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Sample records for overt diabetes mellitus

  1. Association of Overt Diabetes Mellitus with the Non-CC but not the CC Genotype of Interleukin-28B in Hepatitis C Virus Infected Patients

    PubMed Central

    Kumar, Ashish; Gupta, Varun; Sharma, Praveen; Bansal, Naresh; Singla, Vikas; Arora, Anil

    2016-01-01

    Background: Interleukin-28B (IL-28B) polymorphism is an important predictor for hepatitis C virus (HCV) treatment response. Whether IL-28b genotypes also influence other nontreatment related clinical parameters is unclear. Methods: Patients with HCV-related chronic liver diseases who attended our department during 2012-2014 were retrospectively analyzed. The single nucleotide polymorphisms (SNPs) of rs12979860 (IL-28B) were correlated with various clinical parameters. We also compared these parameters in patients with and without overt diabetes to identify possible associations. Results: A total of 115 patients were included (median age 48, range 15-76 years; 70% males). Overall, 43/115 (37%) patients had chronic hepatitis, while the remaining 72/115 (63%) had cirrhosis. The most common IL-28B genotype was CC, which was found in 53% of patients (61/115), while the remaining 47% were nonCC [CT 42% (48/115) and TT 5% (6/115)]. Clinical and laboratory parameters like Hb, white blood cell (WBC), platelets, bilirubin, transaminases, and albumin were similar in the CC and nonCC genotypes. Overt diabetes mellitus was present in 22% (25/115) of patients. Patients with nonCC genotype had significantly higher prevalence of overt diabetes mellitus than patients with CC genotype (31% [17/54] versus 13% [8/61]; p < 0.05). When parameters were compared in patients with and without overt diabetes mellitus, only IL-28B and age were significantly associated with overt diabetes mellitus (p < 0.05). Conclusion: In HCV patients, overt diabetes mellitus was more commonly associated with the nonCC genotype of IL-28B than the CC genotype. Carriers of the T-allele of SNP rs12979860 were more likely to have insulin resistance than CC homozygotes, and this finding may explain the higher prevalence of diabetes in non-CC genotypes. Thus, an IL-28B test may be useful in patients of HCV in order to determine their likelihood of developing diabetes mellitus. PMID:27047769

  2. Risk factors for development of incipient and overt diabetic nephropathy in patients with non-insulin dependent diabetes mellitus: prospective, observational study.

    PubMed Central

    Gall, M. A.; Hougaard, P.; Borch-Johnsen, K.; Parving, H. H.

    1997-01-01

    OBJECTIVE: To evaluate putative risk factors for the development of incipient diabetic nephropathy (persistent microalbuminuria) and overt diabetic nephropathy (persistent macroalbuminuria) in patients with non-insulin dependent diabetes. DESIGN: Prospective, observational study of a cohort of white, non-insulin dependent diabetic patients followed for a median period of 5.8 years. SETTING: Outpatient clinic in tertiary referral centre. SUBJECTS: 191 patients aged under 66 years with non-insulin dependent diabetes and normoalbuminuria (urinary albumin excretion rate < 30 mg/24 h) who attended the clinic during 1987. MAIN OUTCOME MEASURES: Incipient and overt diabetic nephropathy. RESULTS: Fifteen patients were lost to follow up. Thirty six of the 176 remaining developed persistent microalbuminuria (30-299 mg/24 h in two out of three consecutive 24 hour urine collections) and five developed persistent macroalbuminuria (> or = mg/24 h in two out of three consecutive collections) during follow up. The five year cumulative incidence of incipient diabetic nephropathy was 23% (95% confidence interval 17% to 30%). Cox's multiple stepwise regression analysis revealed the following risk factors for the development of incipient or overt diabetic nephropathy: increased baseline log urinary albumin excretion rate (relative risk 11.1 (3.4 to 35.9); P < 0.0001); male sex (2.6 (1.2 to 5.4); P < 0.02); presence of retinopathy (2.4 (1.3 to 4.7); P < 0.01); increased serum cholesterol concentration (1.4 (1.1 to 1.7); P < 0.01); haemoglobin A1c concentration (1.2 (1.0 to 1.4); P < 0.05); and age (1.07 (1.02 to 1.12); P < 0.01). Known duration of diabetes, body mass index, arterial blood pressure, serum creatinine concentration, pre-existing coronary heart disease, and history of smoking were not risk factors. CONCLUSION: Several potentially modifiable risk factors predict the development of incipient and overt diabetic nephropathy in normoalbuminuric patients with non

  3. [Diabetes mellitus].

    PubMed

    Bosi, E

    2003-01-01

    Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes is a serious health concern. The number of cases of diabetes mellitus is estimated to grow at a rate of 50% between 2000 and 2010. There are several types of diabetes: type 1 diabetes, type 2 diabetes, gestational diabetes, and other specific types of diabetes. Beta cell dysfunction plays a key role in the physiopathology of diabetes, even when insulin resistance, which is often present in several diabetes-related diseases, is considered among the causes of hyperglycemic type 2 diabetes. The prolonged hyperglycemia that is peculiar to all kind of diabetes has long term complications on several organs and systems. The diagnosis of diabetes is based on the evaluation of glucose plasma levels performed under fasting conditions or two hours after the oral ingestion of 75 grams of glucose. Currently, achieving and maintaining normal plasma levels of glucose are the aims of therapy for both type 1 and type 2 diabetes. Particularly, the therapy for type 1 diabetes is based on the administration of insulin, whereas that of type 2 diabetes changes over the time: diet and physical activity are the first treatments; oral hypoglycemic drugs are used as a second therapeutic step; and the administration of insulin is the last therapeutic option. The principal therapeutic innovation of the past ten years is represented by the tight and flexible control of glucose plasma level obtained by using the insulin analogues produced by recombinant DNA technology. PMID:14523905

  4. [Diabetes mellitus].

    PubMed

    Pérez-Díaz, Iván

    2016-09-01

    Worldwide, the cases of type 2 Diabetes Mellitus (DM2) has doubled in the last two decades. In the same period, obesity rates have triplicated, mainly because of the increase in the caloric intake and physical inactivity. According to the World Health Organization (WHO), more than 6 billion people consume cow´s milk and dairy products. By far, this amount exceeds the number o patients suffering from DM2. The increased consumption of highly caloric beverages including whole cow´s milk has incited several countries to publish recommendations on and encourage the intake of low fat milk and non-fat or reduced fat dairy products intake. Because of the multifactorial basis of DM2 and the controversial evidence regarding the relationship between cow's milk consumption and DM2 development, it is difficult to establish an optimal amount of milk per day for a good health, with no side effects. It is necessary to inform the general population on the nutritional value and health benefits of cow's milk. PMID:27603888

  5. Graded sucrose/carbohydrate diets in overtly hypertriglyceridemic diabetic patients.

    PubMed

    Jellish, W S; Emanuele, M A; Abraira, C

    1984-12-01

    Overtly hypertriglyceridemic patients with non-insulin-dependent diabetes mellitus were given a control diet containing 120 g of sucrose and 50 percent carbohydrate, and later randomly assigned to receive isocaloric high- (220 g), intermediate- (120 g), or low- (less than 3 g) sucrose/carbohydrate diets for four weeks. The low-sucrose diet group demonstrated a modest but significant decrease in mean fasting serum glucose level in the first week only, although this change was no different from the other two dietary groups and was not sustained. All groups had little change in late postprandial serum glucose levels from control values, and no significant alterations in 24-hour glycosuria. The high-sucrose diet group demonstrated a significant increase in fasting serum triglyceride levels by the second week of the study, whereas the intermediate- and low-sucrose diet groups showed a decrease in mean fasting triglyceride levels. In contrast, the low-sucrose diet group's late postprandial serum triglyceride levels increased by the fourth week, whereas levels fell in the high-sucrose diet group. Mean fasting serum cholesterol concentrations decreased from control values in the high-sucrose diet group. Thus, although very high sucrose and carbohydrate consumption is clearly deleterious to fasting tryglyceride levels in non-insulin-dependent diabetes mellitus with preexisting hypertriglyceridemia, it appears that low dietary sucrose and carbohydrate proportions do not further improve preprandial glycemia and glycosuria and may adversely affect late postprandial serum triglyceride concentration. This study suggests that isocaloric sucrose and carbohydrate restriction below usual daily levels (120 g per day) offers no consistent benefit in glycemia or lipid control in overt type II diabetes. PMID:6391162

  6. Diabetes mellitus in Greenland.

    PubMed

    Pedersen, Michael Lynge

    2012-02-01

    Fifty years ago type 2 diabetes mellitus was very rare in Greenland. Recent epidemiological studies have found a high prevalence of diabetes among Greenlanders comparable to levels among Inuit populations in Canada and Alaska. In 2008 a national diabetes programme was implemented aiming to improve the care for patients with type 2 diabetes mellitus in Greenland based on a donation from Novo Nordisk A/S to the national health care service. A diabetes concept based on national guidelines, systematized recording in an electronically medical record and feedback to the clinics were used to improve the diabetes care. The overall aim of this thesis was to evaluate if implementation of a diabetes programme in Greenland would have a measurable effect on the quality in diabetes care including diagnostic activity and screening for diabetic complications. Two observational and cross sectional studies were performed in Greenland 2008 and 2010 before and after implementation of the diabetes programme. The medical records of patients with diabetes were reviewed. The prevalence was estimated using the whole adult population in Greenland as background population. The quality of the diabetes care was monitored by 12 health care indicators. The prevalence of diagnosed cases with type 2 diabetes mellitus among Greenlanders has increased over a period of two years. In the same period a significant increase in the quality of care in diabetes in Greenland has been documented concerning all process-of-care indicators. Significantly regional variation in the diabetes care was demonstrated in 2008. The quality in the diabetes care was best in clinics with a database. In 2010 a more homogenate quality among the clinics in the diabetes care was demonstrated. These effects could be a result of the diabetes programme implanted in between the two observations. In conclusion, improved quality in the diabetes care along with an increasing prevalence of diagnosed type 2 diabetes mellitus has been

  7. Diabetes mellitus prevention.

    PubMed

    Allende-Vigo, Myriam Zaydee

    2015-01-01

    The aim of this study was to review lifestyle modification interventions and pharmacological clinical studies designed to prevent diabetes and provide evidence-based recommendations for the prevention of Diabetes Mellitus. A review of relevant literature compiled via a literature search (PUBMED) of English-language publications between 1997 and 2010 was conducted. It is found that people at increased risk of developing type 2 diabetes mellitus can halt the development of the disease. Lifestyle modification intervention with reduction of 5%-10% of excess body weight and increase in moderate physical activity by 150 min/wk has consistently proven to reduce the appearance of diabetes in different at-risk populations. Pharmacologic interventions have also demonstrated the prevention of the appearance of diabetes in persons at risk. Bariatric surgery has decreased the appearance of diabetes patients in a select group of individuals. The progression from prediabetes to diabetes mellitus can be prevented. Lifestyle modification intervention changes with weight loss and increased physical activity are currently recommended for the prevention of diabetes. PMID:22020084

  8. Gestational diabetes mellitus in South Asia: Epidemiology.

    PubMed

    Jawad, Fatema; Ejaz, Kiran

    2016-09-01

    Gestational diabetes mellitus, is defined by the American Diabetes Association as "diabetes diagnosed in the second or third trimester of pregnancy that is not clearly overt diabetes". WHO has further classified the period of diagnosis as Hyperglycaemia in Pregnancy and Gestational Diabetes Mellitus. The former term is applicable in the early period of gestation and GDM is detected after 24 weeks. Irrespective of the guidelines followed, the presence of Diabetes Mellitus during pregnancy, has to be taken seriously as it is an important metabolic derangement and can prove to be harmful for the mother and dangerous for the foetus. The rising incidence of Type 2 Diabetes Mellitus in the world along with obesity, is a major contributing factor for GDM. The trend of this rise is more steep in the low and middle income countries thus proportionately increasing the risk for GDM. South Asia falls in this bracket and the responsible factors have to be identified and corrected. Management should begin from primordial prevention for which education is a key factor. Every woman should be taught the way to follow a healthy life style. Identification of the contributing factors and universal screening facilities for all pregnant women living in both rural and urban areas, should be given prime importance. On detecting Hyperglycaemia in Pregnancy or GDM, monitoring and health care facilities should be provided. This review provides some available figures of GDM in South Asia, the risk factors in this population and the steps for prevention. PMID:27582153

  9. Introduction to diabetes mellitus.

    PubMed

    Kaul, Kirti; Tarr, Joanna M; Ahmad, Shamim I; Kohner, Eva M; Chibber, Rakesh

    2012-01-01

    The chronic metabolic disorder diabetes mellitus is a fast-growing global problem with huge social, health, and economic consequences. It is estimated that in 2010 there were globally 285 million people (approximately 6.4% of the adult population) suffering from this disease. This number is estimated to increase to 430 million in the absence of better control or cure. An ageing population and obesity are two main reasons for the increase. Furthermore it has been shown that almost 50% of the putative diabetics are not diagnosed until 10 years after onset of the disease, hence the real prevalence of global diabetes must be astronomically high. This chapter introduces the types of diabetes and diabetic complications such as impairment of immune system, periodontal disease, retinopathy, nephropathy, somatic and autonomic neuropathy, cardiovascular diseases and diabetic foot. Also included are the current management and treatments, and emerging therapies. PMID:23393665

  10. Bioreactors Addressing Diabetes Mellitus

    PubMed Central

    Minteer, Danielle M.; Gerlach, Jorg C.

    2014-01-01

    The concept of bioreactors in biochemical engineering is a well-established process; however, the idea of applying bioreactor technology to biomedical and tissue engineering issues is relatively novel and has been rapidly accepted as a culture model. Tissue engineers have developed and adapted various types of bioreactors in which to culture many different cell types and therapies addressing several diseases, including diabetes mellitus types 1 and 2. With a rising world of bioreactor development and an ever increasing diagnosis rate of diabetes, this review aims to highlight bioreactor history and emerging bioreactor technologies used for diabetes-related cell culture and therapies. PMID:25160666

  11. Dyslipidemia in diabetes mellitus.

    PubMed

    Yoshino, G; Hirano, T; Kazumi, T

    1996-06-01

    Patients with diabetes mellitus have a higher rate of mortality than the general population. This higher mortality may be attributed mainly to cardiovascular disease. A high prevalence of dyslipidemia in diabetics can be one of the reasons for this. The most commonly recognized lipid abnormality in non-insulin-dependent diabetics (NIDDM) is hypertriglyceridemia, which is known to be an independent risk factor for coronary heart disease in diabetics. Hypertriglyceridemia can be produced by two mechanisms, increased synthesis of very-low-density lipoprotein (VLDL) triglyceride and removal defect of plasma triglyceride. It has been a matter of debate whether insulin always stimulates hepatic VLDL secretion but it is generally accepted that insulin deficiency results in an impairment of plasma triglyceride clearance. Considerable attention has recently been focused on the atherogenecity of postprandial hyperlipidemia, remnant lipoproteins, small, dense LDL, lipoprotein (a) [Lp(a)] and isolated hypo-alphalipoproteinemia in NIDDM subjects. Several reports suggested that these atherogenic lipoprotein abnormalities are present in NIDDMs even if they are apparently normolipidemic. Association of visceral fat obesity, insulin resistance and nephropathy may aggravate the atherogenic lipoprotein profile. Therefore, we propose here that plasma lipid levels of diabetic subjects must be more strictly controlled than for the non-diabetic population in order to avoid an increased risk for coronary heart disease. If they are obese or associated with insulin resistance or nephropathy, these conditions should be carefully controlled. PMID:8877270

  12. [Gestational diabetes mellitus].

    PubMed

    Anazawa, Sonoko

    2015-12-01

    Five years have passed since the criteria of gestational diabetes mellitus (GDM) were revised. Under these new criteria, prevalence of GDM has increased from 2-3% to 8-10%. This increase raises many arguments especially about cost effectiveness of managing newly diagnosed mild GDM showing only one abnormal value in 75 gOGTT. No evidence is yet to be found. But in our everyday experience, we find out few poor perinatal outcome with mild GDM mothers who are treated only with diet regimen to control their body weight. Considering later development to type 2 diabetes with these mild GDM mothers, they show no obvious difference from non GDM mothers in the retrospective study. PMID:26666146

  13. Diabetes mellitus in elderly

    PubMed Central

    Chentli, Farida; Azzoug, Said; Mahgoun, Souad

    2015-01-01

    Diabetes mellitus (DM) frequency is a growing problem worldwide, because of long life expectancy and life style modifications. In old age (≥60–65 years old), DM is becoming an alarming public health problem in developed and even in developing countries as for some authors one from two old persons are diabetic or prediabetic and for others 8 from 10 old persons have some dysglycemia. DM complications and co-morbidities are more frequent in old diabetics compared to their young counterparts. The most frequent are cardiovascular diseases due to old age and to precocious atherosclerosis specific to DM and the most bothersome are visual and cognitive impairments, especially Alzheimer disease and other kind of dementia. Alzheimer disease seems to share the same risk factors as DM, which means insulin resistance due to lack of physical activity and eating disorders. Visual and physical handicaps, depression, and memory troubles are a barrier to care for DM treatment. For this, old diabetics are now classified into two main categories as fit and independent old people able to take any available medication, exactly as their young or middle age counterparts, and fragile or frail persons for whom physical activity, healthy diet, and medical treatment should be individualized according to the presence or lack of cognitive impairment and other co-morbidities. In the last category, the fundamental rule is “go slowly and individualize” to avoid interaction with poly medicated elder persons and fatal iatrogenic hypoglycemias in those treated with sulfonylureas or insulin. PMID:26693423

  14. Diabetes mellitus in elderly.

    PubMed

    Chentli, Farida; Azzoug, Said; Mahgoun, Souad

    2015-01-01

    Diabetes mellitus (DM) frequency is a growing problem worldwide, because of long life expectancy and life style modifications. In old age (≥60-65 years old), DM is becoming an alarming public health problem in developed and even in developing countries as for some authors one from two old persons are diabetic or prediabetic and for others 8 from 10 old persons have some dysglycemia. DM complications and co-morbidities are more frequent in old diabetics compared to their young counterparts. The most frequent are cardiovascular diseases due to old age and to precocious atherosclerosis specific to DM and the most bothersome are visual and cognitive impairments, especially Alzheimer disease and other kind of dementia. Alzheimer disease seems to share the same risk factors as DM, which means insulin resistance due to lack of physical activity and eating disorders. Visual and physical handicaps, depression, and memory troubles are a barrier to care for DM treatment. For this, old diabetics are now classified into two main categories as fit and independent old people able to take any available medication, exactly as their young or middle age counterparts, and fragile or frail persons for whom physical activity, healthy diet, and medical treatment should be individualized according to the presence or lack of cognitive impairment and other co-morbidities. In the last category, the fundamental rule is "go slowly and individualize" to avoid interaction with poly medicated elder persons and fatal iatrogenic hypoglycemias in those treated with sulfonylureas or insulin. PMID:26693423

  15. Screening and diagnosis of gestational diabetes mellitus.

    PubMed

    Gupta, Yashdeep; Kalra, Bharti

    2016-09-01

    American Diabetes Association defines gestational diabetes mellitus (GDM) as diabetes which is diagnosed in the 2nd or 3rd trimester of pregnancy and is not clearly overt diabetes. GDM, if missed or not treated properly can result in maternal and foetal complications, short as well as long term. Screening for overt diabetes, especially for high risk women should be done at the earliest in pregnancy and for GDM, universally at 24-28 weeks of gestation. One step screening by IADPSG (75 gram OGTT), has been recently adopted by most of professional bodies to achieve uniformity. IADPSG criteria have resulted in increase in prevalence of GDM, and consequently increase pressure on health care services as well as on patients. This has resulted in discordance of view on universal adoption of the criteria. Many feel this criteria results in over diagnosis without clear benefits. This brief review will provide the answers to some of the important questions pertaining to screening for GDM. PMID:27582144

  16. [Mental disorders and diabetes mellitus].

    PubMed

    Abrahamian, Heidemarie; Kautzky-Willer, Alexandra; Rießland-Seifert, Angelika; Fasching, Peter; Ebenbichler, Christoph; Hofmann, Peter; Toplak, Hermann

    2016-04-01

    Psychiatric disorders and psychological problems are common in patients with diabetes mellitus. There is a twofold increase in depression which is associated with suboptimal glycemic control and increased morbidity and mortality. Other psychiatric disorders with a higher incidence of diabetes mellitus are cognitive impairment, dementia, disturbed eating behaviour, anxiety disorders, schizophrenia, bipolar disorders and borderline personality disorder. The coincidence of mental disorders and diabetes mellitus has unfavourable influences on metabolic control and micro- and macroangiopathic late complications. Improvement of therapeutic outcome is a challenge in the modern health care system. The intentions behind this position paper are to rise awareness of this special set of problems, to intensify cooperation between involved health care providers and to reduce incidence of diabetes mellitus as well as morbidity and mortality from diabetes in this patient group. PMID:27052238

  17. [Gestational diabetes mellitus].

    PubMed

    Kautzky-Willer, Alexandra; Harreiter, Jürgen; Bancher-Todesca, Dagmar; Berger, Angelika; Repa, Andreas; Lechleitner, Monika; Weitgasser, Raimund

    2016-04-01

    Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset during pregnancy and is associated with increased feto-maternal morbidity as well as long-term complications in mothers and offspring. Women detected to have diabetes early in pregnancy receive the diagnosis of overt, non-gestational, diabetes (glucose: fasting > 126 mg/dl, spontaneous > 200 mg/dl or HbA1c > 6.5 % before 20 weeks of gestation). GDM is diagnosed by an oral glucose tolerance test (OGTT) or fasting glucose concentrations (> 92 mg/dl). Screening for undiagnosed type 2 diabetes at the first prenatal visit (Evidence level B) is recommended in women at increased risk using standard diagnostic criteria (high risk: history of GDM or pre-diabetes (impaired fasting glucose or impaired glucose tolerance); malformation, stillbirth, successive abortions or birth weight > 4,500 g in previous pregnancies; obesity, metabolic syndrome, age > 45 years, vascular disease; clinical symptoms of diabetes (e. g. glucosuria)). Performance of the OGTT (120 min; 75 g glucose) may already be indicated in the first trimester in some women but is mandatory between 24 and 28 gestational weeks in all pregnant women with previous non-pathological glucose metabolism (Evidence level B). Based on the results of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study GDM is defined, if fasting venous plasma glucose exceeds 92 mg/dl or 1 h 180 mg/dl or 2 h 153 mg/dl after glucose loading (OGTT; international consensus criteria). In case of one pathological value a strict metabolic control is mandatory. This diagnostic approach was recently also recommended by the WHO. All women should receive nutritional counseling and be instructed in blood glucose self-monitoring and to increase physical activity to moderate intensity levels- if not contraindicated. If blood glucose levels cannot be maintained in the normal range (fasting < 95 mg/dl and 1 h after meals < 140

  18. Platelets and diabetes mellitus.

    PubMed

    Santilli, Francesca; Simeone, Paola; Liani, Rossella; Davì, Giovanni

    2015-07-01

    Platelet activation plays a key role in atherothrombosis in type 2 diabetes mellitus (T2DM) and increased in vivo platelet activation with enhanced thromboxane (TX) biosynthesis has been reported in patients with impairment of glucose metabolism even in the earlier stages of disease and in the preclinical phases. In this regards, platelets appear as addresses and players carrying and transducing metabolic derangement into vascular injury. The present review critically addresses key pathophysiological aspects including (i) hyperglycemia, glycemic variability and insulin resistance as determinants and predictors of platelet activation, (ii) inflammatory mediators derived from platelets, such as soluble CD40 ligand, soluble CD36, Dickkopf-1 and probably soluble receptor for advanced glycation-end-products (sRAGE), which expand the functional repertoire of platelets from players of hemostasis and thrombosis to powerful amplifiers of inflammation by promoting the release of cytokines and chemokines, cell activation, and cell-cell interactions; (iii) molecular mechanisms underpinning the less-than-expected antithrombotic protection by aspirin (ASA), despite regular antiplatelet prophylaxis at the standard dosing regimen, and (iv) stratification of patients deserving different antiplatelet strategies, based on the metabolic phenotype. Taken together, these pathophysiological aspects may contribute to the development of promising mechanism-based therapeutic strategies to reduce the progression of atherothrombosis in diabetic subjects. PMID:25986598

  19. Diabetic retinopathy - ocular complications of diabetes mellitus

    PubMed Central

    Nentwich, Martin M; Ulbig, Michael W

    2015-01-01

    In industrialized nations diabetic retinopathy is the most frequent microvascular complication of diabetes mellitus and the most common cause of blindness in the working-age population. In the next 15 years, the number of patients suffering from diabetes mellitus is expected to increase significantly. By the year 2030, about 440 million people in the age-group 20-79 years are estimated to be suffering from diabetes mellitus worldwide (prevalence 7.7%), while in 2010 there were 285 million people with diabetes mellitus (prevalence 6.4%). This accounts for an increase in patients with diabetes in industrialized nations by 20% and in developing countries by 69% until the year 2030. Due to the expected rise in diabetic patients, the need for ophthalmic care of patients (i.e., exams and treatments) will also increase and represents a challenge for eye-care providers. Development of optimized screening programs, which respect available resources of the ophthalmic infrastructure, will become even more important. Main reasons for loss of vision in patients with diabetes mellitus are diabetic macular edema and proliferative diabetic retinopathy. Incidence or progression of these potentially blinding complications can be greatly reduced by adequate control of blood glucose and blood pressure levels. Additionally, regular ophthalmic exams are mandatory for detecting ocular complications and initiating treatments such as laser photocoagulation in case of clinical significant diabetic macular edema or early proliferative diabetic retinopathy. In this way, the risk of blindness can considerably be reduced. In advanced stages of diabetic retinopathy, pars-plana vitrectomy is performed to treat vitreous hemorrhage and tractional retinal detachment. In recent years, the advent of intravitreal medication has improved therapeutic options for patients with advanced diabetic macular edema. PMID:25897358

  20. Erythropoietin and diabetes mellitus

    PubMed Central

    Maiese, Kenneth

    2015-01-01

    Erythropoietin (EPO) is a 30.4 kDa growth factor and cytokine that governs cell proliferation, immune modulation, metabolic homeostasis, vascular function, and cytoprotection. EPO is under investigation for the treatment of variety of diseases, but appears especially suited for the treatment of disorders of metabolism that include diabetes mellitus (DM). DM and the complications of this disease impact a significant portion of the global population leading to disability and death with currently limited therapeutic options. In addition to its utility for the treatment of anemia, EPO can improve cardiac function, reduce fatigue, and improve cognition in patients with DM as well as regulate cellular energy metabolism, obesity, tissue repair and regeneration, apoptosis, and autophagy in experimental models of DM. Yet, EPO can have adverse effects that involve the vasculature system and unchecked cellular proliferation. Critical to the cytoprotective capacity and the potential for a positive clinical outcome with EPO are the control of signal transduction pathways that include protein kinase B, the mechanistic target of rapamycin, Wnt signaling, mammalian forkhead transcription factors of the O class, silent mating type information regulation 2 homolog 1 (Saccharomyces cerevisiae), and AMP activated protein kinase. Therapeutic strategies that can specifically target and control EPO and its signaling pathways hold great promise for the development of new and effective clinical treatments for DM and the complications of this disorder. PMID:26516410

  1. Prevalence of peripheral arterial disease in subjects with moderate cardiovascular risk: Italian results from the PANDORA study Data from PANDORA (Prevalence of peripheral Arterial disease in subjects with moderate CVD risk, with No overt vascular Diseases nor Diabetes mellitus)

    PubMed Central

    2011-01-01

    Background The PANDORA study has recently examined the prevalence of low ankle brachial index (ABI) in subjects with moderate risk of cardiovascular disease. This sub-analysis of the PANDORA study examines the prevalence of asymptomatic peripheral arterial disease (PAD), as determined by ABI, in Italian subjects presenting with moderate cardiovascular risk, in the absence of diabetes or overt vascular disease. Methods PANDORA is a non-interventional, cross-sectional study that was performed in 6 European countries, involving subjects with at least one cardiovascular (CV) risk factor. The primary objective was to evaluate the prevalence of asymptomatic PAD using ABI. For this post-hoc sub-analysis, data were extracted for subjects enrolled in Italy, comprising 51.5% (n = 5298) of subjects from the original PANDORA study. Secondary objectives were to establish the prevalence and treatment of CV risk factors. Results The mean age was 63.9 years and 22.9% (95% CI 21.7-24.0) of subjects presented with asymptomatic PAD. A range of risk factors comprising smoking, hypertension, low HDL-cholesterol, family history of coronary heart disease and habit of moderate-high alcohol intake were significantly associated with asymptomatic PAD (p < 0.0001). Statin treatment had the lowest incidence in Italian subjects. Furthermore, patients treated with statins were significantly less likely to have asymptomatic PAD than those who were not (p = 0.0001). Conclusions Asymptomatic PAD was highly prevalent in Italian subjects, the majority of whom were not candidates for ABI assessment according to current guidelines. Findings from this study suggest that these patients should be carefully examined in clinical practice and ABI measured so that therapeutic interventions known to decrease their CV risk may be offered. Trial registration number ClinicalTrials.gov: NCT00689377 PMID:21981988

  2. Diabetes mellitus and oral health.

    PubMed

    Kudiyirickal, Marina George; Pappachan, Joseph M

    2015-05-01

    The oral health is influenced by systemic health, and one of the most common chronic diseases encountered in dental practice is diabetes mellitus. Diabetes can worsen oral infections and vice versa. In the literature, periodontitis and diabetes in the young to middle-aged adults have been the most widely researched area. Understanding the patho-physiology, clinical manifestations and management of different types of orofacial diseases in diabetic patients are important to the diabetologist and the dentist for the optimal care of patients with these diseases. This review explores the inter-link between diabetes and oral health. PMID:25487035

  3. Mitochondrial Plasticity in Obesity and Diabetes Mellitus

    PubMed Central

    Jelenik, Tomas

    2013-01-01

    Abstract Significance: Insulin resistance and its related diseases, obesity and type 2 diabetes mellitus (T2DM), have been linked to changes in aerobic metabolism, pointing to a possible role of mitochondria in the development of insulin resistance. Recent Advances: Refined methodology of ex vivo high-resolution respirometry and in vivo magnetic resonance spectroscopy now allows describing several features of mitochondria in humans. In addition to measuring mitochondrial function at baseline and after exercise-induced submaximal energy depletion, the response of mitochondria to endocrine and metabolic challenges, termed mitochondrial plasticity, can be assessed using hyperinsulinemic clamp tests. While insulin resistant states do not uniformly relate to baseline and post-exercise mitochondrial function, mitochondrial plasticity is typically impaired in insulin resistant relatives of T2DM, in overt T2DM and even in type 1 diabetes mellitus (T1DM). Critical Issues: The variability of baseline mitochondrial function in the main target tissue of insulin action, skeletal muscle and liver, may be attributed to inherited and acquired changes in either mitochondrial quantity or quality. In addition to certain gene polymorphisms and aging, circulating glucose and lipid concentrations correlate with both mitochondrial function and plasticity. Future Directions: Despite the associations between features of mitochondrial function and insulin sensitivity, the question of a causal relationship between compromised mitochondrial plasticity and insulin resistance in the development of obesity and T2DM remains to be resolved. Antioxid. Redox Signal. 19, 258–268. PMID:22938510

  4. Gestational diabetes mellitus: Get, set, go From diabetes capital of the world to diabetes care capital of the world

    PubMed Central

    Magon, Navneet

    2011-01-01

    Screening and diagnosis for gestational diabetes mellitus (GDM) as well as interventions for its management evoke considerable controversy. There are different types of screening methods: universal or risk-based, one step or two step. Different thresholds for diagnosis of GDM have been in vogue. Previous definition and diagnostic criteria had no place for diagnosis of overt diabetes in pregnancy. Following Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study and International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommendations, new screening and diagnostic criteria around the world seem to be gaining consensus. The present recommendation given by IADPSG for screening and diagnosis of diabetes mellitus in pregnancy has two discrete phases. The first is detection of women with overt diabetes not previously diagnosed or treated outside of pregnancy. Universal early testing in populations is recommended at the first prenatal visit. The second phase is a 75-g OGTT at 24–28 week gestation in all women not previously found to have overt diabetes or GDM. ACHOIS and MFMU Network trails have proven benefit in treating hyperglycemias less than what is diagnostic for diabetes. DIPSI has shown the alternative way for resource-challenged communities. Efforts from all stake holders with interest in GDM are required to make the diabetes capital of the world into the diabetes care capital of the world. PMID:21897891

  5. Diabetic mastopathy in type II diabetes mellitus.

    PubMed

    Tsung, Jeffrey S H; Wang, Teh Y; Lin, Christopher K Z

    2005-01-01

    Diabetic mastopathy can mimic cancer. We report 2 cases of diabetic mastopathy in patients with long-standing type II diabetes. One was insulin-dependent, and the other had never been treated with insulin. These 2 patients had classical acoustical shadow on ultrasonograms. Breast core biopsies showed constellations of morphological features resembling diabetic mastopathy, including sclerotic changes of the fibrous stroma with keloid-like collagen fibers, few epithelioid fibroblasts, perivascular and interlobular mononuclear cell infiltrates, and focal atrophic changes of the ductal-lobular units. Both patients were free of malignancy at 3 and 4 years of follow-up, respectively. There are limited data on diabetic mastopathy in insulin-naive type II diabetes mellitus patients. Better awareness of this entity and its sonographic features may allow more patients to be spared from excisional biopsy. PMID:15660177

  6. Monogenic Forms of Diabetes: Neonatal Diabetes Mellitus and Maturity-Onset Diabetes of the Young

    MedlinePlus

    ... Neonatal Diabetes Mellitus and MODY Monogenic Forms of Diabetes: Neonatal Diabetes Mellitus and MODY The most common forms of ... is inherited from each parent. Monogenic Forms of Diabetes Some rare forms of diabetes result from mutations ...

  7. [Diabetic mastopathy in diabetes mellitus type 2].

    PubMed

    Membrilla, Estela; Jimeno, Mireya; Martínez, Miguel; Maria Corominas, Josep; Solsona, Jordi; Grande, Luis

    2009-01-01

    Diabetic mastopathy is a little known entity and can easily be mistaken for breast carcinoma. This entity has mainly been described in patients with diabetes type 1 and, to a much lesser extent, in those with other endocrine disorders. We describe a case of diabetic mastopathy associated with diabetes mellitus type 2, which showed a rapid clinical course. Lack of awareness of this entity can lead to inappropriate management. Because there are no specific histological or clinical features for diabetic mastopathy, patients may receive an incorrect diagnosis or undergo unnecessary investigations. A high index of suspicion is required to reach a correct diagnosis and provide appropriate treatment. The results of diagnostic tests are non-specific and the key to diagnosis is core needle biopsy. PMID:19627708

  8. Genetics of gestational diabetes mellitus.

    PubMed

    Radha, Venkatesan; Kanthimathi, Sekar; Anjana, Ranjit Mohan; Mohan, Viswanathan

    2016-09-01

    Gestational diabetes mellitus (GDM) has now become a major public health problem because of its prevalence and its associated complications during pregnancy. Earlier studies have suggested that type 2 diabetes mellitus (T2DM) and GDM might have similar pathophysiology, such as increased insulin resistance, decreased insulin secretion resulting in hyperglycaemia. Evidence for a genetic basis of GDM has been poorly understood. To some extent, the current advancement in genomic techniques has thrown better light on the genetics of GDM. Based on the candidate gene approach and genome wide association studies, genetic loci in several genes that are responsible for insulin secretion, insulin resistance, lipid and glucose metabolism and other pathways have shown association with the GDM susceptibility. Understanding the possible underlying genetic factors of GDM would help us in gaining knowledge on the pathophysiologic mechanism of the disease. PMID:27582142

  9. [Eating disorders and diabetes mellitus].

    PubMed

    Herpertz, S; von Blume, B; Senf, W

    1995-01-01

    Numerous empirical studies indicate a higher frequency of eating disorders such as anorexia or bulimia nervosa in young female diabetic patients compared to the normal population. The comorbidity of the two syndromes usually leads to a continuous metabolic disorder bearing high risks of acute metabolic failure or early microangiopathic lesions. In addition to "restraint eating" as an essential element of diabetic therapy a premorbid neurotic malformation and/or poor coping strategies are further predisposing aspects for the development of an eating disorder. The inpatient treatment of a 22 year old patient suffering from both diabetes mellitus and bulimia nervosa demonstrates the association of neurotic malformation, poor coping style and the directive function of diabetic therapy. PMID:8560950

  10. Ocular complications of diabetes mellitus

    PubMed Central

    Sayin, Nihat; Kara, Necip; Pekel, Gökhan

    2015-01-01

    Diabetes mellitus (DM) is a important health problem that induces ernestful complications and it causes significant morbidity owing to specific microvascular complications such as, retinopathy, nephropathy and neuropathy, and macrovascular complications such as, ischaemic heart disease, and peripheral vasculopathy. It can affect children, young people and adults and is becoming more common. Ocular complications associated with DM are progressive and rapidly becoming the world’s most significant cause of morbidity and are preventable with early detection and timely treatment. This review provides an overview of five main ocular complications associated with DM, diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases. PMID:25685281

  11. Ocular complications of diabetes mellitus.

    PubMed

    Sayin, Nihat; Kara, Necip; Pekel, Gökhan

    2015-02-15

    Diabetes mellitus (DM) is a important health problem that induces ernestful complications and it causes significant morbidity owing to specific microvascular complications such as, retinopathy, nephropathy and neuropathy, and macrovascular complications such as, ischaemic heart disease, and peripheral vasculopathy. It can affect children, young people and adults and is becoming more common. Ocular complications associated with DM are progressive and rapidly becoming the world's most significant cause of morbidity and are preventable with early detection and timely treatment. This review provides an overview of five main ocular complications associated with DM, diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases. PMID:25685281

  12. [Metabolic syndrome and diabetes mellitus].

    PubMed

    2013-09-01

    Metabolic syndrome is based on visceral fat accumulation and brings about various metabolic abnormality such as hypertention, dyslipidemia, and glucose intolerance with the insulin resistance. Dyslipidemia in metabolic syndrome and diabetes mellitus features hypertriglycemia and low HDL cholesterolemia. The lipoprotein of triglycerides is consisted of mainly high remnant and VLDL lipoprotein. In addition, small dense LDL appears in these state. Small dense LDL is a high risk for atherosclerosis. For a treatment strategy, not only drug treatment such as fibrates, anti-diabetic drug, but we pay attention to visceral fat accumulation, and stratificate pathologically to appropriate treatment orientation. Early lifestyle intervention for example health instruction should be needed. PMID:24205723

  13. Gastrointestinal complications of diabetes mellitus

    PubMed Central

    Krishnan, Babu; Babu, Shithu; Walker, Jessica; Walker, Adrian B; Pappachan, Joseph M

    2013-01-01

    Diabetes mellitus affects virtually every organ system in the body and the degree of organ involvement depends on the duration and severity of the disease, and other co-morbidities. Gastrointestinal (GI) involvement can present with esophageal dysmotility, gastro-esophageal reflux disease (GERD), gastroparesis, enteropathy, non alcoholic fatty liver disease (NAFLD) and glycogenic hepatopathy. Severity of GERD is inversely related to glycemic control and management is with prokinetics and proton pump inhibitors. Diabetic gastroparesis manifests as early satiety, bloating, vomiting, abdominal pain and erratic glycemic control. Gastric emptying scintigraphy is considered the gold standard test for diagnosis. Management includes dietary modifications, maintaining euglycemia, prokinetics, endoscopic and surgical treatments. Diabetic enteropathy is also common and management involves glycemic control and symptomatic measures. NAFLD is considered a hepatic manifestation of metabolic syndrome and treatment is mainly lifestyle measures, with diabetes and dyslipidemia management when coexistent. Glycogenic hepatopathy is a manifestation of poorly controlled type 1 diabetes and is managed by prompt insulin treatment. Though GI complications of diabetes are relatively common, awareness about its manifestations and treatment options are low among physicians. Optimal management of GI complications is important for appropriate metabolic control of diabetes and improvement in quality of life of the patient. This review is an update on the GI complications of diabetes, their pathophysiology, diagnostic evaluation and management. PMID:23772273

  14. Modeling the Disease Progression from Healthy to Overt Diabetes in ZDSD Rats.

    PubMed

    Choy, Steve; de Winter, Willem; Karlsson, Mats O; Kjellsson, Maria C

    2016-09-01

    Studying the critical transitional phase between healthy to overtly diabetic in type 2 diabetes mellitus (T2DM) is of interest, but acquiring such clinical data is impractical due to ethical concerns and would require a long study duration. A population model using Zucker diabetic Sprague-Dawley (ZDSD) rats was developed to describe this transition through altering insulin sensitivity (IS, %) as a result of accumulating excess body weight and β-cell function (BCF, %) to affect glucose-insulin homeostasis. Body weight, fasting plasma glucose (FPG), and fasting serum insulin (FSI) were collected biweekly over 24 weeks from ZDSD rats (n = 23) starting at age 7 weeks. A semi-mechanistic model previously developed with clinical data was adapted to rat data with BCF and IS estimated relative to humans. Non-linear mixed-effect model estimation was performed using NONMEM. Baseline IS and BCF were 41% compared to healthy humans. BCF was described with a non-linear rise which peaked at 14 weeks before gradually declining to a negligible level. A component for excess growth reflecting obesity was used to affect IS, and a glucose-dependent renal effect exerted a two- to sixfold increase on the elimination of glucose. A glucose-dependent weight loss effect towards the end of experiment was implemented. A semi-mechanistic model to describe the dynamics of glucose and insulin was successfully developed for a rat population, transitioning from healthy to advanced diabetes. It is also shown that weight loss can be modeled to mimic the glucotoxicity phenomenon seen in advanced hyperglycemia. PMID:27245226

  15. Effects of gestational and overt diabetes on placental cytochromes P450 and glutathione S-transferase.

    PubMed

    Glover; McRobie; Tracy

    1998-07-01

    Objective: Animal and in vivo human studies have observed that diabetes alters the expression of hepatic metabolizing cytochrome P450 (CYP) and glutathione S-transferase (GST) enzymes. The placenta has the ability to metabolize a number of xenobiotic and endogenous compounds by processes similar to those seen in the liver. Our objective was to compare placental xenobiotic metabolizing activity in diabetics to matched non-diabetic controls to determine if the presence of diabetes alters placental xenobiotic metabolizing activity.Methods: The catalytic activities of 7-ethoxyresorufin-O-deethylation [EROD] (CYP1A1), chlorzoxazone 6-hydroxylation (CYP2E1), dextromethorphan N-demethylation (CYP3A4), dextromethorphan O-demethylation (CYP2D6), and 1-chloro-2,4-dinitrobenzene (CDNB) conjugation with glutathione (GST) from placentas of diet controlled (class A1) and insulin-dependent (class A2) gestational diabetics and overt diabetics were compared to matched controls.Results: No differences in EROD activity were observed among overt or gestational diabetics and their respectively matched controls. CYP2E1, 2D6, and 3A4 enzyme activity were not detected in human placentas. In contrast, GST activity was significantly reduced by 30% (P <.05) in overt diabetics as compared to their matched controls and gestational diabetics.Conclusion: Pregnant women with overt diabetes have reduced GST activity in the placenta, which could potentially result in exposure of the fetus to harmful reactive electrophilic metabolites. PMID:10838356

  16. 18-FDG in diabetes mellitus

    NASA Astrophysics Data System (ADS)

    Fares, Y.; Itoh, M.; Watabe, H.; Ghista, D. N.

    1993-06-01

    The intravenous glucose tolerance test, IVGTT, has been used to evaluate patients in whom abnormalities in carbohydrate metabolism and diabetes mellitus are suspected. IVGTT, if analyzed using "minimal models", or discrete-time methods, provides information on the sensitivity of glucose disappearance to insulin and on pancreatic sensitivity to glucose, information that cannot be obtained from direct analysis of the dynamic response alone. In a preliminary study, data obtained by intravenously injecting 18-FDG in four subjects was analyzed using a discrete-time model. The experimental details, the results and their implications will be discussed.

  17. Periodontal disease and diabetes mellitus

    PubMed Central

    NEGRATO, Carlos Antonio; TARZIA, Olinda; JOVANOVIČ, Lois; CHINELLATO, Luiz Eduardo Montenegro

    2013-01-01

    Periodontal disease (PD) is one of the most commonly known human chronic disorders. The relationship between PD and several systemic diseases such as diabetes mellitus (DM) has been increasingly recognized over the past decades. Objective: The purpose of this review is to provide the reader with knowledge concerning the relationship between PD and DM. Many articles have been published in the english and Portuguese literature over the last 50 years examining the relationship between these two chronic diseases. Data interpretation is often confounded by varying definitions of DM, PD and different clinical criteria were applied to determine the prevalence, extent and severity of PD, levels of glycemic control and diabetes-related complications. Methods: This paper provides a broad overview of the predominant findings from research conducted using the BBO (Bibliografia Brasileira de Odontologia), MEDLINE, LILACS and PubMed for Controlled Trials databases, in english and Portuguese languages published from 1960 to October 2012. Primary research reports on investigations of relationships between DM/DM control, PD/periodontal treatment and PD/DM/diabetes-related complications identified relevant papers and meta-analyses published in this period. Results: This paper describes the relationship between PD and DM and answers the following questions: 1- The effect of DM on PD, 2- The effects of glycemic control on PD and 3- The effects of PD on glycemic control and on diabetes-related complications. Conclusions: The scientific evidence reviewed supports diabetes having an adverse effect on periodontal health and PD having an adverse effect on glycemic control and on diabetes-related complications. Further research is needed to clarify these relationships and larger, prospective, controlled trials with ethnically diverse populations are warranted to establish that treating PD can positively influence glycemic control and possibly reduce the burden of diabetes

  18. [Diabetes mellitus: definition, classification and diagnosis].

    PubMed

    Roden, Michael

    2016-04-01

    Diabetes mellitus comprises of a group of heterogeneous disorders, which have an increase in blood glucose concentrations in common. The current classifications for diabetes mellitus type 1-4 are described and the main features of type 1 and type 2 diabetes are compared to allow for better discrimination between these diabetes types. Furthermore, the criteria for the correct biochemical diagnosis during fasting and oral glucose tolerance tests as well as the use of hemoglobin A1c (HbA1c) are summarized. These data form the basis of the recommendations of the Austrian Diabetes Association for the clinical praxis of diabetes treatment. PMID:27052219

  19. Noninvasive detection of diabetes mellitus

    NASA Astrophysics Data System (ADS)

    Eppstein, Jonathan A.; Bursell, Sven-Erik

    1992-05-01

    Recent advances in fluorescence spectroscopy of the lens reveal the potential of a non-invasive device and methodology to sensitively measure changes in the lens of the eye associated with diabetes mellitus. The system relies on the detection of the spectrum of fluorescence emitted from a selected volume (approximately 1/10 mm3) of the lens of living human subjects using low power excitation illumination from monochromatic light sources. The sensitivity of this technique is based on the measurement of the fluorescence intensity in a selected region of the fluorescence spectrum and normalization of this fluorescence with respect to attenuation (scattering and absorption) of the incident excitation light. The amplitude of the unshifted Rayleigh line, measured as part of the fluorescence spectrum, is used as a measure of the attenuation of the excitation light in the lens. Using this methodology we have demonstrated that the normalized lens fluorescence provides a more sensitive discrimination between diabetic and non-diabetic lenses than more conventional measurements of fluorescence intensity from the lens. The existing instrumentation will be described as well as the proposed design for a commercial version of the instrument expected to be ready for FDA trials by late 1992. The results from clinical measurements are used to describe a relationship between normalized lens fluorescence and hemoglobin A1c levels in diabetic patients.

  20. Ayurvedic treatments for diabetes mellitus

    PubMed Central

    Sridharan, Kalpana; Mohan, Roshni; Ramaratnam, Sridharan; Panneerselvam, Deepak

    2013-01-01

    Background Patients with diabetes frequently use complimentary and alternative medications including Ayurvedic medications and hence it is important to determine their efficacy and safety. Objectives To assess the effects of Ayurvedic treatments for diabetes mellitus. Search methods We searched The Cochrane Library (issue 10, 2011), MEDLINE (until 31 August 2011), EMBASE (until 31 August 2011), AMED (until 14 October 2011), the database of randomised trials from South Asia (until 14 October 2011), the database of the grey literature (OpenSigle, until 14 October 2011) and databases of ongoing trials (until 14 October 2011). In addition we performed hand searches of several journals and reference lists of potentially relevant trials. Selection criteria We included randomized trials of at least two months duration of Ayurvedic interventions for diabetes mellitus. Participants of both genders, all ages and any type of diabetes were included irrespective of duration of diabetes, antidiabetic treatment, comorbidity or diabetes related complications. Data collection and analysis Two authors independently extracted data. Risk of bias of trials was evaluated as indicated in the Cochrane Handbook for Systematic Reviews of Intervention. Main results Results of only a limited number of studies could be combined, in view of different types of interventions and variable quality of data. We found six trials of proprietary herbal mixtures and one of whole system Ayurvedic treatment. These studies enrolled 354 participants ( 172 on treatment, 158 on controls, 24 allocation unknown). The treatment duration ranged from 3 to 6 months. All these studies included adults with type 2 diabetes mellitus. With regard to our primary outcomes, significant reductions in glycosylated haemoglobin A1c (HbA1c), fasting blood sugar (FBS) or both were observed with Diabecon, Inolter and Cogent DB compared to placebo or no additional treatment, while no significant hypoglycaemic response was found

  1. Diabetes mellitus and its complications in India.

    PubMed

    Unnikrishnan, Ranjit; Anjana, Ranjit Mohan; Mohan, Viswanathan

    2016-06-01

    India is one of the epicentres of the global diabetes mellitus pandemic. Rapid socioeconomic development and demographic changes, along with increased susceptibility for Indian individuals, have led to the explosive increase in the prevalence of diabetes mellitus in India over the past four decades. Type 2 diabetes mellitus in Asian Indian people is characterized by a young age of onset and occurrence at low levels of BMI. Available data also suggest that the susceptibility of Asian Indian people to the complications of diabetes mellitus differs from that of white populations. Management of this disease in India faces multiple challenges, such as low levels of awareness, paucity of trained medical and paramedical staff and unaffordability of medications and services. Novel interventions using readily available resources and technology promise to revolutionise the care of patients with diabetes mellitus in India. As many of these challenges are common to most developing countries of the world, the lessons learnt from India's experience with diabetes mellitus are likely to be of immense global relevance. In this Review, we discuss the epidemiology of diabetes mellitus and its complications in India and outline the advances made in the country to ensure adequate care. We make specific references to novel, cost-effective interventions, which might be of relevance to other low-income and middle-income countries of the world. PMID:27080137

  2. Administration of antisomatotropin serum in diabetes mellitus.

    PubMed

    Góth, M; Szabolcs, I

    1981-03-01

    The effect of antisomatotropin serum (ASS), raised in horse against human growth hormone, on the carbohydrate metabolism of diabetics has been investigated. Among the eight diabetic patients treated so far two had GH secreting pituitary adenoma, two insulin-dependent, and four others adult onset diabetes mellitus. The glucose tolerance curve improved in all but one patient. The effect lasted for two--four weeks. Because of this short time of efficiency, the place of ASS in the definite treatment of diabetes mellitus cannot been judged so far, however, its administration in diabetic retinopathy seems to be advantageous. PMID:7227326

  3. Prevention of Gestational Diabetes Mellitus (GDM).

    PubMed

    Kalra, Sanjay; Gupta, Yashdeep; Kumar, Arun

    2016-09-01

    Prevention of Gestational diabetes mellitus holds the key to prevention of the diabetes and metabolic syndrome epidemic sweeping the world. This review discusses prevention of gestational diabetes and provides a scientific framework for the study of this topic. It classifies prevention in various ways, and suggests strategies which fit the different levels of prevention of gestational diabetes. The review also cites recent evidence and best practices to support the feasibility of prevention of gestational diabetes. PMID:27582141

  4. Monogenic Forms of Diabetes: Neonatal Diabetes Mellitus and Maturity-Onset Diabetes of the Young

    MedlinePlus

    ... For More Information American Diabetes Association JDRF MedlinePlus Diabetes Disease Organizations Many organizations provide support to patients ... 293 KB). Alternate Language URL Monogenic Forms of Diabetes: Neonatal Diabetes Mellitus and Maturity-onset Diabetes of ...

  5. Neurologic infections in diabetes mellitus.

    PubMed

    Jay, Cheryl A; Solbrig, Marylou V

    2014-01-01

    Even at a time when HIV/AIDS and immunosuppressive therapy have increased the number of individuals living with significant immunocompromise, diabetes mellitus (DM) remains a major comorbid disorder for several rare but potentially lethal infections, including rhino-orbital-cerebral mucormycosis and malignant external otitis. DM is also a commonly associated condition in patients with nontropical pyomyositis, pyogenic spinal infections, Listeria meningitis, and blastomycosis. As West Nile virus spread to and across North America over a decade ago, DM appeared in many series as a risk factor for death or neuroinvasive disease. More recently, in several large international population-based studies, DM was identified as a risk factor for herpes zoster. The relationships among infection, DM, and the nervous system are multidirectional. Viral infections have been implicated in the pathogenesis of type 1 and type 2 DM, while parasitic infections have been hypothesized to protect against autoimmune disorders, including type 1 DM. DM-related neurologic disease can predispose to systemic infection - polyneuropathy is the predominant risk factor for diabetic foot infection. Because prognosis for many neurologic infections depends on timely institution of antimicrobial and sometimes surgical therapy, neurologists caring for diabetic patients should be familiar with the clinical features of the neuroinfectious syndromes associated with DM. PMID:25410222

  6. Antioxidant plants and diabetes mellitus

    PubMed Central

    Nasri, Hamid; Shirzad, Hedayatollah; Baradaran, Azar; Rafieian-kopaei, Mahmoud

    2015-01-01

    The incidence of diabetes mellitus (DM) is increasing rapidly and it is expected to increase by 2030. Other than currently available therapeutic options, there are a lot of herbal medicines, which have been recommended for its treatment. Herbal medicines have long been used for the treatment of DM because of the advantage usually having no or less side-effects. Most of these plants have antioxidant activities and hence, prevent or treat hard curable diseases, other than having the property of combating the toxicity of toxic or other drugs. In this review other than presenting new findings of DM, the plants, which are used and have been evaluated scientifically for the treatment of DM are introduced. PMID:26487879

  7. Insulin degludec for diabetes mellitus.

    PubMed

    2013-07-01

    Over the last few years there has been a steady increase in the number of prescriptions dispensed in primary care for intermediate and long-acting insulin analogues and a reduction in prescriptions for biphasic isophane insulin. For example, in England, the volume of intermediate and long-acting insulin analogues in general practice has risen from approximately 650,000 prescriptions per quarter in 2007 to over 850,000 per quarter in 2012.(1) ▾Insulin degludec (Tresiba, Novo Nordisk) is a new long acting basal insulin analogue for the management of diabetes mellitus in adults.(2) Two strengths of insulin degludec (100 units/mL and 200 units/mL) were launched in the UK in February 2013. Here we discuss evidence for the effectiveness and safety of insulin degludec. PMID:23842634

  8. Coronary Artery Revascularization in Patients with Diabetes Mellitus

    MedlinePlus

    ... Patient Page Coronary Artery Revascularization in Patients With Diabetes Mellitus David H. Fitchett , Milan Gupta , Michael E. ... with exertion), heart attack, and possibly sudden death. Diabetes and Coronary Artery Disease Patients with diabetes mellitus ...

  9. Telomere attrition and diabetes mellitus.

    PubMed

    Tamura, Yoshiaki; Takubo, Kaiyo; Aida, Junko; Araki, Atsushi; Ito, Hideki

    2016-03-01

    Type 2 diabetes mellitus (DM) is a disease characterized by dysfunction of various organs. Recent studies have shown a close relationship between DM and telomere attrition in leukocytes. In patients with DM or impaired glucose tolerance, excessive oxidative stress induces damage to telomeres and shortens their length. Furthermore, it is suggested that telomere length is a good surrogate marker for mortality and diabetic complications in DM patients. We recently found that telomere length in pancreatic β-cells is also shortened in DM patients, potentially leading to an impaired capacity for proliferation and insulin secretion, and accelerated cell death. In contrast, leukocyte telomere length has also been reported in patients with obesity or insulin resistance, both of which are frequently associated with type 2 DM. In an animal model, it has been shown that telomere attrition in adipose tissue induces insulin resistance. Taken together, the available data suggest that hyperglycemia, oxidative stress, and telomere attrition in pancreatic β-cells and adipocytes create a vicious cycle that underlies the pathophysiology of type 2 DM. Inhibition of telomere attrition in various organs, including pancreatic β-cells, could be a new approach for preventing the progression of DM and its complications. PMID:27018285

  10. Electrocardiographic changes in diabetes mellitus.

    PubMed

    Kittnar, O

    2016-01-01

    Diabetes mellitus (DM) has been known for many years to be associated with poor cardiovascular prognosis. Due to the sensitive neuropathy, the coronary artery disease in diabetic patients is frequently asymptomatic. Also twelve leads resting ECG can be within normal limits even in an advanced stage of coronary artery disease. Therefore in addition to the standard ECG other electrocardiographic procedures started to be studied in order to find some typical signs of myocardial damages caused by DM. Repeatedly reported results showed in DM patients without cardiovascular complications the tachycardia, shortening of the QRS and QT intervals, increase of the dispersion of QT interval, decreased amplitudes of depolarization waves, shortened activation time of ventricular myocardium and a flattening of T waves confirmed by the lower value of maximum and minimum in repolarization body surface isopotential maps. Most of these changes are even more pronounced in patients with cardiac autonomic neuropathy. Comparison with similar ECG changes in other diseases suggests that the electrocardiographic changes in DM patients are not specific and that they are particularly caused by an increased tone of the sympathetic nervous system what was indirectly confirmed by the heart rate variability findings in these patients. PMID:26674294

  11. [Driving license and mellitus diabetes].

    PubMed

    Cimino, Luc; Deneufgermain, Alain; Lalau, Jean-Daniel

    2015-10-01

    For the "light group" as for the "heavy group" driving license cannot be issued or renewed to the applicant or drivers suffering from a condition that may constitute or lead to functional disability jeopardize road safety when driving a motor vehicle. The decision to issue or renew the license by the prefectural authority is taken on the advice of the departmental medical commission or a licensed physician. The decree of August 31, 2010 establishes the list of medical conditions incompatible with obtaining or maintaining the driving license or which may give rise to the issue of driving license limited validity. "Diabetes mellitus treated with medications that can cause hypoglycemia" belongs to this list. If the medical control of driving ability comes at the initiative of the user, the treating physician should firstly ensure the understanding of prescribed treatments that can cause hypoglycaemic episodes and other by informing diabetic person she must pass a medical examination of fitness to drive in a licensed physician. PMID:25956301

  12. Real life with type 1 diabetes mellitus

    PubMed Central

    Yagnik, Deepak

    2015-01-01

    Type 1 diabetes mellitus (T1DM) is a form of diabetes mellitus that results from the autoimmune destruction of the insulin-producing beta cells in the pancreas. Those affected by this disorder have a challenging life, both in terms of health and social adjustments. Various “alternative medicines” are offered to them in an effort to cure. Research has shown that good control over diabetes can be maintained through regular self-monitoring of blood glucose and frequent checking of diabetic complications. Here, I describe a female with T1DM and her journey with the disorder. PMID:25941661

  13. Diabetes mellitus: The epidemic of the century

    PubMed Central

    Kharroubi, Akram T; Darwish, Hisham M

    2015-01-01

    The epidemic nature of diabetes mellitus in different regions is reviewed. The Middle East and North Africa region has the highest prevalence of diabetes in adults (10.9%) whereas, the Western Pacific region has the highest number of adults diagnosed with diabetes and has countries with the highest prevalence of diabetes (37.5%). Different classes of diabetes mellitus, type 1, type 2, gestational diabetes and other types of diabetes mellitus are compared in terms of diagnostic criteria, etiology and genetics. The molecular genetics of diabetes received extensive attention in recent years by many prominent investigators and research groups in the biomedical field. A large array of mutations and single nucleotide polymorphisms in genes that play a role in the various steps and pathways involved in glucose metabolism and the development, control and function of pancreatic cells at various levels are reviewed. The major advances in the molecular understanding of diabetes in relation to the different types of diabetes in comparison to the previous understanding in this field are briefly reviewed here. Despite the accumulation of extensive data at the molecular and cellular levels, the mechanism of diabetes development and complications are still not fully understood. Definitely, more extensive research is needed in this field that will eventually reflect on the ultimate objective to improve diagnoses, therapy and minimize the chance of chronic complications development. PMID:26131326

  14. Type 2 Diabetes Mellitus in Youth

    ERIC Educational Resources Information Center

    Quarry-Horn, Jill L.; Evans, Barbara J.; Kerrigan, James R.

    2003-01-01

    In the United States, the incidence of type 2 diabetes mellitus (DM) in children and adolescents has been increasing at an alarming rate. Early recognition and intervention can delay the onset of type 2 DM and prevent the long-term complications. School nurses have an essential role in implementing the American Diabetes Association (ADA)…

  15. Cardiovascular risk in type 1 diabetes mellitus

    PubMed Central

    Slim, Ines Ben Hadj Slama

    2013-01-01

    Commonly cardiovascular risk (CVR) is linked to type 2 diabetes mellitus as this type is known to be part of the metabolic syndrome, which includes other cardiovascular factors such as hypertension, dyslipidemia. Inversely, CVR of type 1 diabetes mellitus (T1DM) is currently being debated apart from the occurrence of diabetic nephropathy (DN). For this, we did a review of CVR in patients with T1DM complicated or not with DN. The place of novel non-invasive techniques in screening of subclinical vascular damage is also discussed in this review. PMID:24251225

  16. Ocular autofluorescence in diabetes mellitus. A review.

    PubMed

    Calvo-Maroto, Ana M; Perez-Cambrodi, Rafael J; Garcia-Lazaro, Santiago; Ferrer-Blasco, Teresa; Cerviño, Alejandro

    2016-09-01

    Diabetes mellitus is a metabolic disease with a considerable impact on healthcare owing to its increased prevalence and high mortality rate. Structural, morphological, and physiological changes in each of the ocular components have been described in detail. Autofluorescence has been described as a good indicator of metabolic activity. The aim of the present review is to provide an overview of ocular endogenous fluorophores in the cornea, the crystalline lens, and the retinal pigment epithelium, the effects of diabetes mellitus and therefore the potential of autofluorescence assessment for screening and monitoring changes in diabetic patients. PMID:27147470

  17. [Epidemiology of diabetes mellitus in childhood].

    PubMed

    Barat, P; Lévy-Marchal, C

    2013-12-01

    Diabetes mellitus in childhood may correspond to different pathophysiological entities but type 1 diabetes is by far the most common form of diabetes in children. Its incidence has been increasing steadily over the past two decades. This trend is particularly important among younger children, leading to a youngest median age at the discovery of diabetes. Thus, approximately 25% of diagnoses of type 1 diabetes are in children under 5 years. In France, the type 2 diabetes in children is rare despite the rise in obesity. Investigations for the diagnosis are recommended in obese adolescents with a family history of type 2 diabetes. Monogenic diabetes are more common than type 2 diabetes in Europe. Their research depends on the analysis of family history and may lead to a specific therapeutic approach. PMID:24360361

  18. Statins and Risk of New-Onset Diabetes Mellitus

    MedlinePlus

    ... Association Cardiology Patient Page Statins and Risk of New-Onset Diabetes Mellitus Ravi V. Shah and Allison ... most common adverse effects, and recent concerns about new-onset diabetes mellitus to help patients and providers ...

  19. The association between Diabetes mellitus and Depression

    PubMed Central

    Bădescu, SV; Tătaru, C; Kobylinska, L; Georgescu, EL; Zahiu, DM; Zăgrean, AM; Zăgrean, L

    2016-01-01

    Depression occurrence is two to three times higher in people with diabetes mellitus, the majority of the cases remaining under-diagnosed. The purpose of this review was to show the links between depression and diabetes, point out the importance of identifying depression in diabetic patients and identify the possible ways to address both diseases. Possible common pathophysiological mechanisms as stress and inflammation were explained, while emphasis was made on screening for depression in diabetic patients. An important aspect for the diabetic specialist would be the understanding of the common origins of diabetes and depression and the awareness of this quite common comorbidity, in order to improve the outcomes of both diseases. Abbreviations: DALYS = disability adjusted life years, DSM-5 = American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, DM1 = Type 1 diabetes mellitus, DM2 = Type 2 diabetes mellitus, HPA-axis = hypothalamus – pituitary – adrenal axis, SNS = sympathetic nervous system, BDI = Beck Depression Inventory, CES-D = Centre for Epidemiologic Studies Depression Scale, HADS = Hospital Anxiety and Depression Scale, PHQ = Patient Health Questionnaire. PMID:27453739

  20. Diabetes mellitus and metformin in hepatocellular carcinoma

    PubMed Central

    Fujita, Koji; Iwama, Hisakazu; Miyoshi, Hisaaki; Tani, Joji; Oura, Kyoko; Tadokoro, Tomoko; Sakamoto, Teppei; Nomura, Takako; Morishita, Asahiro; Yoneyama, Hirohito; Masaki, Tsutomu

    2016-01-01

    Hepatocellular carcinoma (HCC) is the leading cause of cancer-related death worldwide. Diabetes mellitus, a risk factor for cancer, is also globally endemic. The clinical link between these two diseases has been the subject of investigation for a century, and diabetes mellitus has been established as a risk factor for HCC. Accordingly, metformin, a first-line oral anti-diabetic, was first proposed as a candidate anti-cancer agent in 2005 in a cohort study in Scotland. Several subsequent large cohort studies and randomized controlled trials have not demonstrated significant efficacy for metformin in suppressing HCC incidence and mortality in diabetic patients; however, two recent randomized controlled trials have reported positive data for the tumor-preventive potential of metformin in non-diabetic subjects. The search for biological links between cancer and diabetes has revealed intracellular pathways that are shared by cancer and diabetes. The signal transduction mechanisms by which metformin suppresses carcinogenesis in cell lines or xenograft tissues and improves chemoresistance in cancer stem cells have also been elucidated. This review addresses the clinical and biological links between HCC and diabetes mellitus and the anti-cancer activity of metformin in clinical studies and basic experiments. PMID:27468203

  1. Endothelial Dysfunction in Type 2 Diabetes Mellitus.

    PubMed

    Dhananjayan, R; Koundinya, K S Srivani; Malati, T; Kutala, Vijay Kumar

    2016-10-01

    Endothelial dysfunction is an imbalance in the production of vasodilator factors and when this balance is disrupted, it predisposes the vasculature towards pro-thrombotic and pro-atherogenic effects. This results in vasoconstriction, leukocyte adherence, platelet activation, mitogenesis, pro-oxidation, impaired coagulation and nitric oxide production, vascular inflammation, atherosclerosis and thrombosis. Endothelial dysfunction is focussed as it is a potential contributor to the pathogenesis of vascular disease in diabetes mellitus. Under physiological conditions, there is a balanced release of endothelial-derived relaxing and contracting factors, but this delicate balance is altered in diabetes mellitus and atherosclerosis, thereby contributing to further progression of vascular and end-organ damage. This review focuses on endothelial dysfunction in atherosclerosis, insulin resistance, metabolic syndrome, oxidative stress associated with diabetes mellitus, markers and genetics that are implicated in endothelial dysfunction. PMID:27605734

  2. [Diabetes mellitus, coronary artery disease and heart disease].

    PubMed

    Clodi, Martin; Säly, Christoph; Hoppichler, Friedrich; Resl, Michael; Steinwender, Clemens; Eber, Bernd

    2016-04-01

    Diabetes mellitus, cardiovascular disease and heart failure are interacting dynamically. Patients being diagnosed with cardiovascular disease should be screened for diabetes mellitus. Enhanced cardiovascular risk stratification based on biomarkers, symptoms and classical risk factors should be performed in patients with pre-existing diabetes mellitus. PMID:27052249

  3. Glycogenic Hepatopathy in Type 1 Diabetes Mellitus.

    PubMed

    Atmaca, Murat; Ucler, Rifki; Kartal, Mehmet; Seven, Ismet; Alay, Murat; Bayram, Irfan; Olmez, Sehmus

    2015-01-01

    Glycogenic hepatopathy is a rare cause of high transaminase levels in type 1 diabetes mellitus. This condition, characterized by elevated liver enzymes and hepatomegaly, is caused by irreversible and excessive accumulation of glycogen in hepatocytes. This is a case report on a 19-year-old male case, diagnosed with glycogenic hepatopathy. After the diagnosis was documented by liver biopsy, the case was put on glycemic control which led to significant decline in hepatomegaly and liver enzymes. It was emphasized that, in type 1 diabetes mellitus cases, hepatopathy should also be considered in the differential diagnoses of elevated liver enzyme and hepatomegaly. PMID:26347835

  4. Glycogenic Hepatopathy in Type 1 Diabetes Mellitus

    PubMed Central

    Atmaca, Murat; Ucler, Rifki; Kartal, Mehmet; Seven, Ismet; Alay, Murat; Bayram, Irfan; Olmez, Sehmus

    2015-01-01

    Glycogenic hepatopathy is a rare cause of high transaminase levels in type 1 diabetes mellitus. This condition, characterized by elevated liver enzymes and hepatomegaly, is caused by irreversible and excessive accumulation of glycogen in hepatocytes. This is a case report on a 19-year-old male case, diagnosed with glycogenic hepatopathy. After the diagnosis was documented by liver biopsy, the case was put on glycemic control which led to significant decline in hepatomegaly and liver enzymes. It was emphasized that, in type 1 diabetes mellitus cases, hepatopathy should also be considered in the differential diagnoses of elevated liver enzyme and hepatomegaly. PMID:26347835

  5. [Surgical treatment of type 2 diabetes mellitus].

    PubMed

    Carrillo-Esper, Raúl; Muciño-Bermejo, María Jimena

    2014-01-01

    Sustained remission of type 2 diabetes mellitus and significantly improved hyperlipidemia and arterial hypertension, control has been achieves in both lean and obese patient after bariatric surgery procedures or other gastrointestinal surgical procedures. It has been demonstrated that the metabolic effects of bariatric surgery in these patients derives not only in reducing weight and caloric intake, but also endocrine changes resulting from surgical manifestation gastrointestinal tract. In this article we review the clinical outcomes of such interventions (collectively called "metabolic surgery") and the perspectives on the role that these surgeries play in the treatment of patients with type 2 diabetes mellitus. PMID:25312324

  6. [TYPE 2 DIABETES MELLITUS AND DEPRESSION].

    PubMed

    Kravchenko, A Ya; Esaulenko, I E; Sahnenko, V V; Budnevskyj, A V; Podvygyn, S N

    2016-01-01

    The clinical significance of type 2 diabetes mellitus is not confined to metabolic disorders. A serious problem is also affective pathology that occurs in the majority (30-70%) of patients. However, diagnostics and correction of anxiety and depressive disorders associated with diabetes are often given insufficient attention. Many studies showed relationship between affective disorders and low adherence to the prescribed treatment resulting in general deterioration of clinical prognosis of diabetes. This review article describes the basic mechanisms behind the interrelation of affective disorders and diabetes. The role of persistent subclinical inflammation in diabetes and depression is discussed. The influence of emotional stress on the activation of the hypothalamic-pituitary-adrenal axis on the overproduction of cortisol is emphasized. The similarity of some structural changes in the brain tissue in diabetes and depression is discussed. Effect of endocrine disruption in the emotional sphere is demonstrated. Mechanisms responsible for the development of diabetes and its complications provoked by depression are considered. PMID:27459757

  7. Diabetes mellitus: Trends in northern India.

    PubMed

    Gutch, Manish; Razi, Syed Mohd; Kumar, Sukriti; Gupta, Keshav Kumar

    2014-09-01

    Diabetes mellitus is becoming a global health issue with more than 80% diabetics living in developing countries. India accounts for 62.4 million diabetics (2011). Indian Council of Medical Research India Diabetes Study (ICMR-INDIAB) study showed highest weighted prevalence rate in the north India among all studied regions. Diabetes in north India has many peculiarities in all aspects from risk factors to control programmers. North Indians are becoming more prone for diabetes and dyslipidemia because rapid westernization of living style and diet due rapid migration to metropolitan cities for employment. North Indian diabetes is plagued with gender bias against females, poor quality of health services, myths, and lack of disease awareness compounded with small number of prevention and awareness programmers that too are immature to counteract the growing pandemic. PMID:25285295

  8. Diabetes mellitus among ethnic seniors: contrasts with diabetes in whites.

    PubMed

    Kamel, H K; Rodriguez-Saldaña, J; Flaherty, J H; Miller, D K

    1999-05-01

    Diabetes mellitus is one of the most common chronic diseases affecting older persons in the United States. It occurs in 18% of persons between 65 and 75 years of age and in as many as 40% of persons over 80 years of age. The prevalence of diabetes mellitus varies considerably by ethnic group and is higher among most minority groups in the United States than among non-Hispanic white persons. Published data also show increased complications and mortality rate from diabetes in the minority groups. In this article, we review the current literature on the prevalence, complications, and mortality-rate effects of diabetes mellitus and the results of interventions in three major minority groups in the United States, namely African Americans, Hispanic Americans, and Native Americans. Recent studies of diabetes mellitus in Mexican seniors also are described. Our review focuses primarily on patients with non-insulin-dependent diabetes mellitus, because by far this is the most prevalent type in older persons. PMID:10339633

  9. [Diabetes mellitus and its animal models].

