalbuminuria and their correlation in type II diabetic patients. METHODS: In this cross-sectional study 590 patients suffering from diabetis type II were examined. Fundoscopy was performed by practising ophthalmologist. The ratio of urinary albumin to creatinine was assessed by clinitek 100 (Bayer corporation–USA).

  13. Functional Limitations in Patients With Diabetes and Transmetatarsal Amputations

    Microsoft Academic Search

    Michael J Mueller; Gretchen B Salsich; Michael J Shube

    Background and Purpose. Reports in the surgical and rehabilitation literature suggest that patients with transmetatarsal amputations (TMAs) function well with regular shoes and a toe filler. Functional limitations, however, have not been documented in this population. The purpose of this study was to compare the function of patients with diabetes mellitus (DM) and TMA with that of age- and gender-matched

  14. Lipid peroxides in type 2 diabetic patients with neuropathy.

    PubMed

    Migdalis, I N; Triantafilou, P; Petridou, E; Varvarigos, N; Totolos, V; Rigopoulos, A

    2005-01-01

    Diabetes and its metabolic changes in peripheral nerves contribute to cause a decrease of nitric oxide production and diminished nerve blood flow. Since lipid peroxides are thought to be formed by free radicals and may play an important role in the development of vascular disease, we have investigated the possible relationship between lipid peroxides (measured as thiobarbitouric acid reacting substances (TBARS) in diabetic patients with peripheral neuropathy. Seventy-seven patients with Type 2 diabetes (39 neuropathic and 38 non-neuropathic) and 38 control subjects were studied. The neuropathy study group had significantly lower levels of TBARS, 3.5micromol/l (2.2-5.6, 95% confidence limits) compared to controls 4.5microm/l (3.08-6.8), p < 0.001 and to diabetics without neuropathy 4.9micromol/l (3.09-8.05), p < 0.001. No differences were found in metabolic control between the two diabetic groups. In the neuropathy group there was a negative correlation between the score for nerve dysfunction with the TBARS levels (r = - 0.42, p < 0.01). In conclusion, in diabetic patients with neuropathy there are abnormalities of TBARS levels. PMID:18426075

  15. Osteoprotegerin as a Marker of Atherosclerosis in Diabetic Patients

    PubMed Central

    Augoulea, Areti; Vrachnis, Nikolaos; Lambrinoudaki, Irene; Dafopoulos, Konstantinos; Iliodromiti, Zoe; Daniilidis, Angelos; Varras, Michail; Alexandrou, Andreas; Deligeoroglou, Efthymios; Creatsas, George

    2013-01-01

    Atherosclerosis is the principal cause of cardiovascular disease (CVD) and has many risk factors, among which is diabetes. Osteoprotegerin (OPG) is a soluble glycoprotein, involved in bone metabolism. OPG is also found in other tissues, and studies have shown that it is expressed in vascular smooth muscle cells. OPG has been implicated in various inflammations and also has been linked to diabetes mellitus. Increased serum OPG levels were found in patients with diabetes and poor glycemic control. Furthermore, prepubertal children with type 1 diabetes have significantly increased OPG levels. Receptor activator of nuclear factor kappa-B ligand (RANKL) is not found in the vasculature in normal conditions, but may appear in calcifying areas. OPG and RANKL are important regulators of mineral metabolism in both bone and vascular tissues. Few data are available on the relationship between plasma OPG/RANKL levels and endothelial dysfunction as assessed using noninvasive methods like ultrasound indexes, neither in the general population nor, more specifically, in diabetic patients. The aim of our review study was to investigate, based on the existing data, these interrelationships in order to identify a means of predicting, via noninvasive methods, later development of endothelial dysfunction and vascular complications in diabetic patients. PMID:23401681

  16. Body mass index and retinopathy in type 1 diabetic patients.

    PubMed

    Kaštelan, Snježana; Salopek Rabati?, Jasminka; Tomi?, Martina; Gverovi? Antunica, Antonela; Ljubi?, Spomenka; Kaštelan, Helena; Novak, Branko; Oreškovi?, Darko

    2014-01-01

    Aim. To investigate whether body mass index (BMI) independently or in correlation with other risk factors is associated with diabetic retinopathy (DR) progression. Methods. The study included 176 patients with type 1 diabetes divided into three groups according to DR status: group 1 (no retinopathy; n = 86), group 2 (mild/moderate nonproliferative DR; n = 33), and group 3 (severe/very severe NPDR or proliferative DR; n = 57). Results. A significant deterioration of HbA1c, an increase in total cholesterol, systolic, diastolic blood pressure, and diabetic nephropathy with the progression of retinopathy were found. DR progression was correlated with diabetes duration, HbA1c, hypertension, total cholesterol, and the presence of nephropathy. In patients without nephropathy, statistical analyses showed that progression of retinopathy increased significantly with higher BMI (gr. 1: 24.03?±?3.52, gr. 2: 25.36?±?3.44, gr. 3: 26.93?±?3.24; P < 0.01). A positive correlation between BMI and a significant deterioration of HbA1c, an increase in cholesterol, triglycerides, and hypertension was observed. Conclusion. BMI in correlation with HbA1c, cholesterol, and hypertension appears to be associated with the progression of DR in type 1 diabetic patients without nephropathy. However, additional studies are required to investigate the pathogenic role of obesity and weight loss in retinal diabetic complications particularly relating to nephropathy. PMID:24696683

  17. Body Mass Index and Retinopathy in Type 1 Diabetic Patients

    PubMed Central

    Kaštelan, Snježana; Salopek Rabati?, Jasminka; Tomi?, Martina; Gverovi? Antunica, Antonela; Ljubi?, Spomenka; Kaštelan, Helena; Oreškovi?, Darko

    2014-01-01

    Aim. To investigate whether body mass index (BMI) independently or in correlation with other risk factors is associated with diabetic retinopathy (DR) progression. Methods. The study included 176 patients with type 1 diabetes divided into three groups according to DR status: group 1 (no retinopathy; n = 86), group 2 (mild/moderate nonproliferative DR; n = 33), and group 3 (severe/very severe NPDR or proliferative DR; n = 57). Results. A significant deterioration of HbA1c, an increase in total cholesterol, systolic, diastolic blood pressure, and diabetic nephropathy with the progression of retinopathy were found. DR progression was correlated with diabetes duration, HbA1c, hypertension, total cholesterol, and the presence of nephropathy. In patients without nephropathy, statistical analyses showed that progression of retinopathy increased significantly with higher BMI (gr. 1: 24.03?±?3.52, gr. 2: 25.36?±?3.44, gr. 3: 26.93?±?3.24; P < 0.01). A positive correlation between BMI and a significant deterioration of HbA1c, an increase in cholesterol, triglycerides, and hypertension was observed. Conclusion. BMI in correlation with HbA1c, cholesterol, and hypertension appears to be associated with the progression of DR in type 1 diabetic patients without nephropathy. However, additional studies are required to investigate the pathogenic role of obesity and weight loss in retinal diabetic complications particularly relating to nephropathy. PMID:24696683

  18. Identifying patients at risk of type 2 diabetes.

    PubMed

    Savill, Peter

    2012-01-01

    At present there are nearly 3 million people with diabetes in the UK. It is predicted that this number will almost double by 2025. Nine out of ten of these individuals will have type 2 diabetes. It is estimated that one in seven adults have impaired glucose regulation and up to 12% of these will develop type 2 diabetes each year. The impact of obesity on the development of type 2 diabetes cannot be overemphasised, with a 1 kg/m2 increase in BMI raising the risk of impaired fasting glycaemia by 9.5% and of developing new-onset type 2 diabetes by 8.4%. A 1 cm increase in waist circumference increases the risks by 3.2% and 3.5% respectively. NICE advises using a validated risk assessment tool to identify patients at risk of diabetes. Risk factors used by such tools include: age; ethnicity; weight; first-degree relative with type 2 diabetes; low birthweight and sedentary lifestyle. Certain comorbidities increase the risk of type 2 diabetes, these include: cardiovascular and cerebrovascular disease; polycystic ovary syndrome; a history of gestational diabetes; and mental health problems. The initial screening blood test could be a fasting plasma glucose, HbA1c, or an oral glucose tolerance test, according to WHO criteria. NICE recommends that high-risk patients should be offered a programme encouraging them to undertake a minimum of 150 minutes of moderate intensity physical activity a week, gradually lose weight to reach and maintain a BMI within the healthy range, increase consumption of whole grains, vegetables, and other foods that are high in dietary fibre, reduce the total amount of fat in their diet and eat less saturated fat. PMID:22988703

  19. Cortisol correlates with metabolic disturbances in a population study of type 2 diabetic patients

    Microsoft Academic Search

    Kerstin M Oltmanns; Baerbel Dodt; Bernd Schultes; Hans H Raspe; Ulrich Schweiger; Jan Born; Horst L Fehm; Achim Peters

    2006-01-01

    Objective: The prevalence of type 2 diabetes mellitus is increasing rapidly in industrialized countries, and adrenal glucocorticoids may intensify this disease. We sought to assess the relationship between diabetes-associated metabolic disturbances and cortisol concentrations in patients with type 2 diabetes. Design: We investigated 190 type 2 diabetic patients who volunteered from a population study of 12430 people in Luebeck and

  20. 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

  1. Identification of two novel mutations in the CLCN5 gene in Japanese patients with familial idiopathic low molecular weight proteinuria (Japanese Dent's disease).

    PubMed

    Takemura, T; Hino, S; Ikeda, M; Okada, M; Igarashi, T; Inatomi, J; Yoshioka, K

    2001-01-01

    Two Japanese patients, belonging to unrelated families, with idiopathic low-molecular-weight proteinuria (LMWP; Japanese Dent's disease) showed novel mutations of the gene encoding renal-specific chloride channel 5 (CLC-5). Proteinuria was first noticed at the ages of 2 and 3 years in patients 1 and 2, respectively. During follow-up, marked increases in urinary ss(2)-microglobulin levels, hypercalciuria, and high levels of urinary excretion of growth hormone were observed in both patients. Nephrocalcinosis was detected in patient 2. Renal biopsy specimens from both patients showed minimal alterations in glomeruli and tubulointerstitium, except for mild mesangial proliferation in patient 2. DNA sequence analysis of the entire 2,238-bp coding region and exon-intron boundaries of the CLCN5 gene showed the presence of two novel mutations in exon 10, consisting of one missense mutation (I524K) in patient 1 and one nonsense mutation (R637X) in patient 2. DNA analysis and measurement of urinary ss(2)-microglobulin levels in family members indicated an X-linked mode of inheritance in patient 1 and sporadic occurrence in patient 2. These results have expanded our understanding of the association between idiopathic LMWP (Japanese Dent's disease) and mutations of the CLCN5 gene. PMID:11136179

  2. Diabetic hand syndromes as a clinical and diagnostic tool for diabetes mellitus patients.

    PubMed

    Al-Matubsi, Hisham Y; Hamdan, Farqad; Alhanbali, Othman A; Oriquat, Ghaleb A; Salim, Maher

    2011-11-01

    Diabetes mellitus (DM) is a chronic disease characterized by hyperglycemia with various complications including diabetic hand syndrome (DHS); a condition characterized by association of distinct entities; limited joint mobility (LJM), Dupuytren's disease (DD), flexor tenosynovitis (FTS) and carpal tunnel syndrome (CTS) resulting in significant morbidity and mortality. The aim of this study was to evaluate the prevalence of these changes and their association to diabetes duration. We studied 142 type 2 and 45 type 1 DM patients and investigated the presence of these hand changes and peripheral neuropathy (PNP). The prevalence of LJM was 29.4%, DD was 17.6%, FTS was 10.7% and CTS 41.7% in all diabetics. The prevalence of CTS was more in type 2 DM (83.3%) as compared to type 1 DM (24.4%). Age and duration of diabetes were clearly related to these changes. A clear association between these changes and PNP was observed. The prevalence of CTS and hand changes was higher in type 2 diabetics. The association of DD and PNP suggests that common factors could contribute to their pathogenesis. Consequently, clinical examination for diabetic hand should not ignore it. PMID:21831469

  3. Patient Complexity and Diabetes Quality of Care in Rural Settings

    PubMed Central

    Salanitro, Amanda H.; Safford, Monika M.; Houston, Thomas K.; Williams, Jessica H.; Ovalle, Fernando; Payne-Foster, Pamela; Allison, Jeroan J.; Estrada, Carlos A.

    2011-01-01

    Purpose Even though pay-for-performance programs are being rapidly implemented, little is known about how patient complexity affects practice-level performance assessment in rural settings. We sought to determine the association between patient complexity and practice-level performance in the rural United States. Basic procedures Using baseline data from a trial aimed at improving diabetes care, we determined factors associated with a practice’s proportion of patients having controlled diabetes (hemoglobin A1c ?7%): patient socioeconomic factors, clinical factors, difficulty with self-testing of blood glucose, and difficulty with keeping appointments. We used linear regression to adjust the practice-level proportion with A1c controlled for these factors. We compared practice rankings using observed and expected performance and classified practices into hypothetical pay-for-performance categories. Main Findings Rural primary care practices (n = 135) in 11 southeastern states provided information for 1641 patients with diabetes. For practices in the best quartile of observed control, 76.1% of patients had controlled diabetes vs 19.3% of patients in the worst quartile. After controlling for other variables, proportions of diabetes control were 10% lower in those practices whose patients had the greatest difficulty with either self testing or appointment keeping (p < .05 for both). Practice rankings based on observed and expected proportion of A1c control showed only moderate agreement in pay-for-performance categories (? = 0.47; 95% confidence interval, 0.32–0.56; p < .001). Principal Conclusions Basing public reporting and resource allocation on quality assessment that does not account for patient characteristics may further harm this vulnerable group of patients and physicians. PMID:21671526

  4. Novel mutations of ATP2A2 gene in Japanese patients of Darier's disease.

    PubMed

    Takahashi, H; Atsuta, Y; Sato, K; Ishida-Yamamoto, A; Suzuki, H; Iizuka, H

    2001-07-01

    Darier's disease (DD) is a rare, dominantly inherited skin disorder with abnormal keratinization and acantholysis. Recently, mutations of ATP2A2 encoding the sarco/endoplasmic reticulum Ca(2+)-ATPase type 2 isoform (SERCA2) have been reported in Caucasian DD families. In the present study, we examined the ATP2A2 gene mutations of three sporadic (AS1,AS3,AS4) and one familial (AS2) Japanese DD patients. Sequence analysis revealed that the patients had novel mutations, one nonsense mutation (AS1 (C613X)) and three single base changes leading to amino acid substitutions (AS2 (L321F), AS3 (I274V), and AS4 (M719I)). These results demonstrate that distinct ATP2A2 gene mutations are present in Japanese DD patients. PMID:11390201

  5. Low-dose aspirin-associated upper gastric and duodenal ulcers in Japanese patients with no previous history of peptic ulcers

    PubMed Central

    2013-01-01

    Background Long-term administration of low-dose aspirin (LDA) is associated with a greater risk of adverse events, including gastroduodenal ulcers. The purpose of this study was to identify the risk factors for and assess the role of medication use in the development of peptic ulcer disease in Japanese patients with no history of peptic ulcers. Methods Consecutive outpatients receiving LDA (75 mg/day) who underwent esophagogastroduodenoscopy between January and December 2010 were enrolled. Clinical parameters, peptic ulcer history, concomitant drugs, the presence of Helicobacter pylori infection, reason for endoscopy, and endoscopic findings were analysed. Results Of 226 total patients, 14 (6.2%) were endoscopically diagnosed with peptic ulcer. Age, sex, current smoking status, current alcohol consumption, endoscopic gastric mucosal atrophy, and abdominal symptoms were not significantly associated with peptic ulcers. Diabetes mellitus was more frequent (42.9% vs. 16.5%; P?=?0.024) in patients with peptic ulcers than in those without peptic ulcers. Using multiple logistic regression analysis, co-treatment with anticoagulants or proton pump inhibitors (PPIs) was significantly associated with increased and decreased risk for peptic ulcer, respectively (odds ratio [OR], 5.88; 95% confidence interval [CI], 1.19???28.99; P?=?0.03 and OR, 0.13; 95% CI, 0.02???0.73; P?=?0.02, respectively). Co-treatment with additional antiplatelet agents, H2-receptor antagonists, angiotensin II Type 1 receptor blockers, angiotensin-converting enzyme inhibitor, 3-hydroxy-3-methylglutaryl-CoA reductase inhibitor, or nonsteroidal anti-inflammatory drugs was not associated with peptic ulcer development. Conclusion The use of PPIs reduces the risk of developing gastric or duodenal ulcers in Japanese patients taking LDA without pre-existing gastroduodenal ulcers. However, this risk is significantly increased in both patients ingesting anticoagulants and patients with diabetes. These results may help identify patients who require intensive prophylaxis against aspirin-induced peptic ulcers. PMID:24215903

  6. Multifocal Electroretinograms Predict Onset of Diabetic Retinopathy in Adult Patients with Diabetes

    PubMed Central

    Bearse, Marcus A.; Ng, Jason S.; Jewell, Nicholas P.; Barez, Shirin; Burger, Dennis; Schneck, Marilyn E.; Adams, Anthony J.

    2011-01-01

    Purpose. The authors' previous models predicted local formation of diabetic retinopathy (DR) in adults with diabetes and existing retinopathy. Here they derived a multivariate model for local prediction of DR onset in patients with no previous retinopathy. Methods. Seventy-eight eyes from 41 diabetes patients were tested annually for several years. The presence or absence of DR at the last study visit was the outcome measure, and measurements of risk factors from the previous visit were used for prediction. Logistic regression was used to assess the relationship between DR development and 7 factors: multifocal ERG (mfERG) implicit time (IT) Z-score, sex, diabetes duration, blood glucose, HbA1c, age, and diabetes type. Thirty-five retinal zones, spanning 45°, were constructed from the mfERG stimulus elements. The maximum IT Z-score for each zone was calculated based on data from 50 control subjects. ROC curve analysis, using fivefold cross-validation, was used to determine the model's predictive properties. Results. Mild DR developed in 80 of 2730 retinal zones (3%) in 29 of 78 eyes (37%). Multivariate analysis showed mfERG IT to be predictive for DR development in a zone after adjusting for diabetes type. The multivariate model has a sensitivity of 80% and a specificity of 74%. Conclusions. mfERG IT is a good predictor of DR onset, 1 year later, in patients with diabetes without DR. It can be used to assess the risk for DR development in these patients and may be a valuable outcome measure in evaluation of novel prophylactic therapeutics directed at impeding DR. PMID:20926810

  7. Clinical characteristics of silent myocardial ischemia diagnosed with adenosine stress 99mTc-tetrofosmin myocardial scintigraphy in Japanese patients with acute cerebral infarction.

    PubMed

    Nomura, Tetsuya; Kusaba, Tetsuro; Kodama, Naotoshi; Terada, Kensuke; Urakabe, Yota; Nishikawa, Susumu; Keira, Natsuya; Matsubara, Hiroaki; Tatsumi, Tetsuya

    2013-01-01

    It is well known that silent myocardial ischemia (SMI) often complicates patients with cerebral infarction and that stroke patients often die of ischemic heart disease. Therefore, it is considered important to treat myocardial ischemia in stroke patients. This study investigated SMI complicating Japanese patients with fresh stroke, using (99m)Tc-tetrofosmin myocardial scintigraphy with pharmacologic stress testing to elucidate their clinical manifestations. This study included 41 patients (26 men, mean age 76.0 ± 10.7 years) with acute cerebral infarction and no history of coronary artery disease. All patients underwent (99m)Tc-tetrofosmin myocardial scintigraphy with intravenous administration of adenosine to diagnose SMI. Of the 41 patients, myocardial ischemia was confirmed in 17 patients (41.5%). Atherosclerotic etiology was the major cause of stroke in the ischemia(+) group and embolic origin was the major cause in the ischemia(-) group. Patients with myocardial ischemia had a higher incidence of diabetes mellitus (52.9 vs 20.8%; P = 0.0323) and more than two conventional cardiovascular risk factors (64.7 vs 25.0%; P = 0.0110) compared with the nonischemic patients. Infarction subtype of atherosclerotic origin was an independent positive predictor of asymptomatic myocardial ischemia in patients with stroke. These findings indicate that the prevalence of asymptomatic myocardial ischemia is relatively high, especially in patients with stroke of atherosclerotic origin. Therefore, it is beneficial for us to narrow the target population who are at the highest risk when screening for SMI in Japanese patients with acute cerebral infarction. PMID:22124530

  8. Guidelines for Perioperative Management of the Diabetic Patient

    PubMed Central

    Surani, Salim R.

    2015-01-01

    Management of glycemic levels in the perioperative setting is critical, especially in diabetic patients. The effects of surgical stress and anesthesia have unique effects on blood glucose levels, which should be taken into consideration to maintain optimum glycemic control. Each stage of surgery presents unique challenges in keeping glucose levels within target range. Additionally, there are special operative conditions that require distinctive glucose management protocols. Interestingly, the literature still does not report a consensus perioperative glucose management strategy for diabetic patients. We hope to outline the most important factors required in formulating a perioperative diabetic regimen, while still allowing for specific adjustments using prudent clinical judgment. Overall, through careful glycemic management in perioperative patients, we may reduce morbidity and mortality and improve surgical outcomes. PMID:26078998

  9. Health coaching in diabetes: empowering patients to self-manage.

    PubMed

    Wong-Rieger, Durhane; Rieger, Francis P

    2013-02-01

    To effectively manage diabetes mellitus, patients must adhere to treatment recommendations and healthy lifestyle behaviors, but research shows many patients do not do this. Education is effective when combined with self-management support but peer-support programs do not lead to lasting changes. Health coaching, or professional support, can be highly effective if it focuses on developing self-efficacy and skills such as goal-setting, problem-solving and managing cognitive and emotional barriers. This overview discusses the benefits of patient self-management for chronic conditions such as diabetes, core competencies for health coaching, theoretical bases and principles of health coaching interventions, delivery methods and the evidence that health coaching works for diabetes self-management. PMID:24070747

  10. 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

  11. Diabetes patient at risk score - a novel system for triaging appropriate referrals of inpatients with diabetes to the diabetes team.

    PubMed

    Rajendran, Rajesh; Round, Rachael-Marie; Kerry, Christopher; Barker, Sarah; Rayman, Gerry

    2015-06-01

    The acceptability, uptake and effectiveness of a new referral tool - the diabetes patient at risk (DPAR) score - were evaluated and the timeliness of review of referred inpatients by the diabetes team was measured. For this, a snapshot survey of ward healthcare professionals (HCPs) and a review of all DPAR referrals to the diabetes team between 1 September 2013 and 31 January 2014 were undertaken. All referrals in November 2013 were audited for timeliness of review. 77% of HCPs agreed/strongly agreed that the tool improved access to the diabetes team. 76% of referrals were from nurses. 80% of who should have been referred were referred; the remaining had already been reviewed by the diabetes team and therefore did not require referral. Only 11% of referrals were inappropriate. All DPAR referrals were reviewed within the stipulated time period in November 2013. Overall, the DPAR system was well accepted, successfully identified appropriate referrals and facilitated referrals in a timely manner to the diabetes team. PMID:26031970

  12. Reticulated platelets and antiplatelet therapy response in diabetic patients.

    PubMed

    Mijovic, Romana; Kovacevic, Nada; Zarkov, Marija; Stosic, Zoran; Cabarkapa, Velibor; Mitic, Gorana

    2015-08-01

    Increased platelet turnover and high level of reticulated platelets are associated with low response to antiplatelet therapy in diabetes mellitus type 2. This study evaluated association between percentage of reticulated platelets (%RP) and the response to antiplatelet therapy in patients with type 2 diabetes mellitus (T2DM). This prospective, pilot, case-control, clinical trial included 79 subjects stratified in three groups: group I included 30 patients with T2DM, group II included 34 non-diabetic patients and 15 healthy age and sex matched healthy volunteers were enrolled in control group. Platelet response to clopidogrel and aspirin was assessed by Multiplate(®) aggregometry analyzer. Individual response to dual antiplatelet therapy was estimated by the percentage of decrease in overall platelet aggregability (%DPA) obtained after antiplatelet therapy, calculated by presented formulas: %DPAadp = 100 × (1 - ADP/TRAP) and %DPAaspi = 100 × (1 - ASPI/TRAP). %RP was significantly higher in diabetics, than in non-diabetics, (3.17 ± 1.26 vs. 2.39 ± 1.56; p < 0.05). Significantly lower response to clopidogrel (31.55 ± 13.02 vs. 50.24 ± 11.38; p < 0.001) and aspirin (52.33 ± 22.67 vs. 64.31 ± 16.47; p < 0.05) therapy was observed in diabetics. %RP negatively correlated with response to clopidogrel therapy, but positively with metabolic profile indicators in diabetics (p < 0.05, all). Correlation of %RP with metabolic profile indicators and poor response to antiplatelet therapy suggest that altered metabolic profile can affect platelet turnover in T2DM leading to low responsiveness to antiplatelet therapy in these patients. PMID:25575607

  13. Prevalence of metabolic syndrome in type 2 diabetes mellitus patients

    PubMed Central

    Nsiah, Kwabena; Shang, V Owusua; Boateng, K Agyenim; Mensah, FO

    2015-01-01

    Background: The diabetic condition is influenced by several factors, some of which can accelerate the disease's progression to various complications that aggravate the morbidity. Aims: This study aimed at determining the prevalence of metabolic syndrome (MetS) and its individual components and the most critical predictive risk factors of MetS in type 2 diabetic patients. Materials and Methods: This cross-sectional study involved 150 type 2 diabetes mellitus patients and was conducted at the Diabetes Centre of the Komfo Anokye Teaching Hospital in Kumasi, the Ashanti Region of Ghana, from February, 2013 to April, 2013. The study involved the use of a questionnaire to obtain some information on the diabetics, undertaking anthropometric measurements, as well as collecting blood samples for the measurement of some biochemical parameters; fasting blood glucose and lipid profile. MetS was defined according to the National Cholesterol Education Program/Adult Treatment Panel III criteria. Results: The prevalence of MetS was 58% in the studied Ghanaian population. Hypertension was the commonest risk factor (60%), followed by central obesity (48.67%) and dyslipidemia (37%). Female type 2 diabetics had a higher prevalence of MetS, and carried more components than their male counterparts. Regression analysis showed three factors; femininity, high body mass index and low educational status were the most critical predictive risk factors of MetS, according to this study. Conclusion: With hypertension being the commonest component, future cardiovascular disease prevention strategies should focus attention on its management and prevention, through education.

  14. Mechanisms of hypoglycemia unawareness and implications in diabetic patients

    PubMed Central

    Martín-Timón, Iciar; del Cañizo-Gómez, Francisco Javier

    2015-01-01

    Hypoglycemia unawareness (HU) is defined at the onset of neuroglycopenia before the appearance of autonomic warning symptoms. It is a major limitation to achieving tight diabetes and reduced quality of life. HU occurs in approximately 40% of people with type 1 diabetes mellitus (T1DM) and with less frequency in T2DM. Though the aetiology of HU is multifactorial, possible mechanisms include chronic exposure to low blood glucose, antecedent hypoglycaemia, recurrent severe hypoglycaemia and the failure of counter-regulatory hormones. Clinically it manifests as the inability to recognise impeding hypoglycaemia by symptoms, but the mechanisms and mediators remain largely unknown. Prevention and management of HU is complex, and can only be achieved by a multifactorial intervention of clinical care and structured patient education by the diabetes team. Less know regarding the impact of medications on the development or recognition of this condition in patients with diabetes. Several medications are thought to worsen or promote HU, whereas others may have an attenuating effect on the problem. This article reviews recent advances in how the brain senses and responds to hypoglycaemia, novel mechanisms by which people with insulin-treated diabetes develop HU and impaired counter-regulatory responses. The consequences that HU has on the person with diabetes and their family are also described. Finally, it examines the evidence for prevention and treatment of HU, and summarizes the effects of medications that may influence it. PMID:26185599

  15. Diabetic patients treated with dialysis: complications and quality of life

    Microsoft Academic Search

    V. R. Sørensen; E. R. Mathiesen; T. Watt; J. B. Bjorner; M. V. N. Andersen; B. Feldt-Rasmussen

    2007-01-01

    Aims\\/hypothesis  The aim of this study was to describe the prevalence of complications, health-related quality of life (HRQOL) and the influence\\u000a of beliefs about control over health in diabetic dialysis patients.\\u000a \\u000a \\u000a \\u000a Methods  Of 53 eligible diabetic patients on chronic dialysis during January 2004 in our clinic, 38 (76%) completed a kidney-specific\\u000a (Kidney Disease Quality of Life) and a generic (SF-36) questionnaire and

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

    MedlinePLUS

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

  17. A comprehensive review of urologic complications in patients with diabetes.

    PubMed

    Arrellano-Valdez, Fernando; Urrutia-Osorio, Marta; Arroyo, Carlos; Soto-Vega, Elena

    2014-01-01

    Diabetes Mellitus (DM) is a chronic disease characterized by hyperglycemia, as a result of abnormal insulin production, insulin function, or both. DM is associated with systemic complications, such as infections, neuropathy and angiopathy, which involve the genitourinary tract. The three most significant urologic complications include: bladder cystopathy, sexual dysfunction and urinary tract infections. Almost half of the patients with DM have bladder dysfunction or cystopathy, which can be manifested in women as hypersensitivity (in 39-61% of the diabetic women) or neurogenic bladder. In males it can be experienced as lower urinary tract symptoms (in 25% of diabetic males with a nearly twofold increased risk when seen by age groups). Additionally, an increased prostate volume affects their micturition as well as their urinary tract. Involving sexual dysfunction in women, it includes reduced libido, decreased arousal, clitoral erectile dysfunction and painful or non-sensitive intercourse; and in diabetic males it varies from low libido, ejaculatory abnormalities and erectile dysfunction. Globally, sexual disorders have a prevalence of 18-42%. Erectile dysfunction is ranked as the third most important complication of DM. Urinary tract infections are observed frequently in diabetic patients, and vary from emphysematous infections, Fournier gangrene, staghorn infected lithiasis to repetitive bacterial cystitis. The most frequent finding in diabetic women has been lower urinary tract infections. Because of the high incidence of obesity worldwide and its association with diabetes, it is very important to keep in mind the urologic complication associated with DM in patients, in order to better diagnose and treat this population. PMID:25332855

  18. Postoperative Mortality in Cancer Patients With Preexisting Diabetes

    PubMed Central

    Barone, Bethany B.; Yeh, Hsin-Chieh; Snyder, Claire F.; Peairs, Kimberly S.; Stein, Kelly B.; Derr, Rachel L.; Wolff, Antonio C.; Brancati, Frederick L.

    2010-01-01

    OBJECTIVE Diabetes appears to increase risk for some cancers, but the association between preexisting diabetes and postoperative mortality in cancer patients is less clear. Our objective was to systematically review postoperative mortality in cancer patients with and without preexisting diabetes and summarize results using meta-analysis. RSEARCH DESIGN AND METHODS We searched the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Excerpta Medica Database (EMBASE) for articles published on or before 1 July 2009, including references of qualifying articles. We included English language investigations of short-term postoperative mortality after initial cancer treatment. Titles, abstracts, and articles were reviewed by at least two independent readers. Study population and design, results, and quality components were abstracted with standard protocols by one reviewer and checked for accuracy by additional reviewers. RESULTS Of 8,828 titles identified in our original search, 20 articles met inclusion criteria for qualitative systematic review. Of these, 15 reported sufficient information to be combined in meta-analysis. Preexisting diabetes was associated with increased odds of postoperative mortality across all cancer types (OR = 1.85 [95% CI 1.40–2.45]). The risk associated with preexisting diabetes was attenuated but remained significant when we restricted the meta-analysis to models that controlled for confounders (1.51 [1.13–2.02]) or when we accounted for publication bias using the trim and fill method (1.52 [1.13–2.04]). CONCLUSIONS Compared with their nondiabetic counterparts, cancer patients with preexisting diabetes are ?50% more likely to die after surgery. Future research should investigate physiologic pathways to mortality risk and determine whether improvements in perioperative diabetes care can reduce postoperative mortality. PMID:20351229

  19. Should all diabetic patients receive statins?

    Microsoft Academic Search

    Paul J. Garcia; Craig W. Spellman

    2006-01-01

    Diabetes is known to play a causal role in promoting both microvascular and macrovascular complications. Reducing rates of\\u000a end-organ damage has been a key objective of multiple clinical trials. In addition to the roles of glycemic and blood pressure\\u000a control, it is evident that lipid reduction via statin therapy independently helps to reduce the risk of primary and secondary\\u000a vascular

  20. Mutations in CLCN5 Chloride Channel in Japanese Patients with Low Molecular Weight Proteinuria

    Microsoft Academic Search

    TETSUJI MORIMOTO; SHINICHI UCHIDA; HISATO SAKAMOTO; YOSHIAKI KONDO; HIROSHI HANAMIZU; MITSUMINE FUKUI; YASUHIKO TOMINO; NAOKO NAGANO; FUMIAKI MARUMO

    Mutations in the CLCN5 gene have been demon- strated in three disorders of hypercalciurie nephrolithiasis, i.e., Dent's disease, X-linked recessive nephrobithiasis, and X-linked recessive hypophosphatemie rickets. Recently, a number of Japanese children with low molecular weight pro- teinuria (LMWP) showing symptoms similar to those shown by patients with Dent's disease in British families have also been reported to have mutations

  1. Cognitive profile of patients with burning mouth syndrome in the Japanese population

    Microsoft Academic Search

    Hirofumi Matsuoka; Mika Himachi; Hirokazu Furukawa; Shiho Kobayashi; Harumi Shoki; Ryo Motoya; Masato Saito; Yoshihiro Abiko; Yuji Sakano

    2010-01-01

    The present study investigated which cognitive characteristics, including cancer phobia, self-efficacy, pain-related catastrophizing,\\u000a and anxiety sensitivity, affect burning mouth syndrome (BMS) symptoms in the Japanese population. A total of 46 BMS patients\\u000a (44 women and 2 men; mean age, 59.98 ± 9.57 years; range, 30–79 years) completed a battery of questionnaires, including measures\\u000a of pain severity, oral-related quality of life

  2. 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

  3. Novel mutations of ATP2A2 gene in Japanese patients of Darier's disease

    Microsoft Academic Search

    Hidetoshi Takahashi; Yoshiaki Atsuta; Katsuhiko Sato; Akemi Ishida-Yamamoto; Hiroshi Suzuki; Hajime Iizuka

    2001-01-01

    Darier's disease (DD) is a rare, dominantly inherited skin disorder with abnormal keratinization and acantholysis. Recently, mutations of ATP2A2 encoding the sarco\\/endoplasmic reticulum Ca2+-ATPase type 2 isoform (SERCA2) have been reported in Caucasian DD families. In the present study, we examined the ATP2A2 gene mutations of three sporadic (AS1,AS3,AS4) and one familial (AS2) Japanese DD patients. Sequence analysis revealed that

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

    PubMed Central

    Mayberry, Lindsay Satterwhite; Mulvaney, Shelagh A.; Hess, Rachel

    2011-01-01

    Patient web portals (PWPs), defined as the integration of electronic medical records and patient health records, have been related to enhanced patient outcomes. A literature review was conducted to characterize the design and evaluation of PWPs to improve health care processes and outcomes in diabetes. A summary of 26 articles revealed the positive impact PWPs have on patient outcomes, patient-provider communication, disease management, and access to and patient satisfaction with health care. Innovative and useful approaches included the evaluation of specific components of the PWPs, assessing the impact of PWPs on mediators of health behaviors, such as patient distress, identification of barriers to use, and patient willingness to pay for access. Future research should focus on relevant processes that mediate patient and provider use, impact on health care utilization, and a patient-centered approach to the design and integration of educational opportunities afforded through PWPs. PMID:20890688

  5. Aldehyde dehydrogenase-2 genotypes and HLA haplotypes in Japanese patients with esophageal cancer.

    PubMed

    Watanabe, Seishiro; Sasahara, Katsuyuki; Kinekawa, Fumihiko; Uchida, Naohito; Masaki, Tsutomu; Kurokohchi, Kazutaka; Murota, Masayuki; Touge, Tetsuo; Kawauchi, Kazuyoshi; Oda, Syuji; Kuriyama, Shigeki

    2002-01-01

    The aim of this study was to examine how aldehyde dehydrogenase-2 (ALDH2) genotypes and human leukocyte antigen (HLA) haplotypes contribute to the risk for esophageal cancer. We examined ALDH2 genotypes and HLA haplotypes in 29 Japanese patients with esophageal cancer. The ratio of patients who experienced current or former intense vasodilatation upon consuming alcohol (flushing type) was much higher in individuals with the inactive form of ALDH2 encoded by the ALDH2(2)/2(2) or ALDH2(1)/2(2) genotype than in those with the active form of ALDH2 encoded by the ALDH2(1)/2(1) genotype. The ratio of inactive ALDH2 was significantly higher in patients with esophageal cancer than in control normal subjects, suggesting that alcoholics with inactive ALDH2 were susceptible to esophageal cancer. HLA haplotypes A24, A26, B54, B61 and DR9 were prevalent in patients with esophageal cancer (82.8, 24.1, 34.5, 37.9 and 44.8%, respectively). HLA haplotype of A24 and inactive ALDH2 were simultaneously found in 58.6% of patients with esophageal cancer. Furthermore, we found other primary malignancies in 6 of 29 (20.7%) patients with esophageal cancer, and 4 of these 6 patients had both the inactive form of ALDH2 and the HLA A24 haplotype. The present study showed the high prevalence of the inactive form of ALDH2 and HLA haplotypes A24, A26, B54, B61 and DR9 in Japanese patients with esophageal cancer. Therefore, the examination of genotypes of ALDH2 loci and HLA haplotypes may allow the early detection of esophageal cancer in the Japanese population. PMID:12168074

  6. Efficacy and safety of intravenous daptomycin in Japanese patients with skin and soft tissue infections.

    PubMed

    Aikawa, Naoki; Kusachi, Shinya; Mikamo, Hiroshige; Takesue, Yoshio; Watanabe, Shinichi; Tanaka, Yoshiyuki; Morita, Akiko; Tsumori, Keiko; Kato, Yoshiaki; Yoshinari, Tomoko

    2013-06-01

    Daptomycin is a lipopeptide antibiotic active against gram-positive organisms and recently approved for marketing in Japan. This study investigates the efficacy and safety of daptomycin in Japanese patients with skin and soft tissue infections (SSTIs) caused by methicillin-resistant Staphylococcus aureus (MRSA) for regulatory filing in Japan. Overall, 111 Japanese patients with SSTI were randomized in this open-label, randomized, active-comparator controlled, parallel-group, multicenter, phase III study. Patients received intravenous daptomycin 4 mg/kg once daily or vancomycin 1 g twice daily for 7-14 days. Efficacy was determined by a blinded Efficacy Adjudication Committee. Among patients with SSTIs caused by MRSA, 81.8 % (95 % CI, 69.1-90.9) of daptomycin recipients and 84.2 % (95 % CI, 60.4-96.6) of vancomycin recipients achieved a successful clinical response at the test-of-cure (TOC) visit. The microbiological success rate against MRSA at the TOC visit was 56.4 % (95 % CI, 42.3-69.7) with daptomycin and 47.4 % (95 % CI, 24.4-71.1) with vancomycin. Daptomycin was generally well tolerated; most adverse events were of mild to moderate severity. The measurement of daptomycin concentration in plasma revealed that patients with mild or moderate impaired renal function showed similar pharmacokinetics profiles to patients with normal renal function. Clinical and microbiological responses, stratified by baseline MRSA susceptibility, suggested that patients infected with MRSA of higher daptomycin MIC showed a trend of lower clinical success with a P value of 0.052 by Cochran-Armitage test. Daptomycin was clinically and microbiologically effective for the treatment of MRSA-associated SSTIs in Japanese patients. PMID:23085743

  7. Recurrence of diabetic kidney disease in a type 1 diabetic patient after kidney transplantation.

    PubMed

    Nyumura, Izumi; Honda, Kazuho; Babazono, Tetsuya; Horita, Shigeru; Murakami, Toru; Fuchinoue, Shohei; Uchigata, Yasuko

    2015-07-01

    Post-transplant hyperglycaemia of diabetic patients may cause recurrent diabetic kidney disease (DKD) in kidney allografts. We report a patient with slowly progressive DKD with calcineurin inhibitor toxicity (CNI) toxicity after the kidney transplantation. A 28-year-old female with type 1 diabetes mellitus underwent successful kidney transplantation from her mother in April 2003, and the kidney graft survived for more than 10 years. She was treated with combined immunosuppressive therapy consisting of cyclosporine and mycophenolate mofetil. After transplantation, she continued to take insulin injection four times per day, but her glycosylated haemoglobin (HbA1c) was above 10%. Protocol allograft kidney biopsies performed 5 and 10 years after transplantation revealed the recurrence of slowly progressive diabetic kidney disease. In addition, arteriolar hyalinosis partly associated with calcineurin inhibitor toxicity (CNI) was detected with progression. Post-transplant hyperglycaemia causes recurrent diabetic kidney disease (DKD) in kidney allografts, but its progression is usually slow. For long-term management, it is important to prevent the progression of the calcineurin inhibitor arteriolopathy, as well as maintain favourable glycaemic control. PMID:26031596

  8. A Polymorphism in the AMPK2 Subunit Gene Is Associated With Insulin Resistance and Type 2 Diabetes in the Japanese Population

    Microsoft Academic Search

    Momoko Horikoshi; Kazuo Hara; Jun Ohashi; Kazuaki Miyake; Katsushi Tokunaga; Chikako Ito; Masato Kasuga; Ryozo Nagai; Takashi Kadowaki

    2006-01-01

    AMP-activated protein kinase (AMPK) acts as a fuel gauge for glucose and lipid metabolism. The gene encoding the 2 isoform of the catalytic subunit of AMPK (PRKAA2 )i s located at one of the Japanese type 2 diabetes loci mapped by our previous genome scan (1p36-32). PRKAA2 is, there- fore, a good candidate gene for insulin resistance and type 2

  9. Risk of radiocontrast nephropathy in patients with and without diabetes mellitus

    Microsoft Academic Search

    Lawrence S Weisberg; Peter B Kurnik; Brenda R C Kurnik

    1994-01-01

    Risk of radiocontrast nephropathy in patients with and without diabetes mellitus. The present study was designed to test whether altered renovascular reactivity is associated with the increased risk of radiocontrast nephropathy (RCN) in diabetics. We studied 50 patients (24 diabetics, 26 nondiabetics) with chronic renal insufficiency undergoing cardiac catheterization. Patients were randomized to receive either saline, or one of three

  10. Diabetes mellitus patients' family caregivers' subjective quality of life.

    PubMed Central

    Awadalla, Abdel W.; Ohaeri, Jude U.; Al-Awadi, Shafika A.; Tawfiq, Adel M.

    2006-01-01

    OBJECTIVES: To assess the subjective quality of life (QOL) of family caregivers of Sudanese type-1 and type-2 diabetic outpatients, using the WHO 26-item QOL instrument, compared with a general population sample; and to examine the factors associated with caregiver QOL. METHOD: Responses of caregivers of 105 outpatients with type-1 diabetes and 135 with type-2 diabetes were compared with 139 general population subjects. RESULTS: Caregivers were satisfied with the content of items related to general social supports. Type-1 caregivers had significantly lower QOL scores than type-2 caregivers and the general population. Parents and siblings had lowest scores compared with other family groups. Caregivers scored higher than patients. Patients' age and duration of illness, and caregivers' education, marital status and state of health were positively associated with caregiver QOL. Caregivers' QOL was predicted by their appraisal of patients' QOL. CONCLUSIONS: Caregivers who were sick, younger, single, less educated and caring for patients with more recent illness appeared relatively vulnerable. Clinicians should be interested in the dynamics of the family caregiving situation--as it impacts QOL--and in promoting caregiver awareness of diabetes in order to enhance the caregiving role, quality of care and QOL. PMID:16749648

  11. Repurposing an Osteoporosis Drug for ? Cell Regeneration in Diabetic Patients.

    PubMed

    Schmitz, Felizitas; Roscioni, Sara; Lickert, Heiko

    2015-07-01

    Replenishing the lost or dysfunctional insulin-producing ? cell mass in diabetic patients could slow down or reverse disease progression. Kondegowda et al. (2015) now show that osteoprotegerin and denosumab, inhibitors of the receptor activator of the NF-?B Ligand (RANKL) pathway and osteoclast activation, stimulate human ? cell proliferation and therefore possess therapeutic potential. PMID:26094892

  12. Evaluating Patient Education: A Case Study of a Diabetes Program

    Microsoft Academic Search

    Jerome S. Legge; Veta M. Massey; Catherine I. Vena; Bernard J. Reilly

    1980-01-01

    This paper presents an evaluation of a diabetic education program for patients at Stephens County Hospital in Toccoa, Georgia. An analysis of covariance is employed along with multiple classification analysis to determine the effect of the program in reducing hospital readmissions. The major finding is that the teaching program is an important variable in the reduction of readmissions. A second

  13. Pharmacokinetics, efficacy, and safety of caspofungin in Japanese pediatric patients with invasive candidiasis and invasive aspergillosis.

    PubMed

    Mori, Masaaki; Imaizumi, Masue; Ishiwada, Naruhiko; Kaneko, Takashi; Goto, Hiroaki; Kato, Koji; Hara, Junichi; Kosaka, Yoshiyuki; Koike, Kazutoshi; Kawamoto, Hiroshi; Maeda, Naoko; Yoshinari, Tomoko; Kishino, Hiroyuki; Takahashi, Kenichi; Kawahara, Shizuko; Kartsonis, Nicholas A; Komada, Yoshihiro

    2015-06-01

    The antifungal agents approved in Japan for pediatric use are limited and many unapproved drugs are actually used without clear instruction for dosage. We investigated the pharmacokinetics of caspofungin for the treatment of invasive candidiasis and invasive aspergillosis in 20 Japanese pediatric patients using a pediatric-specific dosage based on body surface area. Caspofungin was administered intravenously over 60 min as 70 mg/m(2) on Day 1, followed by 50 mg/m(2) per day. Five or 4 point blood sampling were done in 15 patients on Day 4-5 to calculate AUC0-24 h. The geometric means (95% confidence interval) of C24 h and AUC0-24 h in the pediatric patients were 3.3(2.5, 4.4) ?g/mL and 175.1 (139.3, 220.1) ?g hr/mL, respectively, which were comparable to those in Japanese adult patients [3.2 (2.8, 3.5) ?g/mL and 144.9 (131.7, 159.3) ?g hr/mL, respectively]. Among the 20 patients, 10 (50%) had at least 1 drug-related adverse event which was considered related to caspofungin therapy. No drug-related serious adverse event and no death occurred. The most common drug-related adverse events were events relating to hepatic function (mainly increases in ALT and AST). The overall success in efficacy was observed in 13 of 20 patients. In conclusion, once daily administration of caspofungin (70 mg/m(2) on Day 1, followed by 50 mg/m(2) [maximum daily dose not to exceed 70 mg]), which is the same dosage being used in overseas, achieved sufficient drug exposure and a favorable efficacy and acceptable safety profile in Japanese pediatric patients with invasive fungal infections. PMID:25701307

  14. 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. PMID:25892991

  15. 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

  16. Increased DNA Dicarbonyl Glycation and Oxidation Markers in Patients with Type 2 Diabetes and Link to Diabetic Nephropathy

    PubMed Central

    Waris, Sahar; Winklhofer-Roob, Brigitte M.; Roob, Johannes M.; Fuchs, Sebastian; Sourij, Harald; Rabbani, Naila; Thornalley, Paul J.

    2015-01-01

    Aim. The aim of this study was to assess the changes of markers of DNA damage by glycation and oxidation in patients with type 2 diabetes and the association with diabetic nephropathy. Methodology. DNA oxidation and glycation adducts were analysed in plasma and urine by stable isotopic dilution analysis liquid chromatography-tandem mass spectrometry. DNA markers analysed were as follows: the oxidation adduct 7,8-dihydro-8-oxo-2?-deoxyguanosine (8-OxodG) and glycation adducts of glyoxal and methylglyoxal—imidazopurinones GdG, MGdG, and N2-(1,R/S-carboxyethyl)deoxyguanosine (CEdG). Results. Plasma 8-OxodG and GdG were increased 2-fold and 6-fold, respectively, in patients with type 2 diabetes, with respect to healthy volunteers. Median urinary excretion rates of 8-OxodG, GdG, MGdG, and CEdG were increased 28-fold, 10-fold, 2-fold, and 2-fold, respectively, in patients with type 2 diabetes with respect to healthy controls. In patients with type 2 diabetes, nephropathy was associated with increased plasma 8-OxodG and increased urinary GdG and CEdG. In a multiple logistic regression model for diabetic nephropathy, diabetic nephropathy was linked to systolic blood pressure and urinary CEdG. Conclusion. DNA oxidative and glycation damage-derived nucleoside adducts are increased in plasma and urine of patients with type 2 diabetes and further increased in patients with diabetic nephropathy. PMID:25950009

  17. [The cure of type 2 diabetes and patient education].

    PubMed

    Lagger, G; Chambouleyron, M; Correia, J C; Sittarame, F; Miganne, G; Lasserre Moutet, A; Golay, A

    2015-03-25

    Type 2 diabetes is a potentially reversible disease. Patient education encompasses a deep investment of the health care providers, who with the aid of pedagogic tools, help the pa tient commit to this path. This facilitates the learning of uncommon knowledge and skills required. Whether or not it leads to a complete remission of the disease may not be the main purpose. The main goal lies in the patient's motivation to learn and change on a long term basis. PMID:26027202

  18. The Management of Type 2 Diabetic Patients with Hypoglycemic Agents

    PubMed Central

    Carnevale Schianca, G. P.; Sola, D.; Rossi, L.; Fra, G. P.; Bartoli, E.

    2012-01-01

    Aims and Scope. Aims of the paper are to suggest the best treatment to improve the glycemic control in patients with Type 2 diabetes using hypoglycemic agents, in particularly, we think that every patient is different from another one in terms of BMI, family history, duration of the disease and so on. We propose for every clinical aspect the best hypoglycemic agents to use, considering the scientific evidence and physiopathology. PMID:22577575

  19. 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

  20. Association of soluble epoxide hydrolase gene polymorphism with insulin resistance in type 2 diabetic patients

    Microsoft Academic Search

    Kentaro Ohtoshi; Hideaki Kaneto; Koichi Node; Yumiko Nakamura; Toshihiko Shiraiwa; Munehide Matsuhisa; Yoshimitsu Yamasaki

    2005-01-01

    The insulin resistance found in diabetes is influenced by vascular tone and local blood flow. Endothelial-derived hyperpolarizing factor (EDHF) functions as a potent vasodilator to regulate vascular tone, and its production is regulated by soluble epoxide hydrolase (sEH). In this study, we examined the genotype distribution and allele frequency of sEH gene G860A (Arg287Gln) polymorphism in Japanese subjects (n=499) (non-diabetic

  1. 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

  2. Scheduled and Unscheduled Hospital Readmissions among Diabetes Patients

    PubMed Central

    Kim, Hongsoo; Ross, Joseph S.; Melkus, Gail D.; Zhao, Zhonglin; Boockvar, Kenneth

    2011-01-01

    Objective The purpose of this study is to describe rates of scheduled and unscheduled readmissions among mid-life and older diabetes patients and examine associated factors. Study Design and Methods Using the 2006 California State Inpatient Dataset, we identified 124,967 patients aged 50 or older with diabetes who were discharged from acute care hospitals between April and September 2006, and examined readmissions in the 3 months following their index hospitalizations. Results About 26.3% of the patients were readmitted within the 3-month period, 87.2% of which were unscheduled readmissions. Patients with unscheduled readmissions were more likely to have a higher comorbidity burden, be ethnic minorities with public insurance, and live in lower income neighborhoods. Having a history of hospitalization in the 3 months preceding the index hospitalization was also a strong predictor of unscheduled readmissions. Almost one fifth of the unscheduled readmissions were potentially preventable based on AHRQ’s PQI definitions, making up about 27,477 inpatient days and costing approximately 72.7 million dollars. Scheduled readmissions were less likely to occur in patients aged 80 or older, the uninsured, and those with an unscheduled index hospitalization. Conclusion The predictors of scheduled and unscheduled readmissions are different. Transition care to prevent unscheduled readmissions in acutely ill diabetes patients may help reduce rates, improving care. Further studies are needed on potential disparities in scheduled readmissions. PMID:20964472

  3. Model driven mobile care for patients with type 1 diabetes.

    PubMed

    Skrøvseth, Stein Olav; Arsand, Eirik; Godtliebsen, Fred; Joakimsen, Ragnar M

    2012-01-01

    We gathered a data set from 30 patients with type 1 diabetes by giving the patients a mobile phone application, where they recorded blood glucose measurements, insulin injections, meals, and physical activity. Using these data as a learning data set, we describe a new approach of building a mobile feedback system for these patients based on periodicities, pattern recognition, and scale-space trends. Most patients have important patterns for periodicities and trends, though better resolution of input variables is needed to provide useful feedback using pattern recognition. PMID:22874353

  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. 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

    2015-08-01

    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

  6. The 5-Year Onset and Regression of Diabetic Retinopathy in Chinese Type 2 Diabetes Patients

    PubMed Central

    Jin, Peiyao; Peng, Jinjuan; Zou, Haidong; Wang, Weiwei; Fu, Jiong; Shen, Binjie; Bai, Xuelin; Xu, Xun; Zhang, Xi

    2014-01-01

    Purpose To determine the rate and risk factors of diabetic retinopathy (DR) onset and regression in Chinese type 2 diabetes mellitus patients. Methods This is a 5-year community-based prospective study. The demographic information, systemic examination results and ophthalmological test results of each participant were collected. The study outcomes were DR incidence, defined as the onset of DR in at least one eye, and DR regression, defined as full regression from existing DR to no retinopathy without invasive treatments. The associations between each potential risk factor and the outcomes were studied. Results In total, 778 participants were enrolled. There were 322 patients without DR at baseline, of which 151 participants developed DR during follow-up (DR incidence rate?=?46.89%). Baseline hyperglycemia and high blood pressure were two independent risk factors associated with DR incidence. Among the 456 participants with existing DR at entry, 110 fully recovered after 5 years (DR regression rate?=?24.12%). Low baseline glucose and low serum triglyceride were two independent factors associated with DR regression. Conclusions DR incidence occurred more frequently in patients with hyperglycemia and high blood pressure. DR regression occurred mostly in patients with lower glucose and lower serum triglyceride levels among Chinese type 2 diabetes patients. PMID:25402474

  7. MRI appearance of the pancreas in patients with cystic fibrosis: a comparison of pancreas volume in diabetic and non-diabetic patients.

    PubMed

    Sequeiros, I M; Hester, K; Callaway, M; Williams, A; Garland, Z; Powell, T; Wong, F S; Jarad, N A

    2010-11-01

    We investigated differences in the volume of the pancreas in cystic fibrosis (CF) patients with and without diabetes using MRI to study the natural history of CF-related diabetes (CFRD). We investigated 29 pancreas-insufficient adult CF patients, 13 with CFRD and 16 without diabetes. Patients with CFRD were receiving insulin therapy at the time of study. None of the non-diabetic CF patients had evidence of impaired glucose tolerance. Pancreas volume was estimated by MRI scans using T? weighted fat-suppression sequences and assessed by an examiner who was unaware of the patients' diabetes status. Pancreas volume of CF patients was measured and subsequently compared with that of non-CF age-matched Type 1 diabetes (T1DM) patients and healthy controls previously investigated. The two CF groups were matched for age and gender. There were no differences in spirometry values, body mass index or pancreatic exocrine function. The pancreas was visible by MRI in only 3 of 13 (23.1%) patients with CFRD and in 5 of 16 (31.3%) patients without diabetes (p-value = 0.7). In total, the pancreas was not detected by MRI as an anatomical entity in 21 of 29 (72.4%) CF patients, irrespective of their diabetes status. When comparing the four study groups, the pancreas was significantly smaller in CF patients than in T1DM patients and healthy controls. PMID:20965902

  8. MRI appearance of the pancreas in patients with cystic fibrosis: a comparison of pancreas volume in diabetic and non-diabetic patients

    PubMed Central

    Sequeiros, I M; Hester, K; Callaway, M; Williams, A; Garland, Z; Powell, T; Wong, F S; Jarad, N A

    2010-01-01

    We investigated differences in the volume of the pancreas in cystic fibrosis (CF) patients with and without diabetes using MRI to study the natural history of CF-related diabetes (CFRD). We investigated 29 pancreas-insufficient adult CF patients, 13 with CFRD and 16 without diabetes. Patients with CFRD were receiving insulin therapy at the time of study. None of the non-diabetic CF patients had evidence of impaired glucose tolerance. Pancreas volume was estimated by MRI scans using T1 weighted fat-suppression sequences and assessed by an examiner who was unaware of the patientsdiabetes status. Pancreas volume of CF patients was measured and subsequently compared with that of non-CF age-matched Type 1 diabetes (T1DM) patients and healthy controls previously investigated. The two CF groups were matched for age and gender. There were no differences in spirometry values, body mass index or pancreatic exocrine function. The pancreas was visible by MRI in only 3 of 13 (23.1%) patients with CFRD and in 5 of 16 (31.3%) patients without diabetes (p-value = 0.7). In total, the pancreas was not detected by MRI as an anatomical entity in 21 of 29 (72.4%) CF patients, irrespective of their diabetes status. When comparing the four study groups, the pancreas was significantly smaller in CF patients than in T1DM patients and healthy controls. PMID:20965902

  9. 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

  10. Insulin resistance and endothelial dysfunction in type 2 diabetes patients with or without microalbuminuria

    Microsoft Academic Search

    Yerong Yu; Lixia Suo; Hongling Yu; Chun Wang; Hong Tang

    2004-01-01

    Objective: To evaluate the relationship between insulin resistance and endothelial function in type 2 diabetes patients with or without microalbuminuria and to explore the pathophysiological mechanisms of the increased macrovascular risk in type 2 diabetes mellitus. Methods: Twelve type 2 diabetes patients with microalbuminuria (urinary albumin 30–300?g\\/mg creatinine, DM-MA) and 12 type 2 diabetes patients without microalbuminuria (urinary albumin <30?g\\/mg

  11. Association between diabetes complications and leukocyte counts in Iranian patients

    PubMed Central

    Moradi, Sedigheh; Kerman, Scott Reza Jafarian; Rohani, Farzaneh; Salari, Fereshteh

    2012-01-01

    Background The long term complications of diabetes can be fatal. They are also renowned for being an economic burden. Previous studies have demonstrated a relationship between inflammatory markers and complications of diabetes. The objective of this study was to evaluate the relationship between leukocyte counts and these complications. Methods The study included 184 patients diagnosed with type 2 diabetes. The study was carried out in Iran during 2007 and 2008. Data collected on the subjects were as follows: age, gender, weight, height, blood pressure, smoking history, lipid profile including low density lipoprotein (LDL), high density lipoprotein (HDL), total cholesterol, triglycerides, and leukocyte count, albuminuria, and retinopathy. Furthermore, information on cardiac history for 100 patients was collected. The subjects were split into two groups according to their leukocyte levels: low (?7000/mm3) and high (>7000/mm3); and then analyzed by Student’s t-test or Mann–Whitney U-test as appropriate. Results The average leukocyte count in these patients was 7594 ± 1965/mm3. Leukocyte count was significantly different in patients with and without retinopathy and albuminuria (P < 0.0001). According to this analysis, a leukocyte count of 6750/mm3 with a sensitivity of 80.2% and a specificity of 56.4%, and a count of 7550/mm3 with a sensitivity of 63.2% and a specificity of 74.6% indicated at least one diabetes complication. Conclusion An elevated leukocyte count even within the normal range was associated with chronic complications in type 2 diabetes. PMID:22334791

  12. Investigation on Carbohydrate Counting Method in Type 1 Diabetic Patients

    PubMed Central

    Son, Osman; Efe, Belgin; Son, Nazan Ereno?lu; Akalin, Aysen; Kebapçi, Nur

    2014-01-01

    Objective. The results from Diabetes Control and Complications Trial (DCCT) have propounded the importance of the approach of treatment by medical nutrition when treating diabetes mellitus (DM). During this study, we tried to inquire carbohydrate (Kh) count method's positive effects on the type 1 DM treatment's success as well as on the life quality of the patients. Methods. 22 of 37 type 1 DM patients who applied to Eski?ehir Osmangazi University, Faculty of Medicine Hospital, Department of Endocrinology and Metabolism, had been treated by Kh count method and 15 of them are treated by multiple dosage intensive insulin treatment with applying standard diabetic diet as a control group and both of groups were under close follow-up for 6 months. Required approval was taken from the Ethical Committee of Eski?ehir Osmangazi University, Medical Faculty, as well as informed consent from the patients. The body weight of patients who are treated by carbohydrate count method and multiple dosage intensive insulin treatment during the study beginning and after 6-month term, body mass index, and body compositions are analyzed. A short life quality and medical research survey applied. At statistical analysis, t-test, chi-squared test, and Mann-Whitney U test were used. Results. There had been no significant change determined at glycemic control indicators between the Kh counting group and the standard diabetic diet and multiple dosage insulin treatment group in our study. Conclusion. As a result, Kh counting method which offers a flexible nutrition plan to diabetic individuals is a functional method. PMID:25202704

  13. 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

  14. Designing mobile support for glycemic control in patients with diabetes.

    PubMed

    Harris, Lynne T; Tufano, James; Le, Tung; Rees, Courtney; Lewis, Ginny A; Evert, Alison B; Flowers, Jan; Collins, Carol; Hoath, James; Hirsch, Irl B; Goldberg, Harold I; Ralston, James D

    2010-10-01

    We assessed the feasibility and acceptability of using mobile phones as part of an existing Web-based system for collaboration between patients with diabetes and a primary care team. In design sessions, we tested mobile wireless glucose meter uploads and two approaches to mobile phone-based feedback on glycemic control. Mobile glucose meter uploads combined with graphical and tabular data feedback were the most desirable system features tested. Participants had a mixture of positive and negative reactions to an automated and tailored messaging feedback system for self-management support. Participants saw value in the mobile system as an adjunct to the Web-based program and traditional office-based care. Mobile diabetes management systems may represent one strategy to improve the quality of diabetes care. PMID:20937484

  15. [Non-diabetic renal disease in type II diabetes mellitus patients in Mohammed V Military Hospital, Rabat, Morocco].

    PubMed

    Y, Zajjari; Benyahia, M; Ibrahim, D Montasser; Kassouati, J; Maoujoud, O; El Guendouz, F; Oualim, Z

    2012-06-01

    The distinction between diabetic nephropathy lesions and non-diabetic renal lesions is not always obvious and is often based on renal biopsy. This study evaluated the prevalence and predictors of nondiabetic renal disease in people with type 2 diabetes. The study was conducted between January 2008 and October 2010 in the nephrology department of the military hospital in Rabat. The study included 16 patients with type 2 diabetes in whom renal biopsy was indicated. Non-diabetic renal disease was found in 6 of the patients (37.5%); IgA nephropathy was the most frequent non-diabetic renal disease (half of non-diabetic renal diseases). Hypertension was significantly less frequent in the non-diabetic renal disease group than the diabetic nephropathy group (16.7% versus 80.0%, P = 0024), duration of diabetes was a shorter (4.5 versus 15.5 years, P = 0.022) and diabetic retinopathy was absent (100% versus 40%, P = 0.026). There were no statistically significant differences between the 2 groups in relation to age, sex, creatinine level, 24-hour proteinuria, nephrotic syndrome and microscopic haematuria. PMID:22888619

  16. 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

  17. Salivary IgA and periodontal treatment needs in diabetic patients.

    PubMed

    Branco-de-Almeida, Luciana Salles; Alves, Cláudia Maria Coêlho; Lopes, Fernanda Ferreira; Pereira, Adriana de Fátima Vasconcelos; Guerra, Rosane Nassar Meireles; Pereira, Antônio Luiz Amaral

    2011-01-01

    Salivary IgA can serve as a first line of defense against pathogens that colonize and invade mucosal surfaces and may be protective against periodontal disease. The aim of this study was to assess salivary immunoglobulin A levels in diabetic and non-diabetic patients with different periodontal treatment needs. The Periodontal Screening & Recording (PSR) system was used to evaluate the periodontal treatment needs of 41 diabetic and 42 non-diabetic patients. Unstimulated whole saliva was collected from each patient immediately before clinical examination and stored at -20 °C until analysis. Salivary immunoglobulin A (s-IgA) levels were determined using an enzyme-linked immunosorbent assay, and values were expressed as optical density. Diabetic and non-diabetic patients were compared using clinical and laboratory data. PSR data indicated that periodontal disease was more frequent and more severe in diabetic patients. A higher prevalence of codes 3 and 4 was observed in diabetics as compared with non-diabetics (odds ratio = 2, P < 0.05). Furthermore, non-diabetic patients had more healthy sextants (code 0) than did diabetic patients. Over half of diabetic patients (?54%) presented with s-IgA levels that were lower than the normal range (optical density from 0.4 nm to 0.6 nm; P < 0.05). In addition, diabetic patients showed a higher variability in s-IgA levels as compared with non-diabetic patients. In conclusion, diabetic individuals had lower s-IgA levels, more-frequent and more-severe periodontal disease, and a greater need for periodontal treatment as compared with non-diabetic patients. PMID:22147237

  18. Hypothesis of Long-Term Outcome after Coronary Revascularization in Japanese Patients Compared to Multiethnic Groups in the US

    PubMed Central

    Inohara, Taku; Kohsaka, Shun; Goto, Masashi; Furukawa, Yutaka; Fukushima, Masanori; Sakata, Ryuzo; Elayda, MacArthur; Wilson, James M.; Kimura, Takeshi

    2015-01-01

    Background Ethnicity has a significant impact on coronary artery disease (CAD). This study investigated the long-term outcomes of Japanese patients undergoing revascularization compared with US patients belonging to multiple ethnic groups. Methods and Results We evaluated clinical outcomes, based on ethnicity, of patients included in the Coronary Revascularization Demonstrating Outcome (CREDO-Kyoto) and the Texas (US) Heart Institute Research Database (THIRDBase) registries. For the analysis, we included 8871 patients from the CREDO-Kyoto registry (median follow-up period [FU], 3.5 years; interquartile range [IQR], 2.6–4.3) and 6717 patients from the THIRDBase registry (FU, 5.2 years; IQR, 3.8–6.5) who underwent percutaneous coronary intervention or bypass surgery. Cox proportional hazard models were constructed to compare the adjusted long-term outcomes for each ethnic group. A total of 8871 Japanese, 5170 Caucasians, 648 African-Americans, 817 Hispanics, and 82 Asian-Americans were identified. When adjusted, Japanese patients had significantly better outcomes than US patients, classified by ethnicity (Caucasians: hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.35–1.79; Hispanics: HR, 1.53; 95% CI, 1.22–1.93; African-Americans: HR, 2.03; 95% CI, 1.62–2.56), except for Asian-Americans (HR, 0.84; 95% CI. 0.38–1.89) who had outcomes similar to Japanese patients. Conclusion Our findings indicate better survival outcomes in re-vascularized Japanese CAD patients compared to major ethnic groups in the US, including Caucasian, Hispanic, and African-American CAD patients. The characteristics and outcomes of Japanese CAD patients were similar to those of Asian-Americans, despite the sample size limitations in the US dataset. PMID:26023784

  19. Total Antioxidant Status in Type 2 Diabetic Patients in Palestine

    PubMed Central

    Kharroubi, Akram T.; Darwish, Hisham M.; Akkawi, Mutaz A.; Ashareef, Abdelkareem A.; Almasri, Zaher A.; Bader, Khaldoun A.; Khammash, Umaiyeh M.

    2015-01-01

    The objective of this study was to compare the level of total antioxidant status (TAS) in type 2 diabetic and normal Palestinian subjects as well as the major factors influencing TAS levels. A sample of convenience composed of 212 type 2 diabetic and 208 normal subjects above the age of 40 were recruited. Only 9.8% of the subjects had normal body mass index (BMI) levels (<25), 29% were overweight (?25 to <30), and 61.2% were obese (?30). The mean levels of TAS were significantly higher in diabetic compared to control subjects (2.18 versus 1.84?mM Trolox, P = 0.001) and in hypertensive subjects compared to subjects with normal blood pressure (BP). Mean TAS levels were higher in obese compared to nonobese subjects (2.12 versus 1.85?mM Trolox, P = 0.001). Mean TAS levels were similarly higher in subjects with high fasting plasma glucose (FPG) compared to normal FPG (2.19 versus 1.90?mM Trolox) and high HbA1c (?6.5%) compared to HbA1c < 6.5% (2.14 versus 1.91?mM Trolox). Multivariate analysis revealed that only diabetic status (P = 0.032) and the level of education (P = 0.036) were significantly associated with TAS. In conclusion diabetic patients had 18.5% increase in TAS levels compared to control subjects.

  20. Association between retinal neuronal degeneration and visual function impairment in type 2 diabetic patients without diabetic retinopathy.

    PubMed

    Zhu, TiePei; Ma, Jin; Li, YongHao; Zhang, Zheng

    2015-06-01

    The changes in retinal thickness and visual function in type 2 diabetic patients without clinical evidence of diabetic retinopathy were evaluated. A total of 141 diabetic subjects without retinopathy and 158 healthy subjects were enrolled in this study. Superior macular ganglion cell complex thicknesses were significantly decreased in diabetic cases, and no significant peripapillary retinal nerve fiber layer thickness changes were observed. The contrast sensitivities at all space frequencies were significantly different between diabetic patients and controls. The mean P50 amplitude from pattern electroretinogram results was reduced significantly in the diabetic group. In the diabetic group, average superior ganglion cell complex thicknesses positively correlated with both contrast sensitivities at high spatial frequencies and P50 amplitudes. The results indicated that ganglion cell complex thickness and visual function changes could be observed in diabetic subjects before the onset of any significant diabetic retinopathy. Macular ganglion cell complex reduction occurred much earlier than peripapillary retinal nerve fiber layer thinning in diabetic patients without retinopathy. PMID:25951931

  1. Visual outcome in Japanese patients with Acanthamoeba keratitis

    PubMed Central

    Yamazoe, K; Yamamoto, Y; Shimazaki-Den, S; Shimazaki, J

    2012-01-01

    Purpose To identify prognostic factors affecting visual outcome in Acanthamoeba keratitis (AK) treated with topical chlorhexidine gluconate (CHG). Methods A total of 35 eyes in 34 patients with AK were treated with 0.02% topical CHG. Patients were divided into two groups according to the final visual outcome: Group 1, final visual acuity (VA) of 20/25 or greater (22 eyes); Group 2, less than 20/25 (13 eyes). We compared these groups and evaluated the effectiveness of topical CHG compared with outcomes in previous reports. Results Ring infiltrate was observed more often in Group 2 (4.5% vs 61.5%, OR 33.6, 95% confidence interval (CI) 3.4–333.9, P<0.01). The duration between onset and diagnosis of AK was significantly longer (24.9 days vs 48.4 days, OR 1.03, 95% CI 1.00–1.06, P=0.04) and VA at initial examination (log MAR) significantly lower (0.47 vs 1.59, OR 25.5, 95% CI 3.4–186.7, P<0.01) in Group 2 (visual outcome <20/25). Multivariate analysis revealed that only VA at initial examination was independently associated with worse visual outcome (adjusted OR 24.5, 95% CI 1.9–312.6, P=0.01). Seventeen (85.0%) of the 20 eyes diagnosed within 1 month and 24 (82.8%) of 29 eyes diagnosed within 2 months achieved a VA of 20/40 or greater. Conclusion VA at initial examination was the most predictive factors for final visual outcome in AK. Topical CHG was comparably effective to other treatments, including polyhexamethyl biguanide and propamidine isethionate. PMID:22241017

  2. 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

  3. 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

  4. Correlates of venous catecholamine concentrations in patients with type 1 diabetes during a cold pressor test

    Microsoft Academic Search

    Dieter Luft; Christine Maisch; Valerie Hofmann-Kriick; Mahmoud Radjaipour; Hans-Ulrich Häring

    2000-01-01

    In some patients with type 1 diabetes, various physiologic reactions during a cold pressor test (CPT) are impaired. Whether this is caused by diabetic autonomic neuropathy, disturbed secretion of catecholamines, or disturbed blood glucose control is unknown. The authors, therefore, performed CPTs in patients with type 1 diabetes and in control subjects. They measured blood glucose concentrations, insulin concentrations, cardiac

  5. Effect of Electrical Stimulation on Acupuncture Points in Diabetic Patients with Gastric Dysrhythmia: A Pilot Study

    Microsoft Academic Search

    Chi-Sen Chang; Chung-Wang Ko; Chun-Ying Wu; Gran-Hum Chen

    2001-01-01

    Background\\/Aims: Abnormal gastric slow-wave frequencies have been observed in diabetic gastroparesis and are associated with impaired antral motor activity. In this study, we aimed at evaluating the effect of acupuncture on gastric slow waves in diabetic patients with symptoms suggesting gastric motor dysfunction. Methods: Fifteen patients with type II diabetes who had had dyspeptic symptoms for more than 3 months

  6. Increased plasma soluble endoglin levels as an indicator of cardiovascular alterations in hypertensive and diabetic patients

    Microsoft Academic Search

    Ana M Blázquez-Medela; Luis García-Ortiz; Manuel A Gómez-Marcos; José I Recio-Rodríguez; Angel Sánchez-Rodríguez; José M López-Novoa; Carlos Martínez-Salgado

    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

  7. Cardiac autonomic neuropathy in patients with diabetes mellitus

    PubMed Central

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

    2014-01-01

    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

  8. Investigation of auditory brainstem function in diabetic patients.

    PubMed

    Tóth, Ferenc; Várkonyi, Tamás T; Rovó, László; Lengyel, Csaba; Légrády, Péter; Jóri, József; Czigner, Jenö; Kiss, József G

    2003-01-01

    We performed brainstem auditory evoked potential (BAEP) examinations in 15 patients with long-standing type 1 diabetes mellitus. We applied cardiovascular reflex tests for assessment of autonomic neuropathy. The aim of our investigation was to compare the BAEP results of this patient group with those of controls and to look for the possible correlation between alteration of the auditory brainstem function and cardiovascular autonomic neuropathy. Analysis of the latencies (waves I, II, III, and V) and the interpeak latencies (I-III and I-V) of BAEP revealed a significant difference between those of diabetics and those of healthy controls. The amplitudes of waves I, III, and V were definitely lower in comparison with amplitudes of healthy controls. We observed a positive correlation between the overall autonomic score and the latencies (waves III and V) and interpeak latencies (I-III, I-V). These data support the hypothesis that long-standing diabetes mellitus and diabetic neuropathy might be revealed as a cause of certain dysfunctions of the central auditory pathways. PMID:15106279

  9. Distributed intelligent data analysis in diabetic patient management.

    PubMed Central

    Bellazzi, R.; Larizza, C.; Riva, A.; Mira, A.; Fiocchi, S.; Stefanelli, M.

    1996-01-01

    This paper outlines the methodologies that can be used to perform an intelligent analysis of diabetic patients' data, realized in a distributed management context. We present a decision-support system architecture based on two modules, a Patient Unit and a Medical Unit, connected by telecommunication services. We stress the necessity to resort to temporal abstraction techniques, combined with time series analysis, in order to provide useful advice to patients; finally, we outline how data analysis and interpretation can be cooperatively performed by the two modules. PMID:8947655

  10. Myeloperoxidase Levels Predict Accelerated Progression of Coronary Atherosclerosis in Diabetic Patients: Insights from Intravascular Ultrasound

    PubMed Central

    Kataoka, Yu; Shao, Mingyuan; Wolski, Kathy; Uno, Kiyoko; Puri, Rishi; Tuzcu, E. Murat; Hazen, Stanley L.; Nissen, Steven E.; Nicholls, Stephen J.

    2014-01-01

    Objective While inflammation has been proposed to contribute to the adverse cardiovascular outcome in diabetic patients, the specific pathways involved have not been elucidated. The leukocyte derived product, myeloperoxidase (MPO), has been implicated in all stages of atherosclerosis. The relationship between MPO and accelerated disease progression observed in diabetic patients has not been studied. Methods We investigated the relationship between MPO and disease progression in diabetic patients. 881 patients with angiographic coronary artery disease underwent serial evaluation of atherosclerotic burden with intravascular ultrasound. Disease progression in diabetic (n=199) and non-diabetic (n=682) patients, stratified by baseline MPO levels was investigated. Results MPO levels were similar in patients with and without diabetes (1362 vs. 1255 pmol/L, p=0.43). No relationship was observed between increasing quartiles of MPO and either baseline (p=0.81) or serial changes (p=0.43) in levels of percent atheroma volume (PAV) in non-diabetic patients. In contrast, increasing MPO quartiles were associated with accelerated PAV progression in diabetic patients (p=0.03). While optimal control of lipid and the use of high-dose statin were associated with less disease progression, a greater benefit was observed in diabetic patients with lower compared with higher MPO levels at baseline. Conclusions Increasing MPO levels are associated with greater progression of atherosclerosis in diabetic patients. This finding indicates the potential importance of MPO pathways in diabetic cardiovascular disease. PMID:24468151

  11. 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. PMID:25792848

  12. Association of genetic variants for susceptibility to obesity with type 2 diabetes in Japanese individuals

    Microsoft Academic Search

    F. Takeuchi; K. Yamamoto; T. Katsuya; T. Nabika; T. Sugiyama; A. Fujioka; M. Isono; K. Ohnaka; T. Fujisawa; E. Nakashima; H. Ikegami; J. Nakamura; Y. Yamori; S. Yamaguchi; S. Kobayashi; T. Ogihara; R. Takayanagi; N. Kato

    2011-01-01

    Aims\\/hypothesis  In populations of East Asian descent, we performed a replication study of loci previously identified in populations of European\\u000a descent as being associated with obesity measures such as BMI and type 2 diabetes.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We genotyped 14 single nucleotide polymorphisms (SNPs) from 13 candidate loci that had previously been identified by genome-wide\\u000a association meta-analyses for obesity measures in Europeans. Genotyping was

  13. The under-use of statin in type 2 diabetic patients attending diabetic clinics in Italy

    Microsoft Academic Search

    Angelo Avogaro; Pietro Guida; Carlo Giorda; Edoardo Mannucci; Gerardo Medea; Marco Comaschi; Mario Velussi; Guglielmo Armienti; Roberta Zucchetti

    2007-01-01

    Background and aimsThe greatest decrease in mortality from cardiovascular disease (CAD) that can be achieved with 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) is seen in patients with the highest risk for CAD, such as diabetics. Yet, there is evidence for inadequate use of drug therapies to achieve lipid goals. Our aims were to: (1) assess the prevalence of statin use in

  14. Peripheral artery disease in patients with diabetes: Epidemiology, mechanisms, and outcomes

    PubMed Central

    Thiruvoipati, Thejasvi; Kielhorn, Caitlin E; Armstrong, Ehrin J

    2015-01-01

    Peripheral artery disease (PAD) is the atherosclerosis of lower extremity arteries and is also associated with atherothrombosis of other vascular beds, including the cardiovascular and cerebrovascular systems. The presence of diabetes mellitus greatly increases the risk of PAD, as well as accelerates its course, making these patients more susceptible to ischemic events and impaired functional status compared to patients without diabetes. To minimize these cardiovascular risks it is critical to understand the pathophysiology of atherosclerosis in diabetic patients. This, in turn, can offer insights into the therapeutic avenues available for these patients. This article provides an overview of the epidemiology of PAD in diabetic patients, followed by an analysis of the mechanisms by which altered metabolism in diabetes promotes atherosclerosis and plaque instability. Outcomes of PAD in diabetic patients are also discussed, with a focus on diabetic ulcers and critical limb ischemia. PMID:26185603

  15. High Mannose-Binding Lectin Serum Levels Are Associated with Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes

    PubMed Central

    Huang, Qian; Shang, Guilian; Deng, Haohua; Liu, Jie; Mei, Yan; Xu, Yancheng

    2015-01-01

    Objective To investigate mannose-binding lectin (MBL) serum levels in type 2 diabetic patients with and without diabetic retinopathy (DR). Methods Serum MBL levels were determined in type 2 diabetic patients (N=324) as well as in 300 healthy control Subjects. Multivariate analyses were performed using logistic regression models. Receiver operating characteristic curves (ROC) was used to test the overall predict accuracy of MBL and other markers. Results Diabetic patients with DR and vision-threatening diabetic retinopathy (VTDR) had significantly higher MBL levels on admission (P<0.0001 and P<0.0001). MBL improved the area under the receiver operating characteristic curve of the diabetes duration for DRfrom 0.82(95% confidence interval [CI], 0.77–0.86) to 0.88(95% CI, 0.82–0.96; P<0.01) and for VDTR from 0.85(95% CI, 0.77–0.92) to 0.90(95% CI, 0.83–0.96; P<0.01). Multivariate logistic regression analysis adjusted for common risk factors showed that serum MBL levels(per log-unit increase) was an independent predictor of DR (OR=3.45; 95%CI: 1.42–7.05) and VTDR (OR=4.42; 95%CI: 1.51-8.18). Conclusion MBL is a novel, independent diagnostic marker of DR in type 2 diabetic patients, suggesting that MBL may be involved in the pathogenesis of DR in diabetic patients. PMID:26136138

  16. [Coronary drug-eluting stents in diabetic patients].