    PubMed

    Duhault, J; Koenig-Berard, E

    1997-01-01

    This review presents the major animal models usually used for the study of the pathological processes related to insulin-dependent diabetes mellitus (IDDM), non-insulin-dependent diabetes mellitus (NIDDM) and to the main diabetic complications. These models can be observed spontaneously or can be obtained by selective cross-breeding or toxic exposure (chemical or viral), as well as genetically induced. They reproduce some aspects of the human pathology without combining them all in a single model. Consequently, a pertinent pharmacological approach may compare the results obtained with several models. The examination of the recent results obtained with transgenesis does not allow these animal models to replace more classical ones but they may constitute a future challenge for gene therapy despite the multifactorial aspect of diabetic disease. PMID:9501560

  10. Type 2 diabetes mellitus and renal stones

    PubMed Central

    Nerli, Rajendra; Jali, Mallikarjuna; Guntaka, Ajay Kumar; Patne, Pravin; Patil, Shivagouda; Hiremath, Murigendra Basayya

    2015-01-01

    Background: The incidence of urinary stone disease has shown a steep rise in recent decades along with marked modifications in dietary habits and life- style. There has been an increased prevalence of urinary stone disease in patients with diabetes. We took up this study to determine the association of diabetes mellitus with kidney stones in patients undergoing surgical treatment. Materials and Methods: Patients presenting with renal stones for surgical management formed the study group. Body mass index (BMI) was calculated by noting the weight and height of the patient. The extracted stone/stone fragments were analyzed to determine the chemical composition. Urinary pH was similarly noted in all. Results: The mean BMI among the diabetics was 26.35 ± 5.20 (range 17.75-35.60), whereas the mean BMI among the non-diabetics was 23.41 ± 2.85 (range 17.71-31.62) (P < 0.0004). The incidence of uric acid calculi in the diabetics was significantly high (P < 0.03). The mean urinary pH among the diabetics was 5.61 ± 0.36 and among the non-diabetics was 6.87 ± 0.32, which was significantly lower (P < 0.000044). Conclusions: There is a strong association between type 2 diabetes and uric acid stone formation. There is also a strong association between diabetes mellitus, BMI, and also with lower urinary pH. PMID:26605219

  11. Hypothalamic and pancreatic lesions with diabetes mellitus.

    PubMed Central

    Shuangshoti, S; Samranvej, P

    1975-01-01

    A case is reported of a neoplasm of mixed mesenchymal and neuroepithelial origin consisting of plasmacytoma, lymphoma, ganglioneuroma, and astrocytoma in the same mass. The tumour arose in the hypothalamus of a 43 year old diabetic woman who also had alpha cell hyperplasia and beta cell hypoplasia of the islets of Langerhans. It is suggested that both hypothalamic and pancreatic lesions produced diabetes mellitus in this patient. Images PMID:1104774

  12. [Evaluation of nopal capsules in diabetes mellitus].

    PubMed

    Frati Munari, A C; Vera Lastra, O; Ariza Andraca, C R

    1992-01-01

    To find out if commercial capsules with dried nopal (prickle-pear cactus, Opuntia ficus indica may have a role in the management of diabetes mellitus, three experiments were performed: 30 capsules where given in fasting condition to 10 diabetic subjects and serum glucose was measured through out 3 hours; a control test was performed with 30 placebo capsules. OGTT with previous intake of 30 nopal or placebo capsules was performed in ten healthy individuals. In a crossover and single blinded study 14 diabetic patients withdrew the oral hypoglycemic treatment and received 10 nopal or placebo capsules t.i.d. during one week; serum glucose, cholesterol and tryglycerides levels were measured before and after each one-week period. Five healthy subjects were also studied in the same fashion. Opuntia capsules did not show acute hypoglycemic effect and did not influence OGTT. In diabetic patients serum glucose, cholesterol and tryglycerides levels did not change with Opuntia, but they increased with placebo (P < 0.01 glucose and cholesterol, P = NS triglycerides). In healthy individuals glycemia did not change with nopal, while cholesterol and triglycerides decreased (P < 0.01 vs. placebo). The intake of 30 Opuntia capsules daily in patients with diabetes mellitus had a discrete beneficial effect on glucose and cholesterol. However this dose is unpractical and at present it is not recommended in the management of diabetes mellitus. PMID:1307994

  13. Serum markers for type II diabetes mellitus

    DOEpatents

    Metz, Thomas O; Qian, Wei-Jun; Jacobs, Jon M; Polpitiya, Ashoka D; Camp, II, David G; Smith, Richard D

    2014-03-18

    A method for identifying persons with increased risk of developing type 2 diabetes mellitus utilizing selected biomarkers described hereafter either alone or in combination. The present invention allows for broad based, reliable, screening of large population bases and provides other advantages, including the formulation of effective strategies for characterizing, archiving, and contrasting data from multiple sample types under varying conditions.

  14. Diabetes Mellitus Standards of Care.

    PubMed

    Mays, Lucy

    2015-12-01

    Diabetes is a worldwide epidemic with a high cost regarding consumption of health care resources and is associated with high levels of morbidity and mortality. The complex nature of diabetes requires the use of evidence-based guidelines regarding diabetes management. These evidence-based guidelines are lengthy and do not readily translate into nursing care. As an integral component of the interprofessional team, the nurse must provide a thorough assessment of patients with diabetes and work to achieve individual patient treatment goals. Evaluation of patient progress toward treatment goals with regular/frequent follow-up is necessary to promote effective self-management of diabetes. PMID:26596658

  15. Stroke in patients with diabetes mellitus.

    PubMed

    Mankovsky, Boris N; Ziegler, Dan

    2004-01-01

    The article's objective is to review the key advances in the scientific literature related to the association of stroke with diabetes mellitus and to summarize the current approaches to stroke prevention in diabetic patients. The key findings from the literature regarding stroke incidence in patients with diabetes, specific and nonspecific risk factors of stroke in the diabetic population, such as arterial hypertension, dyslipidemia, hyperglycemia, diabetes duration, diabetic complications, insulin resistance/hyperinsulinemia, course and outcome of stroke in subjects with diabetes and/or hyperglycemia, and the peculiarities of type, site and size of stroke in diabetic patients are discussed. The results of recent clinical trials aimed at correcting hyperglycemia, hypertension, and dyslipidemia, to prevent stroke in people with diabetes, are reviewed. The medical database Medline along with original articles from peer-reviewed journals were used for analysis. There is convincing evidence suggesting that diabetes mellitus represents a strong independent risk factor of stroke. The contribution of hyperglycemia to increased stroke risk is not proven. Data suggest an association of the full cluster of the insulin resistance syndrome and stroke. Diabetes is a risk factor mainly for ischemic stroke, while its association with hemorrhagic stroke remains controversial. Hyperglycemia is common in stroke patients, but it is not known whether it independently influences the course and outcome of stroke or merely reflects stroke severity and location. Aggressive control of arterial hypertension and dyslipidemia allows to decrease the risk of stroke in diabetic patients substantially, while the importance of glucose control for stroke prevention remains unproven. PMID:15250030

  16. Effect of diabetes mellitus on sleep quality

    PubMed Central

    Surani, Salim; Brito, Veronica; Surani, Asif; Ghamande, Shekhar

    2015-01-01

    Diabetes mellitus (DM) is a highly prevalent condition affecting about 347 million people worldwide. In addition to its numerous clinical implications, DM also exerts a negative effect on patient’s sleep quality. Impaired sleep quality disrupts the adequate glycemic control regarded as corner stone in DM management and also lead to many deleterious effects causing a profound impact on health related quality of life. This article outlines various factors leading to impaired sleep quality among diabetics and delineates how individual factor influences sleep. The article also discusses potential interventions and lifestyle changes to promote healthy sleep among diabetics. PMID:26131327

  17. Antioxidant role of zinc in diabetes mellitus

    PubMed Central

    Cruz, Kyria Jayanne Clímaco; de Oliveira, Ana Raquel Soares; Marreiro, Dilina do Nascimento

    2015-01-01

    Chronic hyperglycemia statue noticed in diabetes mellitus favors the manifestation of oxidative stress by increasing the production of reactive oxygen species and/or by reducing the antioxidant defense system activity. Zinc plays an important role in antioxidant defense in type 2 diabetic patients by notably acting as a cofactor of the superoxide dismutase enzyme, by modulating the glutathione metabolism and metallothionein expression, by competing with iron and copper in the cell membrane and by inhibiting nicotinamide adenine dinucleotide phosphate-oxidase enzyme. Zinc also improves the oxidative stress in these patients by reducing chronic hyperglycemia. It indeed promotes phosphorylation of insulin receptors by enhancing transport of glucose into cells. However, several studies reveal changes in zinc metabolism in individuals with type 2 diabetes mellitus and controversies remain regarding the effect of zinc supplementation in the improvement of oxidative stress in these patients. Faced with the serious challenge of the metabolic disorders related to oxidative stress in diabetes along with the importance of antioxidant nutrients in the control of this disease, new studies may contribute to improve our understanding of the role played by zinc against oxidative stress and its connection with type 2 diabetes mellitus prognosis. This could serve as a prelude to the development of prevention strategies and treatment of disorders associated with this chronic disease. PMID:25789115

  18. Changing trends in management of gestational diabetes mellitus

    PubMed Central

    Poomalar, Gunasekaran Kala

    2015-01-01

    Gestational diabetes mellitus (GDM) is on the rise globally. In view of the increasing prevalence of GDM and fetal and neonatal complications associated with it, there is a splurge of research in this field and management of GDM is undergoing a sea change. Trends are changing in prevention, screening, diagnosis, treatment and future follow up. There is emerging evidence regarding use of moderate exercise, probiotics and vitamin D in the prevention of GDM. Regarding treatment, newer insulin analogs like aspart, lispro and detemir are associated with better glycemic control than older insulins. Continuous glucose monitoring systems and continuous subcutaneous insulin systems may play a role in those who require higher doses of insulin for sugar control. Evidence exists that favors metformin as a safer alternative to insulin in view of good glycemic control and better perinatal outcomes. As the risk of developing GDM in subsequent pregnancies and also the risk of overt diabetes in later life is high, regular assessment of these women is required in future. Lifestyle interventions or metformin should be offered to women with a history of GDM who develop pre-diabetes. Further studies are required in the field of prevention of GDM for optimizing obstetric outcome. PMID:25789109

  19. Platelet adhesiveness in diabetes mellitus

    PubMed Central

    Shaw, S.; Pegrum, G. D.; Wolff, Sylvia; Ashton, W. L.

    1967-01-01

    Platelet adhesiveness has been assessed on whole blood from a series of 34 diabetics and 50 control subjects using adenosine diphosphate (A.D.P.) and by adherence to glass microspherules (ballotini). Using both techniques it was possible to demonstrate a significant increase in platelet adhesiveness in the diabetic patients. PMID:5614070

  20. Affordable Care Act and Diabetes Mellitus.

    PubMed

    Shi, Qian; Nellans, Frank P; Shi, Lizheng

    2015-12-01

    The Affordable Care Act (ACA) has the potential for great impact on U.S. health care, especially for chronic disease patients requiring long-term care and management. The act was designed to improve insurance coverage, health care access, and quality of care for all Americans, which will assist patients with diabetes mellitus in acquiring routine monitoring and diabetes-related complication screening for better health management and outcomes. There is great potential for patients with diabetes to benefit from the new policy mandating health insurance coverage and plan improvement, Medicaid expansion, minimum coverage guarantees, and free preventative care. However, policy variability among states and ACA implementation present challenges to people with diabetes in understanding and optimizing ACA impact. This paper aims to select the most influential components of the ACA as relates to people with diabetes and discuss how the ACA may improve health care for this vulnerable population. PMID:26458377

  1. [The relationship of periodontitis and diabetes mellitus].

    PubMed

    Kasaj, Adrian; Gortan-Kasaj, Aristea; Willerhausen, Brita; Hoffmann, Oliver; Angelov, Nikola; Zafiropoulos, Gregory-George

    2007-09-01

    Periodontitis is a chronic, dental-plaque induced inflammatory disease of the tooth-supporting tissues, resulting in a gradual loss of connective tissue attachment and alveolar bone. The interrelationship between diabetes mellitus and periodontitis has been studied for many years. At,present, there is strong evidence to suggest that the incidence and severity of periodontitis is influenced by the presence or absence of diabetes mellitus as well as by the degree of diabetes control by patients. Elevated blood glucose levels in poorly controlled diabetics result in an increase of protein glycosylation leading to amplified formation of so-called Advanced Glycation End products (AGE). AGEs are glucose products that have the ability to attract and stimulate inflammatory cells to produce inflammatory cytokines, elevating the risk of periodontal attachment and/or alveolar bone loss. Gram-negative periodontal infection significantly decreases glucose tolerance and can lead, like other types of inflammation, to an increase in the severity of diabetes. Thus, diabetes and periodontal disease form a system in which periodontitis is aggravated and metabolic control of blood glucose levels becomes more difficult. This in turn leads to mutual aggravation that results in a self-enforcing catabolic process, a vicious circle of inflammation, tissue destruction and insulin resistance. PMID:18044471

  2. Vitamins and Type 2 Diabetes Mellitus

    PubMed Central

    Valdés-Ramos, Roxana; Ana Laura, Guadarrama-López; Elina, Martínez-Carrillo Beatriz; Donají, Benítez-Arciniega Alejandra

    2015-01-01

    The present review evaluates the relationship between type 2 diabetes mellitus and individual or combined vitamins. Antioxidant vitamins A, C and E are found decreased in diabetic subjects, possibly due to an increased need to control the excessive oxidative stress produced by abnormalities in glucose metabolism. On the other hand, retinol binding protein exerts a modulating effect, as it has adipokine functions. With respect to the B group vitamins, thiamin, pyridoxine and biotin have been found decreased but the mechanisms are not clear, however supplementation has shown some improvement of the metabolic control in diabetic patients. The absorption of folic acid and vitamin B12 is importantly decreased by the prolongued use of metformin, which is the first choice drug in uncomplicated diabetes, thus these two nutrients have been found deficient in the disease and most probably need to be supplemented regularly. On the other hand, vitamin D is considered a risk factor for the development of diabetes as well as its complications, particularly cardiovascular ones. Although some studies have found an association of vitamin K intake with glucose metabolism further research is needed. Studies on the use of multivitamin supplements have shown unconclusive results. After reviewing the evidence, no real recommendation on the use of vitamin supplements in type 2 diabetes mellitus can be issued, however patients using metformin during prolongued periods may need folic acid and vitamin B12. PMID:25388747

  3. [Sudden cardiac death in diabetes mellitus].

    PubMed

    Israel, C W; Lee-Barkey, Y H

    2016-05-01

    Sudden cardiac death (SCD) represents one of the most frequent causes of death in patients with diabetes. In contrast to patients without diabetes it has not been significantly reduced despite improvements in the treatment of acute myocardial infarction and long-term treatment of cardiovascular diseases as well as diabetes mellitus. Several mechanisms can be responsible for the high incidence of SCD in diabetics: 1. arrhythmogenic effects mediated via cardiac autonomic neuropathy, repolarization disturbances or sympathetic tone activation (hypoglycemia), 2. myocardial ischemia due to atherosclerosis, endothelial dysfunction, platelet aggregation or thrombophilic effects, 3. myocardial disease due to inflammation, fibrosis, associated hypertension or uremia and 4. potassium imbalance due to diabetic nephropathy or hypoglycemia. This review introduces concepts of mechanisms that are responsible for SCD in patients with diabetes. Treatment of patients with diabetes should primarily consider a systematic assessment of any deterioration of this chronic disease and of complications at an early stage. Cardiovascular drug treatment corresponds to that of non-diabetics. In antidiabetic treatment drugs with a low risk of hypoglycemia should be preferred. Treatment with implantable cardioverter defibrillators (ICD) also combined with cardiac resynchronization therapy () demonstrated a high life-saving potential particularly in patients with diabetes. PMID:27071967

  4. Transient diabetes mellitus in a domestic ferret (Mustela putorius furo)

    PubMed Central

    Duhamelle, Alexis; Langlois, Isabelle; Desmarchelier, Marion

    2015-01-01

    A 3.5-year-old spayed female ferret, fed a diet high in refined sugar, was referred for lethargy, polyuria, polydipsia, and polyphagia. Diabetic ketoacidosis was diagnosed. Treatment included insulin therapy and a low carbohydrate diet. Diabetes mellitus resolved 54 d later, and insulin therapy was discontinued. There has been no recurrence of the diabetes mellitus. PMID:26130836

  5. The role of blood groups in the development of diabetes mellitus after gestational diabetes mellitus

    PubMed Central

    Karagoz, Hatice; Erden, Abdulsamet; Ozer, Ozerhan; Esmeray, Kubra; Cetinkaya, Ali; Avci, Deniz; Karahan, Samet; Basak, Mustafa; Bulut, Kadir; Mutlu, Hasan; Simsek, Yasin

    2015-01-01

    Introduction Gestational diabetes mellitus (GDM) is a common condition that is defined as glucose intolerance of varying degree with onset or first recognition during pregnancy and it affects approximately 5% of all pregnancies all over the world. GDM is not only associated with adverse pregnancy outcomes such as macrosomia, dystocia, birth trauma, and metabolic complications in newborns, but it is also a strong predictor of transitioning to overt DM postpartum. The association of ABO blood groups with DM has been observed before in several epidemiological and genetic studies and resulted with inconsistent findings, but still there are not enough studies in the literature about the association of ABO blood groups with GDM. In this study, we aimed at investigating any possible relationship between the ABO blood group system and GDM and also the transitioning of GDM to overt DM postpartum, in Turkey. Patients and methods A total of 233 patients with GDM from Kayseri Training and Research Hospital between 2002 and 2012 were included in the study. The cases that have serologically determined blood groups and Rh factor in the hospital records were included in the study, and the patients with unknown blood groups were excluded. Patients were classified according to blood groups (A, B, AB, and O) and Rh status (+/−). GDM was diagnosed based on the glucose cut-points of the International Association of the Diabetes and Pregnancy Society Groups. The distributions of blood groups of the patients with GDM were compared with the distribution of blood groups of 17,314 healthy donors who were admitted to the Turkish Red Crescent Blood Service in our city in 2012. Results There was a significant difference between the patients with GDM and control group in terms of distribution of ABO blood groups. Blood group AB was found to be higher in the patients with GDM compared to the control group (P=0.029). When the patients were compared according to the development of DM, the ratio

  6. 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

  7. Type 2 diabetes mellitus and exercise impairment.

    PubMed

    Reusch, Jane E B; Bridenstine, Mark; Regensteiner, Judith G

    2013-03-01

    Limitations in physical fitness, a consistent finding in individuals with both type I and type 2 diabetes mellitus, correlate strongly with cardiovascular and all-cause mortality. These limitations may significantly contribute to the persistent excess cardiovascular mortality affecting this group. Exercise impairments in VO2 peak and VO2 kinetics manifest early on in diabetes, even with good glycemic control and in the absence of clinically apparent complications. Subclinical cardiac dysfunction is often present but does not fully explain the observed defect in exercise capacity in persons with diabetes. In part, the cardiac limitations are secondary to decreased perfusion with exercise challenge. This is a reversible defect. Similarly, in the skeletal muscle, impairments in nutritive blood flow correlate with slowed (or inefficient) exercise kinetics and decreased exercise capacity. Several correlations highlight the likelihood of endothelial-specific impairments as mediators of exercise dysfunction in diabetes, including insulin resistance, endothelial dysfunction, decreased myocardial perfusion, slowed tissue hemoglobin oxygen saturation, and impairment in mitochondrial function. Both exercise training and therapies targeted at improving insulin sensitivity and endothelial function improve physical fitness in subjects with type 2 diabetes. Optimization of exercise functions in people with diabetes has implications for diabetes prevention and reductions in mortality risk. Understanding the molecular details of endothelial dysfunction in diabetes may provide specific therapeutic targets for the remediation of this defect. Rat models to test this hypothesis are under study. PMID:23299658

  8. Experimental Diabetes Mellitus in Different Animal Models.

    PubMed

    Al-Awar, Amin; Kupai, Krisztina; Veszelka, Médea; Szűcs, Gergő; Attieh, Zouhair; Murlasits, Zsolt; Török, Szilvia; Pósa, Anikó; Varga, Csaba

    2016-01-01

    Animal models have historically played a critical role in the exploration and characterization of disease pathophysiology and target identification and in the evaluation of novel therapeutic agents and treatments in vivo. Diabetes mellitus disease, commonly known as diabetes, is a group of metabolic disorders characterized by high blood glucose levels for a prolonged time. To avoid late complications of diabetes and related costs, primary prevention and early treatment are therefore necessary. Due to its chronic symptoms, new treatment strategies need to be developed, because of the limited effectiveness of the current therapies. We overviewed the pathophysiological features of diabetes in relation to its complications in type 1 and type 2 mice along with rat models, including Zucker Diabetic Fatty (ZDF) rats, BB rats, LEW 1AR1/-iddm rats, Goto-Kakizaki rats, chemically induced diabetic models, and Nonobese Diabetic mouse, and Akita mice model. The advantages and disadvantages that these models comprise were also addressed in this review. This paper briefly reviews the wide pathophysiological and molecular mechanisms associated with type 1 and type 2 diabetes, particularly focusing on the challenges associated with the evaluation and predictive validation of these models as ideal animal models for preclinical assessments and discovering new drugs and therapeutic agents for translational application in humans. PMID:27595114

  9. Experimental Diabetes Mellitus in Different Animal Models

    PubMed Central

    Al-awar, Amin; Veszelka, Médea; Szűcs, Gergő; Attieh, Zouhair; Murlasits, Zsolt; Török, Szilvia; Pósa, Anikó; Varga, Csaba

    2016-01-01

    Animal models have historically played a critical role in the exploration and characterization of disease pathophysiology and target identification and in the evaluation of novel therapeutic agents and treatments in vivo. Diabetes mellitus disease, commonly known as diabetes, is a group of metabolic disorders characterized by high blood glucose levels for a prolonged time. To avoid late complications of diabetes and related costs, primary prevention and early treatment are therefore necessary. Due to its chronic symptoms, new treatment strategies need to be developed, because of the limited effectiveness of the current therapies. We overviewed the pathophysiological features of diabetes in relation to its complications in type 1 and type 2 mice along with rat models, including Zucker Diabetic Fatty (ZDF) rats, BB rats, LEW 1AR1/-iddm rats, Goto-Kakizaki rats, chemically induced diabetic models, and Nonobese Diabetic mouse, and Akita mice model. The advantages and disadvantages that these models comprise were also addressed in this review. This paper briefly reviews the wide pathophysiological and molecular mechanisms associated with type 1 and type 2 diabetes, particularly focusing on the challenges associated with the evaluation and predictive validation of these models as ideal animal models for preclinical assessments and discovering new drugs and therapeutic agents for translational application in humans. PMID:27595114

  10. 78 FR 14561 - Notice of Diabetes Mellitus Interagency Coordinating Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-06

    ... meeting on March 28, 2013, focusing on ``Federal Initiatives to Address Gestational Diabetes Mellitus... 28, 2013 DMICC meeting will focus on ``Federal Initiatives to Address Gestational Diabetes Mellitus... HUMAN SERVICES National Institutes of Health Notice of Diabetes Mellitus Interagency...

  11. Shoulder manifestations of diabetes mellitus.

    PubMed

    Garcilazo, Cintia; Cavallasca, Javier A; Musuruana, Jorge L

    2010-09-01

    The musculoskeletal system can be affected by diabetes in a number of ways. The shoulder is one of the frequently affected sites. One of the rheumatic conditions caused by diabetes is frozen shoulder (adhesive capsulitis), which is characterized by pain and severe limited active and passive range of motion of the glenohumeral joint, particularly external rotation. This disorder has a clinical diagnosis and the treatment is based on physiotherapy, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections and, in refractory cases, surgical resolution. As with adhesive capsulitis, calcific periarthritis of the shoulder causes pain and limited joint mobility, although usually it has a better prognosis than frozen shoulder. Reflex sympathetic dystrophy, also known as shoulder-hand syndrome, is a painful syndrome associated with vasomotor and sudomotor changes in the affected member. Diabetic amyotrophy usually affects the peripheral nerves of lower limbs. However, when symptoms involve the shoulder girdle, it must be considered in the differential diagnosis of shoulder painful conditions. Osteoarthritis is the most common rheumatic condition. There are many risk factors for shoulder osteoarthritis including age, genetics, sex, weight, joint infection, history of shoulder dislocation, and previous injury, in older age patients, diabetes is a risk factor for shoulder OA. Treatment options include acetaminophen, NSAIDs, short term opiate, glucosamine and chondroitin. Corticosteroid injections and/or injections of hyaluronans could also be considered. Patients with continued disabling pain that is not responsive to conservative measures may require surgical referral. The present review will focus on practice points of view about shoulder manifestations in patients with diabetes. PMID:20701586

  12. Thyroid Dysfunction and Associated Risk Factors among Nepalese Diabetes Mellitus Patients.

    PubMed

    Khatiwada, Saroj; Kc, Rajendra; Sah, Santosh Kumar; Khan, Seraj Ahmed; Chaudhari, Rajendra Kumar; Baral, Nirmal; Lamsal, Madhab

    2015-01-01

    Objectives. To assess thyroid function and associated risk factors in Nepalese diabetes mellitus patients. Methods. A cross-sectional study was carried out among 419 diabetes mellitus patients at B. P. Koirala Institute of Health Sciences, Dharan, Nepal. Information on demographic and anthropometric variables and risk factors for thyroid dysfunction was collected. Blood samples were analysed to measure thyroid hormones, blood sugar, and lipid profile. Results. Prevalence rate of thyroid dysfunction was 36.03%, with subclinical hypothyroidism (26.5%) as the most common thyroid dysfunction. Thyroid dysfunction was much common in females (42.85%) compared to males (30.04%) (p = 0.008) and in type 1 diabetes (50%) compared to type 2 diabetes mellitus (35.41%) (p = 0.218). Diabetic patients with thyroid dysfunction had higher total cholesterol, HDL cholesterol, and LDL cholesterol in comparison to patients without thyroid dysfunction. Significant risk factors for thyroid dysfunction, specifically hypothyroidism (overt and subclinical), were smoking (relative risk of 2.56 with 95% CI (1.99-3.29, p < 0.001)), family history of thyroid disease (relative risk of 2.57 with 95% CI (2.0-3.31, p < 0.001)), and female gender (relative risk of 1.44 with 95% CI (1.09-1.91, p = 0.01)). Conclusions. Thyroid dysfunction is common among Nepalese diabetic patients. Smoking, family history of thyroid disease, and female gender are significantly associated with thyroid dysfunction. PMID:26435714

  13. Autonomic Neuropathy in Diabetes Mellitus

    PubMed Central

    Verrotti, Alberto; Prezioso, Giovanni; Scattoni, Raffaella; Chiarelli, Francesco

    2014-01-01

    Diabetic autonomic neuropathy (DAN) is a serious and common complication of diabetes, often overlooked and misdiagnosed. It is a systemic-wide disorder that may be asymptomatic in the early stages. The most studied and clinically important form of DAN is cardiovascular autonomic neuropathy defined as the impairment of autonomic control of the cardiovascular system in patients with diabetes after exclusion of other causes. The reported prevalence of DAN varies widely depending on inconsistent definition, different diagnostic method, different patient cohorts studied. The pathogenesis is still unclear and probably multifactorial. Once DAN becomes clinically evident, no form of therapy has been identified, which can effectively stop or reverse it. Prevention strategies are based on strict glycemic control with intensive insulin treatment, multifactorial intervention, and lifestyle modification including control of hypertension, dyslipidemia, stop smoking, weight loss, and adequate physical exercise. The present review summarizes the latest knowledge regarding clinical presentation, epidemiology, pathogenesis, and management of DAN, with some mention to childhood and adolescent population. PMID:25520703

  14. Aldose reductase, oxidative stress, and diabetic mellitus.

    PubMed

    Tang, Wai Ho; Martin, Kathleen A; Hwa, John

    2012-01-01

    Diabetes mellitus (DM) is a complex metabolic disorder arising from lack of insulin production or insulin resistance (Diagnosis and classification of diabetes mellitus, 2007). DM is a leading cause of morbidity and mortality in the developed world, particularly from vascular complications such as atherothrombosis in the coronary vessels. Aldose reductase (AR; ALR2; EC 1.1.1.21), a key enzyme in the polyol pathway, catalyzes nicotinamide adenosine dinucleotide phosphate-dependent reduction of glucose to sorbitol, leading to excessive accumulation of intracellular reactive oxygen species (ROS) in various tissues of DM including the heart, vasculature, neurons, eyes, and kidneys. As an example, hyperglycemia through such polyol pathway induced oxidative stress, may have dual heart actions, on coronary blood vessel (atherothrombosis) and myocardium (heart failure) leading to severe morbidity and mortality (reviewed in Heather and Clarke, 2011). In cells cultured under high glucose conditions, many studies have demonstrated similar AR-dependent increases in ROS production, confirming AR as an important factor for the pathogenesis of many diabetic complications. Moreover, recent studies have shown that AR inhibitors may be able to prevent or delay the onset of cardiovascular complications such as ischemia/reperfusion injury, atherosclerosis, and atherothrombosis. In this review, we will focus on describing pivotal roles of AR in the pathogenesis of cardiovascular diseases as well as other diabetic complications, and the potential use of AR inhibitors as an emerging therapeutic strategy in preventing DM complications. PMID:22582044

  15. Diabetes Mellitus in the Transplanted Kidney

    PubMed Central

    Peev, Vasil; Reiser, Jochen; Alachkar, Nada

    2014-01-01

    Diabetes mellitus (DM) is the most common cause of chronic kidney disease and end stage renal disease. New onset diabetes mellitus after transplant (NODAT) has been described in approximately 30% of non-diabetic kidney-transplant recipients many years post transplantation. DM in patients with kidney transplantation constitutes a major comorbidity, and has significant impact on the patients and allografts’ outcome. In addition to the major comorbidity and mortality that result from cardiovascular and other DM complications, long standing DM after kidney-transplant has significant pathological injury to the allograft, which results in lowering the allografts and the patients’ survivals. In spite of the cumulative body of data on diabetic nephropathy (DN) in the native kidney, there has been very limited data on the DN in the transplanted kidney. In this review, we will shed the light on the risk factors that lead to the development of NODAT. We will also describe the impact of DM on the transplanted kidney, and the outcome of kidney-transplant recipients with NODAT. Additionally, we will present the most acceptable data on management of NODAT. PMID:25221544

  16. [DGRW-Update: Rehabilitation in Diabetes Mellitus].

    PubMed

    Pollmann, H; Hübner, P

    2013-08-01

    In the years to come, prevalence and socio-medical relevance of diabetes mellitus will continue to increase. Therapeutic aims must be defined on an individual basis considering risks and benefits. No longer is it reasonable to insist on normoglycaemia as a general therapeutic aim. There are numerous effective and evidence-based therapeutic modules for diabetes mellitus which are also offered within the scope of rehabilitation. Reliable evidence exists to confirm that therapy should start as early as possible, because it is less effective during later phases of the disease when concomitant cardiovascular illnesses may occur. In most cases, medical rehabilitation of diabetic patients is based on other diagnoses. There is a considerable need for rehabilitation among diabetics who are in ambulant care but do not intend to file a request for rehabilitative measures. Sustainability of rehabilitative effects must be improved by means of follow-up treatment and networking with the ambulant structures of long-term care. Provided that the indication makes it appropriate, bariatric surgery constitutes a new effective therapy. PMID:23986288

  17. Exercise-related hypoglycemia in diabetes mellitus

    PubMed Central

    Younk, Lisa M; Mikeladze, Maia; Tate, Donna; Davis, Stephen N

    2011-01-01

    Current recommendations are that people with Type 1 and Type 2 diabetes mellitus exercise regularly. However, in cases in which insulin or insulin secretagogues are used to manage diabetes, patients have an increased risk of developing hypoglycemia, which is amplified during and after exercise. Repeated episodes of hypoglycemia blunt autonomic nervous system, neuroendocrine and metabolic defenses (counter-regulatory responses) against subsequent episodes of falling blood glucose levels during exercise. Likewise, antecedent exercise blunts counter-regulatory responses to subsequent hypoglycemia. This can lead to a vicious cycle, by which each episode of either exercise or hypoglycemia further blunts counter-regulatory responses. Although contemporary insulin therapies cannot fully mimic physiologic changes in insulin secretion, people with diabetes have several management options to avoid hypoglycemia during and after exercise, including regularly monitoring blood glucose, reducing basal and/or bolus insulin, and consuming supplemental carbohydrates. PMID:21339838

  18. [Geriatric aspects for the management of diabetes mellitus].

    PubMed

    Huber, Joakim; Smeikal, Michael; Lechleitner, Monika; Fasching, Peter

    2016-04-01

    There is a high prevalence of diabetes mellitus in the elderly population of industrial countries. The present article provides recommendations for the screening, prevention and treatment of elderly diabetic patients according to current scientific evidence. PMID:27052230

  19. 78 FR 79062 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... January 17, 2008 (73 FR 3316). FOR FURTHER INFORMATION CONTACT: Elaine M. Papp, Chief, Medical Programs... Federal Motor Carrier Safety Administration Qualification of Drivers; Exemption Applications; Diabetes... exemption from the diabetes mellitus requirement; request for comments. SUMMARY: FMCSA announces receipt...

  20. Cerebral Syndromes of Diabetes Mellitus

    PubMed Central

    Shavelle, Henry S.

    1969-01-01

    Three labile diabetic patients had recurring episodes of altered sensorium. Each had severe cerebrovascular disease with superimposed metabolic derangements, including ketoacidosis, hyperglycemia without ketosis, mild uremia, and possibly cerebral edema. Two of the patients were examined postmortem. Severe leptomeningeal scarring, basal ganglial calcification and destruction of small intracerebral vessels without evidence of large vessel atherosclerosis were found unexpectedly in one patient, a rare occurrence in this country although recently reported from Europe. The other patient had large vessel atherosclerosis only. The clinical expression of the vascular disease was modified by concurrent abnormalities and reflected the sum total of the complexities which coexisted. The pathophysiology of the unconscious state necessarily depends on the inciting factors. Ketoacidotic coma is associated with depressed cerebral oxygen consumption. Spinal fluid pH is usually maintained during ketosis but is sometimes lowered inadvertently during bicarbonate therapy, with resultant coma. Other variables influencing the clinical expression, with or without ketosis, would include, among others, blood viscosity alterations, rapid decrements in blood sugar, and existing degrees of lactic acidosis. The increasing life-span of the juvenile diabetics, favorably influenced by improved management and recently by hemodialysis, may uncover vascular complications heretofore rarely seen and create additional diagnostic and therapeutic enigmas. ImagesFigure 1.Figure 2.Figure 3. PMID:5798497

  1. Homocysteine, Cortisol, Diabetes Mellitus, and Psychopathology

    PubMed Central

    Kontoangelos, K.; Papageorgiou, C. C.; Raptis, A. E.; Tsiotra, P.; Lambadiari, V.; Papadimitriou, G. N.; Rabavilas, A. D.; Dimitriadis, G.; Raptis, S. A.

    2015-01-01

    Objective. This study investigates the association of homocysteine and cortisol with psychological factors in type 2 diabetic patients. Method. Homocysteine, cortisol, and psychological variables were analyzed from 131 diabetic patients. Psychological factors were assessed with the Eysenck Personality Questionnaire (EPQ), Hostility and Direction of Hostility Questionnaire (HDHQ), the Symptom Checklist 90-R (SCL 90-R), the Zung Self-Rating Depression Scale (ZDRS), and the Maudsley O-C Inventory Questionnaire (MOCI). Blood samples were taken by measuring homocysteine and cortisol in both subgroups during the initial phase of the study (T0). One year later (T1), the uncontrolled diabetic patients were reevaluated with the use of the same psychometric instruments and with an identical blood analysis. Results. The relation of psychoticism and homocysteine is positive among controlled diabetic patients (P value = 0.006 < 0.05) and negative among uncontrolled ones (P value = 0.137). Higher values of cortisol correspond to lower scores on extraversion subscale (rp = −0.223, P value = 0.010). Controlled diabetic patients showed a statistically significant negative relationship between homocysteine and the act-out hostility subscale (rsp = −0.247, P = 0.023). There is a statistically significant relationship between homocysteine and somatization (rsp = −0.220, P = 0.043). Conclusions. These findings support the notion that homocysteine and cortisol are related to trait and state psychological factors in patients with diabetes mellitus type 2. PMID:25722989

  2. [Obesity disease with diabetes mellitus].

    PubMed

    Nagamine, Kazuhiro; Ueno, Hiroaki; Nakazato, Masamitsu

    2015-12-01

    Obesity has been increasing not only in Japan but also in both developed and developing countries. Mean body mass index of Japanese patients with type 2 diabetes has been increasing, and it reached 25.0 in 2013. If body weight decreases more than 3% of initial body weight in patients with metabolic syndrome, not only glucose metabolism but also dyslipidemia and hypertension improve. To reduce the excess body weight, behavior therapy, calorie restriction, and exercise are necessary. The next strategies are drugs including mazindol, glucose-like peptide-1 receptor agonist and sodium-dependent glucose cotransporter 2 inhibitor, and bariatric surgery. Because it is often difficult to reduce body weight using only present non-invasive therapies, clarification of appetite mechanisms and development of novel anti-obesity drugs with few side effects are needed. PMID:26666154

  3. Indicators of glycemic control in patients with gestational diabetes mellitus and pregnant women with diabetes mellitus

    PubMed Central

    Hashimoto, Kunihiko; Koga, Masafumi

    2015-01-01

    Recently, it has become clear that mild abnormal glucose tolerance increases the incidence of perinatal maternal-infant complications, and so the definition and diagnostic criteria of gestational diabetes mellitus (GDM) have been changed. Therefore, in patients with GDM and pregnant women with diabetes mellitus, even stricter glycemic control than before is required to reduce the incidence of perinatal maternal-infant complications. Strict glycemic control cannot be attained without an indicator of glycemic control; this review proposes a reliable indicator. The gold standard indicator of glycemic control in patients with diabetes mellitus is hemoglobin A1c (HbA1c); however, we have demonstrated that HbA1c does not reflect glycemic control accurately during pregnancy because of iron deficiency. It has also become clear that glycated albumin, another indicator of glycemic control, is not influenced by iron deficiency and therefore might be a better indicator of glycemic control in patients with GDM and pregnant women with diabetes mellitus. However, large-population epidemiological studies are necessary in order to confirm our proposal. Here, we outline the most recent findings about the indicators of glycemic control during pregnancy including fructosamine and 1,5-anhydroglucitol. PMID:26240701

  4. Diabetes Mellitus in Outpatients in Debre Berhan Referral Hospital, Ethiopia

    PubMed Central

    Habtewold, Tesfa Dejenie; Tsega, Wendwesen Dibekulu; Wale, Bayu Yihun

    2016-01-01

    Introduction. Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Most people with diabetes live in low- and middle-income countries and these will experience the greatest increase in cases of diabetes over the next 22 years. Objective. To assess the prevalence and associated factors of diabetes mellitus among outpatients of Debre Berhan Referral Hospital. Methods and Materials. A cross-sectional study was conducted from April to June 2015 among 385 patients. Random quota sampling technique was used to get individual patients and risk factors assessment. Patients diabetes status was ascertained by World Health Organization Diabetes Mellitus Diagnostic Criteria. The collected data were entered, cleaned, and analyzed and Chi-square test was applied to test any association between dependent and independent variable. Result. Out of the total 385 study patients, 368 have participated in the study yielding a response rate of 95.3%. Concerning clinical presentation of diabetes mellitus, 13.3% of patients reported thirst, 14.4% of patients declared polyurea, and 14.9% of patients ascertained unexplained weight loss. The statistically significant associated factors of diabetes mellitus were hypertensive history, obesity, the number of parities, and smoking history. Conclusion. The prevalence of diabetes mellitus among outpatients in Debre Berhan Referral Hospital was 0.34% and several clinical and behavioral factors contribute to the occurrence of diabetes mellitus which impose initiation of preventive, promotive, and curative strategies. PMID:26881245

  5. Visual Perception Associated With Diabetes Mellitus

    NASA Astrophysics Data System (ADS)

    Suaste, Ernesto

    2004-09-01

    We designs and implement an instrumental methodology of analysis of the pupillary response to chromatic stimuli in order to observe the changes of pupillary area in the process of contraction and dilation in diabetic patients. Visual stimuli were used in the visible spectrum (400nm-650nm). Three different programs were used to determinate the best stimulation in order to obtain the better and contrasted pupillary response for diagnosis of the visual perception of colors. The stimulators PG0, PG12 and PG20 were designed in our laboratory. The test was carried out with 44 people, 33 men, 10 women and a boy (22-52 and 6 years), 12 with the stimulator PG0, 21 with PG12 and 17 with PG20, 7 subjects participated in more than a test. According to the plates of Ishihara, 40 of those subjects have normal vision to the colors, one subject suffers dicromasy (inability to differ or to perceive red and green) and while three of them present deficiencies to observe the blue and red spectrum (they suffer type II diabetes mellitus). With this instrumental methodology, we pretend to obtain an indication in the pupillary variability for the early diagnose of the diabetes mellitus, as well as a monitoring instrument for it.

  6. EXECUTIVE DYSFUNCTION IN HOMEBOUND OLDER PEOPLE WITH DIABETES MELLITUS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of this study was to describe patterns of cognitive deficits and activities of daily living (ADLs) in older people with diabetes mellitus. We conducted a cross-sectional, population-based study on two hundred ninety-one homebound people aged 60 and older, 40% with diabetes mellitus, in...

  7. Type 2 diabetes mellitus in children and adolescents

    PubMed Central

    Reinehr, Thomas

    2013-01-01

    Type 2 diabetes mellitus is emerging as a new clinical problem within pediatric practice. Recent reports indicate an increasing prevalence of type 2 diabetes mellitus in children and adolescents around the world in all ethnicities, even if the prevalence of obesity is not increasing any more. The majority of young people diagnosed with type 2 diabetes mellitus was found in specific ethnic subgroups such as African-American, Hispanic, Asian/Pacific Islanders and American Indians. Clinicians should be aware of the frequent mild or asymptomatic manifestation of type 2 diabetes mellitus in childhood. Therefore, a screening seems meaningful especially in high risk groups such as children and adolescents with obesity, relatives with type 2 diabetes mellitus, and clinical features of insulin resistance (hypertension, dyslipidemia, polycystic ovarian syndrome, or acanthosis nigricans). Treatment of choice is lifestyle intervention followed by pharmacological treatment (e.g., metformin). New drugs such as dipeptidyl peptidase inhibitors or glucagon like peptide 1 mimetics are in the pipeline for treatment of youth with type 2 diabetes mellitus. However, recent reports indicate a high dropout of the medical care system of adolescents with type 2 diabetes mellitus suggesting that management of children and adolescents with type 2 diabetes mellitus requires some remodeling of current healthcare practices. PMID:24379917

  8. Genetic Links between Diabetes Mellitus and Coronary Atherosclerosis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Diabetes mellitus is one of the most common endocrine disorders affecting almost 6% of the world's population and with clear indication that its prevalence continues to increase. The causes of diabetes mellitus are multifactorial and in the general population, both genetic and environmental factors ...

  9. Peptide and protein biomarkers for type 1 diabetes mellitus

    DOEpatents

    Zhang, Qibin; Metz, Thomas O.

    2014-06-10

    A method for identifying persons with increased risk of developing type 1 diabetes mellitus, or having type I diabetes mellitus, utilizing selected biomarkers described herein either alone or in combination. The present disclosure allows for broad based, reliable, screening of large population bases. Also provided are arrays and kits that can be used to perform such methods.

  10. Peptide and protein biomarkers for type 1 diabetes mellitus

    DOEpatents

    Zhang, Qibin; Metz, Thomas O.

    2016-08-30

    A method for identifying persons with increased risk of developing type 1 diabetes mellitus, or having type I diabetes mellitus, utilizing selected biomarkers described herein either alone or in combination. The present disclosure allows for broad based, reliable, screening of large population bases. Also provided are arrays and kits that can be used to perform such methods.

  11. Exocrine Pancreas in Cats With Diabetes Mellitus.

    PubMed

    Zini, E; Ferro, S; Lunardi, F; Zanetti, R; Heller, R S; Coppola, L M; Guscetti, F; Osto, M; Lutz, T A; Cavicchioli, L; Reusch, C E

    2016-01-01

    Pancreatitis has been described in cats with diabetes mellitus, although the number of studies currently available is very limited. In addition, ketoacidosis has been hypothesized to be associated with pancreatitis in diabetic cats. The aims of the present study were to investigate whether diabetic cats have pancreatitis and to determine if pancreatitis is more frequent with ketoacidosis. Samples of pancreas were collected postmortem from 37 diabetic cats, including 15 with ketoacidosis, and 20 control cats matched for age, sex, breed, and body weight. Sections were stained with hematoxylin and eosin, double-labeled for insulin/CD3, insulin/CD20, insulin/myeloperoxidase, insulin/PCNA, and glucagon/Ki67, and single-labeled for Iba1. A previously proposed semiquantitative score was used to characterize pancreatitis, along with counts of inflammatory cells. Scores of pancreatitis and the number of neutrophils, macrophages, and lymphocytes in the exocrine pancreas did not differ between diabetic and control cats or between diabetic cats with and without ketoacidosis. Of note, PCNA-positive acinar cells were increased (P = .002) in diabetic cats, particularly near islets (P < .001). Ki67-positive acinar cells were increased only near islets (P = .038). Ketoacidosis was not linked to proliferation. The results suggest that histopathologic evidence of pancreatitis may not be more frequent in diabetic cats and that ketoacidosis may not be associated with it at the time of death. Augmented PCNA-positive acinar cells might indicate increased proliferation due to chronic pancreatitis. The reason behind the prevalent proliferation of acinar cells surrounding pancreatic islets deserves further investigation. PMID:26319779

  12. Endocrine Pancreas in Cats With Diabetes Mellitus.

    PubMed

    Zini, E; Lunardi, F; Zanetti, R; Heller, R S; Coppola, L M; Ferro, S; Guscetti, F; Osto, M; Lutz, T A; Reusch, C E; Cavicchioli, L

    2016-01-01

    Pancreatic amyloidosis and loss of α and β cells have been shown to occur in cats with diabetes mellitus, although the number of studies currently available is very limited. Furthermore, it is not known whether pancreatic islet inflammation is a common feature. The aims of the present study were to characterize islet lesions and to investigate whether diabetic cats have inflammation of the pancreatic islets. Samples of pancreas were collected postmortem from 37 diabetic and 20 control cats matched for age, sex, breed, and body weight. Histologic sections were stained with hematoxylin and eosin and Congo red; double labeled for insulin/CD3, insulin/CD20, insulin/myeloperoxidase, insulin/proliferating cell nuclear antigen, and glucagon/Ki67; and single labeled for amylin and Iba1. Mean insulin-positive cross-sectional area was approximately 65% lower in diabetic than control cats (P = .009), while that of amylin and glucagon was similar. Surprisingly, amyloid deposition was similar between groups (P = .408). Proliferation of insulin- and glucagon-positive cells and the number of neutrophils, macrophages, and T (CD3) and B (CD20) lymphocytes in the islets did not differ. The presence of T and B lymphocytes combined tended to be more frequent in diabetic cats (n = 8 of 37; 21.6%) than control cats (n = 1 of 20; 5.0%). The results confirm previous observations that loss of β cells but not α cells occurs in diabetic cats. Islet amyloidosis was present in diabetic cats but was not greater than in controls. A subset of diabetic cats had lymphocytic infiltration of the islets, which might be associated with β-cell loss. PMID:26113611

  13. Update on Echocardiographic Assessment in Diabetes Mellitus.

    PubMed

    Wang, Ying; Marwick, Thomas H

    2016-09-01

    Type 2 diabetes mellitus (T2DM) is a well-recognized risk factor for cardiovascular diseases and cardiac death. While the increased mortality of patients with DM has traditionally been attributed to coronary artery disease, approximately half of the mortality has other causes, including non-ischemic heart failure (HF). In this context, effective screening and diagnosis of cardiac structural and functional abnormalities are crucial for preventive strategies and for predicting prognosis. This review discusses various echocardiographic diagnostic modalities, including tissue Doppler imaging (TDI) and two-dimensional (2D) speckle-tracking echocardiography (STE) for screening, risk stratification, and guidance of management of patients with T2DM. PMID:27443381

  14. Coronary artery disease and diabetes mellitus.

    PubMed

    Aronson, Doron; Edelman, Elazer R

    2014-08-01

    Diabetes mellitus (DM) is a major risk factor for cardiovascular disease. Near-normal glycemic control does not reduce cardiovascular events. For many patients with 1- or 2-vessel coronary artery disease, there is little benefit from any revascularization procedure over optimal medical therapy. For multivessel coronary disease, randomized trials demonstrated the superiority of coronary artery bypass grafting over multivessel percutaneous coronary intervention in patients with treated DM. However, selection of the optimal myocardial revascularization strategy requires a multidisciplinary team approach ('heart team'). This review summarizes the current evidence regarding the effectiveness of various medical therapies and revascularization strategies in patients with DM. PMID:25091969

  15. Coronary Artery Disease and Diabetes Mellitus.

    PubMed

    Aronson, Doron; Edelman, Elazer R

    2016-01-01

    Diabetes mellitus (DM) is a major risk factor for cardiovascular disease. Near-normal glycemic control does not reduce cardiovascular events. For many patients with 1- or 2-vessel coronary artery disease, there is little benefit from any revascularization procedure over optimal medical therapy. For multivessel coronary disease, randomized trials demonstrated the superiority of coronary artery bypass grafting over multivessel percutaneous coronary intervention in patients with treated DM. However, selection of the optimal myocardial revascularization strategy requires a multidisciplinary team approach ('heart team'). This review summarizes the current evidence regarding the effectiveness of various medical therapies and revascularization strategies in patients with DM. PMID:26567979

  16. Effects of gestational and overt diabetes on human placental cytochromes P450 and glutathione S-transferase.

    PubMed

    McRobie, D J; Glover, D D; Tracy, T S

    1998-04-01

    The placenta possesses the ability to metabolize a number of xenobiotics and endogenous compounds by processes similar to those seen in the liver. Animal and in vivo studies have observed that the presence of diabetes alters the expression of hepatic metabolizing enzymes (cytochrome P450 and glutathione S-transferase); however, it is unknown whether similar alterations occur in the human placenta. To evaluate whether diabetes has any effect of placental xenobiotic metabolizing activity, the catalytic activities of 7-ethoxyresorufin O-deethylation (EROD, CYP1A1), chlorzoxazone 6-hydroxylation (CYP2E1), dextromethorphan N-demethylation (CYP3A4), dextromethorphan O-demethylation (CYP2D6), and 1-chloro-2, 4-dinitrobenzene (CDNB) conjugation with glutathione (glutathione S-transferase, GST) from placentas of diet (class A1) and insulin-dependent (class A2) gestational diabetics and overt diabetics were compared with matched controls. EROD activity (CYP1A1) ranged from 0.29 to 2.67 pmol/min/mg protein. However, no differences were observed among overt or gestational diabetics and their respective matched controls. CDNB conjugation (GST) ranged from 0.275 to 1.65 units/min/mg protein. In contrast to that observed with CYP1A1, a small but statistically significant reduction in GST activity was noted in overt diabetics as compared with their matched controls and gestational diabetics. CYP2E1, 2D6, and 3A4 enzymatic activities were not detected in human placental tissue. GST protein was detectable in all tissues studied, but no CYP protein could be detected in any of the tissues. Thus, it seems that pregnant women with overt diabetes have reduced GST activity in the placenta, which could potentially result in the exposure of the fetus to harmful electrophiles. However, the full clinical significance of this finding remains to be elucidated. PMID:9531526

  17. Statin use and risk of diabetes mellitus.

    PubMed

    Chogtu, Bharti; Magazine, Rahul; Bairy, K L

    2015-03-15

    The 3-hydroxy-methylglutaryl coenzyme A reductase inhibitors, statins, are widely used in the primary and secondary prevention of cardiovascular diseases to lower serum cholesterol levels. As type 2 diabetes mellitus is accompanied by dyslipidemia, statins have a major role in preventing the long term complications in diabetes and are recommended for diabetics with normal low density lipoprotein levels as well. In 2012, United States Food and Drug Administration released changes to statin safety label to include that statins have been found to increase glycosylated haemoglobin and fasting serum glucose levels. Many studies done on patients with cardiovascular risk factors have shown that statins have diabetogenic potential and the effect varies as per the dosage and type used. The various mechanisms for this effect have been proposed and one of them is downregulation of glucose transporters by the statins. The recommendations by the investigators are that though statins can have diabetogenic risk, they have more long term benefits which can outweigh the risk. In elderly patients and those with metabolic syndrome, as the risk of diabetes increase, the statins should be used cautiously. Other than a subset of population with risk for diabetes; statins still have long term survival benefits in most of the patients. PMID:25789118

  18. [Impact of diabetes mellitus on driving safety].

    PubMed

    Ekoé, J M; Laberge-Nadeau, C; Ghadirian, P; Hamet, P

    1991-01-01

    Driving ability is controlled by specific regulations. Therefore disabled individuals or those with certain chronic diseases may be affected by these regulations. These latter are based on assumption that the existence and the nature of certain diseases may cause particular hazard; and this could be prevented by introducing certain driving regulations. This hypothesis has not been tested properly, considering the proposed and suspected risk factors. Diabetes mellitus is a good example of the interested medical condition in this field. Review of the literature do not provide adequate information to allow us to conclude whether the insulin treated diabetic person is at higher risk to develop traffic accident, compared with non diabetic individual; and there is no definite explanation whether hypoglycaemia play a causative role in the etiology of traffic accident among insulin treated diabetics. Perhaps the lack of knowledge in this field is due to use of non-standardized methodologies and small sample size studies which make the comparisons difficult. The existing regulations in different countries are based on empirical knowledge and common sense. This often leads to conflictual situations and apparently discriminatory decisions regarding diabetics. Further comparative and prospective studies are needed. PMID:1868962

  19. Pancreatic carcinoma: differences between patients with or without diabetes mellitus.

    PubMed

    Girelli, C M; Reguzzoni, G; Limido, E; Savastano, A; Rocca, F

    1995-04-01

    In order to assess the prevalence and type of diabetes mellitus in patients with pancreatic carcinoma and if the risk factors for the cancer have a different distribution among diabetics and non-diabetics, we reviewed the charts of 127 histologically and/or cytologically proven pancreatic carcinomas consecutively diagnosed from 1977 to 1989 and referred to our Primary Care Hospital from the attending physician. 48 out of 127 (37.7%) subjects were found to be diabetic; 3 had long standing insulin dependent diabetes mellitus, 10 long standing non insulin dependent diabetes mellitus and 35 (73% of all diabetics) new onset diabetes mellitus. 5 out of 10 long standing non insulin dependent diabetics showed secondary failure to oral antidiabetic agents and weight loss in the last six months before the diagnosis of pancreatic carcinoma. When compared to non-diabetics, all diabetics were older (p = 0.05), drank less alcohol (p = 0.047) and had a higher rate of previous neoplasms (p = 0.005). New onset diabetics had a less advanced cancer than those of long standing (p = 0.009). Our study calls for a careful search for pancreatic carcinoma in new onset diabetes of elderly and in long standing, weight losing, non insulin dependent diabetics on secondary failure to oral antidiabetic agents and support the hypothesis that diabetes associated pancreatic carcinoma may bear an its own etiopathogenesis. PMID:7617956

  20. Diabetes mellitus in a domesticated Spanish mustang.

    PubMed

    Johnson, Philip J; Scotty, Nicole C; Wiedmeyer, Charles; Messer, Nat T; Kreeger, John M

    2005-02-15

    An 18-year-old Spanish Mustang mare was referred for evaluation of progressive weight loss and persistent hyperglycemia. Clinicopathologic abnormalities included marked hyperglycemia and glycosuria. Serum cortisol concentration was appropriately decreased following administration of dexamethasone, indicating that the horse did not have pituitary pars intermedia dysfunction. Serum insulin and plasma C-peptide concentrations were low, suggesting that hyperglycemia was a result of decreased secretion of insulin by pancreatic beta cells. In addition, glucose concentration did not return to the baseline concentration until 5 hours after i.v. administration of a glucose bolus, suggesting that insulin secretion, insulin effect, or both were reduced. However, i.v. administration of insulin caused only a slight decrease in the plasma glucose concentration, giving the impression that the action of insulin was impaired. Within 5 hours after administration of a combination of glyburide and metformin, which is used to treat diabetes mellitus in humans, the glucose concentration was within reference limits. The horse was euthanized, and a postmortem examination was done. Immunohistochemical staining of sections of the pancreas revealed attenuation of the pancreatic islet beta-cell population, with beta cells that remained generally limited to the periphery of the islets. These findings indicate that, albeit rare, pancreatic beta-cell failure may contribute to the development of diabetes mellitus in horses. PMID:15742701

  1. Physical activity and gestational diabetes mellitus.

    PubMed

    van Poppel, Mireille N M; Ruchat, Stephanie-May; Mottola, Michelle F

    2014-01-01

    Gestational diabetes mellitus (GDM) is defined as 'carbohydrate intolerance resulting in hyperglycemia of variable severity with onset or first recognition during pregnancy'. GDM is associated with several detrimental health consequences during pregnancy and delivery for both mother and baby. The largest public health impact of GDM is through its role on future diabetes in the mother and obesity and diabetes in the offspring. Physical activity (PA) is likely an effective intervention for prevention and treatment of GDM, given its known effectiveness in prevention and treatment of type 2 diabetes. Based on observational studies, PA initiated before and/or during pregnancy has a positive influence on maternal glucose and insulin metabolism and reduces the risk of GDM. However, although PA interventions have been reported to be effective at improving glycemic control in women who already developed GDM, prenatal PA interventions aimed at preventing GDM have shown modest effectiveness in increasing PA levels and thus were not effective in improving glucose/insulin metabolism or reducing GDM incidence. There is therefore a strong need to develop effective strategies for increasing PA levels, especially in women at high risk for GDM who are often obese and inactive. The optimal intervention for preventing or managing GDM is still unknown, and further studies are needed to determine the type, intensity, frequency and duration for the most successful PA intervention. Furthermore, the effects of PA on neonatal outcomes are not clear, and it is highly recommended that future studies examine more specific neonatal outcomes such as body composition. PMID:25226805

  2. Risk Related to Pre–Diabetes Mellitus and Diabetes Mellitus in Heart Failure With Reduced Ejection Fraction

    PubMed Central

    Kristensen, Søren L.; Preiss, David; Jhund, Pardeep S.; Squire, Iain; Cardoso, José Silva; Merkely, Bela; Martinez, Felipe; Starling, Randall C.; Desai, Akshay S.; Lefkowitz, Martin P.; Rizkala, Adel R.; Rouleau, Jean L.; Shi, Victor C.; Solomon, Scott D.; Swedberg, Karl; Zile, Michael R.; Packer, Milton

    2016-01-01

    Background— The prevalence of pre–diabetes mellitus and its consequences in patients with heart failure and reduced ejection fraction are not known. We investigated these in the Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial. Methods and Results— We examined clinical outcomes in 8399 patients with heart failure and reduced ejection fraction according to history of diabetes mellitus and glycemic status (baseline hemoglobin A1c [HbA1c]: <6.0% [<42 mmol/mol], 6.0%–6.4% [42–47 mmol/mol; pre–diabetes mellitus], and ≥6.5% [≥48 mmol/mol; diabetes mellitus]), in Cox regression models adjusted for known predictors of poor outcome. Patients with a history of diabetes mellitus (n=2907 [35%]) had a higher risk of the primary composite outcome of heart failure hospitalization or cardiovascular mortality compared with those without a history of diabetes mellitus: adjusted hazard ratio, 1.38; 95% confidence interval, 1.25 to 1.52; P<0.001. HbA1c measurement showed that an additional 1106 (13% of total) patients had undiagnosed diabetes mellitus and 2103 (25%) had pre–diabetes mellitus. The hazard ratio for patients with undiagnosed diabetes mellitus (HbA1c, >6.5%) and known diabetes mellitus compared with those with HbA1c<6.0% was 1.39 (1.17–1.64); P<0.001 and 1.64 (1.43–1.87); P<0.001, respectively. Patients with pre–diabetes mellitus were also at higher risk (hazard ratio, 1.27 [1.10–1.47]; P<0.001) compared with those with HbA1c<6.0%. The benefit of LCZ696 (sacubitril/valsartan) compared with enalapril was consistent across the range of HbA1c in the trial. Conclusions— In patients with heart failure and reduced ejection fraction, dysglycemia is common and pre–diabetes mellitus is associated with a higher risk of adverse cardiovascular outcomes (compared with patients with no diabetes mellitus and HbA1c <6.0%). LCZ696 was beneficial compared with enalapril

  3. 76 FR 20358 - National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency Coordinating Committee; Notice of Workshop The Diabetes Mellitus Interagency Coordinating Committee (DMICC)...

  4. 76 FR 9587 - National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-18

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency Coordinating Committee; Notice of Meeting The Diabetes Mellitus Interagency Coordinating Committee (DMICC)...

  5. 77 FR 37060 - National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency Coordinating Committee; Notice of Meeting The Diabetes Mellitus Interagency Coordinating Committee (DMICC)...

  6. 76 FR 43694 - National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency Coordinating Committee; Notice of Meeting The Diabetes Mellitus Interagency Coordinating Committee (DMICC)...

  7. Diabetes mellitus related bone metabolism and periodontal disease

    PubMed Central

    Wu, Ying-Ying; Xiao, E; Graves, Dana T

    2015-01-01

    Diabetes mellitus and periodontal disease are chronic diseases affecting a large number of populations worldwide. Changed bone metabolism is one of the important long-term complications associated with diabetes mellitus. Alveolar bone loss is one of the main outcomes of periodontitis, and diabetes is among the primary risk factors for periodontal disease. In this review, we summarise the adverse effects of diabetes on the periodontium in periodontitis subjects, focusing on alveolar bone loss. Bone remodelling begins with osteoclasts resorbing bone, followed by new bone formation by osteoblasts in the resorption lacunae. Therefore, we discuss the potential mechanism of diabetes-enhanced bone loss in relation to osteoblasts and osteoclasts. PMID:25857702

  8. Fatty liver disease in diabetes mellitus

    PubMed Central

    Bhatt, Harikrashna B.

    2015-01-01

    Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in type 2 diabetes mellitus (T2DM), likely reflecting the frequent occurrence of obesity and insulin resistance in T2DM. NAFLD also can occur in type 1 DM (T1DM), but must be distinguished from the more common glycogen hepatopathy as a cause of hepatomegaly and liver function abnormalities in T1DM. Weight reduction achieved by diet and exercise is effective in preventing and treating NAFLD in obese diabetic subjects. Bariatric surgery also has been shown to reverse NAFLD in T2DM, and recently approved weight loss medications should be evaluated for their impact on the development and progression of NAFLD. There is limited evidence suggesting that specific drugs used for blood glucose control in T2DM [thiazolidinediones (TZDs), glucagon-like peptide-1 (GLP-1) analogs, and dipeptidyl peptidase-4 (DPP-4) inhibitors] and also statins may have a role in preventing or treating NAFLD in patients with diabetes. PMID:26005676

  9. Iliopsoas abscess in adolescents with type 1 diabetes mellitus

    PubMed Central

    Maines, Evelina; Franceschi, Roberto; Cauvin, Vittoria; d’Annunzio, Giuseppe; Pini Prato, Alessio; Castagnola, Elio; Di Palma, Annunziata

    2015-01-01

    Key Clinical Message Iliopsoas abscesses have been reported in adult diabetic patients, but only one case has been so far reported in the pediatric diabetic literature. We report three cases of iliopsoas abscesses in three adolescents with type 1 diabetes mellitus, suggesting that an increased awareness of this condition is required for its early recognition and prompt treatment. PMID:26273460

  10. Traumatic injuries in patients with diabetes mellitus

    PubMed Central

    El-Menyar, Ayman; Mekkodathil, Ahammed; Al-Thani, Hassan

    2016-01-01

    Diabetes mellitus (DM) is associated with increased in-hospital morbidity and mortality in patients sustained traumatic injuries. Identification of risk factors of traumatic injuries that lead to hospital admissions and death in DM patients is crucial to set effective preventive strategies. We aimed to conduct a traditional narrative literature review to describe the role of hypoglycemia as a risk factor of driving and fall-related traumatic injuries. DM poses significant burden as a risk factor and predictor of worse outcomes in traumatic injuries. Although there is no consensus on the impact and clear hazards of hyperglycemia in comparison to the hypoglycemia, both extremes of DM need to be carefully addressed and taken into consideration for proper management. Moreover, physicians, patients, and concerned authorities should be aware of all these potential hazards to share and establish the right management plans. PMID:27162438

  11. Acromegaly and diabetes mellitus associated with hyperthyroidism.

    PubMed

    Deng, Datong; Luo, Li; Chen, Mingwei; Xu, Min; Wang, Youmin

    2014-01-01

    A 66-year-old woman with acromegaly and diabetes mellitus as well as primary hyperthyroidism is described. Serum GH Levels were inappprpriately high.MRI revealed an enlarged sella turcica with intrasellar mass. Her HbAlc was 12.2% and fasting blood glucose 8.89 mmol/l. Thyroid hormone levels in serum and thyroidal radioiodine uptake values were elevated, while TSH measurements in serum were low. Anti TPO antibodies were negative, TSH receptor antibodies were normal. Thyrotoxicosis as the first presenting illness in acromegaly was particulary uncommon. An ultrasound thyroid scan showed a multinodular goiter. Histology of the pituitary lesion showed a typical eosinophilic adenoma which only secreted GH when tested with specific immunostain. Post-operatively, the patient's clinical conditions improved, however, secondary hypoadrenalism appeared. PMID:24977962

  12. [New therapies for type 2 diabetes mellitus].

    PubMed

    Puig-Domingo, Manuel; Pellitero, Silvia

    2015-06-22

    The increasing prevalence of obesity and type 2 diabetes mellitus (T2DM) has led to a growing interest in the investigation of new therapies. Treatment of T2DM has focused on the insulinopenia and insulin resistance. However, in the last 10 years, new lines of research have emerged for the treatment of T2DM and preclinical studies appear promising. The possibility of using these drugs in combination with other currently available drugs will enhance the antidiabetic effect and promote weight loss with fewer side effects. The data provided by post-marketing monitoring will help us to better understand their safety profile and potential long-term effects on target organs, especially the cardiovascular risk. PMID:25194974

  13. Relationship between Urinary Bisphenol A Levels and Diabetes Mellitus

    PubMed Central

    Teppala, Srinivas

    2011-01-01

    Background: Bisphenol A (BPA) is a widely used chemical in the manufacture of polycarbonate plastics and epoxy resins. Recent animal studies have suggested that BPA exposure may have a role in the development of weight gain, insulin resistance, pancreatic endocrine dysfunction, thyroid hormone disruption, and several other mechanisms involved in the development of diabetes. However, few human studies have examined the association between markers of BPA exposure and diabetes mellitus. Methods: We examined the association between urinary BPA levels and diabetes mellitus in the National Health and Nutritional Examination Survey (NHANES) 2003–2008. Urinary BPA levels were examined in quartiles. The main outcome of interest was diabetes mellitus defined according the latest American Diabetes Association guidelines. Results: Overall, we observed a positive association between increasing levels of urinary BPA and diabetes mellitus, independent of confounding factors such as age, gender, race/ethnicity, body mass index, and serum cholesterol levels. Compared to quartile 1 (referent), the multivariate-adjusted odds ratio (95% confidence interval) of diabetes associated with quartile 4 was 1.68 (1.22–2.30) (p-trend = 0.002). The association was present among normal-weight as well as overweight and obese subjects. Conclusions: Urinary BPA levels are found to be associated with diabetes mellitus independent of traditional diabetes risk factors. Future prospective studies are needed to confirm or disprove this finding. PMID:21956417

  14. Vitamin D and diabetes mellitus: an update 2013.

    PubMed

    Griz, Luiz Henrique Maciel; Bandeira, Francisco; Gabbay, Mônica Andrade Lima; Dib, Sergio Atala; Carvalho, Eduardo Freese de

    2014-02-01

    Vitamin D deficiency and diabetes mellitus are two common conditions and they are widely prevalent across all ages, races, geographical regions, and socioeconomic conditions. Epidemiologic studies have shown association of vitamin D deficiency and increased risk of chronic diseases, such as cancer, cardiovascular disease, type 2 diabetes, and autoimmune diseases, such as multiple sclerosis and type 1 diabetes mellitus. The identification of 1,25(OH)2D receptors and 1-α-hydroxilase expression in pancreatic beta cells, in cells of the immune system, and in various others tissues, besides the bone system support the role of vitamin D in the pathogenesis of type 2 diabetes. Observational studies have revealed an association between 25(OH) D deficiency and the prevalence of type 1 diabetes in children and adolescents. This review will focus on the concept of vitamin D deficiency, its prevalence, and its role in the pathogenesis and risk of diabetes mellitus and cardiovascular diseases. PMID:24728158

  15. Associations of serum Magnesium levels with diabetes mellitus and diabetic complications

    PubMed Central

    Arpaci, D; Tocoglu, A G; Ergenc, H; Korkmaz, S; Ucar, A; Tamer, A

    2015-01-01

    Background Magnesium (Mg) deficiency is a common problem in diabetic patients. Deficiency of Mg may increase the incidence of diabetes mellitus (DM) and occurrence of diabetic complications. In this study, our aim was to evaluate an association between serum Mg level,  glycemic regulation, and diabetic complications. Material-Methods In this retrospective study 673 diabetic patients were evaluated. According to Mg levels, the patients were divided into two groups; as normomagnesemic patients and hypomagnesemic patients. Results Among the patients, 57.8% were men and 42.2% were women. Mean age was 55.6 years and the mean duration of diabetes was 81 ± 86.9 months. The mean glycosylated hemoglobin (HbA1c) was 9.0 ±2.4 % (4.5-18); mean magnesium level was 1.97 ± 0.25 (1.13 to 3.0) mg / dl.  There were 55 patients (8.2%) with diabetic retinopathy and 95 patients (14.1%) with diabetic neuropathy. Five hundred patients (74.3%)  had normoalbuminuria; 133 patients (19. 8%) had microalbuminuria (MA) and 40 patients (5.9%) had overt proteinuria. One hundred and seventy one patients (25.4%) had HbA1c levels equal or below 7%; and 502 patients (74.6%) had HbA1c levels above 7%. There was no statistical difference in age or duration of diabetes between the groups formed according to Mg levels. Although there were no differences between the groups for retinopathy and neuropathy, MA was more common in hypomagnesemic patients (p =0.004). HbA1c levels did not differ between the groups (p =0.243). However there was a weak negative correlation between serum Mg and HbA1c levels (r =-0.110, p =0.004) and also between serum Mg and urine protein level  (r =-0.127, p =0.018). Conclusion Mg depletion is a common problem in patients with DM. It affects both glycemic regulation and the occurence of complications. Also, poor glycemic regulation affects serum Mg levels. Hippokratia 2015; 19 (2):153-157.

  16. Diabetes mellitus and tuberculosis: programmatic management issues.

    PubMed

    Harries, A D; Kumar, A M V; Satyanarayana, S; Lin, Y; Zachariah, R; Lönnroth, K; Kapur, A

    2015-08-01

    In August 2011, the World Health Organization and the International Union Against Tuberculosis and Lung Disease launched the Collaborative Framework for Care and Control of Tuberculosis (TB) and diabetes mellitus (DM) to guide policy makers and implementers in combatting the epidemics of both diseases. Progress has been made, and includes identifying how best to undertake bidirectional screening for both diseases, how to provide optimal treatment and care for patients with dual disease and the most suitable framework for monitoring and evaluation. Key programmatic challenges include the following: whether screening should be directed at all patients or targeted at those with high-risk characteristics; the most suitable technologies for diagnosing TB and diabetes in routine settings; the best time to screen TB patients for DM; how to provide an integrated, coordinated approach to case management; and finally, how to persuade non-communicable disease programmes to adopt a cohort analysis approach, preferably using electronic medical records, for monitoring and evaluation. The link between DM and TB and the implementation of the collaborative framework for care and control have the potential to stimulate and strengthen the scale-up of non-communicable disease care and prevention programmes, which may help in reducing not only the global burden of DM but also the global burden of TB. PMID:26162352

  17. Obesity and type 1 diabetes mellitus management.

    PubMed

    Chillarón, J J; Benaiges, D; Mañé, L; Pedro-Botet, J; Flores Le-Roux, J A

    2015-03-01

    Patients with type 1 diabetes mellitus (T1DM) traditionally had a low body mass index and microangiopathic complications were common. The Diabetes Control and Complications Trial, published in 1993, demonstrated that therapy aimed at maintaining HbA1c levels as close to normal as feasible reduced the incidence of microangiopathy. Since then, the use of intensive insulin therapy to optimise metabolic control became generalised, with two main side effects: a higher rate of severe hypoglycaemia and increased weight gain. Approximately 50% of patients with T1DM are currently obese or overweight, which reduces or nullifies the benefits of good metabolic control, and which has other negative consequences; therefore, strategies to achieve weight control in patients with T1DM are necessary. At present, treatment with GLP-1 and SGLT-2 inhibitors has yielded promising short-term results that need to be confirmed in studies with larger numbers of patients and long-term follow-up. It is possible that, in coming years, the applicability of bariatric surgery in obese patients with T1DM will be similar to that of the general population or T2DM. PMID:25413942

  18. Clinical Implication of Diabetes Mellitus in Primary Total Hip Arthroplasty

    PubMed Central

    Chun, Young-Soo; Lee, Seung-Hyuk; Lee, Sang-Hoon; Cho, Yoon-Je

    2014-01-01

    Purpose The purpose of this study was to investigate the effect of diabetes mellitus on primary total hip arthroplasty by comparing the clinical outcomes of patients diagnosed to have diabetes mellitus before the operation with those without diabetes. Materials and Methods A total 413 patients who underwent unilateral cementless total hip arthroplasty from June 2006 to May 2009 were recruited and divided into diabetic and non-diabetic groups. The comparative analysis between the two groups was made. We evaluated Harris hip score, postoperative complications such as wound problem, surgical site infection, other medical complication and length of stay in hospital as clinical parameters. Radiographic evaluations were also included to determine loosening, dislocation and osteolysis. Results Patients with diabetes had an increased incidence of orthopaedic complications including surgical site infection and mortality, but other medical complications were not increased in diabetic patients. All complications after primary total hip arthroplasty were associated with diabetes mellitus, but the degree of diabetes was not associated with complications. Conclusion Diabetes mellitus increases incidence of orthopaedic complications, particularly deep infection, after cementless primary total hip arthroplasty.