    PubMed

    Nyssen, Astrid; Legrand, Victor; Scheen, André J

    2008-08-27

    In diabetic patients, the use of drug-eluting stents (paclitaxel-PES or sirolimus-SES) reduces the risk of restenosis as compared to bare-metal stents. However, the risk of (very) late thrombosis is higher with drug-eluting stents than with bare-metal stents. All together, the incidence of major cardiovascular events is reduced with drug-eluting stents, mainly resulting from a diminution of revascularisation procedures rather than from a reduction in myocardial infarcts or cardiovascular deaths. Attempts to compare SES and PES gave discordant results in both randomised trials and registries. Efficacious antiplatelet therapy in the long run is mandatory in all diabetic patients treated with drug-eluting stents. PMID:18814764

  17. Mutations in argininosuccinate synthetase mRNA of Japanese patients, causing classical citrullinemia.

    PubMed Central

    Kobayashi, K.; Shaheen, N.; Terazono, H.; Saheki, T.

    1994-01-01

    Citrullinemia is an autosomal recessive disease caused by a genetic deficiency of argininosuccinate synthetase. In order to characterize mutations in Japanese patients with classical citrullinemia, RNA isolated from 10 unrelated patients was reverse-transcribed, and cDNA amplified by PCR was cloned and sequenced. The 10 mutations identified included 6 missense mutations (A118T, A192V, R272C, G280R, R304W, and R363L), 2 mutations associated with an absence of an exon 7 or exon 13, 1 mutation with a deletion of the first 7 bp in exon 16 (which might be caused by abnormal splicing), and 1 mutation with an insertion of 37 bp within exons 15 and 16 in cDNA. The insertion mutation and the five missense mutations (R304W being excluded) are new mutations described in the present paper. These are in addition to 14 mutations (9 missense mutations, 4 mutations associated with an absence of an exon in mRNA, and 1 splicing mutation) that we identified previously in mainly American patients with neonatal citrullinemia. Two of these 20 mutations, a deletion of exon 13 sequence and a 7-bp deletion in exon 16, were common to Japanese and American populations from different ethnic backgrounds; however, other mutations were unique to each population. Furthermore, the presence of a frequent mutation--the exon 7 deletion mutation in mRNA, which accounts for 10 of 23 affected alleles--was demonstrated in Japanese citrullinemia. This differs from the situation in the United States, where there was far greater heterogeneity of mutations. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 7 Figure 8 PMID:7977368

  18. Prevalence of antiplatelet therapy in patients with diabetes

    PubMed Central

    Miller, Shaun R; Littenberg, Benjamin; MacLean, Charles D

    2005-01-01

    Objective To determine the prevalence of, and patient characteristics associated with, antiplatelet therapy in a cohort of primary care patients with Type 1 or Type2 diabetes. Methods Subjects participating in a randomized trial of a decision support system were interviewed at home and medication usage verified by a research assistant. Eligibility for antiplatelet therapy was determined by American Diabetes Association criteria and clinical contraindications. The association between antiplatelet use and patient characteristics was examined using bivariate and multivariate logistic regression. Results The mean age of subjects was 64 years (range 31–93). The prevalence of antiplatelet use was 54% overall; 45% for subjects without known CVD vs. 78% for those with CVD; 46% for women vs. 63% for men; and 45% for younger subjects (age< 65) vs. 62% for senior citizens. After controlling for race/ethnicity, income, education, marital status, insurance status and prescription coverage, the following were associated with the use of antiplatelet therapy: presence of known CVD (OR 3.4 [2.2, 5.1]), male sex (OR 2.0 [1.4, 2.8]), and age > = 65 (OR 1.9 [1.3, 2.7]). The prevalence of antiplatelet therapy for younger women without CVD was 32.8% compared to a prevalence of 90.3% for older men with CVD. Conclusion Despite clinical practice guidelines recommending antiplatelet therapy for patients with diabetes, there are still many eligible patients not receiving this beneficial therapy, particularly patients under 65, women, and patients without known CVD. Effective methods to increase antiplatelet use should be considered at the national, community, practice and provider level. PMID:16321162

  19. Controversies surrounding the treatment of the hypertensive patient with diabetes

    Microsoft Academic Search

    L. Michael Prisant; Rita J. Louard

    1999-01-01

    Diabetes mellitus without previous myocardial infarction carries the same risk of a future myocardial infarction as someone\\u000a who has had one. Intense glucose, lipid, and blood pressure control in diabeti patients is advocated to reduce cardiovascular\\u000a events and decrease the incidence of end-stage renal disease, retinal damage, and peripheral vascular disease. Recent studies,\\u000a including the Systolic Hypertension in the Elderly

  20. Screening for Ketonemia in Patients With Diabetes

    Microsoft Academic Search

    Theresa M Schwab; Gregory W Hendey; Tricia C Soliz

    1999-01-01

    Study objectives: To determine the sensitivity and specificity of the urine ketone dip test as a screening test for ketonemia in hyperglycemic patients and to compare the performance of the urine ketone dip test with the anion gap and serum bicarbonate level. Methods: This was a prospective study conducted in an urban, university-affiliated public hospital emergency department. Inclusion criteria consisted

  1. Phase I study of olaratumab in Japanese patients with advanced solid tumors.

    PubMed

    Doi, Toshihiko; Ma, Yan; Dontabhaktuni, Aruna; Nippgen, Cornelia; Nippgen, Johannes; Ohtsu, Atsushi

    2014-07-01

    Olaratumab (IMC-3G3) is a fully human IgG1 monoclonal antibody that selectively binds the external domain of human platelet-derived growth factor receptor-? with high affinity and blocks ligand binding. This was a single-center, dose-escalation, phase I trial of olaratumab in Japanese patients with advanced/refractory solid malignancies. Three to six patients were enrolled into each of three cohorts: Patients received i.v. olaratumab: 10 mg/kg on days 1 and 8 every 3 weeks (cohort 1); 20 mg/kg every 2 weeks (cohort 2); and 15 mg/kg on days 1 and 8 every 3 weeks (cohort 3). Doses were escalated from cohort 1 through cohort 3. The primary objective was to establish the safety and pharmacokinetic profile of olaratumab. Sixteen patients were treated across three cohorts. There were no dose-limiting toxicities, so the maximum tolerated dose was not reached. The most common olaratumab-related treatment-emergent adverse events (TEAEs) were proteinuria (25.0%) and elevated aspartate transaminase (12.5%). One patient (cohort 2) had two olaratumab-related Grade 3 TEAEs (increased aspartate aminotransferase and tumor hemorrhage); otherwise, olaratumab-related TEAEs were Grade 1/2. Seven patients (43.8%) had a best response of stable disease. Based on the pharmacokinetic concentration profile of olaratumab, the trough concentrations following single and multiple doses at 15 mg/kg on days 1 and 8 every 3 weeks (cohort 3) and multiple doses at 20 mg/kg every 2 weeks (cohort 2) were above the 155 ?g/mL target. Thus, these two doses could represent an acceptable schedule for future trials in Japanese patients. Olaratumab had an acceptable safety profile and was well tolerated. PMID:24816152

  2. [Influence of diabetes on the clinical course and hospital mortality of patients with recent myocardial infarction].

    PubMed

    Stanis?awska, J; Krzymie?, J; Opolski, G; Wardaszko, T; Górecki, A; Kraska, T

    1993-01-01

    In group of 1026 patients with recent myocardial infarction (from program "Streptokinase in acute myocardial infarction"--patients below 70 years old, up to 12 hours from the onset of the symptoms) we analyzed the influence of diabetes on clinical course and hospital mortality. In this group were 77 patients with noninsulin-dependent diabetes (NIDDM), and 21 patients were insulin-dependent diabetes (IDDM). The risk factors of coronary heart disease and myocardial infarction in the past were significantly more often in patients with diabetes than in subjects without diabetes. In hospital mortality was significantly higher (p < 0.05) in group of patients with diabetes (17.3%) than in group without diabetes (9.5%). Reinfarction in the hospital period occurred significantly more often in diabetes group (p < 0.01). Congestive heart failure was observed in 50% patients with diabetes and in 32.3% cases without diabetes (p < 0.01), the left ventricle aneurysm occurred accordingly 9.8% i 5.2% (N.S.). Early ventricular fibrillation and atrio-ventricular blocks occurred with the same frequency in the both groups. We analyzed also the influence of thrombolytic therapy on clinical course in patients with diabetes proving the benefit of this treatment. PMID:8479943

  3. Low Lung Function and Risk of Type 2 Diabetes in Japanese Men: The Toranomon Hospital Health Management Center Study 9 (TOPICS 9)

    PubMed Central

    Heianza, Yoriko; Arase, Yasuji; Tsuji, Hiroshi; Saito, Kazumi; Amakawa, Kazuhisa; Hsieh, Shiun Dong; Kodama, Satoru; Shimano, Hitoshi; Yamada, Nobuhiro; Hara, Shigeko; Sone, Hirohito

    2012-01-01

    Objective To evaluate the effect of elevated fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) concentrations on lung dysfunction and to prospectively investigate whether reduced lung function would be independently predictive of diabetes. Participants and Methods From January 6, 1997, through December 22, 2008, we observed 5346 men with no history of diabetes or lung dysfunction. Hazard ratios (HRs) for incident diabetes (FPG ?126 mg/dL, HbA1c ?6.5%, or self-reported clinician-diagnosed diabetes) were estimated for spirometry indices as continuous and categorical variables. Results Elevated HbA1c concentrations within the normal range were significantly and more strongly associated with reduced forced vital capacity and forced expiratory volume in the first second after expiration (FEV1) than were FPG concentrations. During a 4.0-year follow-up, diabetes developed in 214 individuals. A 10-point decrease in percentage of FEV1 predicted value was associated with an increased HR of 1.21 (95% confidence interval [CI], 1.09-1.34; P=.001) for diabetes after adjustment for demographic factors and body mass index. This association remained significant even after adjustment for metabolic factors, smoking status, and FPG or HbA1c concentrations but was attenuated substantially after adjustment for baseline HbA1c values (HR, 1.13; 95% CI, 1.01-1.26; P=.03). Lower quartile (Q) categories of percentage of FEV1 predicted value were associated with increased risk of diabetes independently of known predictors including HbA1c (HR, 1.73; 95% CI, 1.14-2.62 for Q1; and HR, 1.76; 95% CI, 1.15-2.69 for Q2). Conclusion Reduced lung function was significantly related to chronic glycemic exposure within a normal range. Relatively low pulmonary function was an independent risk factor for diabetes in apparently healthy Japanese men. PMID:22958989

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

    E-print Network

    Collins, James J.

    neuropathy (age range, 53­77y). Interventions: Each subject's detection thresholds (ie, min- imum level of stimulus to be detected) for a vibrotactile stim- ulus without and with mechanical noise (ie, random that vibrotactile detection thresholds in older adults, patients with stroke, and patients with diabetic neuropathy

  5. Management of blood pressure in patients with diabetes.

    PubMed

    Grossman, Ehud; Messerli, Franz H

    2011-08-01

    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 the cornerstone of the antihypertensive drug arsenal; however, in most patients, combination therapy is required. For many patients, a combination of RAAS blocker and calcium antagonist is the combination preferred by the treating physician. Often three or even four drugs are needed. Treatment should be individualized according to concomitant risk factors and diseases and depending on the age and hemodynamic and laboratory parameters of the patient. In order to maximally reduce cardio renal risk, control of lipid and glycemic levels should also be ensured. PMID:21525967

  6. Plasma Free Amino Acid Profiles Predict Four-Year Risk of Developing Diabetes, Metabolic Syndrome, Dyslipidemia, and Hypertension in Japanese Population.

    PubMed

    Yamakado, Minoru; Nagao, Kenji; Imaizumi, Akira; Tani, Mizuki; Toda, Akiko; Tanaka, Takayuki; Jinzu, Hiroko; Miyano, Hiroshi; Yamamoto, Hiroshi; Daimon, Takashi; Horimoto, Katsuhisa; Ishizaka, Yuko

    2015-01-01

    Plasma free amino acid (PFAA) profile is highlighted in its association with visceral obesity and hyperinsulinemia, and future diabetes. Indeed PFAA profiling potentially can evaluate individuals' future risks of developing lifestyle-related diseases, in addition to diabetes. However, few studies have been performed especially in Asian populations, about the optimal combination of PFAAs for evaluating health risks. We quantified PFAA levels in 3,701 Japanese subjects, and determined visceral fat area (VFA) and two-hour post-challenge insulin (Ins120?min) values in 865 and 1,160 subjects, respectively. Then, models between PFAA levels and the VFA or Ins120?min values were constructed by multiple linear regression analysis with variable selection. Finally, a cohort study of 2,984 subjects to examine capabilities of the obtained models for predicting four-year risk of developing new-onset lifestyle-related diseases was conducted. The correlation coefficients of the obtained PFAA models against VFA or Ins120?min were higher than single PFAA level. Our models work well for future risk prediction. Even after adjusting for commonly accepted multiple risk factors, these models can predict future development of diabetes, metabolic syndrome, and dyslipidemia. PFAA profiles confer independent and differing contributions to increasing the lifestyle-related disease risks in addition to the currently known factors in a general Japanese population. PMID:26156880

  7. Plasma Free Amino Acid Profiles Predict Four-Year Risk of Developing Diabetes, Metabolic Syndrome, Dyslipidemia, and Hypertension in Japanese Population

    PubMed Central

    Yamakado, Minoru; Nagao, Kenji; Imaizumi, Akira; Tani, Mizuki; Toda, Akiko; Tanaka, Takayuki; Jinzu, Hiroko; Miyano, Hiroshi; Yamamoto, Hiroshi; Daimon, Takashi; Horimoto, Katsuhisa; Ishizaka, Yuko

    2015-01-01

    Plasma free amino acid (PFAA) profile is highlighted in its association with visceral obesity and hyperinsulinemia, and future diabetes. Indeed PFAA profiling potentially can evaluate individuals’ future risks of developing lifestyle-related diseases, in addition to diabetes. However, few studies have been performed especially in Asian populations, about the optimal combination of PFAAs for evaluating health risks. We quantified PFAA levels in 3,701 Japanese subjects, and determined visceral fat area (VFA) and two-hour post-challenge insulin (Ins120?min) values in 865 and 1,160 subjects, respectively. Then, models between PFAA levels and the VFA or Ins120?min values were constructed by multiple linear regression analysis with variable selection. Finally, a cohort study of 2,984 subjects to examine capabilities of the obtained models for predicting four-year risk of developing new-onset lifestyle-related diseases was conducted. The correlation coefficients of the obtained PFAA models against VFA or Ins120?min were higher than single PFAA level. Our models work well for future risk prediction. Even after adjusting for commonly accepted multiple risk factors, these models can predict future development of diabetes, metabolic syndrome, and dyslipidemia. PFAA profiles confer independent and differing contributions to increasing the lifestyle-related disease risks in addition to the currently known factors in a general Japanese population. PMID:26156880

  8. Depression among patients with diabetes mellitus in North India evaluated using patient health questionnaire-9

    PubMed Central

    Thour, Amit; Das, Subhash; Sehrawat, Tejasav; Gupta, Yashdeep

    2015-01-01

    Background: Depression is common among diabetes, and is associated with poor outcomes. However, the data on this important relationship are limited from India. Objective: The aim was to estimate the prevalence of depression in patients with diabetes and to determine the association of depression with age, sex, and other related parameters. Materials and Methods: The study was cross-sectional carried out in endocrinology clinic of tertiary care hospital in North India. Cases were patients with type 2 diabetes mellitus (T2DM) above 30 years of age. Depression was assessed using the patient health questionairre-9 (PHQ-9). The relationship with sociodemographic profile, duration of diabetes, hypertension and microvascular complications was also analyzed. Results: Seventy-three subjects (57.5% females) with mean age 50.8 ± 9.2 years were evaluated. The prevalence of depression was 41%. Severe depression (PHQ score ?15) was present in 3 (4%) subjects, moderate depression (PHQ score ?10) in 7 (10%) subjects, and mild depression was present in 20 (27%) of subjects. Depression was significantly more prevalent in rural subjects (57%) when compared to urban ones (31%, P = 0.049). Depression increased with presence of microvascular complications, fasting plasma glucose, hypertension, but the differences were not statistically significant. Conclusions: Our study demonstrates higher prevalence of depression in patients with type 2 diabetes. Apart from being belonging to the rural area, no other factor was significantly associated with depression. Therefore, depression should be assessed in each and every patient, irrespective of other factors. PMID:25729687

  9. Genetic Polymorphisms of Dihydropyrimidinase in a Japanese Patient with Capecitabine-Induced Toxicity

    PubMed Central

    Akai, Fumika; Hosono, Hiroki; Hishinuma, Eiji; Hirasawa, Noriyasu

    2015-01-01

    Dihydropyrimidinase (DHP) is the second enzyme in the catabolic pathway of uracil, thymine, and chemotherapeutic fluoropyrimidine agents such as 5-fluorouracil (5-FU). Thus, DHP deficiency might be associated with 5-FU toxicity during fluoropyrimidine chemotherapy. We performed genetic analyses of the family of a patient with advanced colon cancer who underwent radical colectomy followed by treatment with 5-FU prodrug capecitabine and developed severe toxicity attributable to a lack of DHP. We measured urinary uracil and dihydrouracil, and genotyped DPYS in the patient and her family. We also measured the allele frequency of DPYS polymorphisms in 391 unrelated Japanese subjects. The patient had compound heterozygous missense and nonsense polymorphisms comprising c.1001A>G (p.Gln334Arg) in exon 6 and c.1393C>T (p.Arg465Ter) in exon 8, which are known to result in a DHP enzyme with little or no activity. The urinary dihydrouracil/uracil ratio in the patient was 17.08, while the mean ± SD urinary dihydrouracil/uracil ratio in family members who were heterozygous or homozygous for wild-type DPYS was 0.25 ± 0.06. In unrelated subjects, 8 of 391 individuals were heterozygous for the c.1001A>G mutation, while the c.1393C>T mutation was not identified. This is the first report of a DHP-deficient patient with DPYS compound heterozygous polymorphisms who was treated with a fluoropyrimidine, and our findings suggest that polymorphisms in the DPYS gene are pharmacogenomic markers associated with severe 5-FU toxicity in Japanese patients. PMID:25915935

  10. [Acute oesophageal necrosis in patients with diabetic ketoacidosis.

    PubMed

    Edling, Poul; Thomsen, Henrik

    2013-11-25

    Acute oesophageal necrosis is a rarely seen phenomenon, occurring in situations with ischaemic insult in combination with gastric outlet obstruction or gastro-oesophageal reflux. The hallmark is circumferential necrosis of the oesophageal mucosa and it is associated with a high mortality. Two patients presented with haematemesis. They were admitted to hospital in a state of diabetic ketoacidosis. Endoscopy revealed acute oesophageal necrosis. They were stabilized and treated with high-dose proton pump inhibitors. Both patients recovered and were discharged without sequelae. PMID:25353192

  11. Use of complementary and alternative medicine by patients with urologic cancer: a prospective study at a single Japanese institution

    Microsoft Academic Search

    Koji Yoshimura; Nobufumi Ueda; Kentaro Ichioka; Yoshiyuki Matsui; Akito Terai; Yoichi Arai

    2005-01-01

    Objectives: We prospec- tively evaluated the prevalence and predictors of complementary medicine (CAM) use among Japanese patients with urologic cancer 1 year after diagnosis. Patients and methods: A total of 349 patients with newly diagnosed urologic cancer answered a self-administered questionnaire on CAM use 1 year after diagnosis. General-health-related quality of life (GHQL) of the patients was also assessed at

  12. Salivary-type amylase producing lung cancers examined clinically and pathologically in 260 Japanese patients of lung lobectomy or segmentectomy

    Microsoft Academic Search

    Tadako Nakatsuji

    2008-01-01

    The causative mechanisms of lung cancers producing salivary-type amylase (S-Amy) were hypothesized from clinical and pathological\\u000a analysis of lung cancers. A total of 260 Japanese patients who received lung lobectomy or segmentectomy during the last 4 years\\u000a at Hamamatsu University Hospital, Japan, were objective patients in this study. Among the 260 patients, 212 patients were\\u000a operated on for lung cancers. Of

  13. 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

  14. 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

  15. The effects of muscle activation on postural stability in diabetes mellitus patients with cutaneous sensory deficit in the foot

    Microsoft Academic Search

    Roger W. Simmons; Charles Richardson

    2001-01-01

    Activity of the lower leg muscles in response to an unexpected disturbance to upright standing was studied in diabetic patients and non-diabetic matched controls. The diabetic individuals were classified into two groups: diabetic patients with normal cutaneous sensitivity in the foot (n=27) and patients with cutaneous sensory deficit (n=23). All participants completed twenty trials standing on a force platform that

  16. On experiences of i2b2 (Informatics for integrating biology and the bedside) database with Japanese clinical patients’ data

    PubMed Central

    Takai-Igarashi, Takako; Akasaka, Ryo; Suzuki, Kenji; Furukawa, Takahisa; Yoshida, Makiko; Inoue, Keisuke; Maruyama, Tomohisa; Maejima, Toshimasa; Bando, Masahiro; Takasaki, Masakazu; Sakota, Miki; Eguchi, Maki; Konagaya, Akihiko; Matsuura, Hiroya; Suzumura, Toyotaro; Tanaka, Hiroshi

    2011-01-01

    Informatics for Integrating Biology and the Bedside (i2b2) is a database system to facilitate sharing and reuse of clinical patients' data collected in individual hospitals. The i2b2 provides an ontology based object-oriented database system with highly simple and flexible database schema which enables us to integrate clinical patients' data from different laboratories and different hospitals. 392 patients' data including carcinoma and non-carcinoma specimens from cancer patients are transported from the Integrated Clinical Omics Database (iCOD) to the i2b2 database for a feasibility study to check applicability of i2b2 ontology and database schema on Japanese clinical patients’ data. No modification is required for the i2b2 data model to deal with Japanese characters. Some modification of ontology is required to integrate biomedical information extracted from the cancer patients’ data. We believe that the i2b2 system will be practical infrastructure to integrate Japanese clinical databases if appropriate disease ontology for Japanese patients is provided. PMID:21544172

  17. 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

  18. Clinical management of concurrent diabetes and tuberculosis and the implications for patient services.

    PubMed

    Riza, Anca Lelia; Pearson, Fiona; Ugarte-Gil, Cesar; Alisjahbana, Bachti; van de Vijver, Steven; Panduru, Nicolae M; Hill, Philip C; Ruslami, Rovina; Moore, David; Aarnoutse, Rob; Critchley, Julia A; van Crevel, Reinout

    2014-09-01

    Diabetes triples the risk for active tuberculosis, thus the increasing burden of type 2 diabetes will help to sustain the present tuberculosis epidemic. Recommendations have been made for bidirectional screening, but evidence is scarce about the performance of specific tuberculosis tests in individuals with diabetes, specific diabetes tests in patients with tuberculosis, and screening and preventive therapy for latent tuberculosis infections in individuals with diabetes. Clinical management of patients with both diseases can be difficult. Tuberculosis patients with diabetes have a lower concentration of tuberculosis drugs and a higher risk of drug toxicity than tuberculosis patients without diabetes. Good glycaemic control, which reduces long-term diabetes complications and could also improve tuberculosis treatment outcomes, is hampered by chronic inflammation, drug-drug interactions, suboptimum adherence to drug treatments, and other factors. Besides drug treatments for tuberculosis and diabetes, other interventions, such as education, intensive monitoring, and lifestyle interventions, might be needed, especially for patients with newly diagnosed diabetes or those who need insulin. From a health systems point of view, delivery of optimum care and integration of services for tuberculosis and diabetes is a huge challenge in many countries. Experience from the combined tuberculosis and HIV/AIDS epidemic could serve as an example, but more studies are needed that include economic assessments of recommended screening and systems to manage concurrent tuberculosis and diabetes. PMID:25194887

  19. 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

  20. Predictive Power of a Body Shape Index for Development of Diabetes, Hypertension, and Dyslipidemia in Japanese Adults: A Retrospective Cohort Study

    PubMed Central

    Fujita, Misuzu; Sato, Yasunori; Nagashima, Kengo; Takahashi, Sho; Hata, Akira

    2015-01-01

    Background/Objectives Recently, a body shape index (ABSI) was reported to predict all-cause mortality independently of body mass index (BMI) in Americans. This study aimed to evaluate whether ABSI is applicable to Japanese adults as a predictor for development of diabetes, hypertension, and dyslipidemia. Subjects/Methods We evaluated the predictive power of ABSI in a retrospective cohort study using annual health examination data from Chiba City Hall in Japan, for the period 2008 to 2012. Subjects included 37,581 without diabetes, 23,090 without hypertension, and 20,776 without dyslipidemia at baseline who were monitored for disease incidence for 4 years. We examined the associations of standardized ABSI, BMI, and waist circumference (WC) at baseline with disease incidence by logistic regression analyses. Furthermore, we conducted a case-matched study using the propensity score matching method. Results Elevated BMI, WC, and ABSI increased the risks of diabetes and dyslipidemia [BMI-diabetes: odds ratio (OR) = 1.26, 95% confidence interval (95%CI) = 1.20?1.32; BMI-dyslipidemia: OR = 1.15, 95%CI = 1.12?1.19; WC-diabetes: OR = 1.24, 95%CI = 1.18?1.31; WC-dyslipidemia: OR = 1.15, 95%CI = 1.11?1.19; ABSI-diabetes: OR = 1.06, 95%CI = 1.01?1.11; ABSI-dyslipidemia: OR = 1.04, 95%CI = 1.01?1.07]. Elevated BMI and WC, but not higher ABSI, also increased the risk of hypertension [BMI: OR = 1.32, 95%CI = 1.27?1.37; WC: OR = 1.22, 95%CI = 1.18?1.26; ABSI: OR = 1.00, 95%CI = 0.97?1.02]. Areas under the curve (AUCs) in regression models with ABSI were significantly smaller than in models with BMI or WC for all three diseases. In case-matched subgroups, the power of ABSI was weaker than that of BMI and WC for predicting the incidence of diabetes, hypertension, and dyslipidemia. Conclusions Compared with BMI or WC, ABSI was not a better predictor of diabetes, hypertension, and dyslipidemia in Japanese adults. PMID:26030122

  1. Patients’ Experiences with and Attitudes towards a Diabetes Patient Web Portal

    PubMed Central

    Ronda, Maaike C. M.; Dijkhorst-Oei, Lioe-Ting; Rutten, Guy E. H. M.

    2015-01-01

    Objective A diabetes patient web portal allows patients to access their personal health record and may improve diabetes outcomes; however, patients’ adoption is slow. We aimed to get insight into patients’ experiences with a web portal to understand how the portal is being used, how patients perceive the content of the portal and to assess whether redesign of the portal might be needed. Materials and Methods A survey among 1500 patients with type 1 and type 2 diabetes with a login to a patient portal. Setting: 62 primary care practices and one outpatient hospital clinic, using a combined patient portal. We compared patients who requested a login but never used it or once (‘early quitters’) with patients who used it at least two times (‘persistent users’). Results 632 patients (42.1%) returned the questionnaire. Their mean age was 59.7 years, 63.1% was male and 81.8% had type 2 diabetes. 413 (65.3%) people were persistent users and 34.7% early quitters. In the multivariable analysis, insulin use (OR2.07; 95%CI[1.18–3.62]), experiencing more frequently hyperglycemic episodes (OR1.30;95%CI[1.14–1.49]) and better diabetes knowledge (OR1.02, 95%CI[1.01–1.03]) do increase the odds of being a persistent user. Persistent users perceived the usefulness of the patient portal significantly more favorable. However, they also more decisively declared that the patient portal is not helpful in supporting life style changes. Early quitters felt significantly more items not applicable in their situation compared to persistent users. Both persistent users (69.8%) and early quitters (58.8%) would prefer a reminder function for scheduled visits. About 60% of both groups wanted information about medication and side-effects in their portal. Conclusions The diabetes patient web portal might be improved significantly by taking into account the patients’ experiences and attitudes. We propose creating separate portals for patients on insulin or not. PMID:26086272

  2. Prediction, by Retinal Location, of the Onset of Diabetic Edema in Patients with Nonproliferative Diabetic Retinopathy

    PubMed Central

    Bearse, Marcus A.; Schneck, Marilyn E.; Wolff, Brian E.; Jewell, Nicholas P.; Barez, Shirin; Mick, Andrew B.; Dolan, Bernard J.; Adams, Anthony J.

    2011-01-01

    Purpose. To formulate a model to predict the location of the onset of diabetic retinal edema (DE) in adults with diabetic retinopathy (DR), at risk for DE. Methods. In all, 46 eyes from 23 patients with DR were included. Subjects were followed semiannually until DE developed or the study concluded. The presence or absence of DE within the central 45° at the final visit was the outcome measure, and data from the prior visit were used as baseline. A logistic regression model was formulated to assess the relationship between DE development and: multifocal electroretinogram (mfERG) implicit time (IT) Z-score, mfERG amplitude (Amp) Z-score, sex, diabetes duration, diabetes type, blood glucose, HbA1c, age, systolic (SBP) and diastolic blood pressure, and grade of retinopathy. A total of 35 retinal zones were constructed from the mfERG elements and each was graded for DE. Data from 52 control subjects were used to calculate the maximum IT and minimum Amp Z-scores for each zone. Receiver operating characteristic curves from a fivefold cross-validation were used to determine the model's predictive properties. Results. Edema developed in 5.2% of all retinal zones and in 35% of the eyes. The mfERG Amp, mfERG IT, SBP, and sex were together predictive of edema onset. Combined, these factors produce a model that has 84% sensitivity and 76% specificity. Conclusions. Together mfERG, SBP, and sex are good predictors of local edema in patients with DR. The model is a useful tool for assessing risk for edema development and a candidate measure to evaluate novel therapeutics directed at DE. PMID:21743017

  3. Clinical Results of Percutaneous Needle Fasciotomy for Dupuytren’s Disease in Japanese Patients

    PubMed Central

    Tokunaga, Susumu

    2015-01-01

    Background: Clinical results of percutaneous needle fasciotomy (PNF) in Japanese patients with Dupuytren’s disease are reported. Methods: In this prospective study, 51 patients (103 fingers: 1 index, 9 middle, 47 ring, and 46 small) underwent PNF at 99 metacarpophalangeal (MCP) and 68 proximal interphalangeal (PIP) joints. Patients were assessed postoperatively after 1 day, at 1, 2, 4, 6, and 8 weeks, and at 3, 6, 9, and 12 months. Correction of contracture was measured in degrees, and an improvement index (% improvement) was described previously by Tonkin et al. A correction of the contracture to 5° or less at each joint and at each digital ray represented a successful correction. The recurrence rates in MCP and PIP joints were also evaluated. Correlations between the Tubiana classification stage and successful correction, % improvement, and recurrence rate were evaluated. The relationships between recurrence rate and the diathesis score (more/less than 5 points) and between recurrence rate and age at surgery (<50/?50 years) were also examined. Results: In MCP and PIP joints, the improvement maintained at final follow-up was 89% and 57%, respectively, with successful corrections in 89% and 76%, respectively. PNF corrected digital rays at various Tubiana stages: stage 1 = 100%, stage 2 = 82%, stage 3 = 46%, and stage 4 = 0%. Improvements were preserved in stage 1 = 83%; stage 2 = 62%; stage 3 = 58%, and stage 4 = 60%. Recurrence of Dupuytren’s disease was significant for the PIP joint, severe Tubiana stage, and younger patients. Conclusions: Clinical results of PNF in Japanese patients with Dupuytren’s contractures were similar to those of whites.

  4. Implantable cardioverter defibrillators in diabetics: efficacy and safety in patients at risk of sudden cardiac death.

    PubMed

    Shahreyar, Muhammad; Mupiddi, Vijayadershan; Choudhuri, Indrajit; Sra, Jasbir; Tajik, Abdul Jamil; Jahangir, Arshad

    2015-08-01

    Diabetes mellitus is a major risk factor for arrhythmogenesis and is associated with a two-fold increase in all-cause mortality and a four-fold increase in cardiovascular mortality including sudden cardiac death when compared with nondiabetics. Implantable cardioverter defibrillators (ICD) have been shown to effectively reduce arrhythmic death and all-cause mortality in patients with severe myocardial dysfunction. With a high competing risk of nonarrhythmic cardiac and noncardiac death, survival benefit of ICD in patients with diabetes mellitus could be reduced, but the subanalysis of diabetic patients in randomized clinical trials provides reassurance regarding a similar beneficial survival effect of ICD and cardiac resynchronization therapy in diabetics, as observed in the overall population with advanced heart disease. In this article, the authors highlight some of the clinical issues related to diabetes, summarize the data on the efficacy of ICD in diabetics when compared with nondiabetics and discuss concerns related to ICD implantation in patients with diabetes. PMID:26098816

  5. Retinal Blood Flow in Type 1 Diabetic Patients With No or Mild Diabetic Retinopathy During Euglycemic Clamp

    PubMed Central

    Pemp, Berthold; Polska, El?bieta; Garhofer, Gerhard; Bayerle-Eder, Michaela; Kautzky-Willer, Alexandra; Schmetterer, Leopold

    2010-01-01

    OBJECTIVE To compare total retinal blood flow in diabetic patients with no or mild nonproliferative diabetic retinopathy and healthy control subjects and to investigate in patients whether there is a difference between retinal blood flow before morning insulin and under normoglycemic conditions using a glucose clamp. RESEARCH DESIGN AND METHODS Twenty patients with type 1 diabetes with no or mild diabetic retinopathy were included in this open parallel-group study, and 20 healthy age- and sex-matched subjects were included as control subjects. Retinal blood flow was assessed by combining velocity measurements using laser Doppler velocimetry and diameter measurements using a commercially available dynamic vessel analyzer. Measurements were performed before and during a euglycemic clamp. RESULTS Total retinal blood flow was higher in diabetic patients (53 ± 16 ?l/min) than in healthy subjects (43 ± 16 ?l/min; P = 0.034 between groups). When plasma glucose in diabetic patients was reduced from 9.3 ± 1.7 to 5.3 ± 0.5 mmol/l (P < 0.001) retinal blood flow decreased to 49 ± 15 ?l/min (P = 0.0003 vs. baseline). Total retinal blood flow during the glucose clamp was not significantly different from blood flow in normal control subjects (P = 0.161). CONCLUSIONS Type 1 diabetic patients with no or only mild diabetic retinopathy have increased retinal blood flow before their morning insulin dosage. Blood flow is reduced toward normal during euglycemic conditions. Retinal blood flow may fluctuate significantly with fluctuating plasma glucose levels, which may contribute to the microvascular changes seen in diabetic retinopathy. PMID:20585003

  6. Determinants of sexual dysfunction among clinically diagnosed diabetic patients

    PubMed Central

    2011-01-01

    Background Diabetes mellitus is a chronic disease that can result in various medical, psychological and sexual dysfunctions (SD) if not properly managed. SD in men is a common under-appreciated complication of diabetes. This study assessed the prevalence and determinants of SD among diabetic patients in Tema, Greater Accra Region of Ghana. Method Sexual functioning was determined in 300 consecutive diabetic men (age range: 18-82 years) visiting the diabetic clinic of Tema General Hospital with the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire, between November, 2010 and March, 2011. In addition to the socio-demographic characteristics of the participants, the level of glycosylated haemoglobin, fasting blood sugar (FBS) and serum testosterone were assessed. All the men had a steady heterosexual relationship for at least 2 years before enrolment in the study. Results Out the 300 participants contacted, the response rate was 91.3% after 20 declined participation and 6 incomplete data were excluded All the respondents had at least basic education, 97.4% were married, 65.3% were known hypertensive, 3.3% smoked cigarettes, 27% took alcoholic beverages and 32.8% did some form of exercise. The 69.3% SD rate observed in this study appears to be related to infrequency (79.2%), non-sensuality (74.5%), dissatisfaction with sexual acts (71.9%), non-communication (70.8%) and impotence (67.9%). Other areas of sexual function, including premature ejaculation (56.6%) and avoidance (42.7%) were also substantially affected. However, severe SD was seen in only 4.7% of the studied population. The perceived "adequate", "desirable", "too short" and "too long intra-vaginal ejaculatory latency time (IELT) are 5-10, 5-10, 1-2 and 15-30 minutes respectively. Testosterone correlates negatively with glycated haemoglobin (HBA1c), FBS, perceived desirable, too short IELT, and weight as well as waist circumference. Conclusion SD rate from this study is high but similar to that reported among self-reported diabetic patients in Kumasi, Ghana and vary according to the condition and age. The determinants of SD from this study are income level, exercise, obesity, higher perception of "desirable" and "too short" IELT. PMID:21612653

  7. 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

  8. Efficacy and safety of pitavastatin in Japanese patients with hypercholesterolemia: LIVES study and subanalysis.

    PubMed

    Yokote, Koutaro; Shimano, Hitoshi; Urashima, Mitsuyoshi; Teramoto, Tamio

    2011-05-01

    The Livalo Effectiveness and Safety (LIVES) study was an observational study to examine the efficacy and safety of pitavastatin, a newly developed drug, in approximately 20,000 Japanese patients with hypercholesterolemia. During a 2-year follow-up period, no significant problems concerning safety were observed upon treatment with pitavastatin. Pitavastatin demonstrated potent and stable lowering of the LDL-cholesterol level. The LIVES study subanalyses revealed significant and continuous elevation of HDL-cholesterol in association with pitavastatin treatment and also showed that the drug did not adversely affect glycemic control as evaluated by the glycohemoglobin A(1c) level. Moreover, pitavastatin treatment was associated with an increase in estimated glomerular filtration rate in subjects with chronic kidney disease. These results suggest the usefulness of pitavastatin in hypercholesterolemic patients from various backgrounds. The ongoing LIVES study extension is expected to provide further data on cardiovascular outcome in subjects treated with pitavastatin. PMID:21615316

  9. Clinical characteristics of eight patients with congenital nephrogenic diabetes insipidus.

    PubMed

    Mizuno, Haruo; Sugiyama, Yukari; Ohro, Yoichiro; Imamine, Hiroki; Kobayashi, Masanori; Sasaki, Sei; Uchida, Sinichi; Togari, Hajime

    2004-06-01

    Congenital nephrogenic diabetes insipidus (NDI) is characterized by the insensitivity of the distal nephron to arginine vasopressin. Clinical knowledge of this disease is based largely on case reports. For this study, we investigated the clinical findings of eight patients in terms of age at onset, age at diagnosis, main complaint, results of physical examination, the diagnosis, the effect of treatment, kidney function, and presence or absence of gene defects. The main complaints of all eight cases at initial examination were unknown fever, failure to thrive, and short stature. Polyuria and polydipsia are not always the chief complaints with congenital NDI. In one case, diabetes insipidus could be diagnosed based only on the results of a 5% hypertonic saline test. In six cases, we found abnormalities in the V2 receptor gene. Initially, trichlormethiazide therapy was shown to have a significant effect on polyuria; however, this effect decreased over time. In one patient with partial NDI, the addition of trichlormethiazide twice a day to 1-desamino-8-D-arginine vasopressin increased urine osmolality in the morning and caused nocturia to disappear. Results of 99mTc-diethylenetriamine pentaacetic acid kidney scintigraphy revealed a slight decrease in glomerular filtration rate in three patients. No patient experienced serious renal dysfunction. PMID:15249704

  10. DECREASED VASCULAR MATRIX METALLOPROTEINASE ABUNDANCE IN DIABETIC PATIENTS WITH SYMPTOMATIC MACROANGIOPATHY

    Microsoft Academic Search

    J. Sheppard Mondy; Mark P. Anstadt; Dion L. Franga; Vera Portik-Dobos; Jimmie Hutchinson; Adviye Ergul

    2002-01-01

    The incidence of diabetic amputations is 2- to 3-fold higher in African-American patients compared to Caucasians. Vascular remodeling characterized by extracellular matrix (ECM) deposition occurs in diabetes and contributes to vascular complications. The matrix metal- loproteinases (MMP) play important roles in the regulation of collagen turnover and vas- cular remodeling. However, the temporal ex- pression profile of MMPs in diabetic

  11. Hyperbaric Oxygen Therapy Facilitates Healing of Chronic Foot Ulcers in Patients With Diabetes

    Microsoft Academic Search

    MAGNUS LONDAHL; PER KATZMAN; ANDERS NILSSON; CHRISTER HAMMARLUND

    2010-01-01

    OBJECTIVE — Chronic diabetic foot ulcers are a source of major concern for both patients and health care systems. The aim of this study was to evaluate the effect of hyperbaric oxygen therapy (HBOT) in the management of chronic diabetic foot ulcers. RESEARCH DESIGN AND METHODS — The Hyperbaric Oxygen Therapy in Diabet- ics with Chronic Foot Ulcers (HODFU) study

  12. 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…

  13. Preparing nurses to prescribe medicines for patients with diabetes: a national questionnaire survey

    Microsoft Academic Search

    Molly Courtenay; Nicola Care

    Title. Preparing nurses to prescribe medicines for patients with diabetes: a national questionnaire survey Aim. This paper is a report of a study to examine Nurse Independent\\/Nurse Sup- plementary Prescribing for people with diabetes and the extent to which these nurses feel prepared for this role. Background. An area of care in which nurses, caring for people with diabetes, are

  14. Evaluation of cerebrovascular carbon dioxide reactivity in patients with diabetes mellitus under sedative doses of propofol

    Microsoft Academic Search

    Chikara Kawauchi; Yuji Kadoi; Hiroshi Hinohara; Fumio Kunimoto; Shigeru Saito

    2008-01-01

    The present study compared cerebrovascular CO2 reactivity in diabetic patients on different treatment modalities under sedative doses of propofol. Fifteen patients with\\u000a diabetes mellitus (on three different antidiabetic treatment modalities) who required mechanical ventilation during intensive\\u000a care therapy were studied, sedation during mechanical ventilation being maintained using propofol. As controls, 6 patients\\u000a without diabetes were monitored. A 2.5-MHz pulsed transcranial

  15. 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

  16. Influence of the development of diabetes mellitus on clinical status in patients with cystic fibrosis

    Microsoft Academic Search

    S. Lanng; B. Thorsteinsson; J. Nerup; C. Koch

    1992-01-01

    The impact of pre-diabetes on clinical status was retrospectively studied in 38 cystic fibrosis (CF) patients with diabetes mellitus (DM) and 38 non-diabetic CF patients (control patients), matched in pairs for age, sex, and chronicPseudomonas aeruginosa lung infection. Quarterly parameters of CF clinical status were collected for 6 years prior to the diagnosis of DM in the index case. Compared

  17. Correlation between Circulating Adhesion Molecule Levels and Albuminuria in Type2 Diabetic Hypertensive Patients

    Microsoft Academic Search

    Alberto Francisco Rubio-Guerra; Hilda Vargas-Robles; José Juan Lozano Nuevo; Bruno Alfonso Escalante-Acosta

    2009-01-01

    Background\\/Aims: Endothelial dysfunction, a common feature among hypertensive and type-2 diabetic patients, is associated with inflammation, increased levels of circulating soluble adhesion molecules (SAM), and urinary albumin excretion. The aim of this study was to evaluate the role of circulating SAM levels in the development of albuminuria in hypertensive type-2 diabetic patients. Methods: We studied 30 hypertensive type-2 diabetic patients

  18. Lack of association between the angiotensin-converting enzyme gene (I\\/D) polymorphism and diabetic nephropathy in  Tunisian type 2 diabetic patients

    Microsoft Academic Search

    Imen Arfa; Abdelmajid Abid; Sonia Nouira; Houda Elloumi-Zghal; Dhafer Malouche; Imen Mannai; Mohamed Majdi Zorgati; Nissaf Ben Alaya; Ahmed Rebai; Béchir Zouari; Slim Ben Ammar; Mohamed Chiheb Ben Rayana; Slama Hmida; Samira Blousa-Chabchoub; Sonia Abdelhak

    2008-01-01

    Objective. The aim of the present study was to investigate whether the angiotensin-converting enzyme (ACE) insertion\\/deletion (I\\/D) polymorphism is associated with diabetic nephropathy and type 2 diabetes in the Tunisian population. Design. A case-control study was conducted among 141 unrelated type 2 diabetic patients with (90 patients) or without nephropathy (51 patients) and 103 non-diabetic controls with normal fasting blood

  19. Are patients with diabetes mellitus satisfied with technologies used to assist with diabetes management and coping?: A structured review.

    PubMed

    Harrison, Samantha; Stadler, Marietta; Ismail, Khalida; Amiel, Stephanie; Herrmann-Werner, Anne

    2014-11-01

    Modern technological devices supporting coping and management for patients with diabetes are increasingly popular and could be important healthcare tools. This review aimed to evaluate patient satisfaction and perceptions regarding these devices, examples of which include short message service reminder systems, online educational programs, and clinician-patient electronic communication. Therapy devices such as continuous glucose monitors and continuous subcutaneous insulin infusion pumps are not included in this review. Embase, Psychinfo, Medline, CINAHL, and gray literature databases were searched for "diabetes mellitus," "technical device," "patient satisfaction," and their synonyms. This review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. The search produced 1,902 studies, 26 of which were included in the review: type 1 diabetes mellitus (eight studies), type 2 diabetes mellitus (nine studies), and both (nine studies). High satisfaction was seen with almost all devices and correlated strongly with ease of use and improved diabetes management. Satisfaction was not affected by participant age, and the effect of diabetes type was not assessed. Web devices were reported as easiest to use. Increased support was valued and resulted from devices facilitating interaction with healthcare professionals (HCPs) or peers. Technical difficulties were barriers to both use and satisfaction. Overall, patients enjoyed supplementing their usual therapy with these devices. Perceived support from HCPs or peers formed an important aspect of patient satisfaction and should be considered for future interventions. PMID:25069057

  20. Potentially functional variants in the core nucleotide excision repair genes predict survival in Japanese gastric cancer patients.

    PubMed

    Li, Yangkai; Liu, Zhensheng; Liu, Hongliang; Wang, Li-E; Onodera, Hisashi; Suzuki, Akihiro; Suzuki, Koyu; Wadhwa, Roopma; Elimova, Elena; Sudo, Kazuki; Shiozaki, Hironari; Estrella, Jeannelyn; Lee, Ju-Seog; Song, Shumei; Tan, Dongfeng; Ajani, Jaffer A; Wei, Qingyi

    2014-09-01

    Functional genetic variants of DNA repair genes may alter the host DNA repair capacity, and thus influence efficiency of therapies. We genotyped eight potentially functional single nucleotide polymorphisms (SNPs) in genes (i.e. ERCC1, XPA, XPC, XPD and XPG) involved in the nucleotide excision repair (NER) pathway in 496 Japanese gastric cancer patients, and assessed overall survival and recurrence-free survival. The combined effects of risk genotypes of these eight SNPs in Japanese patients were further replicated in 356 North-American gastric cancer patients. In Japanese patients, we found that the XPC rs2228000 TT genotype was associated with shorter overall survival [hazards ratio (HR) = 1.75, 95% confidence interval (95% CI) = 1.07-2.86] and recurrence-free survival (HR = 2.17, 95% CI = 1.19-3.95), compared with CC/CT genotypes, and the XPG rs17655 CC genotype was associated with shorter overall survival (HR = 1.60, 95% CI = 1.08-2.36), compared with GG/CG genotypes. The number of observed risk genotypes in the combined analysis was associated with shorter overall survival and recurrence-free survival in a dose-response manner (P(trend) = 0.006 and P(trend) < 0.000) in Japanese patients; specifically, compared with those with ?1 risk genotypes, those with ?2 risk genotypes showed markedly shorter overall survival (HR = 1.79, 95% CI = 1.18-2.70) and recurrence-free survival (HR = 2.80, 95% CI = 1.66-4.73). The association between ?2 risk genotypes and shorter overall survival was not significant (HR = 1.26, 95% CI = 0.82-1.94) in North-American patients, but the trends were similar in these two groups of patients. These data show that functional SNPs in NER core genes may impact survival in Japanese gastric cancer patients. PMID:24990617

  1. Role of patient factors in therapy resistance to antiproteinuric intervention in nondiabetic and diabetic nephropathy

    Microsoft Academic Search

    Hendrik Bos; Steen Andersen; Peter Rossing; Dick de Zeeuw; Hans-Henrik Parving; Paul E. De Jong; Gerjan Navis

    2000-01-01

    Role of patient factors in therapy resistance to antiproteinuric intervention in nondiabetic and diabetic nephropathy. Reduction of proteinuria is a prerequisite for successful long-term renoprotection. To investigate whether individual patient factors are determinants of antiproteinuric efficacy, we analyzed individual responses to different modes of antiproteinuric intervention in nondiabetic and diabetic patients, obtained in prior studies comparing the efficacy of various

  2. 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…

  3. The effects of sour tea (Hibiscus sabdariffa) on hypertension in patients with type II diabetes

    Microsoft Academic Search

    H Mozaffari-Khosravi; B-A Jalali-Khanabadi; M Afkhami-Ardekani; F Fatehi; M Noori-Shadkam

    2009-01-01

    To compare the antihypertensive effectiveness of sour tea (ST; Hibiscus sabdariffa) with black tea (BT) infusion in diabetic patients, this double-blind randomized controlled trial was carried out. Sixty diabetic patients with mild hypertension, without taking antihypertensive or antihyperlipidaemic medicines, were recruited in the study. The patients were randomly allocated to the ST and BT groups and instructed to drink ST

  4. Lower urinary tract symptoms and erectile dysfunction associated with depression among Japanese patients with late-onset hypogonadism symptoms.

    PubMed

    Takao, Tetsuya; Tsujimura, Akira; Okuda, Hidenobu; Yamamoto, Keisuke; Fukuhara, Shinichiro; Matsuoka, Yasuhiro; Miyagawa, Yasushi; Nonomura, Norio; Okuyama, Akihiko

    2011-06-01

    The aim of this study was to investigate the relation between lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and depression in Japanese patients with late-onset hypogonadism (LOH) symptoms. The study comprised 87 Japanese patients with LOH symptoms (>27 points on the Aging Males Symptoms Scale). Thirty-four patients were diagnosed as having depression and the remaining 53 patients were diagnosed as not having depression by the Mini International Neuropsychiatric Interview. We compared the International Index of Erectile Function (IIEF) 5, International Prostate Symptom Score (IPSS), IPSS quality-of-life (QOL) index, King's Health Questionnaire (KHQ), endocrinological data, and free uroflow study between depression and non-depression patients and performed multiple logistic regression analysis. IIEF5 scores of depression patients were significantly lower than those of non-depression patients. In KHQ, only the category of general health perceptions was significantly higher in depression patients than non-depression patients. However, IPSS, QOL index, and endocrinological and uroflowmetric data showed no significant difference between the groups. Multiple logistic regression analysis revealed moderate and severe ED to be risk factors for depression. However, LUTS are not related to depression. Moderate and severe ED is correlated with depression, whereas LUTS are not related to depression in Japanese LOH patients. PMID:20828247

  5. 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).

  6. Mutational analysis of TSC1 and TSC2 in Japanese patients with tuberous sclerosis complex revealed higher incidence of TSC1 patients than previously reported.

    PubMed

    Niida, Yo; Wakisaka, Akiko; Tsuji, Takanori; Yamada, Hiroshi; Kuroda, Mondo; Mitani, Yusuke; Okumura, Akiko; Yokoi, Ayano

    2013-04-01

    Tuberous sclerosis complex (TSC) is an autosomal dominant disorder characterized by multiple hamartias and hamartomas involving throughout the body. To date, many TSC1 and TSC2 mutations have been reported all over the world, however, few TSC mutation studies have been performed in the Japanese population, and genetic characteristics of Japanese TSC patients are not yet clear. In this study, we analyzed TSC1 and TSC2 in 57 Japanese patients with TSC (8 familial and 49 sporadic; 46 definite and 11 suspect TSC) and identified 31 mutations including 11 TSC1 mutations (two familial and nine sporadic; all definite TSC) and 20 TSC2 mutations (2 familial and 18 sporadic; 19 definite and 1 suspect TSC). We also reviewed all Japanese TSC mutations previously reported. Our study demonstrates significantly higher incidence (P=0.007) of TSC1 mutations among sporadic TSC patients in the Japanese population compared with US and European studies. No differences emerged in mutation distributions and types in precedent studies, excepting low frequency of the TSC2 nonsense mutation. Comparing clinical manifestations, developmental delay and/or mental retardation were milder in TSC1 patients than TSC2 patients for its frequency (P=0.032) and severity (P=0.015); however, no other symptoms were clearly different. PMID:23389244

  7. 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.

  8. Cognitive dysfunction in type 2 diabetes patients accompanied with obstructive sleep apnea syndrome

    PubMed Central

    Li, Huanyin; Gong, Qi; Shao, Jinshan; Liu, Xueyuan; Zhao, Yanxin

    2014-01-01

    Objective: To investigate cognitive dysfunction of type 2 diabetes patients accompanied with obstructive sleep apnea syndrome (OSAS), and to analyze its relevant characteristics. Methods: Total 115 type 2 diabetes patients were divided into OSAS group (O group, n=83) and non-OSAS group (N group, n=32); Physical examination patients (C1 group, n=64) and OSAS patients without diabetes (C2 group, n=47) served as the control group. Apnea-hypopnea index (AHI), nocturnal lowest saturation of pulse oxygen (LSPO2) and simple mental state examination scale (MMSE) were evaluated. Results: Among diabetes patients, patients with OSAS have lower glycated hemoglobin, platelet count, thrombocytocrit, MMSE score and lowest mean arterial oxygen than non-OSAS patients; cognitive dysfunction state and glycemic control of patients are related to their diabetic duration, and then along with increase of diabetic duration, glycemic control becomes poor, so that cognitive dysfunction becomes more and more obvious. Conclusion: Along with increased diabetic duration in type 2 diabetes accompanied with OSAS, glycemic control becomes poor, so that cognitive dysfunction more easily occurs. Meanwhile, coagulation function of blood system in OSAS patients with diabetes is impacted to some extent. PMID:25674144

  9. Importance of family history in type 2 black South African diabetic patients

    PubMed Central

    Erasmus, R; Blanco, E; Okesina, A; Arana, J; Gqweta, Z; Matsha, T

    2001-01-01

    OBJECTIVE—To assess the family history of diabetes in type 2 black South African diabetics with emphasis on the parental phenotype.?DESIGN—Prospective case-control study in which family histories were obtained from patients.?SETTING—Diabetic clinic of a provincial teaching hospital in the Transkei region of South Africa.?SUBJECTS—A total of 1111 type 2 diabetics attending the diabetic clinic and 687 controls.?MAIN OUTCOME MEASURES—History of diabetes in parents, siblings, maternal and paternal grandparents, aunts, and uncles.?RESULTS—Altogether 27.3% of diabetic subjects had a family history of diabetes compared with 8.4% in the control group (p<0.01). Among the group with positive family history 82.6% reported only one diabetic family member, while 17.4% reported at least two relatives; 6.6% had a diabetic relative from both maternal and paternal sides, and 87.8% had first degree relative with diabetes. Among them there was a significant maternal aggregation with 64.7% of patients having a diabetic mother compared with 27% who had a diabetic father (p<0.01). No maternal effect was observed among the second and third degree relatives. Patients with positive family history had an earlier onset of diabetes than those without family history (p<0.01).?CONCLUSION—These data suggest that type 2 diabetes is heritable in black South African diabetics. It is also likely that maternal influences may play an important part.???Keywords: diabetes; family history PMID:11320276

  10. Prevalence of 52-kd and 60-kd Ro\\/SSA autoantibodies in Japanese patients with polymyositis\\/dermatomyositis

    Microsoft Academic Search

    Masahide Kubo; Hironobu Ihn; Yoshihide Asano; Kenichi Yamane; Norihito Yazawa; Kunihiko Tamaki

    2002-01-01

    To determine the prevalence of 52-kd and 60-kd Ro\\/SS-A antibodies in Japanese patients with polymyositis\\/dermatomyositis, we examined serum samples from 61 patients with PM\\/DM, 10 patients with primary Sjögren's syndrome, and 25 healthy control subjects. Six serum samples possessed anti-Ro\\/SS-A antibodies and were positive for anti-Ro52, anti-Ro60, or both. Two reacted with both Ro52 and Ro60, and 4 reacted with

  11. Clinicopathological features of antineutrophil cytoplasmic antibodies-associated vasculitis in Japanese patients with IgA nephropathy

    Microsoft Academic Search

    Miho Shimizu; Takashi Wada; Norihiko Sakai; Yoshiaki Izumiya; Kengo Furuichi; Tsugiho Misaki; Ken-ichi Kobayashi; Satoshi Goshima; Shin-ichi Takeda; Hitoshi Yokoyama

    2000-01-01

    Antineutrophil cytoplasmic antibodies (ANCA) have been reported to be associated with systemic vasculitis. However, the roles\\u000a of ANCA subtypes in patients with IgA nephropathy remain to be fully investigated. We describe three Japanese patients with\\u000a IgA nephropathy complicated by ANCA-associated vasculitis. Two patients with IgG class ANCA developed rapidly progressive\\u000a renal failure and demonstrated mesangial proliferation with extensive extracapillary proliferation

  12. Assessment of Blood Glucose Using Gingival Crevicular Blood in Diabetic and Non-Diabetic Patients: A Chair Side Method

    PubMed Central

    Kaur, Harmanpreet; Singh, Bhawanpreet; Sharma, Anshu

    2013-01-01

    Aim: Diabetes mellitus is undiagnosed in approximately half of the patients actually suffering from the disease. The prevalence of diabetes mellitus is nearly twice in patients with periodontitis as compared to periodontally healthy subjects.In addition, the prevalence of Diabetes mellitus is more than twice as high as in patients with periodontitis when compared to periodontally healthy subjects. The purpose of the present study was to evaluate whether blood oozing from gingival crevice during routine periodontal examination can be used for determining glucose levels. Material and Methods: In the present study 50 patients(25 diabetic and 25 non-diabetic) with chronic periodontitis were selected and were divided into two groups i.e. Group I and Group II, respectively. Blood glucose measurements were made using gingival crevicular blood, finger stick blood using glucose self-monitoring device (FinetestTM; Infopia Co.Ltd;Korea) and at the same time intra venous blood was collected for measurement in a laboratory glucose analyzer. Each laboratory measurement was corrected from a serum glucose value to a whole blood glucose value by a function of the patient’s haematocrit. Results: The patient’s blood glucose values ranged from 83.6 to 483mg/dl in diabetic patients(Group I) and 70-218 mg/dl in non-diabetic individuals (Group II) to 83.6 to 483mg/dl. The comparison between gingival crevicular blood, finger-prick blood and corrected intra venous blood showed a very strong correlation with an r value of 0.99(P level< 0.001) Conclusion: The data from this study has shown that gingival crevicular blood collected during diagnostic periodontal examination can be an excellent source of blood for glucometric analysis. PMID:24551729

  13. Factors Increasing Physical Activity Levels in Diabetes Mellitus: A Survey of Patients after an Inpatient Diabetes Education Program

    PubMed Central

    Murano, Isamu; Asakawa, Yasutsugu; Mizukami, Masafumi; Takihara, Jun; Shimizu, Kaoru; Imai, Taihei

    2014-01-01

    [Purpose] The aim of this study was to understand the factors involved in increasing physical activity levels in type 2 diabetes mellitus patients for improved glycemic control. [Subjects] The subjects were 101 type 2 diabetes mellitus patients who had completed an inpatient diabetes education program. [Methods] The survey evaluated physical activity levels on the basis of the International Physical Activity Questionnaire and a questionnaire listing physical and psychosocial factors. [Results] Four variables—participation or non-participation in farm work, presence or absence of a job, stage of change in attitude toward exercise behavior, and social support—accounted for 34% of physical activity levels in these diabetes mellitus patients. The Spearman’s rank correlation coefficient between physical activity level and HbA1c was ?0.31. [Conclusion] Intervention in terms of practical use of living environments, promotion of exercise behavior, and social support may be effective in helping to improve glycemic control. PMID:24926134

  14. JAMA Patient Page: Starting Insulin Treatment for Diabetes

    MedlinePLUS

    ... body does not use insulin properly and, over time, cannot make enough insulin. Some people with type 2 diabetes will need treatment with insulin. The Importance of Insulin in Treating Type 2 Diabetes Diabetes ...

  15. 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

  16. Unexpected hypercalcemia in a diabetic patient with kidney disease.

    PubMed

    Lupica, Rosaria; Buemi, Michele; Campennì, Alfredo; Trimboli, Domenico; Canale, Valeria; Cernaro, Valeria; Santoro, Domenico

    2015-07-01

    We report a case of a diabetic patient with progressive chronic kidney disease and unexplained hypercalcemia. This unusual presentation and the investigation of all possible causes led us to perform a renal biopsy. The systemic sarcoidosis diagnosis was confirmed by the presence of interstitial multiple granulomas composed of epithelioid and multinucleated giant cells delimited by a thin fibrous reaction, and by pulmonary computed tomography finding of numerous lumps with ground-glass appearance. Sarcoidosis most commonly involves lungs, lymph nodes, skin and eyes, whilst kidney is less frequently involved. When it affects males it is characterized by hypercalcemia, hypercalciuria, and progressive loss of renal function. Early treatment with steroids allows for a gradual improvement in renal function and normalization of calcium serum values. Otherwise, the patient would quickly progress to end stage renal disease. Finding of hypercalcemia in a patient with renal failure must alert physicians because it may be a sign of several pathological entities. PMID:26167468

  17. Unexpected hypercalcemia in a diabetic patient with kidney disease

    PubMed Central

    Lupica, Rosaria; Buemi, Michele; Campennì, Alfredo; Trimboli, Domenico; Canale, Valeria; Cernaro, Valeria; Santoro, Domenico

    2015-01-01

    We report a case of a diabetic patient with progressive chronic kidney disease and unexplained hypercalcemia. This unusual presentation and the investigation of all possible causes led us to perform a renal biopsy. The systemic sarcoidosis diagnosis was confirmed by the presence of interstitial multiple granulomas composed of epithelioid and multinucleated giant cells delimited by a thin fibrous reaction, and by pulmonary computed tomography finding of numerous lumps with ground-glass appearance. Sarcoidosis most commonly involves lungs, lymph nodes, skin and eyes, whilst kidney is less frequently involved. When it affects males it is characterized by hypercalcemia, hypercalciuria, and progressive loss of renal function. Early treatment with steroids allows for a gradual improvement in renal function and normalization of calcium serum values. Otherwise, the patient would quickly progress to end stage renal disease. Finding of hypercalcemia in a patient with renal failure must alert physicians because it may be a sign of several pathological entities.

  18. Self Care Behavior among Patients with Diabetes in Harari, Eastern Ethiopia: The Health Belief Model Perspective

    PubMed Central

    Girma, Eshetu

    2012-01-01

    Background Diabetes mellitus is a chronic disease that requires lifelong medical treatments and a life style adjustment. To prevent serious morbidity and mortality, it requires dedication to demanding self-care behaviors in multiple domains. The objective of this study was to identify predictors of self care behaviors among patients with diabetes. Methods From a total of 425 follow up diabetic patients, a quantitative cross sectional study was conducted among 222 of them from three different hospitals in Harar town, from March to April, 2011. The sample was taken using simple random sampling method. Data was collected using pretested questionnaire. Descriptive statistics multiple logistic regression analysis were also used to assess the predicators of self care behaviors among patients with diabetes. Result Majority of the study respondents 134 (60.4%) were female and the mean age was 49.7 (SD±14.7) years. More than half 147(66.2%) of them were medically diagnosed with type-2 diabetes. 208(93.7%) had general knowledge about diabetes and specific knowledge about diabetes self care 207(93.2%). Large proportion of them had moderate perceived susceptibility 174(78.4%) and severity 112(50.5%). More than half of the respondents 149(67.1%) had less perceived barrier while only 30 (13.5%) of them had high self efficacy to self care practices related to diabetes mellitus. Only 87(39.2%) followed the recommended self care practices on diabetes. Conclusions Patients with less frequent information were less likely to take diabetes self care. Patients who were more educated, middle income, had high perceived severity of diabetes and less perceived barrier to self care were more likely to take diabetes self care. To increase the self care behavior, diabetes messages should focus on severity of diabetes and how to overcome barriers for self care by segmenting the audiences based on income and educational status with increasing the frequency and reach of message on diabetes. PMID:22530039

  19. Aging-associated inflammation in healthy Japanese individuals and patients with Werner syndrome.

    PubMed

    Goto, Makoto; Sugimoto, Kazunori; Hayashi, Seigaku; Ogino, Tetsuhito; Sugimoto, Masanobu; Furuichi, Yasuhiro; Matsuura, Masaaki; Ishikawa, Yuichi; Iwaki-Egawa, Sachiko; Watanabe, Yasuhiro

    2012-12-01

    Minor inflammation-driven aging (inflammaging) has been proposed to explain human aging mechanism. To study the inflammatory condition associated with normal human aging, highly sensitive CRP (hsCRP) was examined in the sera collected from 217 healthy Japanese individuals aged between 1 and 100years and 41 mutation-proven Japanese Werner syndrome (WS) patients. The serum hsCRP was assayed by ELISA. The serum hsCRP level increased significantly (p<0.001) with normal aging from both sexes. The serum hsCRP was significantly elevated in WS (mean±SE: 11.0±1.6?g/ml) compared with age-matched normal population (1.3±0.3?g/ml, p<0.001) and normal elderly population ages between 71 and 100years (4.2±0.7?g/ml, p<0.001). Both normal aging and WS were associated with minor inflammation that can be evaluated by serum hsCRP. WS may be a good candidate to study inflammaging. PMID:22960593

  20. Diabetic retinopathy: variations in patient therapeutic outcomes and pharmacogenomics

    PubMed Central

    Agarwal, Aniruddha; Soliman, Mohamed K; Sepah, Yasir J; Do, Diana V; Nguyen, Quan Dong

    2014-01-01

    Diabetes and its microvascular complications in patients poses a significant challenge and constitutes a major health problem. When it comes to manifestations in the eye, each case of diabetic retinopathy (DR) is unique, in terms of the phenotype, genotype, and, more importantly, the therapeutic response. It is therefore important to identify factors that distinguish one patient from another. Personalized therapy in DR is a new trend aimed at achieving maximum therapeutic response in patients by identifying genotypic and phenotypic factors that may result in less than optimal response to conventional therapy, and consequently, lead to poorer outcome. With advances in the identification of these genetic markers, such as gene polymorphisms and human leucocyte antigen associations, as well as development of drugs that can target their effects, the future of personalized medicine in DR is promising. In this comprehensive review, data from various studies have been analyzed to present what has been achieved in the field of pharmacogenomics thus far. An insight into future research is also provided. PMID:25548526

  1. Metformin in Patients With Type 2 Diabetes and Kidney Disease

    PubMed Central

    Inzucchi, Silvio E.; Lipska, Kasia J.; Mayo, Helen; Bailey, Clifford J.; McGuire, Darren K.

    2015-01-01

    IMPORTANCE Metformin is widely viewed as the best initial pharmacological option to lower glucose concentrations in patients with type 2 diabetes mellitus. However, the drug is contraindicated in many individuals with impaired kidney function because of concerns of lactic acidosis. OBJECTIVE To assess the risk of lactic acidosis associated with metformin use in individuals with impaired kidney function. EVIDENCE ACQUISITION In July 2014, we searched the MEDLINE and Cochrane databases for English-language articles pertaining to metformin, kidney disease, and lactic acidosis in humans between 1950 and June 2014. We excluded reviews, letters, editorials, case reports, small case series, and manuscripts that did not directly pertain to the topic area or that met other exclusion criteria. Of an original 818 articles, 65 were included in this review, including pharmacokinetic/metabolic studies, large case series, retrospective studies, meta-analyses, and a clinical trial. RESULTS Although metformin is renally cleared, drug levels generally remain within the therapeutic range and lactate concentrations are not substantially increased when used in patients with mild to moderate chronic kidney disease (estimated glomerular filtration rates, 30-60 mL/min per 1.73 m2). The overall incidence of lactic acidosis in metformin users varies across studies from approximately 3 per 100 000 person-years to 10 per 100 000 person-years and is generally indistinguishable from the background rate in the overall population with diabetes. Data suggesting an increased risk of lactic acidosis in metformin-treated patients with chronic kidney disease are limited, and no randomized controlled trials have been conducted to test the safety of metformin in patients with significantly impaired kidney function. Population-based studies demonstrate that metformin may be prescribed counter to prevailing guidelines suggesting a renal risk in up to 1 in 4 patients with type 2 diabetes mellitus—use which, in most reports, has not been associated with increased rates of lactic acidosis. Observational studies suggest a potential benefit from metformin on macrovascular outcomes, even in patients with prevalent renal contraindications for its use. CONCLUSIONS AND RELEVANCE Available evidence supports cautious expansion of metformin use in patients with mild to moderate chronic kidney disease, as defined by estimated glomerular filtration rate, with appropriate dosage reductions and careful follow-up of kidney function. PMID:25536258

  2. Plateau iris in Japanese patients with primary angle closure and primary angle closure glaucoma

    PubMed Central

    Mizoguchi, Takanori; Ozaki, Mineo; Wakiyama, Harumi; Ogino, Nobuchika

    2015-01-01

    Purpose To determine the prevalence of plateau iris in Japanese patients with primary angle closure (PAC) and primary angle closure glaucoma (PACG) and analyze the biometric parameters in patients with plateau iris using ultrasound biomicroscopy (UBM). Methods In this cross-sectional observational study, subjects aged >50 years with PAC and PACG who had previously undergone a patent laser peripheral iridotomy underwent UBM in one eye. UBM images were qualitatively analyzed using standardized criteria. Plateau iris in a quadrant was defined by anteriorly directed ciliary body, absent ciliary sulcus, steep iris root from its point of insertion followed by a downward angulation, flat iris plane, and irido-angle contact. At least two quadrants had to fulfill these UBM criteria for an eye to be classified as having plateau iris. A-scan biometry was used to measure anterior segment parameters. Results Ninety-one subjects with PAC (58 subjects) or PACG (33 subjects) and 68 normal controls were recruited. The mean (standard deviation) ages of PAC and PACG patients and normal controls were 73.5 (6.2) and 72.6 (7.3), respectively. Based on UBM criteria, plateau iris was found in 16 eyes (17.6%) of 91 eyes. In these 16 eyes, quadrant-wise analysis showed ten eyes (62.5%) had plateau iris in two quadrants; four eyes (25%) had plateau iris in three quadrants; and two eyes (12.5%) had plateau iris in four quadrants. Anterior chamber depth, lens thickness, axial length, lens position, and relative lens position were not statistically significant between the group having plateau iris and that not having plateau iris, respectively. Conclusion Approximately 20% of Japanese subjects with PAC and PACG with a patent laser peripheral iridotomy were found to have plateau iris on UBM. No morphological difference was noted in the anterior segment of the eye between those with or without plateau iris. PMID:26170608

  3. The prevention of foot ulceration in diabetic patients.

    PubMed

    Howard, Ileana M

    2009-11-01

    Diabetic foot ulcerations are a costly and common public health challenge. Although several organizations have emphasized the need to increase awareness of this problem and called health care providers to action to decrease the incidence of ulceration and amputation, there is limited evidence regarding what interventions are best suited to accomplish this goal. This article reviews the pathogenesis, risk factors, and current interventions that have been studied for the prevention of foot ulceration. Preventive measures with evidence for decreasing incidence of ulceration include patient education, offloading abnormal pressures with foot orthotics, and thermal monitoring. PMID:19781501

  4. Lifestyle Intervention in Obese Patients with Type 2 Diabetes: Impact of the Patient’s Educational Background

    Microsoft Academic Search

    Matthew J. Gurka; Anne M. Wolf; Mark R. Conaway; Jayne Q. Crowther; Jerry L. Nadler; Viktor E. Bovbjerg

    2006-01-01

    Objective: To determine whether people with different educational backgrounds respond differently to a lifestyle intervention program for obese patients with type 2 diabetes.Research Methods and Procedures: The study consisted of a 12-month randomized controlled trial of 147 health plan members with type 2 diabetes who were overweight or obese (BMI ? 27 kg\\/m2). Participants were randomized to lifestyle case management

  5. Diagnosed diabetes and premature death among middle-aged Japanese: results from a large-scale population-based cohort study in Japan (JPHC study)

    PubMed Central

    Kato, Masayuki; Noda, Mitsuhiko; Mizoue, Tetsuya; Goto, Atsushi; Takahashi, Yoshihiko; Matsushita, Yumi; Nanri, Akiko; Iso, Hiroyasu; Inoue, Manami; Sawada, Norie; Tsugane, Shoichiro

    2015-01-01

    Objective To examine the association between diabetes and premature death for Japanese general people. Design Prospective cohort study. Setting The Japan Public Health Center-based prospective study (JPHC study), data collected between 1990 and 2010. Population A total of 46?017 men and 53?567 women, aged 40–69?years at the beginning of baseline survey. Main outcome measures Overall and cause specific mortality. Cox proportional hazards models were used to calculate the HRs of all cause and cause specific mortality associated with diabetes. Results The median follow-up period was 17.8?years. During the follow-up period, 8223 men and 4640 women have died. Diabetes was associated with increased risk of death (856 men and 345 women; HR 1.60, (95% CI 1.49 to 1.71) for men and 1.98 (95% CI 1.77 to 2.21) for women). As for the cause of death, diabetes was associated with increased risk of death by circulatory diseases (HR 1.76 (95% CI 1.53 to 2.02) for men and 2.49 (95% CI 2.06 to 3.01) for women) while its association with the risk of cancer death was moderate (HR 1.25 (95% CI 1.11 to 1.42) for men and 1.04 (95% CI 0.82 to 1.32) for women). Diabetes was also associated with increased risk of death for ‘non-cancer, non-circulatory system disease’ (HR 1.91 (95% CI 1.71 to 2.14) for men and 2.67 (95% CI 2.25 to 3.17) for women). Conclusions Diabetes was associated with increased risk of death, especially the risk of death by circulatory diseases. PMID:25941187

  6. Anti-oxidative effects of pomegranate juice (PJ) consumption by diabetic patients on serum and on macrophages

    Microsoft Academic Search

    Mira Rosenblat; Tony Hayek; Michael Aviram

    2006-01-01

    Diabetes is associated with increased oxidative stress and atherosclerosis development. In the present study, we investigated the effects of pomegranate juice (PJ; which contains sugars and potent anti-oxidants) consumption by diabetic patients on blood diabetic parameters, and on oxidative stress in their serum and macrophages. Ten healthy subjects (controls) and 10 non-insulin dependent diabetes mellitus (NIDDM) patients who consumed PJ

  7. 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

  8. 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

  9. Redesigning an intensive insulin service for patients with type 1 diabetes: a patient consultation exercise

    PubMed Central

    Ozcan, Seyda; Rogers, Helen; Choudhary, Pratik; Amiel, Stephanie A; Cox, Alison; Forbes, Angus

    2013-01-01

    Context Providing effective support for patients in using insulin effectively is essential for good diabetes care. For that support to be effective it must reflect and attend to the needs of patients. Purpose To explore the perspectives of adult type 1 diabetes patients on their current diabetes care in order to generate ideas for creating a new patient centered intensive insulin clinic. Methods A multi-method approach was used, comprising: an observational exercise of current clinical care; three focus groups (n = 17); and a survey of service users (n = 419) to test the ideas generated from the observational exercise and focus groups (rating 1 to 5 in terms of importance). The ideas generated by the multi-method approach were organized thematically and mapped onto the Chronic Care Model (CCM). Results The themes and preferences for service redesign in relation to CCM components were: health care organization, there was an interest in having enhanced systems for sharing clinical information; self-management support, patients would like more flexible and easy to access resources and more help with diabetes technology and psychosocial support; delivery system design and clinical information systems, the need for greater integration of care and better use of clinic time; productive relationships, participants would like more continuity; access to health professionals, patient involvement and care planning. The findings from the patient survey indicate high preferences for most of the areas for service enhancement identified in the focus groups and observational exercise. Clinical feedback and professional continuity (median = 5, interquartile range = 1) were the most highly rated. Conclusion The patient consultation process had generated important ideas on how the clinical team and service can improve the care provided. Key areas for service development were: a stronger emphasis of collaborative care planning; improved patient choice in the use of health technology; more resources for self-management support; and a more explicit format for the process of care in the clinic. PMID:23776329

  10. Behavioral economics survey of patients with type 1 and type 2 diabetes

    PubMed Central

    Emoto, Naoya; Okajima, Fumitaka; Sugihara, Hitoshi; Goto, Rei

    2015-01-01

    Background Adherence to treatment and the metabolic control of diabetes are challenging in many patients with diabetes. The theory of neuroeconomics can provide important clues for understanding unreasonable human behavior concerning decisions between outcomes occurring at different time points. Objective We investigated patients with type 1 and type 2 diabetes to determine whether patients who are at a risk of developing complications are less risk averse. We also examined whether patients with type 1 and type 2 diabetes have different behavioral traits in decision making under risk. Methods We conducted a behavioral economics survey of 219 outpatients, 66 with type 1 diabetes and 153 with type 2 diabetes. All patients had been referred by general practitioners or other departments in the hospital. At the time of the survey, levels of hemoglobin A1c were not significantly different between patients with type 1 and type 2 diabetes. Results Patients with type 2 diabetes showed a lower response rate to the survey compared with patients with type 1 diabetes (71.9% vs 87.9%, P<0.01). Logistic regression analysis indicated that diabetic retinopathy was negatively associated with risk averse in pricing of hypothetical lotteries, myopic time preference, willingness to pay for preventive medicine, and levels of satisfaction with life. Diabetic nephropathy was also negatively associated with risk averse in pricing of hypothetical lotteries. Detailed analysis revealed that a lower proportion of patients with type 2 diabetes (22.7%) were categorized as risk averse compared with patients with type 1 diabetes (43.1%, P<0.05) in hypothetical lottery risk estimation. Conclusion This is the first report that investigated patients with diabetes in a clinical setting using a method based on behavioral economics. The results suggest that the attitude of patients toward risk plays an important role in the progress of the complications of diabetes. Different educational and psychological approaches may be necessary to assess patients with diabetes based on whether they have traits such as risk seeking or risk averse. PMID:25999700

  11. Corneal Changes in Diabetic Patients after Manual Small Incision Cataract Surgery

    PubMed Central

    Singh, I.P.; Nagpal, Ramesh C.

    2014-01-01

    Background: Diabetics have abnormal corneal morphology along with higher rate of corneal endothelial cell loss and decreased corneal endothelial cell density and early onset of cataract. Aim: To evaluate the changes in corneal endothelium and corneal thickness in patients with diabetes mellitus after Manual Small Incision Cataract Surgery (MSICS) in eyes with brunescent Cataract. Materials and Methods: Sixty eyes of 60 patients with Type 2 diabetes mellitus and 60 eyes of 60 age matched healthy patients of advanced brunescent cataract underwent MSICS were evaluated. All the patients underwent specular microscopy for the corneal endothelial cell count of cornea and central corneal thickness pre-operatively, at one week, six weeks and 12 weeks post-operatively. The morphology, variation in the endothelial size and shape and percentage of hexagonal cells were assessed. Results: The mean pre-operative endothelial count in the control was higher than the diabetic group (p<0.001). The post-operative endothelial count loss in both the groups were statistically significant (one-way ANOVA p<0.001). On comparing post-operative endothelial loss in non diabetics (8.05%) to diabetic group, the diabetic group had significantly higher endothelial loss (14.19% p<0.001). There was also a significant increase in central corneal thickness in diabetics as compared to control (p = 0.004). The change in percentage hexagon cells in diabetic group was significantly higher than in non diabetic group (p = 0.005). Inter group change in coefficient of variance was not statistically significant (p=0.144). Conclusion: Compared to non-diabetic patients, diabetic patients have more endothelial cells damage after MSICS. Corneal endothelial evaluation of diabetic patients is recommended before any intraocular surgery. PMID:24959498

  12. Sensitivity of Interferon-? release assays is not compromised in tuberculosis patients with diabetes

    PubMed Central

    Walsh, Mary C.; Camerlin, Aulasa J.; Miles, Reyna; Pino, Paula; Martinez, Perla; Mora-Guzmán, Francisco; Crespo-Solis, J. Gonzalo; Olivarez, Eduardo; Fisher-Hoch, Susan P.; McCormick, Joseph B.; Restrepo, Blanca I.