  19. Heart rate variability in children with type 1 diabetes mellitus

    PubMed Central

    Gardim, Camila Balsamo; de Oliveira, Bruno Affonso P.; Bernardo, Aline Fernanda B.; Gomes, Rayana Loch; Pacagnelli, Francis Lopes; Lorençoni, Roselene Modolo R.; Vanderlei, Luiz Carlos M.

    2014-01-01

    OBJECTIVE: To gather current information about the effects of type 1 diabetes mellitus on children's cardiac autonomic behavior. DATA SOURCES: The search of articles was conducted on PubMed, Ibecs, Medline, Cochrane, Lilacs, SciELO and PEDro databases using the MeSH terms: "autonomic nervous system", "diabetes mellitus", "child", "type 1 diabetes mellitus", "sympathetic nervous system" and "parasympathetic nervous system", and their respective versions in Portuguese (DeCS). Articles published from January 2003 to February 2013 that enrolled children with 9-12 years old with type 1 diabetes mellitus were included in the review. DATA SYNTHESIS: The electronic search resulted in four articles that approached the heart rate variability in children with type 1 diabetes mellitus, showing that, in general, these children present decreased global heart rate variability and vagal activity. The practice of physical activity promoted benefits for these individuals. CONCLUSIONS: Children with type 1 diabetes mellitus present changes on autonomic modulation, indicating the need for early attention to avoid future complications in this group. PMID:25119762

  20. Hypoglycaemia in diabetes mellitus: epidemiology and clinical implications.

    PubMed

    Frier, Brian M

    2014-12-01

    Hypoglycaemia is a frequent adverse effect of treatment of diabetes mellitus with insulin and sulphonylureas. Fear of hypoglycaemia alters self-management of diabetes mellitus and prevents optimal glycaemic control. Mild (self-treated) and severe (requiring help) hypoglycaemia episodes are more common in type 1 diabetes mellitus but people with insulin-treated type 2 diabetes mellitus are also exposed to frequent hypoglycaemic events, many of which occur during sleep. Hypoglycaemia can disrupt many everyday activities such as driving, work performance and leisure pursuits. In addition to accidents and physical injury, the morbidity of hypoglycaemia involves the cardiovascular and central nervous systems. Whereas coma and seizures are well-recognized neurological sequelae of hypoglycaemia, much interest is currently focused on the potential for hypoglycaemia to cause dangerous and life-threatening cardiac complications, such as arrhythmias and myocardial ischaemia, and whether recurrent severe hypoglycaemia can cause permanent cognitive impairment or promote cognitive decline and accelerate the onset of dementia in middle-aged and elderly people with diabetes mellitus. Prevention of hypoglycaemia is an important part of diabetes mellitus management and strategies include patient education, glucose monitoring, appropriate adjustment of diet and medications in relation to everyday circumstances including physical exercise, and the application of new technologies such as real-time continuous glucose monitoring, modified insulin pumps and the artificial pancreas. PMID:25287289

  1. Faecal microbiota of cats with insulin-treated diabetes mellitus.

    PubMed

    Bell, Erin T; Suchodolski, Jan S; Isaiah, Anitha; Fleeman, Linda M; Cook, Audrey K; Steiner, Jörg M; Mansfield, Caroline S

    2014-01-01

    Microorganisms within the gastrointestinal tract significantly influence metabolic processes within their mammalian host, and recently several groups have sought to characterise the gastrointestinal microbiota of individuals affected by metabolic disease. Differences in the composition of the gastrointestinal microbiota have been reported in mouse models of type 2 diabetes mellitus, as well as in human patients. Diabetes mellitus in cats has many similarities to type 2 diabetes in humans. No studies of the gastrointestinal microbiota of diabetic cats have been previously published. The objectives of this study were to compare the composition of the faecal microbiota of diabetic and non-diabetic cats, and secondarily to determine if host signalment and dietary factors influence the composition of the faecal microbiota in cats. Faecal samples were collected from insulin-treated diabetic and non-diabetic cats, and Illumina sequencing of the 16S rRNA gene and quantitative PCR were performed on each sample. ANOSIM based on the unweighted UniFrac distance metric identified no difference in the composition of the faecal microbiota between diabetic and non-diabetic cats, and no significant differences in the proportions of dominant bacteria by phylum, class, order, family or genus as determined by 16S rRNA gene sequencing were identified between diabetic and non-diabetic cats. qPCR identified a decrease in Faecalibacterium spp. in cats aged over ten years. Cat breed or gender, dietary carbohydrate, protein or fat content, and dietary formulation (wet versus dry food) did not affect the composition of the faecal microbiota. In conclusion, the composition of the faecal microbiota was not altered by the presence of diabetes mellitus in cats. Additional studies that compare the functional products of the microbiota in diabetic and non-diabetic cats are warranted to further investigate the potential impact of the gastrointestinal microbiota on metabolic diseases such as

  2. Immunogenetics of Type 1 Diabetes Mellitus

    PubMed Central

    Morran, Michael P.; Vonberg, Andrew; Khadra, Anmar; Pietropaolo, Massimo

    2015-01-01

    Type 1 diabetes mellitus (T1DM) is an autoimmune disease arising through a complex interaction of both genetic and immunologic factors. Similar to the majority of autoimmune diseases, T1DM usually has a relapsing remitting disease course with autoantibody and T cellular responses to islet autoantigens, which precede the clinical onset of the disease process. The immunological diagnosis of autoimmune diseases relies primarily on the detection of autoantibodies in the serum of T1DM patients. Although their pathogenic significance remains uncertain, they have the practical advantage of serving as surrogate biomarkers for predicting the clinical onset of T1DM. Type 1 diabetes is a polygenic disease with a small number of genes having large effects, (i.e. HLA) and a large number of genes having small effects. Risk of T1DM progression is conferred by specific HLA DR/DQ alleles [e.g., DRB1*03-DQB1*0201 (DR3) or DRB1*04-DQB1*0302 (DR4)]. In addition, HLA alleles such as DQB1*0602 are associated with dominant protection from T1DM in multiple populations. A discordance rate of greater than 50% between monozygotic twins indicates a potential involvement of environmental factors on disease development. Viral infections may play a role in the chain of events leading to disease, albeit conclusive evidence linking infections with T1DM remains to be firmly established. Two syndromes have been described in which an immune-mediated form of diabetes occurs as the result of a single gene defect. These syndromes are termed autoimmune polyglandular syndrome type I (APS-I) or autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), and X-linked poyendocrinopathy, immune dysfunction and diarrhea (XPID). These two syndromes are unique models to understand the mechanisms involved in the loss of tolerance to self-antigens in autoimmune diabetes and its associated organ-specific autoimmune disorders. A growing number of animal models of these diseases have greatly helped

  3. Postmortem diagnosis of diabetes mellitus and its complications

    PubMed Central

    Palmiere, Cristian

    2015-01-01

    Diabetes mellitus has become a major cause of death worldwide and diabetic ketoacidosis is the most common cause of death in children and adolescents with type 1 diabetes. Acute complications of diabetes mellitus as causes of death may be difficult to diagnose due to missing characteristic macroscopic and microscopic findings. Biochemical analyses, including vitreous glucose, blood (or alternative specimen) beta-hydroxybutyrate, and blood glycated hemoglobin determination, may complement postmortem investigations and provide useful information for determining the cause of death even in corpses with advanced decompositional changes. In this article, we performed a review of the literature pertaining to the diagnostic performance of classical and novel biochemical parameters that may be used in the forensic casework to identify disorders in glucose metabolism. We also present a review focusing on the usefulness of traditional and alternative specimens that can be sampled and subsequently analyzed to diagnose acute complications of diabetes mellitus as causes of death. PMID:26088843

  4. Low-density lipoprotein cholesterol level and statin use among Medicare beneficiaries with diabetes mellitus.

    PubMed

    Qualls, Laura G; Hammill, Bradley G; Maciejewski, Matthew L; Curtis, Lesley H; Jones, W Schuyler

    2016-05-01

    At the time of this study, guidelines recommended a primary goal of low-density lipoprotein cholesterol level less than 100 mg/dL for all patients, an optional goal of low-density lipoprotein cholesterol less than 70 mg/dL for patients with overt cardiovascular disease and statins for patients with diabetes and overt cardiovascular disease and patients 40 years and older with diabetes and at least one risk factor for cardiovascular disease. This study examined statin use and achievement of lipid goals among 111,730 Medicare fee-for-service beneficiaries 65 years and older in 2011. Three-quarters of patients met the low-density lipoprotein cholesterol goal of less than 100 mg/dL. Patients with cardiovascular disease were more likely to meet the goal than those without, not controlling for other differences. Patients on a statin were more likely to meet the goal. There is considerable opportunity for improvement in cholesterol management in high-risk patients with diabetes mellitus. PMID:26802221

  5. Corneal biomechanical properties in children with diabetes mellitus.

    PubMed

    Kara, Necip; Yildirim, Yusuf; Univar, Tolga; Kontbay, Tugba

    2012-08-01

    Purpose. To compare the biomechanical properties of corneas in eyes of children with diabetes mellitus and in eyes of children without diabetes mellitus.
Methods. In this prospective, comparative, and cross-sectional study, 46 patients with diabetes mellitus (study group) and 50 healthy individuals (control group) were enrolled. The corneal hysteresis (CH) and corneal resistance factor (CRF) were measured in children with and without diabetes using the Ocular Response Analyzer. Differences in the corneal biomechanical properties were determined using an independent-samples t test. Correlations between ocular and diabetic parameters were also evaluated.
Results. Mean CH was 12.3±1.3 (SD) mmHg and 12.5±1.5 mmHg and the mean CRF was 12.4±1.7 mmHg and 11.9±1.5 mmHg in the diabetic and control groups, respectively (p>0.05). Corneal hysteresis and CRF were not correlated with fasting glucose level, HbA1c, age, or duration of diabetes.
Conclusions. The findings indicate that diabetes mellitus does not affect corneal biomechanical parameters such as CH and CRF in children. In addition, CH and CRF are not affected by fasting glucose level, HbA1c, age, or duration of diabetes. PMID:22890598

  6. Childhood diabetes mellitus: recent advances & future prospects.

    PubMed

    Dejkhamron, Prapai; Menon, Ram K; Sperling, Mark A

    2007-03-01

    Diabetes mellitus (DM) is a metabolic disease characterized by absolute or relative insulin deficiency. Absolute deficiency of insulin most commonly results from an autoimmune destruction of insulin producing cells in the pancreas and in general, the term Type 1 DM (T1DM) is used to denote childhood diabetes associated with autoimmunity and absolute insulin deficiency. The term Type 2 DM (T2DM) is used to denote diabetes resulting from a relative deficiency of insulin when insulin secretion is inadequate to overcome co-existent resistance to insulin action on carbohydrate, protein or fat metabolism; T2DM is most commonly associated with the prototypic insulin resistant state of obesity. In the western hemisphere DM is one of the most prevalent chronic diseases in childhood, whereas the incidence of T1DM in developing countries is significantly less than that in the western hemisphere. Epidemiological studies indicate that there is gradual but steady increase in the incidence of both T1DM and T2DM in both developed and developing countries. This review provides an overview of the major advances in our understanding of the aetiology, pathogenesis, and clinical management of DM in children with the focus being on T1DM. Genetic predisposition, environmental causes, and emerging concepts of the pathogenesis of T1DM such as the accelerator hypothesis are discussed. The goals of treating a child with DM are to achieve normal growth and development with prevention of acute and chronic complications of DM. These goals are achieved by co-ordinated care delivered by a multidisciplinary team focusing on insulin administrations, glucose monitoring, meal planning, and screening for complications. Newer insulin analogues ("designer" insulin) and automated methods of delivery via programmable pumps have revolutionized the care of the child with diabetes. Though T1DM cannot yet be prevented, ongoing trials and strategies aimed at modulating the autoimmune response and the

  7. Comment on: Statin use and risk of diabetes mellitus.

    PubMed

    Eren, Mehmet Ali; Sabuncu, Tevfik; Karaaslan, Hüseyin

    2016-04-25

    In manuscript named "Statin use and risk of diabetes mellitus" by Chogtu et al, authors defined that pravastatin 40 mg/dL reduced the risk of diabetes by 30% in West of Scotland Coronary Prevention study. In fact, pravastatin 40 mg/dL reduced coronary heart disease risk approximately 30% in mentioned study. PMID:27114756

  8. Counseling Families of Children with Diabetes Mellitus: An Overview.

    ERIC Educational Resources Information Center

    Yousef, Jamal M. S.

    1995-01-01

    The impact that counseling can have on a family with a child with diabetes mellitus is discussed. The benefits for the child's psychosocial adjustment and development are highlighted. An overview of the challenges a family with a diabetic child faces is provided and the counselor's role in assisting such families is emphasized. (CR)

  9. Alcohol, cardiovascular diseases and diabetes mellitus.

    PubMed

    Klatsky, Arthur L

    2007-03-01

    Disparities in associations of alcohol consumption to various cardiovascular conditions lead to separate consideration of several. These include (1) Alcoholic cardiomyopathy from chronic heavy drinking in susceptible persons. (2) Higher blood pressure (hypertension) in some heavier drinkers. (3) A relation of drinking to higher risk of hemorrhagic stroke but to lower risk of ischemic stroke. (4) Certain arrhythmias, especially among binge drinkers. (5) An inverse relation of alcohol use to coronary artery disease. A causal hypothesis of protection is strengthened by plausible mechanisms. The coronary disease data impact upon total mortality statistics, such that lighter drinkers are at slightly lower risk than abstainers of death within a given time period. (6) An inverse relation of drinking to type 2 (adult onset) diabetes mellitus in several recent studies. Because of close relations to cardiovascular disorders, diabetes is considered virtual cardiovascular "equivalent". (7) Composites of (1-6) result in a complex association between alcohol and the common heart failure syndrome. International comparisons suggest wine is more protective against coronary disease than liquor or beer. Reports of antioxidants, endothelial relaxants, and antithrombotic activity in wine (especially red) support hypothetical benefit from non-alcohol wine components. However, prospective population studies show apparent protection from beer, wine, or liquor. Thus, some suggest that favorable traits or drinking patterns of wine drinkers might explain the international comparison findings. Amount of alcohol taken is a crucial consideration in alcohol-health relations. Advice to concerned persons needs to take into account individual risk/benefit factors in drinkers or potential drinkers. PMID:17363263

  10. Preventing and treating foot complications associated with diabetes mellitus.

    PubMed

    Bowling, Frank L; Rashid, S Tawqeer; Boulton, Andrew J M

    2015-10-01

    Diabetes mellitus is associated with a series of macrovascular and microvascular changes that can manifest as a wide range of complications. Foot ulcerations affect ∼2-4% of patients with diabetes mellitus. Risk factors for foot lesions include peripheral and autonomic neuropathy, vascular disease and previous foot ulceration, as well as other microvascular complications, such as retinopathy and end-stage renal disease. Ulceration is the result of a combination of components that together lead to tissue breakdown. The most frequently occurring causal pathways to the development of foot ulcers include peripheral neuropathy and vascular disease, foot deformity or trauma. Peripheral vascular disease is often not diagnosed in patients with diabetes mellitus until tissue loss is evident, usually in the form of a nonhealing ulcer. Identification of patients with diabetes mellitus who are at high risk of ulceration is important and can be achieved via annual foot screening with subsequent multidisciplinary foot-care interventions. Understanding the factors that place patients with diabetes mellitus at high risk of ulceration, together with an appreciation of the links between different aspects of the disease process, is essential to the prevention and management of diabetic foot complications. PMID:26284447

  11. Sporadic hypokalemic paralysis caused by osmotic diuresis in diabetes mellitus.

    PubMed

    Vishnu, Venugopalan Y; Kattadimmal, Anoop; Rao, Suparna A; Kadhiravan, Tamilarasu

    2014-07-01

    A wide variety of neurological manifestations are known in patients with diabetes mellitus. We describe a 40-year-old man who presented with hypokalemic paralysis. On evaluation, we found that the cause of the hypokalemia was osmotic diuresis induced by marked hyperglycemia due to undiagnosed diabetes mellitus. The patient had an uneventful recovery with potassium replacement, followed by glycemic control with insulin. Barring a few instances of symptomatic hypokalemia in the setting of diabetic emergencies, to our knowledge uncomplicated hyperglycemia has not been reported to result in hypokalemic paralysis. PMID:24472241

  12. Gestational diabetes mellitus, programing and epigenetics.

    PubMed

    Yan, Jie; Yang, Huixia

    2014-08-01

    Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. Offspring exposed to maternal hyperglycemia have a higher birth weight and are prone to develop metabolic disease in adult life. The intrauterine environmental or nutritional status seems to be involved in the fetal programing. The concept of "Developmental Origins of Health and Disease" (DOHaD) has been widely accepted and it brings new insights into the molecular pathogenesis of human diseases. The underlying mechanism is still under discussion and epigenetic mechanisms may provide an explanation for the phenomenon. The aim of this review is to illustrate the role of epigenetic modifications in the development of insulin resistance in metabolic diseases induced by adverse intrauterine exposures. Changes in epigenetic mechanism may be an early event in pathogenesis and progression of the metabolic disease in humans. Studies on epigenetic modifications contribute to our understanding of long-term effects of in utero exposure and shed light on the disease prevention and treatment by modulating epigenetic changes. PMID:24125565

  13. Introduction to Personalized Medicine in Diabetes Mellitus

    PubMed Central

    Glauber, Harry S.; Rishe, Naphtali; Karnieli, Eddy

    2014-01-01

    The world is facing an epidemic rise in diabetes mellitus (DM) incidence, which is challenging health funders, health systems, clinicians, and patients to understand and respond to a flood of research and knowledge. Evidence-based guidelines provide uniform management recommendations for “average” patients that rarely take into account individual variation in susceptibility to DM, to its complications, and responses to pharmacological and lifestyle interventions. Personalized medicine combines bioinformatics with genomic, proteomic, metabolomic, pharmacogenomic (“omics”) and other new technologies to explore pathophysiology and to characterize more precisely an individual’s risk for disease, as well as response to interventions. In this review we will introduce readers to personalized medicine as applied to DM, in particular the use of clinical, genetic, metabolic, and other markers of risk for DM and its chronic microvascular and macrovascular complications, as well as insights into variations in response to and tolerance of commonly used medications, dietary changes, and exercise. These advances in “omic” information and techniques also provide clues to potential pathophysiological mechanisms underlying DM and its complications. PMID:24498509

  14. Insulin-dependent (type I) diabetes mellitus.

    PubMed Central

    Rodger, W

    1991-01-01

    Insulin-dependent (type I) diabetes mellitus is a chronic disease characterized by hyperglycemia, impaired metabolism and storage of important nutrients, evidence of autoimmunity, and long-term vascular and neurologic complications. Insulin secretory function is limited. Cell membrane binding is not primarily involved. The goal of treatment is to relieve symptoms and to achieve blood glucose levels as close to normal as possible without severe hypoglycemia. However, even with education and self-monitoring of the blood glucose level, attaining recommended target values (plasma glucose level less than 8.0 mmol/L before main meals for adults) remains difficult. Human insulin offers no advantage in glycemic control but is important in the management and prevention of immune-related clinical problems (e.g., injection-site lipoatrophy, insulin resistance and allergy) associated with the use of beef or pork insulin. Therapy with one or two injections per day of mixed short-acting or intermediate-acting insulin preparations is a compromise between convenience and the potential for achieving target plasma glucose levels. Intensive insulin therapy with multiple daily injections or continuous infusion with an insulin pump improves mean glycated hemoglobin levels; however, it increases rates of severe hypoglycemia and has not been shown to decrease the incidence of clinically significant renal, retinal or neurologic dysfunction. Future prospects include automated techniques of insulin delivery, immunosuppression to preserve endogenous insulin secretion and islet transplantation. PMID:1933705

  15. Clinical profile of diabetes mellitus in tuberculosis

    PubMed Central

    Ogbera, Anthonia Okeoghene; Kapur, Anil; Abdur-Razzaq, Hussein; Harries, Anthony D; Ramaiya, Kaushik; Adeleye, Olufunmilayo; Kuku, Sonny

    2015-01-01

    Objective The objective is to document the clinical profile of diabetes mellitus (DM) in tuberculosis (TB). Type of study This was a descriptive observational study. Methods A total of 4000 persons aged above 12 years with a confirmed diagnosis of TB and on treatment were recruited. The study subjects were screened for DM and diagnoses were made on the basis of the WHO criteria. Clinical parameters were compared between persons with DM and those without DM. Results Mean age was higher in patients with TB and DM than in persons without DM, and this difference was statistically significant (40.9 vs 39.6 years, p=0.0002). DM/TB comorbidity was noted in 480 persons and these made up 12.3% of the study population. Some clinical features of patients with TB who had DM included a positive family history of DM, a history of hypertension, and central obesity. Conclusions Given the substantial burden of DM and TB comorbidity, we recommend that patients with TB be screened routinely for DM. However, further research is needed to clarify the risk factors for the occurrence of DM in TB. PMID:26336610

  16. Exercise guidelines for gestational diabetes mellitus

    PubMed Central

    Padayachee, Cliantha; Coombes, Jeff S

    2015-01-01

    The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. This disease has many detrimental consequences for the woman, the unborn foetus and child. The management of GDM aims to mediate the effects of hyperglycaemia by controlling blood glucose levels. Along with pharmacology and dietary interventions, exercise has a powerful potential to assist with blood glucose control. Due to the uncertainty of risks and benefits of exercise during pregnancy, women tend to avoid exercise. However, under adequate supervision exercise is both safe and beneficial in the treatment of GDM. Therefore it is vital that exercise is incorporated into the continuum of care for women with GDM. Medical doctors should be able to refer to competently informed exercise professionals to aid in GDM treatment. It is important that exercise treatment is informed by research. Hence, the development of evidence-based guidelines is important to inform practice. Currently there are no guidelines for exercise in GDM. This review aims to assess the efficacy of exercise for the management of GDM in order to establish an exercise prescription guideline specific to the condition. It is recommended that women with GDM should do both aerobic and resistance exercise at a moderate intensity, a minimum of three times a week for 30-60 min each time. PMID:26240700

  17. A Review of Insulin for the Treatment of Diabetes Mellitus.

    PubMed

    Freeland, Barbara; Farber, Margo S

    2016-09-01

    Insulin is commonly used in the treatment of diabetes in the home care setting. Understanding the wide variety of insulin preparations available will assist the clinician in guiding people with diabetes and their caregivers through the complexities of self-care and promote safe and optimal glucose control. The purpose of this article is to review the various available insulin preparations and discuss their use in the treatment of diabetes mellitus. PMID:27580280

  18. Hyperglycaemic Environment: Contribution to the Anaemia Associated with Diabetes Mellitus in Rats Experimentally Induced with Alloxan

    PubMed Central

    Bashiru Shola, Oseni; Olatunde Olugbenga, Fakoya

    2015-01-01

    Background. Diabetes mellitus characterized by hyperglycaemia presents with various complications amongst which anaemia is common particularly in those with overt nephropathy or renal impairment. The present study has examined the contribution of the hyperglycaemic environment in diabetic rats to the anaemia associated with diabetes mellitus. Method. Sixty male albino rats weighing 175–250 g were selected for this study and divided equally into control and test groups. Hyperglycaemia was induced with 170 kgbwt−1 alloxan intraperitoneally in the test group while control group received sterile normal saline. Blood samples obtained from the control and test rats were assayed for packed cell volume (PCV), haemoglobin (Hb), red blood cell count (RBC), reticulocyte count, glucose, plasma haemoglobin, potassium, and bilirubin. Result. Significant reduction (P < 0.01) in PCV (24.40 ± 3.87 versus 40.45 ± 3.93) and haemoglobin (7.81 ± 1.45 versus 13.39 ± 0.40) with significant increase (P < 0.01) in reticulocyte count (12.4 ± 1.87 versus 3.69 ± 0.47), plasma haemoglobin (67.50 ± 10.85 versus 34.20 ± 3.83), and potassium (7.04 ± 0.75 versus 4.52 ± 0.63) was obtained in the test while plasma bilirubin showed nonsignificant increase (0.41 ± 0.04 versus 0.24 ± 0.06). Conclusion. The increased plasma haemoglobin and potassium levels indicate an intravascular haemolytic event while the nonsignificant increased bilirubin showed extravascular haemolysis. These play contributory roles in the anaemia associated with diabetes mellitus. PMID:26697217

  19. Plasma Levels of the Interleukin-1-Receptor Antagonist Are Lower in Women with Gestational Diabetes Mellitus and Are Particularly Associated with Postpartum Development of Type 2 Diabetes

    PubMed Central

    Katra, Pernilla; Dereke, Jonatan; Nilsson, Charlotta

    2016-01-01

    Diabetes mellitus is a group of diseases characterized by chronic hyperglycemia. Women who develops hyperglycemia for the first time during pregnancy receive the diagnosis gestational diabetes mellitus (GDM). Presently, there is no consensus about the diagnostic criteria for GDM. A majority of these women subsequently develop postpartum overt diabetes making it important to identify these patients as early as possible. In this study we investigated if plasma levels of the interleukin-1 receptor antagonist (IL-1Ra), an endogenous inhibitor of IL-1 signaling, can be used as a complementary biomarker for diagnosing GDM and predicting postpartum development of overt diabetes mellitus. Patients participating in this study (n = 227) were diagnosed with their first GDM 2004–2013 at Lund University Hospital, Lund, Sweden. Healthy pregnant volunteers (n = 156) were recruited from women’s welfare centers in the same region 2014–2015. Levels of IL-1Ra and C-peptide were analyzed in ethylenediaminetetraacetic acid (EDTA)-plasma or serum using enzyme linked immunosorbent assay (ELISA). GDM patients had significantly lower levels of IL-1Ra than the control group (p = 0.012). In addition, GDM patients that had developed impaired glucose tolerance (IGT) or type 2 diabetes mellitus postpartum had significantly lower levels of IL-1Ra, and significantly higher levels of C-peptide than GDM patients that had not developed diabetes mellitus postpartum (p = 0.023) and (p = 0.0011) respectively. An inverse correlation was found between IL-1Ra and serum C-peptide levels in the control group (rs = -0.31 p = 0.0001). Our results show that IL-1Ra might be included in a future panel of biomarkers, both for diagnosing GDM to complement blood glucose, and also identifying GDM patients that are at risk of developing type 2 diabetes mellitus postpartum. However, the ROC curve analysis provided a sensitivity of 52.2% and specificity of 67.1%, which nonetheless may not be sufficient enough to

  20. Plasma Levels of the Interleukin-1-Receptor Antagonist Are Lower in Women with Gestational Diabetes Mellitus and Are Particularly Associated with Postpartum Development of Type 2 Diabetes.

    PubMed

    Katra, Pernilla; Dereke, Jonatan; Nilsson, Charlotta; Hillman, Magnus

    2016-01-01

    Diabetes mellitus is a group of diseases characterized by chronic hyperglycemia. Women who develops hyperglycemia for the first time during pregnancy receive the diagnosis gestational diabetes mellitus (GDM). Presently, there is no consensus about the diagnostic criteria for GDM. A majority of these women subsequently develop postpartum overt diabetes making it important to identify these patients as early as possible. In this study we investigated if plasma levels of the interleukin-1 receptor antagonist (IL-1Ra), an endogenous inhibitor of IL-1 signaling, can be used as a complementary biomarker for diagnosing GDM and predicting postpartum development of overt diabetes mellitus. Patients participating in this study (n = 227) were diagnosed with their first GDM 2004-2013 at Lund University Hospital, Lund, Sweden. Healthy pregnant volunteers (n = 156) were recruited from women's welfare centers in the same region 2014-2015. Levels of IL-1Ra and C-peptide were analyzed in ethylenediaminetetraacetic acid (EDTA)-plasma or serum using enzyme linked immunosorbent assay (ELISA). GDM patients had significantly lower levels of IL-1Ra than the control group (p = 0.012). In addition, GDM patients that had developed impaired glucose tolerance (IGT) or type 2 diabetes mellitus postpartum had significantly lower levels of IL-1Ra, and significantly higher levels of C-peptide than GDM patients that had not developed diabetes mellitus postpartum (p = 0.023) and (p = 0.0011) respectively. An inverse correlation was found between IL-1Ra and serum C-peptide levels in the control group (rs = -0.31 p = 0.0001). Our results show that IL-1Ra might be included in a future panel of biomarkers, both for diagnosing GDM to complement blood glucose, and also identifying GDM patients that are at risk of developing type 2 diabetes mellitus postpartum. However, the ROC curve analysis provided a sensitivity of 52.2% and specificity of 67.1%, which nonetheless may not be sufficient enough to use IL

  1. Disorders of colonic motility in patients with diabetes mellitus.

    PubMed Central

    Battle, W. M.; Cohen, J. D.; Snape, W. J.

    1983-01-01

    Motility disturbances of the colon can give significant symptoms in patients with diabetes mellitus. Constipation is a common complaint in these patients. Diarrhea associated with a generalized autonomic neuropathy can be very troublesome. There is a disturbance in the gastrocolonic response to eating in patients with diabetes mellitus who have constipation. These patients have no postprandial increase in colonic motility. However, their colonic smooth muscle contracts normally to the exogenous administration of neostigmine or metoclopramide. Stool softeners used in combination with the smooth muscle stimulants (neostigmine or metoclopramide) are helpful in treating constipation in patients with diabetes mellitus. Diarrhea can be treated with loperamide or diphenoxylate. Biofeedback may be useful in treating incontinence associated with diarrhea in these patients. PMID:6670291

  2. Glycemic control indicators in patients with neonatal diabetes mellitus

    PubMed Central

    Suzuki, Shigeru; Koga, Masafumi

    2014-01-01

    Neonatal diabetes mellitus (NDM) is a type of diabetes mellitus caused by genetic abnormality which develops in insulin dependent state within 6 mo after birth. HbA1c is widely used in clinical practice for diabetes mellitus as the gold standard glycemic control indicator; however, fetal hemoglobin (HbF) is the main hemoglobin in neonates and so HbA1c cannot be used as a glycemic control indicator in NDM. Glycated albumin (GA), another glycemic control indicator, is not affected by HbF. We reported that GA can be used as a glycemic control indicator in NDM. However, it was later found that because of increased metabolism of albumin, GA shows an apparently lower level in relation to plasma glucose in NDM; measures to solve this problem were needed. In this review, we outlined the most recent findings concerning glycemic control indicators in neonates or NDM. PMID:24748932

  3. Ministry of Health Clinical Practice Guidelines: Diabetes Mellitus

    PubMed Central

    Goh, Su Yen; Ang, Seng Bin; Bee, Yong Mong; Chen, Richard YT; Gardner, Daphne; Ho, Emily; Adaikan, Kala; Lee, Alvin; Lee, Chung Horn; Lim, Fong Seng; Lim, Hwee Boon; Lim, Su Chi; Seow, Julie; Soh, Abel Wah Ek; Sum, Chee Fang; Tai, E Shyong; Thai, Ah Chuan; Wong, Tien Yin; Yap, Fabian

    2014-01-01

    The Ministry of Health (MOH) have updated the clinical practice guidelines on Diabetes Mellitus to provide doctors and patients in Singapore with evidence-based treatment for diabetes mellitus. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on Diabetes Mellitus, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines. PMID:25017409

  4. [Insulin therapy for type 1 diabetes mellitus: past and present].

    PubMed

    Pires, Antonio Carlos; Chacra, Antonio Roberto

    2008-03-01

    The discovery of insulin can be considered the milestone of diabetes mellitus history and a great achievement for its treatment. The first insulin available was the regular. Afterwards, Hagedorn added the protamine to the insulin, thus, creating the NPH insulin. In the 1950s an insulin free of protamine was synthesized: the lente insulin. With the advent of molecular biology, synthetic human insulin was synthesized using recombinant DNA technology. Most recently several types of insulin analogues were available, providing the patients with better metabolic control. Type 1 diabetes mellitus treatment includes plain substitution and individualization for short-acting plus long-acting insulin according to the physician's assistance, besides regular practice of physical activities and diet orientations. In type 1 diabetes mellitus the insulin of low variability is the best choice since basal/bolus insulin therapy or continuous subcutaneous insulin infusion pump can mimetize the physiological release of insulin by beta cells. PMID:18438537

  5. First and only symptom of undiagnosed diabetes mellitus: eruptive xanthoma.

    PubMed

    Solak, Berna; Kara, Rabia Oztas; Acikgoz, Seyyid Bilal; Kosem, Mustafa

    2015-01-01

    Eruptive xanthoma (EX) is a very rare dermatosis mostly occurring due to high levels of serum triglycerides or uncontrolled diabetes mellitus. When EX is encountered, it is important to keep in mind that it could be a sign of severe underlying metabolic derangements. Early recognition can help avoid serious complications such as pancreatitis. After treatment of the underlying metabolic disorders, lesions mostly disappear without leaving scars. We present a case of a 55-year-old woman who presented with solely EX lesions and who was eventually diagnosed with diabetes mellitus and severe hypertriglyceridaemia. PMID:26404550

  6. Infantile onset diabetes mellitus in developing countries - India

    PubMed Central

    Varadarajan, Poovazhagi

    2016-01-01

    Infantile onset diabetes mellitus (IODM) is an uncommon metabolic disorder in children. Infants with onset of diabetes mellitus (DM) at age less than one year are likely to have transient or permanent neonatal DM or rarely type 1 diabetes. Diabetes with onset below 6 mo is a heterogeneous disease caused by single gene mutations. Literature on IODM is scanty in India. Nearly 83% of IODM cases present with diabetic keto acidosis at the onset. Missed diagnosis was common in infants with diabetes (67%). Potassium channel mutation with sulphonylurea responsiveness is the common type in the non-syndromic IODM and Wolcott Rallison syndrome is the common type in syndromic diabetes. Developmental delay and seizures were the associated co-morbid states. Genetic diagnosis has made a phenomenal change in the management of IODM. Switching from subcutaneous insulin to oral hypoglycemic drugs is a major clinical breakthrough in the management of certain types of monogenic diabetes. Mortality in neonatal diabetes is 32.5% during follow-up from Indian studies. This article is a review of neonatal diabetes and available literature on IODM from India. PMID:27022444

  7. Milestones in the history of diabetes mellitus: The main contributors

    PubMed Central

    Karamanou, Marianna; Protogerou, Athanase; Tsoucalas, Gregory; Androutsos, George; Poulakou-Rebelakou, Effie

    2016-01-01

    Diabetes mellitus is a group of metabolic diseases involving carbohydrate, lipid, and protein metabolism. It is characterized by persistent hyperglycemia which results from defects in insulin secretion, or action or both. Diabetes mellitus has been known since antiquity. Descriptions have been found in the Egyptian papyri, in ancient Indian and Chinese medical literature, as well as, in the work of ancient Greek and Arab physicians. In the 2nd century AD Aretaeus of Cappadocia provided the first accurate description of diabetes, coining the term diabetes, while in 17th century Thomas Willis added the term mellitus to the disease, in an attempt to describe the extremely sweet taste of the urine. The important work of the 19th century French physiologist Claude Bernard, on the glycogenic action of the liver, paved the way for further progress in the study of the disease. In 1889, Oskar Minkowski and Joseph von Mering performed their famous experiment of removing the pancreas from a dog and producing severe and fatal diabetes. In 1921, Frederick Banting and Charles Best extended Minkowski’s and Mering’s experiment. They isolated insulin from pancreatic islets and administrated to patients suffering from type 1 diabetes, saving thus the lives of millions and inaugurating a new era in diabetes treatment. PMID:26788261

  8. Oxidative Stress: A Link between Diabetes Mellitus and Periodontal Disease

    PubMed Central

    Mezei, Tibor; Popsor, Sorin; Monea, Monica

    2014-01-01

    Objective. To investigate oxidative stress (OS) and histological changes that occur in the periodontium of subjects with type 2 diabetes mellitus without signs of periodontal disease and to establish if oxidative stress is a possible link between diabetes mellitus and periodontal changes. Materials and Methods. Tissue samples from ten adult patients with type 2 diabetes mellitus (T2D) and eight healthy adults were harvested. The specimens were examined by microscope using standard hematoxylin-eosin stain, at various magnifications, and investigated for tissue levels of malondialdehyde (MDA) and glutathione (GSH). Results. Our results showed that periodontal tissues in patients with T2D present significant inflammation, affecting both epithelial and connective tissues. Mean MDA tissue levels were 3.578 ± 0.60 SD in diabetics versus 0.406 ± 0.27 SD in controls (P < 0.0001), while mean GSH tissue levels were 2.48 ± 1.02 SD in diabetics versus 9.7875 ± 2.42 SD in controls (P < 0.0001). Conclusion. Diabetic subjects had higher MDA levels in their periodontal tissues, suggesting an increased lipid peroxidation in T2D, and decreased GSH tissue levels, suggesting an alteration of the local antioxidant defense mechanism. These results are in concordance with the histological changes that we found in periodontal tissues of diabetic subjects, confirming the hypothesis of OS implication, as a correlation between periodontal disease incidence and T2D. PMID:25525432

  9. Translational Implications of the β Cell Epigenome in Diabetes Mellitus

    PubMed Central

    Johnson, Justin S.; Evans-Molina, Carmella

    2014-01-01

    Diabetes mellitus is a disorder of glucose homeostasis that affects over 24 million Americans and 382 million individuals worldwide. Dysregulated insulin secretion from the pancreatic β cells plays a central role in the pathophysiology of all forms of diabetes mellitus. Therefore an enhanced understanding of the pathways that contribute to β cell failure is imperative. Epigenetics refers to heritable changes in DNA transcription that occur in the absence of changes to the linear DNA nucleotide sequence. Recent evidence suggests an expanding role of the β cell epigenome in the regulation of metabolic health. The goal of this review is to discuss maladaptive changes in β cell DNA methylation patterns and chromatin architecture and their contribution to diabetes pathophysiology. Efforts to modulate the β cell epigenome as a means to prevent, diagnose, and treat diabetes will also be discussed. PMID:24686035

  10. Vitamin D status and gestational diabetes mellitus

    PubMed Central

    Muthukrishnan, Jayaraman; Dhruv, Goel

    2015-01-01

    Context: Vitamin D (Vit D) deficiency and gestational diabetes mellitus (GDM) are increasingly being seen in Indian women. The role of Vit D in causing GDM is not clear. Aims: (1) To compare Vit D status in pregnant women with or without GDM. (2) Frequency of GDM in women with Vit D insufficiency and deficiency. (3) To reassess glucose tolerance after replacement of Vit D in those women with Vit D deficiency and GDM. Settings and Design: Tertiary Care Hospital, Antenatal Care Department based prospective, controlled study. Subjects and Methods: Seventy-eight consecutive women (<28 weeks gestational period) were screened for GDM by glucose tolerance test (GTT) (75 g 2 h). Fifty-nine of these women were confirmed to have GDM (2 h postglucose > 140 mg/dl). Eight of these women were excluded as per laid exclusion criteria. Remaining 19 women with normal glucose tolerance (NGT) were included as controls. Serum 25-OH Vit D level was estimated by radioimmuno assay. Standard advice regarding diet, sunlight exposure, and exercise was given to all by the same dietician. Women with Vit D levels below 20 ng/ml were prescribed 60,000 IU of oral cholecalciferol to be administered twice weekly for 4 weeks. GTT was repeated after 6 weeks. Frequency of glucose intolerance was compared between Vit D sufficient and deficient groups. Women with GDM and Vit D deficiency who revert to NGT after supplementation with cholecalciferol were evaluated. Statistical Analysis used: Paired t-test for comparing means, and Fisher's test for comparing proportions. Results: Baseline characteristics of GDM and NGT with respect to their age, prepregnancy body mass index, and gestational period were comparable. Serum 25-OH Vit D levels were significantly lower in GDM 24.7 (±17.6) ng/ml versus NGT (45.8 ± 28) group (P = 0.0004). Frequency of GDM was similar irrespective of Vit D status 67% versus 42% (P = 0.09). Standard advice on diet and exercise with or without Vit D supplementation did not

  11. [Antihyperglycemic treatment guidelines for diabetes mellitus type 2].

    PubMed

    Clodi, Martin; Abrahamian, Heidemarie; Drexel, Heinz; Fasching, Peter; Föger, Bernhard; Francesconi, Claudia; Hoppichler, Friedrich; Kaser, Susanne; Kautzky-Willer, Alexandra; Lechleitner, Monika; Ludvik, Bernhard; Prager, Rudolf; Fröhlich-Reiterer, Elke; Roden, Michael; Säly, Christoph; Schernthaner, Guntram; Sourij, Harald; Toplak, Hermann; Wascher, Thomas C; Weitgasser, Raimund

    2016-04-01

    Hyperglycemia significantly contributes to micro- and macrovascular complications in patients with diabetes mellitus. While lifestyle interventions remain cornerstones of disease prevention and treatment, most patients with type 2 diabetes will eventually require pharmacotherapy for glycemic control. The definition of individual targets regarding optimal therapeutic efficacy and safety is of great importance. In this guideline we present the most current evidence-based best clinical practice data for healthcare professionals. PMID:27052250

  12. Pancreatic atrophy and diabetes mellitus following blunt abdominal trauma.

    PubMed

    Edwards, Mary J; Crudo, David F; Carlson, Terri L; Pedersen, Anita M; Keller, Laura

    2013-02-01

    Following pancreatic trauma, loss of uninjured parenchyma as a result of surgical management is expected, and atrophy of parenchyma following nonoperative management has been described. While endocrine insufficiency as a sequela of pancreatic trauma has been reported in adults, it is not a described entity in children. We report a case of pancreatic atrophy following blunt injury in an 8 year old boy who presented 3 years later with diabetes mellitus. Further analysis revealed significant genetic predisposition to diabetes. PMID:23414880

  13. Common and rare forms of diabetes mellitus: towards a continuum of diabetes subtypes.

    PubMed

    Flannick, Jason; Johansson, Stefan; Njølstad, Pål R

    2016-07-01

    Insights into the genetic basis of type 2 diabetes mellitus (T2DM) have been difficult to discern, despite substantial research. More is known about rare forms of diabetes mellitus, several of which share clinical and genetic features with the common form of T2DM. In this Review, we discuss the extent to which the study of rare and low-frequency mutations in large populations has begun to bridge the gap between rare and common forms of diabetes mellitus. We hypothesize that the perceived division between these diseases might be due, in part, to the historical ascertainment bias of genetic studies, rather than a clear distinction between disease pathophysiologies. We also discuss possible implications of a new model for the genetic basis of diabetes mellitus subtypes, where the boundary between subtypes becomes blurred. PMID:27080136

  14. Different role of zinc transporter 8 between type 1 diabetes mellitus and type 2 diabetes mellitus.

    PubMed

    Yi, Bo; Huang, Gan; Zhou, Zhiguang

    2016-07-01

    Diabetes can be simply classified into type 1 diabetes mellitus and type 2 diabetes mellitus. Zinc transporter 8 (ZnT8), a novel islet autoantigen, is specifically expressed in insulin-containing secretory granules of β-cells. Genetic studies show that the genotypes of SLC30A8 can determine either protective or diabetogenic response depending on environmental and lifestyle factors. The ZnT8 protein expression, as well as zinc content in β-cells, was decreased in diabetic mice. Thus, ZnT8 might participate in insulin biosynthesis and release, and subsequently involved deteriorated β-cell function through direct or indirect mechanisms in type 1 diabetes mellitus and type 2 diabetes mellitus. From a clinical feature standpoint, the prevalence of ZnT8A is gradiently increased in type 2 diabetes mellitus, latent autoimmune diabetes in adults and type 1 diabetes mellitus. The frequency and epitopes of ZnT8-specific T cells and cytokine release by ZnT8-specific T cells are also different in diabetic patients and healthy controls. Additionally, the response to ZnT8 administration is also different in type 1 diabetes mellitus and type 2 diabetes mellitus. In the present review, we summarize the literature about clinical aspects of ZnT8 in the pathogenesis of diabetes, and suggest that ZnT8 might play a different role between type 1 diabetes mellitus and type 2 diabetes mellitus. PMID:27181765

  15. [Diabetes in Pregnancy - Type 1/Type 2 Diabetes Mellitus and Gestational Diabetes Mellitus].

    PubMed

    Kleinwechter, Helmut; Demandt, Norbert

    2016-09-01

    In Germany in 5.5% of all births diabetes is registered. In patients with type 1 and type 2 diabetes planning pregnancy, preconception counseling, diabetologic care with optimized periconceptional metabolic control and folic acid supplementation are essential for good pregnancy outcome. Gestational diabetes (GDM) should be diagnosed timely and managed according to existing guidelines. GDM is treated with insulin in approximately 20%. In 1-2% of GDM cases a glucokinase gene mutation is present (MODY 2). Pregnancies after bariatric-metabolic surgery are increasing and show high risks. PMID:27598916

  16. Diabetes mellitus type 2 and functional foods of plant origin.

    PubMed

    Pathak, Manju

    2014-01-01

    Diabetes is the common, exponentially growing, serious human health problem existing globally. Risk factors like genetic predisposition, lack of balanced diet, inappropriate and lethargic lifestyle, overweight, obesity, stress including emotional and oxidative and lack of probiotics in gut are found to be the causing factors either in isolation or in synergy predisposing Diabetes. High blood sugar is a common symptom in all types of diabetes mellitus and the physiological cause of diabetes is lack of hormone Insulin or resistance in function faced by insulin. Low levels of Insulin causes decreased utilization of glucose by body cells, increased mobilization of fats from fat storage cells and depletion of proteins in the tissues of the body, keeping the body in crisis. The functional foods help achieving optimal physiological metabolism and cellular functions helping the body to come out of these crises. The mechanism of the functional foods is envisaged to act via optimizing vitamins, minerals, essential amino acids, prebiotics and probiotics. This paper reviews role of functional foods of plant origin in the regulation of blood sugar in type 2 diabetes mellitus and also discusses some vital patents in this area. The article aims at creating awareness about key food ingredients in order to prevent most acute effects of diabetes mellitus and to greatly delay the chronic effects as well. PMID:25185980

  17. Association of mitochondrial DNA haplogroups and vascular complications of diabetes mellitus: A population-based study.

    PubMed

    Martikainen, Mika H; Rönnemaa, Tapani; Majamaa, Kari

    2015-07-01

    We investigated whether mitochondrial (mtDNA) haplogroups and maternal family history of diabetes mellitus were associated with vascular diabetes mellitus complications in a population-based cohort of 299 Finnish diabetes mellitus patients with disease onset in young adult age. We found that haplogroup U was more prevalent among patients with no vascular diabetes mellitus complications than among those with at least one complication (p = 0.038). Haplogroup U was also more prevalent among the patients who reported maternal family history of diabetes mellitus than among those who did not (p = 0.0013). Furthermore, haplogroup U was more prevalent among patients with maternal family history of diabetes mellitus but no vascular diabetes mellitus complications than among those with at least one vascular diabetes mellitus complication but no maternal family history of diabetes mellitus (p = 0.0003 for difference). These findings suggest that different mtDNA-related factors may influence the risk of diabetes mellitus per se and the risk of vascular diabetes mellitus complications. Further studies are, however, warranted to replicate and elaborate on these results. PMID:25920916

  18. Coping Styles in Youths with Insulin-Dependent Diabetes Mellitus.

    ERIC Educational Resources Information Center

    Hanson, Cindy L.; And Others

    1989-01-01

    Evaluated relationships between two coping styles and two health outcomes in 135 youth with insulin-dependent diabetes mellitus (IDDM). Found that poor adherence to treatment, older adolescent age, and long duration of IDDM correlated with ventilation and avoidance coping. High ventilation and avoidance coping was predicted by high stress, low…

  19. Jordanian School Counselors' Knowledge about and Attitudes toward Diabetes Mellitus

    ERIC Educational Resources Information Center

    Tannous, Adel G.; Khateeb, Jamal M.; Khamra, Hatem A.; Hadidi, Muna S.; Natour, Mayada M.

    2012-01-01

    This study investigated the knowledge and attitudes of Jordanian school counselors toward diabetes mellitus. A sample of 295 counselors completed a questionnaire consisting of two parts concerning knowledge and attitudes. The face validity of the questionnaire was assessed using an informed panel of judges, and its reliability was established…

  20. Maximum Oxygen Uptake Determination in Insulin-Dependent Diabetes Mellitus.

    ERIC Educational Resources Information Center

    Fremion, Amy S.; And Others

    1987-01-01

    A study of 10 children with insulin-dependent diabetes mellitus performing a maximum-effort cycling test indicated blood glucose levels did not change appreciably during test, while maximal oxygen uptake was substandard for their age groups. Findings suggest patients in fair to poor metabolic control can tolerate stress testing without…

  1. Metabolomics: Insulin Resistance and Type 2 Diabetes Mellitus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Type 2 diabetes mellitus (T2DM) develops over many years, providing an opportunity to consider early prognostic tools that guide interventions to thwart disease. Advancements in analytical chemistry enable quantitation of hundreds of metabolites in biofluids and tissues (metabolomics), providing in...

  2. Method for identifying type I diabetes mellitus in humans

    DOEpatents

    Metz, Thomas O [Kennewick, WA; Qian, Weijun [Richland, WA; Jacobs, Jon M [Pasco, WA

    2011-04-12

    A method and system for classifying subject populations utilizing predictive and diagnostic biomarkers for type I diabetes mellitus. The method including determining the levels of a variety of markers within the serum or plasma of a target organism and correlating this level to general populations as a screen for predisposition or progressive monitoring of disease presence or predisposition.

  3. Diabetes mellitus in patients with cirrhosis: clinical implications and management.

    PubMed

    Elkrief, Laure; Rautou, Pierre-Emmanuel; Sarin, Shiv; Valla, Dominique; Paradis, Valérie; Moreau, Richard

    2016-07-01

    Disorders of glucose metabolism, namely glucose intolerance and diabetes, are frequent in patients with chronic liver diseases. In patients with cirrhosis, diabetes can be either a classical type 2 diabetes mellitus or the so-called hepatogenous diabetes, i.e. a consequence of liver insufficiency and portal hypertension. This review article provides an overview of the possible pathophysiological mechanisms explaining diabetes in patients with cirrhosis. Cirrhosis is associated with portosystemic shunts as well as reduced hepatic mass, which can both impair insulin clearance by the liver, contributing to peripheral insulin resistance through insulin receptors down-regulation. Moreover, cirrhosis is associated with increased levels of advanced-glycation-end products and hypoxia-inducible-factors, which may play a role in the development of diabetes. This review also focuses on the clinical implications of diabetes in patients with cirrhosis. First, diabetes is an independent factor for poor prognosis in patients with cirrhosis. Specifically, diabetes is associated with the occurrence of major complications of cirrhosis, including ascites and renal dysfunction, hepatic encephalopathy and bacterial infections. Diabetes is also associated with an increased risk of hepatocellular carcinoma in patients with chronic liver diseases. Last, the management of patients with concurrent diabetes and liver disease is also addressed. Recent findings suggest a beneficial impact of metformin in patients with chronic liver diseases. Insulin is often required in patients with advanced cirrhosis. However, the favourable impact of controlling diabetes in patients with cirrhosis has not been demonstrated yet. PMID:26972930

  4. Saliva: A tool in assessing glucose levels in Diabetes Mellitus

    PubMed Central

    Satish, B N V S; Srikala, P; Maharudrappa, B; Awanti, Sharanabasappa M; Kumar, Prashant; Hugar, Deepa

    2014-01-01

    Background: Diabetes mellitus is a metabolic disorder affecting people worldwide, which require constant monitoring of their glucose levels. Commonly employed procedures include collection of blood or urine samples causing discomfort to the patients. Hence the need for an alternative non invasive technique is required to monitor glucose levels. Saliva present in the oral cavity not only maintains the health of the oral cavity but plays a important role in diagnosis of cancers of the oral cavity, periodontal diseases, HIV, heart diseases etc. The aim of the present study was undertaken to correlate the glucose levels in saliva and blood of diabetic and healthy non diabetic individuals and to determine the efficacy of saliva as a diagnostic tool. Materials & Methods: A total of 30 individuals of which 20 patients were diabetic patients and on medication and 10 patients were healthy non diabetic individuals were included in the study. Blood and saliva were collected under resting conditions and were subjected to glucose estimation. Results: Salivary and blood glucose concentrations were determined in non diabetic healthy individuals (n=10) and Type II Diabetes mellitus patients (n=20). Glycosylated haemoglobin A1c was also determined in both Type II diabetic patients and Control group and a significant correlation (r=0.73) and (r=0.46) was found between HbA1c and serum glucose concentrations in diabetic and control group respectively. A significant correlation (r=0.54) and (r=0.45) was found between fasting blood glucose and fasting salivary glucose for diabetic group and control group respectively. A positive correlation (r=0.39) and (r=0.38) was found between fasting salivary glucose and HbA1c for diabetic and control group respectively. Conclusion: These findings suggest that the saliva can be used in the assessment of the blood glucose concentration in diabetes mellitus patients. How to cite the article: Satish BN, Srikala P, Maharudrappa B, Awanti M, Kumar P

  5. The HLA system and diabetes mellitus.

    PubMed

    Cudworth, A G; Woodrow, J C

    1977-06-01

    There is a significant positive association between insulin dependent diabetes, irrespective of age of onset, and the HLA system, whereas there is no association of HLA antigens with non-insulin dependent diabetes. There is a significant concordance value for HLA antigen frequencies in insulin dependent diabetics from three different centres, indicating that the genes (s) conferring susceptibility to this type of diabetes is possibly present in all "juvenile-onset" diabetics and is in linkage disequilibrium with all the B locus alleles. PMID:892129

  6. Diabetes mellitus with pulmonary tuberculosis--a double trouble.

    PubMed

    Kant, Surya; Lata, Hem; Natu, S M; Mishra, Arvind Kumar; Verma, N S

    2013-03-01

    Diabetic patients are often at a higher risk for developing several types of infections and infection does alter the handling of glucose by tissues. Pulmonary infections in diabetics are characterised by alteration in host defence, in entire body and in the lung locally as well as in the function of respiratory epithelium and ciliary motility. Association between diabetes mellitus and pulmonary tuberculosis is well established, while the prevalence of tuberculosis is increased 4-5 times more among diabetics. Impairment of host defence plays an important role for changing the clinical, radiological and bacteriological presentation in diabetic patients. It is also reported by the various studies that hyperglycaemia favours the growth of tuberculosis bacilli. So the severity of tuberculosis appears more cirtical with the degree of hyperglycaemia and host defence activity. This overlap between the diabetic and tuberculosis epidemics could adversely affect global tuberculosis control efforts. PMID:24592761

  7. Microvascular complications of diabetes mellitus: renal protection accompanies cardiovascular protection.

    PubMed

    Brown, W Virgil

    2008-12-22

    The microvascular complications of diabetes mellitus confer substantial morbidity and impair patient quality of life. Dyslipidemia and prolonged hyperglycemia promote an increase in oxidative stress, inflammation, and vascular damage, which together promote endothelial dysfunction and are associated with macrovascular and microvascular complications. Microalbuminuria is an early marker of diabetic nephropathy and an independent risk factor for cardiovascular disease. Diabetic nephropathy is the most common cause of end-stage renal disease in developed countries, and its prevalence is increasing. Preventing or limiting the progression of diabetic nephropathy, as demonstrated in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial, may prevent or delay renal complications, as well as convey important cardioprotective benefits in patients with type 2 diabetes. PMID:19084084

  8. Association of GSTs polymorphisms with risk of gestational diabetes mellitus

    PubMed Central

    Li, Yan; Li, Shaoru; Zhai, Qianqian; Hai, Jie; Wang, Di; Cao, Meng; Zhang, Qinggui

    2015-01-01

    We conducted a case-control study to investigate the association between GSTM1, GSTT1 and GSTP1 IIe105Val polymorphisms and development of gestational diabetes mellitus in a Chinese population. A total of 320 patients with gestational diabetes mellitus and 358 pregnancy subjects were consecutively collected between January 2013 and December 2014. Genotyping for detection of GSTM1, GSTT1 and GSTP1 IIe105Val was conducted by using PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphisms) method. By Fisher’s exact test, we found that the genotype distributions of GSTP1 IIe105Val were in line with the Hardy-Weinberg equilibrium in control subjects (P=0.57). By Chi-square test, we found significant differences in the genotype distributions of GSTM1 (χ2=11.49, P=0.001) and GSTT1 (χ2=18.50, P<0.001). Using unconditional logistic analysis, individuals carrying the null genotypes of GSTM1 and GSTT1 were associated with an increased risk of gestational diabetes mellitus when compared with the present genotype, and the adjusted Ors (95% CI) were 1.71 (1.24-2.36) and 2.00 (1.44-2.79), respectively. However, the GSTP1 IIe105Val polymorphism was not associated with an elevated risk of gestational diabetes mellitus. In conclusion, we suggest that the GSTM1 null genotype and GSTT1 null genotype are correlated with an increased risk of gestational diabetes mellitus in a Chinese population. PMID:26823865

  9. Amelioration of diet-induced diabetes mellitus by removal of visceral fat.

    PubMed

    Pitombo, Cid; Araújo, Eliana P; De Souza, Cláudio T; Pareja, José C; Geloneze, Bruno; Velloso, Lício A

    2006-12-01

    The effect of visceral fat removal upon glucose homeostasis, insulin signal transduction, and serum adipokine levels in an animal model of diet-induced obesity and diabetes mellitus (DIO) was evaluated. Swiss mice were initially divided into two groups fed with regular rodent chow or with chow containing 24 g% saturated fat (DIO). DIO mice became obese and overtly diabetic after 8 weeks. DIO mice were then divided into three groups: control, sham, and visceral (epididymal and perinephric) fat removal. All groups were submitted to evaluation of basal glucose and insulin levels and i.p. insulin tolerance test. Insulin signal transduction in muscle was evaluated by immunoprecipitation and immunoblot, and serum adipokine levels were determined by ELISA. DIO mice became diabetic (228 versus 115 mg/dl), hyperinsulinemic (7.59 versus 3.15 ng/ml) and insulin resistant (K(itt) 2.88 versus 4.97%/min) as compared with control. Visceral fat removal partially reverted all parameters (147 mg/dl glucose; 3.82 ng/ml insulin; and 4.20%/min K(itt)). In addition, visceral fat removal completely reversed the impairment of insulin signal transduction through insulin receptor, insulin receptor substrate (IRS)-1, IRS-2 and Akt in muscle. Finally, serum levels of the pro-inflammatory cytokines tumour necrosis factor-alpha, interleukin (IL)-1beta and IL-6 were significantly increased, while adiponectin levels were significantly reduced in DIO mice. After visceral fat removal the levels of adipokines returned to near control levels. The present study shows that removal of visceral fat improves insulin signal transduction and glucose homeostasis in an animal model of diet-induced obesity and diabetes mellitus and these metabolic and molecular outcomes are accompanied by the restoration of adipokine levels. PMID:17170226

  10. Psychosocial factors and diabetes mellitus: evidence-based treatment guidelines.

    PubMed

    Petrak, Frank; Herpertz, Stephan; Albus, Christian; Hirsch, Axel; Kulzer, Bernhard; Kruse, Johannes

    2005-08-01

    The aim of this project was to develop evidence-based guidelines regarding psychosocial aspects of diabetes mellitus in an effort to help the clinician bridge the gap between research and practice. Recommendations address the following topics: patient education, behavioural medicine, and psychiatric disorders of particular relevance to diabetes: depression, anxiety disorders, eating disorders, and dependence on alcohol and nicotine. The present guidelines were developed through an interdisciplinary process of consensus according to the specifications of evidence-based medicine and are recognized by the German Diabetes Association and the German College for Psychosomatic Medicine as their official guidelines. PMID:18220602

  11. Gene therapy progress and prospects: gene therapy for diabetes mellitus.

    PubMed

    Yechoor, V; Chan, L

    2005-01-01

    Diabetes mellitus has long been targeted, as yet unsuccessfully, as being curable with gene therapy. The main hurdles have not only been vector-related toxicity but also the lack of physiological regulation of the expressed insulin. Recent advances in understanding the developmental biology of beta-cells and the transcriptional cascade that drives it have enabled both in vivo and ex vivo gene therapy combined with cell therapy to be used in animal models of diabetes with success. The associated developments in the stem cell biology and immunology have opened up further opportunities for gene therapy to be applied to target autoimmune diabetes. PMID:15496957

  12. Ambient air pollution: an emerging risk factor for diabetes mellitus.

    PubMed

    Rao, Xiaoquan; Montresor-Lopez, Jessica; Puett, Robin; Rajagopalan, Sanjay; Brook, Robert D

    2015-06-01

    Growing evidence supports that air pollution has become an important risk factor for developing diabetes mellitus. Understanding the contributing effect of air pollution in population studies, elucidating the potential mechanisms involved, and identifying the most responsible pollutants are all required in order to promulgate successful changes in policy and to help formulate preventive measures in an effort to reduce the risk for diabetes. This review summarizes recent findings from epidemiologic studies and mechanistic insights that provide links between exposure to air pollution and a heightened risk for diabetes. PMID:25894943

  13. Diabetes Mellitus Type 2: A Driving Force for Urological Complications.

    PubMed

    Sayyid, Rashid K; Fleshner, Neil E

    2016-05-01

    Type 2 diabetes mellitus (T2DM) is a growing epidemic associated with many adverse complications. Urological complications of diabetes mellitus in men are gaining recognition. Previously unknown associations between T2DM and risk for prostate cancer, bladder cancer, renal cell carcinomas, urinary tract infections, nephrolithiasis, penile lesions, androgen deficiency, and erectile dysfunction have been discovered. Significantly, metformin could play a role in the management of urological malignancies, and therapies used for management of these cancers could in return lead to increased risk for diabetes. In this review, we aim to bridge the gap between T2DM and urological complications by discussing the latest findings in these fields, with the ultimate goal being improved patient care on both fronts. PMID:26969242

  14. Diabetes mellitus in a black-footed ferret

    USGS Publications Warehouse

    Carpenter, J.W.; Novilla, M.N.

    1977-01-01

    Diabetes mellitus was tentatively diagnosed in a black-footed ferret with polyuria, polydipsia, polyphagia, dehydration, and weight loss. Laboratory findings (marked hyperglycemia (724 mg/100 ml), glycosuria, and ketonuria) and the subsequent favorable response to insulin therapy confirmed the diagnosis. Although lesions were not observed in the pancreas, gross and histologic findings concomitant with diabetes mellitus included arteriosclerosis, with calcification of the aorta and other major vessels; mild necrotizing hepatitis; and mild proliferative glomerulonephritis. A perineal adenocarcinoma, with metastasis to an internal iliac lymph node, was an incidental finding. Special stains demonstrated adequate numbers of beta cell granules in the islets of Langerhans. Thus, the diabetes was apparently due to a lack of release of the synthesized insulin or to diminished effectiveness of the secreted insulin.

  15. Salmonella Neck Abscess as an Opportunistic Infection in Diabetes Mellitus

    PubMed Central

    Jenkins, Stephen G.

    2013-01-01

    Salmonella neck infections represent an uncommon cause of focal salmonellosis. While the incidence of nontyphoid salmonellosis is estimated at over 2 million cases annually, extraintestinal manifestations account for less than 1% of cases. This paper describes two patients with Salmonella neck abscesses as the initial presentation of diabetes mellitus. The first patient was diagnosed as having Salmonella enterica serotype Enteritidis sternocleidomastoid pyomyositis and the second patient Salmonella enterica serotype Typhimurium parapharyngeal abscess. Both patients had elevated hemoglobin A1c levels and had not been previously diagnosed with diabetes mellitus. Salmonella spp. should be on the differential as a causative pathogen in patients presenting with neck abscesses and poorly controlled glucose levels. Diabetes may be a risk factor for salmonellosis due to decreased gastric acidity and prolonged gastric transit time. Prompt incision and drainage accompanied by antibiotics remains the treatment of choice for infected neck abscesses. PMID:24307959

  16. Type 1 diabetes mellitus and gluten induced disorders

    PubMed Central

    Hogg-Kollars, Sabine; Al Dulaimi, David; Tait, Karen; Rostami, Kamran

    2014-01-01

    Over the last five decades the association between coeliac disease and other autoimmune disorders such as autoimmune thyroid disease or diabetes mellitus type 1 has been well established through many studies and to this day is subject to on-going clinical and scientific investigation worldwide. While no link has been established between celiac disease and type-2 diabetes mellitus, coeliac disease is common in patients with type 1 diabetes. The improvement of symptoms in patients with both conditions through dietary intervention, in the form of a gluten free diet, has been widely described within the literature. Our objectives were to review and synthesise the current knowledge on the nutritional treatment for patients with both conditions. PMID:25289132

  17. Current status of managing diabetes mellitus in Korea.

    PubMed

    Ha, Kyoung Hwa; Kim, Dae Jung

    2016-09-01

    Diabetes mellitus is an increasing global health problem. Guidelines for diabetic care recommend management of lifestyle and risk factors (glucose, blood pressure, and cholesterol), as well as regular screening for complications associated with treatment of the conditions related to diabetes. The prevalence of diabetes increased from 8.6% to 11.0% from 2001 to 2013. According to the diabetes fact sheet 2015, the proportion of patients with diabetes treated with antihypertensive medications increased from 56.0% to 62.5% from 2006 to 2013, and 49.5% of those with diabetes were being treated with lipid-lowering medications in 2013, a 1.8-fold increase since 2006. According to the 2014 Korea National Health and Nutrition Examination Survey data, 45.6% of patients with diabetes achieved a hemoglobin A1c level of < 7.0%, 72.8% achieved a blood pressure of < 140/85 mmHg, and 58.0% achieved a low density lipoprotein cholesterol level of < 100 mg/dL. Only 19.7% of patients with diabetes had good control of all three of these parameters. Despite improvements in health promotion efforts, the rates of adherence to medication and risk-factor control are low. Therefore, a systematic approach to managing diabetes, including self-management education, is needed to prevent or delay complications. The government needs to establish a long-term policy to address the growing burden of diabetes. PMID:27604796

  18. Current status of managing diabetes mellitus in Korea

    PubMed Central

    Ha, Kyoung Hwa; Kim, Dae Jung

    2016-01-01

    Diabetes mellitus is an increasing global health problem. Guidelines for diabetic care recommend management of lifestyle and risk factors (glucose, blood pressure, and cholesterol), as well as regular screening for complications associated with treatment of the conditions related to diabetes. The prevalence of diabetes increased from 8.6% to 11.0% from 2001 to 2013. According to the diabetes fact sheet 2015, the proportion of patients with diabetes treated with antihypertensive medications increased from 56.0% to 62.5% from 2006 to 2013, and 49.5% of those with diabetes were being treated with lipid-lowering medications in 2013, a 1.8-fold increase since 2006. According to the 2014 Korea National Health and Nutrition Examination Survey data, 45.6% of patients with diabetes achieved a hemoglobin A1c level of < 7.0%, 72.8% achieved a blood pressure of < 140/85 mmHg, and 58.0% achieved a low density lipoprotein cholesterol level of < 100 mg/dL. Only 19.7% of patients with diabetes had good control of all three of these parameters. Despite improvements in health promotion efforts, the rates of adherence to medication and risk-factor control are low. Therefore, a systematic approach to managing diabetes, including self-management education, is needed to prevent or delay complications. The government needs to establish a long-term policy to address the growing burden of diabetes. PMID:27604796

  19. [Photocoagulation in diabetes mellitus--our results].

    PubMed

    Stankiewicz, A; Szczuka, A; Bakunowicz-Lazarczyk, A; Zywalewski, B

    1989-01-01

    Fifty six diabetic patients aged 25-74 were under ophthalmological control in the period 1984-87. The mean time of duration of diabetes amounted 14 years. In 29 persons diabetes was insulinodependent and in the remaining insulino-independent. In 11 eyes the fundus exhibited diabetic changes with characteristics of angiopathy, in 43 eyes--of exudative retinopathy and in 58 eyes of proliferative retinopathy. Photocoagulation with a xenon-arc lamp of the diabetic changes was performed in all the patients. In dependence of the extent of the changes one used either a focused or a panretinal photocoagulation. In the majority of cases one could stop the progress of the diabetic changes on the fundus and preserve a fair visual acuity. PMID:2638444

  20. Vitamin D replacement and type 2 diabetes mellitus.

    PubMed

    Issa, Claire M; Zantout, Mira S; Azar, Sami T

    2015-01-01

    The objective of this paper is to review the evidence testing the possible benefit of vitamin D replacement on diabetes control and complications. Type 2 diabetes mellitus (DM 2) has become a significant global health care problem and its reported incidence is increasing at an alarming rate. Despite the improvement in therapy and development of new drugs, treatment is still not optimal especially with the associated adverse effects of most of the available drugs. New efforts are shifted toward disease prevention and a search for safer drugs. New mounting evidence is associating low vitamin D to diabetes mellitus and as such many studies were conducted to test the effect of vitamin D replacement on incidence of diabetes, diabetes control as well as diabetes complications. Although these studies present several limitations, vitamin D replacement seems to have beneficial effect on all aspects of diabetes: incidence, control and complications. Further longer term and more powered controlled trials are necessary to draw firmer conclusions on this beneficial role of vitamin D treatment on DM. PMID:25495839

  1. [Ketosis-prone atypical diabetes mellitus: report of two cases].

    PubMed

    Belhadi, L; Chadli, A; Bennis, L; Ghomari, H; Farouqi, A

    2007-12-01

    An atypical presentation of diabetes mellitus was described in black subjects, initially in adolescents by Winter et al. then, in adult populations. The principal characteristics of "African" diabetes are an acute onset with severe hyperglycemia and ketosis, and a clinical course of type 2 diabetes mellitus. In the subsequent clinical course after initiation of insulin therapy, prolonged remission is often possible with cessation of insulin therapy and maintenance of appropriate metabolic control. In the subsequent clinical course after initiation of insulin therapy, prolonged remission is often possible with cessation of insulin therapy and maintenance of appropriate metabolic control. The molecular mechanisms underlining the insulin secretory dysfunction are still to be understood and may involve glucolipotoxicity processes. The HLA alleles associated with susceptibility to type 1 diabetes were reported of high frequency in some populations with this form of diabetes, in the absence of makers of pancreatic beta cell autoimmunity. The aim of the present review is to discuss two cases of African diabetes and review the specific diagnostic, metabolic, pathogenic and management features of this atypical diabetes. PMID:17692810

  2. Stress and Diabetes Mellitus in Later Life.

    ERIC Educational Resources Information Center

    Krause, Neal

    1995-01-01

    Examines the relationship between stress and diabetes with data provided by a recent nationwide survey of older adults. Two main findings emerged. First, stressors arising in social roles that are highly important to older adults are more strongly related to diabetes than events associated with less important roles. Second, social support buffers…

  3. Insulin-Dependent Diabetes Mellitus: Educational Implications.

    ERIC Educational Resources Information Center

    Yousef, Jamal M. S.

    1995-01-01

    This article provides an overview of the educational implications of diabetes in children through discussion of the nature of diabetes, factors associated with educational performance, and the teacher's role in meeting the child's needs. It argues that teachers should treat these students as normal learners, without ignoring their unique needs or…

  4. [Evaluation of central dopaminergic tone in diabetes mellitus].

    PubMed

    Mainini, E; Martinelli, I; Scarsi, G; Mazzi, C

    1991-01-01

    The role of dopaminergic ways in human copulatory activity and the high frequency of impotence in diabetes mellitus are well known. In order to study the involvement of the central dopaminergic tone in diabetic impotence we have evaluated the PRL and TSH response to metoclopramide (MCP 10 mg ev) in 28 diabetic male patients (15 ID including 6 impotent and 13 NID including 5 impotent ) compared with 9 healthy controls. All subjects were investigated for the presence of neuropathy, retinopathy, macroangiopathy, gonadal and thyroid diseases. The PRL response to MCP was greater (p less than 0.05) in impotent patients than in controls at 60' and 90' in ID, and at 30' and 120' in NID. There was no significant difference in TSH increase and in PRL and TSH response areas between the groups considered. In conclusion, the dopaminergic tone is substantially normal in diabetic patients, while some PRL hyperresponsiveness to MCP exists in impotent diabetics. PMID:1815118

  5. Functional herbal food ingredients used in type 2 diabetes mellitus

    PubMed Central

    Perera, Pathirage Kamal; Li, Yunman

    2012-01-01

    From many reports it is clear that diabetes will be one of the major diseases in the coming years. As a result there is a rapidly increasing interest in searching new medicines, or even better searching prophylactic methods. Based on a large number of chemical and pharmacological research work, numerous bioactive compounds have been found in functional herbal food ingredients for diabetes. The present paper reviews functional herbal food ingredients with regards to their anti-diabetic active principles and pharmacological test results, which are commonly used in Asian culinary system and medical system and have demonstrated clinical or/and experimental anti-diabetic effectiveness. Our idea of reviewing this article is to give more attention to these functional food ingredients as targets medicinal foods in order to prevent or slow down the development of type 2 diabetes mellitus. PMID:22654403

  6. Diabetes Mellitus, Arterial Wall, and Cardiovascular Risk Assessment

    PubMed Central

    Kozakova, Michaela; Palombo, Carlo

    2016-01-01

    Diabetes mellitus is an independent risk factor for atherothrombotic cardiovascular disease. Adults with diabetes are two to four times more likely to develop heart disease or stroke than adults without diabetes. The two major features of diabetes, i.e., hyperglycemia and insulin-resistance, trigger arterial stiffening and increase the susceptibility of the arterial wall to atherosclerosis at any given age. These pathological changes in the arterial wall may provide a functional and structural background for cardiovascular events. The present paper provides a critical overview of the clinical evidence linking diabetes-related metabolic abnormalities to cardiovascular risk, debates the pathophysiologic mechanisms through which insulin resistance and hyperglycemia may affect the arterial wall, and discusses the associations between vascular biomarkers, metabolic abnormalities and cardiovascular events. PMID:26861377

  7. Current and Emerging Aspects of Diabetes Mellitus in Acromegaly.

    PubMed

    Frara, Stefano; Maffezzoni, Filippo; Mazziotti, Gherardo; Giustina, Andrea

    2016-07-01

    Diabetes mellitus is a frequent complication of acromegaly, a disease characterized by chronic hypersecretion of growth hormone (GH) by a pituitary adenoma. Diabetes occurs commonly but not only as a consequence of an insulin-resistant state induced by GH excess. The development of diabetes in patients with acromegaly is clinically relevant, since such a complication is thought to increase the already elevated cardiovascular morbidity and mortality risk of the disease. Emerging data suggest that a specific cardiomyopathy can be identified in acromegaly patients with diabetes. Moreover, the presence of diabetes may also influence therapeutic decision making in acromegaly, since traditional and newly developed drugs used in this clinical setting may impact glucose metabolism regardless of control of GH hypersecretion. PMID:27229934

  8. Chronic inflammatory demyelinating polyneuropathy associated with diabetes mellitus

    PubMed Central

    Fatehi, Farzad; Nafissi, Shahriar; Basiri, Keivan; Amiri, Mostafa; Soltanzadeh, Akbar

    2013-01-01

    Various forms of neuropathy are seen diabetic patients; chronic inflammatory demyelinating polyneuropathy (CIDP) seems not to be infrequent neuropathy in patients suffering from diabetes and it seems to be more common than in the general population; on the contrary, some authorities do not support pathogenetic association between diabetes mellitus (DM) and CIDP. Also, there are some controversies on the subject of CIDP treatment in diabetic patients. Some studies showed that patients with CIDP-DM considerably had recovered following treatment with immunotherapeutic modalities like (Intravenous immunoglobulin) IVIG and conversely, some else have argued against the prescription of IVIG in this group and recommend treatment with corticosteroids and provided that resistant, rituximab may be beneficial. The main limitation in most studies is the inadequate number of cases and as a result, problematic decision making in treatment. This article represents an inclusive review of diabetic CIDP presentation and treatment. PMID:24174953

  9. Personalized medicine in diabetes mellitus: current opportunities and future prospects.

    PubMed

    Kleinberger, Jeffrey W; Pollin, Toni I

    2015-06-01

    Diabetes mellitus affects approximately 382 million individuals worldwide and is a leading cause of morbidity and mortality. Over 40 and nearly 80 genetic loci influencing susceptibility to type 1 and type 2 diabetes, respectively, have been identified. In addition, there is emerging evidence that some genetic variants help to predict response to treatment. Other variants confer apparent protection from diabetes or its complications and may lead to development of novel treatment approaches. Currently, there is clear clinical utility to genetic testing to find the at least 1% of diabetic individuals who have monogenic diabetes (e.g., maturity-onset diabetes of the young and KATP channel neonatal diabetes). Diagnosing many of these currently underdiagnosed types of diabetes enables personalized treatment, resulting in improved and less invasive glucose control, better prediction of prognosis, and enhanced familial risk assessment. Efforts to enhance the rate of detection, diagnosis, and personalized treatment of individuals with monogenic diabetes should set the stage for effective clinical translation of current genetic, pharmacogenetic, and pharmacogenomic research of more complex forms of diabetes. PMID:25907167

  10. Red blood cell deformability in diabetes mellitus: effect of phytomenadione.

    PubMed

    Sabo, A; Jakovljević, V; Stanulović, M; Lepsanović, L; Pejin, D

    1993-01-01

    Decreased deformability of red blood cells (RBC) in diabetes mellitus (DM) is considered to be linked to microcirculatory complications in this condition. As we found that phytomenadione increased RBC deformability in experimental animals, the question was raised, whether phytomenadione had the same effect on the RBC of diabetic patients. The study was performed in 10 patients with insulin-dependent diabetes mellitus, where the erythrocyte deformability was impaired. Patients received 10 mg/day phytomenadione i.m. for five days. Deformability was measured with policarbonate membranes (Nucleopore) with pore diameter 5 microns, under gravity. The results were expressed as the ratio (r) between the flow of 1.5 ml (r1) and 2 ml (r2) of RBC suspension and 1.5 ml of buffer. Phytomenadione increased the erythrocyte deformability in patients with diabetes mellitus, lowering the value r1 from 3.54 +/- 0.84 to 2.32 +/- 0.61 (p 0.02) and r2 from 7.80 +/- 2.41 to 4.65 +/- 1.07 (p 0.01). The values after treatment reached the range of healthy controls (r1 3.11 +/- 0.98, r2 6.52 +/- 3.04). The whole blood viscosity was significantly lowered after phytomenadione (5.28 +/- 0.58 mPas before, 4.64 +/- 0.74 mPas after, p < 0.02) with unchanged plasma viscosity, but significantly lowered internal viscosity of erythrocytes. PMID:8444511

  11. Fluoroquinolone antibiotics and type 2 diabetes mellitus.

    PubMed

    Telfer, Stephen J

    2014-09-01

    Exposure to fluoroquinolone antibiotics is postulated as a risk factor for subsequent development of type 2 diabetes. It is hypothesized that fluoroquinolones induce an intracellular magnesium deficit that can lead to insulin resistance. A temporal correlation is reported between the rate of outpatient prescription of quinolones and the incidence of diabetes during the period 1980-2011 with a lag of approximately two years (R(2)=0.86, P<10(-9)). The increase in incidence of diabetes after 1990 and the recent decrease in the number of new cases are both reflected in the fluoroquinolone prescription rates. A geographical correlation is reported (adj. R(2)=0.7, P<0.0001) between rates of increase in prevalence of diabetes in each U.S. state and a model using only local rates of outpatient fluoroquinolone prescription, local rates of increase in the prevalence of obesity, and local rates of population growth as predictor variables. Prescription rates of non-quinolone antibiotics correlated less well with the local rates of increase in prevalence of diabetes. The data are consistent with fluoroquinolone exposure predisposing an individual to develop diabetes with a probability that strongly depends upon factors that also lead to an increase in obesity. According to the hypothesis, much of the increase in the incidence of type 2 diabetes in the U.S. from 1990 to the present can be attributed to fluoroquinolone exposure. PMID:24947193

  12. Brainstem Auditory Evoked Potential Abnormalities in Type 2 Diabetes Mellitus

    PubMed Central

    Gupta, Sharat; Baweja, Pooja; Mittal, Shallu; Kumar, Avnish; Singh, Kamal D; Sharma, Raghuvansh

    2013-01-01

    Background: Diabetes mellitus represents a syndrome complex in which multiple organ systems, including the central nervous system, are affected. Aim: The study was conducted to determine the changes in the brainstem auditory evoked potentials in type 2 diabetes mellitus. Materials and Methods: A cross sectional study was conducted on 126 diabetic males, aged 35-50 years, and 106 age-matched, healthy male volunteers. Brainstem auditory evoked potentials were recorded and the results were analyzed statistically using student's unpaired t-test. The data consisted of wave latencies I, II, III, IV, V and interpeak latencies I-III, III-V and I-V, separately for both ears. Results: The latency of wave IV was significantly delayed only in the right ear, while the latency of waves III, V and interpeak latencies III-V, I-V showed a significant delay bilaterally in diabetic males. However, no significant difference was found between diabetic and control subjects as regards to the latency of wave IV unilaterally in the left ear and the latencies of waves I, II and interpeak latency I-III bilaterally. Conclusion: Diabetes patients have an early involvement of central auditory pathway, which can be detected with fair accuracy with auditory evoked potential studies. PMID:23378959

  13. Gestational Diabetes Mellitus: Risks and Management during and after Pregnancy

    PubMed Central

    Buchanan, Thomas A.; Xiang, Anny H.; Page, Kathleen A.

    2015-01-01

    Gestational diabetes mellitus (GDM) represents glucose levels in the high end of the population distribution during pregnancy. GDM carries a small but potentially important risk of adverse perinatal outcomes and a longer-term risk of obesity and glucose intolerance in offspring. Mothers with GDM have an excess of hypertensive disorders during pregnancy and a high risk of diabetes mellitus thereafter. Diagnosing and treating GDM can reduce perinatal complications, but only a small fraction of pregnancies benefit. Nutritional management is the cornerstone of treatment; insulin, glyburide and metformin can be used to intensify treatment. Fetal measurements compliment maternal glucose measurements in identifying pregnancies that need such intensification. Glucose testing shortly after pregnancy can stratify the near-term diabetes risk in mothers, Thereafter, annual glucose and HbA1C testing can detect deteriorating glycaemic control, a harbinger of future diabetes, usually type 2. Interventions that mitigate obesity or its metabolic effects are most potent in preventing or delaying diabetes. Lifestyle modification is the primary approach; use of medications for diabetes prevention after GDM remains controversial. Family planning allows optimization of health in subsequent pregnancies. Breastfeeding may reduce obesity in children and is recommended. Families should be encouraged to help children adopt lifestyles that reduce the risk of obesity. PMID:22751341

  14. Review and update of insulin dependent diabetes mellitus.

    PubMed

    Gorrell, Jennifer Justice; Williams, Jennifer Schoelles; Powell, Paula

    2003-10-01

    The purpose of this article is to provide the health care practitioner with a comprehensive review of the pathophysiology and treatment of Type 1 Diabetes Mellitus. Traditionally, insulin has been administered via an insulin syringe. In the recent past, diabetes research has focused on developing more convenient insulin delivery devices and longer acting insulin's in hopes of increasing compliance with insulin therapy and improving the management of Type 1 diabetes in both children and adults. Rapidly developing approaches to insulin delivery for Type 1 diabetes continue to be developed at a rapid rate, including administration via continuous subcutaneous insulin infusion in addition to other new approaches. With these advances in therapy, pediatric patients with Type 1 diabetes have been able to achieve strict glycemic control, although the treatment of hypoglycemia remains a burden. The objectives of this article are to the following: to review the epidemiology, risk factors, pathophysiology, clinical manifestations, and diagnostic criteria of Type 1 diabetes mellitus in children,; to discuss the management of these patients, including, insulin therapy, monitoring, diet and exercise, carbohydrate counting and treatment of hypoglycemia,; and to review insulin administration devices, including insulin pens, insulin jet injectors, insulin pumps, and novel insulin delivery systems. PMID:23118681

  15. Clinical Update: Cardiovascular Disease in Diabetes Mellitus: Atherosclerotic Cardiovascular Disease and Heart Failure in Type 2 Diabetes Mellitus - Mechanisms, Management, and Clinical Considerations.

    PubMed

    Low Wang, Cecilia C; Hess, Connie N; Hiatt, William R; Goldfine, Allison B

    2016-06-14

    Cardiovascular disease remains the principal cause of death and disability among patients with diabetes mellitus. Diabetes mellitus exacerbates mechanisms underlying atherosclerosis and heart failure. Unfortunately, these mechanisms are not adequately modulated by therapeutic strategies focusing solely on optimal glycemic control with currently available drugs or approaches. In the setting of multifactorial risk reduction with statins and other lipid-lowering agents, antihypertensive therapies, and antihyperglycemic treatment strategies, cardiovascular complication rates are falling, yet remain higher for patients with diabetes mellitus than for those without. This review considers the mechanisms, history, controversies, new pharmacological agents, and recent evidence for current guidelines for cardiovascular management in the patient with diabetes mellitus to support evidence-based care in the patient with diabetes mellitus and heart disease outside of the acute care setting. PMID:27297342

  16. Effect of diet on type 2 diabetes mellitus: a review.

    PubMed

    Khazrai, Y M; Defeudis, G; Pozzilli, P

    2014-03-01

    Type 2 diabetes mellitus is one of the fastest growing diseases; the number of people affected by diabetes will soon reach 552 million worldwide, with associated increases in complications and healthcare expenditure. Lifestyle and medical nutrition therapy are considered the keystones of type 2 diabetes prevention and treatment, but there is no definite consensus on how to treat this disease with these therapies. The American Diabetes Association has made several recommendations regarding the medical nutrition therapy of diabetes; these emphasize the importance of minimizing macrovascular and microvascular complications in people with diabetes. Four types of diets were reviewed for their effects on diabetes: the Mediterranean diet, a low-carbohydrate/high-protein diet, a vegan diet and a vegetarian diet. Each of the four types of diet has been shown to improve metabolic conditions, but the degree of improvement varies from patient to patient. Therefore, it is necessary to evaluate a patient's pathophysiological characteristics in order to determine the diet that will achieve metabolic improvement in each individual. Many dietary regimens are available for patients with type 2 diabetes to choose from, according to personal taste and cultural tradition. It is important to provide a tailor-made diet wherever possible in order to maximize the efficacy of the diet on reducing diabetes symptoms and to encourage patient adherence. Additional randomized studies, both short term (to analyse physiological responses) and long term, could help reduce the multitude of diets currently recommended and focus on a shorter list of useful regimens. PMID:24352832

  17. Diabetes mellitus, tuberculosis and the mycobacteria: two millenia of enigma.

    PubMed

    Broxmeyer, Lawrence

    2005-01-01

    The thought that tuberculosis and the mycobacteria could cause diabetes seems farfetched, but is not. The peculiar relationship and frequent association of diabetes mellitus and tuberculosis has been observed for more than 2000 years, yet the reason for this correlation is, to this day, not known. Before the discovery of insulin, a diagnosis of diabetes was a death sentence within 5 years, and the usual cause of that death was tuberculosis. Despite this, in the 5th century, tuberculosis was already being portrayed as a "complication" of diabetes, a view little changed to this day, parroting Root's original 1934 description of "a one-sided relationship": tuberculosis still seen as a common complication of diabetes, while diabetes is thought to be no more common among TB patients than in the population at large. To Nichol's, this was "not logically tenable" and in his study of 178 otherwise healthy, non-diabetic military men with tuberculosis at Fitzsimmons Army Hospital, one-third had abnormal glucose screening tests. But despite his findings and those of Reaud in New York and others, this was not being recognized elsewhere, and Nichols wanted to know why. Nichols concluded that the incidence of diabetes among tuberculosis patients was considerably underestimated and that in tuberculosis patients, diabetes develops quite commonly. Diabetes was easy to detect. Tuberculosis and the mycobacteria were not. The evidence for a mycobacterial cause of diabetes is mounting rapidly. Schwartz and Haas both linked Type-2 diabetes to tuberculosis. And the pancreatic islet amyloid deposits that they found as a by-product of systemic tubercular infection have recently been dissolved by rifampicin, a first line drug against tuberculosis. Engelbach spoke of "transitory" diabetes in TB and Karachunskii noted changes in carbohydrate metabolism in patients with tuberculosis which commonly led to insulin deficiency with persistent hyperglycemia. Furthermore, mycobacterial elements have

  18. SWEETWISE: developing a multi-professional approach to diabetes mellitus.

    PubMed

    Takhar, Amrit; Herbert, Jenny; Plum, Rosemary; Lad, Mukesh; Manger, Deborah; Murdoch, Tony; Patel, Vinesh; Tanna, Piyus

    2016-03-01

    The formation of a local joint professional network (LJPN) in Northamptonshire has led to a joint Continuing professional development initiative and an audit project to determine the take up of annual health checks by patients with diabetes mellitus with dentists, optometrists, pharmacists as well as the usual check with the General Medical Practice team. The findings showed that a significant number of patients (29-50%) do not access available dental, optometry and pharmacy advice. Better collaboration between the professions has the potential to improve health outcomes in diabetes mellitus and other areas where lifestyle modification reduces adverse health risks. A patient advice card (SWEETWISE) was developed by the group and could be used to help educate patients and health professionals. PMID:25777340

  19. Fulminant type 1 diabetes mellitus acutely emerged during pregnancy.

    PubMed

    Yamada, Kyoko; Takakuwa, Koichi; Takeyama, Satoru; Minagawa, Shinichi; Morikawa, Hiroshi; Matsunaga, Masamichi; Tomita, Masatoshi; Tanaka, Kenichi

    2010-04-01

    A pregnant woman at 32 weeks of gestation was emergently admitted to our hospital with symptoms of nausea, vomiting, and uterine contraction. Cardiotocogram demonstrated a loss of variability and late deceleration in fetal heart rate pattern. Emergency cesarean section was performed, and a male infant weighing 1750 g was born with Apgar scores of 1 at 1 min, and 3 at 5 min after delivery. After cesarean section, the patient developed an acetone breath odor, and blood examination demonstrated remarkable acidemia and an extremely high level of blood glucose. The patient was diagnosed with ketoacidosis with acute onset of fulminant type 1 diabetes mellitus. Intensive care was applied due to the severe diabetes mellitus conditions. The patient's general condition ameliorated during the postoperative period, although there was a possibility of neurological complications in the infant. PMID:20492400

  20. Fungal Esophagitis in a Child with Insulin Dependent Diabetes Mellitus.

    PubMed

    Saeed, Anjum; Assiri, Asaad; Zaidi, Zafar; Alsheikh, Abdulmalik

    2016-08-01

    Esophagitis in children is not uncommon, mostly due to gastro-esophageal reflux. Other conditions like eosinophilic and infective esophagitis need to be elucidated in differential diagnoses. Fungal orCandida esophagitisusually occurs in high risk children who are immune-compromised, malnourished, on steroid therapy or have uncontrolled diabetes mellitus. An eleven-year girl presented with uncontrolled type I diabetes mellitus and recurrent epigastric pain with vomiting. Her oral intake was satisfactory. There was no dysphagia and odynophagia. Physical examination was normal with good oral hygiene. Failure in responding to conventional medications led to endoscopic evaluation, which revealed white patches and esophageal inflammation and diagnosed as fungal esophagitis on histopathology. Although infective esophagitis is encountered sporadically in pediatric age group, but it should always be considered in high risk individuals and when conventional medication fails to resolve the symptoms. PMID:27539771

  1. Seasonal variations of severe hypoglycemia in patients with type 1 diabetes mellitus, type 2 diabetes mellitus, and non-diabetes mellitus: clinical analysis of 578 hypoglycemia cases.

    PubMed

    Tsujimoto, Tetsuro; Yamamoto-Honda, Ritsuko; Kajio, Hiroshi; Kishimoto, Miyako; Noto, Hiroshi; Hachiya, Remi; Kimura, Akio; Kakei, Masafumi; Noda, Mitsuhiko

    2014-11-01

    Blood glucose control in patients with diabetes mellitus (DM) is reportedly influenced by the seasons, with hemoglobin A1c (HbA1c) levels decreasing in the summer or warm season and increasing in the winter or cold season. In addition, several studies have shown that sepsis is also associated with the seasons. Although both blood glucose control and sepsis can strongly affect the occurrence of severe hypoglycemia, few studies have examined the seasonal variation of severe hypoglycemia. The aim of the present study is to examine the association between severe hypoglycemia and the seasons in patients with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and non-diabetes mellitus (non-DM). We retrospectively reviewed all the patients with severe hypoglycemia at a national center in Japan between April 1, 2006 and March 31, 2012. A total of 57,132 consecutive cases that had visited the emergency room by ambulance were screened, and 578 eligible cases of severe hypoglycemia were enrolled in this study. The primary outcome was to assess the seasonality of severe hypoglycemia. In the T1DM group (n  =  88), severe hypoglycemia occurred significantly more often in the summer than in the winter (35.2% in summer vs 18.2% in winter, P  =  0.01), and the HbA1c levels were highest in the winter and lowest in the summer (9.1% [7.6%-10.1%] in winter vs 7.7% [7.1%-8.3%] in summer, P  =  0.13). In the non-DM group (n  =  173), severe hypoglycemia occurred significantly more often in the winter than in the summer (30.6% in winter vs 19.6% in summer, P  =  0.01), and sepsis as a complication occurred significantly more often in winter than in summer (24.5% in winter vs 5.9% in summer, P  =  0.02). In the T2DM group (n  =  317), the occurrence of severe hypoglycemia and the HbA1c levels did not differ significantly among the seasons. The occurrence of severe hypoglycemia might be seasonal and might fluctuate with temperature changes

  2. Seasonal Variations of Severe Hypoglycemia in Patients With Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, and Non-diabetes Mellitus

    PubMed Central

    Tsujimoto, Tetsuro; Yamamoto-Honda, Ritsuko; Kajio, Hiroshi; Kishimoto, Miyako; Noto, Hiroshi; Hachiya, Remi; Kimura, Akio; Kakei, Masafumi; Noda, Mitsuhiko

    2014-01-01

    Abstract Blood glucose control in patients with diabetes mellitus (DM) is reportedly influenced by the seasons, with hemoglobin A1c (HbA1c) levels decreasing in the summer or warm season and increasing in the winter or cold season. In addition, several studies have shown that sepsis is also associated with the seasons. Although both blood glucose control and sepsis can strongly affect the occurrence of severe hypoglycemia, few studies have examined the seasonal variation of severe hypoglycemia. The aim of the present study is to examine the association between severe hypoglycemia and the seasons in patients with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and non-diabetes mellitus (non-DM). We retrospectively reviewed all the patients with severe hypoglycemia at a national center in Japan between April 1, 2006 and March 31, 2012. A total of 57,132 consecutive cases that had visited the emergency room by ambulance were screened, and 578 eligible cases of severe hypoglycemia were enrolled in this study. The primary outcome was to assess the seasonality of severe hypoglycemia. In the T1DM group (n = 88), severe hypoglycemia occurred significantly more often in the summer than in the winter (35.2% in summer vs 18.2% in winter, P = 0.01), and the HbA1c levels were highest in the winter and lowest in the summer (9.1% [7.6%–10.1%] in winter vs 7.7% [7.1%–8.3%] in summer, P = 0.13). In the non-DM group (n = 173), severe hypoglycemia occurred significantly more often in the winter than in the summer (30.6% in winter vs 19.6% in summer, P = 0.01), and sepsis as a complication occurred significantly more often in winter than in summer (24.5% in winter vs 5.9% in summer, P = 0.02). In the T2DM group (n = 317), the occurrence of severe hypoglycemia and the HbA1c levels did not differ significantly among the seasons. The occurrence of severe hypoglycemia might be seasonal and might fluctuate with temperature changes. Patients

  3. The Therapeutic Effect of Zuogui Wan in Gestational Diabetes Mellitus Rats

    PubMed Central

    Feng, Qianjin; Niu, Xin; Liu, Xinshe; Xu, Kaixia; Yang, Xiangzhu; Wang, Huifeng

    2014-01-01

    In this experiment, we established an animal model of gestational diabetes mellitus rats using streptozotocin. Using the rat model of GDM, the pregnant rats in 1-19d were divided into three groups: (1) Zuogui Wan gestational diabetes mellitus group (group I, n = 12), (2) gestational diabetes mellitus rats as the control group (group II, n = 11), and (3) rats of normal pregnancy group (group III, n = 11). Compared with gestational diabetes mellitus rats as the control group, Zuogui Wan can change the indexes of fasting blood glucose, body weight, total cholesterol, insulin, and metabolism cage index significantly in Zuogui Wan gestational diabetes mellitus group. We can conclude that Zuogui Wan has the therapeutic effect on gestational diabetes mellitus. PMID:25136475

  4. Review of gestational diabetes mellitus effects on vascular structure and function.

    PubMed

    Jensen, Louise A; Chik, Constance L; Ryan, Edmond A

    2016-05-01

    Vascular dysfunction has been described in women with a history of gestational diabetes mellitus. Furthermore, previous gestational diabetes mellitus increases the risk of developing Type 2 diabetes mellitus, a risk factor for cardiovascular disease. Factors contributing to vascular changes remain uncertain. The aim of this review was to summarize vascular structure and function changes found to occur in women with previous gestational diabetes mellitus and to identify factors that contribute to vascular dysfunction. A systematic search of electronic databases yielded 15 publications from 1998 to March 2014 that met the inclusion criteria. Our review confirmed that previous gestational diabetes mellitus contributes to vascular dysfunction, and the most consistent risk factor associated with previous gestational diabetes mellitus and vascular dysfunction was elevated body mass index. Heterogeneity existed across studies in determining the relationship of glycaemic levels and insulin resistance to vascular dysfunction. PMID:26940821

  5. [Exocrine pancreatic insufficiency and diabetes mellitus].

    PubMed

    Weitgasser, Raimund; Abrahamian, Heidemarie; Clodi, Martin; Zlamal-Fortunat, Sandra; Hammer, Heinz F

    2016-04-01

    Exocrine pancreatic insufficiency (EPI) in diabetic patients is frequent. Studies based on fecal elastase-1 measurement give prevalence rates of 10‒30 % of severe and 22‒56 % of moderate EPI in type 1 and rates of 5‒46 % in type 2 diabetic patients. Nevertheless, not all patients report typical symptoms like diarrhea, steatorrhea and weight loss. For noninvasive testing the determination of fecal elastase-1 has the highest sensitivity and specificity. This test should be performed at least in all symptomatic patients. As differential diagnosis celiac disease (with a prevalence of about 3-5 % of type 1 diabetic patients), autonomic neuropathy, but also diseases like irritable bowel syndrome and gastrointestinal tumors have to be taken into account. Patients with symptoms and a fecal elastase-1 < 100 µg/g should be treated with pancreatic enzymes in adequate daily doses administered at main meals. Treatment improves symptoms significantly, supply with fat soluble vitamins is normalised, risk for osteoporosis is reduced. However, improvement of glucose metabolism has not been demonstrated consistently. A pancreatogenic diabetes, also termed as type 3c diabetes, has not necessarily to be treated with insulin, often-at least initially-treatment with oral antidiabetic drugs is sufficient. PMID:27052236

  6. Diabetes mellitus in patients with cystic fibrosis.

    PubMed

    Alves, Crésio de Aragão Dantas; Aguiar, Renata Arruti; Alves, Ana Cláudia S; Santana, Maria Angélica

    2007-01-01

    Cystic fibrosis-related diabetes (CFRD) is the principal extra-pulmonary complication of cystic fibrosis, occurring in 15-30% of adult cystic fibrosis patients. The number of cystic fibrosis patients who develop diabetes is increasing in parallel with increases in life expectancy. The aim of this study was to review the physiopathology, clinical presentation, diagnosis and treatment of CFRD. A bibliographic search of the Medline and Latin American and Caribbean Health Sciences Literature databases was made. Articles were selected from among those published in the last twenty years. Insulin deficiency, caused by reduced beta-cell mass, is the main etiologic mechanism, although insulin resistance also plays a role. Presenting features of type 1 and type 2 diabetes, CFRD typically affects individuals of approximately 20 years of age. It can also be accompanied by fasting, non-fasting or intermittent hyperglycemia. Glucose intolerance is associated with worsening of nutritional status, increased morbidity, decreased survival and reduced pulmonary function. Microvascular complications are always present, although macrovascular complications are rarely seen. An oral glucose tolerance test is recommended annually for patients > or = 10 years of age and for any patients presenting unexplained weight loss or symptoms of diabetes. Patients hospitalized with severe diseases should also be screened. If fasting hyperglycemia persists for more than 48 h, insulin therapy is recommended. Insulin administration remains the treatment of choice for diabetes and fasting hyperglycemia. Calories should not be restricted, and patients with CFRD should be managed by a multidisciplinary team. PMID:17724542

  7. Chronic complications of diabetes mellitus related to the respiratory system.

    PubMed

    Vojtková, Jarmila; Ciljaková, Miriam; Michnová, Zuzana; Turčan, Tomá

    2012-01-01

    The quality of life in patients with diabetes mellitus is mainly determined by chronic diabetic complications which may affect all organ tissues including respiratory system. Microangiopathy of pulmonary capillaries, autonomic neuropathy, myopathy of respiratory muscles or changes in collagen belong to supposed pathophysiological pathways. This paper brings brief review about reported functional consequences in subjects with diabetes - decreased vital lung capacity and pulmonary volumes, decreased diffuse lung capacity for carbon monoxide, lower basal bronchial tone, lower cough reflex sensitivity, increased incidence of sleep obstructive apnea, increase in respiratory infections, disorders in respiratory muscles or phrenical nerve. Examination of pulmonary functions may serve for early detection of chronic complications in patients with diabetes. PMID:23146790

  8. Tuberculosis and diabetes mellitus – an underappreciated association

    PubMed Central

    Zozulińska-Ziółkiewicz, Dorota; Barinow-Wojewódzki, Aleksander

    2014-01-01

    The current review presents up-to-date knowledge on tuberculosis (TB) in diabetic patients. On the basis of available literature, there is little doubt about the close relationship between these two conditions. Diabetes mellitus in this association may still contribute substantially to the burden of TB and negatively affect control of the latter. Chronic hyperglycemia at least to some extent may alter the clinical manifestation, radiological appearance, treatment outcome and prognosis of TB. Although the pathogenesis is not clear, diabetes may impair both innate and adaptive immune responses to Mycobacterium tuberculosis. Eventually, effective screening and dual management of the diseases have to be addressed both in low- and high-income countries in order to limit the negative effects of the forthcoming global diabetes epidemic. PMID:25395955

  9. Involvement of central nervous system in diabetes mellitus.

    PubMed Central

    Verma, A; Bisht, M S; Ahuja, G K

    1984-01-01

    Brainstem auditory evoked responses were recorded in 22 diabetic patients with a variable duration of illness (mean 5.8 years) and 14 normal healthy controls of comparable age. The initial 10 millisecond components, found to be most consistent and reproducible, were analysed. Variations in the form of individual wave latency, interpeak latencies and V wave amplitude were compared in both the groups. No difference was found in any of the parameters. It was concluded that central neural pathways are not involved at least initially in diabetes mellitus. PMID:6726270

  10. Myo-Inositol Supplementation to Prevent Gestational Diabetes Mellitus.

    PubMed

    Celentano, Claudio; Matarrelli, Barbara; Mattei, Peter A; Pavone, Giulia; Vitacolonna, Ester; Liberati, Marco

    2016-03-01

    Gestational diabetes mellitus (GDM) is a common complication characterized by increased insulin resistance, and by increased risk for adverse pregnancy outcomes affecting both the mother and the fetus. International guidelines describe optimal ways to recognize it, and the recommended treatment of patients affected to reduce adverse outcomes. Improving insulin resistance could reduce incidence of GDM and its complications. Recently, a few trials have been published on the possible prevention of GDM. Inositol has been proposed as a food supplement that might reduce gestational diabetes incidence in high-risk pregnant women. PMID:26898405

  11. Role of Exercise in Reducing Gestational Diabetes Mellitus.

    PubMed

    Mottola, Michelle F; Artal, Raul

    2016-09-01

    Exercise plays an important role in reducing the prevalence of gestational diabetes mellitus (GDM) in women with or without risk factors. GDM risk factors include obesity, family history of diabetes, high-risk ethnicity, increased maternal age, history of GDM, delivering a macrosomic infant, excessive gestational weight gain early in pregnancy (before glucose screening), sedentary behavior, low physical activity, and vitamin D deficiency. Most GDM patients can be managed with lifestyle modifications that include medical nutrition therapy and physical activity. When adherence is high and women are fully engaged in the exercise program, GDM can be effectively managed and prevented. PMID:27135873

  12. Glycemic Control and Implant Stabilization in Type 2 Diabetes Mellitus

    PubMed Central

    Oates, T.W.; Dowell, S.; Robinson, M.; McMahan, C.A.

    2009-01-01

    Diabetes mellitus is considered a relative contra-indication for implant therapy. However, the effect of glycemic level on implant integration in persons with diabetes remains poorly understood. The hypothesis of this research was that poor glycemic control is directly related to short-term-impairment implant stabilization. This prospective clinical study evaluated 10 non-diabetic individuals (12 implants) and 20 persons with type 2 diabetes (30 implants). Glycated hemoglobin (HbA1c) levels ranged from 4.7-12.6%. Implant stability was assessed by resonance frequency analysis over 4 months following placement. Minimum stability levels were observed 2-6 weeks following placement for all 42 implants. Persons with HbA1c ≥ 8.1% had a greater maximum decrease in stability from baseline and required a longer time for healing, as indicated by return of stability level to baseline. This study demonstrates alterations in implant stability consistent with impaired implant integration for persons with type 2 diabetes mellitus in direct relation to hyperglycemic conditions. PMID:19407159

  13. [Relationship diabetes mellitus-periodontal disease: etiology and risk factors].

    PubMed

    Foia, Liliana; Toma, Vasilica; Ungureanu, Didona; Aanei, Carmen; Costuleanu, M

    2007-01-01

    The interrelation between diabetes mellitus and inflammatory periodontal disease has been intensively studied for more than 50 years, a real bidirectional influence existing between patient's glycemic level disorder and periodontal territories alteration. Several studies developed in this direction emerged to the evidences that reveal a general increase of prevalence, extent and severity of gingivitis and periodontitis. Inflammation plays an important role in this interrelation, orchestrating both the periodontal disease and diabetes mellitus pathogeny and complications. Conversely, periodontal disease--infectious disease characterized by a significant inflammatory component--can seriously impair metabolic control of some diabetic patient. Moreover, treatment of periodontal disease and reduction of oral signs of inflammation may have a beneficial result on the diabetic condition (1). Less clear are the mechanisms governing this interrelation (even the literature is abundant in this direction), and, very probably, periodontal diseases serve as initiators of insulin resistance (in a way similar to obesity), thereby aggravating glycemic control. Further research is so imposed in order to clarify this aspect of the relationship between diabetes and periodontal disease. PMID:18293711

  14. [Neuroprotector therapy of patients with decompensated diabetes mellitus type 1].

    PubMed

    Kligunenko, E N; Sedinkin, V A

    2011-01-01

    The influence of actovegin and reamberin on diabetic ketoacidotic crises has been studied on a group of 128 patients with severe diabetic ketoacidosis on the background of diabetes mellitus type 1 with disorders ranging from consciousness to coma or precoma states. Patients of group 1 received standard intensive therapy of diabetic ketoacidosis. In group 2, an intensive therapy for neuroprotection by actovegin was added. In group 3, patients received reamberin on the background of standard therapy. In group 4, the neuroprotective therapy using actovegin and reamberin was combined. The mental status was estimated upon recovery from coma, on 5th and 28th days from the beginning of treatment, by taking into consideration cognitive functions such as attention, memory, mentality. The results showed that the use of neuroprotective drugs, including the combination of actovegin and reamberin, allowed to the restore the compensatory-adaptive reaction of patients to ketoacidotic crisis, accelerate the restoration of consciousness within 19.2 +/- 3.8 h, restore the cognitive functions with exceeding norm for patients with diabetes mellitus in compensation stage and maintain their high level on 28th day after crisis. PMID:22379876

  15. Treating Hispanic patients for type 2 diabetes mellitus: special considerations.

    PubMed

    Freeman, Jeffrey S

    2008-05-01

    The number of Hispanic people in the United States with diagnosed diabetes mellitus is projected to increase by 107% by 2020. The author presents the case of a 62-year-old obese Hispanic man, with newly diagnosed type 2 diabetes mellitus (T2DM), diabetic peripheral neuropathy, background retinopathy, and diabetic nephropathy. The patient also had diagnosed hypertension, peripheral vascular disease, and hyperlipidemia. The treatment plan for this patient included the following medications: pioglitazone hydrochloride (a thiazolidinedione, 30 mg/d); irbesartan (an angiotensin receptor blocker, 150 mg/d titrated to 300 mg/d); hydrochlorothiazide (an antikaliuretic agent, 12.5 mg/d); and aspirin (325 mg/d). Sitagliptin phosphate (a dipeptidyl peptidase IV inhibitor, 50 mg/d) was added to the treatment regimen to improve glycemic control. Simvastatin (20 mg/d) and niacin (1 g/d) were used for lipid management. Therapy also included a low-protein diet and walking program. At 6-month follow-up, the patient showed substantial improvement in his glycosylated hemoglobin level, lipid profile, blood pressure, creatinine clearance rate, and urine albumin level. There were also improvements in his peripheral vascular disease and diabetic peripheral neuropathy. Furthermore, the patient demonstrated encouraging progress in diet and lifestyle modification and in mental attitude. PMID:18519840

  16. Mesenchymal Stem Cell Therapy in Diabetes Mellitus: Progress and Challenges

    PubMed Central

    El-Badri, Nagwa; Ghoneim, Mohamed A.

    2013-01-01

    Advanced type 2 diabetes mellitus is associated with significant morbidity and mortality due to cardiovascular, nervous, and renal complications. Attempts to cure diabetes mellitus using islet transplantation have been successful in providing a source for insulin secreting cells. However, limited donors, graft rejection, the need for continued immune suppression, and exhaustion of the donor cell pool prompted the search for a more sustained source of insulin secreting cells. Stem cell therapy is a promising alternative for islet transplantation in type 2 diabetic patients who fail to control hyperglycemia even with insulin injection. Autologous stem cell transplantation may provide the best outcome for those patients, since autologous cells are readily available and do not entail prolonged hospital stays or sustained immunotoxic therapy. Among autologous adult stem cells, mesenchymal stem cells (MSCs) therapy has been applied with varying degrees of success in both animal models and in clinical trials. This review will focus on the advantages of MSCs over other types of stem cells and the possible mechanisms by which MSCs transplant restores normoglycemia in type 2 diabetic patients. Sources of MSCs including autologous cells from diabetic patients and the use of various differentiation protocols in relation to best transplant outcome will be discussed. PMID:23762531

  17. Hyperglycemia and Diabetes Mellitus Following Organ Transplantation.

    PubMed

    Galindo, Rodolfo J; Wallia, Amisha

    2016-02-01

    Hyperglycemia is common following organ transplantation, regardless of the pre-transplant diabetes status. Transient post-transplant hyperglycemia and/or new-onset diabetes after transplantation (NODAT) are common and are associated with increased morbidity and mortality. NODAT and type 2 diabetes share similar characteristics, but the pathophysiology may differ. Immunosuppressive agents and steroids play a key role in the development of NODAT. Glycemic control is challenging in this population due to fluctuating renal/end-organ function, immunosuppressive dosing, nutritional status, and drug-drug interactions. A proactive and multidisciplinary approach is essential, along with flexible protocols to adjust to patient status, type of organ transplanted, and corticosteroid regimens. Insulin is the preferred agent for hospitalized patients and during the early post-transplant period; optimal glycemic control (BG < 180 mg/dl with minimal hypoglycemia [<70 mg/dl]) is desired. PMID:26803650

  18. Emerging treatments for post-transplantation diabetes mellitus.

    PubMed

    Jenssen, Trond; Hartmann, Anders

    2015-08-01

    Post-transplantation diabetes mellitus (PTDM), also known as new-onset diabetes mellitus (NODM), occurs in 10-15% of renal transplant recipients and is associated with cardiovascular disease and reduced lifespan. In the majority of cases, PTDM is characterized by β-cell dysfunction, as well as reduced insulin sensitivity in liver, muscle and adipose tissue. Glucose-lowering therapy must be compatible with immunosuppressant agents, reduced glomerular filtration rate (GFR) and severe arteriosclerosis. Such therapy should not place the patient at risk by inducing hypoglycaemic episodes or exacerbating renal function owing to adverse gastrointestinal effects with hypovolaemia. First-generation and second-generation sulphonylureas are generally avoided, and caution is currently advocated for the use of metformin in patients with GFR <60 ml/min/1.73 m(2). DPP-4 inhibitors do not interact with immunosuppressant drugs and have demonstrated safety in small clinical trials. Other therapeutic options include glinides and glitazones. Evidence-based treatment regimens used in patients with type 2 diabetes mellitus cannot be directly implemented in patients with PTDM. Studies investigating the latest drugs are required to direct the development of improved treatment strategies for patients with PTDM. This Review outlines the modern principles of glucose-lowering treatment in PTDM with specific reference to renal transplant recipients. PMID:25917553

  19. Cushing's Syndrome with Concurrent Diabetes Mellitus in a Rhesus Monkey.

    PubMed

    Wilkinson, Andrew C.; Harris, Linda D.; Saviolakis, George A.; Martin, Dale G.

    1999-05-01

    Cushing's syndrome is the clinical expression of the overproduction of glucocorticoids and is well recognized in both human and veterinary medicine. Spontaneous diabetes mellitus is well known in Macaca spp., however the occurrence of hyperadrenocorticism and diabetes mellitus concurrently in macaques has not been reported previously. This unusual case presents a rare opportunity to examine the relationships between two important endocrine diseases in a nonhuman primate. A male, 14-year-old rhesus macaque (Macaca mulatta) was diagnosed with hyperadrenocorticism and concurrent diabetes mellitus. Initially, the monkey had mildly elevated blood glucose values upon routine semi-annual physical examination. Further diagnostic work-up demonstrated hypercortisolism. Adrenocorticotropic hormone-dependent Cushing's syndrome was subsequently diagnosed in light of results from dexamethasone testing, magnetic resonance imaging, and computed tomography scans. A therapeutic course of L-deprenyl (Anipryl(r)) was begun, and 8 weeks later, insulin therapy was initiated. The patient responded well to insulin therapy, however the dosage was rapidly increased. After 6 months, Anipryl(r) therapy was determined to be of little or no value, and ketoconazole was selected as the drug of choice to control the hypercortisolism. The monkey has shown remarkable improvement with the dual therapies of insulin and ketoconazole. Approximately 2 months after the initiation of ketoconazole therapy, the animal was returned to an experimental protocol under the conditions of twice-daily treatment and strict dietary control. The ongoing plan for clinical management includes periodic blood glucose and liver function surveillance. PMID:12086427

  20. Prognostic value of endothelial dysfunction in type 1 diabetes mellitus

    PubMed Central

    Ladeia, Ana Marice; Sampaio, Raphael Ribeiro; Hita, Maiara Costa; Adan, Luis F

    2014-01-01

    Patients with diabetes mellitus are at high risk of developing atherosclerosis, associated with higher rates of micro and macro vascular involvement such as coronary artery disease and renal disease. The role of hyperglycemia to induce synthesis of reactive oxygen species by the oxidation of glucose, leading to an increased production of advanced glycosylation end products, as well as inflammation and oxidative stress has been proposed as a possible mechanism in the pathogenesis of endothelial dysfunction (ED). The interaction between C-peptide - the connecting segment of pro-insulin-and nitric oxide in vasodilation is also discussed. Therefore, endothelial dysfunction has been identified as an early marker of vascular disorder in type 1 and type 2 diabetes mellitus. In some other diseases, ED has been considered an independent predictor of vascular disease, regardless of the method used. Studies have demonstrated the importance of endothelial dysfunction as an useful tool for identifying the risk of vascular complications in patients with type 1 diabetes mellitus, particularly as regards to renal impairment. The aim of this review is to clarify the prognostic value of endothelial dysfunction as a marker of vascular disease in these subjects. PMID:25317238

  1. Streptococcus agalactiae pyomyositis in diabetes mellitus.

    PubMed

    Panikkath, Deepa; Tantrachoti, Pakpoom; Panikkath, Ragesh; Nugent, Kenneth

    2016-07-01

    Pyomyositis is an acute infectious disorder affecting the skeletal muscle. Although seen more commonly in the tropics, cases are being reported in temperate countries, including the United States. We report a case of nontropical pyomyositis in a 58-year-old diabetic man who presented with a vague chest wall swelling. His initial clinical presentation and imaging findings suggested an intramuscular hematoma. He later developed fever with increased swelling, and pyomyositis was diagnosed after an aspiration of the swelling yielded Streptococcus agalactiae. Aspiration of the abscess and the use of appropriate antibiotics led to complete resolution of the disease. We discuss possible factors in diabetics that might predispose them to pyomyositis. PMID:27365874

  2. Aldosterone and type 2 diabetes mellitus.

    PubMed

    Zavatta, Guido; Casadio, Elena; Rinaldi, Eleonora; Pagotto, Uberto; Pasquali, Renato; Vicennati, Valentina

    2016-04-01

    Primary hyperaldosteronism (PA) has recently been demonstrated to be strictly associated to metabolic syndrome as compared with essential hypertension (EH). Besides, the characteristics of metabolic syndrome are different in PA compared to EH, as high fasting glucose is more frequent in the former condition. The adverse effect of excess aldosterone on insulin metabolic signaling has generated increasing interest in the role of hyperaldosteronism in the pathogenesis of insulin resistance and resistant hypertension. Moreover, aldosterone receptor antagonist therapy in diabetic and cardiopathic patients improved coronary flow. The aim of this review is to present recent knowledge about the relationship between aldosterone, insulin resistance and diabetes. PMID:26876814

  3. Streptococcus agalactiae pyomyositis in diabetes mellitus

    PubMed Central

    Tantrachoti, Pakpoom; Panikkath, Ragesh; Nugent, Kenneth

    2016-01-01

    Pyomyositis is an acute infectious disorder affecting the skeletal muscle. Although seen more commonly in the tropics, cases are being reported in temperate countries, including the United States. We report a case of nontropical pyomyositis in a 58-year-old diabetic man who presented with a vague chest wall swelling. His initial clinical presentation and imaging findings suggested an intramuscular hematoma. He later developed fever with increased swelling, and pyomyositis was diagnosed after an aspiration of the swelling yielded Streptococcus agalactiae. Aspiration of the abscess and the use of appropriate antibiotics led to complete resolution of the disease. We discuss possible factors in diabetics that might predispose them to pyomyositis. PMID:27365874

  4. [Progress in treating diabetes mellitus with adult stem cells].

    PubMed

    Zhang, Lixin; Teng, Chunbo; An, Tiezhu

    2008-02-01

    Diabetes mellitus is a metabolic diseases, mainly including type 1 and type 2 diabetes. Treatment for type 1 and part of type 2 often involves regular insulin injection. However, this treatment neither precisely controls the blood sugar levels, nor prevents the diabetes complications. Transplantation of islets of Langerhans offers an attractive strategy for diabetes therapies, but its wide application has been limited by donor shortage and immunological rejection after transplantation. Stem cells with strong proliferation capacity and multipotential may be potential cell sources in diabetes therapies. For this, adult stem cells are interesting because of absence of teratoma formation and ethnical problems. Adult pancreatic stem cells (PSCs) really exist and could produce insulin-secreting cells both under the condition of pancreatic injury and in vitro culture, but lack of effective markers to enrich PSCs hampers the studies of exploring the expanding and differentiating conditions in vitro. Some other adult stem cells, such as hepatic stem cells, marrow stem cells or intestine stem cells, were also suggested to transdifferentiate into insulin-producing cells under special culture conditions in vitro or by genetic modifications. Moreover, transplanting these adult stem cells-derived insulin-secreting cells into the diabetic mouse could cure diabetes. Thus, adult stem cells would supply the abundant beta-cell sources for cell replacement therapy of diabetes. PMID:18464596

  5. Prevalence of Diabetes Mellitus in Patients with Chronic Kidney Disease

    PubMed Central

    Stojceva-Taneva, Olivera; Otovic, Natasa Eftimovska; Taneva, Borjanka

    2016-01-01

    BACKGROUND: Chronic kidney disease (CKD) became a new epidemic of the twentieth and twenty-first centuries. Diabetic nephropathy is one of the leading causes of end-stage renal failure as a result of the diabetes epidemic worldwide. AIM: The aim of our study was to assess the prevalence of CKD in the Republic of Macedonia and its association with diabetes mellitus. MATERIALS AND METHODS: The study was a part of a study conducted in 2006 in terms of screening for early detection of kidney disease. It was a cross-sectional study based on a random sample of patients aged > 20, consecutively consulting their primary physician for any cause. Fifty physicians throughout the country were included in the study. A total of 2637 patients have been analyzed based on integrity data. GFR was estimated using corrected values of serum creatinine and calculating kidney function by the Cockroft & Gault formula, adjusted for body surface using the Gehan & George formula. Patients with estimated glomerular filtration rate (eGFR) less than 60 ml/min were considered as having CKD. Blood pressure, body weight, height, serum creatinine, glucose, hemoglobin, hematocrit, urinalysis and medical history for presence of cardiovascular diseases or diabetes were also assessed. RESULTS: The mean age of the subjects was 45.97 ± 16.55 SD and 17.97% were older than 60. Regarding gender, 44.14% were males. The prevalence of diabetes mellitus was 13.9%. Subjects with CKD (eGFR less than 60 ml/min) were 7.53% of the total. Subjects aged 60 or above, had 20 times higher risk of having CKD (eGFR less than 60 ml/min/1.73 m2). Out of the total group of subjects, 13.9% had diabetes mellitus and they had 3.13 times higher risk of having CKD stage 3-5 (eGFR less than 60 ml/min/1.73 m2) when compared to non-diabetics. The results showed that diabetes was significantly more associated with lower eGFR (less than 60 ml/min/1.73 m2) in younger subjects (age less than 60) compared to older ones (odds ratio 3

  6. An uncommon case of diabetic mastopathy in type II non-insulin dependent diabetes mellitus.

    PubMed

    Sotome, Keiichi; Ohnishi, Tatsuya; Miyoshi, Ryo; Nakamaru, Makoto; Furukawa, Akio; Miyazaki, Hiroshi; Morozumi, Kyoei; Tanaka, Yoichi; Iri, Hisami

    2006-01-01

    Diabetic mastopathy is an uncommon tumor-like proliferation of fibrous tissue of the breast that usually occurs in a patient who has suffered from type I diabetes mellitus of long duration. Here we report a rare case of diabetic mastopathy that occurred in type II non-insulin dependent diabetes mellitus. This patient was a 63-year-old postmenopausal woman. Mammography, ultrasonography and MR imaging could not distinguish it from breast cancer. Although the core needle biopsy specimen showed fibrosis without evidence of malignancy, excisional biopsy was performed. Histological findings demonstrated typical diabetic mastopathy with keloid-like fibrosis, perivascular lymphocytic infiltration, and lymphocytic lobulitis without evidence of malignancy. These lymphocytes were composed predominantly of B-cells. Five months after surgical biopsy, a nodular formation approximately 4 cm in diameter recurred adjacent to the resected end of the biopsy. PMID:16755119

  7. Preventing insulin dependent diabetes mellitus: the environmental challenge. Diabetes Epidemiology Research International.

    PubMed Central

    1987-01-01

    The epidemiology of insulin dependent diabetes mellitus was evaluated to determine the degree to which the disease results from environmental agents and therefore might be prevented. The results of research indicate that insulin dependent diabetes can be produced in animal models by environmental factors, there are major geographical variations in diabetes, certain populations have shown rapid changes in incidence over time, migrants appear to take on the risk of diabetes in their new country, and certain viruses and chemicals cause insulin dependent diabetes in humans. The results of genetic and epidemiological studies also show that at least 60% of insulin dependent diabetes world wide, and perhaps over 95%, is environmentally determined and thus potentially avoidable. It is concluded that the primary worldwide determinants of diabetes are environmental not immunogenetic and that identifying and altering the diabetogenic environmental factor(s) are likely to be more effective and less risky in preventing insulin dependent diabetes than current immunogenetic approaches. PMID:3117180

  8. The treatment of diabetes mellitus of patients with chronic liver disease.

    PubMed

    García-Compeán, Diego; González-González, José A; Lavalle-González, Fernando J; González-Moreno, Emmanuel I; Maldonado-Garza, Héctor J; Villarreal-Pérez, Jesús Zacarías

    2015-01-01

    About 80% of patients with liver cirrhosis may have glucose metabolism disorders, 30% show overt diabetes mellitus (DM). Prospective studies have demonstrated that DM is associated with an increased risk of hepatic complications and death in patients with liver cirrhosis. DM might contribute to liver damage by promoting inflammation and fibrosis through an increase in mitochondrial oxidative stress mediated by adipokines. Based on the above mentioned the effective control of hyperglycemia may have a favorable impact on the evolution of these patients. However, only few therapeutic studies have evaluated the effectiveness and safety of antidiabetic drugs and the impact of the treatment of DM on morbidity and mortality in patients with liver cirrhosis. In addition, oral hypoglycemic agents and insulin may produce hypoglycemia and lactic acidosis, as most of these agents are metabolized by the liver. This review discusses the clinical implications of DM in patients with chronic liver disease. In addition the effectiveness and safety of old, but particularly the new antidiabetic drugs will be described based on pharmacokinetic studies and chronic administration to patients. Recent reports regarding the use of the SGLT2 inhibitors as well as the new incretin-based therapies such as injectable glucagon-like peptide-1 (GLP-1) receptor agonists and oral inhibitors of dipeptidylpeptidase-4 (DPP-4) will be discussed. The establishment of clear guidelines for the management of diabetes in patients with CLD is strongly required. PMID:26436350

  9. Diabetes mellitus: an important risk factor for reactivation of tuberculosis

    PubMed Central

    Rivera, Carmen; Mangual, Michelle; Martinez, José; Rivera, Kelvin; Fernandez, Ricardo

    2016-01-01

    Summary Diabetes mellitus was identified as a risk factor for developing tuberculosis (TB) infection, and relapse after therapy. The risk of acquiring TB is described as comparable to that of HIV population. The fact that diabetics are 3× times more prone to develop pulmonary TB than nondiabetics cannot be overlooked. With DM recognized as global epidemic, and TB affecting one-third of the world population, physicians must remain vigilant. We present a 45-year-old woman born in Dominican Republic (DR), with 10-year history of T2DM treated with metformin, arrived to our Urgency Room complaining of dry cough for the past 3months. Interview unveiled unintentional 15lbs weight loss, night sweats, occasional unquantified fever, and general malaise but denied bloody sputum. She traveled to DR 2years before, with no known ill exposure. Physical examination showed a thin body habitus, otherwise well appearing woman with stable vital signs, presenting solely right middle lung field ronchi. LDH, ESR, hsCRP and Hg A1C were elevated. Imaging revealed a right middle lobe cavitation. Sputum for AFB disclosed active pulmonary TB. Our case portrays that the consideration of TB as differential diagnosis in diabetics should be exercised with the same strength, as it is undertaken during the evaluation of HIV patients with lung cavitation. Inability to recognize TB will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace. Learning points Diabetes mellitus should be considered an important risk factor for the reactivation of pulmonary tuberculosis. High clinical suspicious should be taken into consideration as radiological findings for pulmonary tuberculosis in patients with diabetes mellitus may be atypical, involving middle and lower lobes. Inability to recognize pulmonary tuberculosis will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace. PMID:27482384

  10. Are gastrointestinal symptoms related to diabetes mellitus and glycemic control?

    PubMed

    Koch, Christian A; Uwaifo, Gabriel I

    2008-09-01

    Many patients with diabetes mellitus suffer from upper and lower GI symptoms. The reported prevalence of these symptoms varies among different ethnic groups/populations. The natural history of GI symptoms as well as their pathogenesis in patients with diabetes remains poorly understood, although it is known that gastric emptying is influenced by hyperglycemia, euglycemia, and hypoglycemia. Poor glycemic control over a long period of time can lead to neuropathy and damage the vagus nerve, resulting in diabetic gastroparesis whose signs and symptoms vary in the individual patient. Gastroparesis can further worsen glycemic control by adversely altering the pharmacokinetics of orally administered hypoglycemic agents as well as by altering the delivery of diet-derived calories to intestines from which absorption, subsequently, determines incipient blood glucose, and thus effectiveness of various injectable antidiabetics including various insulins and related insulin analogs. As GI symptoms may overlap with other disorders, including functional dyspepsia, irritable bowel syndrome, and depression, it is important to have such patients/patients with diabetes undergo standardized testing for measuring gastric emptying. Certain medications including metformin, amylin analogues (i.e. pramlintide), glucagon-like peptide 1 analogs (i.e. exenatide, liraglutide), anticholinergic agents, antidepressants, calcium-channel blockers, and others may contribute to GI symptoms observed in patients with diabetes. Given the global diabetes pandemic, it is of utmost importance to not only diagnose and treat present patients with diabetes mellitus and its comorbidities, but also to help prevent the development of further disease burden by educating children and adolescents about healthy lifestyle modifications (avoidance of overeating, portion control, healthy food choices, increased physical and reduced sedentary activity), as changing behavior in adulthood has proven to be notoriously

  11. [Guidelines for the management of diabetes mellitus type 2].

    PubMed

    Mediavilla Bravo, José Javier

    2014-09-01

    In the last few years, the publication of new studies in diabetes, together with the development of new classes of blood glucose-lowering medications, have led to updates of the most prestigious clinical practice guidelines for the treatment of diabetes. Thus, a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes on the management of hyperglycemia in type 2 diabetes was published in April 2012. An update of one of the evidence-based guidelines issued by the Canadian Diabetes Association appeared in 2013 and this year, 2014, saw the publication of the consensus document of the redGDPS, whose guidelines are those most closely followed by primary care physicians in Spain. The three guidelines highlight the need for an individualized approach to type 2 diabetes mellitus, outlining both target glycemic goals and distinct treatment regimens based on patient characteristics, disease stage and the presence of comorbidities or complications. In the treatment of the disease, the three guidelines also stress the importance of considering patients' opinions and of recommending lifestyle modifications to achieve good disease control. Metformin is identified as the first-line drug, with the addition of other glucose-lowering agents if necessary. PMID:25595348

  12. Ensete superbum ameliorates renal dysfunction in experimental diabetes mellitus

    PubMed Central

    Sreekutty, MS; Mini, S

    2016-01-01

    Objective(s): Hyperglycemia mediated oxidative stress plays a key role in the pathogenesis of diabetic complications like nephropathy. In the present study, we evaluated the effect of ethanolic extract of Ensete superbum seeds (ESSE) on renal dysfunction and oxidative stress in streptozotocin-induced diabetic rats. Materials and Methods: Glucose, HbA1c, total protein, albumin, renal function markers (urea, uric acid and creatinine), and lipid peroxidation levels were evaluated. Renal enzymatic and non-enzymatic antioxidants were examined along with renal histopathological study. Results: ESSE (400 mg/kg BW t) administration reduced glucose and HbA1c, and improved serum total protein and albumin in diabetic rats. ESSE in diabetic rats recorded decrement in renal function markers and renal lipid peroxidation products along with significant increment in enzymatic and non-enzymatic antioxidants. Renal morphological abnormalities of diabetic rats were markedly ameliorated by E. superbum. Conclusion: These results suggest that the antioxidant effect of E. superbum could ameliorate oxidative stress and delay/prevent the progress of diabetic nephropathy in diabetes mellitus. PMID:27096072

  13. Syndromes of Ketosis-Prone Diabetes Mellitus

    PubMed Central

    Balasubramanyam, Ashok; Nalini, Ramaswami; Hampe, Christiane S.; Maldonado, Mario

    2008-01-01

    Ketosis-prone diabetes (KPD) is a widespread, emerging, heterogeneous syndrome characterized by patients who present with diabetic ketoacidosis or unprovoked ketosis but do not necessarily have the typical phenotype of autoimmune type 1 diabetes. Multiple, severe forms of β-cell dysfunction appear to underlie the pathophysiology of KPD. Until recently, the syndrome has lacked an accurate, clinically relevant and etiologically useful classification scheme. We have utilized a large, longitudinally followed, heterogeneous, multiethnic cohort of KPD patients to identify four clinically and pathophysiologically distinct subgroups that are separable by the presence or absence of β-cell autoimmunity and the presence or absence of β-cell functional reserve. The resulting “Aβ” classification system of KPD has proven to be highly accurate and predictive of such clinically important outcomes as glycemic control and insulin dependence, as well as an aid to biochemical and molecular investigations into novel causes of β-cell dysfunction. In this review, we describe the current state of knowledge in regard to the natural history, pathophysiology, and treatment of the subgroups of KPD, with an emphasis on recent advances in understanding their immunological and genetic bases. PMID:18292467

  14. [Type 2 diabetes mellitus: new treatments].

    PubMed

    Ascaso, Juan F

    2014-08-01

    The benefits and problems associated with traditional hypoglycemic drugs, such as failure of beta cells, hypoglycemia and weight gain, that lead to a worsening of diabetes, are reviewed. New hypoglycemic drugs with incretin effect (glucagon-like peptide-1 agonists and dipeptidyl peptidase 4 inhibitors), achieve, in a glucose dependent manner, an glycosylated hemoglobin reduction without hypoglycemia or increase in body weight. Recently, another group of oral hypoglycemic drugs, sodium-glucose cotransporter type 2 inhibitors, have demonstrated efficacy in diabetes control by inhibiting renal glucose reabsorption. However, long-term effects and cardiovascular prevention remain to be demonstrated. We have more and better drugs nowadays. Hypoglycemic treatment should be customized (glycosylated hemoglobin levels, risk-benefit, risk of hypoglycemia, weight changes, cardiovascular risk), with a combination of drugs being necessary in most cases. However, we do not have yet an ideal hypoglycemic drug. Moreover we must remember that an early and intensive treatment of dyslipidemia and hypertension is essential for the prevention of cardiovascular disease in patients with type 2 diabetes. PMID:23937815

  15. Laser therapy in wound healing associated with diabetes mellitus - Review*

    PubMed Central

    de Sousa, Raquel Gomes; Batista, Keila de Nazaré Madureira

    2016-01-01

    The article discusses the results of a literature review on the application of low intensity laser therapy on the healing of wounds associated diabetes mellitus in the last 10 years. Objective To determine the most effective parameter in healing wounds related to diabetes mellitus, as well as the most widely used type of laser. Methodology consisted of bibliographic searching the databases Bireme, SciELO, PubMed/Medline and Lilacs by using the keywords related to the topic. Were selected from these keywords, papers discussing the use of laser on wounds associated with diabetes, published in the period 2005-2014, in Portuguese or English. Results After analyzing the research, 12 studies consistent with the theme were selected. Conclusion Based on this review, the studies that showed more satisfactory results in healing diabetic wounds were those who applied energy densities in the range of 3-5 J/cm2, power densities equal to or below 0.2 W/cm2 and continuous emission. The He-Ne laser with a wavelength of 632.8 nm was used more often. PMID:27579745

  16. [Knowledge and attitude towards diabetes mellitus in Argentina].

    PubMed

    Rodríguez, Martín; Puchulu, Félix

    2015-01-01

    A population survey was conducted in 9 provinces of Argentina in 2012 aimed at determining the level of knowledge of diabetes mellitus and the risk of developing the disease. This was a cross-sectional study based on the general population and including men and women aged 18-70 years from all socioeconomic backgrounds. Results showed that 30.5% of participants without diabetes mellitus were at risk of developing the disease. Fifty-nine percent of participants had a body mass index = 25 kg/m2. Forty-nine percent did less than 30 minutes of daily physical activity. Only 34% of the population ate fruits and vegetables every day. Ninety-eight percent of participants had once heard of diabetes, and 67% defined it as a severe or very severe disease. In view of the findings resulting from this survey, healthcare services are expected to improve prevention and effective control of cardiovascular risk factors as well as to enhance preventive actions in order to encourage the adoption of healthier lifestyles from an earlier age and to achieve greater knowledge not only among patients living with diabetes, but also within the general population. PMID:26707657

  17. The Effect of Perceived Stress and Family Functioning on People with Type 2 Diabetes Mellitus

    PubMed Central

    Bhandary, Bhagyashree; Rao, Satheesh; T.S., Sanal

    2013-01-01

    Background: Various studies have suggested that support from a patient’s family can facilitate his/her recovery from a physical illness and improve the ability of the patient to deal with consequences of Type 2 Diabetes. Stress is considered to play a major role in influencing Type 2 Diabetes Mellitus. Aim: To determine the roles of Perceived Stress and Family functioning on behaviours of individuals with Type 2 Diabetes Mellitus. Material and Methods: The present study included 250 Diabetics as per the WHO criteria and 250 Non-Diabetics. Questionnaires were given to them to obtain data. Results: Stress was found to be high among Diabetics (22.17%) as compared to that in non-Diabetics (16.92%). Family assessment showed a significant difference among its subscales when it was compared between Diabetics and Non-Diabetics. Conclusion: Perceived stress influences Type 2 Diabetes Mellitus. Role played by the Family is significant in managing Diabetes. PMID:24551677

  18. [Type 2 diabetes mellitus and obesity: should we treat the obesity or the diabetes?].

    PubMed

    García, Santiago Durán; Sanz, Santiago Durán; Sanz, Alejandro Durán

    2013-09-01

    In this article, we review the results that can be expected after significant weight loss in patients with type 2 diabetes mellitus. We provide consensus-based documentation supported by the American Diabetes Association, the European Association for the Study of Diabetes, and the International Diabetes Federation on the importance of physical exercise, metabolic-bariatric surgery, and drug therapy. Lastly, we report the results of studies published in the last few years on glucagon-like peptide-1 analogs and the new family of oral drugs known as gliflozins, specifically studies published on dapagliflozin. PMID:24444519

  19. Prevalence of diabetic foot ulcers in newly diagnosed diabetes mellitus patients.

    PubMed

    Sinharay, Keshab; Paul, Uttam Kumar; Bhattacharyya, Anup Kumar; Pal, Salil Kumar

    2012-09-01

    Foot ulcer is one of the most common and dreadest complication of diabetes mellitus.This is also a frequent cause of hospitalisation and disability. Most of the patients with diabetic foot ulcers living in developing countries present to healthcare facilities fairly late with advanced foot ulcers because of poor economic status, inadequate knowledge of self-care, sociocultural reasons and poor and inadequate diabetes healthcare. To determine the prevalence of diabetic foot ulcers amongst the newly diagnosed diabetes mellitus patients (n = 1674) a cross-sectional study was carried out during the period January 2010 to January 2011 in the department of medicine, NRS Medical College, Kolkata. Diabetic foot ulcers were found in 4.54% newly diagnosed diabetes mellitus patients. Neuropathic type of foot ulcer was present in 46.06% of patients (52.5% in male and 38.88% in female). Ischaemic type of foot ulcer was present in 19.74% of patients (22.5% in male and in 16.66% females). Neuroischaemic type of foot ulcer was present in 34.2% of patients (25% in males and 44.44% in females). Neuropathy occurred most frequently either singly or with peripheral vascular disease. General awareness about the disease, early diagnosis and proper management will prevent this dreaded complication. PMID:23741832

  20. Epidemiology of paediatric metabolic syndrome and type 2 diabetes mellitus.

    PubMed

    De Ferranti, Sarah D; Osganian, Stavroula K

    2007-12-01

    The epidemic in childhood obesity is a driving force behind the increase in paediatric metabolic syndrome, a collection of abnormalities that is associated in adults with increased risk for cardiovascular disease and type 2 diabetes mellitus. Although there is no clear consensus about the paediatric definition for metabolic syndrome, the prevalence of this syndrome is clearly rising. Children with metabolic syndrome are at increased risk for metabolic syndrome in adulthood. A late consequence of metabolic syndrome is type 2 diabetes, which increasingly affects adolescents. The rise in metabolic syndrome and type 2 diabetes in children is almost sure to lead to an increase in associated complications in young adulthood, including early cardiovascular disease. This epidemic will bear fruit in forthcoming decades, putting further stress on the healthcare system and probably leading to increased morbidity and a shorter lifespan for future generations. PMID:18158698

  1. Limited joint mobility syndrome in diabetes mellitus: A minireview

    PubMed Central

    Gerrits, Esther G; Landman, Gijs W; Nijenhuis-Rosien, Leonie; Bilo, Henk J

    2015-01-01

    Limited joint mobility syndrome (LJMS) or diabetic cheiroarthropathy is a long term complication of diabetes mellitus. The diagnosis of LJMS is based on clinical features: progression of painless stiffness of hands and fingers, fixed flexion contractures of the small hand and foot joints, impairment of fine motion and impaired grip strength in the hands. As the syndrome progresses, it can also affect other joints. It is important to properly diagnose such a complication as LJMS. Moreover, it is important to diagnose LJMS because it is known that the presence of LJMS is associated with micro- and macrovascular complications of diabetes. Due to the lack of curative treatment options, the suggested method to prevent or decelerate the development of LJMS is improving or maintaining good glycemic control. Daily stretching excercises of joints aim to prevent or delay progression of joint stiffness, may reduce the risk of inadvertent falls and will add to maintain quality of life. PMID:26265997

  2. [Pantethine, diabetes mellitus and atherosclerosis. Clinical study of 1045 patients].

    PubMed

    Donati, C; Bertieri, R S; Barbi, G

    1989-03-31

    After a review of the clinical studies on the treatment of diabetic patients with pantethine, the authors discuss the results obtained in a postmarketing surveillance (PMS) study on 1045 hyperlipidemic patients receiving pantethine (900 mg/day on average). Of these patients, 57 were insulin-dependent (Type I) and 241 were non insulin-dependent (Type II) diabetics. Beyond the epidemiological considerations made possible by a PMS study, the authors show that pantethine brought about a statistically significant and comparable improvement of lipid metabolism in the three groups of patients, with very good tolerability. Pantethine should therefore be considered for the treatment of lipid abnormalities also in patients at risk such as those with diabetes mellitus. PMID:2524328

  3. Gestational and Pregestational Diabetes Mellitus in Omani Women

    PubMed Central

    Abu-Heija, Adel T.; Al-Bash, Majeda; Mathew, Mariam

    2015-01-01

    Objectives: The aim of this study was to assess the prevalence of gestational diabetes mellitus (GDM) and pregestational diabetes mellitus (PGDM) among pregnant women in Oman and compare their obstetric and perinatal outcomes. Methods: This retrospective study assessed the obstetric and perinatal outcomes of pregnant Omani women with GDM or PGDM who delivered at the Sultan Qaboos University Hospital in Muscat, Oman, between January 2009 and December 2010. Results: There were a total of 5,811 deliveries during the study period. Of the 5,811 women who gave birth, 639 women were found to have diabetes mellitus (11.0%). A total of 581 of the diabetic women had GDM (90.9%) and only 58 (9.1%) had PGDM. Women with PGDM had a significantly higher incidence of pre-eclampsia (P = 0.022), preterm deliveries (P <0.001) and Caesarean sections (P <0.001). Neonatal complications, such as respiratory distress syndrome (RDS), neonatal hypoglycaemia, neonatal jaundice and subsequent admission to a neonatal intensive care unit (NICU) were significantly higher for neonates born to mothers with PGDM compared to those born to mothers with GDM (P <0.001). The corrected perinatal mortality rates for women with PGDM and GDM were 34.5 and 13.7 per 1,000 live births, respectively. Conclusion: In this Omani cohort, women with PGDM were at higher risk of developing obstetric and perinatal complications such as pre-eclampsia, preterm delivery and Caesarean delivery compared to women with GDM. In addition, neonates who had mothers with PGDM had higher rates of RDS, neonatal hypoglycaemia, neonatal jaundice and admission to the NICU. PMID:26629376

  4. Problems in diabetes mellitus management. Insulin resistance.

    PubMed

    Wolfsheimer, K J

    1990-12-01

    Insulin resistance is a cause for morning hyperglycemia seen in diabetic patients. Other reasons for morning hyperglycemia should be eliminated by performing an insulin response test. Once insulin resistance has been established as the cause of hyperglycemia, a step-by-step process should be used to establish the cause of the insulin resistance. Common causes of insulin resistance include hyperadrenocorticism, acromegaly, hyperthyroidism, and obesity. Hepatic disease, renal insufficiency, and sepsis are other causes of insulin resistance in practice. Less common causes include insulin antibodies, pregnancy, neoplasia, hyperandrogenism, and pheochromocytoma. If the underlying cause cannot be found or resolved, then increased doses of insulin are required to manage the hyperglycemia. PMID:2134077

  5. Preconceptional Iron Intake and Gestational Diabetes Mellitus.

    PubMed

    Darling, Anne Marie; Mitchell, Allen A; Werler, Martha M

    2016-01-01

    Our objective was to assess the impact of preconceptional heme and non-heme iron on gestational diabetes mellitius (GDM) in the Boston University Slone Epidemiology Birth Defects Study (BDS). This retrospective cohort analysis included 7229 participants enrolled in the BDS between 1998 and 2008 who gave birth to non-malformed infants and were free of pre-existing diabetes. All data were collected through structured interviews conducted within 6 months of delivery. Calorie-adjusted and multivariable odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression models. Preconceptional dietary heme iron was modestly associated with an elevated risk of GDM among those (multivariable OR comparing the fifth quintile to the first: 1.55; 95% CI 0.98, 2.46). Conversely, preconceptional dietary non-heme iron was associated with a decreased risk of GDM among those in the fifth quintile of intake compared to the first (multivariable OR: 0.48; 95% CI 0.28, 0.81). Women who consumed supplemental iron during preconception also had a decreased risk of GDM (multivariable OR: 0.78; 95% CI 0.60, 1.02). In conclusion, our data support a positive association between preconceptional heme iron intake and GDM and an inverse association between preconceptional non-heme iron intake from foods and preconceptional intake from supplements. PMID:27231921

  6. Preconceptional Iron Intake and Gestational Diabetes Mellitus

    PubMed Central

    Darling, Anne Marie; Mitchell, Allen A.; Werler, Martha M.