    2011-01-01

    SUMMARY Setting The sensitivity of the IFN-? release assays (IGRAs) to detect Mycobacterium tuberculosis infection or disease may be affected by immune derangement in diabetes. Since millions of type 2 diabetes patients are at risk for tuberculosis worldwide, it is important to determine if the sensitivity of IGRAs is compromised in this vulnerable population. Objective Determine if IGRA sensitivity is reduced in tuberculosis patients with diabetes. Design The sensitivity of IGRAs (QuantiFERON®-TB Gold and T-SPOT®.TB) was evaluated on specimens from newly-diagnosed adults with microbiologically-confirmed TB with and without diabetes. We also evaluated the association between QuantiFERON-TB Gold results and diabetes-associated conditions (dyslipidemia, obesity). Results QuantiFERON-TB Gold sensitivity was 70% among tuberculosis patients. Those with diabetes, chronic hyperglycemia or overweight/obesity were more than twice as likely to have positive test results multivariate models (p<0.05). Low HDL cholesterol or high triglycerides were not associated with assay results. In a separate group of tuberculosis patients (n=43) the T-SPOT.TB was 93% sensitive, with similar performance in patients with and without diabetes. Conclusion IGRA sensitivity is not compromised by diabetes in TB patients. Accordingly, IGRAs may also be suitable to diagnose TB infection in diabetes patients, which is required to assess TB risk. PMID:21219678

  13. Local effect of stereotactic body radiotherapy for primary and metastatic liver tumors in 130 Japanese patients

    PubMed Central

    2014-01-01

    Background and aims Stereotactic body radiotherapy (SBRT) is a relatively new treatment for liver tumor. The outcomes of SBRT for liver tumor unfit for ablation and surgical resection were evaluated. Methods Liver tumor patients treated with SBRT in seven Japanese institutions were studied retrospectively. Patients given SBRT for liver tumor between 2004 and 2012 were collected. Patients treated with SBRT preceded by trans-arterial chemoembolization (TACE) were eligible. Seventy-nine patients with hepatocellular carcinoma (HCC) and 51 patients with metastatic liver tumor were collected. The median biologically effective dose (BED) (?/??=?10 Gy) was 96.3 Gy for patients with HCC and 105.6 Gy with metastatic liver tumor. Results The median follow-up time was 475.5 days in patients with HCC and 212.5 days with metastatic liver tumor. The 2-year local control rate (LCR) for HCC and metastatic liver tumor was 74.8%?±?6.3% and 64.2?±?9.5% (p?=?0.44). The LCR was not different between BED10???100 Gy and??30 mm vs. ? 30 mm (64% vs. 85%, p?=?0.040) in all 130 patients. No grade 3 laboratory toxicities in the acute, sub-acute and chronic phases were observed. Conclusions There was no difference in local control after SBRT in the range of median BED10 around 100 Gy for between HCC and metastatic liver tumor. SBRT is safe and might be an alternative method to resection and ablation. Summary There was no difference in local control after SBRT in the range of median BED10 around 100 Gy for between HCC and metastatic liver tumor and SBRT is safe and might be an alternative method to resection and ablation. PMID:24886477

  14. 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

  15. 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

  16. Recreational drug abuse in patients hospitalized for diabetic ketosis or diabetic ketoacidosis.

    PubMed

    Isidro, María L; Jorge, Segundo

    2013-04-01

    To evaluate the association between recreational drug use and diabetic ketosis (DK) and diabetic ketoacidosis (DKA) in our area. Retrospective examination of records from a 1,450 bed urban teaching hospital in Spain. All adult admissions for DK or DKA from January 1, 2005, to December 31, 2009 in our hospital were included. Demographic, exploratory (blood pressure, heart rate, respiratory rate), and analytical data (glucose, urea, creatinine, corrected Na(+), K(+), pH, HCO3(-) and HbA1c) at admittance were recorded. In 152 patients, 253 episodes of DK or DKA occurred. Screening for drug use was performed in 40.3% of the events; 20.6% of the episodes (n = 52) were shown to be substance abuse. Cocaine, followed by cannabis and alcohol, was the most frequently involved drug. Poly-substance abuse occurred in 67.3% of them. Comorbidities were present in 11.5 and 39.8% of the cases shown and not shown to be related to drug use (P = 0.00). Seventy percent of the patients who were at least once shown to have consumed drugs, and 15.9% of those who were never shown to have done so, were admitted more than once (P = 0.00). The frequency of recent drug misuse in patients presenting with DK or DKA was high. Substance abuse screening was frequently neglected. Adverse profile, most significantly in readmission to hospital, was found in the patients with positive drug findings. History taking in this context should routinely include questions on substance abuse, and toxicology screening may be worthwhile, particularly in those with the history of frequent readmissions. PMID:21136122

  17. [Individualized treatment of diabetic patients in special clinical situations].

    PubMed

    Franch Nadal, J

    2014-07-01

    Type 2 diabetes mellitus is a complex disease that is frequently associated with a constellation of risk factors that contribute to worsening morbidity and mortality in affected individuals. To increase quality of life in these persons, both hyperglycemia and other risk factors need to be considered. The first step is probably to establish the glycemic targets for each patient at each stage of the disease. Currently, clinical practice guidelines recommend individualizing glycemic targets with HbA1c values that range from 6-8.5%, depending on the patient's characteristics. Nine different antidiabetic drug families are available, each with distinct characteristics, thus allowing multiple combinations to aid the individual approach to hyperglycemia in each patient at each time point. There are numerous treatment algorithms that aim to simplify and summarize the various therapeutic possibilities. However, with some exceptions, these algorithms do not take into account the individual characteristics of each patient and are excessively general. To select the most appropriate drug for each patient at distinct moments, it is essential to evaluate the patient's comorbidities, such as heart failure, frailty, and the risk of hypoglycemias. PMID:25311719

  18. Survival outcomes after stereotactic body radiotherapy for 79 Japanese patients with hepatocellular carcinoma.

    PubMed

    Yamashita, Hideomi; Onishi, Hiroshi; Murakami, Naoya; Matsumoto, Yasuo; Matsuo, Yukinori; Nomiya, Takuma; Nakagawa, Keiichi

    2015-05-01

    Stereotactic body radiotherapy (SBRT) is a relatively new treatment for liver tumor. Outcomes of SBRT for liver tumors unsuitable for ablation or surgical resection were evaluated. A total of 79 patients treated with SBRT for primary hepatocellular carcinoma (HCC) between 2004 and 2012 in six Japanese institutions were studied retrospectively. Patients treated with SBRT preceded by trans-arterial chemoembolization were eligible. Their median age was 73 years, 76% were males, and their Child-Pugh scores were Grades A (85%) and B (11%) before SBRT. The median biologically effective dose (?/? = 10 Gy) was 96.3 Gy. The median follow-up time was 21.0 months for surviving patients. The 2-year overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival were 53%, 40% and 76%, respectively. Sex and serum PIVKA-II values were significant predictive factors for OS. Hypovascular or hypervascular types of HCC, sex and clinical stage were significant predictive factors for PFS. The 2-year PFS was 66% in Stage I vs 18% in Stages II-III. Multivariate analysis indicated that clinical stage was the only significant predictive factor for PFS. No Grade 3 laboratory toxicities in the acute, sub-acute, and chronic phases were observed. PFS after SBRT for liver tumor was satisfactory, especially for Stage I HCC, even though these patients were unsuitable for resection and ablation. SBRT is safe and might be an alternative to resection and ablation. PMID:25691453

  19. Survival outcomes after stereotactic body radiotherapy for 79 Japanese patients with hepatocellular carcinoma

    PubMed Central

    Yamashita, Hideomi; Onishi, Hiroshi; Murakami, Naoya; Matsumoto, Yasuo; Matsuo, Yukinori; Nomiya, Takuma; Nakagawa, Keiichi

    2015-01-01

    Stereotactic body radiotherapy (SBRT) is a relatively new treatment for liver tumor. Outcomes of SBRT for liver tumors unsuitable for ablation or surgical resection were evaluated. A total of 79 patients treated with SBRT for primary hepatocellular carcinoma (HCC) between 2004 and 2012 in six Japanese institutions were studied retrospectively. Patients treated with SBRT preceded by trans-arterial chemoembolization were eligible. Their median age was 73 years, 76% were males, and their Child–Pugh scores were Grades A (85%) and B (11%) before SBRT. The median biologically effective dose (?/? = 10 Gy) was 96.3 Gy. The median follow-up time was 21.0 months for surviving patients. The 2-year overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival were 53%, 40% and 76%, respectively. Sex and serum PIVKA-II values were significant predictive factors for OS. Hypovascular or hypervascular types of HCC, sex and clinical stage were significant predictive factors for PFS. The 2-year PFS was 66% in Stage I vs 18% in Stages II–III. Multivariate analysis indicated that clinical stage was the only significant predictive factor for PFS. No Grade 3 laboratory toxicities in the acute, sub-acute, and chronic phases were observed. PFS after SBRT for liver tumor was satisfactory, especially for Stage I HCC, even though these patients were unsuitable for resection and ablation. SBRT is safe and might be an alternative to resection and ablation. PMID:25691453

  20. Efficacy of sildenafil as the first-step therapeutic tool for Japanese patients with erectile dysfunction.

    PubMed

    Ochiai, A; Naya, Y; Soh, J; Ishida, Y; Mizutani, Y; Kawauchi, A; Fujiwara, T; Miki, T

    2005-01-01

    The aim of this study was to assess the efficacy of sildenafil as the first-step tool for erectile dysfunction (ED) in Japanese males. Between March 1999 and March 2003, 281 patients were prescribed five tablets of sildenafil (50 mg) as the first step in the therapeutic management of ED. Of the 281 patients, 206 were evaluable patients. The overall success rate in achieving sexual intercourse in subjects after taking sildenafil was 77.2% (159/206), while 22.8% (47/206) were unsuccessful. The success rates in men with functional ED and organic ED were 91.4% (85/93) and 65.5% (74/113), respectively (P<0.0001). Overall, transient adverse effects of sildenafil occurred in 16 (8%) males. Intolerable adverse effects (edema and dizziness) occurred in only 1% of patients (2/206). Sildenafil citrate may be recommended as the first choice drug for ED because of its high success rate and low invasiveness. PMID:15829991

  1. 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

  2. Prevalence of diabetes mellitus in patients with newly evaluated papillary thyroid cancer

    PubMed Central

    2014-01-01

    Background This study investigates whether diabetes mellitus is a risk factor for the development of papillary thyroid cancer, using an age-, gender-, and race-matched analysis. Methods We retrospectively reviewed the charts of 1559 patients with newly evaluated thyroid cancer over a 4-year period at our institution and identified 1313 patients (84%) with papillary thyroid carcinoma. Characteristics of patients with diabetes versus those without diabetes were compared with a chi-square test for categorical variables and the Wilcoxon Rank Sum test for numeric variables. The prevalence of diabetes among patients with papillary thyroid carcinoma at our institution was compared (using an age-, gender-, and race-matched analysis) with that expected based on data from the continuous National Health and Nutrition Examination Survey (NHANES) from the same time period. Results For patients with papillary thyroid carcinoma, the median age was 47 years; 74% were female; 83% were white; and the prevalence of diabetes was 8%. Among those with diabetes, 92% had type 2 diabetes, and 24% were treated with insulin. Risk factors for diabetes included age and race. The prevalence of diabetes among patients with papillary thyroid carcinoma of all ages versus that among patients from NHANES of all ages was not significantly different (RR 1.07, CI 0.88 - 1.28). The prevalence of diabetes among patients with papillary thyroid cancer who were 44 years of age or younger versus that among patients from NHANES who were 44 years of age or younger, however, was significantly increased (RR 2.32, CI 1.37 - 3.66). There was no significant difference when subgroup analysis was performed by gender or race. Conclusions We found an increased prevalence of diabetes in patients with papillary thyroid carcinoma who were 44 years of age or younger. PMID:25237398

  3. Stratified Patient-Centered Care in Type 2 Diabetes

    PubMed Central

    Slingerland, Annabelle S.; Herman, William H.; Redekop, William K.; Dijkstra, Rob F.; Jukema, J. Wouter; Niessen, Louis W.

    2013-01-01

    OBJECTIVE Diabetes treatment should be effective and cost-effective. HbA1c-associated complications are costly. Would patient-centered care be more (cost-) effective if it was targeted to patients within specific HbA1c ranges? RESEARCH DESIGN AND METHODS This prospective, cluster-randomized, controlled trial involved 13 hospitals (clusters) in the Netherlands and 506 patients with type 2 diabetes randomized to patient-centered (n = 237) or usual care (controls) (n = 269). Primary outcomes were change in HbA1c and quality-adjusted life years (QALYs); costs and incremental costs (USD) after 1 year were secondary outcomes. We applied nonparametric bootstrapping and probabilistic modeling over a lifetime using a validated Dutch model. The baseline HbA1c strata were <7.0% (53 mmol/mol), 7.0–8.5%, and >8.5% (69 mmol/mol). RESULTS Patient-centered care was most effective and cost-effective in those with baseline HbA1c >8.5% (69 mmol/mol). After 1 year, the HbA1c reduction was 0.83% (95% CI 0.81–0.84%) (6.7 mmol/mol [6.5–6.8]), and the incremental cost-effectiveness ratio (ICER) was 261 USD (235–288) per QALY. Over a lifetime, 0.54 QALYs (0.30–0.78) were gained at a cost of 3,482 USD (2,706–4,258); ICER 6,443 USD/QALY (3,199–9,686). For baseline HbA1c 7.0–8.5% (53–69 mmol/mol), 0.24 QALY (0.07–0.41) was gained at a cost of 4,731 USD (4,259–5,205); ICER 20,086 USD (5,979–34,193). Care was not cost-effective for patients at a baseline HbA1c <7.0% (53 mmol/mol). CONCLUSIONS Patient-centered care is more valuable when targeted to patients with HbA1c >8.5% (69 mmol/mol), confirming clinical intuition. The findings support treatment in those with baseline HbA1c 7–8.5% (53–69 mmol/mol) and demonstrate little to no benefit among those with HbA1c <7% (53 mmol/mol). Further studies should assess different HbA1c strata and additional risk profiles to account for heterogeneity among patients. PMID:23949558

  4. Emergencies in diabetic patients in the primary care setting.

    PubMed

    Wolfsthal, Susan D; Manno, Rebecca; Fontanilla, Evonne

    2006-09-01

    The diabetic patient poses special problems in the primary care setting. Symptoms that are relatively unimpressive on initial presentation, such as polyuria or dizziness, may actually be the beginning of serious medical complications. With careful evaluation and follow-up, some patients, such as those who have mild hypo- and hyperglycemia and certain infections, can be managed as an outpatients; however, many cardiovascular conditions, such as cardiac ischemia or limb-threatening peripheral vascular disease, require immediate transfer to an acute care facility. In all situations, close monitoring of glucose levels during all phases of care--in the office, in the hospital and at home--is essential to achieving target glycemic control and rapid detection of clinical conditions that often first manifest as alterations in glycemic control. PMID:17088157

  5. 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...

  6. Seroprevalence of tetanus immunity among noninsulin-dependent diabetes mellitus patients

    Microsoft Academic Search

    Dilek Kiliç; Sedat Kaygusuz; Meral Saygun; Aytül Çakmak; Hazel Üzer; Levent Do?anci

    2003-01-01

    Tetanus is a preventable disease that continues to affect people in both developing and developed countries. The aim of the present study was to evaluate the immunity profile to tetanus in patients with Type II diabetes mellitus (DM) and to compare them with healthy controls. The tetanus antitoxin levels in 310 diabetic patients (104 males and 206 females) and in

  7. A diabetes management system empowering patients to reach optimised glucose control: From monitor to advisor

    Microsoft Academic Search

    Jens Ulrik Poulsen; Angelo Avogaro; Fabien Chauchard; Claudio Cobelli; Rolf Johansson; L. Nita; M. Pogose; L. del Re; E. Renard; S. Sampath; F. Saudek; M. Skillen; J. Soendergaard

    2010-01-01

    The DIAdvisor™ is an EC\\/FP7 funded project aiming at the development of a Blood Glucose prediction device which uses easily available information to optimise the therapy of patients with diabetes. The project will achieve its objectives by developing a unique system for patients with diabetes to help them manage their disease effectively, optimising safety and giving an improved quality of

  8. Stabilized incidence of diabetic patients referred for renal replacement therapy in Denmark

    Microsoft Academic Search

    V R Sørensen; P M Hansen; J Heaf; B Feldt-Rasmussen

    2006-01-01

    Despite an improvement in diabetes care during the last 20 years, the number of diabetic patients starting renal replacement therapy (RRT) has continued to increase in the Western world. The aim was to study the incidence of patients starting RRT in Denmark from 1990 to 2004. Data were obtained from The Danish National Registry; Report on Dialysis and Transplantation, where

  9. Disposition of lorazepam in diabetes: differences between patients treated with beef\\/pork and human insulins

    Microsoft Academic Search

    R. J. Herman; A. Chaudhary; C. B. Szakacs; D. Woo; M. A. Boctor

    1995-01-01

    The pharmacokinetics of lorazepam was examined in 10 male patients with insulin-dependent diabetes mellitus before and following treatment with neomycin and cholestyramine. Neomycin and cholestyramine were given in an attempt to block the enterohepatic circulation of lorazepam and so to permit an in vivo estimate of hepatic glucuronidation. The volume of distribution and clearance of free lorazepam in diabetic patients

  10. 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…

  11. Accelerated vascular calcification and relative hypoparathyroidism in incident haemodialysis diabetic patients receiving calcium binders

    Microsoft Academic Search

    Andrea Galassi; David M. Spiegel; Antonio Bellasi; Geoffrey A. Block; Paolo Raggi

    2006-01-01

    Background. Vascular calcification and low bone turnover with a relatively low parathyroid hormone (PTH) often coexist in diabetic patients undergoing haemodialysis. Since calcium salts (CaS) are used extensively as primary phosphate binders and have been associated with progressive vascular calcification, we studied the effects of CaS on coronary arteries and parathyroid activity in incident haemodialysis diabetic patients. Methods. We measured

  12. A "Family-Based" Approach to the Treatment of Obese Type II Diabetic Patients.

    ERIC Educational Resources Information Center

    Wing, Rena R.; And Others

    1991-01-01

    Assigned 49 obese diabetic patients with obese spouses (diabetic or nondiabetic) to an alone or together (with spouses) treatment condition of behavioral weight control program. Found no significant differences in weight losses of patients at posttreatment or one-year followup, but did find that women did better when treated with their spouses,…

  13. Decreased Coronary Microvascular Reactivity after Cardioplegic Arrest in Patients with Poorly Controlled Diabetes

    PubMed Central

    Feng, Jun; Chu, Louis M.; Nikola, Dobrilovic N; Liu, Yuhong; Singh, Arun K.; Sellke, Frank W.

    2012-01-01

    Background We investigated the effects of cardioplegic arrest and reperfusion (CP/Rep) on coronary arteriolar responses to endothelium-dependent and -independent vasodilators and associated signaling pathways in poorly controlled diabetic, well controlled diabetic and case-matched non-diabetic patients undergoing coronary artery bypass grafting (CABG). Methods and Results Coronary arterioles from harvested right-atrial tissues were dissected pre- and post-CP/Rep from poorly controlled diabetic (n = 10, hemoglobin A1c [HbA1c] = 9.3 ± 0.3), well controlled diabetic (n = 10, HbA1c = 6.2 ± 0.2) and non-diabetic patients (n = 10, HbA1c = 5.1 ± 0.1) undergoing CABG surgery. The baseline microvascular response to ADP, substance P and SNP of arterioles from poorly controlled diabetic patients were decreased as compared to the respective response from non-diabetic or well controlled diabetic patients (P < 0.05). The vasodilatory responses to ADP, and substance P after CP/Rep were significantly decreased in all three groups compared to pre-CP/Rep responses (P < 0.05). However, these decreases were more pronounced in the poorly controlled diabetic group (P < 0.05). The expression of protein kinase C-? (PKC-?), PKC-?, and protein oxidation in atrial tissues was significantly increased in the poorly controlled diabetic group as compared with those of non-diabetes or controlled diabetes. Conclusion Poorly controlled is associated with endothelium-dependent and -independent vascular dysfunction of coronary arterioles. Additionally, poorly controlled diabetes worsens the recovery of coronary arteriolar function after CP/Rep. These alterations are associated with the increased expression/activation of PKC-? and PKC-?, and enhanced oxidative stress. PMID:22828147

  14. Japanese cancer patient participation in and satisfaction with treatment-related decision-making: A qualitative study

    Microsoft Academic Search

    Yoshiko Watanabe; Miyako Takahashi; Ichiro Kai

    2008-01-01

    BACKGROUND: Over the last decade, patient involvement in treatment-related decision-making has been widely advocated in Japan, where patient-physician encounters are still under the influence of the long-standing tradition of paternalism. Despite this profound change in clinical practice, studies investigating the actual preferences of Japanese people regarding involvement in treatment-related decision-making are limited. The main objectives of this study were to

  15. Full-Length Sequence of Hepatitis B Virus Belonging to Genotype H Identified in a Japanese Patient with Chronic Hepatitis

    Microsoft Academic Search

    Akira Nakajima; Mitsugu Usui; Tran Thien; Tuan Huy; Naomi Khaing Than Hlaing; Naohiko Masaki; Tetsutaro Sata; Kenji Abe

    2005-01-01

    SUMMARY: We have isolated and cloned the full-length nucleotide sequence of the hepatitis B virus (HBV) genome (denoted HBV-IM806-2) recovered from a Japanese patient with chronic hepatitis. This patient had a history of travel to Bangkok, Thailand, and then suffered the onset of acute hepatitis B 3 months after his return to Japan. The HBV-IM806-2 isolate was composed of 3,215

  16. Effects of Gastric Bypass Surgery in Patients With Type 2 Diabetes and Only Mild Obesity

    PubMed Central

    Cohen, Ricardo V.; Pinheiro, Jose C.; Schiavon, Carlos A.; Salles, João E.; Wajchenberg, Bernardo L.; Cummings, David E.

    2012-01-01

    OBJECTIVE Roux-en-Y gastric bypass (RYGB) ameliorates type 2 diabetes in severely obese patients through mechanisms beyond just weight loss, and it may benefit less obese diabetic patients. We determined the long-term impact of RYGB on patients with diabetes and only class I obesity. RESEARCH DESIGN AND METHODS Sixty-six consecutively selected diabetic patients with BMI 30–35 kg/m2 underwent RYGB in a tertiary-care hospital and were prospectively studied for up to 6 years (median 5 years [range 1–6]), with 100% follow-up. Main outcome measures were safety and the percentage of patients experiencing diabetes remission (HbA1c <6.5% without diabetes medication). RESULTS Participants had severe, longstanding diabetes, with disease duration 12.5 ± 7.4 years and HbA1c 9.7 ± 1.5%, despite insulin and/or oral diabetes medication usage in everyone. For up to 6 years following RYGB, durable diabetes remission occurred in 88% of cases, with glycemic improvement in 11%. Mean HbA1c fell from 9.7 ± 1.5 to 5.9 ± 0.1% (P < 0.001), despite diabetes medication cessation in the majority. Weight loss failed to correlate with several measures of improved glucose homeostasis, consistent with weight-independent antidiabetes mechanisms of RYGB. C-peptide responses to glucose increased substantially, suggesting improved ?-cell function. There was no mortality, major surgical morbidity, or excessive weight loss. Hypertension and dyslipidemia also improved, yielding 50–84% reductions in predicted 10-year cardiovascular disease risks of fatal and nonfatal coronary heart disease and stroke. CONCLUSIONS This is the largest, longest-term study examining RYGB for diabetic patients without severe obesity. RYGB safely and effectively ameliorated diabetes and associated comorbidities, reducing cardiovascular risk, in patients with a BMI of only 30–35 kg/m2. PMID:22723580

  17. Niacin results in reduced monocyte adhesion in patients with type 2 diabetes mellitus

    Microsoft Academic Search

    S. Tavintharan; K. Woon; L. T. Pek; N. Jauhar; X. Dong; S. C. Lim; C. F. Sum

    2011-01-01

    Background and aimPatients with type 2 diabetes have increased expression of cell adhesion molecules (CAMs). CAMs and monocyte adhesion mediate essential processes in atherogenesis. It remains unclear if monocytes from patients on niacin have reduced adhesion function.

  18. Association of retinopathy and intima media thickness of common carotid artery in type 2 diabetic patients

    PubMed Central

    Momeni, Ali; Dyani, Mohamad Ali; Ebrahimi, Elnaz; Sedehi, Morteza; Naderi, Afsaneh

    2015-01-01

    Background: This study was carried out in order to evaluate the relationship between retinopathy and carotid intima-media thickness (CIMT). Materials and Methods: In a cross-sectional study, 154 diabetic patients who had a history of diabetic disease were evaluated in two equal groups of 77 patients with and without retinopathy, respectively. CIMT was evaluated in all of the patients. Results: Mean age of the patients was 59.65 ± 9.37 years. Mean CIMT of all patients was 0.84 ± 0.18. CIMT of patients with retinopathy was significantly greater than patients without retinopathy (P < 0.001). CIMT also correlated with age, duration of diabetes, systolic blood pressure, blood urea nitrogen, and serum creatinine. Conclusion: CIMT may be used as a simple, available and noninvasive method for screening of macro and microvascular complication of diabetic patients.

  19. Small ubiquitin-like modifier 4 M55V polymorphism is not associated with diabetic nephropathy in Iranian type 2 diabetes patients

    PubMed Central

    Shahsavar, Farhad; Jafarzadeh, Mehrzad; Azargoon, Alireza; Hedayati, Mehdi; Asadifar, Behnam

    2013-01-01

    INTRODUCTION: We studied the impact of small ubiquitin-like modifier 4 (SUMO4) M55V polymorphism on susceptibility to diabetic nephropathy in Iranian type 2 diabetes patients. MATERIALS AND METHODS: The patient group consisted of 50 Iranian type 2 diabetes patients with nephropathy, and the control group consisted of 50 Iranian type 2 diabetes patients without nephropathy. Genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism method for the M55V. RESULTS: The frequency of SUMO4 AA, AG, and GG genotypes were 23%, 18%, and 9% in the patient group and 10%, 22%, and 18% in the control group. There was no significant difference in frequency of SUMO4 genotypes in patients compared to controls. CONCLUSION: These findings indicate that SUMO4 M55V polymorphism is not associated with diabetic nephropathy in Iranian type 2 diabetes patients. PMID:24019619

  20. Medical groups can reduce costs by investing in improved quality of care for patients with diabetes.

    PubMed

    Kralewski, John E; Dowd, Bryan E; Xu, Yi Wendy

    2012-08-01

    A major feature of many new contracts between providers and payers is shared savings programs, in which providers can earn a percentage of the savings if the cost of the care they provide is lower than the projected cost. Unless providers are also held accountable for meeting quality benchmarks, some observers fear that these programs could erode quality of care by rewarding only cost savings. We estimated the effects on Medicare expenditures of improving the quality of care for patients with diabetes. Analyzing 234 practices that provided care for 133,703 diabetic patients, we found a net savings of $51 per patient with diabetes per year for every one-percentage-point increase in a score of the quality of care. Cholesterol testing for all versus none of a practice's patients with diabetes, for example, was associated with a dramatic drop in avoidable hospitalizations. These results show that improving the quality of care for patients with diabetes does save money. PMID:22869662

  1. Revisiting Shimoda's “Shuuchaku-Kishitsu” (Statothymia): A Japanese View of Manic-Depressive Patients

    PubMed Central

    Tsuda, Hitoshi

    2011-01-01

    Although the empiric paradigm is now dominant in academic research, in Japan quite a few psychiatric clinicians still take phenomenological-anthropological approaches into consideration, especially when they address manic-depressive illness with typical endogenous features. This is because Shimoda's concept of “shuuchaku-kishitsu” (statothymia) has been widely accepted, together with other phenomenological views of continental origin. In the present paper the author first delineates Shimoda's concept which is based on observations of patients' personality features and the characteristics of their emotionality. He then attempts to refine this concept in spatiotemporal terms, presenting the view that in patients the past self tends to adhere to the present self (the term “shuuchaku” means “adhering to” or “preoccupied with”). He also considers that patients tend to incorporate “soto” (outer space) into “uchi” (inner space), where they believe that symbiotic relations are preserved. Finally, he argues the clinical significance of the presented views in the cultural milieu in which Japanese psychiatric practices are situated. PMID:21941642

  2. Empowerment assessment and influential factors among patients with type 2 diabetes

    PubMed Central

    2013-01-01

    Background Diabetic patients need high awareness of disease prevention to adopt self-management behaviors in their daily life. Central to this activity is patients’ empowerment. Current study was conducted to assess empowerment score and its related factors among type 2 diabetic patients. Method A cross-sectional study carried out over a period of nine months during 2010–2011. All patients with a diagnosis of type 2 diabetes including those referring to four hospitals affiliated with Tehran University of Medical Sciences were recruited. A total of 688 diabetic patients were identified who met the inclusion criteria and were all included in the study. Patients’ empowerment was measured by Diabetes Empowerment Scale reflecting three dimensions including managing psychosocial aspect of diabetes, assessing dissatisfaction and readiness to change and Setting and achieving diabetes goal. Collected data was analysed using SPSS software version 11.5. Results As total, 688 were available for analysis, ranging from 37–81 years old with mean of 54.41 years (SD?=?8.22). The Mean duration of the disease was approximately 6.67 years (SD?=?4.58). Dimensions of ‘managing the psychosocial aspect of diabetes’, ‘assessing dissatisfaction and readiness to change’ and ‘setting and achieving diabetes goal’ were all measured and scored for each patient. The mean score for each domain was 25.75?±?5.55, 24.78?±?7.54, 27.63?±?7.90, respectively. Data analysis revealed a statistically significant reverse relationship between age and ‘assessing dissatisfaction and readiness to change’ and ‘setting and achieving diabetes goal’. In addition, disease duration had a statistically significant reverse relationship with ‘assessing dissatisfaction and readiness to change’. Conclusion Patients with type 2 diabetes have the potential to be empowered to manage their chronic disease if they are actively informed and educated. PMID:23497631

  3. Blood pressure control among hypertensive patients with and without diabetes mellitus in six public primary care clinics in Malaysia.

    PubMed

    Cheong, Ai Theng; Tong, Seng Fah; Sazlina, Sharrif G; Azah, Abdul Samad; Salmiah, Md Sharif

    2015-03-01

    Hypertension is a common comorbidity among diabetic patients. This study aimed to determine blood pressure (BP) control among hypertensive patients with and without diabetes. This was a cross-sectional study in 6 public primary care clinics in Wilayah Persekutuan, Malaysia. Hypertensive patients aged ?18 years and attending the clinics were selected via systematic random sampling. The BP control target was defined as <130/80 mm Hg for diabetic patients and <140/90 mm Hg for nondiabetic patients. A total of 1107 hypertensive patients participated in this study and 540 (48.7%) had diabetes. About one fourth (24.3%) of the hypertensive patients with diabetes achieved BP control target, compared with 60.1% patients without diabetes (P < .001). Being diabetic and on ?2 antihypertensive treatments were associated with poor BP control. Attention needs to be given to these groups of patients when managing patients with hypertension. PMID:23536235

  4. Study of 27 Aqueous Humor Cytokines in Type 2 Diabetic Patients with or without Macular Edema

    PubMed Central

    Dong, Ning; Xu, Bing; Chu, Liqun; Tang, Xin

    2015-01-01

    The aim of the present study was to compare the changes in the levels of 27 aqueous humor cytokines between diabetic patients with macular edema (ME) and diabetic patients without ME. Undiluted aqueous humor samples were obtained from 68 consecutive type 2 diabetic patients without ME and 56 consecutive type 2 diabetic patients with ME. The concentrations of 27 cytokines in the aqueous humor samples were measured using a multiplex bead immunoassay. Compared with diabetic patients without ME, diabetic patients with ME had significantly higher concentrations of IL-1?, IL-6, IL-8, IP-10, MCP-1, and VEGF in the aqueous humor. However, the concentrations of IL-10 and IL-12 were significantly lower in the diabetic patients with ME. The aqueous humor levels of IL-1?, IL-6, IL-8, MCP-1, IP-10, and VEGF were closely correlated with retinal macular thickness, retinal macular volume and the severity of ME. In addition, the aqueous humor levels of IL-10 and IL-12 decreased with increasing the severity of ME. A variety of cytokines associated with inflammation and angiogenesis may contribute to the pathogenesis of diabetic macular edema, and both anti-inflammatory and antiangiogenic agents should be included in the treatment of ME simultaneously. PMID:25923230

  5. Comprehensive diabetes management program for poorly controlled Hispanic type 2 patients at a community health center.

    PubMed

    Welch, Garry; Allen, Nancy A; Zagarins, Sofija E; Stamp, Kelly D; Bursell, Sven-Erik; Kedziora, Richard J

    2011-01-01

    Technology and improved care coordination models can help diabetes educators and providers meet national care standards and provide culturally sensitive diabetes education that may improve diabetes outcomes. The purpose of the study was to evaluate the clinical usefulness of a nurse-led diabetes care program (Comprehensive Diabetes Management Program, CDMP) for poorly controlled Hispanic type 2 diabetes (T2DM) patients in an urban community health center setting. Patients were randomized to the intervention condition (IC; n = 21) or an attention control condition (AC; n = 18). IC and AC conditions were compared on rates of adherence to national clinical practice guidelines (blood glucose, blood pressure, foot exam, eye exam), and levels of diabetes distress, depression, and treatment satisfaction. IC patients had a significant improvement in A1C from baseline to 12-month follow-up compared with AC (-1.6% ± 1.4% versus -0.6% ± 1.1%; P = .01). The proportion of IC patients meeting clinical goals at follow-up tended to be higher than AC for A1c (IC = 45%; AC = 28%), systolic blood pressure (IC = 55%; AC = 28%), eye screening (IC = 91%; AC = 78%), and foot screening, (IC = 86%; AC = 72%). Diabetes distress and treatment satisfaction also showed greater improvement for IC than AC (P = .05 and P = .06, respectively), with no differences for depression. The CDMP intervention was more effective than an attention control condition in helping patients meet evidence-based guidelines for diabetes care. PMID:21918206

  6. Laser in-situ keratomileusis in patients with diabetes mellitus: a review of the literature

    PubMed Central

    Simpson, Rachel G; Moshirfar, Majid; Edmonds, Jason N; Christiansen, Steven M

    2012-01-01

    Purpose A growing number of diabetic patients request laser in situ keratomileusis (LASIK) for elective vision correction each year. While the United States Food and Drug Administration considers diabetes a relative contraindication to LASIK surgery, there are several reports in the literature of LASIK being performed safely in this patient population. The purpose of this review was to examine whether diabetes should still be considered a contraindication to LASIK surgery by reviewing the ocular and systemic complications of diabetes, and examining the existing data on the outcomes of LASIK in diabetic patients. Methods A literature review was conducted through PubMed, Medline, and Ovid to identify any study on LASIK surgery in patients with diabetes mellitus. This search was conducted without date restrictions. The search used the Medical Subject Headings (MeSH®) term LASIK linked by the word “and” to the following MeSH and natural language terms: diabetes, diabetes mellitus, systemic disease, and contraindications. Abstracts for all studies meeting initial search criteria were reviewed for relevance. There were no prospective clinical studies identified. Three retrospective studies were identified. Key sources from these papers were identified, reviewed, and included as appropriate. An additional literature search was conducted to identify any study of ocular surgery on patients with diabetes using the MeSH terms refractive surgery, photorefractive keratectomy, radial keratotomy, cataract surgery, vitrectomy, and iridectomy linked by the word “and” to the following MeSH terms: diabetes, diabetes mellitus, and systemic disease. This search was conducted without date restrictions. Abstracts of studies meeting the initial search criteria were reviewed and articles deemed relevant to the subject were included in this review. Conclusion LASIK may be safe in diabetic patients with tight glycemic control and no ocular or systemic complications. PMID:23109803

  7. MicroRNA expression in inflamed and noninflamed gingival tissues from Japanese patients.

    PubMed

    Ogata, Yorimasa; Matsui, Sari; Kato, Ayako; Zhou, Liming; Nakayama, Yohei; Takai, Hideki

    2014-01-01

    Periodontitis is a chronic inflammatory disease caused by specific bacteria and viruses. Local, systemic, and environmental factors affect the rate of disease progression. Immune responses to bacterial products, and the subsequent production of inflammatory cytokines, are crucial in the destruction of periodontal tissue. MicroRNAs (miRNAs) are a class of small RNAs that control various cell processes by negatively regulating protein-coding genes. In this study, we compared miRNA expression in inflamed and noninflamed gingival tissues from Japanese dental patients. Total RNAs were isolated from inflamed and noninflamed gingival tissues. miRNA expression profiles were examined by an miRNA microarray, and the data were analyzed by GeneSpring GX, Ingenuity Pathways Analysis, and the TargetScan databases. Observed miRNA expression levels in inflamed gingiva were confirmed by real-time PCR. The three most overexpressed (by >2.72-fold) miRNAs were hsa-miR-150, hsa-miR-223, and hsa-miR-200b, and the three most underexpressed (by <0.39-fold) miRNAs were hsa-miR-379, hsa-miR-199a-5p, and hsa-miR-214. In IPA analysis, hsa-miR-150, hsa-miR-223, and hsa-miR-200b were associated with inflammatory disease, organismal injury, abnormalities, urological disease, and cancer. The present findings suggest that miRNAs are associated with chronic periodontitis lesions in Japanese. PMID:25500922

  8. Short telomere length is associated with arterial aging in patients with type 2 diabetes mellitus.

    PubMed

    Dudinskaya, E N; Tkacheva, O N; Shestakova, M V; Brailova, N V; Strazhesko, I D; Akasheva, D U; Isaykina, O Y; Sharashkina, N V; Kashtanova, D A; Boytsov, S A

    2015-09-01

    It is known that glucose disturbances contribute to micro- and macrovascular complications and vascular aging. Telomere length is considered to be a cellular aging biomarker. It is important to determine the telomere length role in vascular structural and functional changes in patients with diabetes mellitus. We conducted a cross-sectional observational study in a high-risk population from Moscow, Russia. The study included 50 patients with diabetes and without clinical cardiovascular disease and 49 control group participants. Glucose metabolism assessment tests, measuring intima-media complex thickness and determining the presence of atherosclerotic plaques, pulse wave velocity measurement, and telomere length measurement were administered to all participants. Vascular changes were more dramatic in patients with diabetes than in the control group, and the telomeres were shorter in patients with diabetes. Significant differences were found in the vascular wall condition among diabetes patients, and there were no substantial differences in the arterial structure between patients with 'long' telomeres; however, there were statistically significant differences in the vascular wall condition between patients with 'short' telomeres. Vascular ageing signs were more prominent in patients with diabetes. However, despite diabetes, vascular changes in patients with long telomeres were very modest and were similar to the vascular walls in healthy individuals. Thus, long lymphocyte telomeres may have a protective effect on the vascular wall and may prevent vascular wall deterioration caused by glucose metabolism disorders. PMID:26034119

  9. Short telomere length is associated with arterial aging in patients with type 2 diabetes mellitus

    PubMed Central

    Dudinskaya, E N; Tkacheva, O N; Shestakova, M V; Brailova, N V; Strazhesko, I D; Akasheva, D U; Isaykina, O Y; Sharashkina, N V; Kashtanova, D A; Boytsov, S A

    2015-01-01

    It is known that glucose disturbances contribute to micro- and macrovascular complications and vascular aging. Telomere length is considered to be a cellular aging biomarker. It is important to determine the telomere length role in vascular structural and functional changes in patients with diabetes mellitus. We conducted a cross-sectional observational study in a high-risk population from Moscow, Russia. The study included 50 patients with diabetes and without clinical cardiovascular disease and 49 control group participants. Glucose metabolism assessment tests, measuring intima–media complex thickness and determining the presence of atherosclerotic plaques, pulse wave velocity measurement, and telomere length measurement were administered to all participants. Vascular changes were more dramatic in patients with diabetes than in the control group, and the telomeres were shorter in patients with diabetes. Significant differences were found in the vascular wall condition among diabetes patients, and there were no substantial differences in the arterial structure between patients with ‘long’ telomeres; however, there were statistically significant differences in the vascular wall condition between patients with ‘short’ telomeres. Vascular ageing signs were more prominent in patients with diabetes. However, despite diabetes, vascular changes in patients with long telomeres were very modest and were similar to the vascular walls in healthy individuals. Thus, long lymphocyte telomeres may have a protective effect on the vascular wall and may prevent vascular wall deterioration caused by glucose metabolism disorders. PMID:26034119

  10. Predictors of Sustained Walking among Diabetes Patients in Managed Care: The Translating Research into Action for Diabetes (TRIAD) Study

    Microsoft Academic Search

    O. Kenrik Duru; Robert B. Gerzoff; Arleen F. Brown; Andrew J. Karter; Catherine Kim; David Kountz; K. M. Venkat Narayan; Stephen H. Schneider; Chien-Wen Tseng; Beth Waitzfelder; Carol M. Mangione

    2008-01-01

    BACKGROUND  Although patients with diabetes may benefit from physical activity, few studies have examined sustained walking in this population.\\u000a \\u000a \\u000a \\u000a OBJECTIVE  To examine the factors associated with sustained walking among managed care patients with diabetes.\\u000a \\u000a \\u000a \\u000a DESIGN  Longitudinal, observational cohort study with questionnaires administered 2.5 years apart.\\u000a \\u000a \\u000a \\u000a PARTICIPANTS  Five thousand nine hundred thirty-five patients with diabetes walking at least 20 minutes\\/day at baseline.\\u000a \\u000a \\u000a \\u000a MEASUREMENTS  The primary outcome was the

  11. Dapagliflozin in patients with type 2 diabetes mellitus.

    PubMed

    Filippatos, Theodosios D; Liberopoulos, Evangelos N; Elisaf, Moses S

    2015-02-01

    Dapagliflozin is a selective and reversible inhibitor of sodium-glucose linked transporter type 2 (SGLT2), which mediates approximately 90% of active renal glucose reabsorption in the early proximal tubule of the kidney. Dapagliflozin significantly reduces glucose reabsorption and decreases serum glucose concentration in an insulin-independent manner. The decrease of glucose reabsorption by dapagliflozin has also been associated with a reduction in body weight. Furthermore, the drug modestly reduces blood pressure levels through weight loss and its action as osmotic diuretic. Dapagliflozin has been approved as monotherapy in patients with type 2 diabetes mellitus (T2DM) who cannot tolerate metformin or in combination with other antidiabetic drugs, with the exception of pioglitazone due to the theoretical increased risk of bladder cancer. The drug should not be prescribed in patients with moderate or severe renal impairment or in patients at risk for developing volume depletion. Dapagliflozin is associated with increased incidence of genital and lower urinary tract infections, but these infections are usually mild to moderate and respond to standard antimicrobial treatment. Based on current evidence, dapagliflozin is a useful drug for patients with T2DM with a favorable safety profile. However, further research regarding the effects of dapagliflozin on cardiovascular outcomes is needed. PMID:25678954

  12. Apelin in epiretinal membranes of patients with proliferative diabetic retinopathy

    PubMed Central

    Lu, Qiang; Ma, Yan; Xu, Yong-sheng

    2014-01-01

    Purpose Formation of epiretinal membranes (ERMs) in the posterior fundus results in visual impairment. ERMs have been associated with numerous clinical conditions, including proliferative diabetic retinopathy (PDR), a neovascular disease. Apelin has been identified as a novel angiogenesis contributor. The aim of this study was to investigate the correlation between apelin and ERMs after PDR. Methods ERM samples were obtained by vitrectomy from 12 subjects with PDR (aged 57±6 years; duration of diabetes 16±7 years), and 12 subjects with idiopathic ERM (aged 68±5 years). The samples were processed for immunohistochemistry and reverse transcription–PCR (RT–PCR). We also analyzed samples from patients with PDR who received an intravitreal injection of bevacizumab (IVB) before vitrectomy. Results The mRNA expression of apelin was significantly higher in the PDR ERMs than in the idiopathic ERMs. Accordingly, immunohistochemical analysis revealed strong expression of apelin in all eight PDR ERMs without IVB, and was double-labeled with glial fibrillary acidic protein antibody (GFAP), platelet endothelial cell adhesion molecule-1 (CD31), cytokeratin (CK) and vascular endothelial growth factor (VEGF) but not with fibronectin. They were mainly located in the adventitia. In contrast, the expression of apelin was lower in the PDR ERMs after IVB and the idiopathic ERMs. Conclusions The results showed that apelin was involved in the formation of ERMs and promoted the formation of adventitia, including glial, endothelial, and RPE cells. Bevacizumab blocked the expression of apelin and regressed gliosis and angiogenesis. PMID:25324682

  13. Fasting during Ramadan: efficacy, safety, and patient acceptability of vildagliptin in diabetic patients.

    PubMed

    Aziz, Kamran Ma

    2015-01-01

    Diabetes management during Ramadan fasting is challenging to the physician in terms of minimizing the risk of hypoglycemia. As compared to oral hypoglycemic agents (OHAs) and sulfonylureas (SUs), which carry a higher and significant risk of hypoglycemia, newer antidiabetic agents such as dipeptidyl peptidase-4 (DPP-4) inhibitors have demonstrated lower risk of hypoglycemia during Ramadan fasting, with better patient compliance. In addition to diabetes education and pre-Ramadan assessments, the physician should also consider use of DPP-4 inhibitors (such as vildagliptin) during Ramadan fasting to minimize the risk of hypoglycemia in type 2 diabetic subjects. Severe episodes of hypoglycemia have been demonstrated in recent research and clinical trials with OHAs/SUs. Conversely, these research observations have also demonstrated comparative safety and efficacy with lower risk of hypoglycemia associated with vildagliptin. Current research review has collected evidence-based clinical trials and observations for the drug vildagliptin to minimize the risk of hypoglycemia during Ramadan fasting, while at the same time focusing the role of diabetes self-management education (DSME), pre-Ramadan assessments, and patient care. PMID:25931826

  14. Fasting during Ramadan: efficacy, safety, and patient acceptability of vildagliptin in diabetic patients

    PubMed Central

    Aziz, Kamran MA

    2015-01-01

    Diabetes management during Ramadan fasting is challenging to the physician in terms of minimizing the risk of hypoglycemia. As compared to oral hypoglycemic agents (OHAs) and sulfonylureas (SUs), which carry a higher and significant risk of hypoglycemia, newer antidiabetic agents such as dipeptidyl peptidase-4 (DPP-4) inhibitors have demonstrated lower risk of hypoglycemia during Ramadan fasting, with better patient compliance. In addition to diabetes education and pre-Ramadan assessments, the physician should also consider use of DPP-4 inhibitors (such as vildagliptin) during Ramadan fasting to minimize the risk of hypoglycemia in type 2 diabetic subjects. Severe episodes of hypoglycemia have been demonstrated in recent research and clinical trials with OHAs/SUs. Conversely, these research observations have also demonstrated comparative safety and efficacy with lower risk of hypoglycemia associated with vildagliptin. Current research review has collected evidence-based clinical trials and observations for the drug vildagliptin to minimize the risk of hypoglycemia during Ramadan fasting, while at the same time focusing the role of diabetes self-management education (DSME), pre-Ramadan assessments, and patient care. PMID:25931826

  15. 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

  16. Phase I study of tivantinib in Japanese patients with advanced hepatocellular carcinoma: Distinctive pharmacokinetic profiles from other solid tumors.

    PubMed

    Okusaka, Takuji; Aramaki, Takeshi; Inaba, Yoshitaka; Nakamura, Shinichiro; Morimoto, Manabu; Moriguchi, Michihisa; Sato, Takashi; Ikawa, Yuta; Ikeda, Masafumi; Furuse, Junji

    2015-05-01

    A c-Met inhibitor tivantinib is a candidate anticancer agent for patients with hepatocellular carcinoma (HCC), and CYP2C19 is the key metabolic enzyme for tivantinib. Previous Japanese phase I studies in patients with solid tumors (except HCC) recommend 360 mg twice daily (BID) and 240 mg BID for CYP2C19 extensive metabolizers (EM) and poor metabolizers (PM), respectively. In this study, Japanese patients with HCC in whom sorafenib treatment has failed were enrolled to evaluate the safety, tolerability and pharmacokinetics of oral tivantinib as a single agent. The dose was escalated separately in EM and PM, from 120 mg BID to 240 mg BID, in both capsule and tablet formulations. A total of 28 patients (EM: 21, PM: 7) received tivantinib. At a dose of 120 mg BID, dose-limiting toxicities (DLT) did not develop in 12 EM (capsule: 6, tablet: 6) and 7 PM (capsule: 4, tablet: 3) during the DLT-observation period (for 29 days after first dosing). At this dose, the pharmacokinetic profiles of tivantinib (AUC0-12 and Cmax ) did not remarkably differ between EM and PM. When treated with 240 mg BID, 5 of 9 EM (capsule: 4 of 6, tablet: 1 of 3) developed neutropenia-related DLT accompanying plasma tivantinib concentration higher than expected from the previous studies. Consequently, PM did not receive 240 mg BID. In conclusion, 120 mg BID of tivantinib is recommended among Japanese patients with HCC regardless of CYP2C19 phenotype. PMID:25711511

  17. Development and External Validation of a Nomogram Predicting the Probability of Significant Gleason Sum Upgrading among Japanese Patients with Localized Prostate Cancer

    PubMed Central

    Imamoto, Takashi; Utsumi, Takanobu; Takano, Makoto; Komaru, Atsushi; Fukasawa, Satoshi; Suyama, Takahito; Kawamura, Koji; Kamiya, Naoto; Miura, Junichiro; Suzuki, Hiroyoshi; Ueda, Takeshi; Ichikawa, Tomohiko

    2011-01-01

    Objective. The aim of this study is to develop a prognostic model capable of predicting the probability of significant upgrading among Japanese patients. Methods. The study cohort comprised 508 men treated with RP, with available prostate-specific antigen levels, biopsy, and RP Gleason sum values. Clinical and pathological data from 258 patients were obtained from another Japanese institution for validation. Results. Significant Gleason sum upgrading was recorded in 92 patients (18.1%) at RP. The accuracy of the nomogram predicting the probability of significant Gleason sum upgrading between biopsy and RP specimens was 88.9%. Overall AUC was 0.872 when applied to the validation data set. Nomogram predictions of significant upgrading were within 7.5% of an ideal nomogram. Conclusions. Nearly one-fifth of Japanese patients with prostate cancer will be significantly upgraded. Our nomogram seems to provide considerably accurate predictions regardless of minor variations in pathological assessment when applied to Japanese patient populations. PMID:22110999

  18. Phase-1 study of abiraterone acetate in chemotherapy-naïve Japanese patients with castration-resistant prostate cancer.

    PubMed

    Matsubara, Nobuaki; Uemura, Hiroji; Fukui, Iwao; Niwakawa, Masashi; Yamaguchi, Akito; Iizuka, Koho; Akaza, Hideyuki

    2014-10-01

    Persistent androgen synthesis under castration status in adrenal gland, testes and tumor cells is thought to be one of the major causes of development and progression of castration-resistant prostate cancer (CRPC). Abiraterone acetate (AA), the prodrug of abiraterone, which is an inhibitor of androgen synthesis enzymes, was evaluated for pharmacokinetics, pharmacodynamics, preliminary efficacy and safety in Japanese patients with CRPC in a phase-1, open-label and dose-escalation study. Chemotherapy-naïve Japanese CRPC patients (N = 27) received one of four AA daily doses (250 mg [n = 9], 500 mg [n = 6], 1000 [1 h premeal] mg [n = 6] and 1000 [2 h postmeal] mg [n = 6]) continuously through 28-day treatment cycles. In the first cycle, AA monotherapy was given on days 1-7 for pharmacokinetics, and AA plus prednisone (5 mg twice daily) from days 8 to 28. Of 27 patients, 9 continued treatment with AA until the data cut-off date (18 July 2013). Over the evaluated dose range, plasma abiraterone concentrations increased with dose, with median tmax 2-3 h. At each dose level, mean serum corticosterone concentrations increased, while testosterone and dehydroepiandrosterone sulfate concentrations rapidly decreased following a single AA dose and were further reduced to near the quantification limit on day 8 regardless of the dose. At least 3 patients from each dose-group experienced ?50% prostate-specific antigen reduction, suggesting clinical benefit from AA in Japanese CRPC patients. AA was generally well-tolerated, and, therefore, the recommended AA dosage regimen in Japanese CRPC patients is 1000 mg oral dose under modified fasting conditions (at least 1 h premeal or 2 h postmeal). This study is registered at ClinicalTrials.gov: NCT01186484. PMID:25117615

  19. 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

  20. Prevalence of scars and "mini-scars", and their impact on quality of life in Japanese patients with acne.

    PubMed

    Hayashi, Nobukazu; Miyachi, Yoshiki; Kawashima, Makoto

    2015-07-01

    There have been very few studies on the prevalence and severity of acne scars in Japanese patients. The aim of the present study was to investigate the prevalence of acne scars and their impact on the quality of life (QOL) in Japanese acne patients. Acne scars were classified as mini-scars (atrophic scars of ?0.5 and <2 mm in diameter) atrophic scars (?2 mm in diameter), and hypertrophic scars. The severity of acne and acne scars were evaluated. The background of patients and their QOL in relation to acne were assessed. Of 240 subjects, 218 (90.8%) had scars. All patients with scars had mini-scars; 61.2% and 14.2% of 240 had atrophic scars and hypertrophic scars, respectively. Severe scarring was found in patients who had experienced severe acne symptoms, although 15.0% of patients with scars had experienced only mild acne symptoms. The total Dermatology Life Quality Index score was significantly higher in patients with scars than in patients without scars (5.9 ± 4.4 vs 4.2 ± 4.1). Almost all the patients had small atrophic scars with a diameter of 0.5 or more and less than 2 mm, which we have termed "mini-scars". Acne scars had a negative impact on patient QOL. Early initiation of treatment is recommended to avoid acne scars. PMID:25916427

  1. 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

  2. Patient and health care provider views of depressive symptoms and diabetes in American Samoa.

    PubMed

    Held, Rachel Forster; DePue, Judith; Rosen, Rochelle; Bereolos, Nicole; Nu'usolia, Ofeira; Tuitele, John; Goldstein, Michael; House, Meaghan; McGarvey, Stephen

    2010-10-01

    High Type 2 diabetes prevalence, associated with recent cultural changes in diet and physical activity, characterizes the U.S. territory of American Samoa. Comorbid diabetes and depression rates are high worldwide and contribute to negative diabetes outcomes; these rates have not been assessed in American Samoa. In this study, 6 focus groups were conducted with 39 American Samoan adults with diabetes; questions on perceptions of diabetes and depressive symptoms were included. Thirteen health care staff interviews were conducted to gain insight into diabetes care in American Samoa. Focus groups and health care staff interviews were translated, transcribed, and entered into NVivo 8 to facilitate analysis. Thematic analysis showed that diabetes patients saw depressive symptoms as directly contributing to high blood sugar. However, these symptoms were rarely mentioned spontaneously, and providers reported they seldom assess them in patients. Many patients and health care staff believed the best ways to respond to feelings of depression involved relaxing, leaving difficult situations, or eating. Staff also discussed cultural stigma associated with depression and the importance of establishing rapport before discussing it. Health care providers in American Samoa need training to increase their awareness of depressive symptoms' negative impact on diabetes management in patients who screen positive for depression. All providers must approach the subject in a supportive context after establishing rapport. This information will be used for cultural translation of a community health worker and primary care-coordinated intervention for adults with diabetes in American Samoa, with the goal of creating an effective and sustainable intervention. PMID:21058808

  3. Early alterations in left ventricular diastolic function in normotensive diabetic patients.

    PubMed

    Capra, Anna; Galderisi, Maurizio; Giannattasio, Cristina; Innelli, Pasquale; Facchetti, Rita; Cesana, Francesca; Alloni, Marta; Carugo, Stefano; Grassi, Guido; de Divitiis, Oreste; Mancia, Giuseppe

    2012-04-01

    In diabetes mellitus, structural and functional alterations of the heart can be already present at the time of first diagnosis. However, how early these alterations may occur has never been fully clarified. The present study aimed at investigating cardiac functional abnormalities in uncomplicated hypertensive or normotensive patients with a recent diagnosis of diabetes mellitus. We studied 40 diabetics (24 normotensives and 16 hypertensives) by means of routine echocardiography plus pulse tissue Doppler analysis. Data were compared with those obtained in healthy age- and sex-matched controls. Left ventricular remodelling was more evident in hypertensive diabetics than in normotensive diabetics vs controls. Diastolic function was altered in diabetic patients only when detected by pulse tissue Doppler analysis and not by conventional transmitral Doppler evaluation. Normotensive patients with type 2 diabetes with little or no evidence at standard echocardiography of alterations in cardiac structure and function, already displayed an alteration in diastolic function when the evaluation was based on the tissue Doppler approach. Patients with type 2 diabetes combined to hypertension showed more evident functional cardiac alterations at echocardiography. These findings support the conclusion that cardiac abnormalities are very early phenomena in type 2 diabetes. PMID:22050292

  4. Evaluation and management of peripheral neuropathy in diabetic patients with cancer.

    PubMed

    Visovsky, Constance; Meyer, Rachel R; Roller, Jeffre; Poppas, Megan

    2008-04-01

    Recently, chemotherapy-induced peripheral neuropathy has received a great deal of attention. However, the interaction of diabetic neuropathy with potentially neurotoxic chemotherapy is far less understood. The incidence of type II diabetes has risen exponentially in the past two decades. In concert with the rise in type II diabetes, the number of individuals with diabetes who need chemotherapy for cancer also is expected to increase. Diabetic neuropathy and the neurotoxic effects of chemotherapy have a significant potential to cause functional disability. Diabetics may be most at risk for the effects of neurotoxic agents on peripheral nerve functioning, in addition to the other effects induced by chemotherapeutic agents. The purpose of this article is to review the evaluation, management, and clinical implications of peripheral neuropathy in patients with cancer and diabetes. PMID:18390460

  5. [Chronic prophylaxis of urinary tract infections in diabetic patients].

    PubMed

    Di Mauro, M; Leonardi, R; La Bella, G; Iani, P

    1990-01-01

    A mass screening of 600 diabetic revealed 240 (190 female and 50 male) with urinary infections. The comparative antibiotic efficacy (elimination) and tolerability of Cinoxacin and Norfloxacin were assessed in the treatment of these patients. The traditional protocol (2 daily doses for 10-20 days) was supplemented in every case by chronic prophylaxis (a single daily dose for 10 days each month for 6 months) that was designed to prevent recurrences and the development of chronic urinary infections. Cinoxacin was always found to be faster acting in antibacterial terms than Norfloxacin (at 10 days x2 = p less than 0.01; at 2 degrees, 4 degrees, and 6 degrees month x2 = p less than 0.05) providing a more complete and faster remission of the subjective symptoms, as well as being considerably better tolerated a both locally and systematically than Norfloxacin. PMID:2314619

  6. 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

  7. [Medical nutritional therapy and therapeutic patient education in diabetes].

    PubMed

    Jansà, Margarida; Murillo, Serafin; Vidal, Mercè

    2011-05-01

    This article includes an introduction to the current approach to dietary treatment of diabetes. Are provided the nutritional recommendations to primary secondary and tertiary prevention of diabetes, as recommended by the American Diabetes Association (ADA) adapted to different types of diabetes, treatments and special situations. Secondly, it introduces the concept of Therapeutic Education, especially education and nutritional diet for persons with diabetes and their families, the educational objectives in food according to type of diabetes type 1 or type 2 in different treatment modalities and educational strategies recommended by the Diabetes Education Study Group (wear) of the European Association for the Study of Diabetes (EASD) to facilitate better adherence to dietary treatment. PMID:21776930

  8. Depression and Quality of Life in Patients With Type 2 Diabetes

    PubMed Central

    Derakhshanpour, Firooze; Vakili, Mohammad Ali; Farsinia, Maryam; Mirkarimi, Kamal

    2015-01-01

    Background: Frequency of mood disorders in patients with chronic diseases, especially diabetes and its effects on life quality are dramatically increasing. Objectives: This study aimed to investigate the relation between depression and quality of life in patients with diabetes. Patients and Methods: This is a cross sectional survey. Subjects were selected from 330 eligible people referred to the only diabetes clinic in Gorgan City during 6 months, using systematic random sampling. Beak Depression questionnaire and the brief questioner with 26 questions recommended by the World Health Organization (WHOQOL-BREF) were used to measure depression and quality of life, respectively. Data were analyzed through descriptive methods, Chi-square, Independent t test and linear regression model using SPSS16; moreover, P value < 0.05 was considered as significant. Results: In total, 330 patients with diabetes (35.5 % male and 64.5% women) were studied. The mean and standard deviation of their age and years involved with diabetes were 50.6 ± 9.0 and 5.4 ± 4.5 years, respectively. Range of age was 25 - 75 years, as well. The prevalence of depression in all patients with diabetes was 58.2% (124 mild, 56 medium, and 12 with severe depression). Hypertension was 13.9% more in diabetic patients with depression (P value < 0.001) and physical activity in 24.7% of the cases was less with a meaningful difference (P value = 0.01). The mean and standard deviation of quality of life in diabetic patients with and without depression was 50.7 ± 14 and 60.5 ± 13.3, respectively that was significant in two groups (P < 0.0001). Conclusions: The prevalence of depression is high in patients with diabetes and has a considerable impact on the consequences of diabetes and quality of life too.

  9. High prevalence of lower extremity peripheral artery disease in type 2 diabetes patients with proliferative diabetic retinopathy.

    PubMed

    Chen, Yi-Wen; Wang, Ying-Ying; 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 ?60 mL/min/1.73 m2 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

  10. Time trends of surgical treatment and the prognosis for Japanese patients with gastric cancer

    PubMed Central

    Maehara, Y; Kakeji, Y; Oda, S; Takahashi, I; Akazawa, K; Sugimachi, K

    2000-01-01

    The incidence of gastric cancer is much higher in Japan than in other countries even though diagnostics and treatments of such patients have improved. The objective of this study was to present an overview of the past, present and future of surgical treatment for our patients with gastric cancer. We analysed data on 2152 Japanese men and women with gastric cancer who underwent surgical resection from 1965 to 1995 at Kyushu University in Fukuoka, Japan, based on a univariate and the multivariate analysis. We focused on time trends of surgical treatment and the postoperative outcome. Over the years, there have been favourable changes in the numbers of patients with early gastric cancer. In all cases of gastric cancer, the rate of 18% in the first six year period (group 1) was 57% in the last 5 year period (group 6). Size of the tumour was smaller, well-differentiated tumour tissue was more common, and lymphatic involvement was less frequent. Lymph node metastasis, liver metastasis and peritoneal dissemination all decreased. Extensive lymph node dissection was more frequently done and the rate of curative resection (curability A and B) increased. With increases in identifying the early stage of cancer and better perioperative care, mortality rates 30 days after the surgery greatly decreased. Multivariate analysis revealed that the 10 factors of depth of invasion, lymph node metastasis, lymph node dissection, tumour size, liver metastasis, peritoneal dissemination, lymphatic invasion, vascular invasion, lesion in the whole stomach and lesion in the middle stomach were independent factors for determining the prognosis. Detection of the tumour in an early stage, standardized surgical treatment, including routine lymph node dissection, close follow-up schedules and better perioperative management are expected to increase survival time for patients with this malignancy. © 2000 Cancer Research Campaign PMID:10993643

  11. 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

  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. Early peri-operative hyperglycaemia and renal allograft rejection in patients without diabetes

    PubMed Central

    Thomas, Merlin C; Moran, John; Mathew, Timothy H; Russ, Graeme R; Mohan Rao, M

    2000-01-01

    Background Patients with diabetes have an increased risk for allograft rejection, possibly related to peri-operative hyperglycaemia. Hyperglycaemia is also common following transplantation in patients without diabetes. We hypothesise that exposure of allograft tissue to hyperglycaemia could influence the risk for rejection in any patient with high sugars. To investigate the relationship of peri-operative glucose control to acute rejection in renal transplant patients without diabetes, all patients receiving their first cadaveric graft in a single center were surveyed and patients without diabetes receiving cyclosporin-based immunosuppression were reviewed (n = 230). Records of the plasma blood glucose concentration following surgery and transplant variables pertaining to allograft rejection were obtained. All variables suggestive of association were entered into multivariate logistic regression analysis, their significance analysed and modeled. Results Hyperglycaemia (>8.0 mmol/L) occurs in over 73% of non-diabetic patients following surgery. Glycaemic control immediately following renal transplantation independently predicted acute rejection (Odds ratio=1.08). 42% of patients with a glucose < 8.0 mmol/L following surgery developed rejection compared to 71% of patients who had a serum glucose above this level. Hyperglycaemia was not associated with any delay of graft function. Conclusion Hyperglycaemia is associated with an increased risk for allograft rejection. This is consistent with similar findings in patients with diabetes. We hypothesise a causal link concordant with epidemiological and in vitro evidence and propose further clinical research. PMID:11038266

  14. Hours of work and the risk of developing impaired fasting glucose or type 2 diabetes mellitus in Japanese male office workers

    PubMed Central

    Nakanishi, N; Nishina, K; Yoshida, H; Matsuo, Y; Nagano, K; Nakamura, K; Suzuki, K; Tatara, K

    2001-01-01

    OBJECTIVE—To investigate the association between duration of overtime and the development of impaired fasting glucose (IFG) or type 2 diabetes mellitus (DM).?METHODS—A cohort of 1266 Japanese male office workers aged 35-59 years and free of IFG (fasting plasma glucose concentration 6.1-6.9 mmol/l), type 2 DM (fasting plasma glucose concentration of 7.0 mmol/l or more or taking hypoglycaemic medication), history of diabetes, or medication for hypertension were re-examined over 5 successive years after their initial examinations in 1994.?RESULTS—138 men developed IFG or type 2 DM during the 5736 person-years of follow up. After controlling for potential predictors of diabetes, the relative risks of IFG or type 2 DM, compared with those who worked <8.0 hours a day, were 0.82 (95% confidence interval (95% CI) 0.54 to 1.26), 0.69 (95% CI 0.38 to 1.26), 0.63 (95% CI: 0.37 to 1.09), and 0.50 (95% CI: 0.25 to 0.98) for those who worked 8.0-8.9, 9.0-9.9, 10.0-10.9, and of 11.0 hours or more a day, respectively (p for trend=0.020). 87 and 54 men developed IFG and type 2 DM during the 5817 and 5937 person-years of follow up, respectively. The multivariate adjusted relative risks of IFG tended to decrease with an increase in hours of overtime work a day, but did not reach significance (p for trend=0.202). On the other hand, the multivariate adjusted relative risks of type 2 DM significantly decreased with an increase in hours of overtime work a day (p for trend=0.014).?CONCLUSION—Longer overtime is a negative risk factor for the development of IFG or type 2 DM in Japanese male office workers.???Keywords: long overtime; impaired fasting glucose; type 2 diabetes mellitus PMID:11511743

  15. Patient-provider communication and trust in relation to use of an online patient portal among diabetes patients: The Diabetes and Aging Study.

    PubMed

    Lyles, Courtney R; Sarkar, Urmimala; Ralston, James D; Adler, Nancy; Schillinger, Dean; Moffet, Howard H; Huang, Elbert S; Karter, Andrew J

    2013-01-01

    Patient-provider relationships influence diabetes care; less is known about their impact on online patient portal use. Diabetes patients rated provider communication and trust. In this study, we linked responses to electronic medical record data on being a registered portal user and using secure messaging (SM). We specified regression models to evaluate main effects on portal use, and subgroup analyses by race/ethnicity and age. 52% of subjects were registered users; among those, 36% used SM. Those reporting greater trust were more likely to be registered users (relative  risk (RR)=1.14) or SM users (RR=1.29). In subgroup analyses, increased trust was associated with being a registered user among white, Latino, and older patients, as well as SM use among white patients. Better communication ratings were also related to being a registered user among older patients. Since increased trust and communication were associated with portal use within subgroups, this suggests that patient-provider relationships encourage portal engagement. PMID:23676243

  16. Prognosis of Japanese patients with previously untreated metastatic renal cell carcinoma in the era of molecular-targeted therapy.

    PubMed

    Shinohara, Nobuo; Obara, Wataru; Tatsugami, Katsunori; Naito, Sei; Kamba, Tomomi; Takahashi, Masayuki; Murai, Sachiyo; Abe, Takashige; Oba, Koji; Naito, Seiji

    2015-05-01

    A multicenter cooperative study was conducted to clarify the prognosis of Japanese patients with metastatic renal cell carcinoma in the era of molecular-targeted therapy and the clinical usefulness of the Japanese metastatic renal cancer (JMRC) prognostic classification. Of 389 consecutive patients for whom treatment was started between 2008 and 2010 at 23 hospitals in Japan, 357 patients who received vascular endothelial growth factor receptor-tyrosine kinase inhibitor (VEGFR-TKI) or cytokine as initial systemic therapy were the subject of the present study. Patients were classified into three prognostic groups according to the JMRC prognostic classification. The endpoints were progression-free survival (PFS) and overall survival (OS) after the start of the initial treatment. The median PFS and OS for the entire cohort of 357 patients were 9.1 and 27.2 months, respectively. VEGFR-TKI were selected for patients with multiple organ metastases, those with liver metastasis, and those with bone metastasis. The median PFS and OS were 11.0 and 23.2 months and 5.4 and 38.2 months in the VEGFR-TKI group and the cytokines group, respectively. The JMRC prognostic classification was useful as a prognostic model for PFS and OS (c-indexes: 0.613 and 0.630 in patients who initially received VEGFR-TKI and 0.647 and 0.642 in patients who received cytokines, respectively). The present study showed for the first time the prognosis of Japanese patients with metastatic renal cell carcinoma in the era of molecular-targeted therapy. The JMRC prognostic classification may be clinically useful as a prognostic model. PMID:25711777

  17. Evidence for a Specific Diabetic Cardiomyopathy: An Observational Retrospective Echocardiographic Study in 656 Asymptomatic Type 2 Diabetic Patients

    PubMed Central

    Pham, Isabelle; Cosson, Emmanuel; Nguyen, Minh Tuan; Banu, Isabela; Genevois, Isabelle; Poignard, Patricia; Valensi, Paul

    2015-01-01

    Aim. Our aim was to assess the prevalence of subclinical diabetic cardiomyopathy, occurring among diabetic patients without hypertension or coronary artery disease (CAD). Methods. 656 asymptomatic patients with type 2 diabetes for 14 ± 8 years (359 men, 59.7 ± 8.7 years old, HbA1c 8.7 ± 2.1%) and at least one cardiovascular risk factor had a cardiac echography at rest, a stress cardiac scintigraphy to screen for silent myocardial ischemia (SMI), and, in case of SMI, a coronary angiography to screen for silent CAD. Results. SMI was diagnosed in 206 patients, and 71 of them had CAD. In the 157 patients without hypertension or CAD, left ventricular hypertrophy (LVH: 24.1%) was the most frequent abnormality, followed by left ventricular dilation (8.6%), hypokinesia (5.3%), and systolic dysfunction (3.8%). SMI was independently associated with hypokinesia (odds ratio 14.7 [2.7–81.7], p < 0.01) and systolic dysfunction (OR 114.6 [1.7–7907], p < 0.01), while HbA1c (OR 1.9 [1.1–3.2], p < 0.05) and body mass index (OR 1.6 [1.1–2.4], p < 0.05) were associated with systolic dysfunction. LVH was more prevalent among hypertensive patients and hypokinesia in the patients with CAD. Conclusion. In asymptomatic type 2 diabetic patients, diabetic cardiomyopathy is highly prevalent and is predominantly characterized by LVH. SMI, obesity, and poor glycemic control contribute to structural and functional LV abnormalities.

  18. Cost-Effectiveness of a Diabetes Pay-For-Performance Program in Diabetes Patients with Multiple Chronic Conditions

    PubMed Central

    Hsieh, Hui-Min; Gu, Song-Mao; Shin, Shyi-Jang; Kao, Hao-Yun; Lin, Yi-Chieh; Chiu, Herng-Chia

    2015-01-01

    Pay for performance (P4P) has been used as a strategy to improve quality for patients with chronic illness. Little was known whether care provided to individuals with multiple chronic conditions in a P4P program were cost-effective. This study investigated cost effectiveness of a diabetes P4P program for caring patients with diabetes alone (DM alone) and diabetes with comorbid hypertension and hyperlipidemia (DMHH) from a single payer perspective in Taiwan. Analyzing data using population-based longitudinal databases, we compared costs and effectiveness between P4P and non-P4P diabetes patient groups in two cohorts. Propensity score matching (PSM) was used to match comparable control groups for intervention groups. Outcomes included life-years, quality-adjusted life-years (QALYs), program intervention costs, cost-savings and incremental cost-effectiveness ratios (ICERs). QALYs for P4P patients and non-P4P patients were 2.80 and 2.71 for the DM alone cohort and 2.74 and 2.66 for the DMHH patient cohort. The average incremental intervention costs per QALYs was TWD$167,251 in the DM alone cohort and TWD$145,474 in the DMHH cohort. The average incremental all-cause medical costs saved by the P4P program per QALYs were TWD$434,815 in DM alone cohort and TWD$506,199 in the DMHH cohort. The findings indicated that the P4P program for both cohorts were cost-effective and the resulting return on investment (ROI) was 2.60:1 in the DM alone cohort and 3.48:1 in the DMHH cohort. We conclude that the diabetes P4P program in both cohorts enabled the long-term cost-effective use of resources and cost-savings, especially for patients with multiple comorbid conditions. PMID:26173086

  19. Efficacy of misoprostol in the treatment of tinnitus in patients with diabetes and\\/or hypertension

    Microsoft Academic Search

    Babur Akkuzu; Ismail Yilmaz; Ozcan Cakmak; Levent N. Ozluoglu

    2004-01-01

    Objective: To determine the efficacy of the prostaglandin E1 analogue misoprostol in the treatment of tinnitus in diabetic and\\/or hypertensive patients. Design: Double-blind, randomized, placebo-controlled trial. Settings: Tertiary care referral center. Methods: The subjects were 42 patients with hypertension and\\/or diabetes mellitus who had chronic tinnitus and had experienced tinnitus symptoms for a minimum of 6 months. Twenty-eight patients were

  20. Profile of patients with diabetes in Eritrea: results of first phase registry analyses

    Microsoft Academic Search

    Berhane Seyum; Goitom Mebrahtu; Abdulmumini Usman; Jacob Mufunda; Beyene Tewolde; Solomon Haile; Andrew Kosia; Ermias Negassi

    2010-01-01

    A cross-sectional descriptive study was done on patients recently entered into the National Diabetes Registry in Eritrea where\\u000a the prevalence was estimated to be 2.2% based on patient information in 2004. Of the 627 patients with diabetes, two thirds\\u000a were type 2. Although type 1 had poorer control (42.9%) than type 2 (29.9%), some of the risk factors such as

  1. Routine MRI findings of the asymptomatic foot in diabetic patients with unilateral Charcot foot

    Microsoft Academic Search

    Ludger W Poll; Ernst A Chantelau

    2010-01-01

    BACKGROUND: Imaging studies of bones in patients with sensory deficits are scarce. AIM: To investigate bone MR images of the lower limb in diabetic patients with severe sensory polyneuropathy, and in control subjects without sensory deficits. METHODS: Routine T1 weighted and T2-fat-suppressed-STIR-sequences without contrast media were performed of the asymptomatic foot in 10 diabetic patients with polyneuropathy and unilateral inactive

  2. Increased serum adiponectin levels in type 1 diabetic patients with microvascular complications

    Microsoft Academic Search

    J. Frystyk; L. Tarnow; T. Krarup Hansen; H.-H. Parving; A. Flyvbjerg

    2005-01-01

    Aims\\/hypothesis  Low serum adiponectin (ADPN) has been associated with increased risk of cardiovascular disease (CVD) and retinopathy in patients with type 2 diabetes mellitus. In type 1 diabetic patients, the relationship between ADPN and the presence of vascular complications is largely unknown.Methods  We investigated the relationship between serum ADPN and the presence of retinopathy, nephropathy and CVD in patients with type 1

  3. EVALUATION OF CARDIAC RISK BY OXIDATIVE STRESS AND INFLAMMATORY MARKERS IN DIABETIC PATIENTS

    Microsoft Academic Search

    Dilshad Ahmed Khan; Shazia Qayyum

    Objectives: To evaluate the diabetic patients for cardiac risk by measuring oxidative stress and inflammatory markers in relation with glycaemic control. Methodology: A total of 140 subjects were included in this case-control study, comprising of 70 diabetic patients with coronary heart disease (CHD) and an equal number, age and sex matched controls. The patients were non-alcoholic and had age >40years,

  4. Relation of diabetic patients' health-related control appraisals and physician-patient interpersonal impacts to patients' metabolic control and satisfaction with treatment.

    PubMed

    Auerbach, Stephen M; Clore, John N; Kiesler, Donald J; Orr, Tamara; Pegg, Phillip O; Quick, Ben G; Wagner, Christopher

    2002-02-01

    Desire for healthcare control, health locus of control, perceived control over diabetes, satisfaction with diabetes treatment, and general personality traits were assessed in 54 Type 1 and Type 2 diabetic patients of the same male endocrinologist during a regularly scheduled office visit. At the end of the consultation, both patients and the physician completed a measure describing the interpersonal impacts produced in each by the other's control and affiliation behaviors. Patient success at diabetes control was assessed via glycosylated hemoglobin A1C (HA1C) level on the day of the visit and variability in HA1C levels across several visits. Patients' satisfaction with treatment was unrelated to diabetes control measures. Patients' desire for behavioral involvement in their own healthcare and NEO Agreeableness scores were positively associated with diabetes control. Better diabetes control also resulted when the physician perceived patients to be more controlling and less submissive, and when there was more reciprocity in patient and physician's perceptions of the other's controlling interpersonal behavior. Findings support the conclusion that both a patient's self-reported desire for involvement in his or her healthcare and the transactional fit of patient-physician interpersonal behaviors are potentially important contributors to better diabetes outcomes. PMID:11845556

  5. Vascular defect beyond the endothelium in type II diabetic patients with overt nephropathy and moderate renal insufficiency

    Microsoft Academic Search

    W B Chan; N N Chan; C W K Lai; W Y So; M K W Lo; K F Lee; C C Chow; C Metreweli; J C N Chan

    2006-01-01

    There is a paucity of data on the effects of overt nephropathy and moderate renal impairment on endothelial function in diabetic patients. A total of 26 type II diabetic (DM) patients with nephropathy (DMN+) (mean±s.d. age: 63.7±6.3 years), 32 diabetic patients without nephropathy (DMN?) (59.4±10.1 years), and 52 non-diabetic subjects (54.9±8.2 years) were recruited. High-resolution ultrasound scan was used to

  6. Simultaneous pancreas-kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease

    Microsoft Academic Search

    Bryan N. Becker; Peter C. Brazy; Yolanda T. Becker; Jon S. Odorico; Thomas J. Pintar; Bradley H. Collins; John D. Pirsch; Glen E. Leverson; Dennis M. Heisey; Hans W. Sollinger

    2000-01-01

    Simultaneous pancreas-kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease.BackgroundDiabetic renal disease continues to be the most significant cause of end-stage renal disease (ESRD) in the United States. Renal transplantation improves diabetic ESRD patient survival; however, the diabetic state remains associated with poor patient survival. Simultaneous pancreas-kidney (SPK) transplantation can restore normoglycemia and thus may

  7. Adiponectin serum levels correlate with insulin resistance in type 2 diabetic patients

    PubMed Central

    Aleidi, Shereen; Issa, Ala; Bustanji, Haidar; Khalil, Mohammad; Bustanji, Yasser

    2014-01-01

    The adipose tissue is not only an inert storage depot for lipids, but also it secretes a variety of bioactive molecules, known as adipokines, which affect whole-body homeostasis. Adiponectin is the most abundant of these adipocytokines and is known to have a regulatory effect on the metabolism of glucose and lipid. The main objectives of this study were to evaluate the serum levels of adiponectin and to establish a correlation between adiponectin serum levels and the degree of insulin resistance in type 2 diabetic patients. Eighty participants were enrolled in this study; 61 type 2 diabetic patients and 19 apparently healthy subjects. Serum level of adiponectin was measured by enzyme-linked immunosorbent assay (ELISA) for each participant. Data collection sheet was filled with all required information for each participant. Adiponectin level in the diabetic patients (5.05 ± 2.61 ?g/ml) was lower than in non-diabetic healthy controls (5.71 ± 2.35 ?g/ml). When the results were compared according to gender, diabetic females showed significantly higher adiponectin levels (5.76 ± 2.64 ?g/ml) than diabetic males (4.366 ± 2.43 ?g/ml, P = 0.035). In addition, female diabetic patients with abdominal obesity (waist circumference (WC) ? 88 cm) had lower adiponectin levels (5.58 ± 2.58 ?g/ml) than diabetic females without abdominal obesity (6.96 ± 3.12 ?g/ml). The correlation analysis indicated that adiponectin had a significant positive correlation with age (r = ?0.450, P < 0.001). In conclusion, female diabetic patients had a statistically significant higher adiponectin level than male diabetic patients which could indicate a gender effect. Adiponectin levels were inversely related to insulin resistance; as patients with abdominal obesity had lower serum levels of adiponectin.