    2016-01-01

    Our objective was to assess the impact of preconceptional heme and non-heme iron on gestational diabetes mellitius (GDM) in the Boston University Slone Epidemiology Birth Defects Study (BDS). This retrospective cohort analysis included 7229 participants enrolled in the BDS between 1998 and 2008 who gave birth to non-malformed infants and were free of pre-existing diabetes. All data were collected through structured interviews conducted within 6 months of delivery. Calorie-adjusted and multivariable odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression models. Preconceptional dietary heme iron was modestly associated with an elevated risk of GDM among those (multivariable OR comparing the fifth quintile to the first: 1.55; 95% CI 0.98, 2.46). Conversely, preconceptional dietary non-heme iron was associated with a decreased risk of GDM among those in the fifth quintile of intake compared to the first (multivariable OR: 0.48; 95% CI 0.28, 0.81). Women who consumed supplemental iron during preconception also had a decreased risk of GDM (multivariable OR: 0.78; 95% CI 0.60, 1.02). In conclusion, our data support a positive association between preconceptional heme iron intake and GDM and an inverse association between preconceptional non-heme iron intake from foods and preconceptional intake from supplements. PMID:27231921

  7. The changing demography of diabetes mellitus in Singapore.

    PubMed

    Lee, W R

    2000-10-01

    Diabetes mellitus has been on the rise in Singapore, while Singaporeans are becoming more affluent, our lifestyles are more sedentary and our population is ageing rapidly. The prevalence of diabetes mellitus rose from 2% in 1975 to 4.7% in 1984, 8.6% in 1992 and 9.0% of adults 18-69 years old in 1998. Malay and Indian women and Indian men were at higher risk, with 14.3, 14.9 and 16.7% prevalence rates, respectively. A further 15% of the adult population have impaired glucose tolerance (IGT). Diabetes was a factor in 39.7% of strokes and in 9.3% of all deaths in Singapore, and is the sixth most common cause of death. In the Diabcare Singapore 1998 Study, 91% of participants were diagnosed with Type 2 diabetes, with mean BMI of 25.1+/-4.4 kg/m(2). The incidence of Type 1 diabetes in childhood is 2.46 per 100000 children 0-12 years of age, while Type 2 diabetes in childhood is an emerging problem. The prevalence of obesity (BMI >30 kg/m(2)) among persons aged 18-69 years rose to 6% in 1998, up from 5.1% in 1992. The prevalence of obesity was highest among the Malays (16.2%) followed by the Indians (12.2%) and the Chinese (3.8%). About 12% of schoolchildren are obese. Increased efforts must be made to change lifestyle and eating patterns in our society, reduce childhood obesity and encourage adults to make lifelong sports and exercise part of the Singaporean way of life. Singapore has one of the world's fastest ageing populations, and even now, 32.4% of Singaporeans 60-69 years of age have diabetes. We should consider screening for diabetes in obese schoolchildren and seek to improve quality of care for people with diabetes, including enlisting the aid of community organisations to improve access to diabetes education, monitoring, support and complications screening services. PMID:11024582

  8. Brain changes in diabetes mellitus patients with gastrointestinal symptoms.

    PubMed

    Drewes, Anne M; Søfteland, Eirik; Dimcevski, Georg; Farmer, Adam D; Brock, Christina; Frøkjær, Jens B; Krogh, Klaus; Drewes, Asbjørn M

    2016-01-25

    Diabetes mellitus is a common disease and its prevalence is increasing worldwide. In various studies up to 30%-70% of patients present dysfunction and complications related to the gut. To date several clinical studies have demonstrated that autonomic nervous system neuropathy and generalized neuropathy of the central nervous system (CNS) may play a major role. This systematic review provides an overview of the neurodegenerative changes that occur as a consequence of diabetes with a focus on the CNS changes and gastrointestinal (GI) dysfunction. Animal models where diabetes was induced experimentally support that the disease induces changes in CNS. Recent investigations with electroencephalography and functional brain imaging in patients with diabetes confirm these structural and functional brain changes. Encephalographic studies demonstrated that altered insular processing of sensory stimuli seems to be a key player in symptom generation. In fact one study indicated that the more GI symptoms the patients experienced, the deeper the insular electrical source was located. The electroencephalography was often used in combination with quantitative sensory testing mainly showing hyposensitivity to stimulation of GI organs. Imaging studies on patients with diabetes and GI symptoms mainly showed microstructural changes, especially in brain areas involved in visceral sensory processing. As the electrophysiological and imaging changes were associated with GI and autonomic symptoms they may represent a future therapeutic target for treating diabetics either pharmacologically or with neuromodulation. PMID:26839652

  9. Brain changes in diabetes mellitus patients with gastrointestinal symptoms

    PubMed Central

    Drewes, Anne M; Søfteland, Eirik; Dimcevski, Georg; Farmer, Adam D; Brock, Christina; Frøkjær, Jens B; Krogh, Klaus; Drewes, Asbjørn M

    2016-01-01

    Diabetes mellitus is a common disease and its prevalence is increasing worldwide. In various studies up to 30%-70% of patients present dysfunction and complications related to the gut. To date several clinical studies have demonstrated that autonomic nervous system neuropathy and generalized neuropathy of the central nervous system (CNS) may play a major role. This systematic review provides an overview of the neurodegenerative changes that occur as a consequence of diabetes with a focus on the CNS changes and gastrointestinal (GI) dysfunction. Animal models where diabetes was induced experimentally support that the disease induces changes in CNS. Recent investigations with electroencephalography and functional brain imaging in patients with diabetes confirm these structural and functional brain changes. Encephalographic studies demonstrated that altered insular processing of sensory stimuli seems to be a key player in symptom generation. In fact one study indicated that the more GI symptoms the patients experienced, the deeper the insular electrical source was located. The electroencephalography was often used in combination with quantitative sensory testing mainly showing hyposensitivity to stimulation of GI organs. Imaging studies on patients with diabetes and GI symptoms mainly showed microstructural changes, especially in brain areas involved in visceral sensory processing. As the electrophysiological and imaging changes were associated with GI and autonomic symptoms they may represent a future therapeutic target for treating diabetics either pharmacologically or with neuromodulation. PMID:26839652

  10. Rehabilitation of Tendon Problems in Patients with Diabetes Mellitus.

    PubMed

    Rees, Jonathan; Gaida, Jamie E; Silbernagel, Karin Grävare; Zwerver, Johannes; Anthony, Joseph S; Scott, Alex

    2016-01-01

    Exercise is crucial in the management of diabetes mellitus and its associated complications. However, individuals with diabetes have a heightened risk of musculoskeletal problems, including tendon pathologies. Diabetes has a significant impact on the function of tendons due to the accumulation of advanced glycation end-products in the load-bearing collagen. In addition, tendon vascularity and healing may be reduced due to diabetes-induced changes in the peripheral vascular system, and impaired synthesis of collagen and glycosaminoglycan. The current chapter presents an evidence-based discussion of considerations for the rehabilitation of tendon problems in people with diabetes. The following conditions are discussed in detail - calcific tendinopathy, tenosynovitis, tendon rupture, and non-calcifying tendinopathy. Common diabetes-related findings are presented, along with their potential impact on tendinopathy management and suggested modifications to standard tendinopathy treatment protocols. A holistic approach should be used to optimize musculotendinous function, including a comprehensive exercise prescription addressing strength, flexibility, and aerobic fitness. PMID:27535262

  11. Inorganic arsenic exposure and type 2 diabetes mellitus in Mexico

    SciTech Connect

    Coronado-Gonzalez, Jose Antonio; Razo, Luz Maria del; Garcia-Vargas, Gonzalo; Sanmiguel-Salazar, Francisca; Escobedo-de la Pena, Jorge . E-mail: jorgeep@servidor.unam.mx

    2007-07-15

    Inorganic arsenic exposure in drinking water has been recently related to diabetes mellitus. To evaluate this relationship the authors conducted in 2003, a case-control study in an arseniasis-endemic region from Coahuila, a northern state of Mexico with a high incidence of diabetes. The present analysis includes 200 cases and 200 controls. Cases were obtained from a previous cross-sectional study conducted in that region. Diagnosis of diabetes was established following the American Diabetes Association criteria, with two fasting glucose values {>=}126 mg/100 ml ({>=}7.0 mmol/l) or a history of diabetes treated with insulin or oral hypoglycemic agents. The next subject studied, subsequent to the identification of a case in the cross-sectional study was taken as control. Inorganic arsenic exposure was measured through total arsenic concentrations in urine, measured by hydride-generation atomic absorption spectrophotometry. Subjects with intermediate total arsenic concentration in urine (63.5-104 {mu}g/g creatinine) had two-fold higher risk of having diabetes (odds ratio=2.16; 95% confidence interval: 1.23, 3.79), but the risk was almost three times greater in subjects with higher concentrations of total arsenic in urine (odds ratio=2.84; 95% confidence interval: 1.64, 4.92). This data provides additional evidence that inorganic arsenic exposure may be diabetogenic.

  12. Diabetes insipidus, diabetes mellitus, optic atrophy and deafness. A clinical and genetic study.

    PubMed Central

    Nagi, N. A.

    1979-01-01

    Two Iraqi sisters and a female cousin developed diabetes insipidus (DI), diabetes mellitus (DM), optic atrophy (OA), and deafness (D), (the 'DIDMOAD' syndrome) before the age of 12 years. One girl exhibited all the features of this disease complex only 3 months after an unusually late onset of recognizable symptoms at 11 years 9 months. Another girl died suddenly and unexpectedly. This family study illustrates the recessive inheritance pattern of the syndrome. Images Fig. 2 Fig. 3 PMID:482181

  13. Processing Diabetes Mellitus Composite Events in MAGPIE.

    PubMed

    Brugués, Albert; Bromuri, Stefano; Barry, Michael; Del Toro, Óscar Jiménez; Mazurkiewicz, Maciej R; Kardas, Przemyslaw; Pegueroles, Josep; Schumacher, Michael

    2016-02-01

    The focus of this research is in the definition of programmable expert Personal Health Systems (PHS) to monitor patients affected by chronic diseases using agent oriented programming and mobile computing to represent the interactions happening amongst the components of the system. The paper also discusses issues of knowledge representation within the medical domain when dealing with temporal patterns concerning the physiological values of the patient. In the presented agent based PHS the doctors can personalize for each patient monitoring rules that can be defined in a graphical way. Furthermore, to achieve better scalability, the computations for monitoring the patients are distributed among their devices rather than being performed in a centralized server. The system is evaluated using data of 21 diabetic patients to detect temporal patterns according to a set of monitoring rules defined. The system's scalability is evaluated by comparing it with a centralized approach. The evaluation concerning the detection of temporal patterns highlights the system's ability to monitor chronic patients affected by diabetes. Regarding the scalability, the results show the fact that an approach exploiting the use of mobile computing is more scalable than a centralized approach. Therefore, more likely to satisfy the needs of next generation PHSs. PHSs are becoming an adopted technology to deal with the surge of patients affected by chronic illnesses. This paper discusses architectural choices to make an agent based PHS more scalable by using a distributed mobile computing approach. It also discusses how to model the medical knowledge in the PHS in such a way that it is modifiable at run time. The evaluation highlights the necessity of distributing the reasoning to the mobile part of the system and that modifiable rules are able to deal with the change in lifestyle of the patients affected by chronic illnesses. PMID:26590982

  14. Salivary gland dysfunction markers in type 2 diabetes mellitus patients

    PubMed Central

    Aitken-Saavedra, Juan; Rojas-Alcayaga, Gonzalo; Maturana-Ramírez, Andrea; Escobar-Álvarez, Alejandro; Cortes-Coloma, Andrea; Reyes-Rojas, Montserrat; Viera -Sapiain, Valentina; Villablanca-Martínez, Claudia

    2015-01-01

    Background Diabetes mellitus (DM) is a chronic disease of the carbohydrate metabolism that, when not rigorously controlled, compromises systemic and organ integrity, thereby causing renal diseases, blindness, neuropathy, arteriosclerosis, infections, and glandular dysfunction, including the salivary glands. The aim of this study was to determine the relationship between the qualitative and quantitative parameters of salivary alteration, which are indicators of salivary gland dysfunction, and the level of metabolic control of type 2 diabetes patients. Material and Methods A convenience sample of 74 voluntary patients with type 2 DM was selected, each of whom donated a sample of unstimulated saliva. Salivary parameters such as salivary flow rate, protein concentration, pH, and xerostomia were studied. Results There is a positive relationship between the level of metabolic control measured with HbA1 and the protein concentration in saliva (Spearman rho = 0.329 and p = 0.004). The same assay showed an inverse correlation between HbA1 and pH (Spearman rho = -0.225 and p = 0.05). Conclusions The protein concentration in saliva and, to a lesser extent, the pH may be useful as glandular dysfunction indicators in DM2 patients. Key words:Saliva, type 2 diabetes mellitus, pH, protein concentration, xerostomia. PMID:26535097

  15. Advances in management of type 1 diabetes mellitus

    PubMed Central

    Aathira, Ravindranath; Jain, Vandana

    2014-01-01

    Treatment of type 1 diabetes mellitus has always posed a challenge to balance hyperglycemia control with hypoglycemia episodes. The quest for newer therapies is continuing and this review attempts to outline the recent developments. The insulin molecule itself has got moulded into different analogues by minor changes in its structure to ensure well controlled delivery, stable half-lives and lesser side effects. Insulin delivery systems have also consistently undergone advances from subcutaneous injections to continuous infusion to trials of inhalational delivery. Continuous glucose monitoring systems are also becoming more accurate and user friendly. Smartphones have also made their entry into therapy of diabetes by integrating blood glucose levels and food intake with calculated adequate insulin required. Artificial pancreas has enabled to a certain extent to close the loop between blood glucose level and insulin delivery with devices armed with meal and exercise announcements, dual hormone delivery and pramlintide infusion. Islet, pancreas-kidney and stem cells transplants are also being attempted though complete success is still a far way off. Incorporating insulin gene and secretary apparatus is another ambitious leap to achieve insulin independence though the search for the ideal vector and target cell is still continuing. Finally to stand up to the statement, prevention is better than cure, immunological methods are being investigated to be used as vaccine to prevent the onset of diabetes mellitus. PMID:25317246

  16. 77 FR 43096 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Diabetes Mellitus...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-23

    ...The Diabetes Mellitus Interagency Coordinating Committee (DMICC) will hold a meeting on August 16, 2012, from 9:30 to 11:30 a.m. at 31 Center Drive on the NIH campus, Building 31C, Conference Room 6. The meeting is open to the...

  17. Pediatrics Residents' Attitudes about Insulin-Dependent Diabetes Mellitus and Children with Diabetes.

    ERIC Educational Resources Information Center

    Ingersoll, Gary M.; And Others

    1990-01-01

    Comparison of the beliefs and attitudes of a sample of pediatric residents (n=56) and practicing physicians (n=1,500) concerning children with insulin-dependent Diabetes Mellitus and the disease itself found residents in their second and third years of training considerably more negative about both than physicians or first-year residents.…

  18. Adding liraglutide to lifestyle changes, metformin and testosterone therapy boosts erectile function in diabetic obese men with overt hypogonadism.

    PubMed

    Giagulli, V A; Carbone, M D; Ramunni, M I; Licchelli, B; De Pergola, G; Sabbà, C; Guastamacchia, E; Triggiani, V

    2015-11-01

    The aim of this retrospective observational study was to evaluate whether adding liraglutide to lifestyle changes, metformin (Met) and testosterone replacement therapy (TRT), by means of improving weight and glycaemic control, could boost erectile function in type 2 diabetic obese men with overt hypogonadism and erectile dysfunction (ED) in a 'real-life setting'. Forty-three obese, diabetic and hypogonadal men (aged 45-59 years) were evaluated because of complaining about the recent onset of ED. They were subdivided into two groups according to whether hypogonadism occurred after puberty (G1; n = 30: 25 with dysfunctional hypogonadism and 5 with acquired hypogonadotropic hypogonadism) or before puberty (G2; n = 13: 10 with Klinefelter's syndrome and 3 with idiopathic hypogonadotropic hypogonadism). Both G1 and G2 patients were given a combination of testosterone (T) [testosterone undecanoate (TU) 1000 mg/every 12 weeks] and Met (2000-3000 mg/day) for 1 year. In the poor responders (N) to this therapy in terms of glycaemic target (G1N: n = 16; G2N: n = 10), liraglutide (L) (1.2 μg/day) was added for a second year, while the good responders (Y) to T + Met (G1Y: 14/30 and G2Y: 3/13) continued this two drugs regimen therapy for another year. All patients were asked to fill in the International Index of Erectile Function (IIEF 15) questionnaire before starting TU plus Met (T1) and after 12 months (T2) and 24 months (T3) of treatment. Patients underwent a clinical examination and a determination of serum sex hormone binding globulin (SHBG), total testosterone (T) and glycosylated haemoglobin (HbA1c) at T1, T2 and T3. At T2, each patient obtained an improvement of ED (p < 0.01) and of the metabolic parameters without reaching, however, the glycaemic goals [HbA1c = >7.5% (>58 mmol/mol)], while T turned out to be within the range of young men. L added to TU and Met regimen in G1N and G2N allowed these patients to reach not only the glycaemic target [HbA1c = <7.5% (<58 nmol

  19. The Vogt-Koyanagi-Harada syndrome: association with hypothyroidism and diabetes mellitus.

    PubMed Central

    Jaggarao, N.; Voth, D.; Jacobsen, J.

    1989-01-01

    A 45 year old Saudi male with poliosis, alopecia areata, vitiligo, anterior uveitis, inflammatory changes in the posterior pole of the retina and paraparesis presented with features of the Vogt-Koyanagi-Harada syndrome, uncontrolled diabetes mellitus and hypothyroidism. To the best of our knowledge the association of diabetes mellitus and hypothyroidism in this syndrome has not been reported previously. PMID:2602259

  20. [Pharmacoeconomy of diabetes mellitus--trends in the Czech Republic].

    PubMed

    Horák, P

    2009-04-01

    Since 2002, we found relatively stable number of diabetes mellitus cases among clients of General Health Insurance Company of the Czech Republic. This means, after calculating incidence rate with respect to decline in total numbers of insured during the same period, a 6% increase in real incidence rate. On the doctors side, outpatient, mostly private diabetologists have about the same capacity of their offices, 2.9 physicians (WTE)/100 000 citizens over the last years. Analysis of costs and volume of services provided, clearly demonstrate, that diabetology is medical specialization of a great importance not only from the point of view of number of patients and services provided but also of its influence on the overall health care costs. Data show not only higher average expenses for treatment of patients with diabetes mellitus compared to average expenses incurred for treatments of all other diagnoses, but show also a crucial relationship of costs with presence or absence of diabetes mellitus complications. Money spend by the medical insurance system and also and more importantly health profit to patients can thus be substantially influenced via improvements in organization of care, via higher involvement, compliance of patients to the treatment and to necessary change in their lifestyles and last but not least via increase in quality of care. Cost control can be achieved by strengthening the role of pharmacoeconomics in decisions making processes of health insurance companies, importance of which is demonstrated on the past developments on drug market in the Czech Republic. General Health Insurance Company will target these goals in coming years and in its business plans will also include expected increases of costs for organization of care and for higher renumeration of physicians as well. PMID:19449745

  1. Restless Legs Syndrome in Patients with Hypertension and Diabetes Mellitus

    PubMed Central

    Sabic, Adela; Sinanovic, Osman; Sabic, Dzevad; Galic, Gordan

    2016-01-01

    Aim: The aim of this study was to analyze frequency of restless legs syndrome (RLS) in patients with hypertension and diabetes mellitus. Patients and Methods: It was analyzed 120 subjects (from Health Center Živinice/Family Medicine Department) through a survey conducted in the period from March to June 2015, of which 30 (8 men/22 women). Subjects were 30 patients with longtime hypertension (HT)(18 men/12 women), 30 patients with diabetes mellitus (DM) type I or II (9 men/21 women), 30 patients with long standing DM type I or II and HT (12 men /18 women), and 30 control subjects (12 men/18 women). RLS were evaluated by questionnaire - International RLS Study Group Criteria. The average age of patients in the group with HT was 58.70 ± 9.07, in the group with DM 48.43 ± 15.37, and in the group of patients with HT and DM 63.90 ± 7.49 years. In the control group mean age was 52.76 ± 14.83 years. Statistical data were analyzed in Excel and SSPS statistical program. Results: RLS was identified in 10 (30%) of those with HT; 7 (21%) in patients with DM, and 10 (30%) in patients with HT+DM. In the control group RLS was verified in 4 (12%) patients. Comparing the results, it was observed significant difference between the HT and the control group (p=0.0012) and HT+ DM and control group (p=0.0012). The frequency of RLS between DM and the control group was not significantly significant (p=0.107). Conclusion: RLS is frequent in patients with hypertension (30%), hypertension+ diabetes mellitus (30%), and patients with DM (21%). PMID:27147785

  2. Diabetes mellitus: Exploring the challenges in the drug development process.

    PubMed

    Vaz, Julius A; Patnaik, Ashis

    2012-07-01

    Diabetes mellitus has reached epidemic proportions and continues to be a major burden on society globally. The International Diabetes Federation (IDF) estimated the global burden of diabetes to be 366 million in 2011 and predicted that by 2030 this will have risen to 552 million. In spite of newer and effective treatment options, newer delivery and diagnostic devices, stricter glycaemic targets, better treatment guidelines and increased awareness of the disease, baseline glycosylated hemoglobin remains relatively high in subjects diagnosed and treated with type 2 diabetes. The search continues for an ideal anti diabetic drug that will not only normalize blood glucose but also provide beta cell rest and possibly restoration of beta cell function. The development of anti diabetic drugs is riddled with fundamental challenges. The concept of beta cell rest and restoration is yet to be completely understood and proven on a long term. The ideal therapeutic approach to treating type 2 diabetes is not yet determined. Our understanding of drug safety in early clinical development is primarily limited to "Type A" reactions. Until marketing authorization most drugs are approved based on the principle of confirming non-inferiority with an existing gold standard or determining superiority to a placebo. The need to obtain robust pharmaco-economic data prior to marketing authorization in order to determine appropriate pricing of a new drug remains a major challenge. The present review outlines some of the challenges in drug development of anti-diabetic drugs citing examples of pulmonary insulin, insulin analogues, thiazolidinediones and the GLP1 analogues. PMID:23125962

  3. Celiac disease in type 1 diabetes mellitus

    PubMed Central

    2012-01-01

    Celiac Disease (CD) occurs in patients with Type 1 Diabetes (T1D) ranging the prevalence of 4.4-11.1% versus 0.5% of the general population. The mechanism of association of these two diseases involves a shared genetic background: HLA genotype DR3-DQ2 and DR4-DQ8 are strongly associated with T1D, DR3-DQ2 with CD. The classical severe presentation of CD rarely occurs in T1D patients, but more often patients have few/mild symptoms of CD or are completely asymptomatic (silent CD). In fact diagnosis of CD is regularly performed by means of the screening in T1D patients. The effects of gluten-free diet (GFD) on the growth and T1D metabolic control in CD/T1D patient are controversial. Regarding of the GFD composition, there is a debate on the higher glycaemic index of gluten-free foods respect to gluten-containing foods; furthermore GFD could be poorer of fibers and richer of fat. The adherence to GFD by children with CD-T1D has been reported generally below 50%, lower respect to the 73% of CD patients, a lower compliance being more frequent among asymptomatic patients. The more severe problems of GFD adherence usually occur during adolescence when in GFD non compliant subjects the lowest quality of life is reported. A psychological and educational support should be provided for these patients. PMID:22449104

  4. Imerslund-Grasbeck syndrome: association with diabetes mellitus.

    PubMed

    Madhavan, S; Vijayakumar, M; Rajajee, Sarala; Nammalwar, B R

    2009-03-01

    A 14 year male adolescent born of 2nd degree consanguineous marriage presented with asymptomatic proteinuria and severe anemia. He had leucopenia, anisopoikilocytosis, megaloblastic erythropoiesis, megakaryocytes with low serum B12 level. His younger sibling was similarly affected. This combination suggested Imerslund-Grasbeck syndrome. The hemoglobin levels improved with injection of vitamin B12 but proteinuria persisted. During follow-up, he developed ketoacidosis due to insulin dependent diabetes mellitus. This rare combination has not been reported in the Indian literature. PMID:19346573

  5. [Effectiveness of physical exercise programs in patients with diabetes mellitus].

    PubMed

    Cano-De La Cuerda, Roberto; Aguila-Maturana, Ana María; Miangolarra-Page, Juan Carlos

    2009-02-14

    Clinical studies with methodological rigor have shown that the strategies for lifestyle modification and drug therapies can prevent or at least delay the development of type 2 diabetes mellitus (DM) in individuals at high risk. Combination of regular physical exercise and diet is more effective than each one separately to achieve modest weight loss and improve metabolic control in patients with DM. Our objective is to describe the role of exercise in patients with DM and the exercise programs in relation to the previous considerations, taking into account the intensity of the exercise, components of the program, duration, frequency and precautions. PMID:19211086

  6. [Insulinization in type 2 diabetes mellitus. Intensification options].

    PubMed

    Fuente, Graciela V; Sinay, Isaac; Costa Gil, José E; Puchulu, Félix; Dieuzeide, Guillermo; Rodríguez, Martín; Faingold, María C; Litwak, León E

    2016-01-01

    Diabetes mellitus is associated with vascular complications and high rates of morbidity and mortality. Timely insulin therapy, intensified when necessary, represent appropriate measures to prevent or delay the onset of complications. However, the incidence of hypoglycemia and difficulties in treatment adherence represent barriers to achieve therapeutic success. Premixes analogs and, specially, combinations of insulin analogues are associated with pharmacokinetic and pharmacodynamic advantages, that translate into clinical benefits such as improved metabolic control, decreased hypoglycemic events and, for their simplicity, potentially greater adherence. PMID:27295707

  7. Incus and stapes necrosis associated with diabetes mellitus.

    PubMed

    Tüz, M; Doğru, H; Yasan, H; Döner, F; Yariktaş, M

    2006-07-01

    Chronic otitis media is often associated with ossicular defects, the most frequent being necrosis of the long process of incus. Except for infection and cholesteatoma; trauma and local pressure by chorda tympani are uncommon causes leading to incus erosion. In the literature, no case of incus necrosis has been reported associated with type II diabetes mellitus (DM). A patient is presented in this report with incus and stapes suprastructure necrosis and associated type II DM who was admitted to the out-patient clinic with complaints of conductive hearing loss. PMID:16834796

  8. Oral insulin-delivery system for diabetes mellitus.

    PubMed

    Kanzarkar, Minakshi; Pathak, Prem Prakash; Vaidya, Mandar; Brumlik, Charles; Choudhury, Abhishek

    2015-01-01

    Current insulin therapy for diabetes mellitus involves frequent dosing of subcutaneous injections, causing local discomfort, patient noncompliance, hypoglycemia and hyperinsulinemia, among others. While noninvasive therapy through oral delivery is greatly desired, there are challenges that include low bioavailability due to rapid enzymatic degradation in the stomach, inactivation and digestion by proteolytic enzymes in the intestinal lumen, poor permeability across the intestinal epithelium and poor stability. This article reviews patents that provide novel approaches for oral insulin delivery to the bloodstream through the GI tract. PMID:25565158

  9. Maternal outcomes and follow-up after gestational diabetes mellitus

    PubMed Central

    Kim, C.

    2014-01-01

    Gestational diabetes mellitus reflects impaired maternal insulin secretion relative to demand prior to pregnancy, as well as temporary metabolic stressors imposed by the placenta and fetus. Thus, after delivery, women with gestational diabetes have increased risk of diabetes and recurrent gestational diabetes because of their underlying impairment, which may be further exacerbated by fat accretion during pregnancy and post-partum deterioration in lifestyle behaviours. This hypothetical model is discussed in greater detail, particularly the uncertainty regarding pregnancy as an accelerator of β-cell decline and the role of gestational weight gain. This report also presents risk estimates for future glucose intolerance and diabetes and reviews modifiable risk factors, particularly body mass and lifestyle alterations, including weight loss and breastfeeding. Non-modifiable risk factors such as race/ethnicity and insulin use during pregnancy are also discussed. The review concludes with current literature on lifestyle modification, recommendations for post-partum glucose screening, and future directions for research to prevent maternal disease. PMID:24341443

  10. Management of diabetes mellitus in older people with comorbidities.

    PubMed

    Huang, Elbert S

    2016-01-01

    Diabetes mellitus is a chronic disease of aging that affects more than 20% of people over 65. In older patients with diabetes, comorbidities are highly prevalent and their presence may alter the relative importance, effectiveness, and safety of treatments for diabetes. Randomized controlled trials have shown that intensive glucose control produces microvascular and cardiovascular benefits but typically after extended treatment periods (five to nine years) and with exposure to short term risks such as mortality (in one trial) and hypoglycemia. Decision analysis, health economics, and observational studies have helped to illustrate the importance of acknowledging life expectancy, hypoglycemia, and treatment burden when setting goals in diabetes. Guidelines recommend that physicians individualize the intensity of glucose control and treatments on the basis of the prognosis (for example, three tiers based on comorbidities and functional impairments) and preferences of individual patients. Very few studies have attempted to formally implement and study these concepts in clinical practice. To better meet the treatment needs of older patients with diabetes and comorbidities, more research is needed to determine the risks and benefits of intensifying, maintaining, or de-intensifying treatments in this population. This research effort should extend to the development and study of decision support tools as well as targeted care management. PMID:27307175

  11. Microvasular and macrovascular complications in diabetes mellitus: Distinct or continuum?

    PubMed Central

    Chawla, Aastha; Chawla, Rajeev; Jaggi, Shalini

    2016-01-01

    Diabetes and related complications are associated with long-term damage and failure of various organ systems. The line of demarcation between the pathogenic mechanisms of microvascular and macrovascular complications of diabetes and differing responses to therapeutic interventions is blurred. Diabetes induces changes in the microvasculature, causing extracellular matrix protein synthesis, and capillary basement membrane thickening which are the pathognomic features of diabetic microangiopathy. These changes in conjunction with advanced glycation end products, oxidative stress, low grade inflammation, and neovascularization of vasa vasorum can lead to macrovascular complications. Hyperglycemia is the principal cause of microvasculopathy but also appears to play an important role in causation of macrovasculopathy. There is thought to be an intersection between micro and macro vascular complications, but the two disorders seem to be strongly interconnected, with micro vascular diseases promoting atherosclerosis through processes such as hypoxia and changes in vasa vasorum. It is thus imperative to understand whether microvascular complications distinctly precede macrovascular complications or do both of them progress simultaneously as a continuum. This will allow re-focusing on the clinical issues with a unifying perspective which can improve type 2 diabetes mellitus outcomes. PMID:27366724

  12. Skin disorders in diabetes mellitus: an epidemiology and physiopathology review.

    PubMed

    de Macedo, Geisa Maria Campos; Nunes, Samanta; Barreto, Tania

    2016-01-01

    Skin disorders, usually neglected and frequently underdiagnosed among diabetic patients, are common complications and encounter a broad spectrum of disorders in both type 1 and type 2 diabetes mellitus (DM)-e.g. cutaneous infection, dry skin, pruritus. Skin disorders are highly associated with increased risk of important outcomes, such as skin lesions, ulcerations and diabetic foot, which can lead to major complications and revolve around multifactorial factors besides hyperglycemia and advanced glycation end products. Although diabetic's skin disorders are consistent in the literature, there is limited data regarding early-stage skin disorders in DM patients. Disease control, early-stage treatment (e.g. skin hydration, orthotic devices) and awareness can reduce morbidity of DM patients. Thus, better understanding of the burden of skin disorders in DM patients may raise awareness on prevention and management. Therefore, the aim of this study is to perform a literature review to evaluate the main clinical characteristics and complications of skin disorders in diabetic's patients. Additionally, physiopathology early-stage skin disorders and dermocosmetic management were also reviewed. PMID:27583022

  13. Patient selection and vitamin E treatment in diabetes mellitus.

    PubMed

    Goldenstein, Hagit; Levy, Nina S; Lipener, Yisrael T; Levy, Andrew P

    2013-03-01

    In diabetes, there is an increase in oxidative stress due to elevated glucose levels in the plasma. High glucose promotes glycosylation, of both plasma and cellular proteins, which particularly affects the endothelial-cell lining of the blood vessel wall and interferes with its normal function. Thus, diabetes mellitus patients suffer from a higher incidence of cardiovascular complications such as atherosclerosis as compared with the nondiabetic population. Haptoglobin (Hp) is a plasma protein that binds free hemoglobin and prevents heme-iron mediated oxidation. There are three different types of Hp, which differ in their antioxidant ability. Several clinical studies have shown that the Hp 2-2 genotype is associated with higher incidence of cardiovascular diseases among diabetics. Vitamin E, a low-cost, easy-to-use antioxidant, was found to decrease the risk of developing cardiovascular diseases in Hp 2-2 diabetic patients. This review summarizes several studies that show the importance of vitamin E supplementation in a specific subgroup of patients, diabetic individuals carrying the Hp 2-2 genotype. PMID:23469912

  14. [Antihypertensive therapy in diabetes mellitus: Guidelines of the Austrian Diabetes Association 2016].

    PubMed

    Schernthaner, Guntram; Drexel, Heinz; Rosenkranz, Alexander; Schernthaner, Gerit-Holger; Watschinger, Bruno

    2016-04-01

    Blood pressure lowering is one of the most important interventions for reducing the vascular complications and mortality in patients with diabetes mellitus. Recent studies indicate that the optimal blood pressure level might be in the range between 130-140 mmHg systolic and 80‒90 mmHg diastolic. Lower blood pressure levels (e.g. 120/80 mmHg) can further reduce the risk for stroke and diabetic nephropathy, but are associated with increased cardiovascular mortality. In particular, very low blood pressure levels (< 120 mmHg) should be avoided in patients with coronary heart disease or peripheral arterial disease. Most patients with diabetes mellitus need antihypertensive combination therapies, whereby ACE-inhibitors or Angiotensin-II receptor antagonists should be first line drugs. PMID:27052224

  15. Type 1 diabetes mellitus presenting with diabetic ketoacidosis (DKA) in a neonate.

    PubMed

    Ahmed, Fareed; Kazi, Ghazala; Khan, Waqas

    2016-08-01

    Neonatal diabetes mellitus (NDM) is a rare manifestation with an incidence of one affected individual among 400000 live births. NDM can be divided into Transient (TNDM) and Permanent (PNDM) types. A significant overlap occurs between both groups, to an extent that TNDM cannot be distinguished from PNDM based solely on clinical features. Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus (TIDM). DKA at diagnosis is more common in young children near the age of five years. Neonatal DKA is a rare occurrence causing it to be missed in the differential diagnosis of neonatal illness and results delay in appropriate management and increase in morbidity and mortality rate. PMID:27524542

  16. [Clinical course of purulent and necrotic complications in diabetes mellitus].

    PubMed

    Genyk, S N; Grushetskiĭ, N N

    1993-05-01

    Experience in the treatment of 214 patients with diabetic angiopathy complicated by pyonecrotic processes is generalized. Adequate correction of diabetes mellitus, improvement of microcirculation, dietotherapy, and sanitation of the pyonecrotic foci are the main trends in the complex of therapeutic measures. Hemosorption was applied successfully for detoxifixation in 24 patients. Prolonged intraarterial therapy was also conducted with a [symbol: see text] B-1 gent dosing apparatus. Necrosis of the soft tissues and gangrene of the toes or foot were managed by thorough excision of the necrotic tissues and exarticulation or amputation of the toes and metatarsals, and, in exceptional cases, amputation of the limb through the thigh was resorted to. With such complex therapy the number of amputations through the middle and upper third of the thigh was reduced to 18.3%. PMID:8089982

  17. Transplantation of mesenchymal stem cells improves type 1 diabetes mellitus.

    PubMed

    Li, Lisha; Li, Furong; Gao, Feng; Yang, Yali; Liu, Yuanyuan; Guo, Pingping; Li, Yulin

    2016-05-01

    Bone-marrow-derived stem cells can regenerate pancreatic tissue in a model of type 1 diabetes mellitus. Mesenchymal stem cells (MSCs) form the main part of bone marrow. We show that the intrapancreatic transplantation of MSCs elevates serum insulin and C-peptide, while decreasing blood glucose. MSCs engrafted into the damaged rat pancreas become distributed into the blood vessels, acini, ducts, and islets. Renascent islets, islet-like clusters, and a small number of MSCs expressing insulin protein have been observed in the pancreas of diabetic rats. Intrapancreatic transplantation of MSCs triggers a series of molecular and cellular events, including differentiation towards the pancreas directly and the provision of a niche to start endogenous pancreatic regeneration, which ameliorates hypoinsulinemia and hyperglycemia caused by streptozotocin. These data establish the many roles of MSCs in the restoration of the function of an injured organ. PMID:26650464

  18. [Cytological changes in patients with diabetes mellitus and corneal ulcer].

    PubMed

    Raica, D; Turlea, M; Ciocmăreanu, M; Haidar, A; Demian, C; Jinga, F

    1999-01-01

    There were studied 11 diabetic patients, insulin dependents, from 4 were with juvenile diabetes mellitus. These were hospitalized in the Dept. Ophthalm. of the City Hospital of Arad, during 1996-1998, admitted with the diagnosis of corneal ulcer. There were made samples of the gathered secretion from the level of conjunctiva and of the grataj material, gathered at the level of the edges of the corneal ulcer. All samples were stained with the BPT-Drăgan method. There are described cytologic alterations, insisting on details that indicate the severity of the corneal disease. There are taken into consideration cytologic aspects in relationship with the clinical outcome of the disease, pointing out the cellular alterations which announce a nonfavourable prognosis. Cytologic results can improve the diagnosis and they are involved in therapeutic schedule. PMID:10641114

  19. Oxidative stress, insulin resistance, dyslipidemia and type 2 diabetes mellitus

    PubMed Central

    Tangvarasittichai, Surapon

    2015-01-01

    Oxidative stress is increased in metabolic syndrome and type 2 diabetes mellitus (T2DM) and this appears to underlie the development of cardiovascular disease, T2DM and diabetic complications. Increased oxidative stress appears to be a deleterious factor leading to insulin resistance, dyslipidemia, β-cell dysfunction, impaired glucose tolerance and ultimately leading to T2DM. Chronic oxidative stress, hyperglycemia and dyslipidemia are particularly dangerous for β-cells from lowest levels of antioxidant, have high oxidative energy requirements, decrease the gene expression of key β-cell genes and induce cell death. If β-cell functioning is impaired, it results in an under production of insulin, impairs glucose stimulated insulin secretion, fasting hyperglycemia and eventually the development of T2DM. PMID:25897356

  20. [Gestational diabetes mellitus: importance of blood glucose monitoring].

    PubMed

    Flores Le-Roux, Juana A; Benaiges Boix, David; Pedro-Botet, Juan

    2013-01-01

    Gestational diabetes mellitus (GDM) is common during pregnancy, and is frequently associated with maternal and perinatal complications. Intensive treatment of hyperglycaemia during pregnancy has been shown to reduce perinatal morbidity. In women with pregestational type 1 or 2 diabetes, hyperglycaemia during labour and delivery is an important factor in the development of neonatal hypoglycaemia. There are no generally accepted recommendations for women with GDM. Recent studies evaluating patients with GDM show that peripartum glucose control can be achieved in these women without the need for insulin use in the majority of cases. Hyperglycaemia during labour is not related with treatment established during pregnancy but rather with non-compliance of endocrinological follow-up. Factors such as ethnic origin, neonatal hypoxaemia, and large for gestational age seem to play an important role in the development of neonatal hypoglycaemia. PMID:24183482

  1. Canagliflozin Treatment in Patients with Type 2 Diabetes Mellitus

    PubMed Central

    Triplitt, Curtis; Cornell, Susan

    2015-01-01

    Current guidelines for treatment of type 2 diabetes mellitus (T2DM) indicate a patient-centered approach that should go beyond glycemic control. Of the many antihyperglycemic agents available for treatment of T2DM, sodium-glucose cotransporter 2 (SGLT2) inhibitors offer the advantages of reduced glycated hemoglobin (A1C), body weight (BW), and systolic blood pressure (SBP) and are associated with a low risk of hypoglycemia when used either as monotherapy or with other agents not typically associated with increased risk of hypoglycemia. Collaborative, multidisciplinary teams are best suited to provide care to patients with diabetes, and clinical pharmacists can enhance the care provided by these teams. This review aims to provide insight into the mode of action, pharmacology, potential drug–drug interactions, clinical benefits, and safety considerations associated with use of the SGLT2 inhibitor canagliflozin in patients with T2DM and to provide information to enhance clinical pharmacists’ understanding of canagliflozin. PMID:26523120

  2. Sweating in Systemic Abnormalities: Uremia and Diabetes Mellitus.

    PubMed

    Murota, Hiroyuki

    2016-01-01

    Sweating disorders are sometimes observed in various systemic diseases that include genetic disorders, organ damage, metabolic impairment, autoimmune diseases, and neuropathic disorders. In these diseases, various symptoms such as autonomic failures, psychopathic disorders, abnormal skin innervation, and sweat gland dysfunction can interact with one another in diverse ways, resulting in impaired sweating. This review focuses on the influence of uremia (with or without hemodialysis) and diabetes mellitus on impaired sweating. Dialysis patients perspire less, but their sweat contains higher levels of uremic toxins than do healthy subjects. Neuropathic disorders in diabetes patients develop in relation to disease severity and can impair sweating. Physicians should consider the development of various problems, such as increased body temperature, dry skin, and increased susceptibility to infection, due to decreased sweating, as they are often found in these systemic abnormalities. PMID:27584963

  3. Current view from Alzheimer disease to type 2 diabetes mellitus.

    PubMed

    Rasool, Mahmood; Malik, Arif; Qazi, Aamer M; Sheikh, Ishfaq A; Manan, Abdul; Shaheen, Sumaira; Qazi, Mahmood H; Chaudhary, Adeel G; Abuzenadah, Adel M; Asif, Muhammad; Alqahtani, Mohammed H; Iqbal, Zafar; Shaik, Munvar M; Gan, Siew H; Kamal, Mohammad A

    2014-04-01

    Alzheimer's disease (AD) is a neurodegenerative disorder that leads to memory problems. It has been associated with type 2 diabetes mellitus at both the molecular and biochemical level. Pancreatic cells have molecular similarities to the brain at the transcriptomic and proteomic levels. Several genes have been reported to be responsible for both AD and diabetes. Currently, no proper treatment is available but various therapeutic approaches are utilized worldwide for the management of these disorders and may be nanoparticles and herbal treatment of Bacopa monnieri will make promise for the treatment of AD in future. The formation of amyloids in neurons and the formation of amylin in pancreatic cells are potential links between these two disorders, which can be silent killers. PMID:24059295

  4. Therapeutic approaches to dyslipidemia in diabetes mellitus and metabolic syndrome.

    PubMed

    Cottrell, Daryl A; Marshall, Brian J; Falko, James M

    2003-07-01

    Type 2 diabetes mellitus and the closely related metabolic syndrome are associated with significant risk for cardiovascular disease. Recent evidence suggests that both conditions are increasing in epidemic proportions. Dyslipidemia is characterized by increased triglyceride-rich lipoproteins; low high-density lipoprotein cholesterol; small, dense low-density lipoprotein particles; increased postprandial lipemia; and abnormal apolipoprotein A1 and B metabolism. All these lipoprotein disturbances accelerate atherosclerosis in these patients. It is likely that many patients will need combinations of lipid-modifying therapy to achieve American Diabetes Association (ADA), Adult Treatment Panel III, and American Heart Association (AHA)/American College of Cardiology (ACC) guidelines to help prevent cardiovascular disease and death. PMID:12858129

  5. Risk assessment and management of post-transplant diabetes mellitus.

    PubMed

    Han, Eugene; Kim, Myoung Soo; Kim, Yu Seun; Kang, Eun Seok

    2016-10-01

    The success rate of organ transplantation has been increasing with advances in surgical and pharmacological techniques. However, the number of solid organ transplant recipients who require metabolic disease management is also growing. Post-transplant diabetes mellitus (PTDM) is a common complication after solid organ transplantation and is associated with risks of graft loss, cardiovascular morbidity, and mortality. Other risk factors for PTDM include older age, genetic background, obesity, hepatitis C virus infection, hypomagnesemia, and use of immunosuppressant agents (corticosteroids, calcineurin inhibitors, and mammalian target of rapamycin inhibitor). Management of PTDM should be started before the transplantation plan to properly screen high-risk patients. Even though PTDM management is similar to that of general type 2 diabetes, therapeutic approaches must be made with consideration of drug interactions between immunosuppressive agents, glucose-lowering medications, and graft rejection and function. PMID:27621191

  6. [What is the natural history of type 2 diabetes mellitus].

    PubMed

    Kawamori, Ryuzo

    2015-03-01

    Type 2 diabetes mellitus (T2DM) is widely accepted as the progressive disease. It is natural to think, if the newly diagnosed patient does not change the life-style habits and does not receive any medications, the state of T2DM will become more seriously. However, in this article, how to arrest the natural history of T2DM will be discussed by summarizing the recent findings on this topic. Those are; autophagy of pancreatic β cell: a sweet process to diabetes, hyperglycemia-induced oxidative stress on β cell function, zinc, insulin and the liver, and so on. In short, the important things are; people should know the reasons why minor abnormalities have happened, and the practitioners have to try hard to remove such causes triggering T2DM. PMID:25812360

  7. Effect of Diabetes Mellitus on Outcomes of Colorectal Cancer

    PubMed Central

    Noh, Geum Youb; Hwang, Dae-Yong; Choi, Yoon Hee

    2010-01-01

    Purpose Many studies have revealed that diabetes mellitus (DM) increases a person's lifetime risk of colorectal cancer and that DM is associated with a worse outcome of colon cancer, but this association is controversial. In this study, we intended to examine the relationship between DM and the long-term outcomes of colorectal cancer. Methods A retrospective analysis was conducted on 657 patients who underwent surgery due to colorectal cancer between 1997 and 2004 at Korea Cancer Center Hospital. The operations were done by a single surgeon. With a median follow-up of 4.7 years, we analyzed differences in recurrence-free survival (RFS) and overall survival (OS) between patients with DM and those without DM. Results Of the 657 patients, 374 (57%) were males and 67 (10%) had DM. There was no difference in age at diagnosis, sex and pathologic stage of colorectal cancer according to the presence of DM. There were no difference in the RFS and the OS of colon cancer between the patients with DM and those without DM. At 5 years, the RFS was 71.3% in diabetic patients vs. 70.4% in non-diabetic patients (P = 0.480), and the OS was 68.8% in diabetic patients vs. 75.0% in non-diabetic patients (P = 0.498). There was no difference in the median survival between the groups (9.6 years in the diabetic group vs. 10.6 years in the non-diabetic group; P = 0.495). Conclusion In this study, we did not find any relation between the presence of DM and either the recurrence or the survival in cases of colorectal cancer. More studies to elucidate whether the influence of DM is directly related to a higher rate of cancer recurrence or survival are needed. PMID:21221244

  8. Diabetes Mellitus and Blood-Brain Barrier Dysfunction: An Overview

    PubMed Central

    Prasad, Shikha; Sajja, Ravi K; Naik, Pooja; Cucullo, Luca

    2015-01-01

    A host of diabetes-related insults to the central nervous system (CNS) have been clearly documented in type-1 and -2 diabetic patients as well as experimental animal models. These host of neurological disorders encompass hemodynamic impairments (e.g., stroke), vascular dementia, cognitive deficits (mild to moderate), as well as a number of neurochemical, electrophysiological and behavioral alterations. The underlying causes of diabetes-induced CNS complications are multifactorial and are relatively little understood although it is now evident that blood-brain barrier (BBB) damage plays a significant role in diabetes-dependent CNS disorders. Changes in plasma glucose levels (hyper- or hypoglycemia) have been associated with altered BBB transport functions (e.g., glucose, insulin, choline, amino acids, etc.), integrity (tight junction disruption), and oxidative stress in the CNS microcapillaries. Last two implicating a potential causal role for upregulation and activation of the receptor for advanced glycation end products (RAGE). This type I membrane-protein also transports amyloid-beta (Aβ) from the blood into the brain across the BBB thus, establishing a link between type 2 diabetes mellitus (T2DM) and Alzheimer’s disease (AD, also referred to as “type 3 diabetes”). Hyperglycemia has been associated with progression of cerebral ischemia and the consequent enhancement of secondary brain injury. Difficulty in detecting vascular impairments in the large, heterogeneous brain microvascular bed and dissecting out the impact of hyper- and hypoglycemia in vivo has led to controversial results especially with regard to the effects of diabetes on BBB. In this article, we review the major findings and current knowledge with regard to the impact of diabetes on BBB integrity and function as well as specific brain microvascular effects of hyper- and hypoglycemia. PMID:25632404

  9. Comparative analysis of current diagnostic criteria for gestational diabetes mellitus

    PubMed Central

    Boyadzhieva, Mariya V; Atanasova, Iliana; Zacharieva, Sabina; Tankova, Tsvetalina; Dimitrova, Violeta

    2012-01-01

    Background To compare current guidelines for diagnosis of gestational diabetes mellitus (GDM) and to identify the ones that are the most relevant for application among pregnant Bulgarian population. Methods A total of 800 pregnant women at high risk for GDM underwent 75 g oral glucose tolerance test between 24 and 28 weeks of gestation as antenatal screening. The results were interpreted and classified according to the guidelines of the International Association of Diabetes and Pregnancy Study Groups (IADPSG), American Diabetes Association (ADA), Australasian Diabetes in Pregnancy Society, Canadian Diabetes Association, European Association for the Study of Diabetes, New Zealand Society for the study of Diabetes and World Health Organization. Results The application of different diagnostic criteria resulted in prevalences of GDM between 10.8% and 31.6%. Using any two sets of criteria, women who were classified differently varied between 0.1% and 21.1% (P < 0.001).The IADPSG criteria were the most inclusive criteria and resulted in the highest prevalence of GDM. There was a significant difference in the major metabolic parameters between GDM and control groups, regardless of which of the diagnostic criteria applied. GDM diagnosed according to all criteria resulted in increased proportion of delivery by caesarean section (CS). However, only ADA and IADPSG criteria identified both increased macrosomia (odds ratio, 2.36; 2.29) and CS rate. Conclusion The need for GDM screening is indisputable. In our view, the new IADPSG guidelines offer a unique opportunity for a unified national and global approach to GDM.

  10. Skin and diabetes mellitus: what do we know?

    PubMed

    Quondamatteo, Fabio

    2014-01-01

    Diabetes mellitus (DM) is becoming increasingly prevalent worldwide. Although major complications of this condition involve kidney, retina and peripheral nerves, the skin of diabetic patients is also frequently injured. Hence, interest is mounting in the definition of the structural and molecular profile of non-complicated diabetic skin, i.e., before injuries occur. Most of the available knowledge in this area has been obtained relatively recently and, in part, derives from various diabetic animal models. These include both insulin-dependent and insulin-resistant models. Structural work in human diabetic skin has also been carried out by means of tissue samples or of non-invasive methods. Indications have indeed been found for molecular/structural changes in diabetic skin. However, the overall picture that emerges is heterogeneous, incomplete and often contradictory and many questions remain unanswered. This review aims to detail, as much as possible, the various pieces of current knowledge in a systematic and synoptic manner. This should aid the identification of areas in which key questions are still open and more research is needed. A comprehensive understanding of this field could help in determining molecular targets for the prevention and treatment of skin injuries in DM and markers for the monitoring of cutaneous and systemic aspects of the disease. Additionally, with the increasing development of non-invasive optics-based deep-tissue-imaging diagnostic technologies, precise knowledge of cutaneous texture and molecular structure becomes an important pre-requisite for the use of such methods in diabetic patients. PMID:24318789

  11. Association between Serum Albumin Concentration and Ketosis Risk in Hospitalized Individuals with Type 2 Diabetes Mellitus

    PubMed Central

    2016-01-01

    Objective. This study examined the association between serum albumin concentration and ketosis risk in hospitalized individuals with type 2 diabetes mellitus (T2DM). Methods. A retrospective cross-sectional study was conducted at a medical center in Taiwan. Inclusion criteria were endocrinology ward inpatients exceeding 21 years of age, with preexisting diagnosis of T2DM, and blood glucose above 13.9 millimoles per liter (mmol/L) at admission. Individuals without measurement of serum albumin, urine ketone, or hemoglobin A1C, or harboring active infection, myocardial infarction, cerebrovascular event, cirrhosis, malignancy, or overt proteinuria were excluded. Using serum albumin concentration below 3.0 grams per deciliter to define hypoalbuminemia, 151 hypoalbuminemic cases and 104 normoalbuminemic controls were enrolled. The presence of ketones in urine established ketosis. Results. The prevalence of ketonuria was 48% in hypoalbuminemic subjects compared to 30% in normoalbuminemic controls (odds ratio (OR): 2.15; 95% confidence interval (CI): 1.26–3.57; P = 0.004). Moreover, among the 156 subjects with serum beta-hydroxybutyrate measurement in addition to urine ketone, 33% of the hypoalbuminemic individuals had ketonemia exceeding 3 mmol/L compared to 19% of those with normoalbuminemia (OR: 2.12, 95% CI: 0.99–4.48, P = 0.051). Conclusions. Serum albumin concentration is inversely associated with ketosis risk in hospitalized individuals with T2DM. PMID:27504458

  12. Attenuating type 2 diabetes with postpartum interventions following gestational diabetes mellitus

    PubMed Central

    Wasalathanthri, Sudharshani

    2015-01-01

    Women with a history of gestational diabetes should be screened during and after the postpartum period because of a high risk for developing type 2 diabetes mellitus. Although differences exist between guidelines practiced throughout various parts of the world, all recommend the use of cutoffs for fasting and/or post-load plasma glucose to diagnose diabetes or pre-diabetes. The use of these glycemic parameters could be optimized when a trend is observed, rather than considering them as isolated values at various time points. As the presence of insulin resistance and beta-cell dysfunction start before glycemic changes are evident, the estimation of insulin sensitivity and beta-cell function by Homeostatic Model Assessment is suggested for women who have additional risk factors for diabetes, such as obesity. Disease-modifying lifestyle intervention should be the first-line strategy to prevent or delay the onset of diabetes in women with a history of gestational diabetes mellitus. Intensive lifestyle interventions are designed to decrease caloric intake and increase physical activity in order to reduce body weight and fat, which will in turn reduce insulin resistance. This article also reviews unique problems of postpartum women, which should be considered when designing and implementing an intervention. Innovative “out of the box” thinking is appreciated, as continued adherence to a program is a challenge to both the women and the health care personnel who deal with them. PMID:25987963

  13. Type 2 diabetes mellitus, glycemic control, and cancer risk.

    PubMed

    Onitilo, Adedayo A; Stankowski, Rachel V; Berg, Richard L; Engel, Jessica M; Glurich, Ingrid; Williams, Gail M; Doi, Suhail A

    2014-03-01

    Type 2 diabetes mellitus is characterized by prolonged hyperinsulinemia, insulin resistance, and progressive hyperglycemia. Disease management relies on glycemic control through diet, exercise, and pharmacological intervention. The goal of the present study was to examine the effects of glycemic control and the use of glucose-lowering medication on the risk of breast, prostate, and colon cancer. Patients diagnosed with type 2 diabetes mellitus (N=9486) between 1 January 1995 and 31 December 2009 were identified and data on glycemic control (hemoglobin A1c, glucose), glucose-lowering medication use (insulin, metformin, sulfonylurea), age, BMI, date of diabetes diagnosis, insurance status, comorbidities, smoking history, location of residence, and cancer diagnoses were electronically abstracted. Cox proportional hazards regression modeling was used to examine the relationship between glycemic control, including medication use, and cancer risk. The results varied by cancer type and medication exposure. There was no association between glycemic control and breast or colon cancer; however, prostate cancer risk was significantly higher with better glycemic control (hemoglobin A1c ≤ 7.0%). Insulin use was associated with increased colon cancer incidence in women, but not with colon cancer in men or breast or prostate cancer risk. Metformin exposure was associated with reduced breast and prostate cancer incidence, but had no association with colon cancer risk. Sulfonylurea exposure was not associated with risk of any type of cancer. The data reported here support hyperinsulinemia, rather than hyperglycemia, as a major diabetes-related factor associated with increased risk of breast and colon cancer. In contrast, hyperglycemia appears to be protective in the case of prostate cancer. PMID:23962874

  14. Macroscopic placental changes associated with fetal and maternal events in diabetes mellitus

    PubMed Central

    Salge, Ana Karina Marques; Rocha, Karlla Morgana Nunes; Xavier, Raphaela Maioni; Ramalho, Wilzianne Silva; Rocha, Érika Lopes; Guimarães, Janaína Valadares; Silva, Renata Calciolari Rossi e; Siqueira, Karina Machado; Abdalla, Douglas Reis; Michelin, Márcia Antoniazzi; Murta, Eddie Fernando Candido

    2012-01-01

    OBJECTIVES: The current study sought to identify macroscopic placental changes associated with clinical conditions in women with or without diabetes and their newborns. METHODS: The study population consisted of 62 pregnant women clinically diagnosed with diabetes and 62 healthy women (control group). RESULTS: Among the subjects with diabetes, 43 women (69.3%) were diagnosed with gestational diabetes mellitus, 15 had diabetes mellitus I (24.2%), and four had diabetes mellitus II (6.5%). The mean age of the women studied was 28.5±5.71 years, and the mean gestational age of the diabetic women was 38.51 weeks. Of the 62 placentas from diabetic pregnancies, 49 (79%) maternal surfaces and 59 (95.2%) fetal surfaces showed abnormalities, including calcium and fibrin deposits, placental infarction, hematoma, and fibrosis. A statistical association was found between newborn gender and fetal and maternal placental changes (p = 0.002). The mean weight of the newborns studied was 3,287±563 g for women with diabetes mellitus, 3,205±544 g for those with gestational diabetes mellitus, 3,563±696 g for those with diabetes mellitus II, and 3,095±451 g for those with diabetes mellitus I. CONCLUSIONS: Infarction, hematoma, calcification, and fibrin were found on the maternal and fetal placental surfaces in women with diabetes. Women with gestational diabetes and post-term infants had more calcium deposits on the maternal placental surface as compared to those with type I and type II diabetes. PMID:23070348

  15. Aspirin sensitivity of platelet aggregation in diabetes mellitus.

    PubMed

    Albert, Stewart G; Hasnain, Bibi I; Ritter, Detlef G; Joist, J Heinrich; Mooradian, Arshag D

    2005-11-01

    Although aspirin is cardioprotective in high-risk populations, many with diabetes mellitus (DM) are unresponsive to these benefits. We questioned whether cardiovascular unresponsiveness might be demonstrated by lack of aspirin sensitivity to in vitro platelet functions especially in subjects with poorly controlled diabetes. Six women and 4 men (48+/-8 years [mean+/-S.D.]), selected for poor control (glycohemoglobin 11.9+/-2.2%) and 10 sex-age (+/-5 years) matched controls received 81 mg aspirin daily. There was a 2-week washout from aspirin and related drugs. After the aspirin dose on day-7, blood for platelet aggregation assays, and 24-h urine for 2,3 dinor thromboxane B2 (TxB2) and 2,3 dinor 6-keto (PGF1alpha) were obtained. Aspirin sensitivity was defined as inhibition (i.e., lower than expected) platelet aggregation after exposure to an agonist. Those with diabetes and controls were sensitive to aspirin inhibition of platelet aggregation induced by 1.6 mM arachidonic acid (9.5+/-3.9% versus 9.1+/-3.1%, normal range 40-100%) and by 0.83 microg/mL collagen (17.4+/-13.9% versus 13.2+/-9.3%, normal range 60-93%), respectively. Aspirin sensitivity to 2 microM ADP was present in five with diabetes and five controls. Urinary prostaglandin metabolites were suppressed below reference ranges, without differences between those with DM or controls for TxB2 (350+/-149 pg/mg versus 348+/-93 pg/mg creatinine) and PGF1alpha (255+/-104 pg/mg versus 222+/-88 pg/mg creatinine). In conclusion, in poorly controlled diabetes, there was no differential lack of aspirin sensitivity to platelet aggregation, or lack of aspirin suppression of urinary TxB2 or PGF1alpha, compared with controls on aspirin. Despite suppression of urinary prostaglandin metabolites, aspirin resistance was most apparent to ADP-mediated platelet aggregation. It is not known what level of inhibition of in vitro tests is necessary for the cardioprotective benefits of aspirin in diabetes mellitus. Thus, the lack of

  16. [Homocysteinaemia and degenerative complications in non insulin dependent diabetes mellitus].

    PubMed

    Zied, Aouni; Oudi, M; Chahib, Mazigh; Olfa, Essaies; Brahim, Nsiri; Hédi, M'henni; Habib, Haouala; Borni, Zidi; Salem, Machghoul

    2005-09-01

    Type 2 diabetes mellitus (non insulin-dependent diabetes mellitus: NIDDM) is known to be associated with degenerative complications. Although, the pathophysiology of such complications is well known, the role of homocysteine (Hcy) is still discussed. The aim of the present study was to evaluate the relationship between the homocysteine levels and the NIDDM related complications in a group of NIDDM patients. Our study population consisted of 41 NIDDM patients including 13 subjects (G1) without complications (group controls), 17 patients (G2) with microangiopathy and 11 patients (G3) with coronary deficiency. Plasmatic homocysteine, glycemia, glycated haemoglobin (HbA1C) and lipidic parameters were essessed in all patients. Our results showed that mean levels of plasmatic homocysteine were within the normal range (10.4 +/- 3.3 micromol/l, 9.9 +/- 5.5 micromol/l and 14.8 +/- 10.4 micromol/l in G1, G2 and G3 respectively). Nevertheless, moderate hyperhomocysteinaemia was found in 36% in the coronary group (G3), 17.3% in patients with microangiopathy (G2) and 7.7% in controls. These preliminary results showed that cardiovascular complications in NIDDM patients may be related to high levels of homocysteine. PMID:16383199

  17. A Combined Metabolomic and Proteomic Analysis of Gestational Diabetes Mellitus

    PubMed Central

    Hajduk, Joanna; Klupczynska, Agnieszka; Dereziński, Paweł; Matysiak, Jan; Kokot, Piotr; Nowak, Dorota M.; Gajęcka, Marzena; Nowak-Markwitz, Ewa; Kokot, Zenon J.

    2015-01-01

    The aim of this pilot study was to apply a novel combined metabolomic and proteomic approach in analysis of gestational diabetes mellitus. The investigation was performed with plasma samples derived from pregnant women with diagnosed gestational diabetes mellitus (n = 18) and a matched control group (n = 13). The mass spectrometry-based analyses allowed to determine 42 free amino acids and low molecular-weight peptide profiles. Different expressions of several peptides and altered amino acid profiles were observed in the analyzed groups. The combination of proteomic and metabolomic data allowed obtaining the model with a high discriminatory power, where amino acids ethanolamine, l-citrulline, l-asparagine, and peptide ions with m/z 1488.59; 4111.89 and 2913.15 had the highest contribution to the model. The sensitivity (94.44%) and specificity (84.62%), as well as the total group membership classification value (90.32%) calculated from the post hoc classification matrix of a joint model were the highest when compared with a single analysis of either amino acid levels or peptide ion intensities. The obtained results indicated a high potential of integration of proteomic and metabolomics analysis regardless the sample size. This promising approach together with clinical evaluation of the subjects can also be used in the study of other diseases. PMID:26694367

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

    SciTech Connect

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

    1987-02-01

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

  19. Early Postpartum Glucose Testing in Women with Gestational Diabetes Mellitus.

    PubMed

    Werner, Erika F; Has, Phinnara; Tarabulsi, Gofran; Lee, Joyce; Satin, Andrew

    2016-08-01

    Objective Given that most women with gestational diabetes mellitus (GDM) never undergo the recommended 6 to 12 weeks postpartum glucose tolerance test (GTT), we assessed the feasibility of performing GTTs on postpartum day 2. Study Design We conducted a prospective cohort study in which women with GDM received a 75-g 2-hour GTT on postpartum day 2. We assessed the feasibility of this GTT and compared the results to the standard of care GTT at 6 to 12 weeks postpartum. We also evaluated maternal and pregnancy characteristics of women who return for 6 to 12 weeks GTTs compared with those lost to follow-up. Results In this study, 98 of 106 participants (92%) completed the postpartum day 2 GTT; 59% had normal glucose values at that time. Only 49 women returned at 6 to 12 weeks postpartum. Among women who had testing at both time points, the 2 days postpartum GTT were 100% sensitive and 94% specific for diabetes mellitus but less sensitive and specific for milder forms of abnormal glucose. Women who did not complete the 6 to 12 weeks postpartum GTT were less educated (p < 0.01) and more often had Medicaid (p < 0.01). Conclusion Performing GTTs on postpartum day 2 is feasible and should be further investigated as an alternative postpartum testing regimen in GDM. PMID:27120481

  20. ASSESSMENT OF RISK FACTORS FOR DIABETES MELLITUS TYPE 2

    PubMed Central

    Begic, Edin; Arnautovic, Amira; Masic, Izet

    2016-01-01

    Introduction: Diabetes is a group of metabolic diseases characterized by hyperglycemia, and represents a disease of the modern age, disease of the 21st century. Prevention of this disease is listed as imperative. Aim of this article was to evaluate questionnaires on the assessment of risk factors for Diabetes Mellitus type 2. Material and Methods: A total of 540 questionnaires handed out randomly to citizens of Canton Sarajevo of all ages, sexes and educational levels (in January 2016) were analyzed. Results: Analyzed questionnaires showed relatively low risk of getting diabetes in the next ten years in the majority of the population. These results are rather encouraging but may in some way be in confrontation with the statistics which show a rapid outburst of diabetes. Conclusion: The life-style is the main reason for such a thing to happen, and looking at these questionnaires, we might get the feeling that we really do live in a, conditionally speaking, physically active society. That, from our everyday experience is not entirely true. It would be wise to continue doing research on this topic on the territory of Bosnia and Herzegovina. PMID:27482159

  1. Trends in the Diagnosis of Gestational Diabetes Mellitus

    PubMed Central

    Mishra, Surabhi; Rao, Chythra R.; Shetty, Avinash

    2016-01-01

    Introduction. Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable degree with onset or recognition during pregnancy. As prevalence of diabetes is linked to impaired glucose tolerance during antenatal period, routine antenatal screening of GDM is required. However, screening tests for GDM remain controversial. Objective. To review different diagnostic criteria for GDM. Materials and Methods. Freely accessible, full-text articles from 1964 to 2015, available in PubMed in English language, pertaining to screening of GDM were reviewed. Results. First diagnostic criteria for GDM in 1964 by O'Sullivan and Mahan, modified by the National Diabetes Data Group (NDDG) in 1979 and Carpenter in 1982. The cut-off value as per WHO definition of GDM was 140 mg/dL, 2 hours after 75 g glucose intake. Diabetes in Pregnancy Study Group India (DIPSI), in 2006, endorsed WHO criteria but irrespective of the last meal timings. Being cost-effective, it formed the basis of national guidelines for Indians in 2014. Conclusions. As typical clinical scenarios are usually varied, practical guidelines that meet the constraints of low-resource settings like India are required. PMID:27190681

  2. Pharmacologic Treatment Strategies in Children with Type 2 Diabetes Mellitus

    PubMed Central

    Urakami, Tatsuhiko; Kuwabara, Remi; Habu, Masako; Yoshida, Ayako; Okuno, Misako; Suzuki, Junichi; Takahashi, Shori; Mugishima, Hideo

    2013-01-01

    We treated 80 obese and 28 nonobese children diagnosed as having type 2 diabetes mellitus (T2DM). Among these patients, 26 obese and 23 nonobese children were assigned to pharmacologic therapies during the course of diabetes. Pharmacologic therapies were started if the HbA1c (NGSP) value exceeded 7.0% despite dietary and exercise management. For the 26 obese patients, metformin alone or in combination with an additional medication was frequently used. Only 2 patients independently received sulfonylureas (SUs) in the form of glimepiride. In addition, 9 patients were treated with basal insulin supported with oral hypoglycemic drugs (OHDs) or biphasic premix insulin. On the other hand, the 23 nonobese patients were frequently treated with insulin alone or in combination with an additional medication followed by SUs. The nonobese patients tended to require pharmacologic therapies, in particular insulin, at an earlier stage of diabetes as compared with the obese patients. New antidiabetic drugs, DPP-4 inhibitors and GLP-1 receptor agonists, seemed to exert positive effects on glycemic control without occurrence of hypoglycemic episodes in some patients regardless of the type of diabetes. These results suggest that pharmacologic treatment strategies in childhood T2DM should be tailored to individual patient characteristics. PMID:23966754

  3. [Diabetes mellitus in childhood and adolescence. Clinical types].

    PubMed

    Sires, J M

    1979-01-01

    It is today's general medical opinion that children's diabetes mellitus was uncommon in the past. It was generally admitted at that time the initail stages were so sudden as to make difficut its early diagnosis. It's increased incidence is at present an alarming truth; however, a parallel increase of diabetic coma or of mulminant types has rather dropped. Diabetes may be diagnosed by just considering the main symptoms at the onset which are polydipsia, polyuria and weight loss. If an early diagnosis is not made, acidosis (abdominal pain, nausea, vomiting) may appear within a few days or weeks followed by coma (Kussamul's acidotic respiration and dehydration). Coma may be avoided by an early diagnosis and a life may be saved. It must be stressed that an important percentage of children and adolescents show a slow and gradual evolution (week or months) of their diabetes: gradual weight loss, sometimes with noticeable polyphagia, occasional enuresis, but without other associated symptoms. Asymptomatic, intermittent glucosurias are also frequent; they vary in magnitude an almost always they appear without ketonuria and with fasting normal glycemia. According to our experience they may precede in weeks or months the clinical manifestations of the disease. Postprandial glycemia is a sure diagnostic resource; it is of greater trustworthines than fasting glycemia; therefore we advise it as a routine diagnostic procedure which we recommend widely. In uncertain situations, the oral glucose tolerance test is advisable. PMID:486258

  4. Involvement of liver in diabetes mellitus: herbal remedies.

    PubMed

    Thent, Z C; Das, S

    2014-01-01

    Liver disease is considered as one of the major complications in oxidative stress disorders like diabetes mellitus (DM). DM presents with deterioration in carbohydrate metabolism which is characterized with chronic hyperglycemia. The organ which involves in glucose or carbohydrate metabolism and is most likely to be affected is the liver. Deterioration in liver architecture and metabolism in DM, are considered as common findings. In the present review both biochemical and histological changes occurring in diabetic liver are conferred in detail. To counteract the oxidative stress disorders and its untoward complications, antioxidant or herbs have emerged as alternative medicine. The present review focuses on several herbs with antioxidant properties towards diabetic liver disease such as Liquorice, Pelargonium gravenolens, Momordica charantia, Propolis from bee hives, Dihar, Curcuma Longa, Tinospora cordifolia, Kangen-karyu, Parsley, Chard, Green tea Catechins and Piper sarmentosum (P.s). The herbs or the compounds present in herbs have potential to improve the liver metabolism and maintain the integrity of liver tissue in DM. The review also opens the door for effective use of herbal products for complications involved in the diabetic liver disease. PMID:25203338

  5. Application of Berberine on Treating Type 2 Diabetes Mellitus

    PubMed Central

    Pang, Bing; Zhao, Lin-Hua; Zhou, Qiang; Zhao, Tian-Yu; Wang, Han; Gu, Cheng-Juan; Tong, Xiao-Lin

    2015-01-01

    Traditional Chinese medicine (TCM) performs a good clinical practice and is showing a bright future in the treatment of diabetes mellitus (DM). TCM treatment has certain advantages of less toxicity and/or side effects, and herbs could provide multiple therapeutic effects. Berberine (BBR) is a classical natural medicine. In this review, we summarize the application of BBR in the treatment of DM from two aspects. First, modern pharmacological effects of BBR on glucose metabolism are summarized, such as improving insulin resistance, promoting insulin secretion, inhibiting gluconeogenesis in liver, stimulating glycolysis in peripheral tissue cells, modulating gut microbiota, reducing intestinal absorption of glucose, and regulating lipid metabolism. BBR is used to treat diabetic nephropathy (DPN), diabetic neuropathy (DN), and diabetic cardiomyopathy due to its antioxidant and anti-inflammatory activities. Second, the clinical application of BBR is reviewed, such as listing some clinical trials on the effectiveness and safety of BBR, explaining applicable stage and syndrome, the reasonable dose and dose formulation, and the toxicity and/or side effects. This review provides scientific evidence about BBR, as well as introducing some traditional Chinese medical theory and clinical experience, in order to guide clinician to use BBR more suitably and reasonably. PMID:25861268

  6. Development of automated analytical capability for the early detection of diabetes mellitus

    NASA Technical Reports Server (NTRS)

    Zlatkis, A.

    1976-01-01

    The total profile of volatile metabolites in urine of patients with diabetes mellitus was studied. Because of the drastic abnormalities in the metabolism of carbohydrates, lipids, and proteins connected with diabetes it was expected that apart from acetone further characteristic abnormalities occur in the profiles if volatile urinary metabolites in cases of diabetes mellitus. Quantitative and qualitative changes were found in these urines as compared to the urines of normal subjects.

  7. Sexual Dysfunction in Women with Type 2 Diabetes Mellitus

    PubMed Central

    Elyasi, Forouzan; Kashi, Zahra; Tasfieh, Bentolhoda; Bahar, Adele; Khademloo, Mohammad

    2015-01-01

    Background Sexual dysfunction (SD) is one of the important problems in diabetic patients. The present study aimed to determine the prevalence of sexual problems in Iranian women with type 2 diabetes mellitus. Methods A cross-sectional study was conducted among type 2 diabetic women who visited two outpatient endocrine clinics, namely Imam Hospital and Tuba clinic (Sari, Iran) in 2012. Patients were asked to complete two validated questionnaires: Female Sexual Function Index (FSFI) and The Hospital Anxiety and Depression Scale (HADS) as well as a demographic questionnaire. Analysis was performed using descriptive and analytical tests. P<0.05 was considered to be significant. Results One hundred and fifty women with type 2 diabetes were investigated. Most of the cases aged 40-44 years old. The mean of the total score of the FSFI questionnaire was 22. The prevalence of sexual dysfunction was 78.7% (CI: 71.4-84.4); among these, 58% (CI: 50.0-65.6) reported problems in lubrication, 50% (CI: 42.1-57.9) complained of decreased sexual desire, 50% (CI: 42.1-57.9) had problems with arousal, 47.3% (CI: 39.5-55.3) had dyspareunia, 32.7% (CI: 25.7-40.5) complained of orgasmic dysfunction and 42.7% (CI: 35.0-50.7) reported problems in sexual satisfaction. With regard to the results of the HADS questionnaire, 58.7% (CI: 50.7-66.2) of the patients had depression and 96.7% (CI: 92.4-98.6) had anxiety. Conclusion This study showed the high prevalence of sexual dysfunction in diabetic women, especially among those complaining of depression. Health care professionals dealing with diabetic patients should be aware of possible presence of sexual dysfunction in female patients. PMID:25999619

  8. 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. PMID:26097823

  9. Resistin: a potential biomarker for periodontitis influenced diabetes mellitus and diabetes induced periodontitis.

    PubMed

    Devanoorkar, Archana; Kathariya, Rahul; Guttiganur, Nagappa; Gopalakrishnan, D; Bagchi, Paulami

    2014-01-01

    Biomarkers are highly specific and sensitive indicators of disease activity. Resistin is a recently discovered adipocytokine, having a potent biomarker quality. Initially resistin was thought to be produced by adipocytes alone; however, emerging evidence suggests that it is also produced in abundance by various cells of the immunoinflammatory system, indicating its role in various chronic inflammatory diseases. Data suggests that resistin plays a role in obesity, insulin resistance, cardiovascular diseases, and periodontitis. Resistin derived its name from the original observation that it induced insulin resistance (resist-in: resist insulin) in mice and is downregulated in mature murine adipocytes cultured in the presence of insulin sensitizing drugs like thiazolidinediones. It is well recognized that obesity, is associated with insulin resistance and diabetes. A three-way relationship has been established between diabetes, obesity and periodontitis. Recent evidence also suggests an association between obesity and increased risk for periodontitis. Our previous research showed incremental elevation of resistin with periodontal disease activity and a reduced level of resistin, after periodontal therapy. Thus resistin would be one of the molecular links connecting obesity, periodontitis, and diabetes and may serve as a marker that links periodontal disease with other systemic diseases. A Medline/PubMed search was carried out for keywords "Diabetes Mellitus," "Periodontitis," and "Resistin," and all relevant research papers from 1990 in English were shortlisted and finalized based on their importance. This review provides an insight into the biological action of resistin and its possible role in periodontitis influenced diabetes mellitus and diabetes induced periodontitis. PMID:24692844

  10. Management of Type 2 Diabetes Mellitus through Telemedicine

    PubMed Central

    Cipolla, Maurizio; Merante, Valentina; Medaglia, Valeria; Irace, Concetta; Gnasso, Agostino

    2015-01-01

    Background Type 2 diabetes mellitus T2DM has a huge and growing burden on public health, whereas new care models are not implemented into clinical practice; in fact the purpose of this study was to test the effectiveness of a program of integrated care for T2DM, compared with ordinary diligence. Methods "Progetto Diabete Calabria" is a new organizational model for the management of patients with diabetes mellitus, based on General Practitioners (GPs) empowerment and the use of a web-based electronic health record, shared in remote consultations among GPs and Hospital Consultants. One-year change in glucose and main cardiovascular risk factors control in 104 patients (Cases) following this integrated care program has been evaluated and compared with that of 208 control patients (Controls) matched for age, gender, and cardiometabolic profile, and followed in an ordinary outpatient medical management by the Consultants only. Both patient groups had Day Hospitals before and after the study period. Results The mean number of accesses to the Consultants during the study was 0.6±0.9 for Cases, and 1.3±1.5 for Controls (p<0.0001). At follow-up, glycated hemoglobin (HbA1c) significantly decreased from 58±6 to 54±8 mmol/mol in Cases only (p=0.01); LDL cholesterol decreased in both groups; body mass index decreased in Cases only, from 31.0±4.8 to 30.5±4.6 kg/m2 (p=0.03). Conclusions The present study demonstrates that a health care program based on GPs empowerment and taking care plus remote consultation with Consultants is at least as effective as standard outpatient management, in order to improve the control of T2DM. PMID:25974092

  11. Is There a Tendency for Thrombosis in Gestational Diabetes Mellitus?

    PubMed Central

    Gorar, Suheyla; Alioglu, Bulent; Ademoglu, Esranur; Uyar, Seyit; Bekdemir, Handan; Candan, Zehra; Saglam, Beylan; Koc, Gonul; Culha, Cavit; Aral, Yalcin

    2016-01-01

    Context: Impact of gestational diabetes mellitus (GDM) on the coagulation system, dynamics involved at a pathophysiological level and the exact mechanism remain unclear. Aims: To evaluate the association between diabetes-related parameters and hemostatic factors to search for a tendency of thrombosis in GDM. Settings and Design: Nineteen pregnant women who had GDM, 16 healthy pregnant and 13 healthy nonpregnant controls admitted to the Endocrinology outpatient clinics were enrolled in the study. Subjects and Methods: Fasting and postprandial glucose, hemoglobin A1c and insulin levels, and insulin resistance; fructosamine, thrombin activatable fibrinolysis inhibitor (TAFI), tissue factor pathway inhibitor (TFPI), plasminogen activator inhibitor Type-1 (PAI-1), tissue-type plasminogen activator (t-PA), fibrinogen, plasminogen and hemoglobin levels, platelet counts, prothrombin time (PT), and activated partial thromboplastin time (aPTT) were studied. Statistical Analysis Used: One-way analysis of variance, Kruskal–Wallis, and post hoc Tukey honestly significant difference or Conover's nonparametric multiple comparison tests for comparison of the study groups. Results: PT and aPTT were significantly lower in GDM patients compared to controls (P < 0.05), whereas fibrinogen and plasminogen levels were significantly higher in this group compared to both nonpregnant and healthy pregnant controls (P < 0.05 for each). TAFI, TFPI, PAI-1, and tissue t-PA levels were not significantly different among groups. Conclusions: Our findings indicate tendency to develop thrombosis in GDM similar to diabetes mellitus; but more comprehensive studies with larger sample size are needed to determine the relationship between GDM and hemostasis. PMID:27365919

  12. The Prelude on Novel Receptor and Ligand Targets Involved in the Treatment of Diabetes Mellitus

    PubMed Central

    Jonnalagadda, Venu Gopal; Ram Raju, Allam Venkata Sita; Pittala, Srinivas; Shaik, Afsar; Selkar, Nilakash Annaji

    2014-01-01

    Metabolic disorders are a group of disorders, due to the disruption of the normal metabolic process at a cellular level. Diabetes Mellitus and Tyrosinaemia are the majorly reported metabolic disorders. Among them, Diabetes Mellitus is a one of the leading metabolic syndrome, affecting 5 to 7 % of the population worldwide and mainly characterised by elevated levels of glucose and is associated with two types of physiological event disturbances such as impaired insulin secretion and insulin resistance. Up to now, various treatment strategies are like insulin, alphaglucosidase inhibitors, biguanides, incretins were being followed. Concurrently, various novel therapeutic strategies are required to advance the therapy of Diabetes mellitus. For the last few decades, there has been an extensive research in understanding the metabolic pathways involved in Diabetes Mellitus at the cellular level and having the profound knowledge on cell-growth, cell-cycle, and apoptosis at a molecular level provides new targets for the treatment of Diabetes Mellitus. Receptor signalling has been involved in these mechanisms, to translate the information coming from outside. To understand the various receptors involved in these pathways, we must have a sound knowledge on receptors and ligands involved in it. This review mainly summarises the receptors and ligands which are involved the Diabetes Mellitus. Finally, researchers have to develop the alternative chemical moieties that retain their affinity to receptors and efficacy. Diabetes Mellitus being a metabolic disorder due to the glucose surfeit, demands the need for regular exercise along with dietary changes. PMID:24754003

  13. A clinical study of the relationship between diabetes mellitus and periodontal disease

    PubMed Central

    Rajhans, Neelima S.; Kohad, Ramesh M.; Chaudhari, Viren G.; Mhaske, Nilkanth H.

    2011-01-01

    The relationship between diabetes mellitus and periodontal disease is not clear, even though studied intensively. From the available data, it seemed reasonable to believe that diabetics were more susceptible to periodontal disease than non.diabetics. Aim: The present study was to clinically evaluate the relationship of diabetes mellitus with periodontal disease along with various parameters. Materials and Methods: Fifteen hundred patients with diabetes mellitus were examined. A thorough oral examination was carried out and relevant history was recorded for all the patients. Results: Results indicated that the prevalence of periodontal disease in diabetic patients was 86.8%. Conclusion: It can be concluded that poorer the glycemic control, and longer the duration of diabetes, the greater will be the prevalence and severity of periodontal disease. PMID:22368365

  14. Preventing microvascular complications in type 1 diabetes mellitus.

    PubMed

    Viswanathan, Vijay

    2015-04-01

    Patients with complications of diabetes such as retinopathy, nephropathy, and cardiovascular complications have increased hospital stay with greater economic burden. Prevention of complications should be started before the onset of type 1 diabetes mellitus (T1DM) by working on risk factors and thereafter by intervention upon confirmatory diagnosis which can prevent further damage to β-cells. The actual risk of getting microvascular complications like microalbuminuria and retinopathy progression starts at glycated hemoglobin (HbA1c) level of 7%. As per the American Diabetes Association, a new pediatric glycemic control target of HbA1c <7.5% across all ages replaces previous guidelines that had called for different targets by age. Evidence shows that prevalence of microvascular complications is greater in patients with age >20 years as compared to patients <10 years of age. Screening of these complications should be done regularly, and appropriate preventive strategies should be followed. Angiotensin converting enzyme inhibitors and angiotensin II receptor blocker reduce progression from microalbuminuria to macroalbuminuria and increase the regression rate to normoalbuminuria. Diabetic microvascular complications can be controlled with tight glycemic therapy, dyslipidemia management and blood pressure control along with renal function monitoring, lifestyle changes, including smoking cessation and low-protein diet. An integrated and personalized care would reduce the risk of development of microvascular complications in T1DM patients. The child with diabetes who receives limited care is more likely to develop long-term complications at an earlier age. Screening for subclinical complications and early interventions with intensive therapy is the need of the hour. PMID:25941647

  15. Prevalence and risk factors of gestational diabetes mellitus in Yemen

    PubMed Central

    Ali, Abdullatif D; Mehrass, Amat Al-Khaleq O; Al-Adhroey, Abdulelah H; Al-Shammakh, Abdulqawi A; Amran, Adel A

    2016-01-01

    Purpose Gestational diabetes mellitus (GDM) continues to be a significant health disorder triggering harmful complications in pregnant women and fetuses. Our knowledge of GDM epidemiology in Yemen is largely based on very limited data. The aim of this study was, therefore, to determine the prevalence and risk factors of GDM among pregnant women in Dhamar governorate, Yemen. Patients and methods A total of 311 subjects were randomly selected for this cross sectional survey. Health history data and blood samples were collected using a pretested questionnaire. To determine the prevalence of GDM, the fasting and random blood glucose techniques were applied according to the recommendations of the American Diabetes Association, using alternative methods that are more convenient to the targeted population. Poisson’s regression model incorporating robust sandwich variance was utilized to assess the association of potential risk factors in developing GDM. Results The prevalence of GDM was found to be 5.1% among the study population. Multivariate analysis confirmed age ≥30 years, previous GDM, family history of diabetes, and history of polycystic ovary syndrome as independent risk factors for GDM prevalence. However, body mass index ≥30 kg/m2 and previous macrosomic baby were found to be dependent risk factors. Conclusion This study reports new epidemiological information about the prevalence and risk factors of GDM in Yemen. Introduction of proper maternal and neonatal medical care and health education are important in order to save the mother and the baby. PMID:26869814

  16. Characteristics of the somatotropic axis in insulin dependent diabetes mellitus.

    PubMed

    Mercado, M; Baumann, G

    1995-01-01

    Growth hormone (GH) plays an important role in glucose homeostasis in both healthy subjects and patients with diabetes. Patients with poorly controlled insulin-dependent diabetes mellitus (IDDM) have high basal and integrated serum GH concentrations, as well as an enhanced GH response to several secretagogues. Yet, these patients have impaired generation of insulin-like growth factor-I (IGF-I). These abnormalities tend to return to normal as an adequate metabolic control is achieved. In view of this hormonal profile, IDDM has been considered a state of relative GH resistance. Studies in experimental animals with streptozotocin-induced diabetes have shown a decreased binding of radiolabeled GH to liver membranes. More recently, adults and children with IDDM have been found to have low levels of the high affinity growth hormone binding protein (GHBP), which represents the extracellular portion of the GH receptor, and is thought to reflect GH receptor tissue concentrations. The abnormalities in the GH/IGF-I axis have been implicated in the worsening of metabolic control that occurs in some patients, as well as in the development of microvascular complications, particularly retinopathy. PMID:7620273

  17. Diabetes mellitus and renal failure: Prevention and management.

    PubMed

    Nasri, Hamid; Rafieian-Kopaei, Mahmoud

    2015-11-01

    Nowadays, diabetes mellitus (DM) and hypertension are considered as the most common causes of end-stage renal disease (ESRD). In this paper, other than presenting the role of DM in ESRD, glucose metabolism and the management of hyperglycemia in these patients are reviewed. Although in several large studies there was no significant relationship found between tight glycemic control and the survival of ESRD patients, it is recommended that glycemic control be considered as the main therapeutic goal in the treatment of these patients to prevent damage to other organs. Glycemic control is perfect when fasting blood sugar is less than 140 mg/dL, 1-h postprandial blood glucose is less than 200 mg/dL, and glycosylated hemoglobin (HbA1c) is 6-7 in patients with type 1 diabetes and 7-8 in patients with type 2 diabetes. Administration of metformin should be avoided in chronic renal failure (CRF) because of lactic acidosis, the potentially fatal complication of metformin, but glipizide and repaglinide seem to be good choices. PMID:26941817

  18. Diabetes mellitus and renal failure: Prevention and management

    PubMed Central

    Nasri, Hamid; Rafieian-Kopaei, Mahmoud

    2015-01-01

    Nowadays, diabetes mellitus (DM) and hypertension are considered as the most common causes of end-stage renal disease (ESRD). In this paper, other than presenting the role of DM in ESRD, glucose metabolism and the management of hyperglycemia in these patients are reviewed. Although in several large studies there was no significant relationship found between tight glycemic control and the survival of ESRD patients, it is recommended that glycemic control be considered as the main therapeutic goal in the treatment of these patients to prevent damage to other organs. Glycemic control is perfect when fasting blood sugar is less than 140 mg/dL, 1-h postprandial blood glucose is less than 200 mg/dL, and glycosylated hemoglobin (HbA1c) is 6-7 in patients with type 1 diabetes and 7-8 in patients with type 2 diabetes. Administration of metformin should be avoided in chronic renal failure (CRF) because of lactic acidosis, the potentially fatal complication of metformin, but glipizide and repaglinide seem to be good choices. PMID:26941817

  19. A review of current treatment strategies for gestational diabetes mellitus

    PubMed Central

    Kelley, Kristi W; Carroll, Dana G; Meyer, Allison

    2015-01-01

    Approximately 90% of diabetes cases in pregnant women are considered gestational diabetes mellitus (GDM). It is well known that uncontrolled glucose results in poor pregnancy outcomes in both the mother and fetus. Worldwide there are many guidelines with recommendations for appropriate management strategies for GDM once lifestyle modifications have been instituted and failed to achieve control. The efficacy and particularly the safety of other treatment modalities for GDM has been the source of much debate in recent years. Studies that have demonstrated the safety and efficacy of both glyburide and metformin in the management of patients with GDM will be reviewed. There is a lack of evidence with other oral and injectable non-insulin agents to control blood glucose in GDM. The role of insulin will be discussed, with emphasis on insulin analogs. Ideal patient characteristics for each treatment modality will be reviewed. In addition, recommendations for postpartum screening of patients will be described as well as recommendations for use of agents to manage subsequent type 2 diabetes in patients who are breastfeeding. PMID:26213555

  20. Cardioprotective effects of magnesium valproate in type 2 diabetes mellitus.

    PubMed

    Patel, Bhoomika M; Raghunathan, Suchi; Porwal, Urvashi

    2014-04-01

    We have evaluated the effect of magnesium valproate (210 mg/kg/day, p.o.) in type 2 diabetes induced cardiovascular complications induced by streptozotocin (STZ, 90 mg/kg, i.p.) in neonatal wistar rats. Various biochemical, cardiovascular and hemodynamic parameters were measured at the end of 8 weeks of treatment. STZ produced significant hyperglycaemia, hypoinsulinemia and dyslipidemia, which was prevented by magnesium valproate treatment. STZ produced increase in Creatinine Kinase, C-reactive protein and lactate dehydrogenase levels and treatment with magnesium valproate produced reduction in these levels. STZ produced increase in cardiac and LV hypertrophy index, LV/RV ratio, LV collagen deposition and LV cardiomyocyte diameter which were decreased by magnesium valproate treatment. Magnesium valproate also prevented STZ induced hemodynamic alterations and oxidative stress. These results were further supported by histopathological studies in which magnesium valproate showed marked reduction in fibrosis and cardiac fiber disarray. In conclusion, our data suggests that magnesium valproate is beneficial as an anti-diabetic agent in type-2 diabetes mellitus and also prevents its cardiac complications. PMID:24530414

  1. [Drug interactions in the elderly with diabetes mellitus].

    PubMed

    Hendrychová, T; Vlček, J

    2012-04-01

    The elderly with diabetes mellitus are usually treated with many types of drugs. This, together with pharmacokinetic and pharmacodynamic changes connected with aging, can lead to an occurrence of drug interactions. They are often manifested as hypoglycaemia, decompensation of diabetes or an increase of frequency of adverse effects of drugs used together. It is important to pay an attention especially to hypoglycaemia, which brings many risks in the elderly. An article is focused on probable drug interactions when combination of various antidiabetics, antidiabetics with antihypertensives or hypolipidemics is used. Despite ACE-inhibitors and beta-blockers can influence the compensation of diabetics, their use is not contraindicated in these patients, because of their huge benefit in the prevention of cardiovascular events. An article brings an overview of antidiabetics metabolised by means of the system of cytochrome P 450 and resulting drug interactions with inhibitors and inductors of these enzymes. These drug interactions are not usually important in clinical practice and it is possible to prevent them with careful monitoring of glycaemia, instruction of patients and alternatively modification of the doses of hypoglycaemic medication after a termination of the treatment of responsible inductor or inhibitor. PMID:22559804

  2. A simple index for detection of gestational diabetes mellitus

    PubMed Central

    Perea-Carrasco, Rafael; Pérez-Coronel, Rocio; Albusac-Aguilar, Rogelio; Lombardo-Grifol, Manuel; de León, Elena Bassas-Baena; Romero-Diaz, Carlos

    2002-01-01

    The conventional screening test for gestational diabetes mellitus is measurement of plasma glucose 1 hour after 50 g glucose by mouth. The sensitivity and specificity of this test are lower than desirable; we therefore developed an index including other plasma constituents. In a preliminary study, 138 pregnant women had the standard oral glucose load screening test, and plasma fructosamine and total proteins were measured, in addition to glucose, in the 1-hour samples. An index value (I) was calculated as [fructosamine (μmol/L)÷total proteins (g/L)]×[glucose (mmol/L)÷100]. Cut-off values for I were then assessed in a second prospective study, of 642 pregnant women. Definitive diagnosis of gestational diabetes was by oral glucose tolerance test (OGTT). The index was also assessed in terms of fetal macrosomia (birthweight≥4000 g). With a cut-off value of I=27.2, sensitivity was 98%, specificity 89%, diagnostic efficiency 90%, positive likelihood ratio 8.76. Application of the index would have avoided 42% of the OGTTs demanded by the standard screening test, reducing false positives from about 24% to 10%. Predictive efficacy for macrosomia was 10.3% versus 7.9%. Our index offers an efficient screening test for gestational diabetes, and with more stringent cut-off points may be applicable as a single-step diagnostic procedure. PMID:12205206

  3. Albumin microvascular leakage in brains with diabetes mellitus.

    PubMed

    Fujihara, Ryuji; Chiba, Yoichi; Nakagawa, Toshitaka; Nishi, Nozomu; Murakami, Ryuta; Matsumoto, Koichi; Kawauchi, Machi; Yamamoto, Tetsuji; Ueno, Masaki

    2016-09-01

    Their aim was to examine whether microvascular leakage of endogenous albumin, a representative marker for blood-brain barrier (BBB) damage, was induced in the periventricular area of diabetic db/db mice because periventricular white matter hyperintensity formation in magnetic resonance images was accelerating in elderly patients with diabetes mellitus. Using light and electron microscopes, and semi-quantitative analysis techniques, immunoreactivity of endogenous albumin, indicating vascular permeability, was examined in the periventricular area and spinal cord of db/db mice and db/+m control mice. Greater immunoreactivity of albumin was observed in the vessel wall of the periventricular area of db/db mice than in controls. Additionally, weak immunoreactivity was observed in the spinal cord of both db/db mice and controls. The number of gold particles, indicating immunoreactivity of albumin, in the perivascular area of db/db mice was significantly higher than that of control mice, but there was no significant difference in the number of particles in the spinal cord between db/db mice and controls. These findings suggest that albumin microvascular leakage, or BBB breakdown, is induced in the periventricular area of diabetic mice. Microsc. Res. Tech. 79:833-837, 2016. © 2016 Wiley Periodicals, Inc. PMID:27333535

  4. Early life factors and type 2 diabetes mellitus.

    PubMed

    Jiang, Xinli; Ma, Huijie; Wang, Yan; Liu, Yan

    2013-01-01

    Type 2 diabetes mellitus (T2DM) is a multifactorial disease, and its aetiology involves a complex interplay between genetic, epigenetic, and environmental factors. In recent years, evidences from both human and animal experiments have correlated early life factors with programming diabetes risk in adult life. Fetal and neonatal period is crucial for organ development. Many maternal factors during pregnancy may increase the risk of diabetes of offsprings in later life, which include malnutrition, healthy (hyperglycemia and obesity), behavior (smoking, drinking, and junk food diet), hormone administration, and even stress. In neonates, catch-up growth, lactation, glucocorticoids administration, and stress have all been found to increase the risk of insulin resistance or T2DM. Unfavorable environments (socioeconomic situation and famine) or obesity also has long-term negative effects on children by causing increased susceptibility to T2DM in adults. We also address the potential mechanisms that may underlie the developmental programming of T2DM. Therefore, it might be possible to prevent or delay the risk for T2DM by improving pre- and/or postnatal factors. PMID:24455747

  5. [Cytological study of gum epithelium in connection with diabetes mellitus compensation stage].

    PubMed

    Ashurov, G G; Dzhuraeva, Sh F

    2009-01-01

    The structure of interphased nuclei of gum's epithelium and inflammation of periodontal structure in patients with glycolitic disorders in coonection of degree compensation of diabetes mellitus were studied. In patients with diabetes mellitus and inflammation of gum mucosa 67,33+/-0,05% of gum's cells epithelium had morphology changes nuclei from the date of control group (50,99+/-0,05%) patients. This difference were more essential at deterioration of compensation (62,03+/-0,08%), sub - (67,05+/-0,05%), decompensate (75,11+/-0,07%) diabetes mellitus. PMID:19491782

  6. Diabetic euglycemic ketoacidosis in newly diagnosed type 1 diabetes mellitus during Ramadan fasting.

    PubMed

    Baş, Veysel Nijat; Uytun, Salih; Torun, Yasemin Altuner

    2015-03-01

    Real euglycemic diabetic ketoacidosis [DKA; blood glucose <200 mg/dL (11.1 mmol/L)] is rare, and long-lasting starvation conditions due to intervening diseases in type 1 diabetes mellitus patients may also cause it. Euglycemic DKA is also reported in insulin-dependent diabetics with depression, alcoholics, glycogen storage diseases, and chronic liver disease apart from pregnant cases. This case report is presented to emphasize the importance of evaluation of acid-base state, urine glucose, and ketone values at the application in all newly diagnosed type 1 diabetic patients with normal glucose levels by defining euglycemic DKA that resulted from long-lasting starvation during Ramadan fasting in a newly diagnosed 14-year-old male patient. PMID:25423670

  7. Interaction between Sex and Social Support in the Control of Type II Diabetes Mellitus.

    ERIC Educational Resources Information Center

    Heitzmann, Carma A.; Kaplan, Robert M.

    1984-01-01

    Investigated the role of social support in the control of Type II diabetes mellitus. Participants (N=37) in a behavioral program in diabetes care completed questionnaires and provided blood samples. For women, satisfaction with supportive relationships was associated with control of diabetes. The opposite was true for men. (BH)

  8. Neonatal Hyperglycemia due to Transient Neonatal Diabetes Mellitus in Puerto Rico

    PubMed Central

    Fargas-Berríos, N.; García-Fragoso, L.; García-García, I.; Valcárcel, M.

    2015-01-01

    Neonatal hyperglycemia is a metabolic disorder found in the neonatal intensive care units. Neonatal diabetes mellitus (NDM) is a very uncommon cause of hyperglycemia in the newborn, occurring in 1 in every 400,000 births. There are two subtypes of neonatal diabetes mellitus: permanent neonatal diabetes mellitus (PNDM) and transient neonatal diabetes mellitus (TNDM). We describe a term, small for gestational age, female neonate with transient neonatal diabetes mellitus who presented with poor feeding tolerance and vomiting associated with hyperglycemia (385 mg/dL), glycosuria, and metabolic acidosis within the first 12 hours of life. The neonate was treated with intravenous insulin, obtaining a slight control of hyperglycemia. An adequate glycemia was achieved at 5 weeks of life. The molecular studies showed complete loss of maternal methylation at the TND differentially methylated region on chromosome 6q24. The etiology of this neonate's hyperglycemia was a hypomethylation of the maternal TND locus. A rare cause of neonatal diabetes mellitus must be considered if a neonate presents refractory hyperglycemia. To our knowledge, this is the first case reported in Puerto Rico of transient neonatal mellitus due to the uncommon mechanism of maternal hypomethylation of the TND locus. Its prevalence in Puerto Rico is unknown. PMID:26576310

  9. Neonatal Hyperglycemia due to Transient Neonatal Diabetes Mellitus in Puerto Rico.

    PubMed

    Fargas-Berríos, N; García-Fragoso, L; García-García, I; Valcárcel, M

    2015-01-01

    Neonatal hyperglycemia is a metabolic disorder found in the neonatal intensive care units. Neonatal diabetes mellitus (NDM) is a very uncommon cause of hyperglycemia in the newborn, occurring in 1 in every 400,000 births. There are two subtypes of neonatal diabetes mellitus: permanent neonatal diabetes mellitus (PNDM) and transient neonatal diabetes mellitus (TNDM). We describe a term, small for gestational age, female neonate with transient neonatal diabetes mellitus who presented with poor feeding tolerance and vomiting associated with hyperglycemia (385 mg/dL), glycosuria, and metabolic acidosis within the first 12 hours of life. The neonate was treated with intravenous insulin, obtaining a slight control of hyperglycemia. An adequate glycemia was achieved at 5 weeks of life. The molecular studies showed complete loss of maternal methylation at the TND differentially methylated region on chromosome 6q24. The etiology of this neonate's hyperglycemia was a hypomethylation of the maternal TND locus. A rare cause of neonatal diabetes mellitus must be considered if a neonate presents refractory hyperglycemia. To our knowledge, this is the first case reported in Puerto Rico of transient neonatal mellitus due to the uncommon mechanism of maternal hypomethylation of the TND locus. Its prevalence in Puerto Rico is unknown. PMID:26576310

  10. From organophosphate poisoning to diabetes mellitus: The incretin effect.

    PubMed

    Rathish, D; Agampodi, S B; Jayasumana, M A C S; Siribaddana, S H

    2016-06-01

    Organophosphate (OP) poisoning induced disruption of glucose homeostasis is well established. OP poisoning leads to accumulation of acetylcholine (ACh) due to the inhibition of acetylcholinesterases (AChE). On the other hand the incidence of type 2 diabetes mellitus (T2DM) is shown to rise along with the use of pesticides in Southeast Asia. Attenuation of the 'incretin effect' is seen in T2DM. This effect is regulated by a complex loop of mechanism involving ACh driven muscarinic receptors. We hypothesize that OP poisoning leads to disruption of glucose homeostasis by attenuation of the incretin effect. Inhibition of the Glucagon Like Peptide-1 (GLP-1) secretion is our main focus of interest. Positive finding of the hypothesis will open possibility of using incretin based treatment modalities to treat or prevent acute OP induced disruption of glucose homeostasis. PMID:27142144

  11. Type 2 diabetes mellitus in elderly institutionalized patients.

    PubMed

    Cano Megias, M; Guisado Vasco, P

    2014-12-01

    A 93-year-old woman is admitted to a conventional hospital ward for an acute respiratory infection. The patient has type 2 diabetes mellitus of approximately 15 years evolution and has no other associated comorbidities, except for progressive dependence due to senescence and a previous hospitalization for pneumonia 6 months ago. She is currently in an assisted-living residence. A recent laboratory test revealed an HbA1c level of 7.8%, with a serum creatinine level of 1.3mg/dl (MDRD, 45ml/min). Her standard treatment consists of 5mg of glibenclamide a day and 850mg of metformin every 12hours. What regimen should we follow once she is hospitalized? Does she require any change in her treatment at discharge? PMID:24703988

  12. Comments on gestational diabetes mellitus: from pathophysiology to clinical practice.

    PubMed

    Poulakos, Pavlos; Mintziori, Gesthimani; Tsirou, Efrosini; Taousani, Eleftheria; Savvaki, Dimitra; Harizopoulou, Vikentia; Goulis, Dimitrios G

    2015-01-01

    Gestational diabetes mellitus (GDM) is a topic of major interest, as it affects up to 16% of pregnant women and may lead to adverse pregnancy outcomes, which, however, are preventable by appropriate treatment. The aim of the present study was to discuss basic concepts and to critically appraise recent updates on practical issues in the field of GDM. GDM pathophysiology, long-term complications including "fetal programming" and GDM diagnosis are discussed, while clinical practice guidelines on follow-up, medical nutrition therapy, oral hypoglycemic agents and insulin treatment are also reviewed. GDM comprises a serious yet preventable public health problem and prevention by lifestyle changes, early detection and adequate treatment can lead to better health outcomes for both mothers with GDM and their offspring. PMID:26188220

  13. Gestational diabetes mellitus: Screening with fasting plasma glucose.

    PubMed

    Agarwal, Mukesh M

    2016-07-25

    Fasting plasma glucose (FPG) as a screening test for gestational diabetes mellitus (GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-conducted studies. This review: (1) traces the history; (2) weighs the advantages and disadvantages; (3) addresses the significance in early pregnancy; (4) underscores the benefits after delivery; and (5) emphasizes the cost savings of using the FPG in the screening of GDM. It also highlights the utility of fasting capillary glucose and stresses the value of the FPG in circumventing the cumbersome oral glucose tolerance test. An understanding of all the caveats is crucial to be able to use the FPG for investigating glucose intolerance in pregnancy. Thus, all health professionals can use the patient-friendly FPG to simplify the onerous algorithms available for the screening and diagnosis of GDM - thereby helping each and every pregnant woman. PMID:27525055

  14. The role of adipokines in gestational diabetes mellitus

    PubMed Central

    Al-Badri, Marwa R.; Zantout, Mira S.

    2015-01-01

    Gestational diabetes mellitus (GDM) is a complication of pregnancy that is characterized by impaired glucose tolerance with onset or first recognition during pregnancy. The reported prevalence of GDM varies between 0.6% and 20% of pregnancies depending on screening method, gestational age and the population studied. GDM is characterized by pancreatic β-cell function that is insufficient to meet the body’s insulin needs. Available evidence suggests that β-cell defects in GDM result from the same spectrum of causes that underline hyperglycemia in general, including autoimmune disease, monogenic causes and insulin resistance. Adipokines are proteins secreted from the adipocytes and are believed to have a metabolic influence. Our review suggests that, in GDM, various adipokines, mainly leptin and adiponectin, are dysregulated. These two adipokines might have both prognostic and pathophysiological significance in this disease. PMID:26137214

  15. Peripheral Arterial Disease in Patients with Type 2 Diabetes Mellitus

    PubMed Central

    Rhee, Sang Youl

    2015-01-01

    Peripheral arterial disease (PAD) in patients with type 2 diabetes mellitus (T2DM) exhibits broad clinical characteristics and various consequences and is known as one of the major macrovascular complications of T2DM. Atherosclerosis is recognized as the most direct and important cause of PAD, but acute or chronic limb ischemia may be the result of various risk factors. In light of the increasing number of patients who undergo peripheral vascular procedures, the number of subjects who are exposed to the risks for PAD and related complications is increasing. In this review, we will discuss the clinical and epidemiological characteristics of PAD, as well as the clinical significance of PAD in T2DM subjects. PMID:26301189

  16. The Genetics of Vascular Complications in Diabetes Mellitus

    PubMed Central

    Farbstein, Dan; Levy, Andrew P.

    2010-01-01

    Prospective identification of which individuals with diabetes mellitus (DM) are at greatest risk of developing cardiovascular (CVD) complications would have considerable public health importance by allowing the allocation of limited resources to be focused on those individuals who would most benefit from aggressive intervention. Over the past 20 years genetic disease association studies have demonstrated that polymorphisms at specific genetic loci may identify those individuals at greatest risk of developing CVD in the setting of DM. This article reviews the evidence accumulated to date on four polymorphic loci with the aim of explaining how these polymorphisms modify the risk of CVD in DM by modifying the functional activity of a specific gene. Utilization of the knowledge of these genetic differences among individuals in targeting drug therapy (pharmacogenomics) is also discussed. PMID:20621252

  17. Gestational diabetes mellitus: Screening with fasting plasma glucose

    PubMed Central

    Agarwal, Mukesh M

    2016-01-01

    Fasting plasma glucose (FPG) as a screening test for gestational diabetes mellitus (GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-conducted studies. This review: (1) traces the history; (2) weighs the advantages and disadvantages; (3) addresses the significance in early pregnancy; (4) underscores the benefits after delivery; and (5) emphasizes the cost savings of using the FPG in the screening of GDM. It also highlights the utility of fasting capillary glucose and stresses the value of the FPG in circumventing the cumbersome oral glucose tolerance test. An understanding of all the caveats is crucial to be able to use the FPG for investigating glucose intolerance in pregnancy. Thus, all health professionals can use the patient-friendly FPG to simplify the onerous algorithms available for the screening and diagnosis of GDM - thereby helping each and every pregnant woman. PMID:27525055

  18. AB125. Neonatal diabetes mellitus due to insulin gene mutation

    PubMed Central

    Can, Ngoc Thi Bich; Vu, Dung Chi; Bui, Thao Phuong; Nguyen, Khanh Ngoc; Nguyen, Dat Phu; Craig, Maria; Ellard, Sian; Nguyen, Hoan Thi

    2015-01-01

    Background and objective Insulin (INS) gene mutations that cause permanent neonatal diabetes mellitus change single protein building blocks (amino acids) in the protein sequence. These mutations are believed to disrupt the cleavage of the proinsulin chain or the binding of the A and B chains to form insulin, leading to impaired blood sugar control. At least ten mutations in the INS gene have been identified in people with permanent neonatal diabetes mellitus. To describe clinical features and laboratory manifestations of patients with INS gene mutation and to evaluate outcome of management. Methods Clinical features, biochemical finding, mutation analysis and management outcome of six cases from six unrelated families were study. All exons of INS gene were amplified from genomic DNA and directly sequenced. Results Six cases (three girls and three boys) onset at 129.2±128.8 days of age (median 101.5 days) with gestation age of 37.3±3.0 weeks, birth weight of 2,816.6±767.8 g. Five out of six patients admitted with the feature of diabetic ketoacidosis with pH of 7.04±0.22; plasma glucose levels were 34.3±12.7 mmoL/L, HbA1C of 9.75%±3.5%. Mutation analysis of the INS gene showed: heterozygous for a novel missense mutation (c.127T > A; C43S) in exon 2 in one case; heterozygous for a splicing mutation c.188-31G > A in intron 2 in two cases; heterozygous for a missense mutation c.286T > C in exon 3 in one case; heterozygous for a missense mutation c.265C > T [p.Arg89Cys (p.R89C)] in exon 3 in two cases. After 19.2±13.4 months of insulin treatment, 4/5 patients have normal development with DQ 80-100%, HbA1C of 6.85%±0.49%, quite normal blood glucose levels. The case with c.127T > A mutation treated with insulin for 14 years has physical development delay, poor blood glucose control with HbA1C of 11.4%. Conclusions It is important to perform screening gene mutation for patients with diabetes diagnosed before 6 months of age to control blood glucose and follow up the

  19. Relationship between Polycystic Ovarian Syndrome and Subsequent Gestational Diabetes Mellitus: A Nationwide Population-Based Study

    PubMed Central

    Pan, Mei-Lien; Chen, Li-Ru; Tsao, Hsiao-Mei; Chen, Kuo-Hu

    2015-01-01

    Objective This nationwide population-based study aims to explore the relationship between polycystic ovarian syndrome (PCOS) and subsequent gestational diabetes mellitus (GDM). Methods Data from 1998–2012 Taiwan National Health Insurance Research Database were used for this study. ICD9-CM codes 256.4X and 648.X were used separately for the diagnoses of PCOS and GDM, which were further confirmed by records of blood tests or ultrasonography to ensure the accuracy of the diagnoses. Women diagnosed at < 15 or > 45 years of age, and those diagnosed with overt diabetes mellitus or GDM prior to PCOS were excluded. During pregnancy, each woman with a previous diagnosis of PCOS was age-matched to 10 women without PCOS. Odds ratios (ORs) for risk of GDM were calculated by logistic regression analysis with adjustment for economic status and co-morbidities. Results Among 7,629 eligible women with a valid PCOS diagnosis, 3,109 (42.87%) had subsequent pregnancies. GDM occurred frequently among women with a history of PCOS as compared to those without PCOS (20.46% vs. 10.54%, p<0.0001). Logistic regression analysis revealed that PCOS was associated with GDM (adjusted OR = 2.15; 95% CI:1.96–2.37). Among 3,109 affected patients, 1,160 (37.31%) had used medications for PCOS and 261 (8.39%) were treated with an oral hypoglycemic agent (OHA). There was no significant difference in development of GDM between the medication and no medication sub-groups (p>0.05). If not used after conception, OHAs did not reduce the risk of GDM (adjusted OR = 1.20; 95% CI:0.88–1.62). Conclusions A history of PCOS is a significant and independent risk factor for development of GDM. Medication for PCOS or pre-pregnancy use of OHAs does not reduce the risk of GDM. When at-risk women become pregnant, they require closer surveillance for maternal and fetal well-being, and should follow a strict diet and adhere to weight gain control to avoid obstetric complications due to GDM. PMID:26488176

  20. Endothelial Dysfunction and Microvascular Complications in Type 1 Diabetes Mellitus

    PubMed Central

    Jin, Seon Mi; Yang, Sei Won; Bae, Eun Jung; Shin, Choong Ho; Chung, Hae Rim; Kim, You Yeh; Yun, Yong Soo

    2008-01-01

    We examined whether alterations in vascular endothelial function and early structural changes in atherosclerosis are associated with microvascular complications in patients with type 1 diabetes mellitus (DM). Flow-mediated dilation (FMD) of the brachial artery and carotid intima-media thickness (IMT) measurement were performed in 70 young adults (aged 19 to 35 yr), 48 with type 1 DM, and 22 normal controls. Patients with diabetes had a lower peak FMD response (7.8±3.9 vs. 11.1±1.9%, p<0.001) and increased IMT (0.51±0.10 vs. 0.42±0.07 mm, p<0.001) compared with controls. Twenty (41.7%) of the patients had microvascular complications including neuropathy, nephropathy, or retinopathy. In these complicated diabetic patients, we found a lower FMD response (6.1±2.5 vs. 9.9±3.5%, p=0.001) compared with diabetics without microvascular complications. The presence of microvascular complications was also associated with older age and longer duration of the disease. However, no differences were observed in IMT, body size, blood pressure, HbA1c, C-reactive protein, low-density lipoprotein or high-density lipoprotein cholesterol levels between complicated and non-complicated patients. Endothelial dysfunction and early structural atherosclerotic changes are common manifestations in type 1 DM, and endothelial dysfunction is thought to be an early event in the atherosclerotic process and important in the pathogenesis of microvascular complications. PMID:18303203

  1. Diabetes mellitus and its correlates in an Iranian adult population.

    PubMed

    Golozar, Asieh; Khademi, Hooman; Kamangar, Farin; Poutschi, Hossein; Islami, Farhad; Abnet, Christian C; Freedman, Neal D; Taylor, Philip R; Pharoah, Paul; Boffetta, Paolo; Brennan, Paul J; Dawsey, Sanford M; Malekzadeh, Reza; Etemadi, Arash

    2011-01-01

    The rising epidemic of diabetes imposes a substantial economic burden on the Middle East. Using baseline data from a population based cohort study, we aimed to identify the correlates of diabetes mellitus (DM) in a mainly rural population from Iran. Between 2004 and 2007, 50044 adults between 30 and 87 years old from Golestan Province located in Northeast Iran were enrolled in the Golestan Cohort Study. Demographic and health-related information was collected using questionnaires. Individuals' body sizes at ages 15 and 30 were assessed by validated pictograms ranging from 1 (very lean) to 7 in men and 9 in women. DM diagnosis was based on the self-report of a physician's diagnosis. The accuracy of self-reported DM was evaluated in a subcohort of 3811 individuals using fasting plasma glucose level and medical records. Poisson regression with robust variance estimator was used to estimate prevalence ratios (PR's). The prevalence of self-reported DM standardized to the national and world population was 5.7% and 6.2%, respectively. Self-reported DM had 61.5% sensitivity and 97.6% specificity. Socioeconomic status was inversely associated with DM prevalence. Green tea and opium consumption increased the prevalence of DM. Obesity at all ages and extreme leanness in childhood increased diabetes prevalence. Being obese throughout life doubled DM prevalence in women (PR: 2.1; 95% CI: 1.8, 2.4). These findings emphasize the importance of improving DM awareness, improving general living conditions, and early lifestyle modifications in diabetes prevention. PMID:22053206

  2. Inflammatory reaction in chronic periodontopathies in patients with diabetes mellitus. Histological and immunohistochemical study.

    PubMed

    Camen, Georgiana Cristiana; Caraivan, O; Olteanu, Mădălina; Camen, A; Bunget, Adina; Popescu, Florina Carmen; Predescu, Anca

    2012-01-01

    Chronic periodontopathies and diabetes mellitus are two clinical entities, which reciprocally condition one another. The periodontal disease is considered a major complication, which induces an unfavorable evolution of diabetes mellitus. Diabetes mellitus is an endocrine disease which favors the occurrence of periodontopathy through gum's microvascular disorders, the selection and development of an aggressive bacterial plaque and through an exaggerate inflammatory response to the microflora within the oral cavity. Both diabetes mellitus and periodontal disease have an increasing incidence in the whole world. Development of periodontopathy is related to the aggression of bacterial flora in dental plaque, flora that is influenced on its turn by the evolution of diabetes mellitus. In our study, we have evaluated the inflammatory reaction in periodontium in patients with slowly and progressive periodontitis in patients with diabetes mellitus who had diabetes longer than five years. It has been found that all patients presented a chronic inflammatory infiltrate, abundant, with round mononuclear cells of lymphocyte, plasma cells and macrophage type, with non-homogenous arrangement, more intensely where the covering epithelium presented erosions or necrotic areas. Out of the immunity system cells, the most numerous where of T-lymphocytes type. PMID:22395500

  3. The impact of diabetes mellitus on breast cancer outcomes: a single center retrospective study.

    PubMed

    Yerrabothala, Swaroopa; Shaaban, Hamid; Capo, Gerardo; Maroules, Michael; Debari, Vincent A

    2014-01-01

    Diabetes mellitus has been implicated to affect the prognostic outcomes of patients with various types of cancer. This study explores the impact of diabetes mellitus on the survival outcomes of patients with all stages of breast cancer. We performed a retrospective analysis of 255 patients with all stages of breast cancer. Survival outcomes were compared for diabetic and non-diabetic patients. A greater percent of patients in the non-diabetic group (54.1%) presented with early-stage (stage 0 and 1) cancer than diabetics for which 41.2% presented with stage 0 or 1 breast cancer; however this difference did not achieve statistical significance (p = 0.068). Overall, we observed a significant difference in survival between the diabetics and non-diabetic subjects (p = 0.001). Even after adjustment for all covariates and after stratification for Body Mass Index (BMI), diabetics were found to have a poorer prognosis in terms of survival time. In patients with breast cancer, diabetes mellitus is an independent predictor of lower overall survival rates, even after adjusting for other comorbidities. Primary caregivers and oncologists alike should aggressively screen breast cancer patients for diabetes mellitus and vice versa. PMID:23832821

  4. Data analytics identify glycated haemoglobin co-markers for type 2 diabetes mellitus diagnosis.

    PubMed

    Jelinek, Herbert F; Stranieri, Andrew; Yatsko, Andrew; Venkatraman, Sitalakshmi

    2016-08-01

    Glycated haemoglobin (HbA1c) is being more commonly used as an alternative test for the identification of type 2 diabetes mellitus (T2DM) or to add to fasting blood glucose level and oral glucose tolerance test results, because it is easily obtained using point-of-care technology and represents long-term blood sugar levels. HbA1c cut-off values of 6.5% or above have been recommended for clinical use based on the presence of diabetic comorbidities from population studies. However, outcomes of large trials with a HbA1c of 6.5% as a cut-off have been inconsistent for a diagnosis of T2DM. This suggests that a HbA1c cut-off of 6.5% as a single marker may not be sensitive enough or be too simple and miss individuals at risk or with already overt, undiagnosed diabetes. In this study, data mining algorithms have been applied on a large clinical dataset to identify an optimal cut-off value for HbA1c and to identify whether additional biomarkers can be used together with HbA1c to enhance diagnostic accuracy of T2DM. T2DM classification accuracy increased if 8-hydroxy-2-deoxyguanosine (8-OhdG), an oxidative stress marker, was included in the algorithm from 78.71% for HbA1c at 6.5% to 86.64%. A similar result was obtained when interleukin-6 (IL-6) was included (accuracy=85.63%) but with a lower optimal HbA1c range between 5.73 and 6.22%. The application of data analytics to medical records from the Diabetes Screening programme demonstrates that data analytics, combined with large clinical datasets can be used to identify clinically appropriate cut-off values and identify novel biomarkers that when included improve the accuracy of T2DM diagnosis even when HbA1c levels are below or equal to the current cut-off of 6.5%. PMID:27268735

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

    PubMed Central

    Rochester, Charmaine D; Akiyode, Oluwaranti

    2014-01-01

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

  6. Pancreas and Diabetes Mellitus: The Relationship between the Organ and the Disease.

    PubMed

    Menon, Saumya; Rajesh, Gopalakrishna; Balakrishnan, Vallath

    2015-10-01

    Diabetes mellitus has been a fascinating disease from the dawn of medical history. The first breakthrough in its treatment came in 1922, with the discovery of insulin which was extracted from the pancreas of a dog. Even earlier, a relationship between pancreas and diabetes mellitus had been suspected by medical scientists. However, the study of diabetes mellitus is much more than its relationship with the pancreas. On the other hand the pancreas has been known to be a very reclusive organ that is hidden away from physicians and surgeons for centuries. In recent times, it has become more accessible and has yielded some of its secrets. The relationship between the pancreas and diabetes mellitus is a story full of complexities and surprises. This article attempts to reveal some of the important events and persons in the story and the controversies surrounding them. PMID:27608692

  7. [Diabetes mellitus in a cow persistently infected with bovine viral diarrhea virus].

    PubMed

    Bückner, R

    1997-07-01

    A one-year-old Holstein-Frisian heifer, persistently infected with BVD virus, developed diabetes mellitus. Clinical, virological and pathological findings are described and possible relations are discussed. PMID:9312894

  8. [The impact of anthropogenic factors of environment on morbidity of diabetes mellitus].

    PubMed

    Sazonova, O V; Sadovoiy, M A; Trofimovitch, Ye M; Fintchenko, Ye A; Shalygina, L S

    2013-01-01

    The diabetes mellitus is a real threat to population health in all countries. In international practice studying and successful solutions of problems conditioned by this disease are related to development of registries. The Novosibirsk municipal registry of diabetes mellitus is an integral part of the Public registry. The data of municipal registry and analysis of conditions of environment were used to detect characteristics of morbidity of diabetes mellitus in population residing in the territories with different level of anthropogenic pollution by aero-pollutants. The technique of mapping was applied to develop thematic clinical hygienic map. The technique of the thematic clinical hygienic mapping broaden functional possibilities and sphere of application of territorial registry of diabetes mellitus. This technique opens new possibilities and perspectives in development of complex programs of prevention in the territories with anthropogenic pollution. PMID:24649608

  9. Juvenile Diabetes Mellitus and Concurrent Exocrine Pancreatic Insufficiency in a Labrador Retriever: Long-Term Management.

    PubMed

    Alvarez, Maria Saiz; Herrería-Bustillo, Vicente; Utset, Artur Font; Martínez, Jorge

    2015-01-01

    A 3 mo old, female, entire Labrador retriever presented with vomiting, diarrhea, polyuria, polydipsia, polyphagia, and stunted growth. Diagnostics revealed the presence of juvenile diabetes mellitus and concurrent exocrine pancreatic insufficiency. Pancreatic histopathology showed severe pancreatic atrophy. Successful treatment was achieved with a combination of insulin and pancreatic enzymes. This report describes successful long-term treatment of juvenile diabetes mellitus and concurrent exocrine pancreatic insufficiency in a dog. PMID:26535463

  10. Pharmacogenetic studies update in type 2 diabetes mellitus

    PubMed Central

    Singh, Shalini; Usman, Kauser; Banerjee, Monisha

    2016-01-01

    Type 2 diabetes mellitus (T2DM) is a silent progressive polygenic metabolic disorder resulting from ineffective insulin cascading in the body. World-wide, about 415 million people are suffering from T2DM with a projected rise to 642 million in 2040. T2DM is treated with several classes of oral antidiabetic drugs (OADs) viz. biguanides, sulfonylureas, thiazolidinediones, meglitinides, etc. Treatment strategies for T2DM are to minimize long-term micro and macro vascular complications by achieving an optimized glycemic control. Genetic variations in the human genome not only disclose the risk of T2DM development but also predict the personalized response to drug therapy. Inter-individual variability in response to OADs is due to polymorphisms in genes encoding drug receptors, transporters, and metabolizing enzymes for example, genetic variants in solute carrier transporters (SLC22A1, SLC22A2, SLC22A3, SLC47A1 and SLC47A2) are actively involved in glycemic/HbA1c management of metformin. In addition, CYP gene encoding Cytochrome P450 enzymes also play a crucial role with respect to metabolism of drugs. Pharmacogenetic studies provide insights on the relationship between individual genetic variants and variable therapeutic outcomes of various OADs. Clinical utility of pharmacogenetic study is to predict the therapeutic dose of various OADs on individual basis. Pharmacogenetics therefore, is a step towards personalized medicine which will greatly improve the efficacy of diabetes treatment. PMID:27555891

  11. Antidiabetic therapy in post kidney transplantation diabetes mellitus.

    PubMed

    Werzowa, Johannes; Säemann, Marcus; Haidinger, Michael; Krebs, Michael; Hecking, Manfred

    2015-07-01

    Post-transplantation diabetes mellitus (PTDM) is a common complication after kidney transplantation that affects up to 40% of kidney transplant recipients. By pathogenesis, PTDM is a diabetes form of its own, and may be characterised by a sudden, drug-induced deficiency in insulin secretion rather than worsening of insulin resistance over time. In the context of deteriorating allograft function leading to a re-occurrence of chronic kidney disease after transplantation, pharmacological interventions in PTDM patients deserve special attention. In the present review, we aim at presenting the current evidence regarding efficacy and safety of the modern antidiabetic armamentarium. Specifically, we focus on incretin-based therapies and insulin treatment, besides metformin and glitazones, and discuss their respective advantages and pitfalls. Although recent pilot trials are available in both prediabetes and PTDM, further studies are warranted to elucidate the ideal timing of various antidiabetics as well as its long-term impact on safety, glucose metabolism and cardiovascular outcomes in kidney transplant recipients. PMID:25641399

  12. Pharmacogenetic studies update in type 2 diabetes mellitus.

    PubMed

    Singh, Shalini; Usman, Kauser; Banerjee, Monisha

    2016-08-10

    Type 2 diabetes mellitus (T2DM) is a silent progressive polygenic metabolic disorder resulting from ineffective insulin cascading in the body. World-wide, about 415 million people are suffering from T2DM with a projected rise to 642 million in 2040. T2DM is treated with several classes of oral antidiabetic drugs (OADs) viz. biguanides, sulfonylureas, thiazolidinediones, meglitinides, etc. Treatment strategies for T2DM are to minimize long-term micro and macro vascular complications by achieving an optimized glycemic control. Genetic variations in the human genome not only disclose the risk of T2DM development but also predict the personalized response to drug therapy. Inter-individual variability in response to OADs is due to polymorphisms in genes encoding drug receptors, transporters, and metabolizing enzymes for example, genetic variants in solute carrier transporters (SLC22A1, SLC22A2, SLC22A3, SLC47A1 and SLC47A2) are actively involved in glycemic/HbA1c management of metformin. In addition, CYP gene encoding Cytochrome P450 enzymes also play a crucial role with respect to metabolism of drugs. Pharmacogenetic studies provide insights on the relationship between individual genetic variants and variable therapeutic outcomes of various OADs. Clinical utility of pharmacogenetic study is to predict the therapeutic dose of various OADs on individual basis. Pharmacogenetics therefore, is a step towards personalized medicine which will greatly improve the efficacy of diabetes treatment. PMID:27555891

  13. Diabetes mellitus and disturbances in brain connectivity: a bidirectional relationship?

    PubMed

    Mansur, Rodrigo B; Cha, Danielle S; Woldeyohannes, Hanna O; Soczynska, Joanna K; Zugman, Andre; Brietzke, Elisa; McIntyre, Roger S

    2014-12-01

    Diabetes mellitus (DM) is associated with deficits across multiple cognitive domains. The observed impairments in cognitive function are hypothesized to be subserved by alterations in brain structure and function. Several lines of evidence indicate that alterations in glial integrity and function, as well as abnormal synchrony within brain circuits and associated networks, are observed in adults with DM. Microangiopathy and alterations in insulin homeostasis appear to be principal effector systems, although a unitary explanation subsuming the complex etiopathology of white matter in DM is unavailable. A contemporary model of disease pathophysiology for several mental disorders, including but not limited to mood disorders, posits abnormalities in the synchronization of cellular systems in circuits. The observation that similar abnormalities occur in diabetic populations provides the basis for hypothesizing the convergence of pathoetiological factors. Herein, we propose that abnormal structure, function and chemical composition as well as synchrony within and between circuits is an accompaniment of DM and is shared in common with several mental disorders. PMID:24974228

  14. Natural Products for the Treatment of Type 2 Diabetes Mellitus.

    PubMed

    Ríos, José Luis; Francini, Flavio; Schinella, Guillermo R

    2015-08-01

    Type 2 diabetes mellitus is a metabolic disease characterized by persistent hyperglycemia. High blood sugar can produce long-term complications such as cardiovascular and renal disorders, retinopathy, and poor blood flow. Its development can be prevented or delayed in people with impaired glucose tolerance by implementing lifestyle changes or the use of therapeutic agents. Some of these drugs have been obtained from plants or have a microbial origin, such as galegine isolated from Galega officinalis, which has a great similarity to the antidiabetic drug metformin. Picnogenol, acarbose, miglitol, and voglibose are other antidiabetic products of natural origin. This review compiles the principal articles on medicinal plants used for treating diabetes and its comorbidities, as well as mechanisms of natural products as antidiabetic agents. Inhibition of α-glucosidase and α-amylase, effects on glucose uptake and glucose transporters, modification of mechanisms mediated by the peroxisome proliferator-activated receptor, inhibition of protein tyrosine phosphatase 1B activity, modification of gene expression, and activities of hormones involved in glucose homeostasis such as adiponectin, resistin, and incretin, and reduction of oxidative stress are some of the mechanisms in which natural products are involved. We also review the most relevant clinical trials performed with medicinal plants and natural products such as aloe, banaba, bitter melon, caper, cinnamon, cocoa, coffee, fenugreek, garlic, guava, gymnema, nettle, sage, soybean, green and black tea, turmeric, walnut, and yerba mate. Compounds of high interest as potential antidiabetics are: fukugetin, palmatine, berberine, honokiol, amorfrutins, trigonelline, gymnemic acids, gurmarin, and phlorizin. PMID:26132858

  15. Diabetes mellitus in Nigeria: The past, present and future

    PubMed Central

    Ogbera, Anthonia Okeoghene; Ekpebegh, Chukwuma

    2014-01-01

    Diabetes mellitus (DM) is a diverse group of metabolic disorders that is often associated with a high disease burden in developing countries such as Nigeria. In the early nineties, not much was known about DM in Nigeria and traditionally, people related DM to “curses” or “hexes” and diagnosis was made based on blood or urinary tests for glucose. Currently, oral hypoglycaemic agents but not insulin are readily accessible and acceptable to persons with DM. The cost of diabetes care is borne in most instances by individuals and often payment is “out of pocket”-this being a sequel of a poorly functional national health insurance scheme. An insulin requiring individual on a minimum wage would spend 29% of his monthly income on insulin. Complementary and alternative medicines are widely used by persons with DM and form an integral component of DM care. Towards reducing the burden of DM in Nigeria, we suggest that there be concerted efforts by healthcare professionals and stakeholders in the health industry to put in place preventative measures, a better functioning health insurance scheme and a structured DM program. PMID:25512795

  16. The Effect of Diabetes Mellitus on Giant Cell Arteritis

    PubMed Central

    Abel, Anne S; Yashkin, Arseniy P; Sloan, Frank A; Lee, Michael S

    2015-01-01

    Objective To determine if type 2 diabetes mellitus (DM) is protective against giant cell arteritis (GCA) and to estimate the incidence of GCA diagnosis in the Medicare population. Methods Medicare 5% claims files from 1991-2011 were used to identify beneficiaries diagnosed with DM, but not GCA, within a three-year ascertainment period. Propensity score matching was used to define a control group of non-diabetics with comparable demographic covariates. Competing-risk regression was then used to assess the impact of DM diagnosis on GCA diagnosis. To allow for a three-year ascertainment period, the analysis sample was limited to beneficiaries over 68 years old at baseline. Results A total of 151,041 beneficiaries diagnosed with DM were matched to an equal number of controls. Mean study follow-up was 67.75 months. GCA was diagnosed among 1,116 beneficiaries with DM (0.73%) versus 465 (0.30%) controls. The risk of receiving a GCA diagnosis among patients with DM was increased by 100% (sub hazard ratio (SHR): 2.00; 95% confidence interval (CI): 1.78 2.25). The annual incidence of GCA diagnosis among U.S. Medicare beneficiaries over 68 was 93 in 100,000. Conclusion A DM diagnosis is not protective against a GCA diagnosis in the Medicare population. Our data suggests that a DM diagnosis increases the risk of GCA diagnosis within 5.7 years for Medicare beneficiaries over 68. PMID:25602744

  17. Preventing type 2 diabetes mellitus: a call for personalized intervention.

    PubMed

    Glauber, Harry; Karnieli, Eddy

    2013-01-01

    In parallel with the rising prevalence of obesity worldwide, especially in younger people, there has been a dramatic increase in recent decades in the incidence and prevalence of metabolic consequences of obesity, in particular prediabetes and type 2 diabetes mellitus (DM2). Although approximately one-third of US adults now meet one or more diagnostic criteria for prediabetes, only a minority of those so identified as being at risk for DM2 actually progress to diabetes, and some may regress to normal status. Given the uncertain prognosis of prediabetes, it is not clear who is most likely to benefit from lifestyle change or medication interventions that are known to reduce DM2 risk. We review the many factors known to influence risk of developing DM2 and summarize treatment trials demonstrating the possibility of preventing DM2. Applying the concepts of personalized medicine and the potential of "big data" approaches to analysis of massive amounts of routinely gathered clinical and laboratory data from large populations, we call for the development of tools to more precisely estimate individual risk of DM2. PMID:24355893

  18. Prevention of gestational diabetes mellitus: Where are we now?

    PubMed

    Simmons, D

    2015-09-01

    Gestational diabetes mellitus (GDM) is increasing at a rapid rate, driven by the increasing proportion of the population that is overweight/obese from a young age. More than 25 randomized controlled trials testing whether GDM can be prevented have now reported their findings, but only four different interventions have shown a reduction in the proportion of women with GDM (healthy eating alone, healthy eating with physical activity, myoinositol supplementation and probiotic treatment), and these results have not been replicated. The interventions tested to date include different diets and different forms of physical activity, in combination or alone, vitamin D, myoinositol, probiotics and metformin. Studies could be improved by using the International Association of Diabetes and Pregnancy Study Group criteria for GDM (which are probably more sensitive to change because of their multiple time points), targeting and tailoring interventions to subgroups most likely to benefit, and separating those with GDM early in pregnancy from those developing GDM de novo. The greatest societal benefit is likely to arise from population-based lifestyle approaches which include those women yet to become pregnant and those who are already pregnant and their families; an approach that is yet to be fully tested. PMID:25974384

  19. Effects of coffee on type 2 diabetes mellitus.

    PubMed

    Akash, Muhammad Sajid Hamid; Rehman, Kanwal; Chen, Shuqing

    2014-01-01

    This review provides the epidemiologic and research evidences documenting the effects of coffee consumption on type 2 diabetes mellitus (T2DM). We summarize the literature concerning the effects of coffee consumption on different mechanistic factors involving in pathogenesis of T2DM, such as glucose tolerance, insulin sensitivity, insulin resistance, glucose-6-phosphatase, intestinal glucose absorption, antioxidant activity, inflammatory biomarkers, nuclear factor-κB inhibition, glucose uptake, glucose homeostasis, glucose metabolism, and insulin secretion. These factors play a crucial role in influencing the normal levels of glucose in blood. Overall, the experimental and epidemiologic evidences presented here elucidate the protective effects of coffee consumption on T2DM, involving multiple preventive mechanisms. Despite the firm evidences available through a growing literature base, it is still uncertain whether the use of coffee should be recommended to patients with diabetes and/or any patient who might be at the risk of T2DM as a supplementary therapy to prevent further progression of T2DM. PMID:24984989

  20. Diabetes mellitus in Nigeria: The past, present and future.

    PubMed

    Ogbera, Anthonia Okeoghene; Ekpebegh, Chukwuma

    2014-12-15

    Diabetes mellitus (DM) is a diverse group of metabolic disorders that is often associated with a high disease burden in developing countries such as Nigeria. In the early nineties, not much was known about DM in Nigeria and traditionally, people related DM to "curses" or "hexes" and diagnosis was made based on blood or urinary tests for glucose. Currently, oral hypoglycaemic agents but not insulin are readily accessible and acceptable to persons with DM. The cost of diabetes care is borne in most instances by individuals and often payment is "out of pocket"-this being a sequel of a poorly functional national health insurance scheme. An insulin requiring individual on a minimum wage would spend 29% of his monthly income on insulin. Complementary and alternative medicines are widely used by persons with DM and form an integral component of DM care. Towards reducing the burden of DM in Nigeria, we suggest that there be concerted efforts by healthcare professionals and stakeholders in the health industry to put in place preventative measures, a better functioning health insurance scheme and a structured DM program. PMID:25512795

  1. Genetic polymorphisms of cytokine genes in type 2 diabetes mellitus

    PubMed Central

    Banerjee, Monisha; Saxena, Madhukar

    2014-01-01

    Diabetes mellitus is a combined metabolic disorder which includes hyperglycemia, dyslipidemia, stroke and several other complications. Various groups all over the world are relentlessly working out the possible role of a vast number of genes associated with type 2 diabetes (T2DM). Inflammation is an important outcome of any kind of imbalance in the body and is therefore an indicator of several diseases, including T2DM. Various ethnic populations around the world show different levels of variations in single nucleotide polymorphisms (SNPs). The present review was undertaken to explore the association of cytokine gene polymorphisms with T2DM in populations of different ethnicities. This will lead to the understanding of the role of cytokine genes in T2DM risk and development. Association studies of genotypes of SNPs present in cytokine genes will help to identify risk haplotype(s) for disease susceptibility by developing prognostic markers and alter treatment strategies for T2DM and related complications. This will enable individuals at risk to take prior precautionary measures and avoid or delay the onset of the disease. Future challenges will be to understand the genotypic interactions between SNPs in one cytokine gene or several genes at different loci and study their association with T2DM. PMID:25126395

  2. Accelerated cholesteryl ester transfer in noninsulin-dependent diabetes mellitus.

    PubMed

    Bagdade, J D; Lane, J T; Subbaiah, P V; Otto, M E; Ritter, M C

    1993-12-01

    Alterations in core lipid composition of lipoproteins in noninsulin-dependent diabetes mellitus (NIDDM) patients have suggested that the heteroexchange of neutral lipids between HDL and the apo B-containing lipoproteins may be enhanced. For this reason, we studied cholesteryl ester transfer (CET) in ten sulfonylurea-treated patients with stable NIDDM. CET measured in all NIDDM subjects with an assay of mass transfer was significantly greater than that of controls at 1 and 2 h (P < 0.001); the transfer of radiolabeled CE also was increased in a subset of four of the NIDDM group (NIDDM k = 0.21 +/- 0.04 vs. control k = 0.10 +/- 0.05; P < 0.05). A weak correlation was demonstrable between the mass of CE transferred at 1 h and diabetic control expressed as plasma fructosamine (r = 0.58, P < 0.09). To characterize this disturbance in CET further, the donor (HDL + VHDL) and acceptor (VLDL + LDL) lipoprotein fractions were isolated by ultracentrifugation at d 1.063 g/ml from NIDDM and control plasma and a series of recombination experiments were performed. Combining NIDDM acceptor with control donor fractions that contained HDL and CETP and not the combination of NIDDM donor and control acceptor lipoproteins resulted in an accelerated CET response identical to that observed in NIDDM whole plasma. This observation indicated that the abnormality in CET in NIDDM was associated with the VLDL + LDL fraction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8141851

  3. The effects of bariatric surgeries on type 2 diabetes mellitus

    NASA Astrophysics Data System (ADS)

    Lerd Ng, Jia; Ortiz, Roberto; Hughes, Tyler; Abou Ghantous, Michel; Bouhali, Othmane; Arredouani, Abdelilah; Allen, Roland

    2012-10-01

    We consider a scientific mystery which is of central importance in treating the most rapidly emerging national and global health threat: type 2 diabetes mellitus. The mystery involves a surprising effect of certain bariatric surgeries, and specifically Roux-en-Y gastric bypass (RYGB), a procedure which bypasses most of the stomach and upper intestine. An unanticipated result is that RYGB is usually found to contribute within only a few days to glucose homeostasis. This means the surgery can immediately cure patients even before they start losing weight. We are investigating this wondrous biochemical response with a quantitative model which includes the most important mechanisms. One of the major contributors is glucagon-like peptide 1 (GLP-1), an incretin whose concentration is found to increase by a large amount right after the RYGB surgical procedure. However, our results, in conjunction with the experimental and medical data, indicate that other substances must also contribute. If these substances can be definitively identified, it may be possible to replace the surgery with pharmaceuticals as the preferred treatment for type 2 diabetes.

  4. Pregnancy outcome in immigrant women with gestational diabetes mellitus.

    PubMed

    Dalfrà, Maria Grazia; Ragazzi, Eugenio; Masin, Michela; Bonsembiante, Barbara; Cosma, Chiara; Barison, Antonella; Toniato, Rosanna; Fedele, Domenico; Lapolla, Annunziata

    2011-06-01

    Recent studies show adverse outcomes of pregnancy among immigrant women from countries with high diabetes rates. We compared maternal and fetal outcomes in immigrant and Italian women with gestational diabetes mellitus (GDM) followed up at our center. Maternal characteristics considered were age, pre-pregnancy body mass index (BMI), HbA1c, frequency of insulin treatment, timing and mode of delivery, and hypertensive disorders; and, for fetal outcome, infants large or small for gestational age, and fetal complications. Pre-pregnancy BMI and HbA1c were higher in immigrant GDM women than in Italians, and more of them were on insulin. No differences in maternal outcome emerged between the two groups. More large for gestational age (LGA) babies were born to immigrant women than to Italians, but no other differences emerged. Apart from newborn LGA, maternal and fetal outcomes were comparable in our immigrant and Italian GDM women. Immigrant GDM women have favourable outcomes if given access to health care and language and cultural barriers are removed. PMID:20528567

  5. Association of Herpes Zoster and Type 1 Diabetes Mellitus

    PubMed Central

    Chen, Hsuan-Ju; Yeh, Su-Yin; Kao, Chia-Hung

    2016-01-01

    Objective The purpose of our study was to determine the association of type 1 diabetes mellitus (T1DM) and the risk of herpes zoster (HZ). Methods In this cohort study, we selected 4736 patients with T1DM registered in the Catastrophic Illness Patient Database who received insulin therapy before 2003 and 18944 participants without DM who were selected by frequency matched based on sex and age. Cox proportional hazard regression analysis was used to measure the hazard ratios (HRs) of HZ in the T1DM group compared with that in the non-T1DM group. Results Cox proportional hazard regression analysis showed that the adjusted HR of HZ was 2.38 times higher for patients in the T1DM group (95% CI = 1.77–3.19) than for those in the non-T1DM group. According to diabetes severity, mild and serious T1DM patients were associated with a higher risk of HZ (adjusted HR = 2.26, 95% CI = 1.67–3.05; and adjusted HR = 5.08, 95% CI = 2.66–9.71, respectively) than subjects without T1DM. Conclusion Patients with T1DM are at a higher risk of HZ than those without T1DM. PMID:27171477

  6. Managing Diabetes Mellitus in Children and Adolescents: Some Guidelines for Family Physicians

    PubMed Central

    Couch, Robert M.

    1990-01-01

    Insulin-dependent diabetes mellitus is a relatively common condition affecting children and adolescents. Successful management from the time of diagnosis can help prevent chronic complications of diabetes. This article reviews initial and follow-up management of diabetes in children. Guidelines for management during the remission phase, exercise, hypoglycemia, and illness, and the problems of recurrent ketoacidosis management in adolescence are discussed. The keys to successful management of diabetes mellitus in children and adolescents are patient and family education, continued support and encouragement, and early detection of and counselling for the dysfunctional family. PMID:21234001

  7. Risk perception and unrecognized type 2 diabetes in women with previous gestational diabetes mellitus

    PubMed Central

    Malcolm, Janine; Lawson, Margaret L; Gaboury, Isabelle; Keely, Erin

    2009-01-01

    Women with a history of gestational diabetes mellitus (GDM) have a high chance of developing type 2 diabetes mellitus (T2DM) following the index pregnancy, however, little is known of women's perception of this risk. The objectives were to (1) determine women's perception of risk of future development of T2DM following a GDM pregnancy and (2) describe the prevalence of undetected dysglycaemia in a Canadian population. The study was designed as a 9–11 year follow-up study of women previously enrolled in a randomized controlled trial of tight versus minimal intervention for GDM. Women's perception of future risk of diabetes was determined by questionnaire. Fasting lipid profile, height and weight were performed on all participants. Oral glucose tolerance tests were performed on all women without prior history of diabetes mellitus type 2 (DM2). The study was conducted at Ottawa Hospital General Campus and Children's Hospital of Eastern Ontario, in Ottawa, Canada. Eighty-nine of 299 (30%) of the original cohort were recruited. Eighty-eight women completed the questionnaire and 77 women without known diabetes underwent two hour glucose tolerance testing. Twenty-three (30%) felt their risk was no different than other women or did not know, 27 (35%) felt risk was increased a little and 27 (35%) felt risk was increased a lot. Only 52% (40/77) had normal glucose tolerance. Of all, 25/88 (28%) patients had diabetes (11 previously diagnosed and 14 diagnosed within the study). Of those newly diagnosed with DM2, four (29%) were diagnosed by fasting glucose, six (42%) by two hour glucose tolerance test (GTT) alone and four (29%) by both. Twenty-four of the women (27%) had impaired glucose tolerance (IGT). Of those with IGT, 12 (57%) had a fasting food glucose < 5.6 mmol/L. In the high-risk perception group with newly diagnosed diabetes, two were overweight, seven were obese, four had a family history of DM2, and all had a waist circumference >88 cm. In conclusion the

  8. Glycated albumin is an optimal biomarker for gestational diabetes mellitus

    PubMed Central

    HUANG, YAPING; HU, YONGWEI; MA, YU; YE, GUANGYONG

    2015-01-01

    Gestational diabetes mellitus (GDM) refers to abnormal glucose tolerance, which is a common complication that occurs in some women for the first time during the gestation period. However, the relationship between onset of GDM and factors including advanced age and a family history of diabetes remains to be determined. The study aimed to examine the clinical significance of the detection of glycated albumin (GA) in pregnant women with GDM. A total of 893 cases of pregnant women with GDM were included, with 661 healthy pregnant women serving as the normal controls. A conditional logistic regression model was used to analyze the univariate and multivariate data to estimate the odds ratio (OR) and 95% confidence interval (95% CI). As the gestational weeks increased, the fasting blood glucose (FGP) concentration and GA-L value of the pregnant women in the normal control group gradually decreased whereas those of pregnant women with GDM greatly increased. The univariate analysis revealed that the impact factors on the occurrence of early-onset neonatal sepsis included, mother's age >35 years, complication of pregnancy hypertension, family history of hypertension, family history of diabetes, cesarean delivery, height, BMI, GA-L, and FGP. The multivariate logistic regression analysis revealed that the complication of pregnancy hypertension (OR=3.302; 95% CI, 1.705–6.394), family history of hypertension (OR=2.970; 95% CI, 1.520–5.801), GA-L (OR=1.556; 95% CI, 0.940–2.012) and FGP (OR=5.431; 95% CI, 4.097–7.198) were the main factors for pregnant women with GDM. In conclusion, pregnant women with GDM may be affected by various factors. Additionally, GA may be applied to reflect the recent blood glucose control on pregnant women with GDM. PMID:26668607

  9. Impact of diabetes mellitus on bladder uroepithelial cells.

    PubMed

    Hanna-Mitchell, Ann T; Ruiz, Giovanni W; Daneshgari, Firouz; Liu, Guiming; Apodaca, Gerard; Birder, Lori A

    2013-01-15

    Diabetic bladder dysfunction (DBD), a prevalent complication of diabetes mellitus (DM), is characterized by a broad spectrum of symptoms including urinary urgency, frequency, and incontinence. As DBD is commonly diagnosed late, it is important to understand the chronic impact of DM on bladder tissues. While changes in bladder smooth muscle and innervation have been reported in diabetic patients, the impact of DM on the specialized epithelial lining of the urinary bladder, the urothelium (UT), is largely unknown. Quantitative polymerase chain reaction analysis and electron microscopy were used to evaluate UT gene expression and cell morphology 3, 9, and 20 wk following streptozotocin (STZ) induction of DM in female Sprague-Dawley rats compared with age-matched control tissue. Desquamation of superficial (umbrella) cells was noted at 9 wk DM, indicating a possible breach in barrier function. One causative factor may be metabolic burden due to chronic hyperglycemia, suggested by upregulation of the polyol pathway and glucose transport genes in DM UT. While superficial UT repopulation occurred by 20 wk DM, the phenotype was different, with significant upregulation of receptors associated with UT mechanosensation (transient receptor potential vanilloid subfamily member 1; TRPV1) and UT autocrine/paracrine signaling (acetylcholine receptors AChR-M2 and -M3, purinergic receptors P2X(2) and P2X(3)). Compromised barrier function and alterations in UT mechanosensitivity and cell signaling could contribute to bladder instability, hyperactivity, and altered bladder sensation by modulating activity of afferent nerve endings, which appose the urothelium. Our results show that DM impacts urothelial homeostasis and may contribute to the underlying mechanisms of DBD. PMID:23174855

  10. Progression of Coronary Artery Calcium in Type 1 Diabetes Mellitus

    PubMed Central

    Costacou, Tina; Edmundowicz, Daniel; Prince, Catherine; Conway, Baqiyyah; Orchard, Trevor J.