  8. Comparison of Plasma Oxidative Biomarkers and Conformational Modifications of Hemoglobin in Patients With Diabetes on Hemodialysis

    PubMed Central

    Ansarihadipour, Hadi; Dorostkar, Hamidreza

    2014-01-01

    Background: Diabetes is associated with an increased generation of reactive oxygen species (ROS), which plays an important role in the development of oxidative stress and anemia. Objectives: The main purpose of this study was to investigate whether patients with diabetes undergoing hemodialysis (HD) were susceptible to oxidative stress and whether resulting damages affect the structure of hemoglobin (Hb) and plasma proteins. Patients and Methods: Twenty patients with diabetes undergoing HD, 20 patients with diabetes and normal renal function, and 20 age- and sex-matched healthy subjects were included in this study. Methaemoglobin (Met-Hb), hemichrome and conformational changes of Hb were analyzed as oxidative markers in erythrocytes. Ferric reducing ability of plasma (FRAP) and protein carbonyl content (PCO) were determined as plasma oxidative biomarkers. Also triglyceride, cholesterol, albumin, blood urea nitrogen (BUN), creatinine, glucose and uric acid were assayed as biochemical parameters of plasma. Results: Patients with diabetes undergoing hemodialysis had significantly lower levels of PCO and albumin (P < 0.05), but significantly higher levels of FRAP, BUN, creatinine and uric acid (P < 0.05) as compared to patients with diabetes and normal renal function. Linear regression analysis showed significant negative correlations between PCO and FRAP (r = -0.53), oxy-Hb (r = -0.88) and Hb absorbance at 340 nm (r = -0.79), 420 nm (r = -0.85) and 577 nm (r = -0.68) in patients with diabetes undergoing hemodialysis. Also PCO was significantly and positively correlated with Hb absorbance at 275 nm (r = 0.63) and 560 nm (r = 0.61) which confirmed the oxidative damage to erythrocytes in control subjects. Conclusions: Hemodialysis exacerbates oxidative stress and conformational changes of Hb in patients with diabetes on hemodialysis. The FRAP value can be used as a positive determinant, while PCO and Hb derivatives can be used as negative determinants of oxidative stress in patients with diabetes. PMID:25763223

  9. Japanese and North American\\/European patients with Beckwith–Wiedemann syndrome have different frequencies of some epigenetic and genetic alterations

    Microsoft Academic Search

    Kensaku Sasaki; Hidenobu Soejima; Ken Higashimoto; Hitomi Yatsuki; Hirofumi Ohashi; Shinya Yakabe; Keiichiro Joh; Norio Niikawa; Tsunehiro Mukai

    2007-01-01

    Beckwith–Wiedemann syndrome (BWS) is an imprinting-related human disease. The frequencies of causative alterations such as loss of methylation (LOM) of KvDMR1, hypermethylation of H19-DMR, paternal uniparental disomy, CDKN1C gene mutation, and chromosome abnormality have been described for North American and European patients, but the corresponding frequencies in Japanese patients have not been measured to date. Analysis of 47 Japanese cases

  10. Diabetes

    NSDL National Science Digital Library

    Dr. Leslie Nader (MSMR)

    1993-04-14

    Diabetes, in a variety of forms, affects many Americans and is the 4th leading cause of death by disease in the US. Diabetes is fundamentally a disease in which the body cannot produce or effectively use a critical hormone called insulin. Untreated / unmanaged diabetes can lead to blindness, kidney failure, heart disease, loss of limbs and stroke.

  11. [A multi-disciplinary approach to diabetic foot patients--an organizational model for the treatment of leg complications in diabetic patients].

    PubMed

    Zandman-Goddard, Gisele; Feldbrin, Zeev; Ovadia, Shmuel; Zubkov, Tatiana; Lipkin, Alexander; Wainstein, Julio; Vainstein, Hulio

    2011-07-01

    Diabetes mellitus is the major cause of non-traumatic limb amputations in the Western world. In the diabetic foot patient, 85% have developed a leg ulcer prior to limb amputation. Due to the complicated nature of therapy in such patients, a multi-disciplinary approach is warranted. In this review, we describe an organizational model which provides an immediate solution to the factors involved in the evolution of a diabetic foot. At the end of 2002, The Wolfson Medical Center administration decided to centralize the diabetic foot patients into one unit situated in the Department of Medicine C. Ten beds were allocated for this purpose and situated at the far end of the department reducing the potential spread of infections to the rest of the ward. With the opening of the unit, a multi-disciplinary team was established that included internists, orthopedists, vascular surgeons, diabeticians, infectious disease specialists, and a specialized nursing staff that acquired their expertise while working with the medical staff and consultants including plastic surgeons and orthotists as required. With the initiation of the Diabetic Foot Unit, there was a reduction of 50% in major amputations in the unit when compared to the preceding years. During the years 2003-2004, the major amputation rate dropped to Less than 8%. Treatment of the diabetic foot patient is complex. In order to reduce the morbidity of limb amputation, a Diabetic Foot Unit is justified. In addition, specialized staff working in concert enable a synergistic effort that cannot be acquired individually. Most importantly, the amputation rate can be significantly reduced by utilizing the Diabetic Foot Unit model. PMID:21874770

  12. Mucosal lesions may be a minor complication of SAPHO syndrome: a study of 11 Japanese patients with SAPHO syndrome

    Microsoft Academic Search

    Hiroki Yabe; Hisaji Ohshima; Yoji Takano; Takahiro Koyanagi; Hiroshi Usui; Kensuke Ochi; Michiya Kihara; Yukio Horiuchi

    2010-01-01

    Since the term synovitis–acne–pustulosis–hyperostosis–osteitis (SAPHO) syndrome was proposed by Chamot et al. (Rev Rhum Mal\\u000a Osteoartic 54:187–196, 1987), clinical reviews concerning this syndrome have been mainly reported from Europe. We carried out a retrospective analysis\\u000a of 11 Japanese patients with SAPHO syndrome, and reviewed the clinical features of our series in comparison with those in\\u000a a European large case study.

  13. Effects of the dietary supplements, activated charcoal and copper chlorophyllin, on urinary excretion of trimethylamine in Japanese trimethylaminuria patients

    Microsoft Academic Search

    Hiroshi Yamazaki; Masaki Fujieda; Masahiro Togashi; Tetsuya Saito; George Preti; John R Cashman; Tetsuya Kamataki

    2004-01-01

    Trimethylaminuria (TMAU) is a metabolic disorder characterized by the inability to oxidize and convert dietary-derived trimethylamine (TMA) to trimethylamine N-oxide (TMAO). This disorder has been relatively well-documented in European and North American populations, but no reports have appeared regarding patients in Japan. We identified seven Japanese individuals that showed a low metabolic capacity to convert TMA to its odorless metabolite,

  14. Mutations in the CLCN5 gene in Japanese patients with familial idiopathic low-molecular-weight proteinuria

    Microsoft Academic Search

    Hitoshi Nakazato; Shinzaburo Hattori; Akio Furuse; Tomoyasu Kawano; Shinnyo Karashima; Motoko Tsuruta; Junichiro Yoshimuta; Fumio Endo; Ichiro Matsuda

    1997-01-01

    Mutations in the CLCN5 gene in Japanese patients with familial idiopathic low-molecular-weight proteinuria. Familial idiopathic low-molecular-weight proteinuria (FILMWP) is a renal proximal tubulopathy that occurs predominantly in males. FILMWP is characterized by mild proteinuria consisting of low-molecular-weight proteinuria, aminoaciduria and relatively conserved renal function, but without rickets. To determine whether FILMWP is related to the CLCN5 gene, which is responsible

  15. Effects of passive static stretching on blood glucose levels in patients with type 2 diabetes mellitus

    PubMed Central

    Park, Seong Hoon

    2015-01-01

    [Purpose] This study determined the effects of passive static stretching on blood glucose levels in patients with type 2 diabetes. [Subjects] Fifteen patients (8 males and 7 females) with type 2 diabetes were recruited and randomly assigned to the control group or passive static stretching group. [Methods] Glycated hemoglobin was measured before and after the 8-week training period. [Results] Glycated hemoglobin levels decreased significantly in the passive static stretching group, and there were significant differences in blood glucose levels between the 2 groups. [Conclusion] Passive static stretching of the skeletal muscles may be an alternative to exercise to help regulate blood glucose levels in diabetes patients.

  16. 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

  17. Scintigraphic Evaluation of Left Ventricular Function and Correlation with Autonomic Cardiac Neuropathy in Diabetic Patients

    Microsoft Academic Search

    Tomris Erbas; Belkis Erbas; Okay Gedik; Sevinc Bïberoglu; Coskun F. Bekdik

    1992-01-01

    Left ventricular function of 20 diabetic patients was investigated at rest and during hand-grip test using radionuclide ventriculography. The aim of the study was to discuss the correlation of cardiac function with autonomic cardiac neuropathy (ACN) in diabetic subjects. ACN was tested using heart rate response to valsalva maneuver, standing up, deep breathing; blood pressure response to standing up, sustained

  18. Determinants of Quality of Life in Primary Care Patients with Diabetes: Implications for Social Workers

    ERIC Educational Resources Information Center

    Ayalon, Liat; Gross, Revital; Tabenkin, Hava; Porath, Avi; Heymann, Anthony; Porter, Boaz

    2008-01-01

    Using a cross-sectional design of 400 primary care patients with diabetes, the authors evaluated demographics, health status, subjective health and mental health, health behaviors, health beliefs, knowledge of diabetes treatment, satisfaction with medical care, and quality of medical care as potential predictors of QoL and QoL in the hypothetical…

  19. The prevalence of macrovascular complications among diabetic patients in the United Arab Emirates

    Microsoft Academic Search

    Fatma Al-Maskari; Mohammed El-Sadig; John N Norman

    2007-01-01

    BACKGROUND: Diabetes Mellitus (DM) is a major public health problem in the UAE with a prevalence rate reaching 24% in national citizens and 17.4% in expatriates. The aim of this study was to determine the prevalence and risk factors of macrovascular complications among diabetic patients in the Al-Ain district of the United Arab Emirates (UAE). METHODS: The study was part

  20. Diabetes Control among Vietnamese Patients in Ho Chi Minh City: An Observational Cross-Sectional Study

    ERIC Educational Resources Information Center

    Yokokawa, Hirohide; Khue, Nguyen Thy; Goto, Aya; Nam, Tran Quang; Trung, Tran The; Khoa, Vo Tuan; Ngoc, Nguyen Thi Boi; Minh, Pham Nghiem; Vinh, Nguyen Quang; Okayama, Akira; Yasumura, Seiji

    2010-01-01

    The objective of this study was to assess the extent of diabetic control and its associated factors among Vietnamese patients with diabetes mellitus (DM). The study was conducted among 652 outpatients who were recruited at a public general hospital (People Hospital 115) and a private clinic (Medic Center) in Ho Chi Minh City, Vietnam. Median age…

  1. The relationship between anxiety, coping strategies and characteristics of patients with diabetes

    Microsoft Academic Search

    Tarik Tuncay; Ilgen Musabak; Deniz Engin Gok; Mustafa Kutlu

    2008-01-01

    BACKGROUND: This study provided essential information, about Turkish patients with type I and type II diabetes, concerning: levels of anxiety, coping strategies used, and relationships that exist among anxiety, coping strategies, sociodemographic and medical characteristics. METHODS: A sample comprising 161 Turkish adults with both types of diabetes participated in the study. The trait anxiety scale, the brief COPE, sociodemographic and

  2. Protection from retinopathy and other complications in patients with type 1 diabetes of extreme duration

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We performed a cross-sectional, observational study of 351 U.S. residents with at least 50 years of insulin-dependent diabetes. Longitudinal data on retinopathy progression was obtained via chart review in patients followed at the Joslin Diabetes Center eye clinic (Boston, MA). HbA1c was determined ...

  3. Postgraduate education needs of Nurses’ who are caregivers for patients with diabetes

    PubMed Central

    U?ur, Esra; Demir, Hulya; Akbal, Elif

    2015-01-01

    Objective: Diabetic management process requires nurses with expert knowledge and patient care skills. This study was carried out to identify nurses’ diabetic care approaches and their post graduate education needs in order to develop a “Basic Diabetes Patient Care Education Program” in a university hospital in Turkey. Methods: The descriptive study, using the survey technique, was carried out in a university hospital with 87 bedside nurses who were caring for diabetic patients. Investigators developed data collection tool consisting of closed ended questions and opportunities for open-ended responses. Results: Among the 87 nurses, 88.5% were staff nurses, and 11.5% were nurse managers. The mean age was 27.41 ± 4.82 and years of professional experience was 6.86 ± 4.23. The 41.4% of nurses stated that they were caring for 1-2 patients with diabetes per week and 72.4% of nurses stated that they had attended an educational session about diabetes after graduation. The 95.4% of nurses reported a need for a continuous education program for diabetes patient care. Medication regimen (69.0%) and special care applications such as wound care (54.0%) were the most needed educational requirements. There were no difference in educational needs based on basic education or years of professional experience (p>0.05). Conclusions: Nurses caring for patients with diabetes should be supported by orientation, in-service education and continuing education programs. Additionally, the placement of patient care courses for chronic diseases, like diabetes, into the core curriculum of nursing schools would be useful in responding to actual patient care and family needs. PMID:26150859

  4. Efficacy of lipid lowering drug treatment for diabetic and non-diabetic patients: meta-analysis of randomised controlled trials

    Microsoft Academic Search

    João Costa; Margarida Borges; Cláudio David; António Vaz Carneiro

    2010-01-01

    Objective To evaluate the clinical benefit of lipid lowering drug treatment in patients with and without diabetes mellitus, for primary and secondary prevention. Design Systematic review and meta-analysis. Data sources Cochrane, Medline, Embase, and reference lists up to April 2004. Study selection Randomised, placebo controlled, double blind trials with a follow-up of at least three years that evaluated lipid lowering

  5. VDR, RXR, Coronin-1 and Interferon? Levels in PBMCs of Type-2 Diabetes Patients: Molecular Link between Diabetes and Tuberculosis.

    PubMed

    Syal, Kirtimaan; Srinivasan, Anand; Banerjee, Dibyajyoti

    2015-07-01

    Diabetes and tuberculosis are world's most deadly epidemics. People suffering from diabetes are susceptible to tuberculosis. Molecular link between the two is largely unknown. It is known that Vitamin A receptor (RXR) heterodimerizes with Vitamin D receptor (VDR) and Peroxisome proliferator-activator receptor-? (PPAR?) to regulate Tryptophan-aspartate containing coat protein (TACO) expression and fatty acid metabolism respectively, so it would be interesting to check the expression of these genes in diabetes mellitus (DM) patients which might explain the susceptibility of diabetics to tuberculosis. In this study, we checked the expression of RXR, VDR, TACO and Interferon-? (IFN?) genes in type-2 DM patients for understanding the link between the two diseases. We observed down regulation of RXR gene and corresponding up regulation of TACO gene expression. We have not observed significant change in expression of VDR and IFN? genes in type-2 DM patients. Repression of RXR gene could hamper VDR-RXR heterodimer formation and thus would up regulate TACO gene expression which may predispose the type-2 DM patients to tuberculosis. Also, decrease in RXR-PPAR? heterodimer could be involved in DM. PMID:26089620

  6. Reconstruction of traumatic plantar foot defects in diabetic patients.

    PubMed

    Vaienti, Luca; Palitta, Giovanni; Ravasio, Giovanni; Randelli, Pietro; Arrigoni, Paolo

    2010-05-01

    Plantar reconstruction is often challenging for plastic surgeons because of the peculiar anatomical features of this region. A large variety of reconstructive techniques for the plantar aspect of the foot have been described previously, including skin grafts, local flaps, fasciocutaneous flaps, perforator flaps, cross-limb flaps, and free flaps. This article presents a case of a 64-year-old patient with insulin-dependent diabetes who was involved in a traffic accident that resulted in a large plantar tissue defect (9x4 cm) extending to the base of the toes. After debridement of the wound, a subcutaneous flap was raised from the medial aspect of the lower leg in a sovrafascial plane. The flap was based on a double vascularization given by the great saphenous vein and by the perforator vessels from the posterior tibial artery, located anteriorly and inferiorly to the medial malleolus. The flap showed excellent vitality and long-term result with reduced donor site morbidity. We believe this flap represents a reliable surgical option in superficial plantar defects due to easy harvesting, short operative time, and minimal donor site morbidity. The subcutaneous flap of the distal medial fourth of the leg is a safe technique because of the vascular components of the pedicle. It provides durable coverage, mechanical resistance to pressure and shear stresses and, in selected cases (superficial defects, thin patients), is an interesting option to avoid major free flap procedures. PMID:20506944

  7. [Cardiovascular prevention in diabetic patients: an evidenced-based review].

    PubMed

    Furtado, Mariana Vargas; Polanczyk, Carisi Anne

    2007-03-01

    Diabetes mellitus is a condition associated with cardiac complications, especially artherothrombotic disease. Several studies have demonstrated the importance of reducing cardiovascular burden on this population by adopting prevention strategies. This article revised clinical evidences on cardiovascular risk assessment and prevention actions, taking into consideration major recommendations in the field. Life-style changes with low-carbohydrate diet, weight control, and regular physical activity must be implemented. High-risk patients or with established cardiovascular disease ought to have glycemic levels<100 mg/dL and A1c<7%. It is recommended low dose of aspirin and statin for lipid management, targeting LDL<100 mg/dL, HDL>50 mg/dL and tryglycerides<150 mg/dL. Blood pressure control with non-pharmacological and antihypertensive drugs must be instituted, favoring ACE inhibitors as first option, mainly in patients with renal disease, and combined with tiazydes for the majority to achieve target blood pressure of <130/80 mmHg. PMID:17505640

  8. 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

  9. Acute Zonal Occult Outer Retinopathy in Japanese Patients: Clinical Features, Visual Function, and Factors Affecting Visual Function

    PubMed Central

    Saito, Saho; Saito, Wataru; Saito, Michiyuki; Hashimoto, Yuki; Mori, Shohei; Noda, Kousuke; Namba, Kenichi; Ishida, Susumu

    2015-01-01

    Purpose To evaluate the clinical features and investigate their relationship with visual function in Japanese patients with acute zonal occult outer retinopathy (AZOOR). Methods Fifty-two eyes of 38 Japanese AZOOR patients (31 female and 7 male patients; mean age at first visit, 35.0 years; median follow-up duration, 31 months) were retrospectively collected: 31 untreated eyes with good visual acuity and 21 systemic corticosteroid-treated eyes with progressive visual acuity loss. Variables affecting the logMAR values of best-corrected visual acuity (BCVA) and the mean deviation (MD) on Humphrey perimetry at initial and final visits were examined using multiple stepwise linear regression analysis. Results In untreated eyes, the mean MD at the final visit was significantly higher than that at the initial visit (P = 0.00002). In corticosteroid-treated eyes, the logMAR BCVA and MD at the final visit were significantly better than the initial values (P = 0.007 and P = 0.02, respectively). The final logMAR BCVA was 0.0 or less in 85% of patients. Variables affecting initial visual function were moderate anterior vitreous cells, myopia severity, and a-wave amplitudes on electroretinography; factors affecting final visual function were the initial MD values, female sex, moderate anterior vitreous cells, and retinal atrophy. Conclusions Our data indicated that visual functions in enrolled patients significantly improved spontaneously or after systemic corticosteroids therapy, suggesting that Japanese patients with AZOOR have good visual outcomes during the follow-up period of this study. Furthermore, initial visual field defects, gender, anterior vitreous cells, and retinal atrophy affected final visual functions in these patients. PMID:25919689

  10. Predictors for the development of microalbuminuria and macroalbuminuria in patients with type 1 diabetes: inception cohort study

    Microsoft Academic Search

    Peter Hovind; Lise Tarnow; Peter Rossing; Berit Ruud Jensen; Malene Graae; Inge Torp; Christian Binder; Hans-Henrik Parving

    2004-01-01

    Objective To evaluate baseline predictors for the development of persistent microalbuminuria and macroalbuminuria prospectively in patients with type 1 diabetes. Design Prospective observational study of an inception cohort. Setting Outpatient diabetic clinic in a tertiary referral centre, Gentofte, Denmark. Participants 286 patients (216 adults) newly diagnosed with type 1 diabetes consecutively admitted to the clinic between 1 September 1979 and

  11. Management and in-hospital outcome of patients with first episode of acute myocardial infarction: impact of diabetes mellitus.

    PubMed Central

    Atmaca, Aysegul; Dogan, Serkan; Dagdelen, Selcuk; Kabakci, Giray; Kes, Sirri; Nazli, Nasih; Erbas, Tomris

    2006-01-01

    The aim of this study is to compare clinical characteristics, management, complications, in-hospital outcome and mortality of diabetic and nondiabetic patients after the first episode of acute myocardial infarction (MI). This retrospective case-matched study included 60 diabetic and 55 non-diabetic patients. Medical information about patients was retrieved from the hospital recordings. Diabetic patients were older, were more hypertensive and had more coronary artery disease history than nondiabetic patients. The frequency of use of acute reperfusion therapy modalities was not statistically different between the two groups. Diabetes was a significant determinant against the use of beta blockers (OR=0.26; 95% CI 0.06-0.95) but in favor of angiotensin converting enzyme inhibitors (OR=3.3; 95% CI 1.17-9.36), whereas diabetes did not influence the use of other drugs. Diabetic patients had more complications than nondiabetic patients (40.0% and 16.3%, respectively, p=0.005). In-hospital mortality rate for diabetic patients was comparable to nondiabetic patients (16.7% and 10.9%, respectively, p=0.373). Pharmaceutical treatment regimens, particularly beta blockers, are underutilized after acute MI in diabetic patients. More frequent use of these regimens will improve the high complication and mortality rates in diabetic patients as well as in nondiabetic patients. PMID:17128683

  12. Plantar shear stress distributions in diabetic patients with and without neuropathy

    PubMed Central

    Yavuz, Metin

    2014-01-01

    Background The exact pathology of diabetic foot ulcers remains to be resolved. Evidence suggests that plantar shear forces play a major role in diabetic ulceration. Unfortunately, only a few manuscripts exist on the clinical implications of plantar shear. The purpose of this study was to compare global and regional peak plantar stress values in three groups; diabetic patients with neuropathy, diabetic patients without neuropathy and healthy control subjects. Methods Fourteen diabetic neuropathic patients, 14 non-neuropathic diabetic control and 11 non-diabetic control subjects were recruited. Subjects walked on a custom-built stress plate that quantified plantar pressures and shear. Four stress variables were analyzed; peak pressure, peak shear, peak pressure-time and shear-time integral. Findings Global peak values of peak shear (p=0.039), shear-time integral (p=0.002) and pressure-time integral (p=0.003) were significantly higher in the diabetic neuropathic group. Local peak shear stress and shear-time integral were also significantly higher in diabetic neuropathic patients compared to both control groups, in particular, at the hallux and central forefoot. Local peak pressure and pressure-time integral were significantly different between the three groups at the medial and lateral forefoot. Interpretation Plantar shear and shear-time integral magnitudes were elevated in diabetic patients with peripheral neuropathy, which indicates the potential clinical significance of these factors in ulceration. It is thought that further investigation of plantar shear would lead to a better understanding of ulceration pathomechanics, which in turn will assist researchers in developing more effective preventive devices and strategies. PMID:24332719

  13. Yang Deficiency Body Constitution Acts as a Predictor of Diabetic Retinopathy in Patients with Type 2 Diabetes: Taichung Diabetic Body Constitution Study

    PubMed Central

    Lee, Cheng-Hung; Li, Tsai-Chung; Tsai, Chia-I; Lin, Shih-Yi; Lee, I-Te; Lee, Hsin-Jung; Wu, Ya-Chi; Su, Yi-Chang

    2015-01-01

    Objective. Diabetic retinopathy (DR), the most common microvascular complication of diabetes mellitus (DM), can cause severe visual impairment and blindness. To prevent the development of DR, identifying the associated risk factors for patient classification is critical. We conducted a cross-sectional study to determine whether body constitution (BC) is an independent predictor of DR. Method. 673 type 2 DM (T2DM) patients were recruited from a medical center, all received DR examination and body constitution questionnaire to assess BC. Other risk factors for DR were also recorded, including life style, history of diabetes, and blood pressure, etc. Multiple logistic regression analysis was conducted to calculate the odds ratios (ORs) for DR. Results. The prevalence of DR was significantly lower in Yang deficiency patients compared with non-Yang deficiency patients (24.69% versus 38.18% P = 0.02). After adjusting for other risk factors, we observed that patients exhibiting Yang deficiency BC were less likely to present with DR (OR = 0.531; 95% confidence interval = 0.312–0.903, P = 0.018). Conclusion. In addition to traditional risk factors, Yang deficiency BC might be an independent predictor of DR among T2DM patients and the results can be used as evidence for traditional Chinese medicine patient classification.

  14. [Molecular subgrouping and characterization analysis of medulloblastomas in a cohort of Japanese patients].

    PubMed

    Wataya, Takafumi; Hamasaki, Minoru; Taylor, Michael D

    2015-02-01

    Medulloblastoma is the most common solid malignancy and cause of oncologic death among children. Recent advances in genomic analysis obtained through international large-scale collaborations, Medulloblastoma Advanced Genomics International Consortium(MAGIC), have revealed that medulloblastomas can be classified into at least four distinct subgroups depending on their molecular expression profiles. These studies showed that the prognosis, age distributions, and molecular mechanisms of these subgroups of medulloblastomas completely differ from each other. Here we report the first analysis of molecular subgroups of medulloblastoma in Japanese patients(Shizuoka cohort). Molecular subgroups were predicted for 18 medulloblastomas;and age distributions, radiographic features, and histological characteristics were analyzed. It was predicted that 11% of the medulloblastomas were of the WNT type, 50% of the SHH type, 6% of the group 3 type, and 33% of the group 4 type. The percentage of group 3 type medulloblastomas was smaller than in the MAGIC study, while the percentage of the SHH type was larger. However, age distribution, recurrence-free survival, and overall survival for each group were quite similar to the MAGIC study. In addition, in an imaging study, 78% of patients with medulloblastomas of the SHH type presented tumors in the cerebellar hemispheres. The classical pathohistological hallmarks that may predict medulloblastoma prognosis were mainly seen in tumors of the SHH type. Molecular subgrouping of medulloblastomas could be important in the future, not only for prediction of prognosis, but also for decision making regarding the use of future new treatments such as molecular targeting therapy. The establishment of a public molecular analysis system of medulloblastomas in Japan is greatly desired, and it is currently under development;this database will help establish the molecular diagnosis of medulloblastomas in Japan. PMID:25672552

  15. Application of the COOP/WONCA charts to aged patients with chronic obstructive pulmonary disease: a comparison between Japanese and Chinese populations

    PubMed Central

    2013-01-01

    Background The prevalence of chronic obstructive pulmonary disease (COPD) is similar in Japan and China and is increasing due to high rates of smoking in these countries. Reducing COPD is an important public health issue. The goals of this study were to verify the reliability and validity of the Japanese version of the COOP/WONCA charts, a tool for measuring health status, and to examine the qualitative differences in health status between Japanese and Chinese patients with COPD and between these patients and healthy subjects. Methods From 2008 to 2011, we examined the factors affecting the health status of Japanese and Chinese populations living in six cities. Participants were patients with COPD staged according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria (140 Japanese, 201 Chinese) and healthy subjects (243 Japanese, 199 Chinese), all 50 to 79 years old. Health status was measured by using the COOP/WONCA charts, and basic information such as smoking status and medical history was reported by the participants. Results The Japanese and Chinese versions of the COOP/WONCA charts were shown to be reliable and valid by test-retest, comparison with the SF-36 and respiratory symptoms, and correlation of results obtained from patients and their physicians. Stepwise multiple regression analyses demonstrated that “Physical fitness”, “Daily activities”, and “Social activities” were predicted by COPD status and/or respiratory symptoms; “Feelings” by nationality and respiratory symptoms; “Pain” by sex and respiratory symptoms; and “Overall health” by nationality. When the COOP/WONCA scores were stratified by nationality, age, sex, and COPD status, the difference of each score between the patients and healthy subjects was larger for the Chinese subjects than for the Japanese. The physical, psychosocial activities, and pain scores increased significantly as COPD status worsened in Chinese subjects, whereas these scores were not affected by sex, age, or COPD status for Japanese subjects. Brinkman index and use of smoky fuel indoors affected the COOP/WONCA scores in Chinese patients but not in Japanese patients. Conclusions The Japanese COOP/WONCA charts are reliable and valid. COPD more severely affected the health status of Chinese participants than of Japanese participants. These results suggest that countermeasures against insufficient health care and smoky environments may improve the health status of Chinese patients with COPD. PMID:23945173

  16. Comparative study of dental cephalometric patterns of Japanese-Brazilian, Caucasian and Mongoloid patients

    PubMed Central

    Sathler, Renata; Pinzan, Arnaldo; Fernandes, Thais Maria Freire; de Almeida, Renato Rodrigues; Henriques, José Fernando Castanha

    2014-01-01

    Introduction The objective of this study was to identify the patterns of dental variables of adolescent Japanese-Brazilian descents with normal occlusion, and also to compare them with a similar Caucasian and Mongoloid sample. Methods Lateral cephalometric radiographs were used to compare the groups: Caucasian (n = 40), Japanese-Brazilian (n = 32) and Mongoloid (n = 33). The statistical tests used were one-way ANOVA and ANCOVA. The cephalometric measurements used followed the analyses of Steiner, Tweed and McNamara Jr. Results Statistical differences (P < 0.05) indicated a smaller interincisal angle and overbite for the Japanese-Brazilian sample, when compared to the Caucasian sample, although with similar values to the Mongoloid group. Conclusion The dental patterns found for the Japanese-Brazilian descents were, in general, more similar to those of the Mongoloid sample. PMID:25279521

  17. Role of early screening for diabetic retinopathy in patients with diabetes mellitus: an overview.

    PubMed

    Vashist, Praveen; Singh, Sameeksha; Gupta, Noopur; Saxena, Rohit

    2011-10-01

    Diabetes has emerged as a major public health problem in India. It is estimated that there were 40 million persons with diabetes in India in 2007 and this number is predicted to rise to almost 70 million by 2025. The impact of rapid urbanization, industrialization and lifestyle changes has led to an increasing trend in prevalence of diabetes and its associated complications such as neuropathy, nephropathy, vascular diseases (cardiac, cerebral and peripheral) and retinopathy. Diabetic retinopathy is a important cause of avoidable blindness in India. Treatment interventions at early stages of diabetic retinopathy can reduce burden of blindness due to diabetic retinopathy. With the available cost-effective methods of early screening, appropriate strategies/models need to be developed. Such models need to have a well-developed mode for screening, diagnosis and referral at each hierarchal level beginning from primary health centers to specialized institutes for eye care. The National Program for Control of Blindness of India recommends opportunistic screening for identification of diabetic retinopathy. Every opportunity of contact with high-risk cases for diabetes and/or diabetic retinopathy should be utilized for screening, diagnosis and referral. All the stakeholders including the private sector will need to play a role. Along with this, awareness generation and behavior change amongst the diabetics and care support systems should also be part of the overall model. A major role can be played by community participation and improving the health seeking behavior among diabetics in order to reach a larger population and increasing the compliance for continued care. PMID:22279252

  18. Age ? 60 years was an independent risk factor for diabetes-related complications despite good control of cardiovascular risk factors in patients with type 2 diabetes mellitus.

    PubMed

    Chew, Boon How; Ghazali, Sazlina Shariff; Ismail, Mastura; Haniff, Jamaiyah; Bujang, Mohd Adam

    2013-05-01

    Providing effective medical care for older patients with type 2 diabetes mellitus (T2D) that may contribute to their active aging has always been challenging. We examined the independent effect of age ? 60 years on disease control and its relationship with diabetes-related complications in patients with T2D in Malaysia. This was a cross-sectional study using secondary data from the electronic diabetes registry database Adult Diabetes Control and Management (ADCM). A total of 303 centers participated and contributed a total of 70,889 patients from May 2008 to the end of 2009. Demographic data, details on diabetes, hypertension, dyslipidemia and their treatment modalities, various risk factors and complications were updated annually. Independent associated risk factors were identified using multivariate regression analyses. Fifty-nine percent were female. Malay comprised 61.9%, Chinese 19% and Indian 18%. There were more Chinese, men, longer duration of diabetes and subjects that were leaner or had lower BMI in the older age group. Patients aged ? 60 years achieved glycemic and lipid targets but not the desired blood pressure. After adjusting for duration of diabetes, gender, ethnicity, body mass index, disease control and treatment, a significantly higher proportion of patients ? 60 years suffered from reported diabetes-related complications. Age ? 60 years was an independent risk factor for diabetes-related complications despite good control of cardiovascular risk factors. Our findings caution against the currently recommended control of targets in older T2D patients with more longstanding diseases and complications. PMID:23454736

  19. [Pharmacological therapy versus bariatric surgery for patients with obesity and type 2 diabetes].

    PubMed

    Blüher, M

    2015-02-01

    There is strong epidemiological evidence for an association between increased body weight and a higher incidence of type 2 diabetes. Moreover, reduction in body weight may delay the onset of type 2 diabetes. The basic therapy of type 2 diabetes includes lifestyle modifications, such as education, nutritional advice, increased physical activity, non-smoking and strategies to cope with stress. If lifestyle modifications are not successful, antidiabetic pharmacotherapy is stepwise intensified to achieve individual therapeutic targets; however, pharmacological treatment of type 2 diabetes frequently fails to prevent the progress of the disease and the manifestation of diabetes complications. Sustained weight reduction belongs to the individual treatment targets for patients with obesity and type 2 diabetes. Because conservative weight reduction strategies are frequently not successful, bariatric surgery has emerged as an effective treatment particularly for those patients with obesity-associated type 2 diabetes in whom a glycosylated hemoglobin (HbA1c) target patients with obesity-associated type 2 diabetes. PMID:25636953

  20. Reduced folate carrier 1 gene expression levels are correlated with methotrexate efficacy in Japanese patients with rheumatoid arthritis.

    PubMed

    Tazoe, Yui; Hayashi, Hideki; Tsuboi, Seiji; Shioura, Tomone; Matsuyama, Taiji; Yamada, Hiroshi; Hirai, Keita; Tsuji, Daiki; Inoue, Kazuyuki; Sugiyama, Tadashi; Itoh, Kunihiko

    2015-06-01

    Responsiveness to methotrexate (MTX), the "anchor drug" for treating rheumatoid arthritis (RA), varies among individual patients. In this study we investigated the effects of folate transporter gene expression levels on disease activity among 56 Japanese patients with RA who were undergoing MTX therapy. We also assessed gene expression levels for 15 healthy control subjects. The mRNA expression levels of reduced folate carrier 1 (RFC1) and proton-coupled folate transporter (PCFT) in PBMCs from these patients and controls were determined using real-time quantitative polymerase chain reaction (PCR). Compared with PCFT, there were large individual differences in RFC1 mRNA expression levels in both RA patients and healthy controls. RFC1 mRNA expression levels and RA disease activity scores were significantly negatively correlated, as disease activity scores were lower for patients with higher RFC1 mRNA expression levels. However, RFC1 mRNA levels were not correlated with MTX doses. Thus, the clinical efficacy of MTX for Japanese RA patients was associated with the expression level of a folate transporter gene. Increased RFC1 expression may increase MTX uptake by immune cells, such as lymphocytes, and as a result, RA disease activity would be reduced. PMID:26003891

  1. Effectiveness of diabetes interventions in the patient-centered medical home.

    PubMed

    Ackroyd, Sarah A; Wexler, Deborah J

    2014-03-01

    The patient-centered medical home (PCMH) is an innovative care model for the provision of primary care that is being rapidly adopted in the U.S. with the support of federal agencies and professional organizations. Its goal is to provide comprehensive, patient-centered care with increased access, quality, and efficiency. Diabetes, as a common, costly, chronic disease that requires ongoing management by patients and providers, is a condition that is frequently monitored as a test case in PCMH implementations. While in theory a PCMH care model that supports patient engagement and between-visit care may help improve diabetes care delivery and outcomes, the success of this approach may depend largely upon the specific strategies used and implementation approach. The cost-effectiveness of diabetes care in the PCMH model is not yet clear. Interventions have been most effective and most cost-effective for those with the poorest diabetes management at baseline. PMID:24477830

  2. Effectiveness of Diabetes Interventions in the Patient-Centered Medical Home

    PubMed Central

    Ackroyd, Sarah A.; Wexler, Deborah J.

    2014-01-01

    The patient-centered medical home (PCMH) is an innovative care model for the provision of primary care that is being rapidly adopted in the U.S. with the support of federal agencies and professional organizations. Its goal is to provide comprehensive, patient-centered care with increased access, quality, and efficiency. Diabetes, as a common, costly, chronic disease that requires ongoing management by patients and providers, is a condition that is frequently monitored as a test case in PCMH implementations. While in theory a PCMH care model that supports patient engagement and between-visit care may help improve diabetes care delivery and outcomes, the success of this approach may depend largely upon the specific strategies used and implementation approach. The cost-effectiveness of diabetes care in the PCMH model is not yet clear. Interventions have been most effective and most cost-effective for those with the poorest diabetes management at baseline. PMID:24477830

  3. Smart Home-based Health Platform for Behavioral Monitoring and Alteration of Diabetes Patients

    E-print Network

    Cook, Diane J.

    the best possible quality of life for individuals with diabetes. #12;Introduction Medical researchers consoles, health monitoring, sensor data analysis, smart homes #12;Abstract Background: Researchers and medical practitioners have long sought the ability to continuously and automatically monitor patients

  4. Evaluation of Correlation of Blood Glucose and Salivary Glucose Level in Known Diabetic Patients

    PubMed Central

    Singh, Siddharth Kumar; Padmavathi, B.N.; Rajan, S.Y.; Mamatha, G.P.; Kumar, Sandeep; Roy, Sayak; Sareen, Mohit

    2015-01-01

    Introduction Diabetes mellitus is a chronic heterogenous disease in which there is dysregulation of carbohydrates, protein and lipid metabolism; leading to elevated blood glucose levels. The present study was conducted to evaluate the correlation between blood glucose and salivary glucose levels in known diabetic patients and control group and also to evaluate salivary glucose level as a diagnostic tool in diabetic patients. Materials and Methods A total number of 250 patients were studied, out of which 212 formed the study group and 38 formed the control group. Result Among 250 patients, correlation was evaluated between blood glucose and salivary glucose values which on analysis revealed Pearson correlation of 0.073. The p-value was 0.247, which was statistically non significant. Conclusion Salivary glucose values cannot be considered as a diagnostic tool for diabetic individuals.