    2008-01-01

    Coronary artery calcium (CAC) has been previously associated with atherosclerotic plaque disease and coronary events. Thus, identifying predictors of CAC progression may provide new insights on early risk factor intervention and subsequent reduction of more severe atherosclerotic disease. We aimed to identify risk factors of CAC progression and evaluate whether risk factor change relates to CAC progression in a cohort of type 1 diabetes mellitus (DM). Participants of the Pittsburgh Epidemiology of Diabetes Complications study, a prospective investigation of childhood-onset type 1 DM, who received 2 electron beam computed tomography screenings 4 years apart were selected for study (n=222). CAC was calculated by the Agatston method of scoring and progression was defined as an increase >2.5 in the square root-transformed CAC score. Adjusting for diabetes duration and initial CAC score, body mass index (BMI, OR=1.13 95% CI=1.01-1.26), non-high density lipoprotein cholesterol (OR=1.01, 95% CI=1.003-1.03), and albumin excretion rate (OR=1.30, 95% CI=1.03-1.63) were associated with CAC progression. When considering change in risk factors, an increase in BMI (OR=1.38, 95% CI=1.10-1.72) was also associated with CAC progression after adjustment. In conclusion, in this cohort of type 1 DM, in addition to baseline BMI, non-high density lipoprotein cholesterol and albumin excretion rate, all known coronary artery disease risk factors, weight gain further added to the prediction of CAC progression. Thus, weight control, in addition to lipid and renal management may help retard atherosclerosis progression in type 1 DM. PMID:17996516

  11. Non-insulin-dependent (type II) diabetes mellitus.

    PubMed Central

    Rodger, W

    1991-01-01

    Non-insulin-dependent (type II) diabetes mellitus is an inherited metabolic disorder characterized by hyperglycemia with resistance to ketosis. The onset is usually after age 40 years. Patients are variably symptomatic and frequently obese, hyperlipidemic and hypertensive. Clinical, pathological and biochemical evidence suggests that the disease is caused by a combined defect of insulin secretion and insulin resistance. Goals in the treatment of hyperglycemia, dyslipidemia and hypertension should be appropriate to the patient's age, the status of diabetic complications and the safety of the regimen. Nonpharmacologic management includes meal planning to achieve a suitable weight, such that carbohydrates supply 50% to 60% of the daily energy intake, with limitation of saturated fats, cholesterol and salt when indicated, and physical activity appropriate to the patient's age and cardiovascular status. Follow-up should include regular visits with the physician, access to diabetes education, self-monitoring of the blood or urine glucose level and laboratory-based measurement of the plasma levels of glucose and glycated hemoglobin. If unacceptably high plasma glucose levels (e.g., 8 mmol/L or more before meals) persist the use of orally given hypoglycemic agents (a sulfonylurea agent or metformin or both) is indicated. Temporary insulin therapy may be needed during intercurrent illness, surgery or pregnancy. Long-term insulin therapy is recommended in patients with continuing symptoms or hyperglycemia despite treatment with diet modification and orally given hypoglycemic agents. The risk of pancreatitis may be reduced by treating severe hypertriglyceridemia (fasting serum level greater than 10 mmol/L) and atherosclerotic disease through dietary and, if necessary, pharmacologic management of dyslipidemia. Antihypertensive agents are available that have fewer adverse metabolic effects than thiazides and beta-adrenergic receptor blockers. New drugs are being developed that

  12. Impact of diabetes mellitus on bladder uroepithelial cells

    PubMed Central

    Ruiz, Giovanni W.; Daneshgari, Firouz; Liu, Guiming; Apodaca, Gerard; Birder, Lori A.

    2013-01-01

    Diabetic bladder dysfunction (DBD), a prevalent complication of diabetes mellitus (DM), is characterized by a broad spectrum of symptoms including urinary urgency, frequency, and incontinence. As DBD is commonly diagnosed late, it is important to understand the chronic impact of DM on bladder tissues. While changes in bladder smooth muscle and innervation have been reported in diabetic patients, the impact of DM on the specialized epithelial lining of the urinary bladder, the urothelium (UT), is largely unknown. Quantitative polymerase chain reaction analysis and electron microscopy were used to evaluate UT gene expression and cell morphology 3, 9, and 20 wk following streptozotocin (STZ) induction of DM in female Sprague-Dawley rats compared with age-matched control tissue. Desquamation of superficial (umbrella) cells was noted at 9 wk DM, indicating a possible breach in barrier function. One causative factor may be metabolic burden due to chronic hyperglycemia, suggested by upregulation of the polyol pathway and glucose transport genes in DM UT. While superficial UT repopulation occurred by 20 wk DM, the phenotype was different, with significant upregulation of receptors associated with UT mechanosensation (transient receptor potential vanilloid subfamily member 1; TRPV1) and UT autocrine/paracrine signaling (acetylcholine receptors AChR-M2 and -M3, purinergic receptors P2X2 and P2X3). Compromised barrier function and alterations in UT mechanosensitivity and cell signaling could contribute to bladder instability, hyperactivity, and altered bladder sensation by modulating activity of afferent nerve endings, which appose the urothelium. Our results show that DM impacts urothelial homeostasis and may contribute to the underlying mechanisms of DBD. PMID:23174855

  13. Relationship Between Myo-Inositol Supplementary and Gestational Diabetes Mellitus

    PubMed Central

    Zheng, Xiangqin; Liu, Zhaozhen; Zhang, Yulong; Lin, Yuan; Song, Jianrong; Zheng, Lianghui; Lin, Sheng

    2015-01-01

    Abstract To determine whether myo-inositol supplement will increase the action of endogenous insulin, which is mainly measured by markers of insulin resistance such as homeostasis model assessment of insulin resistance. PubMed, Cochrane Library, Embase, and web of science were comprehensively searched using “gestational diabetes mellitus” and “myo-inositol” to identify relevant studies. Both subject headings and free texts were adopted. The methodological quality of the included studies were assessed and pooled analyzed by the methods recommended by the Cochrane collaboration. A total of 5 trials containing 513 participants were included. There was a significant reduction in aspects of gestational diabetes incidence (risk ratio [RR], 0.29; 95% confidence interval (95% CI), 0.19–0.44), birth weight (mean difference [MD], −116.98; 95% CI, −208.87 to −25.09), fasting glucose oral glucose tolerance test (OGTT) (MD, −0.36; 95% CI, −0.51 to −0.21), 1-h glucose OGTT (MD, −0.63; 95% CI, −1.01 to −0.26), 2-h glucose OGTT (MD, −0.45; 95% CI, −0.75 to −0.16), and related complications (odds ratio [OR], 0.28; 95% CI 0.14–0.58). On the basis of current evidence, myo-inositol supplementation reduces the development of gestational diabetes mellitus (GDM), although this conclusion requires further evaluation in large-scale, multicenter, blinded randomized controlled trials. PMID:26496267

  14. Hemodynamic characterization of the diabetic Psammomys obesus--an animal model of type II diabetes mellitus.

    PubMed

    Hilzenrat, N; Sikuler, E; Yaari, A; Maislos, M

    1996-11-01

    The hemodynamic changes occurring early in the course of non-insulin-dependent diabetes mellitus (Type II, NIDDM) are not well understood. We applied the radioactive microspheres technique at an early stage of diabetes in Psammomys abesus (sand rat), an established animal model of spontaneous NIDDM. Ten diabetic and 7 control male animals were studied. Plasma glucose and insulin levels in the diabetic group were significantly higher than in the control group (21.3 +/- 2.1 vs. 6.2 +/- 1.1 mmol/l, and 2,650 +/- 480 vs. 770 +/- 120 pmol/l, respectively). Mean arterial blood pressure, heart rate, cardiac output, splanchnic blood flow, muscular blood flow, and total peripheral resistance were not statistically different between the two groups. Renal blood flow was significantly lower in the diabetic group (7.45 +/- 0.32 vs. 10.48 +/- 0.99 ml/min) and renal arterial resistance was higher (11.65 +/- 0.93 vs. 8.33 +/- 0.76 mm Hg.min/ml) compared with the control group. These results suggest that increased renal resistance and decreased renal blood flow may be the initial hemodynamic alterations in NIDDM. The combination of this animal model with the radioactive microspheres technique provides a new tool for studying the physiopathology, the natural history of hemodynamic changes, and possible therapeutic interventions of Type II diabetes. PMID:8960075

  15. Attitudes to Exercise and Diabetes in Young People with Type 1 Diabetes Mellitus: A Qualitative Analysis

    PubMed Central

    Ryninks, Kirsty; Sutton, Eileen; Thomas, Elizabeth; Jago, Russell; Shield, Julian P. H.; Burren, Christine P.

    2015-01-01

    Aims To investigate young people’s attitudes to, and understanding of, physical activity on glycaemic control in Type 1 Diabetes Mellitus. Methods Four focus groups with 11–14 and 15–16 year olds were conducted with twelve young people with Type 1 Diabetes, from within a larger study investigating physical activity and fitness. Qualitative analysis of the focus group data was performed using Interpretative Phenomenological Analysis. Results Four superordinate themes were identified: Benefits of Exercise, Knowledge and Understanding, Information and Training and “You can do anything”. Young people felt that exercising helped them to manage their diabetes and had a beneficial psychological and physical impact on their bodies. They reported a lack of knowledge and understanding about diabetes among school staff and other young people. The overwhelming sense from young people was that although diabetes impacts upon their lives, with preparation, physical activity can take place as normal. Conclusions Whilst young people had an awareness of the physical and psychological benefits of exercise in managing their diabetes, they experienced difficulties at school. Professional support and discussions with young people, giving tailored strategies for managing Type 1 Diabetes during exercise are needed. Healthcare teams should ensure that the support and educational needs of school staff are met. Providing more opportunities to empower young people to take on the responsibility for their Type 1 Diabetes care is merited. Young people felt diabetes did not stop them from participating in activities; it is simply a part of them that needs managing throughout life. PMID:26465770

  16. Prevalence and risk factors of diabetes mellitus among adults in Jaffna District.

    PubMed

    Amarasinghe, S; Balakumar, S; Arasaratnam, V

    2015-09-01

    A cross sectional descriptive study was carried out to determine the prevalence and risk factors of diabetes mellitus among adults in Jaffna District. Multistage stratified cluster sampling technique was employed to select 544 participants. An interviewer administrated questionnaire was used. Anthropometric and blood pressure (BP) measurements were recorded and biochemical parameters were analysed. Response rate was 95.3%. Of them, 224 (43.8%) were male. The prevalence of diabetes mellitus was 16.4% (95% CI: 13.3- 19.9); in males 19.6% (95% CI: 14.6-25.4) and in females 13.9% (95% CI: 10.1-18.5). Of the diabetics, 27.4% were previously undiagnosed. In the final multivariable model, participants with family history of diabetes were 3.5 times (p<0.001) more likely and those with high waist hip ratio were 2 times (p=0.009) more likely to develop diabetes mellitus. PMID:26520866

  17. 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

  18. Gestational diabetes mellitus: Challenges for different ethnic groups

    PubMed Central

    Yuen, Lili; Wong, Vincent W

    2015-01-01

    Ethnicity is defined as “belonging to a social group that has a common national or cultural tradition”. Membership of certain ethnic groups has long been associated with increased risk of gestational diabetes mellitus (GDM). Studies that examined ethnic differences amongst women with GDM were often conducted in western countries where women from various ethnic backgrounds were represented. The prevalence of GDM appears to be particularly high among women from South Asia and South East Asia, compared to Caucasian, African-American and Hispanic communities. For some, but not all ethnic groups, the body mass index is a risk factor for the development of GDM. Even within a particular ethnic group, those who were born in their native countries have a different risk profile for GDM compared to those born in western countries. In terms of treatment, medical nutrition therapy (MNT) plays a key role in the management of GDM and the prescription of MNT should be culturally sensitive. Limited studies have shown that women who live in an English-speaking country but predominantly speak a language other than English, have lower rates of dietary understanding compared with their English speaking counterparts, and this may affect compliance to therapy. Insulin therapy also plays an important role and there appears to be variation as to the progression of women who progress to requiring insulin among different ethnicities. As for peri-natal outcomes, women from Pacific Islander countries have higher rates of macrosomia, while women from Chinese backgrounds had lower adverse pregnancy outcomes. From a maternal outcome point of view, pregnant women from Asia with GDM have a higher incidence of abnormal glucose tolerance test results post-partum and hence a higher risk of future development of type 2 diabetes mellitus. On the other hand, women from Hispanic or African-American backgrounds with GDM are more likely to develop hypertension post-partum. This review highlights the

  19. Prevalence and severity of periodontal disease in type 2 diabetes mellitus (non–insulin-dependent diabetes mellitus) patients in Bangalore city: An epidemiological study

    PubMed Central

    Apoorva, S. M.; Sridhar, N.; Suchetha, A.

    2013-01-01

    Background: Our objective was to study the prevalence and severity of periodontal disease in type 2 diabetes mellitus (DM) patients in Bangalore city. Materials and Methods: Four hundred and eight type 2 DM patients (Study Group) and 100 non-diabetic patients (Control Group) among the age group of 35-75 years were included in the study. The study group was divided based on Glycated hemoglobin levels into well, moderately and poorly controlled. Relevant information regarding age, oral hygiene habits and personal habits was obtained from the patients. Diabetic status and mode of anti-diabetic therapy of the study group was obtained from the hospital records with consent from the patient. Community periodontal index (CPI) was used to assess the periodontal status. The results were statistically evaluated. Results: The mean CPI score and the number of missing teeth was higher in diabetics compared with non-diabetics, and was statistically significant (P=0.000), indicating that prevalence and extent of periodontal disease was more frequent and more severe in diabetic patients. The risk factors like Glycated hemoglobin, duration of diabetes, fasting blood sugar, personal habits and oral hygiene habits showed a positive correlation with periodontal destruction, whereas mode of anti-diabetic therapy showed a negative correlation according to the multiple regression analysis. The odds ratio of a diabetic showing periodontal destruction in comparison with a non-diabetic was 1.97, 2.10 and 2.42 in well, moderately and poorly controlled diabetics, respectively. Conclusion: Our study has made an attempt to determine the association between type 2 DM (NIDDM) and periodontal disease in Bangalore city. It was found that type 2 DM (non–insulin-dependent diabetes mellitus [NIDDM]) subjects manifested relatively higher prevalence and severity of periodontal disease as compared with non-diabetics. PMID:23633768

  20. Celiac disease in subjects with type 1 diabetes mellitus: a prevalence study in western Sicily (Italy).

    PubMed

    Greco, Domenico; Pisciotta, Maria; Gambina, Francesco; Maggio, Filippo

    2013-02-01

    The association between celiac disease and type 1 diabetes mellitus is well known. Up to now, celiac disease prevalence in children and adults with type 1 diabetes in Sicily has not been reported. The aim of this study was to assess the prevalence of celiac disease in patients with type 1 diabetes mellitus who come from a defined geographical area in western Sicily and to investigate the clinical features of these subjects. The records of 492 consecutive patients with type 1 diabetes mellitus referred in a period of 5 years were analyzed. During the period of the survey, out of 492 patients with type 1 diabetes, 22 (4.5 %) had a previous diagnosis of celiac disease. There were 14 females and 8 males; these patients showed a mean age of 13 years at diabetes onset. Diagnosis of celiac disease was often simultaneous or subsequent to that of diabetes. Autoimmune thyroiditis was coexisting in 8 patients (36 %). Our data confirm, in a Sicilian population, the not unusual association between celiac disease and type 1 diabetes, although prevalence rate is lower than in others Italian studies. Autoimmune thyroiditis is present with high prevalence in these patients. Celiac disease diagnosis often followed onset of type 1 diabetes, particularly in female subjects with a young age at diabetes onset; therefore, in these subjects, an active search for the presence of celiac disease is warranted for many years after appearance of diabetes. PMID:22707396

  1. Well-Being and Diabetes Management in Early Pregnant Women with Type 1 Diabetes Mellitus

    PubMed Central

    Linden, Karolina; Sparud-Lundin, Carina; Adolfsson, Annsofie; Berg, Marie

    2016-01-01

    This paper explores well-being and diabetes management in women with type 1 diabetes mellitus (DM) in early pregnancy and investigates associations among perceived well-being, diabetes management, and maternal characteristics. Questionnaires were answered by 168 Swedish women. Correlation analyses were conducted with Spearman’s correlation coefficient (rs). The women reported relatively high scores of self-efficacy in diabetes management (SWE-DES-10: 3.91 (0.51)) and self-perceived health (excellent (6.5%), very good (42.3%), good (38.7%), fair (11.3%) and poor (1.2%)). Moderate scores were reported for general well-being (WBQ-12: 22.6 (5.7)) and sense of coherence (SOC-13: 68.9 (9.7), moderate/low scores for hypoglycemia fear (SWE-HFS 26.6 (11.8)) and low scores of diabetes-distress (SWE-PAID-20 27.1 (15.9)). A higher capability of self-efficacy in diabetes management showed positive correlations with self-perceived health (rs = −0.41, p < 0.0001) and well-being (rs = 0.34, p < 0.0001) as well as negative correlations with diabetes distress (rs = −0.51, p < 0.0001) and hypoglycemia worries (rs = −0.27, p = 0.0009). Women with HbA1c levels of ≤48 mmL/mol scored higher in the subscales “goal achievement” in SWE-DES (p = 0.0028) and “comprehensibility” in SOC (p = 0.016). Well-being and diabetes management could be supported by strengthening the women’s capability to achieve glycemic goals and their comprehensibility in relation to the treatment. Further studies are needed to test this. PMID:27556476

  2. Well-Being and Diabetes Management in Early Pregnant Women with Type 1 Diabetes Mellitus.

    PubMed

    Linden, Karolina; Sparud-Lundin, Carina; Adolfsson, Annsofie; Berg, Marie

    2016-01-01

    This paper explores well-being and diabetes management in women with type 1 diabetes mellitus (DM) in early pregnancy and investigates associations among perceived well-being, diabetes management, and maternal characteristics. Questionnaires were answered by 168 Swedish women. Correlation analyses were conducted with Spearman's correlation coefficient (rs). The women reported relatively high scores of self-efficacy in diabetes management (SWE-DES-10: 3.91 (0.51)) and self-perceived health (excellent (6.5%), very good (42.3%), good (38.7%), fair (11.3%) and poor (1.2%)). Moderate scores were reported for general well-being (WBQ-12: 22.6 (5.7)) and sense of coherence (SOC-13: 68.9 (9.7), moderate/low scores for hypoglycemia fear (SWE-HFS 26.6 (11.8)) and low scores of diabetes-distress (SWE-PAID-20 27.1 (15.9)). A higher capability of self-efficacy in diabetes management showed positive correlations with self-perceived health (rs = -0.41, p < 0.0001) and well-being (rs = 0.34, p < 0.0001) as well as negative correlations with diabetes distress (rs = -0.51, p < 0.0001) and hypoglycemia worries (rs = -0.27, p = 0.0009). Women with HbA1c levels of ≤48 mmL/mol scored higher in the subscales "goal achievement" in SWE-DES (p = 0.0028) and "comprehensibility" in SOC (p = 0.016). Well-being and diabetes management could be supported by strengthening the women's capability to achieve glycemic goals and their comprehensibility in relation to the treatment. Further studies are needed to test this. PMID:27556476

  3. Development of cataract caused by diabetes mellitus: Raman study

    NASA Astrophysics Data System (ADS)

    Furić, Krešimir; Mohaček-Grošev, Vlasta; Hadžija, Mirko

    2005-06-01

    Diabetes mellitus succeeded by diabetic cataract was induced to experimental animals (Wistar rats) by applying an Alloxan injection. Eye properties deterioration were monitored from clinical standpoint and using Raman and infrared spectroscopies. All cases of developed cataract were followed by important changes in vibrational spectra, but Raman spectroscopy proved to be more useful because of larger number of resolved bands. Each kth Raman spectrum of diseased lens (in our notation k denotes disease age and cataract degree as described in chapter Alloxan diabetes) can be expressed as a sum of the Raman spectrum of healthy lens, I R, multiplied by a suitable constant ck, and the fluorescent background spectrum, I FB. We introduce the ratio of integrated intensities IFB and ck* IR as a physical parameter called fluorescent background index F FB. It turns out that FFB grows as cataract progresses and has its maximum at approx. 4, whence it decreases. FFB values are larger for 200-1800 cm -1 spectral interval than for 2500-4000 cm -1 interval. In the same manner another quantity called water band index FW is defined for each Raman spectrum of diseased lens in the 2800-3730 cm -1 interval. It is the ratio of the integrated intensity from 3100 to 3730 cm -1 (water band interval) divided by the integrated intensity of the 2800-3100 cm -1 interval (C-H stretching region). FW increases monotonously with cataract progression with maximum at the end of monitored period (5 months). These two indices helped us to formulate a model describing disease development from the earliest molecular changes to its macroscopic manifestation. As glucose and other small saccharide molecules enter the lens tissue, they bind to crystallin and other proteins via O- and S-glycosidic linkages which occur probably at tyrosine and cystein sites. In Raman spectrum this corresponds to broad bands at 540 and 1100 cm -1 which grow together with the fluorescent background, because both contributions

  4. Predictive Risk Factors in the Treatment of Gestational Diabetes Mellitus

    PubMed Central

    Aktun, Lebriz Hale; Yorgunlar, Betul; Karaca, Nilay; Akpak, Yaşam Kemal

    2015-01-01

    OBJECTIVE This study aims to investigate predictive risk factors in the treatment of gestational diabetes mellitus (GDM). PATIENTS AND METHODS A total of 256 pregnant women who underwent 75 g oral glucose tolerance test (OGTT) during 24–28 weeks of pregnancy were included according to the World Health Organization criteria. Demographic characteristics of the patients, including age, parity, family history of diabetes, body weight before pregnancy, and body weight at the diagnosis of GDM, were recorded. Fasting insulin and hemoglobin A1c (HbA1c) values at the time of diagnosis were evaluated. The patients were divided into two groups: those requiring insulin treatment (insulin group, n = 89) and those receiving diet therapy (diet group, n = 167) during pregnancy according to the American Diabetes Association recommendations. RESULTS A total of 34.76% of the pregnant women with GDM required insulin treatment. The mean age of these patients was significantly higher compared to the diet group (34.9 ± 0.6 years vs. 31.9 ± 0.6 years; P = 0.004). Body mass index before pregnancy was also significantly higher in the insulin group than that in the diet group (32 ± 0.9 kg/m2 vs. 29 ± 0.7 kg/m2; P = 0.004). Fasting blood glucose (FBG) during OGTT was 105.6 ± 2.1 mg/dL and 96.7 ± 1.1 mg/dL in the insulin group and diet group, respectively (P < 0.001). There was no significant difference in fasting plasma glucose during OGTT between the groups (P = 0.069), while plasma glucose at two hours was 161.1 ± 6.8 mg/dL in the insulin group and 145.1 ± 3.7 mg/dL in the diet group (P = 0.027). At the time of diagnosis, HbA1c values were significantly higher in the insulin group compared to the diet group (5.3 ± 0.1 vs. 4.9 ± 0.1; P = 0.001). There was no significant difference in FBG and homeostasis model assessment-insulin resistance values between the groups (P = 0.908, P = 0.073). CONCLUSION Our study results suggest that age, family history of diabetes, body weight before

  5. AB131. Genotype, phenotype of transient neonatal diabetes mellitus

    PubMed Central

    Can, Ngoc Thi Bich; Vu, Dung Chi; Bui, Thao Phuong; Nguyen, Khanh Ngoc; Nguyen, Dat Phu; Craig, Maria; Hattersley, Andrew; Nguyễn, Hoan Thi

    2015-01-01

    Background and objective Transient neonatal diabetes mellitus (TNDM) is a rare but remarkable form of diabetes which presents in infancy, resolves in the first months of life, but then frequently recurs in later life. It is caused by overexpression of the imprinted genes PLAGL1 and HYMAI on human chromosome 6q24, ABCC8 or KCNJ11 mutation. Over half of patients with maternal hypomethylation at the TNDM1 locus have additional hypomethylation of other maternally methylated imprinted genes throughout the genome, and the majority of these patients havemutations in the transcription factor ZFP57. This article aims to describe clinical features and laboratory manifestations of patient with TNDM and evaluate outcome of management. Methods Clinical features, biochemical finding, mutation analysis and management outcome of five cases from five unrelated families were study. All exon of KCNJ11, ABCC8 and INS genes were amplified from genomic DNA and directly sequenced. If the mutation of KCNJ11, ABCC8 and INS genes has failed to detect, methylation—specific PCR will be done to detect the loss of methylated region on chromosome 6q24. Results Five cases (two girls and three boys) onset at 26.2±11.2 days of age with gestation age of 38.6±2.6 weeks, birth weight of 2,440±512 g. 4/5 patients admitted with the feature of polydipsia, polyuria, macroglossia and diabetes ketone acidosis with pH of 7.11±0.2, blood glucose of 36.64±10.9 mmoL/L, HbA1C of 7.02%±0.96%. Methylation—specific PCR of two patients showed heterozygous mutation in ZFP57; two patients has maternal hypomethylation at the TND differentially methylated region on chromosome 6q24, in there, one methylation signature is characteristic of patients with mutations in ZFP57 in the process of carrying out ZFP57, one patient has heterozygous for the previously reported ABCC8 missense mutation, p.R1183W. All patients stopped insulin after 8.25±5.8 months of treatment. After 32±23 months of insulin stopped, all of

  6. Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus.

    PubMed

    Sohn, Elliott H; van Dijk, Hille W; Jiao, Chunhua; Kok, Pauline H B; Jeong, Woojin; Demirkaya, Nazli; Garmager, Allison; Wit, Ferdinand; Kucukevcilioglu, Murat; van Velthoven, Mirjam E J; DeVries, J Hans; Mullins, Robert F; Kuehn, Markus H; Schlingemann, Reinier Otto; Sonka, Milan; Verbraak, Frank D; Abràmoff, Michael David

    2016-05-10

    Diabetic retinopathy (DR) has long been recognized as a microvasculopathy, but retinal diabetic neuropathy (RDN), characterized by inner retinal neurodegeneration, also occurs in people with diabetes mellitus (DM). We report that in 45 people with DM and no to minimal DR there was significant, progressive loss of the nerve fiber layer (NFL) (0.25 μm/y) and the ganglion cell (GC)/inner plexiform layer (0.29 μm/y) on optical coherence tomography analysis (OCT) over a 4-y period, independent of glycated hemoglobin, age, and sex. The NFL was significantly thinner (17.3 μm) in the eyes of six donors with DM than in the eyes of six similarly aged control donors (30.4 μm), although retinal capillary density did not differ in the two groups. We confirmed significant, progressive inner retinal thinning in streptozotocin-induced "type 1" and B6.BKS(D)-Lepr(db)/J "type 2" diabetic mouse models on OCT; immunohistochemistry in type 1 mice showed GC loss but no difference in pericyte density or acellular capillaries. The results suggest that RDN may precede the established clinical and morphometric vascular changes caused by DM and represent a paradigm shift in our understanding of ocular diabetic complications. PMID:27114552

  7. Diabetes mellitus: An overview on its pharmacological aspects and reported medicinal plants having antidiabetic activity

    PubMed Central

    Patel, DK; Kumar, R; Laloo, D; Hemalatha, S

    2012-01-01

    Diabetes mellitus is not a single disease but is a group of metabolic disorders affecting a huge number of population in the world. It is mainly characterized by chronic hyperglycemia, resulting from defects in insulin secretion or insulin action. It is predicated that the number of diabetes person in the world could reach upto 366 million by the year 2030. Even though the cases of diabetes are increasing day by day, except insulin and oral hypoglycemic drugs no other way of treatment has been successfully developed so far. Thus, the objective of the present review is to provide an insight over the pathophysiological and etiological aspects of diabetes mellitus along with the remedies available for this metabolic disorder. The review also contains brief idea about diabetes mellitus and the experimental screening model with their relevant mechanism and significance mainly used nowadays. Alloxan and streptozotocin are mainly used for evaluating the antidiabetic activity of a particular drug. This review contain list of medicinal plants which have been tested for their antidiabetic activity in the alloxan induced diabetic rat model. From the available data in the literature, it was found that plant having antidiabetic activity is mainly due to the presence of the secondary metabolite. Thus, the information provided in this review will help the researchers for the development of an alternative methods rather than insulin and oral hypoglycemic agents for the treatment of diabetes mellitus, which will minimize the complication associated with the diabetes and related disorder. PMID:23569941

  8. Food Purchase Decision-Making Typologies of Women with Non-Insulin-Dependent Diabetes Mellitus.

    ERIC Educational Resources Information Center

    Miller, Carla; Warland, Rex; Achterberg, Cheryl

    1997-01-01

    Food selection is a key factor in the nutritional management of diabetes. Criteria that influence point-of-purchase decision making in women with non-insulin-dependent diabetes mellitus were identified. Four types of shoppers were distinguished from interviews; cluster analysis was used to confirm the analysis. Usefulness in patient education is…

  9. Cognitive Functioning and Academic Achievement in Children with Insulin-Dependent Diabetes Mellitus (IDDM).

    ERIC Educational Resources Information Center

    Holmes, Clarissa S.; And Others

    1995-01-01

    Consistent evidence relates insulin dependent diabetes mellitus (IDDM) to lower intellectual functioning in children, although performance is still in the average range. Children with IDDM have received specialized classroom assistance at school. Boys with diabetes appear at greater risk for learning problems than girls. Evidence suggests both…

  10. Parent-Child Relationships and the Management of Insulin-Dependent Diabetes Mellitus.

    ERIC Educational Resources Information Center

    Miller-Johnson, Shari; And Others

    1994-01-01

    Examined dimensions of parent-child relationships as predictors of adherence to treatment and metabolic control in study of 88 children/adolescents with insulin-dependent diabetes mellitus. Ratings of parent-child discipline, warmth, and behavioral support were not significantly associated with diabetes outcome, but parent-child conflict was…

  11. Psychoeducational Characteristics of Children and Adolescents with Insulin-Dependent Diabetes Mellitus.

    ERIC Educational Resources Information Center

    Rovet, Joanne F.; And Others

    1993-01-01

    This literature review considers the frequency and consistency of general and specific neurocognitive deficits in pediatric patients with insulin-dependent diabetes mellitus and the impact of these deficits on school achievement and learning disabilities. Findings are discussed in terms of the impact of the adequacy of diabetes control on specific…

  12. Health Behaviors Among Pregnant Latina Women at Risk for Gestational Diabetes Mellitus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Gestational diabetes mellitus (GDM), a common complication of pregnancy, increases the risk of subsequent diabetes and obesity. Latina women have over twice the risk for developing GDM as compared to non-Latina white women. Health-promoting practices during pregnancy may improve metabolic status an...

  13. Liraglutide in Type 2 Diabetes Mellitus: Clinical Pharmacokinetics and Pharmacodynamics.

    PubMed

    Jacobsen, Lisbeth V; Flint, Anne; Olsen, Anette K; Ingwersen, Steen H

    2016-06-01

    Liraglutide is an acylated glucagon-like peptide-1 analogue with 97 % amino acid homology with native glucagon-like peptide-1 and greatly protracted action. It is widely used for the treatment of type 2 diabetes mellitus, and administered by subcutaneous injection once daily. The pharmacokinetic properties of liraglutide enable 24-h exposure coverage, a requirement for 24-h glycaemic control with once-daily dosing. The mechanism of protraction relates to slowed release from the injection site, and a reduced elimination rate owing to metabolic stabilisation and reduced renal filtration. Drug exposure is largely independent of injection site, as well as age, race and ethnicity. Increasing body weight and male sex are associated with reduced concentrations, but there is substantial overlap between subgroups; therefore, dose escalation should be based on individual treatment outcome. Exposure is reduced with mild, moderate or severe renal or hepatic impairment. There are no clinically relevant changes in overall concentrations of various drugs (e.g. paracetamol, atorvastatin, griseofulvin, digoxin, lisinopril and oral combination contraceptives) when co-administered with liraglutide. Pharmacodynamic studies show multiple beneficial actions with liraglutide, including improved fasting and postprandial glycaemic control (mediated by increased insulin and reduced glucagon levels and minor delays in gastric emptying), reduced appetite and energy intake, and effects on postprandial lipid profiles. The counter-regulatory hormone response to hypoglycaemia is largely unaltered. The effects of liraglutide on insulin and glucagon secretion are glucose dependent, and hence the risk of hypoglycaemia is low. The pharmacokinetic and pharmacodynamic properties of liraglutide make it an important treatment option for many patients with type 2 diabetes. PMID:26597252

  14. Severity of Diabetes Mellitus and Total Hip or Knee Replacement

    PubMed Central

    Nielen, Johannes T.H.; Emans, Pieter J.; Dagnelie, Pieter C.; Boonen, Annelies; Lalmohamed, Arief; de Boer, Anthonius; van den Bemt, Bart J.F.; de Vries, Frank

    2016-01-01

    Abstract It is generally thought that people with diabetes mellitus (DM) are more likely to suffer from osteoarthritis (OA) due to an increased body mass index (BMI), resulting in mechanical destruction of cartilage. However, previous studies have suggested a coexisting metabolic causality. To evaluate the risk of hip or knee replacement, as a proxy for severe OA, in patients with DM. We additionally evaluated the risk of total joint replacement (TJR) with various proxies for increased DM severity. A population-based case–control study was performed, using the Clinical Practice Research Datalink (CPRD). Cases (n = 94,609) were defined as patients >18 years who had undergone TJR between 2000 and 2012. Controls were matched by age, gender, and general practice. Conditional logistic regression was used to estimate the risk of total knee (TKR) and total hip replacement (THR) surgery associated with use of antidiabetic drugs (ADs). We additionally stratified current AD users by proxies for DM severity. Current AD use was significantly associated with a lower risk of TKR (OR = 0.86 (95% CI = 0.78–0.94)) and THR (OR = 0.90 (95% CI = 0.82–0.99)) compared to patients not using ADs. Moreover, risk of TKR and THR was decreased with increasing HbA1c. This study does not support the theory that DM patients are more likely to suffer from severe OA as compared to patients without diabetes. Moreover, risk of severe OA necessitating TJR decreases with increasing DM severity. This is possibly due to dissimilarities in methodology, a decrease in eligibility for surgery, or variability of OA phenotypes. PMID:27196498

  15. Placental lipases in pregnancies complicated by gestational diabetes mellitus (GDM).

    PubMed

    Barrett, Helen L; Kubala, Marta H; Scholz Romero, Katherin; Denny, Kerina J; Woodruff, Trent M; McIntyre, H David; Callaway, Leonie K; Nitert, Marloes Dekker

    2014-01-01

    Infants of women with gestational diabetes mellitus (GDM) are more likely to be born large for gestational age with a higher percentage body fat. Elevated maternal lipids may contribute to this. Placental lipases such as lipoprotein lipase (LPL), endothelial lipase (EL) and hormone sensitive lipase (HSL) are involved in transferring lipids from mother to fetus. Previous studies of expression of these lipases in placentae in women with diabetes in pregnancy have reported divergent results. Intracellular lipases such as adipose triglyceride lipase (ATGL), and HSL are central to lipid droplet metabolism. The activities of these lipases are both influenced by Perilipin 1, and ATGL is also activated by a co-factor comparative gene identification-58 (CGI-58) and inhibited by G0/G1 switch gene 2 (GS02). None of these modifying factors or ATGL have been examined previously in placenta. The purpose of this study was therefore to examine the expression of ATGL, HSL, LPL, EL, as well as Perilipin 1, GS02 and CGI-58 in term pregnancies complicated by GDM. mRNA and protein expression of the lipases were measured in placentae from 17 women with GDM and 17 normoglycaemic pregnancies, matched for maternal BMI and gestational age of delivery. ATGL mRNA expression was increased and HSL mRNA expression reduced in placentae from GDM although there was no differences in protein expression of any of the lipases. All lipases were localised to trophoblasts and endothelial cells. The expression of Perilipin 1 and CGI-58 mRNA was increased and GS02 not altered in GDM. These results suggest that there is no difference in expression in these four lipases between GDM and normoglycaemic placentae, and therefore altered lipid transfer via these lipases does not contribute to large for gestational age in infants of women with GDM. PMID:25118138

  16. Biomarkers Associated with Ischemic Stroke in Diabetes Mellitus Patients.

    PubMed

    Yang, Shuisheng; Zhao, Jingfeng; Chen, Yuxiang; Lei, Minxiang

    2016-07-01

    Diabetes is an established risk factor for ischemic stroke, but the associated molecular mechanisms remain to be fully elucidated. This study investigated the role of plasma and platelet microRNAs and their targeting proteins in the activation of platelets and their association with the occurrence of ischemic stroke in patients with type 2 diabetes mellitus (T2DM). Results showed that the expressions of platelet and plasma miR-144 and miR-223 were significantly altered in T2DM patients with or without ischemic stroke compared to that in healthy controls, but these changes were more significant in T2DM patients with ischemic stroke. The expressions of P2Y12 and IRS-1 as well as phosphorylation levels of IRS-1, PI3K, and Akt in platelets were significantly altered in T2DM patients with or without ischemic stroke. The expression of platelet miR-144 and miR-223 significantly correlated with their plasma levels, P2Y12 and IRS-1 expression, blood glucose concentration, and platelet activation rate. High glucose concentration significantly elevated P-selectin, miR-144 and P2Y12 expression and significantly reduced miR-223 and IRS-1 expression in UT-7 cells. Overexpression of miR-223 and blocking of miR-144 expression significantly normalized the effects of high glucose concentration in UT-7 cells. In conclusion, hyperglycemia may activate platelets through miR-144 and miR-223 to downregulate IRS-1 and upregulate P2Y12 expression in the platelets of T2DM patients through an IRS-1-PI3K-Akt signaling. Low platelet and plasma miR-223 expression in addition to high platelet and plasma miR-144 expression are risk factors for ischemic stroke in T2DM patients. PMID:26175178

  17. Insulin Resistance, Diabetes Mellitus, and Brain Structure in Bipolar Disorders

    PubMed Central

    Hajek, Tomas; Calkin, Cynthia; Blagdon, Ryan; Slaney, Claire; Uher, Rudolf; Alda, Martin

    2014-01-01

    Type 2 diabetes mellitus (T2DM) damages the brain, especially the hippocampus, and frequently co-occurs with bipolar disorders (BD). Reduced hippocampal volumes are found only in some studies of BD subjects and may thus be secondary to the presence of certain clinical variables. Studying BD patients with abnormal glucose metabolism could help identify preventable risk factors for hippocampal atrophy in BD. We compared brain structure using optimized voxel-based morphometry of 1.5T MRI scans in 33 BD subjects with impaired glucose metabolism (19 with insulin resistance/glucose intolerance (IR/GI), 14 with T2DM), 15 euglycemic BD participants and 11 euglycemic, nonpsychiatric controls. The group of BD patients with IR, GI or T2DM had significantly smaller hippocampal volumes than the euglycemic BD participants (corrected p=0.02) or euglycemic, nonpsychiatric controls (corrected p=0.004). Already the BD subjects with IR/GI had smaller hippocampal volumes than euglycemic BD participants (t(32)=−3.15, p=0.004). Age was significantly more negatively associated with hippocampal volumes in BD subjects with IR/GI/T2DM than in the euglycemic BD participants (F(2, 44)=9.96, p=0.0003). The gray matter reductions in dysglycemic subjects extended to the cerebral cortex, including the insula. In conclusion, this is the first study demonstrating that T2DM or even prediabetes may be risk factors for smaller hippocampal and cortical volumes in BD. Abnormal glucose metabolism may accelerate the age-related decline in hippocampal volumes in BD. These findings raise the possibility that improving diabetes care among BD subjects and intervening already at the level of prediabetes could slow brain aging in BD. PMID:25074491

  18. Human embryonic stem cell-derived pancreatic endoderm alleviates diabetic pathology and improves reproductive outcome in C57BL/KsJ-Lep(db/+) gestational diabetes mellitus mice.

    PubMed

    Xing, Baoheng; Wang, Lili; Li, Qin; Cao, Yalei; Dong, Xiujuan; Liang, Jun; Wu, Xiaohua

    2015-07-01

    Gestational diabetes mellitus is a condition commonly encountered during mid to late pregnancy with pathologic manifestations including hyperglycemia, hyperinsulinemia, insulin resistance, and fetal maldevelopment. The cause of gestational diabetes mellitus can be attributed to both genetic and environmental factors, hence complicating its diagnosis and treatment. Pancreatic progenitors derived from human embryonic stem cells were shown to be able to effectively treat diabetes in mice. In this study, we have developed a system of treating diabetes using human embryonic stem cell-derived pancreatic endoderm in a mouse model of gestational diabetes mellitus. Human embryonic stem cells were differentiated in vitro into pancreatic endoderm, which were then transplanted into db/+ mice suffering from gestational diabetes mellitus. The transplant greatly improved glucose metabolism and reproductive outcome of the females compared with the control groups. Our findings support the feasibility of using differentiated human embryonic stem cells for treating gestational diabetes mellitus patients. PMID:26066567

  19. Sense of control and diabetes mellitus among U.S. adults: A cross-sectional analysis

    PubMed Central

    Cardarelli, Kathryn M; Vernon, Sally W; Baumler, Elizabeth R; Tortolero, Susan; David Low, M

    2007-01-01

    Background Little is known about the influence of psychosocial factors on diabetes mellitus. The aim of this study was to improve understanding of the association between two psychosocial factors- sense of control and social support- and diabetes mellitus. Methods The authors analyzed data from 2,592 U.S. households in the 1995 survey of the Aging, Status, and the Sense of Control study. Logistic regression analyses were conducted to examine whether sense of personal control and social support were associated with DM and whether gender, race, and Hispanic ethnicity modified these associations. Results After adjusting for age, obesity, and socioeconomic position, a one point increase in sense of control (i.e., a stronger sense of control) was associated a significant reduction in risk of diabetes mellitus (odds ratio = 0.67, 95% confidence interval: 0.47, 0.95). A weak social support system was associated with a non-significant risk of diabetes (odds ratio = 1.32, 95% confidence interval: 0.93, 1.89). No effect modification was detected. Conclusion Sense of control deserves greater attention as a predictor of diabetes mellitus. Further studies of the contribution of psychosocial factors to diabetes mellitus should assess the temporal nature of this relationship. PMID:17971217

  20. Newer oral and noninsulin therapies to treat type 2 diabetes mellitus.

    PubMed

    Hermayer, Kathie L; Dake, Andrew

    2016-05-01

    The pathophysiology of type 2 diabetes mellitus involves several biologic mechanisms and no single medication addresses them all. Most patients require more than one medication to adequately treat their diabetes, needing drugs with unique and complementary mechanisms of action to address and balance insulin and glucagon levels. In the past decade, several therapeutic drug classes have been developed for type 2 diabetes mellitus. Each provides therapeutic options with novel mechanisms of action to help clinicians achieve the goal of glucose homeostasis while controlling adverse events, especially reducing the risk of hypoglycemia. PMID:27176678

  1. Asymmetric dimethylarginine, a biomarker of cardiovascular complications in diabetes mellitus

    PubMed Central

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

    2015-01-01

    Cardiovascular (CV) complications are an essential causal element of prospect in diabetes mellitus (DM), with carotid atherosclerosis being a common risk factor for prospective crisis of coronary artery diseases and/or cerebral infarction in DM subjects. From another point of view, asymmetric dimethylarginine (ADMA) has been established as an inhibitor of endogenous nitric oxide synthesis and the relationship between ADMA and arteriosclerosis has been reported. In our study with 87 type 2 DM (T2DM) patients, we have examined whether ADMA and other CV risk factors are the useful predictors of DMCV complications. After the measurement of the respective CV risk factors, we have followed the enrolled T2DM patients for 5 years. We have finally analyzed 77 patients. DMCV complications developed in 15 cases newly within 5 years, and 4 cases recurred. The concentrations of ADMA in plasma were markedly more elevated in 19 DM patients with CV complications than in 58 DM patients without CV complications. Urinary albumin (U-Alb), mean intimal-medial thickness (IMT) and ankle brachial index (ABI) were also higher in patients with CV complications. Multiple regression analyses showed that U-Alb had an influence on the high level of ADMA (standardized β = 6.59, P = 0.00014) independently of age, systolic BP, fibrinogen, mean IMT, plaque score, and ABI. The review indicates what is presently known regarding plasma ADMA that might be a new and meaningful biomarker of CV complications in DM subjects. PMID:25992325

  2. Arsenic Exposure and Prevalence of Diabetes Mellitus in Korean Adults

    PubMed Central

    Rhee, Sang Youl; Hwang, You-Cheol; Chin, Sang Ouk; Chon, Suk; Kim, Young Seol

    2013-01-01

    It has been suggested that there is an association between environmental, low-level arsenic exposure and the risk of diabetes mellitus (DM), but little research has been conducted. Here, the glucose tolerance status and urinary creatinine adjusted total arsenic concentrations were analyzed in 3,602 subjects ≥ 20 yr of age who were registered for the Korea National Health and Nutrition Examination Survey, 2008-2009. Various demographic parameters were associated with urinary arsenic concentrations. After adjusting for these variables, urinary arsenic concentrations in subjects with DM were significantly higher than those in subjects with normal glucose tolerance and those with impaired fasting glucose (P < 0.001). Compared with the lowest quartile ( < 70.7 µg/g creatinine), the odds ratios and 95% confidence intervals for DM were 1.11 (0.73-1.68), 1.42 (0.94-2.13), and 1.56 (1.03-2.36) for urinary arsenic concentrations of 70.7 to < 117.7, 117.7 to < 193.4, and ≥ 193.4 µg/g creatinine, respectively, following multivariate adjustment. Furthermore, the urinary total arsenic concentration was inversely associated with the insulin secretion index, HOMA2 %B (β = -0.033, P = 0.032). These findings suggest that arsenic exposure, possibly involving beta cell dysfunction, is associated with an increased risk of DM in the Korean population. PMID:23772150

  3. Could Metformin Manage Gestational Diabetes Mellitus instead of Insulin?

    PubMed Central

    Abdelsalam, Walid A.; Mowafy, Hala E.; Abd ElHameid, Azza A.

    2016-01-01

    Gestational diabetes mellitus (GDM) complicates a significant number of pregnancies. Blood glucose control improves perinatal outcomes. Medical nutrition therapy is the foundation in management. Aim of This Study. To evaluate efficacy of metformin in comparison to insulin for managing GDM. Methods. In prospective randomized comparative study, 150 antenatal women whose pregnancies had been complicated by GDM and did not respond to diet alone were recruited from antenatal clinics at Obstetrics Department in Zagazig University Hospitals from November 2012 to December 2014. They were divided randomly into two groups, 75 patients in each, and were subjected to either insulin or metformin medication. Outcomes were comparing the effects of both medications on maternal glycemic control, antenatal complications, and neonatal outcome. Results. No significant difference in controlling high blood sugar in GDM with the use of metformin or insulin (P = 0.95, 0.15). Maternal complications in both groups had no significant difference and fetal outcomes were as well similar except the fact that the hypoglycemia occurred more in insulin group with P value 0.01. Conclusion. Glycaemic control in GDM can be achieved by using metformin orally without increasing risk of maternal hypoglycemia with satisfying neonatal outcome. PMID:27597988

  4. KCNJ11: Genetic Polymorphisms and Risk of Diabetes Mellitus

    PubMed Central

    Haghvirdizadeh, Polin; Mohamed, Zahurin; Abdullah, Nor Azizan; Haghvirdizadeh, Pantea; Haerian, Monir Sadat; Haerian, Batoul Sadat

    2015-01-01

    Diabetes mellitus (DM) is a major worldwide health problem and its prevalence has been rapidly increasing in the last century. It is caused by defects in insulin secretion or insulin action or both, leading to hyperglycemia. Of the various types of DM, type 2 occurs most frequently. Multiple genes and their interactions are involved in the insulin secretion pathway. Insulin secretion is mediated through the ATP-sensitive potassium (KATP) channel in pancreatic beta cells. This channel is a heteromeric protein, composed of four inward-rectifier potassium ion channel (Kir6.2) tetramers, which form the pore of the KATP channel, as well as sulfonylurea receptor 1 subunits surrounding the pore. Kir6.2 is encoded by the potassium inwardly rectifying channel, subfamily J, member 11 (KCNJ11) gene, a member of the potassium channel genes. Numerous studies have reported the involvement of single nucleotide polymorphisms of the KCNJ11 gene and their interactions in the susceptibility to DM. This review discusses the current evidence for the contribution of common KCNJ11 genetic variants to the development of DM. Future studies should concentrate on understanding the exact role played by these risk variants in the development of DM. PMID:26448950

  5. Diabetes Mellitus, Cognitive Impairment, and Traditional Chinese Medicine

    PubMed Central

    Seto, S. W.; Yang, G. Y.; Kiat, H.; Bensoussan, A.; Kwan, Y. W.; Chang, D.

    2015-01-01

    Diabetes mellitus (DM) is a metabolic disorder affecting a large number of people worldwide. Numerous studies have demonstrated that DM can cause damage to multiple systems, leading to complications such as heart disease, cancer, and cerebrovascular disorders. Numerous epidemiological studies have shown that DM is closely associated with dementia and cognition dysfunction, with recent research focusing on the role of DM-mediated cerebrovascular damage in dementia. Despite the therapeutic benefits of antidiabetic agents for the treatment of DM-mediated cognitive dysfunction, most of these pharmaceutical agents are associated with various undesirable side-effects and their long-term benefits are therefore in doubt. Early evidence exists to support the use of traditional Chinese medicine (TCM) interventions, which tend to have minimal toxicity and side-effects. More importantly, these TCM interventions appear to offer significant effects in reducing DM-related complications beyond blood glucose control. However, more research is needed to further validate these claims and to explore their relevant mechanisms of action. The aims of this paper are (1) to provide an updated overview on the association between DM and cognitive dysfunction and (2) to review the scientific evidence underpinning the use of TCM interventions for the treatment and prevention of DM-induced cognitive dysfunction and dementia. PMID:26060494

  6. New Insights for Oxidative Stress and Diabetes Mellitus

    PubMed Central

    2015-01-01

    The release of reactive oxygen species (ROS) and the generation of oxidative stress are considered critical factors for the pathogenesis of diabetes mellitus (DM), a disorder that is growing in prevalence and results in significant economic loss. New therapeutic directions that address the detrimental effects of oxidative stress may be especially warranted to develop effective care for the millions of individuals that currently suffer from DM. The mechanistic target of rapamycin (mTOR), silent mating type information regulation 2 homolog 1 (S. cerevisiae) (SIRT1), and Wnt1 inducible signaling pathway protein 1 (WISP1) are especially justified to be considered treatment targets for DM since these pathways can address the complex relationship between stem cells, trophic factors, impaired glucose tolerance, programmed cell death pathways of apoptosis and autophagy, tissue remodeling, cellular energy homeostasis, and vascular biology that greatly impact the biology and disease progression of DM. The translation and development of these pathways into viable therapies will require detailed understanding of their proliferative nature to maximize clinical efficacy and limit adverse effects that have the potential to lead to unintended consequences. PMID:26064426

  7. Programming Apoptosis and Autophagy with Novel Approaches for Diabetes Mellitus

    PubMed Central

    Maiese, Kenneth

    2015-01-01

    According to the World Health Organization, diabetes mellitus (DM) in the year 2030 will be ranked the seventh leading cause of death in the world. DM impacts all systems of the body with oxidant stress controlling cell fate through endoplasmic reticulum stress, mitochondrial dysfunction, alterations in uncoupling proteins, and the induction of apoptosis and autophagy. Multiple treatment approaches are being entertained for DM with Wnt1 inducible signaling pathway protein 1 (WISP1), mechanistic target of rapamycin (mTOR), and silent mating type information regulation 2 homolog) 1 (S. cerevisiae) (SIRT1) generating significant interest as target pathways that can address maintenance of glucose homeostasis as well as prevention of cellular pathology by controlling insulin resistance, stem cell proliferation, and the programmed cell death pathways of apoptosis and autophagy. WISP1, mTOR, and SIRT1 can rely upon similar pathways such as AMP activated protein kinase as well as govern cellular metabolism through cytokines such as EPO and oral hypoglycemics such as metformin. Yet, these pathways require precise biological control to exclude potentially detrimental clinical outcomes. Further elucidation of the ability to translate the roles of WISP1, mTOR, and SIRT1 into effective clinical avenues offers compelling prospects for new therapies against DM that can benefit hundreds of millions of individuals throughout the globe. PMID:25742566

  8. [Skin graft, smoking and diabetes mellitus type 2].

    PubMed

    Pérez-Guisado, Joaquín; Fidalgo-Rodríguez, Félix T; Gaston, Kate L; Rioja, Luis F; Thomas, Steven J

    2012-01-01

    Smoking and hyperglycemia decrease the success of skin graft survival in specific circumstances. It is well known that smoking and diabetes mellitus (DM) type 2 increase the oxidative and impair the endothelial function. The objective of this retrospective study was to determine if smoking and DM type 2 are factors associated with lower skin graft survival, in different etiologies of the injury associated to the skin loss. It was a bicentric, retrospective, cross sectional case control study, carried out on 2457 medical patients who met the inclusion criteria. It was carried out over a 10 years period between January 2000-December 2009, at Reina Sofía University Hospital (Córdoba, Spain) and UAB Hospital at Birmingham (Alabama, USA). The percentage of successful graft for each group and its control were analyzed by Chi-square test. The confidence interval chosen for statistical differences was 95%. Smoking and DM type 2 decreased the percentage of skin graft survival when compared with their control groups. DM type 2 was associated with greater negative success on skin graft survival than smoking when compared with their control groups. There was a statistically significant drop in skin graft of 18% in smoking group (range: 68-86%) and 25% in DM type 2 group (53-78%). The OR showed a clear association between the risk factors studied and the lower skin graft success, being stronger for DM type 2. In conclusion, DM type 2 and smoking are factors associated to lower skin graft take. PMID:23241288

  9. Ultrastructure of Placenta of Gravidas with Gestational Diabetes Mellitus

    PubMed Central

    Meng, Qian; Shao, Li; Luo, Xiucui; Mu, Yingping; Xu, Wen; Gao, Chao; Gao, Li; Liu, Jiayin; Cui, Yugui

    2015-01-01

    Objectives. Gestational diabetes mellitus (GDM) leads to an abnormal placental environment which may cause some structural alterations of placenta and affect placental development and function. In this study, the ultrastructural appearances of term placentas from women with GDM and normal pregnancy were meticulously compared. Materials and Methods. The placenta tissues of term birth from 10 women with GDM and 10 women with normal pregnancy were applied with the signed informed consent. The morphology of fetomaternal interface of placenta was examined using light microscopy (LM) and transmission electron microscopy (TEM). Results. On LM, the following morphological changes in villous tissues were found in the GDM placentas when compared with the control placentas: edematous stroma, apparent increase in the number of syncytial knots, and perivillous fibrin deposition. On TEM, the distinct ultrastructural alterations indicating the degeneration of terminal villi were found in the GDM placentas as follows: thickening of the basal membrane (BM) of vasculosyncytial membrane (VSM) and the VSM itself, significantly fewer or even absent syncytiotrophoblastic microvilli, swollen or completely destroyed mitochondria and endoplasmic reticulum, and syncytiotrophoblasts with multiple vacuoles. Conclusion. Ultrastructural differences exist between GDM and control placentas. The differences of placenta ultrastructure are likely responsible for the impairment of placental barrier and function in GDM. PMID:26379710

  10. Inflammation in Maternal Obesity and Gestational Diabetes Mellitus

    PubMed Central

    Pantham, Priyadarshini; Aye, Irving L. M. H; Powell, Theresa L.

    2015-01-01

    The prevalence of maternal obesity is rising rapidly worldwide and constitutes a major obstetric problem, increasing mortality and morbidity in both mother and offspring. Obese women are predisposed to pregnancy complications such as gestational diabetes mellitus (GDM), and children of obese mothers are more likely to develop cardiovascular and metabolic disease in later life. Maternal obesity and GDM may be associated with a state of chronic, low-grade inflammation termed “metainflammation”, as opposed to an acute inflammatory response. This inflammatory environment may be one mechanism by which offspring of obese women are programmed to develop adult disorders. Herein we review the evidence that maternal obesity and GDM are associated with changes in the maternal, fetal and placental inflammatory profile. Maternal inflammation in obesity and GDM may not always be associated with fetal inflammation. We propose that the placenta ‘senses’ and adapts to the maternal inflammatory environment, and plays a central role as both a target and producer of inflammatory mediators. In this manner, maternal obesity and GDM may indirectly program the fetus for later disease by influencing placental function. PMID:25972077

  11. Role of the Gut Microbiome in Obesity and Diabetes Mellitus.

    PubMed

    Barlow, Gillian M; Yu, Allen; Mathur, Ruchi

    2015-12-01

    Type 2 diabetes mellitus (T2DM) and obesity represent two of the biggest global health challenges of this century and are associated with significant comorbidities and healthcare costs. Although multiple factors undoubtedly contribute to the development and progression of DM and obesity, research over the last decade has demonstrated that the microbes that colonize the human gut may play key contributory roles. Gut microbes are now known to codevelop with the human host and are strongly influenced by mode of birth and early diet and nutrition, as well as environmental and other factors including antibiotic exposure. Gut microbes contribute to human health through roles in polysaccharide breakdown, nutrient absorption, inflammatory responses, gut permeability, and bile acid modification. Numerous studies have suggested that disruptions in the relative proportions of gut microbial populations may contribute to weight gain and insulin resistance, including alterations in Gammaproteobacteria and Verrucomicrobia and the ratios of Firmicutes to Bacteroidetes in weight gain and possible alterations in butyrate-producing bacteria such as Faecalibacterium prausnitzii in DM. In addition, it has been shown that the methanogenic Archaea may contribute to altered metabolism and weight gain in the host. However, the majority of studies are performed with stool or colonic samples and may not be representative of the metabolically active small intestine. Studies predominantly in rodent models are beginning to elucidate the mechanisms by which gut microbes contribute to DM and obesity, but much remains to be learned before we can begin to approach targeted treatments. PMID:26452391

  12. Gestational diabetes mellitus: does an effective prevention strategy exist?

    PubMed

    Agha-Jaffar, Rochan; Oliver, Nick; Johnston, Desmond; Robinson, Stephen

    2016-09-01

    The overall incidence of gestational diabetes mellitus (GDM) is increasing worldwide. Preventing pathological hyperglycaemia during pregnancy could have several benefits: a reduction in the immediate adverse outcomes during pregnancy, a reduced risk of long-term sequelae and a decrease in the economic burden to healthcare systems. In this Review we examine the evidence supporting lifestyle modification strategies in women with and without risk factors for GDM, and the efficacy of dietary supplementation and pharmacological approaches to prevent this disease. A high degree of heterogeneity exists between trials so a generalised recommendation is problematic. In population studies of dietary or combined lifestyle measures, risk of developing GDM is not improved and those involving a physical activity intervention have yielded conflicting results. In pregnant women with obesity, dietary modification might reduce fetal macrosomia but in these patients, low compliance and no significant reduction in the incidence of GDM has been observed in trials investigating physical activity. Supplementation with probiotics or myoinositol have reduced the incidence of GDM but confirmatory studies are still needed. In randomized controlled trials, metformin does not prevent GDM in certain at-risk groups. Given the considerable potential for reducing disease burden, further research is needed to identify strategies that can be easily and effectively implemented on a population level. PMID:27339886

  13. Obstetric and Neonatal Outcome in PCOS with Gestational Diabetes Mellitus

    PubMed Central

    Foroozanfard, Fatemeh; Moosavi, Seyed Gholam Abbas; Mansouri, Fariba

    2014-01-01

    Objective There are some metabolic similarities between women with gestational diabetes mellitus (GDM) and polycystic ovary syndrome (PCOS); it is still uncertain, however, to what extent coexistence GDM and PCOS affects pregnancy outcome. The present study was designed to determine the obstetric and neonatal outcome in PCOS with GDM. Materials and methods A case-control study was conducted involving 261 GDM women. Thirty hundred-one cases had PCOS based on Rotterdam criteria and the other thirty hundred cases (control group) were women without PCOS. The subjects in each group were evaluated regarding obstetric and those women whose documentation's were complete entered the study. Results In present study, women with PCOS and GDM had more than twofold increased odds of preeclampsia (p = 0.003, CI = 1.56–5.01, and OR = 2.8) and PIH (p= 0.04, CI = 1.28–4.5, and OR= 2.4). Maternal PCOS and GDM were also associated with threefold increased odds of neonatal hypoglycemia (p= 0.004, CI= 1.49–6.58, and OR= 3.13). Conclusion Our finding emphasized that pregnant PCOS patients should be followed carefully for the occurrence of various pregnancy and neonatal complications including hypertension and hypoglycemia. We suggested that these neonates should be given more care regarding hypoglycemia symptoms. PMID:24971127

  14. Effect of Rhizoma coptidis (Huang Lian) on Treating Diabetes Mellitus

    PubMed Central

    Pang, Bing; Yu, Xiao-Tong; Zhou, Qiang; Zhao, Tian-Yu; Wang, Han; Gu, Cheng-Juan; Tong, Xiao-Lin

    2015-01-01

    The rapidly increasing diabetes mellitus (DM) is becoming a major public health issue globally; considerable progress has been made in the field of western hypoglycemic drug and insulin, but some shortages still exist. As one of the most important parts in complementary and alternative therapies, traditional Chinese medicine (TCM) performs a good clinical practice and is showing a bright future in the treatment of DM. TCM therapy has certain advantages of less toxicity and/or side effects, and Chinese herbal medicine which usually contains various active ingredients could provide multiple therapeutic effects. Huang Lian (Rhizoma coptidis, RC) is a herb frequently used in many traditional formulas for properties of “clearing damp-heat, quenching fire, and counteracting poison” in Asia for centuries. In this review, we summarize the application of RC in the treatment of DM from two aspects of contents. Firstly, theoretical principles are explained, including the properties and related records about RC in ancient references and modern pharmacological researches and pharmacokinetics on RC and its active components. Secondly, the clinical application of RC is mainly reviewed, such as applicable stage and syndrome, the reasonable dose range, the preparation formulations, and the toxicity and/or side effects and solutions to its adverse actions. This review provides scientific evidence about the effective components, pharmacological researches, and toxicity of RC, as well as introducing traditional Chinese medical theory and clinical experience, in order to guide clinician to use RC more suitably and reasonably in the clinical practice. PMID:26508987

  15. Decision-making in diabetes mellitus type 1.

    PubMed

    Rustad, James K; Musselman, Dominique L; Skyler, Jay S; Matheson, Della; Delamater, Alan; Kenyon, Norma S; Cáceda, Ricardo; Nemeroff, Charles B

    2013-01-01

    Decreased treatment adherence in patients with diabetes mellitus type 1 (type 1 DM) may reflect impairments in decision-making and underlying associated deficits in working memory and executive functioning. Other factors, including comorbid major depression, may also interfere with decision-making. The authors sought to review the clinically relevant characteristics of decision-making in type 1 DM by surveying the literature on decision-making by patients with type 1 DM. Deficiencies in decision-making in patients with type 1 DM or their caregivers contribute to treatment nonadherence and poorer metabolic control. Animal models of type 1 DM reveal deficits in hippocampal-dependent memory tasks, which are reversible with insulin. Neurocognitive studies of patients with type 1 DM reveal lowered performance on ability to apply knowledge to solve problems in a new situation and acquired scholarly knowledge, psychomotor efficiency, cognitive flexibility, visual perception, speed of information-processing, and sustained attention. Other factors that might contribute to poor decision-making in patients with type 1 DM, include "hypoglycemia unawareness" and comorbid major depression (given its increased prevalence in type 1 DM). Future studies utilizing novel treatment strategies to help patients with type 1 DM make better decisions about their disease may improve their glycemic control and quality of life, while minimizing the impact of end-organ disease. PMID:23487192

  16. Effect of Rhizoma coptidis (Huang Lian) on Treating Diabetes Mellitus.

    PubMed

    Pang, Bing; Yu, Xiao-Tong; Zhou, Qiang; Zhao, Tian-Yu; Wang, Han; Gu, Cheng-Juan; Tong, Xiao-Lin

    2015-01-01

    The rapidly increasing diabetes mellitus (DM) is becoming a major public health issue globally; considerable progress has been made in the field of western hypoglycemic drug and insulin, but some shortages still exist. As one of the most important parts in complementary and alternative therapies, traditional Chinese medicine (TCM) performs a good clinical practice and is showing a bright future in the treatment of DM. TCM therapy has certain advantages of less toxicity and/or side effects, and Chinese herbal medicine which usually contains various active ingredients could provide multiple therapeutic effects. Huang Lian (Rhizoma coptidis, RC) is a herb frequently used in many traditional formulas for properties of "clearing damp-heat, quenching fire, and counteracting poison" in Asia for centuries. In this review, we summarize the application of RC in the treatment of DM from two aspects of contents. Firstly, theoretical principles are explained, including the properties and related records about RC in ancient references and modern pharmacological researches and pharmacokinetics on RC and its active components. Secondly, the clinical application of RC is mainly reviewed, such as applicable stage and syndrome, the reasonable dose range, the preparation formulations, and the toxicity and/or side effects and solutions to its adverse actions. This review provides scientific evidence about the effective components, pharmacological researches, and toxicity of RC, as well as introducing traditional Chinese medical theory and clinical experience, in order to guide clinician to use RC more suitably and reasonably in the clinical practice. PMID:26508987

  17. Accuracy of blood glucose estimates in adolescents with diabetes mellitus.

    PubMed

    Ruggiero, L; Kairys, S; Fritz, G; Wood, M

    1991-03-01

    Although self-monitoring of blood glucose (SMBG) is an integral part of the daily self-care regimen for the effective management of insulin-dependent diabetes mellitus (IDDM), compliance with this task remains a significant problem, particularly for adolescents. Research should be focused on identifying other management approaches which may supplement SMBG. One potential approach involves placing greater reliance on the patient's own ability to estimate glucose levels. Although some research has examined blood glucose self-estimation in adults, little is known about this construct in children and adolescents. The purpose of the current study was to examine the accuracy of blood glucose self-estimates in adolescents with IDDM and examine the relation between child characteristics and accuracy. The results for 70 adolescents with IDDM indicated that as a group they were moderately accurate in estimating their glucose levels; however, much variability in accuracy was found among subjects. Subject characteristics were not found to be significantly related to accuracy. PMID:2015234

  18. Cardiovascular Control during Exercise in Type 2 Diabetes Mellitus

    PubMed Central

    Green, Simon; Egaña, Mikel; Baldi, J. Chris; Lamberts, Regis; Regensteiner, Judith G.