  5. Hypoglycemia is More Common Among Type 2 Diabetes Patients with Limited Health Literacy: The Diabetes Study of Northern California (DISTANCE)

    PubMed Central

    Karter, Andrew J.; Liu, Jennifer Y.; Moffet, Howard H.; Adler, Nancy E.; Schillinger, Dean

    2010-01-01

    BACKGROUND Little is known about the frequency of significant hypoglycemic events in actual practice. Limited health literacy (HL) is common among patients with type 2 diabetes, may impede diabetes self-management, and thus HL could increase the risk of hypoglycemia. OBJECTIVE To determine the proportion of ambulatory, pharmacologically-treated patients with type 2 diabetes reporting ?1 significant hypoglycemic events in the prior 12 months, and evaluate whether HL is associated with hypoglycemia. RESEARCH DESIGN Cross-sectional analysis in an observational cohort, the Diabetes Study of Northern California (DISTANCE). SUBJECTS The subjects comprised 14,357 adults with pharmacologically-treated, type 2 diabetes who are seen at Kaiser Permanente Northern California (KPNC), a non-profit, integrated health care delivery system. MEASURES Patient-reported frequency of significant hypoglycemia (losing consciousness or requiring outside assistance); patient-reported health literacy. RESULTS At least one significant hypoglycemic episode in the prior 12 months was reported by 11% of patients, with the highest risk for those on insulin (59%). Patients commonly reported limited health literacy: 53% reported problems learning about health, 40% needed help reading health materials, and 32% were not confident filling out medical forms by themselves. After adjustment, problems learning (OR 1.4, CI 1.1-1.7), needing help reading (OR 1.3, CI 1.1-1.6), and lack of confidence with forms (OR 1.3, CI 1.1-1.6) were independently associated with significant hypoglycemia. CONCLUSIONS Significant hypoglycemia was a frequent complication in this cohort of type 2 diabetes patients using anti-hyperglycemic therapies; those reporting limited HL were especially vulnerable. Efforts to reduce hypoglycemia and promote patient safety may require self-management support that is appropriate for those with limited HL, and consider more vigilant surveillance, conservative glycemic targets or avoidance of the most hypoglycemia-inducing medications. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1389-7) contains supplementary material, which is available to authorized users. PMID:20480249

  6. An association between anti-platelet drug use and reduced cancer prevalence in diabetic patients: results from the Vermont Diabetes Information System Study

    Microsoft Academic Search

    Chris E Holmes; Maria E Ramos-Nino; Benjamin Littenberg

    2010-01-01

    BACKGROUND: Diabetes is associated with an increased risk of several malignancies. Both diabetic patients and patients with cancer have an increase in platelet reactivity and platelet activation has recently emerged as a potential mediator of cancer progression. Drug therapies, such as aspirin, that reduce platelet reactivity reduce both cardiovascular and cancer risk. METHODS: We performed a cross-sectional analysis to assess

  7. Mortality of Type 1 (insulin-dependent) diabetes mellitus in Denmark: A study of relative mortality in 2930 Danish type 1 diabetic patients diagnosed from 1933 to 1972

    Microsoft Academic Search

    K. Borch-Johnsen; S. Kreiner; T. Deckert

    1986-01-01

    Summary  This study included 2930 (1642 male, 1288 female) Type 1 (insulin-dependent) diabetic patients diagnosed before the age of 31 years and between 1933 to 1972. The patients were followed from first admission to Steno Memorial Hospital until death, emigration, or until 1 January 1983. Relative mortality was studied, and the influence of calendar year of diagnosis, diabetes duration, age at

  8. Self-reported use of complementary and alternative medicine (CAM) products in topical treatment of diabetic foot disorders by diabetic patients in Jeddah, Western Saudi Arabia

    Microsoft Academic Search

    Balkees A Bakhotmah; Hasan A Alzahrani

    2010-01-01

    BACKGROUND: There is little published on current Saudi diabetic patients' practices when they are exposed to foot disorders such as open wound, ulcer, and skin cracks. These factors are usually influenced by local culture and communities beliefs. The aim of the current study was to identify the pattern of patients' use of CAM products in dealing with diabetic foot disorders

  9. Characterization of diabetes risk factors in patients prescribed chronic statin therapy

    PubMed Central

    King, William M.; Saseen, Joseph J.

    2014-01-01

    Objective: Determine the incidence of major diabetes risk factors over time in patients prescribed chronic statin therapy. Methods: Retrospective observational chart review of adult patients without diabetes in primary care who initiated statin therapy between 2005 and 2010. Presence of diabetes risk factors were determined 1 year prior to statin initiation and continued up to a maximum of 7 years. Diabetes risk factors included impaired fasting glucose, body mass index (BMI) ?30 kg/m2, hemoglobin A1c >6% and metabolic syndrome. Descriptive statistics were used to describe the incidence of diabetes risk factors over time. Results: A total of 98 patients met study criteria; mean age was 57 ± 13 years, 43% were men and 71% self-identified as Caucasian/white. Mean baseline values were A1c of 5.97%, fasting glucose of 104 mg/dl and BMI of 28 kg/m2. There were zero diabetes risk factors over time in 54% ± 7% of patients. The incidence over time of 1 risk factor was 25 ± 9%, 2 risk factors was 17 ± 5% and 3 risk factors was 3 ± 2%. A total of 12 patients were diagnosed with type 2 diabetes during the course of the study period. Conclusion: The incidence of diabetes risk factors did not change over time in an ambulatory adult population prescribed chronic statin therapy. Larger population studies assessing the incidence of and change in diabetes risk factors in patients on chronic statin therapy may help assess the association between statin therapy and presence of such risk factors. PMID:25177478

  10. Molecular cloning of the human hepatitis C virus genome from Japanese patients with non-A, non-B hepatitis

    SciTech Connect

    Kato, Nobuyuki; Hijikata, Makoto; Ootsuyama, Yuko; Nakagawa, Masanori; Ohkoshi, Showgo; Sugimura, Takashi; Shimotohno, Kunitada (National Cancer Center Research Inst., Tokyo (Japan))

    1990-12-01

    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 showed 22.6% difference in nucleotide sequence and 15.1% difference in amino acid sequence. Thus HCV-J and the American isolate of HCV are probably different subtypes of HCV. The relationship of HCV-J with other animal RNA virus families and the putative organization of the HCV-J genome are discussed.

  11. Colesevelam hydrochloride: A novel agent in patients with type 2 diabetes.

    PubMed

    Sekhri, Kavita; Saha, Lekha

    2011-07-01

    Hyperglycemia and hyperlipidemia are both risk factors for the development of various complications in patients with type 2 diabetes mellitus. Colesevelam hydrochloride is a novel agent that can improve both hypercholesterolemia and hyperglycemia in such patients. It is an orally administered bile acid sequestrant with high capacity for binding bile acids. This drug can offer potential new diabetes treatment along with other drugs. PMID:23776789

  12. Prevention and noninvasive management of coronary atherosclerosis in patients with diabetes

    Microsoft Academic Search

    Martial G. Bourassa; Colin Berry

    2008-01-01

    Diabetes mellitus (DM) is a worldwide epidemic. Its prevalence is rapidly increasing in both developing and developed countries.\\u000a Coronary heart disease (CHD) is highly prevalent and is the major cause of morbidity and mortality in patients with diabetes.\\u000a Individuals with prediabetes states, with or without known CHD, should undergo lifestyle modifications aimed at preventing\\u000a DM. In patients with CHD and

  13. Cumulative cognitive impairment following recurrent severe hypoglycaemia in adult patients with insulin-treated diabetes mellitus

    Microsoft Academic Search

    S. J. Langan; I. J. Deary; D. A. Hepburn; B. M. Frier

    1991-01-01

    Summary  To examine the hypothesis that episodes of severe hypoglycaemia may cause cumulative cognitive impairment, 100 Type 1 (insulin-dependent) diabetic patients were examined. Their age range was 25–52 years, and the onset of diabetes had occurred after the age of 19 years. Patients with evidence of organic brain disease, including cerebrovascular disease, were excluded. A questionnaire was used to assess the

  14. Is There Enough Information About Foot Care Among Patients With Diabetes?

    Microsoft Academic Search

    Subrata Basu; Julie Hadley; Rebecca Marie Tan; Jenny Williams; C. P. Shearman

    2004-01-01

    The United Kingdom has a diabetic population of approximately 1.2million. 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

  15. Serum C-peptide concentrations poorly phenotype type 2 diabetic end-stage renal disease patients

    Microsoft Academic Search

    Adrian M. C. Covic; Jeffrey R. Schelling; Marigel Constantiner; Sudha K. Iyengar; John R. Sedor

    2000-01-01

    Serum C-peptide concentrations poorly phenotype type 2 diabetic end-stage renal disease patients.BackgroundA homogeneous patient population is necessary to identify genetic factors that regulate complex disease pathogenesis. In this study, we evaluated clinical and biochemical phenotyping criteria for type 2 diabetes in end-stage renal disease (ESRD) probands of families in which nephropathy is clustered. C-peptide concentrations accurately discriminate type 1 from

  16. Angiotensin Type 2 Receptor in Resistance Arteries of Type 2 Diabetic Hypertensive Patients

    Microsoft Academic Search

    Carmine Savoia; Rhian M. Touyz; Massimo Volpe; Ernesto L. Schiffrin

    The role of angiotensin type 2 receptor (AT2R) on vascular responses to angiotensin II in humans remains unclear. In this study we explored whether AT2R is expressed and functionally active on peripheral resistance arteries of hypertensive diabetic patients treated for 1 year with either the angiotensin receptor blocker valsartan or the -blocker atenolol. Twenty-six hypertensive type 2 diabetic patients treated

  17. The impact of diabetes on economic costs in dialysis patients: experiences in Taiwan

    Microsoft Academic Search

    Wu-Chang Yang; Shang-Jyh Hwang; Shoou-Shan Chiang; Hsueh-Fen Chen; Shih-Tzer Tsai

    2001-01-01

    Diabetes mellitus carries a great burden on healthcare costs due to its growing population and high co-morbidity. This adverse effect sustains even when patients develop end-stage renal disease (ESRD). We here present data showing the effect of diabetes on economic costs in dialysis therapy in Taiwan. As of the end of 1997, we have 22?027 ESRD patients with a prevalence

  18. Orbital Doppler Evaluation of Blood Flow Velocities in Patients with Diabetic Retinopathy

    PubMed Central

    Karami, Mehdi; Janghorbani, Mohsen; Dehghani, Alireza; Khaksar, Karim; Kaviani, Ahmad

    2012-01-01

    BACKGROUND: There have been conflicting results in relation to impaired ocular hemodynamics in the orbital vessels of patients with diabetic retinopathy (DR). Clarification of the early signs of retinopathy in diabetic patients is urgently needed. AIMS: We aimed to evaluate orbital blood flow velocities using Doppler and gray-scale sonography in patients with DR, and to compare the results with those of their non-diabetic and diabetic peers without retinopathy. METHODS: Orbital Doppler and gray-scale sonography were performed in 123 patients aged 29-77 who had been divided into 3 groups: non-diabetic controls (n = 25), diabetes and impaired glucose tolerance with minimal clinical retinopathy (n = 74), and diabetes with untreated non-proliferative retinopathy (n = 24). Retinopathy was diagnosed by an ophthalmologist on the basis of fundoscopic examination. The peak systolic (PSV) and end-diastolic (EDV) blood flow velocities, and the resistivity and pulsatile indices, of the ophthalmic artery, central retinal artery, posterior ciliary artery, and central retinal vein were measured. RESULTS: Compared with healthy controls, the age-adjusted resistivity and pulsatile indices of the ophthalmic artery were significantly higher in patients with DR (p < 0.05). PSV and EDV of the posterior ciliary arteries were significantly lower in diabetic patients with DR. After further adjustment for age, gender, HbA1c, fasting plasma glucose, blood pressure, BMI, cholesterol, HDL, LDL, and triglycerides, only the resistivity index of the ophthalmic artery and the central retinal vein remained significantly higher in patients with DR compared with healthy controls (p < 0.005 after Bonferroni adjustment). CONCLUSIONS: Resistivity index alteration of the ophthalmic artery and central retinal vein may be prevalent among patients with early changes in DR. PMID:23403706

  19. Insulin resistance and muscle wasting in non-diabetic end-stage renal disease patients

    Microsoft Academic Search

    Seoung Woo Lee; Geun Ho Park; Seung Won Lee; Joon Ho Song; Kee Chun Hong; Moon-Jae Kim

    2007-01-01

    Background. Insulin resistance (IR) is prevalent in uraemia. Recent experimental studies suggested IR to be a central mechanism for uraemic malnutrition. However, it is not known whether IR is related to muscle wasting in non-diabetic end-stage renal disease (ESRD) patients. Methods. We cross-sectionally assessed IR and muscle wasting in 21 non-diabetic ESRD patients who admitted for the initiation of dialysis.

  20. Impaired saccadic eye movement in diabetic patients: the relationship with visual pathways function

    Microsoft Academic Search

    Marco Alessandrini; Vincenzo Parisi; Ernesto Bruno; Pier Giorgio Giacomini

    1999-01-01

    The aim of this study was to evaluate whether a correlation existed between saccadic eye movements and visual pathways function\\u000a in diabetic patients. Saccadic or fast Eye Movement System (EMS) and Visual Evoked Potentials (VEPs) were assessed in 20 insulin-dependent\\u000a diabetic mellitus (IDDM) patients without long-term complications and in stable metabolic control and in 21 age-matched control\\u000a subjects. In IDDM

  1. The Assessment of Relations between Socioeconomic Status and Number of Complications among Type 2 Diabetic Patients

    PubMed Central

    Tol, A; Pourreza, A; Shojaeezadeh, D; Mahmoodi, M; Mohebbi, B

    2012-01-01

    Background: The prevalence of diabetes mellitus among Iranian aged 25–64 estimated to be about 7.7%. The aim of current study was the assessment of socioeconomic status of diabetic patients and their complications. Methods: A cross sectional study was conducted on type 2 diabetic patients with complications in four major teaching hospitals affiliated to Tehran University of Medical Sciences (TUMS) during July 2009 to March 2010. All patients (530) were interviewed through a questionnaire with 85% response rate (450 patients). Skilled nurses were assigned as responsible for data collection. Collected data analyzed by Exact Fisher and ?2 tests using SPSS version 11.5. Results: The majority of patients had experienced one or more complications. Findings revealed that 50%, 33.6% and 16.4% of the patients suffered from one, two, and three complications of type 2 diabetes, respectively. Patients with cardiovascular complications included 22.2%, with both cardiovascular and eye complications (12.7%), and with cardiovascular, eye and foot ulcer together 14% of the respondents. Frequency of complications demonstrated significant relation with sex, age, educational level, type of occupation, duration of diabetes (P<0.001) and social class (P=0.002). The majority of patients (54.2%) belonged to low income group. Conclusion: It seems patients with low socioeconomic status face more challenges in their social environment together with less psychological support. Health care systems are responsible to empower them to control their illness and feel a better life to live. PMID:23113179

  2. External validation and optimisation of a model for predicting foot ulcers in patients with diabetes

    Microsoft Academic Search

    M. Monteiro-Soares; M. Dinis-Ribeiro

    2010-01-01

    Aims\\/hypothesis  In 2006 a risk stratification model was developed by Boyko et al. to predict foot ulceration in patients with diabetes, using\\u000a seven commonly available clinical variables. We sought to validate and optimise this clinical prediction rule in a different\\u000a setting.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A retrospective cohort study was conducted on all patients with diabetes attending the podiatry section of a diabetic foot\\u000a clinic

  3. Diabetes and Hypertension among Patients Receiving Antiretroviral Treatment Since 1998 in Senegal: Prevalence and Associated Factors

    PubMed Central

    Diouf, Assane; Cournil, Amandine; Ba-Fall, Khadidiatou; Ngom-Guèye, Ndèye Fatou; Eymard-Duvernay, Sabrina; Ndiaye, Ibrahima; Batista, Gilbert; Guèye, Papa Mandoumbé; Bâ, Pape Samba; Taverne, Bernard; Delaporte, Eric; Sow, Papa Salif

    2012-01-01

    Cardiovascular risk factors in people on antiretroviral treatment (ART) are poorly documented in resource-constrained settings. A cross-sectional study was conducted in 2009 to assess prevalence of diabetes and hypertension in a sample of 242 HIV-infected patients who had initiated ART between 1998 and 2002 in Dakar, Senegal (ANRS 1215 observational cohort). World Health Organization (WHO) criteria were applied to diagnose diabetes and hypertension. Multiple logistic regressions were used to identify factors associated with diabetes and hypertension. Patients had a median age of 46 years and had received ART for a median duration of about 9 years. 14.5% had diabetes and 28.1% had hypertension. Long duration of ART (?119 months), older age, higher body mass index (BMI), and higher levels of total cholesterol were associated with higher risks of diabetes. Older age, higher BMI at ART initiation, and higher levels of triglycerides were associated with higher risk of hypertension. This study shows that diabetes and hypertension were frequent in these Senegalese HIV patients on ART. It confirms the association between duration of ART and diabetes and highlights the need to implement programs for prevention of cardiovascular risk factors in HIV patients from resource-constrained settings. PMID:24052880

  4. A personalized approach to deliver health care information to diabetic patients in community care clinics*†

    PubMed Central

    Koonce, Taneya Y.; Giuse, Nunzia B.; Kusnoor, Sheila V.; Hurley, Suzanne; Ye, Fei

    2015-01-01

    Objective The study’s purpose was to test the generalizability of an individualized information prescription model, which has been previously validated for educating patients about hypertension in emergency department and community health center settings. Study investigators assessed the effects of educational materials targeted to health literacy levels and learning styles on patientsdiabetes knowledge in a community clinic setting. Methods From May to August 2012, 160 patients were recruited and randomized into intervention (n?=?81) and control (n?=?79) groups. Inclusion criteria included 18 years or older, English or Spanish speaker, and a type 2 diabetes diagnosis. Measures included modified versions of the Diabetes Knowledge Test and Subjective Numeracy Scale, along with brief health literacy and learning style assessments. Study team members contacted both groups after 2 and 6 weeks to reassess diabetes knowledge. Results The control group showed no significant change in diabetes knowledge at both follow-ups. In contrast, the mean number of diabetes knowledge questions answered correctly by the intervention group increased significantly after 2 weeks (??=?2.66, P?=?0.000), which persisted at 6 weeks (??=?2.46, P?=?0.00). Conclusions This study showed that patients’ knowledge about diabetes increased significantly after exposure to educational materials targeted to their health literacy levels and learning style preferences and that the model is transferrable among health conditions.

  5. Clinical and genetic characteristics of GAD-antibody positive patients initially diagnosed as having type 2 diabetes

    Microsoft Academic Search

    Kazuyuki Hamaguchi; Akinori Kimura; Yoichiro Kusuda; Tsutomu Yamashita; Michio Yasunami; Megumi Takahasi; Nobuyuki Abe; Hironobu Yoshimatsu

    2004-01-01

    The present study was conducted to clarify the clinical and genetic characteristics of the diabetic patients who have antibodies to glutamic acid decarboxylase (GADab) but are diagnosed initially as type 2 diabetes because of the slow progression. Fifty-five GADab+ patients and 137 GADab? patients were recruited. The GADab+ patients were divided into two subgroups according to their antibody titers. The

  6. Prevalence of deep venous incompetence and microvascular abnormalities in patients with diabetes mellitus.

    PubMed

    Mani, Raj; Yarde, Starla; Edmonds, Michael

    2011-06-01

    The involvement of venous disease in the diabetic neuropathic foot is widely accepted. This article reports the result of prevalence of venous incompetence, impaired calf vein hemodynamics, and loss of microvascular control in the skin over the dorsum of the foot in an effort to document whether increased retrograde pressure caused by venous incompetence or loss of sympathetic regulation of the microcirculation is present in the diabetic patient who is at risk of foot disease. It was found that 64% and 70.7% of diabetic patients had deep venous incompetence in their right and left legs, respectively, which was statistically significantly greater than what was found in a previous report on the general population (P < .05); 42.7% and 49.3% of patients had a reduced venous refilling time in the right and left legs, respectively, and 30.7% and 33.3% of patients had loss of the arteriovenous response in the right and left legs. Some previous reports have suggested evidence of hemodynamic and morphological changes in patients with diabetic foot disease. The outstanding contribution of this report is the finding of venous incompetence in patients with diabetes but not foot disease. Because some 15% of the population with diabetes develop foot complications, the reported observations offer hope of alleviating symptoms if not preventing ulcers. PMID:21693442

  7. Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and management

    PubMed Central

    Nitzan, Orna; Elias, Mazen; Chazan, Bibiana; Saliba, Walid

    2015-01-01

    Urinary tract infections are more common, more severe, and carry worse outcomes in patients with type 2 diabetes mellitus. They are also more often caused by resistant pathogens. Various impairments in the immune system, poor metabolic control, and incomplete bladder emptying due to autonomic neuropathy may all contribute to the enhanced risk of urinary tract infections in these patients. The new anti-diabetic sodium glucose cotransporter 2 inhibitors have not been found to significantly increase the risk of symptomatic urinary tract infections. Symptoms of urinary tract infection are similar to patients without diabetes, though some patients with diabetic neuropathy may have altered clinical signs. Treatment depends on several factors, including: presence of symptoms, severity of systemic symptoms, if infection is localized in the bladder or also involves the kidney, presence of urologic abnormalities, accompanying metabolic alterations, and renal function. There is no indication to treat diabetic patients with asymptomatic bacteriuria. Further studies are needed to improve the treatment of patients with type 2 diabetes and urinary tract infections. PMID:25759592

  8. Cardiovascular complications in diabetic patients undergoing regular hemodialysis: a 5-year observational study.

    PubMed

    Al-Thani, Hassan; Shabana, Adel; Hussein, Ahmed; Sadek, Ahmed; Sharaf, Ahmed; Koshy, Valsa; El-Menyar, Ayman

    2015-03-01

    We aimed to study the vascular outcomes in hemodialysis (HD) patients based on their diabetic status. A cohort observational study was conducted among patients undergoing regular HD with a 5-year follow-up. Of the 252 consecutive HD patients, 60% were diabetic. Compared with nondiabetics, diabetics were 11 years older, 4 years lesser on HD, and more likely to have prior cerebrovascular and coronary artery disease (CAD). Overall 5-year follow-up showed that diabetic patients had higher rates of HD vascular accesses (57% vs 41%, P = .01), CAD (64% vs 33%, P = .001), major amputations (8.6% vs 0%, P = .003), and mortality (66% vs 23%, P = .001). On multivariate analysis, independent predictors of mortality included number of vascular accesses in nondiabetics and HD duration, CAD, and peripheral artery disease in diabetic patients. Diabetes mellitus is associated with a significant vascular burden and mortality among HD patients. Moreover, our finding highlights the vascular impact of renal failure and HD. PMID:24576984

  9. Insulin chewing gum: Need of the day for diabetic patients

    PubMed Central

    Mateti, Uday Venkat; Adla, Nagesh; Rajakannan, Thiyagu; Valakkathala, Rajesh

    2011-01-01

    Chewing gum is an excellent drug delivery system for self medication as it is convenient, can be administered discreetly without water and offers the removal of ‘needle fear’ for the patients. As it releases insulin orally, it helps in tackling of the deprivation of insulin by digestive enzyme without adding digestive enzyme inhibitor. This can be done by binding of vitamin B12 and insulin. The vitamin B12 is protected with haptocorrin which is a salivary protein. Another chemical pathway takes over to help vitamin B12 pass into the bloodstream as haptocorrin reaches the intestines. The binding of vitamin B12 and insulin molecules makes the insulin to be protected on this supply chain. The insulin could ride all the way into the bloodstream, where it is released to do its work. By stimulating the brain, chewing gum also increases the releases of insulin. Finding simpler ways to deliver insulin into the blood stream is one important avenue for tackling the diabetes epidemic that is sweeping the developed world. The conditions in gastrointestinal tract may damage the body's protecting and absorbing mechanisms for the valuable molecules. Chewing gum would be a better delivery method in humans. PMID:23071934

  10. Molecular basis of carcinogenesis in diabetic patients (review).

    PubMed

    Matyszewski, Artur; Czarnecka, Anna M; Solarek, Wojciech; Korze?, Piotr; Safir, Ilan J; Kukwa, Wojciech; Szczylik, Cezary

    2015-04-01

    The most important molecular mechanisms promoting carcinogenesis in patients with diabetes mellitus (DM) include oxidative stress, excessive generation of free radicals and nitrous oxide, damage to cellular membranes and DNA, overproduction of lactate, overabundance of protein glycosylation storage products, overexpression of pathological enzyme isoforms, and leakage of cytochromes from organelles. Additionally, dysfunctional signal transduction pathways, especially in pathways involving phosphoinositide 3?kinase (PI3K)/phosphatase and tensin homolog (PTEN)/Akt, RAS/Raf/ERK, and mammalian target of rapamycin (mTOR), have been implicated in malignant transformation and progression. Obesity and metabolic disorders, such as DM, may contribute to a dysfunctional immune system with a suppressed immune response by inducing a chronic inflammatory state, abnormal humoral and cellular mediated immunity, and lower counts and activity levels of natural killer (NK) cells and natural killer T cells (NKT cells). Recent advances in molecular biology will allow for better understanding of abnormal cellular pathways, as well as elucidating how metabolic disorders contribute to oncogenesis. Knowledge gained through these studies may lead to more efficacious oncologic therapies. PMID:25646857

  11. Early postoperative outcome and medium-term survival in 540 diabetic and 2239 nondiabetic patients undergoing coronary artery bypass grafting

    Microsoft Academic Search

    Zoltán Szabó; Erik Håkanson; Rolf Svedjeholm

    2002-01-01

    Background. An increasing proportion of patients undergoing coronary artery bypass grafting (CABG) are diabetics. Patient characteristics, early postoperative outcome, and midterm survival in diabetic patients after CABG were investigated.Methods. A total of 2779 consecutive patients undergoing isolated CABG during 1995 to 1999 were studied, 19.4% of whom had diabetes mellitus. Demographic and peri-procedural data were registered prospectively in a computerized

  12. Effect of sequential application of topical adapalene and clindamycin phosphate in the treatment of Japanese patients with acne vulgaris.

    PubMed

    Kubota, Yasuo; Munehiro, Asuka; Shirahige, Yoshie; Nakai, Kozo; Katsuura, Junko; Moriue, Tetsuya; Murakami, Yumi; Matsunaka, Hiroshi; Yoneda, Kozo

    2012-02-01

    The efficacy of combined therapy with a retinoid and antibiotic for Japanese patients with acne vulgaris remains to be established. Further, maintenance strategies limiting the use of topical retinoids must be identified. The objectives of this study are to determine the efficacy of sequential application of topical adapalene and clindamycin phosphate and to assess the impact of this regimen on patients' quality of life. Sixty-six patients were recruited. The regimen comprised two phases. For the 4-week initial treatment, 1% clindamycin phosphate gel was applied twice daily and 0.1% adapalene gel, once. In the 4-week maintenance phase, patients were randomly assigned to the OD group (adapalene applied once daily) or the TW group (adapalene applied once daily on 2 days per week). The acne severity score, lesion counts, microcomedone count, and sebum amount were measured. Quality of life (QOL) was assessed using Skindex-16. All parameters improved significantly by week 4 of initial treatment. No statistically significant differences were found in the improvement of clinical findings between the groups. All QOL scores improved significantly and did not significantly differ between the groups. Our regimen may enable clinical control of acne in Japanese patients and improve their QOL. For limiting retinoid use, weekly application of adapalene during maintenance is suitable. PMID:21254867

  13. Effect of Orthosis Material Hardness on Walking Pressure in High-Risk Diabetes Patients

    Microsoft Academic Search

    James A. Birke; James G. Foto; Larry A. Pfiefer

    1999-01-01

    This study evaluated the effect of levels of hardness of a commonly used orthosis material in reducing plantar pressure in patients at high-risk for foot ulcers. The mean peak pressure was measured, by using the Pedar System, on 19 patients with diabetes mellitus and a history of plantar foot ulceration. Patients walked in standard extra-depth shoes with no orthoses, standard

  14. A smartphone application for preventing exercise-induced glycemic imbalances in type 1 diabetic patients.

    PubMed

    Vuattolo, Omar; Francescato, Maria Pia; Della Mea, Vincenzo; Accardo, Agostino

    2012-01-01

    Regular moderate-intensity physical activity is strongly recommended as well in patients with type 1 diabetes mellitus. However, the more frequent complication of exercise in T1DM patients is an excessive fall of glycaemia, which remains thus the strongest barrier to physical activity and the number of difficulties patients have to meet often further discourage them. Recently, a new algorithm has been proposed, that estimates, on a patient- and situation-specific basis, the amount of supplemental carbohydrates required by diabetic patients in order to exercise under safe blood glucose levels. The present paper discusses an implementation of the ECRES algorithm aimed at smartphones, and its preliminary evaluation from the accuracy point of view versus the original implementation, as well as usability. The developed mobile application replicates the original algorithm in a portable device that, after its preliminary experimentation, may be useful to make physical activity easier for diabetic patients. PMID:22874351

  15. Indium-111-oxine labeled platelet kinetics in patients with diabetes mellitus

    SciTech Connect

    Forstrom, L.A.; Luikens, B.; Johnson, T.

    1984-01-01

    The possible role of abnormal platelet function in the pathogenesis of vascular disease in patients with diabetes mellitus remains controversial. In vitro studies have shown variable alterations in platelet function in such patients. Studies of in vivo platelet kinetics in diabetic patients have been inconclusive, although decreased platelet survival has been observed in some cases. Earlier studies were carried out using chromium-51 or selenium-75 for platelet labeling. The authors have performed Indium-111-oxine labeled platelet kinetic and biodistribution studies in 4 patients with diabetes mellitus (ages 49-61 years), and in 4 control subjects (ages 46-60 years). All subjects were male. All diabetic patients were poorly controlled at the time of study, with blood glucose > 140 mg% and hemoglobin A-1c > 10%. Autologous platelets were labeled with Indium-111-oxine in ACD:plasma by previously reported methods, and reinjected in a dose of approximately 50 ..mu..Ci (range 42-67..mu..Ci). Average recovery of the injected platelets was 67% (range 41-85%). Computer analyzed images at 24 hours showed no significant difference in liver uptake between diabetic and control subjects. Mildly increased splenic uptake in diabetic patients was of borderline significance (p=.07). Platelet survival was slightly decreased in diabetic subjects by 3 of 4 models utilized (linear, exponential, multiple hit and weighted mean), although the difference achieved significance only for the weighted man model (p=.05). These data support observations by earlier methods which suggest that platelet survival may be decreased in patients with diabetes mellitus.

  16. The Management of Diabetic Neuropathy in CKD and Dialysis Patients

    PubMed Central

    Pop-Busui, Rodica; Roberts, Laurel; Pennathur, Subramaniam; Kretzler, Mathias; Brosius, Frank C.; Feldman, Eva L.

    2014-01-01

    Case Presentation A 64-year-old male with a 15-year history of poorly controlled type 2 diabetes and a 10-year history of hypertension and hyperlipidemia had developed multiple diabetes-related complications within the last 5 years. He first developed albuminuria 5 years ago, and over the next several years experienced fairly rapid decline in kidney function, with eGFR of 55 mL/min/1.73m2 noted 2 years ago. He was diagnosed with proliferative retinopathy 5 years ago and underwent laser photocoagulation. Four years ago, he noted symptoms of peripheral neuropathy manifested as shooting pain and numbness with loss of light touch, thermal and vibratory sensation in a stocking distribution. Last year he developed a non-healing ulcer on the plantar aspect of his left foot which was complicated with gangrene and resulted in a below-the-knee amputation of the left leg one year ago. He now reports a new onset of weakness, lightheadedness and dizziness on standing that affects his daily activities. He reports lancinating pain in his right lower extremity, worse in the evening. Medications include: neutral protamine Hagedorn insulin twice daily and regular insulin on a sliding scale, metoprolol 50 mg/d, lisinopril 40 mg/d, atorvastatin 80 mg/d, furosemide 40 mg/d and aspirin 81 mg/d. Blood pressure is 127/69 mm Hg with a pulse rate of 96 bpm while supine and 94/50 mmHg with a pulse rate of 102 bpm while standing. Strength is normal but with a complete loss of all sensory modalities to the knee in his remaining limb and up to the wrists in both upper extremities, and he is areflexic. Today's laboratory evaluations show a serum creatinine of 2.8 mg/dl, an estimated GFR (eGFR) of 24 ml/min/1.73m2, a hemoglobin A1c (HbA1c) of 7.9 % and 2.1 g of urine protein per gram of creatinine. What would be the most appropriate management for this patient? PMID:20042258

  17. Evaluation of bone metabolism and bone mass in patients with type-2 diabetes mellitus.

    PubMed Central

    Oz, S. Gul; Guven, Gulay Sain; Kilicarslan, Alpaslan; Calik, Nursel; Beyazit, Yavuz; Sozen, Tumay

    2006-01-01

    The objectives of this study were to determine whether type-2 diabetes was associated with a higher bone mineral density (BMD) in men and women and to evaluate the differences in mineral metabolism between diabetic and normal subjects by using biochemical bone turnover markers. In this study, 52 patients (37 females/15 males) aged 41-64 with type-2 diabetes mellitus and 48 nondiabetic control subjects (34 females/14 males) were evaluated. In men, BMD was significantly higher in diabetics at the forearm (p <0.05), whereas in women tended to be higher at the hip (p=0.002). Serum osteocalcin (p<0.0001), bone alkaline phosphatase (BAP) (p<0.05) and carboxyterminal telopeptide (CTx) (p<0.05) were higher in the control group than in diabetics. In men, serum osteocalcin (p<0.05) and CTx (p<0.005) and, in women, serum osteocalcin (p<0.0001) and BAP (p<0.05) were lower in diabetic subjects. In conclusion, our findings suggest that although bone formation is decreased in type-2 diabetes, diabetic patients are not susceptible to bone resorption. This low bone turnover can slow the rate of bone loss and cause a higher bone density than expected for their age. PMID:17052049

  18. Wide gastric antrum and low vagal tone in patients with diabetes mellitus type 1 compared to patients with functional dyspepsia and healthy individuals

    Microsoft Academic Search

    K. A. Undeland; T. Hausken; S. Svebak; S. Aanderud; A. Berstad

    1996-01-01

    Autonomous neuropathy in patients with diabetes is associated with dysmotility and abdominal discomfort. The disturbances resemble to some extent those seen in patients with functional dyspepsia. To gain further insight into the disorders, we compared patients with long-standing diabetes, patients with functional dyspepsia, and healthy individuals with respect to abdominal symptoms, width of gastric antral area, and autonomic nerve function.

  19. Missing Elements Revisited: Information Engineering for Managing Quality of Care for Patients with Diabetes

    PubMed Central

    Connor, Matthew J; Connor, Michael J

    2010-01-01

    Introduction Advances in information technology offer new avenues for assembling data about diet and care regimens of diabetes patients “in the field.” This creates a challenge for their doctors and the diabetes care community—how to organize and use new data to produce better long-term outcomes for diabetes patients. Methods iAbetics approaches the challenge as a quality management problem, drawing on total quality concepts, which in turn are grounded in application of the scientific method. We frame the diabetes patient's quality-of-care problem as an ongoing scientific investigation aimed at quantifying and predicting relationships between specific care-management actions and their outcomes for individual patients in their ordinary course of life. Results Framing diabetes quality-of-care management as a scientific investigation leads to a seven-step model termed “adaptive empirical iteration.” Adaptive empirical iteration is a deliberate process to perfect the patient's choices, decisions, and actions in routine situations that make up most day-to-day life and to systematically adapt across differences in individual patients and/or changes in their physiology, diet, or environment. The architecture incorporates care-protocol management and version control, structured formats for data collection using mobile smart phones, statistical analysis on secure Web sites, tools for comparing alternative protocols, choice architecture technology to improve patient decisions, and information sharing for doctor review. Conclusions Adaptive empirical iteration is a foundation for information architecture designed to systematically improve quality-of-care provided to diabetes patients who act as their own day-to-day care provider under supervision and with support from their doctor. The approach defines “must-have” capabilities for systems using new information technology to improve long-term outcomes for diabetes patients. PMID:20920451

  20. Psychometric Properties of the Diabetes Management Self-Efficacy Scale in Korean Patients with Type 2 Diabetes

    PubMed Central

    Shortridge-Baggett, Lillie M.; Han, Seung Jin; Moon, Seung Hei

    2015-01-01

    Objectives. The aims of this study were to perform a cultural translation of the DMSES and evaluate the psychometric properties of the translated scale in a Korean population with type 2 diabetics. Methods. This study was conducted in patients with diabetes recruited from university hospitals. The first stage of this study involved translating the DMSES into Korean using a forward- and backward-translation technique. The content validity was assessed by an expert group. In the second stage, the psychometric properties of the Korean version of the DMSES (K-DMSES) were evaluated. Results. The content validity of the K-DMSES was satisfactory. Sixteen-items clustered into four-subscales were extracted by exploratory factor analysis, and supported by confirmatory factor analysis. The construct validity of the K-DMSES with the Summary of Diabetes Self-Care Activities scale was satisfactory (r = 0.50, P<0.001). The Cronbach's alpha and intraclass correlation coefficient were 0.92 and 0.85 (P<0.001; 95% CI = 0.75–0.91), respectively, which indicate excellent internal consistency reliability and test-retest reliability. Conclusions. The K-DMSES is a brief instrument that has demonstrated good psychometric properties. It is therefore feasible to use in practice, and is ready for use in clinical research involving Korean patients with type 2 diabetes. PMID:26089892

  1. The Efficacy of Optimism: Benefit Finding in the Treatment of Diabetes in Iranian Patients

    PubMed Central

    Karimi Moonaghi, Hossein; Namdar Areshtanab, Hossein; Jouybari, Leila

    2014-01-01

    The incidence of diabetes mellitus is on the rise around the world. Middle Eastern countries will be facing a vast increase in the number of diabetes mellitus cases by 2030. Diagnosis of a chronic disease such as diabetes mellitus can be a shocking and life-altering event. Conversely, a diagnosis of a chronic illness can also offer the patient opportunities to change unhealthy behaviors such as poor diet, smoking, and lack of exercise, making them healthier than before their diagnosis. This is referred to as “benefit finding”. This study reveals the many benefit findings of Iranian patients who have been diagnosed with diabetes mellitus and illustrates how benefit finding can be an integral part of long-term patient care. PMID:25006496

  2. Glycaemic control influences peripheral blood flow and haemorheological variables in patients with diabetes mellitus.

    PubMed

    Vigilance, Jacqueline E; Reid, Harvey L

    2005-01-01

    Since persistent uncontrolled hyperglycaemia predisposes to vascular complications in diabetics, this study aimed at assessing the relationship of glycaemic control to plasma fibrinogen concentration, relative plasma viscosity and ankle arterial blood flow in diabetic patients with (N = 28) and without neuropathy (N = 34) compared with non-diabetic controls (N = 21). Glycaemic control was determined by total glycated haemoglobin (GHb) levels. Patients were placed into three categories of glycaemic control, namely good (GHb 4 -< 8%), fair (GHb 8-12%) and poor (GHb > 12%).Compared with non-diabetics, blood flow was significantly higher (p < 0.05) in patients with good but not poor glycaemic control. Fibrinogen was significantly higher in patients with fair and poor glycaemic control than in non-diabetic subjects (p < 0.05). In non-neuropathic patients, viscosity was higher (p < 0.05) in those with fair control and significantly different (p < 0.05) between those with fair and poor control. The results suggest that the initial vasodilatation in the periphery is attenuated by poor glycaemic control, contributing to the decrease in ankle arterial blood flow as a consequence of the simultaneous increase in plasma fibrinogen and viscosity. These adverse changes may contribute to the development of the diabetic foot. PMID:16317243

  3. Outcomes of Foot and Ankle Surgery in Diabetic Patients Who Have Undergone Solid Organ Transplantation.

    PubMed

    Zou, Richard H; Wukich, Dane K

    2015-01-01

    Foot and ankle problems are highly prevalent in patients with diabetes mellitus (DM). Increased rates of surgical site infections and noninfectious complications, such as malunion, delayed union, nonunion, and hardware failure, have also been more commonly observed in diabetic patients who undergo foot and ankle surgery. DM is a substantial contributor of perioperative morbidity in patients with solid organ transplantation. To the best of our knowledge, postoperative foot and ankle complications have not been studied in a cohort of diabetic patients who previously underwent solid organ transplantation. The aim of the present study was to evaluate the outcomes of foot and ankle surgery in a cohort of diabetic transplant patients and to compare these outcomes with those of diabetic patients without a history of transplantation. We compared the rates of infectious and noninfectious complications after foot and ankle surgery in 28 diabetic transplant patients and 56 diabetic patients without previous transplantation and calculated the odds ratios (OR) for significant findings. The diabetic transplant patients who underwent foot and ankle surgery in the present cohort were not at an increased risk of overall complications (OR 0.83, 95% confidence interval [CI] 0.33 to 2.08, p = .67), infectious complications (OR 0.54, 95% CI 0.09 to 3.09, p = .49), or noninfectious complications (OR 1.14, 95% CI 0.41 to 3.15, p = .81). Four transplant patients (14.3%) died of non-orthopedic surgery-related events during the follow-up period; however, no deaths occurred in the control group. Diabetic patients with previous solid organ transplantation were not at an increased risk of developing postoperative complications after foot and ankle surgery, despite being immunocompromised. The transplant patients had a greater mortality rate, but their premature death was unrelated to their foot and ankle surgery. Surgeons treating transplant patients can recommend foot and ankle surgery when indicated. However, owing to the increased mortality rate and comorbidities associated with this high-risk group, we recommend preoperative clearance from the transplant team and medical consultations before performing surgery. PMID:25488595

  4. High cardiorespiratory fitness can reduce glycated hemoglobin levels regardless of polygenic risk for Type 2 diabetes mellitus in nondiabetic Japanese men.

    PubMed

    Tanisawa, Kumpei; Ito, Tomoko; Sun, Xiaomin; Ise, Ryuken; Oshima, Satomi; Cao, Zhen-Bo; Sakamoto, Shizuo; Tanaka, Masashi; Higuchi, Mitsuru

    2014-07-15

    High cardiorespiratory fitness (CRF) is associated with a reduced risk of Type 2 diabetes mellitus (T2DM) and improved ?-cell function; genetic factors also determine these risks. This cross-sectional study investigated whether CRF modifies the association of polygenic risk of T2DM with