    2015-01-01

    Controlled studies of male and female subjects with type 2 diabetes mellitus (DM) of short duration (~3–5 years) show that DM reduces peak V˙O2 (L·min−1 and mL·kg−1·min−1) by an average of 12–15% and induces a greater slowing of the dynamic response of pulmonary V˙O2 during submaximal exercise. These effects occur in individuals less than 60 years of age but are reduced or absent in older males and are consistently associated with significant increases in the exercise pressor response despite normal resting blood pressure. This exaggerated pressor response, evidence of exertional hypertension in DM, is manifest during moderate submaximal exercise and coincides with a more constrained vasodilation in contracting muscles. Maximum vasodilation during contractions involving single muscle groups is reduced by DM, and the dynamic response of vasodilation during submaximal contractions is slowed. Such vascular constraint most likely contributes to exertional hypertension, impairs dynamic and peak V˙O2 responses, and reduces exercise tolerance. There is a need to establish the effect of DM on dynamic aspects of vascular control in skeletal muscle during whole-body exercise and to clarify contributions of altered cardiovascular control and increased arterial stiffness to exertional hypertension. PMID:25918732

  19. Ludwig's angina and ketoacidosis as a first manifestation of diabetes mellitus.

    PubMed

    Infante-Cossío, Pedro; Fernández-Hinojosa, Esteban; Mangas-Cruz, Miguel-Angel; González-Pérez, Luis-Miguel

    2010-07-01

    Ludwig's angina is a serious and rapidly progressive infectious process that spreads through the floor of the mouth and neck. In this paper we present an infrequent case of a patient who suffered an odontogenic infection with poor response to the previous treatment, which evolved towards a Ludwig's angina combined with ketoacidosis in the context of a diabetes mellitus not known before. According to the literature reviewed, this case report represents the first contribution of a Ludwig's angina and ketoacidosis as an initial manifestation of a diabetes mellitus. The airway management, the antibiotic prescription and the surgical drainage allowed the healing of the patient without medical complications. Factors of co-morbidity like the diabetes mellitus together with focus tooth of infection may eventually turn into serious medical complications as the diabetic ketoacidosis and develop potentially lethal cervical infections. PMID:20173723

  20. Adiponectin as a Protective Factor Against the Progression Toward Type 2 Diabetes Mellitus in Postmenopausal Women

    PubMed Central

    Darabi, Hossein; Raeisi, Alireza; Kalantarhormozi, Mohammad Reza; Ostovar, Afshin; Assadi, Majid; Asadipooya, Kamyar; Vahdat, Katayoun; Dobaradaran, Sina; Nabipour, Iraj

    2015-01-01

    Abstract Serum adiponectin levels have been suggested to be predictors of type 2 diabetes mellitus in diverse populations. However, the relationship between circulating adiponectin levels and the risk of development of type 2 diabetes in postmenopausal women has not been investigated. A total of 382 healthy postmenopausal women who participated in a prospective cohort study were followed for 5.8 years. Type 2 diabetes mellitus was defined according to the criteria set out by the American Diabetes Association. Adiponectin, osteoprotegerin (OPG), and high-sensitivity C-reactive protein (hs-CRP) levels were measured using ELISA. Of 195 women who did not have diabetes at baseline and who were reexamined in the second phase of the study for diabetic status, 35 subjects (17.9%) developed type 2 diabetes mellitus during the 5.8 years follow-up period. The women with type 2 diabetes had lower adiponectin levels than the healthy postmenopausal women. Multiple regression analysis showed that, after adjustments were made for age, cardiovascular risk factors, OPG, and hs-CRP levels, higher baseline adiponectin levels were associated with a lower relative risk (RR) of having type 2 (RR = 0.07, confidence interval [CI]: 0.01–0.66, P = 0.021). Higher baseline adiponectin levels functioned as a predictor of a lower risk of developing type 2 diabetes mellitus among postmenopausal women during a 5.8 years follow-up study. Therefore, it is suggested that elevated adiponectin levels may offer protection against the development of type 2 diabetes mellitus after the menopause. PMID:26287420

  1. Risk of Hand Syndromes in Patients With Diabetes Mellitus

    PubMed Central

    Chen, Lu-Hsuan; Li, Chung-Yi; Kuo, Li-Chieh; Wang, Liang-Yi; Kuo, Ken N.; Jou, I-Ming; Hou, Wen-Hsuan

    2015-01-01

    Abstract The aim of this study was to assess the overall and cause-specific incidences of diabetic hand syndromes (DHS) in patients with diabetes mellitus (DM) by using age and sex stratifications. The DM and control cohorts comprised 606,152 patients with DM and 609,970 age- and sex-matched subjects, respectively, who were followed up from 2000 to 2008. We estimated the incidence densities (IDs) of overall and cause-specific DHS, namely carpal tunnel syndrome (CTS), stenosing flexor tenosynovitis (SFT), limited joint mobility (LJM), and Dupuytren disease (DD), and calculated the hazard ratios (HRs) of DHS in relation to DM by using a Cox proportional hazards model with adjustment for potential confounders. Over a 9-year period, 51,207 patients with DM (8.45%) and 39,153 matched controls (6.42%) sought ambulatory care visits for various DHS, with an ID of 117.7 and 80.7 per 10,000 person-years, respectively. The highest cause-specific ID was observed for CTS, followed by SFT, LJM, and DD, regardless of the diabetic status. After adjustment for potential confounders, patients with DM had a significantly high HR of overall DHS (1.51, 95% confidence interval [CI] = 1.48–1.53). Men and women aged <35 years had the highest HR (2.64, 95% CI = 2.15–3.24 and 2.99, 95% CI = 2.55–3.50, respectively). Cause-specific analyses revealed that DM was more strongly associated with SFT (HR = 1.90, 95% CI = 1.86–1.95) and DD (HR = 1.83, 95% CI = 1.39–2.39) than with CTS (HR = 1.31, 95% CI = 1.28–1.34) and LJM (HR = 1.24, 95% CI = 1.13–1.35). Men and younger patients with DM have the highest risk of DHS. Certain hand syndromes, such as SFT and DD, were more strongly associated with DM than with other syndromes and require the attention of clinicians. PMID:26469895

  2. Reproductive function in male patients with type 1 diabetes mellitus.

    PubMed

    La Vignera, S; Condorelli, R A; Di Mauro, M; Lo Presti, D; Mongioì, L M; Russo, G; Calogero, A E

    2015-11-01

    This study was undertaken to evaluate conventional and some of the main bio-functional spermatozoa parameters, serum gonadal hormones and didymo-epididymal ultrasound features in patients with type 1 diabetes mellitus (DM1). DM1 affects an increasing number of men of reproductive age. Diabetes may affect male reproduction by acting on the hypothalamic-pituitary-testicular axis, causing sexual dysfunction or disrupting male accessory gland function. However, data on spermatozoa parameters and other aspects of the reproductive function in these patients are scanty. Thirty-two patients with DM1 [27.0 (25.0-30.0 years)] and 20 age-matched fertile healthy men [28.0 (27.25-30.75 years)] were enrolled. Patients with diabetic neuropathy, other endocrine disorders or conditions known to alter spermatozoa parameters were excluded. Each subject underwent semen analysis, blood withdrawal for fasting and post-prandial glycaemia, hormonal analysis and didymo-epididymal ultrasound evaluation before and after ejaculation. Patients with DM1 had a lower percentage of spermatozoa with progressive motility [10.0 (7.0-12.75) vs. 45.0 (42.0-47.75) %; p < 0.01] and a higher percentage of spermatozoa with abnormal mitochondrial function than controls [47.0 (43.0-55.0) vs. 2.0 (1.0-5.0) %; p < 0.01]. Patients also had greater post-ejaculatory diameters of cephalic [11.5 (10.2-13.6) vs. 6.0 (4.0-7.0) mm; p < 0.01] and caudal epididymis [5.5 (4.00-7.55) vs. 3.0 (2.0-4.0) mm; p < 0.01] compared to controls, suggesting a lack of the physiological post-ejaculation epididymal shrinkage. Correlation analysis suggested that progressive motility was associated with fasting glucose (r = -0.68; p < 0.01). The other parameters did not show any significant difference. Patients with DM1 had a lower percentage of spermatozoa with progressive motility, impaired mitochondrial function and epididymal post-ejaculatory dysfunction. These findings may explain why patients with DM1 experience fertility

  3. AB128. Neonatal diabetes mellitus: genotype, phenotype and outcome

    PubMed Central

    Can, Ngoc Thi Bich; Vu, Dung Chi; Bui, Thao Phuong; Nguyen, Khanh Ngoc; Flanagan, Sarah; Ellard, Sian; Craig, Maria; Nguyen, Dat Phu; Nguyen, Hoan Thi

    2015-01-01

    Background and objective Neonatal diabetes mellitus (NDM) is a rare (1:300,000-400,000 newborns) but potentially devastating metabolic disorder characterized by hyperglycemia combined with low levels of insulin. Two main groups have been recognized on clinical grounds, transient NDM (TNDM) and permanent NDM (PNDM). This article aims to describe clinical features and laboratory manifestations of patient with NDM and evaluate outcome of management. Methods and materials Clinical features, biochemical finding, mutation analysis and management outcome of 24 cases 24 unrelated families were study. All exon of KCNJ11, ABCC8 and INS genes were amplified from genomic DNA and directly sequenced. If the mutation of KCNJ11, ABCC8 and INS has failed to detect, methylation—specific PCR will be done to detect the loss of methylated region on chromosome 6q24. Results Twenty-four cases (11 girls and 13 boys) onset at 67.3±44 days of age with gestation age of 38.79±2.2 weeks and birth weight of 2,720.8±571.7 g. 9/24 cases admitted with the feature of polydipsia, polyuria and 17 cases with diabetes keton acidosis with pH of 7.13±0.18, blood glucose of 34.8±10.0 mmoL/L, HbA1C of 7.9%±2.9%. Mutation analysis showed six patients with heterozygous for a KCNJ11 missense mutation, seven patients with ABCC8 mutations, four patients with abnormal of chromosom 6, six patients with INS mutation, one patient with EIF2AK3 mutation. The patients have been followed up during 54.4±46.6 months (4 months to 14 years). Five patients with TNDM stop insulin at 8.25±5.8 months of diagnosis: four cases have abnormal of 6q24, one case has ABCC8 mutation. Now all cases have normoglycemic (blood glucose: 5.0 and 5.9 mmoL/L), one patient has mild development delay and four patients has normal development. Nineteen patients with PNDM: 13 cases successfully transferred onto sulfonylureas and did not need insulin injections, six cases require insulin. In there, two cases with DEND syndrome have

  4. Diabetes mellitus, thyroid dysfunctions and osteoporosis: is there an association?

    PubMed Central

    2013-01-01

    Background Osteoporosis is the most common metabolic bone disease with complicated, multifactorial and heterogenic nature that has no known pathological cause. As the role of Diabetes Mellitus (DM) and thyroid dysfunctions in the prevalence of osteoporosis is not exactly known, therefore this study was designed to evaluate the probable association between osteoporosis with DM and thyroid dysfunctions in Iranian patients. Methods In this cross-sectional study, 300 subjects out of the total number of patients referring to Gorgan bone densitometry centers (3000subjects) were selected via random sampling method in 2009. Individual characteristics, DM, thyroid dysfunctions and densitometry results were collected from densitometry records. Data analysis was carried out by SPSS version 16 software and by using Chi square and T-test. The level of significance in all tests was considered 0.05. Results The mean of T-score in lumbar and femoral areas of diabetic patients were -0.87 ± 1.08 and -1.94 ± 1.33 and in patient with thyroid dysfunctions was -0.80 ± 1.09 and -1.64 ± 1.24 respectively. The mean of BMD in lumbar and femoral areas of diabetic patients were 0.96 ± 0.19 and 0.75 ± 0.19 and in patient with thyroid dysfunctions were 0.96 ± 0.17 and 0.76 ±0.19 respectively. The mean of BMI in osteoporotic subjects in the lumbar and femoral areas were 25.94 ± 5.62 and 26.95 ± 5.20 respectively. The association between BMI and BMD in the lumbar and femoral areas were statistically significant, but the association between DM and thyroid dysfunctions with BMD and T-score in the femoral and lumbar areas was not statistically significant (P-value > 0.05). Conclusion The results of current study show that there is no association between DM and thyroid dysfunctions with osteoporosis. PMID:23834744

  5. The effects of medicinal plants on renal function and blood pressure in diabetes mellitus.

    PubMed

    Musabayane, C T

    2012-09-01

    Diabetes mellitus is one of the most common chronic global diseases affecting children and adolescents in both the developed and developing nations. The major types of diabetes mellitus are type 1 and type 2, the former arising from inadequate production of insulin due to pancreatic β-cell dysfunction, and the latter from reduced sensitivity to insulin in the target tissues and/or inadequate insulin secretion. Sustained hyperglycaemia is a common result of uncontrolled diabetes and, over time, can damage the heart, eyes, kidneys and nerves, mainly through deteriorating blood vessels supplying the organs. Microvascular (retinopathy and nephropathy) and macrovascular (atherosclerotic) disorders are the leading causes of morbidity and mortality in diabetic patients. Therefore, emphasis on diabetes care and management is on optimal blood glucose control to avert these adverse outcomes. Studies have demonstrated that diabetic nephropathy is associated with increased cardiovascular mortality. In general, about one in three patients with diabetes develops end-stage renal disease (ESRD) which proceeds to diabetic nephropathy (DN), the principal cause of significant morbidity and mortality in diabetes. Hypertension, a well-established major risk factor for cardiovascular disease contributes to ESRD in diabetes. Clinical evidence suggests that there is no effective treatment for diabetic nephropathy and prevention of the progression of diabetic nephropathy. However, biomedical evidence indicates that some plant extracts have beneficial effects on certain processes associated with reduced renal function in diabetes mellitus. On the other hand, other plant extracts may be hazardous in diabetes, as reports indicate impairment of renal function. This article outlines therapeutic and pharmacological evidence supporting the potential of some medicinal plants to control or compensate for diabetes-associated complications, with particular emphasis on kidney function and

  6. [Diabetes mellitus, hypercholesterolemia, and therapeutic prospects with simvastatin. General considerations and personal contribution].

    PubMed

    Pipicelli, G; Pentimone, F; Frustaci, G; Notarangelo, R; Beghè, F

    1992-12-01

    The Authors examine the relationship between diabetes mellitus, lipid metabolism and atherosclerosis with particular emphasis on the role of insulin and on the therapeutic consequences. The results of a study on the efficacy and tolerability of simvastatin in the treatment of hypercholesterolemia in non insulin-dependent diabetic patients are reported. Simvastatin administration induce a significant reduction and increase in total and HDL cholesterol levels respectively contributes to the decrease of triglycerides without interfering with the metabolic control of diabetic condition. PMID:1491762

  7. A non-healing corneal ulcer as the presenting feature of type 1 diabetes mellitus: a case report

    PubMed Central

    2011-01-01

    Introduction Diabetic keratopathy is a rare complication of diabetes mellitus. This case illustrates the importance of checking blood sugar levels of patients with non-healing corneal ulcers to rule out the possibility of undiagnosed diabetes mellitus. Case presentation We report the unusual case of a 24-year-old southeast Asian woman who presented with a sterile corneal ulcer to our hospital and later was found to be diabetic after a prolonged hospital stay. Despite all efforts, the corneal ulcer had failed to heal until treatment for previously undiagnosed diabetes was started. The sterile corneal ulcer began to heal once blood sugar levels began to normalize. Conclusions Diabetic keratopathy is a rare complication of diabetes mellitus and needs to be considered as a diagnosis in younger patients with non-healing sterile corneal ulcers. Blood sugar levels should be checked in these cases for undiagnosed diabetes mellitus. PMID:22051138

  8. Evidence that diabetes mellitus favors impaired metabolism of zinc, copper, and selenium in chronic pancreatitis.

    PubMed

    Quilliot, D; Dousset, B; Guerci, B; Dubois, F; Drouin, P; Ziegler, O

    2001-04-01

    Diabetes mellitus, a common complication of chronic pancreatitis, can disturb the metabolism of zinc, copper, and selenium. We analyzed the effects of hyperglycemia, malabsorption, and dietary intake on these factors in 35 men with alcohol-induced chronic pancreatitis complicated by insulin-treated diabetes mellitus (CP-D), 12 men with chronic pancreatitis but no diabetes (nondiabetic CP), 25 men with type 1 diabetes mellitus (type 1 DM), and 20 control subjects. Diabetes due to chronic pancreatitis was associated with decreased plasma zinc and selenium concentrations and with increased urinary copper excretion. Of the chronic pancreatitis patients, 17% had low plasma zinc, and 41% of them had low plasma selenium. None of the type 1 diabetic patients had low plasma concentrations of zinc, but 12% of them had a low selenium concentration. Hyperglycemia, as assessed by fasting plasma glucose and by plasma HbAlc, was responsible for the increased zinc excretion and the decreased superoxide dismutase activity. The perturbations of the copper, selenium, and zinc metabolism were particularly pronounced in subjects with chronic pancreatitis plus diabetes mellitus. We have yet to determine whether the differences in trace-element status contribute to the clinical expression of the disease. PMID:11291933

  9. Anti-diabetic Effect of Fermented Milk Containing Conjugated Linoleic Acid on Type II Diabetes Mellitus

    PubMed Central

    Yang, Hee-Sun; Lee, Sang-Cheon; Huh, Chang-Ki

    2016-01-01

    Conjugated linoleic acid (CLA) is a group of positional and geometric isomers of conjugated dienoic derivatives of linoleic acid. CLA has been reported to be able to reduce body fat. In this study, we investigated the antidiabetic effect of fermented milk (FM) containing CLA on type II diabetes db/db mice. Mice were treated with 0.2% low FM, 0.6% high FM, or Glimepiride (GLM) for 6 wk. Our results revealed that the body weight and the levels of fasting blood glucose, serum insulin, and leptin were significantly decreased in FM fed mice compared to db/db mice. Oral glucose tolerance and insulin tolerance were significantly ameliorated in FM fed mice compared to db/db mice. Consistent with these results, the concentrations of serum total cholesterol, triglycerides, and LDL cholesterol were also significantly decreased in FM fed mice compared to db/db mice. However, the concentration of HDL cholesterol was significantly higher in FM fed mice compared to db/db mice. These results were similar to those of GLM, a commercial anti-diabetic drug. Therefore, our results suggest that FM has anti-diabetic effect as a functional food to treat type II diabetes mellitus. PMID:27194924

  10. Pharmacogenomics in diabetes mellitus: insights into drug action and drug discovery.

    PubMed

    Zhou, Kaixin; Pedersen, Helle Krogh; Dawed, Adem Y; Pearson, Ewan R

    2016-06-01

    Genomic studies have greatly advanced our understanding of the multifactorial aetiology of type 2 diabetes mellitus (T2DM) as well as the multiple subtypes of monogenic diabetes mellitus. In this Review, we discuss the existing pharmacogenetic evidence in both monogenic diabetes mellitus and T2DM. We highlight mechanistic insights from the study of adverse effects and the efficacy of antidiabetic drugs. The identification of extreme sulfonylurea sensitivity in patients with diabetes mellitus owing to heterozygous mutations in HNF1A represents a clear example of how pharmacogenetics can direct patient care. However, pharmacogenomic studies of response to antidiabetic drugs in T2DM has yet to be translated into clinical practice, although some moderate genetic effects have now been described that merit follow-up in trials in which patients are selected according to genotype. We also discuss how future pharmacogenomic findings could provide insights into treatment response in diabetes mellitus that, in addition to other areas of human genetics, facilitates drug discovery and drug development for T2DM. PMID:27062931

  11. Non-Diabetic renal disease in Diabetes Mellitus: clinical features and renal biopsy findings

    PubMed Central

    Yenigun, E C; Dede, F; Ozturk, R; Turgut, D; Koc, E; Piskinpasa, S V; Ozkayar, N; Odabas, A R

    2015-01-01

    Aim Renal diseases in diabetes mellitus (DM) patients, include diabetic nephropathies (DN) and non-diabetic renal diseases (NDRD). The clinical differentiation among them is usually not so clear and effective. Aim of this study which examined renal biopsies in patients with type-2 DM was to identify the prevalence and the nature of NDRD. Materials and Methods We recorded the clinical and laboratory finding alongside with the histopathological examination of the renal biopsies obtained from 71 type-2 DM patients who underwent renal biopsy in our center. Based on the renal biopsy findings patients were classified into two groups (DN and NDRD) and data was compared between the two groups. Results There were 42 women and 29 men; aged 55 ± 12 years. In patients with DN (n: 34), diabetic retinopathy was more common [16 (47.1 %) vs. 6 (16.2 %) respectively, p =0.01], duration of DM was longer (108.8 ± 58.8 months vs 57.8 ± 55.9 months respectively, p <0.001) and the degree of proteinuria was more severe (6 ± 4.3 g/day vs. 4.5 ± 4.6 g/day respectively, p =0.04) compared to the patients with NDRD. Regression analysis revealed that diabetes duration >60 months, presence of diabetic retinopathy and proteinuria >3.5 g/day were independent predictors of DN with 79.4 % sensitivity and 86.5% specificity. Focal segmental glomerulosclerosis was the most frequent diagnosis in patients with NDRD. Conclusions The prevalence of NDRD is remarkably frequent in DM patients in whom nephrologists consider renal biopsy an appropriate measure. Short duration of DM, degree of proteinuria and absence of retinopathy were predictors of NDRD. Hippokratia 2015; 19 (2):148-152.

  12. Catechin averts experimental diabetes mellitus-induced vascular endothelial structural and functional abnormalities.

    PubMed

    Bhardwaj, Pooja; Khanna, Deepa; Balakumar, Pitchai

    2014-03-01

    Diabetes mellitus is associated with an induction of vascular endothelial dysfunction (VED), an initial event that could lead to the pathogenesis of atherosclerosis and hypertension. Previous studies showed that catechin, a key component of green tea, possesses vascular beneficial effects. We investigated the effect of catechin hydrate in diabetes mellitus-induced experimental vascular endothelial abnormalities (VEA). Streptozotocin (50 mg/kg, i.p., once) administration to rats produced diabetes mellitus, which subsequently induced VEA in 8 weeks by markedly attenuating acetylcholine-induced endothelium-dependent relaxation in the isolated aortic ring preparation, decreasing aortic and serum nitrite/nitrate concentrations and impairing aortic endothelial integrity. These abnormalities in diabetic rats were accompanied with elevated aortic superoxide anion generation and serum lipid peroxidation in addition to hyperglycemia. Catechin hydrate treatment (50 mg/kg/day p.o., 3 weeks) markedly prevented diabetes mellitus-induced VEA and vascular oxidative stress. Intriguingly, in vitro incubation of L-NAME (100 μM), an inhibitor of nitric oxide synthase, or Wortmannin (100 nM), a selective inhibitor of phosphatidylinositol 3-kinase (PI3K), markedly prevented catechin hydrate-induced improvement in acetylcholine-provoked endothelium-dependent relaxation in the diabetic rat aorta. Moreover, catechin hydrate treatment considerably reduced the elevated level of serum glucose in diabetic rats. In conclusion, catechin hydrate treatment prevents diabetes mellitus-induced VED through the activation of endothelial PI3K signal and subsequent activation of eNOS and generation of nitric oxide. In addition, reduction in high glucose, vascular oxidative stress, and lipid peroxidation might additionally contribute to catechin hydrate-associated prevention of diabetic VEA. PMID:24048981

  13. Metabolic syndrome independently predicts future diabetes in women with a history of gestational diabetes mellitus

    PubMed Central

    Cho, Nam H.; Ahn, Chang Ho; Moon, Joon Ho; Kwak, Soo Heon; Choi, Sung Hee; Lim, Soo; Park, Kyong Soo; Metzger, Boyd E.; Jang, Hak C.

    2016-01-01

    Abstract Metabolic syndrome (MetS) is an established predisposing condition for type 2 diabetes mellitus (T2DM). However, it is not thoroughly evaluated whether MetS increases the risk of T2DM in women with a previous history of gestational diabetes mellitus (GDM) who already at high risk of T2DM compared with the general population. We investigated the impact of MetS on the development of postpartum diabetes in women with a history of GDM. This was a multicenter, prospective cohort study of women diagnosed with GDM. The follow-up evaluations, including the oral glucose tolerance test, were completed at 6 weeks postpartum and annually thereafter. MetS was diagnosed at the initial postpartum evaluation according to the revised criteria of the National Cholesterol Education Program-Adult Treatment Panel III. The risk of developing type 2 diabetes (T2DM) in the follow-up period was analyzed based on the presence of MetS, and the adjusted risk was calculated using a Cox proportional hazards model. A total of 412 women without diabetes at the initial postpartum evaluation participated in the annual follow-up for median 3.8 years. MetS was prevalent in 66 (19.2%) women at the initial postpartum evaluation. The incidences of diabetes in women with and without MetS were 825 and 227 per 10,000 person-years, respectively (P < 0.001). The presence of MetS was an independent risk factor for T2DM, with a hazard ratio (HR) of 2.23 (95% confidence interval 1.04–5.08) in multivariate analysis after adjustment for clinical and metabolic parameters. When we considered MetS and impaired fasting glucose (IFG) separately, women with MetS, IFG, or both had an increased risk of T2DM, with HRs of 4.17, 4.36, and 6.98, respectively. The presence of MetS during the early postpartum period is an independent risk factor for the development of T2DM in women with a previous history of GDM. PMID:27583868

  14. Metabolic syndrome independently predicts future diabetes in women with a history of gestational diabetes mellitus.

    PubMed

    Cho, Nam H; Ahn, Chang Ho; Moon, Joon Ho; Kwak, Soo Heon; Choi, Sung Hee; Lim, Soo; Park, Kyong Soo; Metzger, Boyd E; Jang, Hak C

    2016-08-01

    Metabolic syndrome (MetS) is an established predisposing condition for type 2 diabetes mellitus (T2DM). However, it is not thoroughly evaluated whether MetS increases the risk of T2DM in women with a previous history of gestational diabetes mellitus (GDM) who already at high risk of T2DM compared with the general population. We investigated the impact of MetS on the development of postpartum diabetes in women with a history of GDM.This was a multicenter, prospective cohort study of women diagnosed with GDM. The follow-up evaluations, including the oral glucose tolerance test, were completed at 6 weeks postpartum and annually thereafter. MetS was diagnosed at the initial postpartum evaluation according to the revised criteria of the National Cholesterol Education Program-Adult Treatment Panel III. The risk of developing type 2 diabetes (T2DM) in the follow-up period was analyzed based on the presence of MetS, and the adjusted risk was calculated using a Cox proportional hazards model.A total of 412 women without diabetes at the initial postpartum evaluation participated in the annual follow-up for median 3.8 years. MetS was prevalent in 66 (19.2%) women at the initial postpartum evaluation. The incidences of diabetes in women with and without MetS were 825 and 227 per 10,000 person-years, respectively (P < 0.001). The presence of MetS was an independent risk factor for T2DM, with a hazard ratio (HR) of 2.23 (95% confidence interval 1.04-5.08) in multivariate analysis after adjustment for clinical and metabolic parameters. When we considered MetS and impaired fasting glucose (IFG) separately, women with MetS, IFG, or both had an increased risk of T2DM, with HRs of 4.17, 4.36, and 6.98, respectively.The presence of MetS during the early postpartum period is an independent risk factor for the development of T2DM in women with a previous history of GDM. PMID:27583868

  15. Diabetes mellitus and impaired glucose tolerance are underdiagnosed in intensive care units

    PubMed Central

    Ladeira, Renata Teixeira; Simioni, Ana Cinthia Marques; Bafi, Antonio Tonete; Nascente, Ana Paula Metran; Freitas, Flavio Geraldo Resende; Machado, Flávia Ribeiro

    2012-01-01

    Objective To evaluate the presence of diabetes mellitus and impaired glucose tolerance in intensive care unit inpatients. Methods The study included patients in post-surgical care for elective and emergency surgery and excluded those patients with known diabetes mellitus. To diagnose prior serum glucose level disorders, we considered the value of glycated hemoglobin (HbA1c) at the time of admission, classifying the patients as normal (<5.7%), glucose intolerant (5.7-6.4%) or diabetic (>6.4%). During the first 3 days of the patient's hospital stay, glycemic control and clinical complications were assessed. Mortality was monitored for 28 days. For the statistical analyses, chi-square, ANOVA, student's t, Kruskal-Wallis or Mann Whitney tests were used. Results Thirty patients were included in the present study, 53% of whom were women; the patients had a mean age of 53.4±19.7 years and an APACHE II score of 13.6±6.6. The majority of patients were admitted for severe sepsis or septic shock followed by post-operative care for elective surgery, oncological surgery, multiple traumas and emergency surgery. When classifying these patients according to HbA1c, despite the absence of a prior history of diabetes mellitus, only 13.3% had a normal HbA1c level, 23.3% had levels compatible with the diagnosis of diabetes mellitus and 63.3% had levels compatible with impaired glucose tolerance. We found a significant association between the diagnosis of diabetes mellitus or impaired glucose tolerance and the use of vasoactive drugs (p=0.04). Conclusion A high prevalence of undiagnosed diabetes mellitus and impaired glucose tolerance was observed in inpatients at a general intensive care unit. PMID:23917931

  16. Effect of edaravone in diabetes mellitus-induced nephropathy in rats

    PubMed Central

    Lim, Li Xin; Tan, Kelly; Tay, Chai Sze; Teoh, Yi Leng; Akhtar, Shaikh Sohrab; Rupeshkumar, Mani; Chung, Ivy; Abdullah, Nor Azizan; Banik, Urmila; Dhanaraj, Sokkalingam A.; Balakumar, Pitchai

    2016-01-01

    Edaravone, a synthetic-free radical scavenger, has been reported to reduce ischemia-reperfusion-induced renal injury by improving tubular cell function, and lowering serum creatinine and renal vascular resistance. The present study investigated the effect of edaravone in diabetes mellitus-induced nephropathy in rats. A single administration of streptozotocin (STZ, 55 mg/kg, i.p.) was employed to induce diabetes mellitus in rats. The STZ-administered diabetic rats were allowed for 10 weeks to develop nephropathy. Mean body weight, lipid alteration, renal functional and histopathology were analysed. Diabetic rats developed nephropathy as evidenced by a significant increase in serum creatinine and urea, and marked renal histopathological abnormalities like glomerulosclerosis and tubular cell degeneration. The kidney weight to body weight ratio was increased. Moreover, diabetic rats showed lipid alteration as evidenced by a signifi cant increase in serum triglycerides and decrease in serum high-density lipoproteins. Edaravone (10 mg/kg, i.p., last 4-weeks) treatment markedly prevented the development of nephropathy in diabetic rats by reducing serum creatinine and urea and preventing renal structural abnormalities. In addition, its treatment, without significantly altering the elevated glucose level in diabetic rats, prevented diabetes mellitus-induced lipid alteration by reducing serum triglycerides and increasing serum high-density lipoproteins. Interestingly, the renoprotective effect of edaravone was comparable to that of lisinopril (5 mg/kg, p.o, 4 weeks, standard drug). Edaravone prevented renal structural and functional abnormalities and lipid alteration associated with experimental diabetes mellitus. Edaravone has a potential to prevent nephropathy without showing an anti-diabetic action, implicating its direct renoprotection in diabetic rats. PMID:27382349

  17. Angiotensin-converting enzyme polymorphism and development of diabetic nephropathy in non-insulin-dependent diabetes mellitus.

    PubMed

    Mizuiri, S; Hemmi, H; Inoue, A; Yoshikawa, H; Tanegashima, M; Fushimi, T; Ishigami, M; Amagasaki, Y; Ohara, T; Shimatake, H

    1995-01-01

    We determined the distribution frequency of angiotensin-converting enzyme insertion/deletion (I/D) polymorphism in 111 Japanese patients with non-insulin-dependent diabetes mellitus (NIDDM) of at least 10 years duration (80 patients with diabetic nephropathy and 31 patients without nephropathy) and 76 healthy Japanese controls. Patients with diabetic nephropathy showed an excess of the ID genotype compared with patients without nephropathy (p < 0.02) and less of the II genotype compared with healthy controls (p < 0.01) and patients without nephropathy (p < 0.01). NIDDM patients with the II genotype have a decreased risk for the development of diabetic nephropathy. PMID:7477652

  18. [Clinical significance of urinary enzymes in diabetes mellitus].

    PubMed

    Morita, E; Kaizu, K; Uriu, K; Eto, S

    1990-06-01

    The aim of this study was to clarify the clinical significance of urinary enzyme activity in patients with diabetes mellitus. Patients were divided into two groups: group A - 102 outpatients, group B-23 inpatients. Spot urine samples before breakfast from group A and aliquots of 24-hours urine collections at 4 degrees C from group B were used. Urinary enzyme activities (N-acetyl- beta-D-glucosaminidase: NAG, alkaline phosphatase: ALP, leucine aminopeptidase: LAP, gamma-glutamyl transpeptidase: gamma-GTP) were determined by spectrophotometric assay, rate assay, Tuppy method and Orlowski method, respectively. 1) In group A, the percentage of the cases which showed higher than the normal range (NAG: 1.3-8.7, ALP: 4.2-17.7, LAP: 0-22.9 U/g. cer.) was 42.2% in NAG, 21.6% in ALP, and 8.8% in LAP. In a multiple regression analysis, the predictor variables which contributed to NAG were HbA1c, age, urinary protein and the one that contributed to ALP, LAP, gamma-GTP was urinary beta 2-microglobulin. 2) In group B, 87% of NAG was above the normal range (Mean +/- 2 SD; 4.8 +/- 3.9 U/day). There was no difference in the NAG activity between patients with and without nephropathy. The percent of high activities of ALP, LAP and gamma-GTP were 17%, 17%, 4%, respectively. Most of them were patients with nephropathy. There were correlations among ALP, LAP and gamma-GTP, though no correlation existed between NAG and the other three enzymes. These results suggested: 1) NAG reflects lysosomal dysfunction of both glomerular and proximal tubular epithelial cells which may be caused by poor glycemic control.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1975116

  19. The Effect of Diabetes Mellitus on Lung Cancer Prognosis

    PubMed Central

    Zhu, Linhai; Cao, Hongxin; Zhang, Tiehong; Shen, Hongchang; Dong, Wei; Wang, Liguang; Du, Jiajun

    2016-01-01

    Abstract Previous studies suggested that diabetes mellitus (DM) was associated with risk and mortality of cancer, but studies investigating the correlation between DM and lung cancer prognosis remain controversial. Herein, a meta-analysis was performed to derive a more precise estimate of the prognostic role of DM in lung cancer. Medline and Embase were searched for eligible articles from inception to October 25, 2015. The pooled hazard ratio (HR) with its 95% confidence interval (95% CI) was calculated to evaluate the correlation between DM and lung cancer prognosis. Subgroup meta-analysis was performed based on the histology and the treatment methods. A total of 20 cohort studies from 12 articles were included in the meta-analysis. Also, 16 studies investigated the overall survival (OS) and 4 studies investigated the progression-free survival (PFS). DM was significantly associated with the inferior OS of lung cancer with the pooled HR 1.28 (95% CI: 1.10–1.49, P = 0.001). The association was prominent in the nonsmall cell lung cancer (NSCLC) subgroup (HR 1.35, 95%CI: 1.14–1.60, P = 0.002), whereas the association was not significant in the small cell lung cancer (SCLC) subgroup (HR 1.33, 95% CI: 0.87–2.03, P = 0.18). When NSCLC patients were further stratified by treatment methods, DM had more influence on the surgically treated subgroup than the nonsurgically treated subgroup. There was no obvious evidence for publication bias by Begg's and Egger's test. The results of this meta-analysis exhibit an association of DM with inferior prognosis amongst lung cancer patients, especially the surgically treated NSCLC patients. Given the small number of studies included in this meta-analysis, the present conclusion should be consolidated with more high-quality prospective cohort studies or randomized controlled trials. PMID:27124062

  20. Preconception care in Saudi women with diabetes mellitus

    PubMed Central

    Madanat, Amal Y.; Sheshah, Eman A.

    2016-01-01

    Background: The rate of preexisting diabetes mellitus (DM) in Saudi Arabia is one of the highest in the world. The role of preconception care (PCC) is well-established as a means of improving pregnancy outcomes in DM. Objectives: To assess the rate of preconception counseling, the level of PCC knowledge, and the rate of unplanned pregnancies in Saudi women with DM. Materials and Methods: A cross-sectional study was conducted among 355 Saudi women aged 18–49 years with self-reported DM. The study questionnaire contained variables about the provision of preconception counseling, knowledge of PCC facts, and the number of unplanned pregnancies after developing DM. The level of PCC knowledge was evaluated using a modified Likert scale. Statistical Package for Social Sciences 20 was used for statistical analysis. Descriptive statistics, mean and standard deviation, and percentages were calculated; t-test was used for statistical significance. Results: About one-third of the participants had received preconception counseling after being diagnosed with DM. Counseling on PCC for older and married participants was significantly less. Of the 355 participants, 42.8% had little or no PCC knowledge. All pregnancies that occurred after developing DM were unplanned. Conclusions: The rate of preconception counseling, the level of PCC knowledge in the studied Saudi women with DM is suboptimal, and none of the pregnancies that occurred after developing DM was planned. The study highlights the need for PCC programs that target all Saudi women of child-bearing age with DM, and their families starting at the age of puberty and at diagnosis of type 2DM, to optimize women's health and improve pregnancy outcomes. PMID:27186158

  1. Childhood Cognitive Ability: Relationship to Gestational Diabetes Mellitus in India

    PubMed Central

    Veena, S R; Krishnaveni, G V; Srinivasan, K; Kurpad, A V; Muthayya, S; Hill, J C; Kiran, K N; Fall, C H D

    2012-01-01

    Aims/Hypothesis To test the hypothesis that maternal gestational diabetes mellitus (GDM) is associated with poorer cognitive ability in children born to mothers with GDM compared to children born to non-GDM mothers in India. Methods During 1997-98 maternal GDM status was assessed at 30±2 weeks of gestation. Between 2007-2008, at a mean age of 9.7 years, 515 children (32-offspring of GDM mothers (ODM’s); 483-offspring of non-GDM mothers (controls)) from the Mysore Parthenon birth cohort underwent cognitive function assessment using tests from the Kaufman Assessment Battery for children-second edition and additional tests measuring learning, long-term storage/retrieval, short-term memory, reasoning, attention and concentration, visuo-spatial and verbal abilities. Results Compared to controls, ODM’S scored higher in tests for learning, long-term retrieval/storage (p=0.008), reasoning (p=0.02), verbal ability (p=0.01) and attention and concentration (p=0.003). In multiple regression, adjusted for the child’s age, sex, gestation, neonatal weight and head circumference, maternal age, parity, BMI, parent’s socio-economic status, education and rural/urban residence, this difference remained significant only for learning, long-term retrieval/storage (β=0.4SD (95% CI: 0.01, 0.75); p=0.042) and verbal ability (β=0.5SD (95% CI: 0.09, 0.83); p=0.015) and not with other test scores. Conclusions/interpretation In this population of healthy Indian children, there was no evidence of lower cognitive ability in ODM’s. In fact some cognitive scores were higher in ODM’s. PMID:20614102

  2. Teneligliptin in management of type 2 diabetes mellitus

    PubMed Central

    Sharma, Surendra Kumar; Panneerselvam, A; Singh, KP; Parmar, Girish; Gadge, Pradeep; Swami, Onkar C

    2016-01-01

    Teneligliptin is a recently developed oral dipeptidyl peptidase 4 inhibitor indicated for the management of type 2 diabetes mellitus (T2DM) in adults along with diet and exercise. Teneligliptin has been recently available in Japan (Teneria®), Argentina (Teneglucon®), and India (Tenepure; Teneza) at relatively affordable price. This is a positive step toward the management of T2DM in developing countries, where the cost of medicine is out-of-pocket expenditure and is a limiting factor for health care. This review evaluates the efficacy and safety of teneligliptin in the management of T2DM. Teneligliptin has been systematically evaluated in T2DM as monotherapy with diet and exercise and in combination with metformin, glimepiride, pioglitazone, and insulin in short-term (12 weeks) and long-term (52 weeks) studies. These studies have reported a reduction in HbA1c of 0.8%–0.9% within 12 weeks of therapy. Two 52-week studies reported sustained improvement in glycemic control with teneligliptin. Teneligliptin has been found to be well tolerated, and the safety profile is similar to other dipeptidyl peptidase 4 inhibitors. Hypoglycemia and constipation are the main adverse events. Teneligliptin can be administered safely to patients with mild, moderate, or severe renal impairment or end-stage renal disease without dose adjustment. Similarly, it can be used in patients with mild-to-moderate hepatic impairment. Teneligliptin is effective and well tolerated and may have an important role in the management of T2DM. PMID:27574456

  3. Abdominal Obesity and Brain Atrophy in Type 2 Diabetes Mellitus

    PubMed Central

    Callisaya, Michele; Blizzard, Leigh; Sharman, James E.; Venn, Alison; Phan, Thanh G.; Beare, Richard; Forbes, Josephine; Blackburn, Nicholas B.; Srikanth, Velandai

    2015-01-01

    Aim Type 2 diabetes mellitus (T2D) is associated with gray matter atrophy. Adiposity and physical inactivity are risk factors for T2D and brain atrophy. We studied whether the associations of T2D with total gray matter volume (GMV) and hippocampal volume (HV) are dependent on obesity and physical activity. Materials and Methods In this cross-sectional study, we measured waist-hip ratio (WHR), body mass index (BMI), mean steps/day and brain volumes in a community dwelling cohort of people with and without T2D. Using multivariable linear regression, we examined whether WHR, BMI and physical activity mediated or modified the association between T2D, GMV and HV. Results There were 258 participants with (mean age 67±7 years) and 302 without (mean age 72±7 years) T2D. Adjusting for age, sex and intracranial volume, T2D was independently associated with lower total GMV (p = 0.001) and HV (p<0.001), greater WHR (p<0.001) and BMI (p<0.001), and lower mean steps/day (p = 0.002). After adjusting for covariates, the inclusion of BMI and mean steps/day did not significantly affect the T2D-GMV association, but WHR attenuated it by 32% while remaining independently associated with lower GMV (p<0.01). The T2D-HV association was minimally changed by the addition of BMI, steps/day or WHR in the model. No statistical interactions were observed between T2D and measures of obesity and physical activity in explaining brain volumes. Conclusions Abdominal obesity or its downstream effects may partially mediate the adverse effect of T2D on brain atrophy. This requires confirmation in longitudinal studies. PMID:26560876

  4. Circulating irisin is lower in gestational diabetes mellitus.

    PubMed

    Zhao, Liang; Li, Jun; Li, Zhao-Liang; Yang, Jie; Li, Ming-Long; Wang, Gong-Ling

    2015-01-01

    Irisin is a newly identified myokine. Several studies have reported irisin concentrations in patients with gestational diabetes mellitus (GDM), but because of smaller sample sizes, the data from previous reports showed a wide range in serum/plasma irisin. Therefore, the present investigation is designed to summarize a precise confidence interval of circulating irisin in participants with GDM from a cross-sectional study in Chinese population and a meta-analysis for validation. Serum irisin was tested in patients with GDM and healthy controls (newly diagnosed cases: 61 and matched controls: 61) in the cross-sectional study. The two groups of participants were matched for age and pregnancy duration. Furthermore, we did a comprehensive meta-analysis to confirm whether serum/plasma irisin differs between participants with GDM and controls. Articles reported "circulating irisin and GDM" in Medline, PubMed, and EMBase were obtained, with the key word "myokine" or "irisin". The comparison was analyzed by Review Manager 5.2. In the cross-sectional investigation, serum irisin showed a significant lower level in the GDM patients, compared with that in the control group. In the meta-analysis study, the summarized results of the present 5 studies in which 632 participants were included indicated that there was a lower level irisin of -58.68 ng/mL [95% confidence interval (CI)](-113.42, -3.93, P=0.04) in GDM patients than in the control group. The present cross-sectional investigation and meta-analysis is the first to show significant lower circulating irisin in subjects with GDM. PMID:26228794

  5. Teneligliptin in management of type 2 diabetes mellitus.

    PubMed

    Sharma, Surendra Kumar; Panneerselvam, A; Singh, K P; Parmar, Girish; Gadge, Pradeep; Swami, Onkar C

    2016-01-01

    Teneligliptin is a recently developed oral dipeptidyl peptidase 4 inhibitor indicated for the management of type 2 diabetes mellitus (T2DM) in adults along with diet and exercise. Teneligliptin has been recently available in Japan (Teneria(®)), Argentina (Teneglucon(®)), and India (Tenepure; Teneza) at relatively affordable price. This is a positive step toward the management of T2DM in developing countries, where the cost of medicine is out-of-pocket expenditure and is a limiting factor for health care. This review evaluates the efficacy and safety of teneligliptin in the management of T2DM. Teneligliptin has been systematically evaluated in T2DM as monotherapy with diet and exercise and in combination with metformin, glimepiride, pioglitazone, and insulin in short-term (12 weeks) and long-term (52 weeks) studies. These studies have reported a reduction in HbA1c of 0.8%-0.9% within 12 weeks of therapy. Two 52-week studies reported sustained improvement in glycemic control with teneligliptin. Teneligliptin has been found to be well tolerated, and the safety profile is similar to other dipeptidyl peptidase 4 inhibitors. Hypoglycemia and constipation are the main adverse events. Teneligliptin can be administered safely to patients with mild, moderate, or severe renal impairment or end-stage renal disease without dose adjustment. Similarly, it can be used in patients with mild-to-moderate hepatic impairment. Teneligliptin is effective and well tolerated and may have an important role in the management of T2DM. PMID:27574456

  6. Recognition of Incident Diabetes Mellitus during an Acute Myocardial Infarction

    PubMed Central

    Arnold, Suzanne V.; Stolker, Joshua M.; Lipska, Kasia J.; Jones, Philip G.; Spertus, John A.; McGuire, Darren K.; Inzucchi, Silvio E.; Goyal, Abhinav; Maddox, Thomas M.; Lind, Marcus; Gumber, Divya; Shore, Supriya; Kosiborod, Mikhail

    2015-01-01

    Background Diabetes mellitus (DM) is common in patients hospitalized with an acute myocardial infarction (AMI), representing in some cases the first opportunity to recognize and treat DM. We report the incidence of new DM and its recognition among AMI patients. Methods and Results Patients in a 24-site U.S. AMI registry (2005–08) had HbA1c assessed at a core lab, with results blinded to clinicians and local clinical measurements left to the discretion of the treating providers. Among 2854 AMI patients without known DM on admission, 287 patients (10%) met criteria for previously unknown DM, defined by core lab HbA1c≥6.5%. Among these, 186 (65%) were unrecognized by treating clinicians, receiving neither DM education, glucose-lowering medications at discharge nor documentation of DM in the chart (median HbA1c of unrecognized patients: 6.7%, range 6.5–12.3%). Six months after discharge, only 5% of those not recognized as having DM during hospitalization had been initiated on glucose-lowering medications vs. 66% of those recognized (p<0.001). Conclusions Underlying DM that has not been previously diagnosed is common among AMI patients, affecting 1 in 10 patients, yet is recognized by the care team only one-third of the time. Given its frequency and therapeutic implications, including but extending beyond the initiation of glucose-lowering treatment, consideration should be given to screening all AMI patients for DM during hospitalization. Inexpensive, ubiquitous, and endorsed as an acceptable screen for DM, HbA1c testing should be considered for this purpose. PMID:25901045

  7. Gender discrimination for women with diabetes mellitus in Algeria

    PubMed Central

    Chentli, Farida; Azzoug, Said; Meskine, Djamila; El Gradechi, Aldjia

    2014-01-01

    Background: Nowadays diabetes mellitus (DM) is one of the greatest global challenges. Its expansion varies from an area to another according to genetic, traditions, socio-economic conditions, and stress. In Algeria, as in other emerging countries undergoing an epidemiological transition, noncommunicable diseases are sharply increasing. After high blood pressure, DM is now the second metabolic disease. But are women more concerned by DM since obesity frequency is higher in females? Can we assert that there is a sort of sex discrimination for DM complications? Materials and Methods: To answer these questions we took into account published documents carried in Algerian population. But, as those were very scarce, we also considered newspapers articles, some documents published by health minister department, posters and oral communications of the Algerian Society of Endocrinology and Diabetology, and our clinical experience. We also have done a small survey to get our patients’ opinions. Results and Conclusion: At the first sight, it seems gender discrimination between men and women cannot exist since most epidemiological studies showed that both sexes are broadly and equally affected by DM, except for old aged females who are the most affected. When we reconsidered the problem, and when we compared past results to those obtained after the terrorism period, many studies showed a sort of gender difference. Apart from gestational DM, which is increasing sharply, some complications and death related to DM are prevailing in women. Coronary diseases and cerebral vascular accidents are more frequent in women too, especially the young ones and those suffering from DM. These complications are probably due to the recent and rapid modification in women's lifestyle with a strong reduction in physical activity, eating disorders, hormonal contraception, and high sensitivity to perceived stress secondary to the near past stressing life and/or to numerous responsibilities taken by

  8. [Transitory neonatal diabetes mellitus and pericentric chromosome 9 inversion].

    PubMed

    Martos Moreno, G A; Muñoz Calvo, M T; Martín Díaz, M J; Pozo Román, J; Argente Oliver, J

    2006-09-01

    Neonatal diabetes mellitus is an infrequent carbohydrate metabolism disorder with an estimated incidence of approximately one case every 400,000 to 600,000 live newborns. We present the case of a 1-month-old girl with irritability, polyuria, and a 24-h history of eagerness to feed, without fever or other associated symptoms. The patient's karyotype, obtained by amniocentesis, was 46XX with a pericentric chromosome 9 inversion. Her birth weight and length were 2,230 g (-2.65 SD) and 46 cm (-1.8 SD), respectively. Glycemic determinations during the first 72 h of extrauterine life oscillated between 90 and 157 mg/dl. Physical examination revealed general involvement, skin and mucosal pallor, evident signs of dehydration, and impaired awareness. Laboratory tests revealed glycemia: 1552 mg/dL, pH 7.16, pCO2: 23.7 mmHg; bicarbonate: 8.1 mEq/L, base excess: -19.1, and positive ketonemia. After initial stabilization, the patient was treated with intravenous fluids and continuous intravenous regular insulin infusion (initial dose 0.03-0.05 IU/kg/h). After intensive treatment, breast feeding was restored and a short-acting insulin analog was administered subcutaneously after every feed (0.1 to 0.3 IU according to capillary glycemic determinations). Insulin requirements decreased and were discontinued when the infant was 5 months old. Currently, the patient is 2 years and 7 months old and her glycemia and glycosylated hemoglobin levels are normal. Anti-islet (ICA and GAD) and anti-tyrosin phosphatase (IA2) antibodies were absent, as were mutations in the glucokinase gene (GCK). PMID:16956505

  9. Clinical outcomes of a diabetes education program for patients with diabetes mellitus in the Micronesian community in Hawaii

    PubMed Central

    Chong, Mok Thoong

    2016-01-01

    Objective: Hawaii has diverse population made up of a cultural mix of different races. Due to different cultural and social influences and language barrier, many of the under-served population who migrated to Hawaii and having diabetes mellitus may be susceptible to long-term complications due to uncontrolled hyperglycemia and medication nonadherence. The purpose of this study was to evaluate the impact of a diabetes education program on the clinical outcomes in patients with diabetes mellitus in the Micronesian community of Hawaii. Methods: This study included patients over age 18 years, with a diagnosis of type 2 diabetes mellitus. The diabetes education program was customized for its weekly classes to fit to the under-served population. Data were collected on participants on the 1st day and then 6 months after attending the education program. Data on primary and secondary endpoints were collected and analyzed. Findings: The mean glycosylated hemoglobin A1c, fasting blood glucose, and triglyceride levels of participants fell significantly from baseline after attending the diabetes education program for 6 months. No significant changes were observed in other secondary outcomes during the study time period. Conclusion: Based on our findings, the diabetes education program that was tailored to the Micronesian population was successful in achieving glycemic goals, enhancing medication adherence, improving clinical outcomes, and also preventing long-term complications among its participants. PMID:27512713

  10. Diabetes mellitus: a review of its associations with different environmental factors.

    PubMed

    Joshi, S K; Shrestha, S

    2010-01-01

    Diabetes Mellitus is a global health problem with a worldwide prevalence of 2.8% in 2000. Type 1 diabetes mellitus is an auto immune disorder genetically mediated, while type 2 is more of a life style induced disorder although the role of genetic susceptibility, infections are also equally strong. Many studies have backed up these statements. However, there have been very few researches that show association of diabetes with environmental factors like pollution, exposure to chemicals e.g. mercury, arsenic, psychological condition e.g. depression, stress, and socio-economic conditions e.g. occupation, earnings etc. Recently, the role of these factors in causation and progression of diabetes have received much attention. Thus, this review has been designed to explore more on association of diabetes with physical, socio-economic and psychological environment. PMID:21209519

  11. A systematic review of the role of renin angiotensin aldosterone system genes in diabetes mellitus, diabetic retinopathy and diabetic neuropathy

    PubMed Central

    Rahimi, Zohreh; Moradi, Mahmoudreza; Nasri, Hamid

    2014-01-01

    Background: The renin angiotensin aldosterone system (RAAS) plays a vital role in regulating glucose metabolism and blood pressure, electrolyte and fluid homeostasis. The aim of this systematic review is to assess the association of the RAAS genes with diabetes mellitus (DM) and its complications of retinopathy, neuropathy and cardiovascular disease (CVD). Materials and Methods: The relevant English-language studies were identified using the key words of DM, type 1 diabetes mellitus (T1DM), T2DM, renin angiotensin aldosterone polymorphisms or genotypes and RAAS from the search engines of MEDLINE/PubMed, and Scopus from January 1, 1995 to July 30, 2014. Inclusion criteria for selecting relevant studies were reporting the role of RAAS gene variants in the pathogenesis of T1DM or T2DM, diabetic retinopathy (DR), diabetic neuropathy and cardiovascular complication of DM. Results: The reviewers identified 204 studies of which 73 were eligible for inclusion in the present systematic review. The review indicates the angiotensinogen (AGT) M235T polymorphism might not affect the risk of DM. The role of angiotensin converting enzyme insertion/deletion (ACE I/D) and angiotensin II type 1 receptor gene (AT1R) A1166C polymorphisms in the pathogenesis of DM could not be established. Studies indicate the absence of an association between three polymorphisms of AGT M235T, ACE I/D and AT1R A1166C and DR in DM patients. A protective role for ACE II genotype against diabetic peripheral neuropathy has been suggested. Also, the ACE I/D polymorphism might be associated with the risk of CVD in DM patients. Conclusion: More studies with adequate sample size that investigate the influence of all RAAS gene variants together on the risk of DM and its complications are necessary to provide a more clear picture of the RAAS genes polymorphisms involvement in the pathogenesis of DM and its complications. PMID:25657757

  12. Detection of an ABCA1 Variant Associated with Type 2 Diabetes Mellitus Susceptibility for Biochemistry and Genetic Laboratory Courses

    ERIC Educational Resources Information Center

    Legorreta-Herrera, M.; Mosqueda-Romo, N. A.; Hernández-Clemente, F.; Soto-Cruz, I.

    2013-01-01

    We selected diabetes mellitus for this laboratory exercise to provide students with an explicit model for scientific research concerning the association between the R230C polymorphism and susceptibility to type 2 diabetes mellitus, which is highly prevalent in the Mexican population. We used a collaborative project-based learning to engage…

  13. The Presence of Family History and the Development of Type 2 Diabetes Mellitus Risk Factors in Rural Children

    ERIC Educational Resources Information Center

    Adams, Marsha Howell; Barnett Lammon, Carol Ann

    2007-01-01

    Type 2 diabetes mellitus is reaching epidemic proportions among children and adolescents. School health fairs offer an opportunity to identify children with risk factors for the development of type 2 diabetes mellitus. This study identified selected risk factors (i.e., high-risk racial/ethnic group, obesity, elevated blood pressure, elevated…

  14. Limited joint mobility (LJM) of the hand in patients with diabetes mellitus: relation to chronic complications.

    PubMed Central

    Starkman, H S; Gleason, R E; Rand, L I; Miller, D E; Soeldner, J S

    1986-01-01

    Limited joint mobility (LJM) of the hand was studied by visual examination in 361 diabetic outpatients aged 11 to 83 years, and 45 non-diabetic controls, without evidence of arthritis. LJM was evident in 58% of diabetic subjects and 4% of controls (p less than 0.001). LJM was noted in 131 (55%) of the 238 patients with insulin-dependent diabetes mellitus (IDDM) as opposed to 31 of the 41 patients (76%) with non-insulin-dependent diabetes mellitus (NIDDM). LJM occurred in 60 of the 82 diabetic subjects (73%) receiving insulin therapy who developed diabetes after the age of 35 years. LJM was significantly related to duration of diabetes in the patients with IDDM less than 40 years of age but was not associated with duration in the patients with NIDDM. A significant association of LJM and neuropathy was noted in patients less than 40 years of age with less than 20 years of diabetes. A significant association of LJM and retinopathy was also noted in those less than 40 years of age with less than 30 years of diabetes. There was no association of LJM and nephropathy regardless of age or duration of diabetes. PMID:3947142

  15. Absence of BiP Co-chaperone DNAJC3 Causes Diabetes Mellitus and Multisystemic Neurodegeneration

    PubMed Central

    Synofzik, Matthis; Haack, Tobias B.; Kopajtich, Robert; Gorza, Matteo; Rapaport, Doron; Greiner, Markus; Schönfeld, Caroline; Freiberg, Clemens; Schorr, Stefan; Holl, Reinhard W.; Gonzalez, Michael A.; Fritsche, Andreas; Fallier-Becker, Petra; Zimmermann, Richard; Strom, Tim M.; Meitinger, Thomas; Züchner, Stephan; Schüle, Rebecca; Schöls, Ludger; Prokisch, Holger

    2014-01-01

    Diabetes mellitus and neurodegeneration are common diseases for which shared genetic factors are still only partly known. Here, we show that loss of the BiP (immunoglobulin heavy-chain binding protein) co-chaperone DNAJC3 leads to diabetes mellitus and widespread neurodegeneration. We investigated three siblings with juvenile-onset diabetes and central and peripheral neurodegeneration, including ataxia, upper-motor-neuron damage, peripheral neuropathy, hearing loss, and cerebral atrophy. Exome sequencing identified a homozygous stop mutation in DNAJC3. Screening of a diabetes database with 226,194 individuals yielded eight phenotypically similar individuals and one family carrying a homozygous DNAJC3 deletion. DNAJC3 was absent in fibroblasts from all affected subjects in both families. To delineate the phenotypic and mutational spectrum and the genetic variability of DNAJC3, we analyzed 8,603 exomes, including 506 from families affected by diabetes, ataxia, upper-motor-neuron damage, peripheral neuropathy, or hearing loss. This analysis revealed only one further loss-of-function allele in DNAJC3 and no further associations in subjects with only a subset of the features of the main phenotype. Our findings demonstrate that loss-of-function DNAJC3 mutations lead to a monogenic, recessive form of diabetes mellitus in humans. Moreover, they present a common denominator for diabetes and widespread neurodegeneration. This complements findings from mice in which knockout of Dnajc3 leads to diabetes and modifies disease in a neurodegenerative model of Marinesco-Sjögren syndrome. PMID:25466870

  16. [Cell engineering in the treatment of diabetes mellitus: current state and prospectives].

    PubMed

    Nagibovich, O A; Golota, A S; Krassii, A B

    2016-04-01

    The article is dedicated to the current state and prospectives of cell engineering in the treatment of diabetes mellitus. The material is based on the analysis of clinical trials in which cell engineering has been applied for the treatment of diabetes mellitus and its complications. It has been shown that despite the decade of intensive research the clinically significant results have not been achieved yet. At the same time the fast growth of the number of publications in the field testified to intensity of basic and applied research and the large quantity of ongoing clinical trials on the topic make it possible to. look at the prospectives of the employment of cell engineering in the treatment of diabetes mellitus with a certain optimism. PMID:27416722

  17. Evolution of β-Cell Replacement Therapy in Diabetes Mellitus: Islet Cell Transplantation

    PubMed Central

    Jahansouz, Cyrus; Jahansouz, Cameron; Kumer, Sean C.; Brayman, Kenneth L.

    2011-01-01

    Diabetes mellitus remains one of the leading causes of morbidity and mortality worldwide. According to the Centers for Disease Control and Prevention, approximately 23.6 million people in the United States are affected. Of these individuals, 5 to 10% have been diagnosed with Type 1 diabetes mellitus (T1DM), an autoimmune disease. Although it often appears in childhood, T1DM may manifest at any age, leading to significant morbidity and decreased quality of life. Since the 1960s, the surgical treatment for diabetes mellitus has evolved to become a viable alternative to insulin administration, beginning with pancreatic transplantation. While islet cell transplantation has emerged as another potential alternative, its role in the treatment of T1DM remains to be solidified as research continues to establish it as a truly viable alternative for achieving insulin independence. In this paper, the historical evolution, procurement, current status, benefits, risks, and ongoing research of islet cell transplantation are explored. PMID:22013505

  18. Diabetes mellitus in a dog with a growth hormone-producing acidophilic adenoma of the adenohypophysis.

    PubMed

    van Keulen, L J; Wesdorp, J L; Kooistra, H S

    1996-07-01

    A 9-year-old male Doberman Pinscher was referred to the Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, for polyuria/polydipsia, anorexia, and vomiting. Laboratory examination of blood and urine revealed hyperglycemia, glucosuria, and acidosis. Diabetes mellitus was diagnosed but was very resistant to subsequent insulin treatment. At the owners' request, the dog was euthanatized and a postmortem examination was performed. In addition to hepatic, pancreatic, and renal changes compatible with diabetes mellitus, an acidophilic adenoma of the adenohypophysis was found. Immunohistochemical staining for growth hormone, adrenocorticotropic hormone, and prolactin showed a strong immunolabeling for growth hormone within the cytoplasm of the tumor cells. Although growth hormone level was not measured in the plasma, our findings suggest that the diabetes mellitus in this dog was caused by excess growth hormone secreted by the pituitary neoplasm. PMID:8817849

  19. Diabetes Mellitus and Risk of Bronchopleural Fistula After Pulmonary Resections: A Meta-Analysis.

    PubMed

    Li, Shuang-Jiang; Fan, Jun; Zhou, Jian; Ren, Yu-Tao; Shen, Cheng; Che, Guo-Wei

    2016-07-01

    We conducted this meta-analysis to evaluate the association between diabetes mellitus and the risk of bronchopleural fistula in patients undergoing pulmonary resection. The PubMed and EMBASE databases were searched, and 15 retrospective observational studies were included. The pooled analysis showed that diabetes mellitus was significantly associated with the formation of bronchopleural fistula after pulmonary resection (odds ratio = 1.97; 95% confidence interval = 1.39 to 2.80; p < 0.001). This association remained statistically prominent in the subgroups classified by statistical analysis, diagnoses and operative modes and in Asian patients. Therefore, diabetes mellitus can be an independent risk factor for bronchopleural fistula after pulmonary resection. PMID:27063612

  20. Does Hsp60 Provide a Link between Mitochondrial Stress and Inflammation in Diabetes Mellitus?

    PubMed Central

    2016-01-01

    The focus of this review is to summarise the known relationships between the expression of heat shock protein 60 (Hsp60) and its association with the pathogenesis of Type 1 and Type 2 diabetes mellitus. Hsp60 is a mitochondrial stress protein that is induced by mitochondrial impairment. It is known to be secreted from a number of cell types and circulating levels have been documented in both Types 1 and 2 diabetes mellitus patients. The biological significance of extracellular Hsp60, however, remains to be established. We will examine the links between Hsp60 and cellular anti- and proinflammatory processes and specifically address how Hsp60 appears to affect immune inflammation by at least two different mechanisms: as a ligand for innate immune receptors and as an antigen recognised by adaptive immune receptors. We will also look at the role of Hsp60 during immune cell activation in atherosclerosis, a significant risk factor during the pathogenesis of diabetes mellitus. PMID:27478851

  1. Diagnosis and Management of Diabetes Mellitus in a Bali Mynah (Leucopsar rothschildi).

    PubMed

    Bartlett, Susan L; Bailey, Ryan; Baitchman, Eric

    2016-06-01

    An 18-year-old female Bali mynah (Leucopsar rothschildi) was presented for polyphagia, weight loss, and incoordination. Diabetes mellitus was diagnosed based on the history and clinical findings, including persistent hyperglycemia with concurrent hypoinsulinemia and glucosuria. A treatment protocol was developed that led to improvement of clinical signs and management of hyperglycemia over several months. Because of the advanced age of the animal, difficulty in maintaining euglycemia, and the stress of handling and treatment, euthanasia was elected 167 days after initial presentation. At postmortem examination, no pancreatic lesions were detected histologically that would account for the diabetes mellitus. To our knowledge this is the first reported case of diabetes mellitus and clinical management of this condition in a passerine species. PMID:27315382

  2. Risk factors for diabetic retinopathy in northern Chinese patients with type 2 diabetes mellitus

    PubMed Central

    Yan, Zhi-Peng; Ma, Jing-Xue

    2016-01-01

    AIM To investigate the prevalence and risk factors of diabetic retinopathy (DR) in northern Chinese patients with type 2 diabetes mellitus (T2DM). METHODS This retrospective cross-sectional study was performed between May 2011 and April 2012. A total of 1100 patients (male/female, 483/617) were included in this study. DR was defined following the Early Treatment Diabetic Retinopathy Study (ETDRS) severity scale. All included patients accepted a comprehensive ophthalmic examination including retinal photographs. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence interval (CI) after adjusting for age and gender. RESULTS Retinopathy was present in 307 patients with a prevalence of 27.9%. In univariate logistic analysis, presence of DR was associated with longer duration of diabetes (OR, 5.70; 95%CI, 2.91-12.56), higher concentration of fasting blood glucose (OR, 12.94; 95%CI, 2.40-67.71), higher level of glycosylated hemoglobin HbA1c (OR, 5.50; 95%CI, 3.78-11.97) and insulin treatment (OR, 6.99; 95%CI, 1.39-35.12). The lifestyle of patients with T2DM including smoking, alcohol consumption and regular exercise seemed not associated with the development of DR. CONCLUSION Our study suggests that fasting serum glucose concentration, HbA1c level, duration of diabetes and insulin treatment are potential risk factors for DR in northern Chinese patients with T2DM, while the lifestyle of included patients seems not associated with DR. PMID:27588275

  3. Analysis of serum from type II diabetes mellitus and diabetic complication using surface-enhanced Raman spectra (SERS)

    NASA Astrophysics Data System (ADS)

    Han, H. W.; Yan, X. L.; Dong, R. X.; Ban, G.; Li, K.

    2009-03-01

    In this paper, we show surface-enhanced Raman spectra (SERS) of serums from type II diabetes mellitus and diabetic complication (coronary disease, glaucoma and cerebral infarction), and analyze the SERS through the multivariate statistical methods of principal component analysis (PCA). In particular, we find that there exist many adenines in these serums, which maybe come from DNA (RNA) damage. The relative intensity of the band at 725±2 cm-1 assigned to adenine is higher for patients than for the healthy volunteers; therefore, it can be used as an important ‘fingerprint’ in order to diagnose these diseases. It is also shown that serums from type II diabetes mellitus group, diabetic complication group and healthy volunteers group can be discriminated by PCA.

  4. Modelling effective diagnosis of risk complications in gestational diabetes mellitus: an e-diabetic expert system for pregnant women

    NASA Astrophysics Data System (ADS)

    Sreedevi, E.; Vijaya Lakshmi, K.; Chaitanya Krishna, E.; Padmavathamma, M.

    2012-04-01

    Diabetes is a chronic illness that requires continuous medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. This paper deals with study and development of algorithm to develop an initial stage expert system to provide diagnosis to the pregnant women who are suffering from Gestational Diabetes Mellitus (GDM) by means of Oral Glucose Tolerance Test (OGTT).

  5. Molecular physiology of cellular glucose transport - a potential area for clinical studies in diabetes mellitus.

    PubMed

    Tatoń, Jan; Piatkiewicz, Paweł; Czech, Anna

    2010-01-01

    The normalization of cellular glucose assimilation is the basic aim of metabolic therapy in type 2 diabetes mellitus (T2DM). It requires parallel changes in the process of cellular glucose transport (CGT). This review presents the pathophysiological and clinical outlines of CGT. Sequentially, the advances in the mechanisms and classification of CGT and their physiological and molecular base are described. The role of CGT pathogenetic significance in diabetes mellitus is stressed. Finally, the opinion is expressed that the CGT study is a potentially important approach to clinical interpretation of glucose metabolism disturbances and their pharmacotherapy. PMID:20602306

  6. Impact of Systemic Inflammation on the Progression of Gestational Diabetes Mellitus.

    PubMed

    Lekva, Tove; Norwitz, Errol R; Aukrust, Pål; Ueland, Thor

    2016-04-01

    With increasing rates of obesity and new diagnostic criteria for gestational diabetes mellitus (GDM), the overall prevalence of GDM is increasing worldwide. Women with GDM have an increased risk of maternal and fetal complications during pregnancy as well as long-term risks including higher prevalence of type 2 diabetes mellitus and cardiovascular disease. In recent years, the role of immune activation and inflammation in the pathogenesis of GDM has gained increasing attention. This monograph explores the current state of the literature as regards the expression of markers of inflammation in the maternal circulation, placenta, and adipose tissue of women with GDM. PMID:26879309

  7. [Actovegin treatment of duodenal ulcer associated with ischemic heart disease and diabetes mellitus].

    PubMed

    Smolianinov, A B

    2000-01-01

    Actovegin, a deproteinized hemoderivative, was used to correct bioenergetic defects of duodenal mucosa, to reduce inflammatory-cell infiltration, to stimulate blood supply of patients with duodenal ulcer associated with ischemic heart disease or diabetes mellitus. As shown by the results obtained in 194 patients (119 males and 75 females), adjuvant actovegin in patients with duodenal ulcer associated with ischemic heart disease and diabetes mellitus stimulates the ulcer healing, prolongs the recurrence-free interval. It can be used both in outpatient departments and specialized hospitals. PMID:10900865

  8. Treatment of feline asthma with ciclosporin in a cat with diabetes mellitus and congestive heart failure.

    PubMed

    Nafe, Laura A; Leach, Stacey B

    2015-12-01

    A 5-year-old domestic shorthair cat that had been previously diagnosed with diabetes mellitus was presented for episodes of coughing and respiratory distress. Diagnostic testing revealed congestive heart failure secondary to hypertrophic cardiomyopathy and concurrent asthma. All clinical signs and eosinophilic airway inflammation resolved with oral ciclosporin while the cat was concurrently receiving medications for treatment of heart failure (furosemide and enalapril). Ciclosporin should be considered for treatment of feline asthma in patients with concurrent diseases (eg, diabetes mellitus, severe heart disease) that may contraindicate use of oral glucocorticoid therapy. PMID:25527351

  9. Hypercalcemia due to latrogenic secondary hypoadrenocorticism and diabetes mellitus in a cat.

    PubMed

    Smith, Stephanie A; Freeman, Lisa C; Bagladi-Swanson, Mary

    2002-01-01

    A 9-year-old, spayed female domestic shorthair cat presented for polyphagia, polydipsia, and polyuria following chronic methylprednisolone acetate therapy for pruritus. Initial diagnostics were consistent with uncomplicated diabetes mellitus. Serum calcium was within reference range. Within 12 hours the cat developed depression, anorexia, vomiting, and severe dehydration. Laboratory analysis indicated marked hypercalcemia as measured by both ionized and total calcium concentration. No underlying neoplastic or inflammatory process was identified. An adrenocorticotropic hormone stimulation test was indicative of adrenocortical insufficiency. The hypercalcemia resolved with glucocorticoid supplementation and correction of the dehydration. The diabetes mellitus and adrenal insufficiency both resolved within 9 weeks. PMID:11804313

  10. 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

  11. Psychiatric co-morbidity with type 1 and type 2 diabetes mellitus.

    PubMed

    Coclami, T; Cross, M

    2011-10-01

    We evaluated the prevalence of diabetes comorbidity in Greek psychiatric patients, differences between type 1 and type 2 diabetics and the outcome of psychiatric disorder. Of 800 psychiatric patients meeting our inclusion criteria, 82 (10.2%) had diabetes mellitus; 28% type 1 and 72% type 2. The mean age at onset of mental illness was earlierfortype 1 diabetics (mean 26.95, SD 9.09 years) than type 2 (mean 33.22, SD 10.71 years) (P < 0.015) and the duration of untreated mental illness was shorter (mean 2.86, SD 3.06 years compared with mean 4.13, SD 6.24 years for type 2 diabetics). Schizophrenia was the commonest psychiatric diagnosis in both types of diabetes. There was no significant difference in outcome of psychiatric disorder between the 2 types of diabetics. Existence of diabetes mellitus (regardless of type), duration of untreated mental illness and lack of patient therapeutic education were negative predictors of (unfavourable) outcome. These findings provide evidence of a high prevalence of diabetes in psychiatric patients and that having diabetes has an adverse effect on outcome of psychiatric illness. PMID:22256413

  12. Successful Management of Tardive Dyskinesia with Quetiapine and Clonazepam in a Patient of Schizophrenia with Type 2 Diabetes Mellitus

    PubMed Central

    Mohapatra, Satyakam

    2016-01-01

    Tardive dyskinesia is one of the most significant side effects of antipsychotic medications. Antipsychotic treated schizophrenia patients with diabetes mellitus are more likely to develop tardive dyskinesia than those without diabetes. Clozapine is probably best supported for management of tardive dyskinesia. But clozapine has been strongly linked to hyperglycaemia and impaired glucose tolerance, so it is not preferred in patients with diabetes mellitus. We present a case of 35-year-old male with a diagnosis of schizophrenia and type 2 diabetes mellitus with tardive dyskinesia, who was successfully treated with quetiapine and clonazepam. PMID:27121435

  13. Successful Management of Tardive Dyskinesia with Quetiapine and Clonazepam in a Patient of Schizophrenia with Type 2 Diabetes Mellitus.

    PubMed

    Mohapatra, Satyakam

    2016-05-31

    Tardive dyskinesia is one of the most significant side effects of antipsychotic medications. Antipsychotic treated schizophrenia patients with diabetes mellitus are more likely to develop tardive dyskinesia than those without diabetes. Clozapine is probably best supported for management of tardive dyskinesia. But clozapine has been strongly linked to hyperglycaemia and impaired glucose tolerance, so it is not preferred in patients with diabetes mellitus. We present a case of 35-year-old male with a diagnosis of schizophrenia and type 2 diabetes mellitus with tardive dyskinesia, who was successfully treated with quetiapine and clonazepam. PMID:27121435

  14. [Type 2 Diabetes mellitus-screening and prevention: Update 2016].

    PubMed

    Stadler, Marietta; Fröhlich-Reiterer, Elke; Prager, Rudolf

    2016-04-01

    The prevalence of diabetes is increasing in westernized countries. In addition, about half of all patients suffering from diabetes are not diagnosed. The current article represents the recommendations of the Austrian Diabetes Association for the screening and prevention of type 2 diabetes, based on currently available evidence. PMID:27052220

  15. Diabetes mellitus associated cardiovascular signalling alteration: a need for the revisit.

    PubMed

    Sharma, Arun Kumar; Khanna, Deepa

    2013-05-01

    Diabetes mellitus, a chronic metabolic disorder, is recognized as a root cause of cardiovascular disorders. A long-term and uncontrolled diabetes mellitus coincides with the cardiovascular signalling alteration, resulting in inadequacy of maintaining the cardiovascular physiology. Nitric oxide (NO) is an imperative mediator of cardiovascular physiology as its signalling is known to mediate vasodilatory, anti-platelet, anti-proliferative, and anti-inflammatory actions in vessels. In 1998, Robert Furchgott, Louis Ignarro and Ferid Murad received the Nobel Prize in Medicine or Physiology for their great discoveries concerning the role of NO (originally identified as endothelium-derived relaxing factor, EDRF) as a key signalling molecule in regulating cardiovascular physiology. The activation of phosphatidylinositol 3-kinase (PI3-K) further activates protein kinase B (PKB/Akt), which subsequently enhances eNOS activation and vascular NO generation. However, in recent studies a marked impairment in PI3-K/Akt-eNOS-NO signalling has been demonstrated in the condition of diabetes mellitus. Therefore, the defective PI3-K-Akt-eNOS-NO signalling pathways could make diabetic patients more vulnerable to cardiovascular disease pathology concerning the key functions of NO. Adenosine produced by cardiac cells has abilities to attenuate the proliferation of cardiac fibroblasts, inhibit collagen synthesis, and defend the myocardium against ischemia-reperfusion injury. However, diabetes mellitus is associated with enhanced unidirectional uptake of interstitial adenosine and reduced ability to release adenosine by cardiac cells during ATP deprivation. The reduced myocardial extracellular availability and increased uptake of adenosine could make diabetic subjects more susceptible to myocardial abnormalities. This review throws lights on diabetes mellitus-associated cardiovascular signalling alterations and their possible contribution to cardiovascular disease pathology. PMID:23385086

  16. Post traumatic type 1 diabetes mellitus (insulin-dependent): a case report

    PubMed Central

    Karrouri, Rabie

    2014-01-01

    Most researchers have studied the influence of life stress as precipitating the onset of type 1 diabetes, but as the relationship between severe psychological trauma and diabetes has been a rarely studied subject in paediatric age group. Here, we report the case of a 10-year-old Libyan boy, without personal or familial diabetes mellitus history, which is presented to Moroccan medico-surgical field hospital, installed in Tunisia for refugees of the Libyan revolution, for type 1 diabetes appeared immediately after severe psychological trauma. PMID:25918568

  17. Post traumatic type 1 diabetes mellitus (insulin-dependent): a case report.

    PubMed

    Karrouri, Rabie

    2014-01-01

    Most researchers have studied the influence of life stress as precipitating the onset of type 1 diabetes, but as the relationship between severe psychological trauma and diabetes has been a rarely studied subject in paediatric age group. Here, we report the case of a 10-year-old Libyan boy, without personal or familial diabetes mellitus history, which is presented to Moroccan medico-surgical field hospital, installed in Tunisia for refugees of the Libyan revolution, for type 1 diabetes appeared immediately after severe psychological trauma. PMID:25918568

  18. Prevalence of oral mucosal lesions among patients with diabetes mellitus types 1 and 2*

    PubMed Central

    Silva, Miguel Franklin Alves; Barbosa, Kevan Guilherme Nóbrega; Pereira, Jozinete Vieira; Bento, Patrícia Meira; Godoy, Gustavo Pina; Gomes, Daliana Queiroga de Castro

    2015-01-01

    BACKGROUND Patients with diabetes mellitus have been associated with a number of changes in the oral cavity, such as gingivitis, periodontitis, mucosal diseases, salivary dysfunction, altered taste, and burning mouth. OBJECTIVES To determine the prevalence of oral mucosal lesions in patients with diabetes mellitus. METHODS A cross-sectional observational study between August and October 2012 with a convenience sampling was performed for 51 patients with diabetes mellitus (type 1 and type 2). The study consisted of two phases: 1) a questionnaire application; 2) intraoral clinical examination. For the analysis of data, we used descriptive statistics, Fisher's exact test in bivariate analysis (significance level of 0.05), and Poisson Regression. RESULTS The prevalence of oral lesions was 78.4%. Traumatic ulcers (16.4%) and actinic cheilitis (12.7%) were the most prevalent lesions. The lips (35.3%) and tongue (23.5%) were the most common location. The bivariate analysis showed an association with the type of diabetes, and two variables (age and comorbidity) were quite close to the significance level. In the Poisson Regression analysis, only diabetes type 2 remained significant after adjusting the model. CONCLUSIONS The results of this study show a high prevalence of oral mucosal lesions in diabetic patients. The oral mucosal lesions are mostly associated with diabetes type 2. PMID:25672299

  19. Alterations in cardiac sarcolemmal Ca/sup 2 +/ pump activity during diabetes mellitus

    SciTech Connect

    Heyliger, C.E.; Prakash, A.; McNeill, J.

    1987-03-01

    Diabetes mellitus is frequently associated with a primary cardiomyopathy. The mechanisms responsible for this heart disease are not clear, but an alteration in myocardial Ca/sup 2 +/ transport is believed to be involved in its development. Even though sarcolemma plays a crucial role in cellular Ca/sup 2 +/ transport, little appears to be known about its Ca/sup 2 +/ transporting capability in the diabetic myocardium. In this regard, the authors have examined the status of the cardiac sarcolemmal Ca/sup 2 +/ pump during diabetes mellitus. Purified sarcolemmal membranes were isolated from male Wistar diabetic rat hearts 8 wk after streptozotocin injection. Ca/sup 2 +/ pump activity assessed by measuring its Ca/sup 2 +/-stimulated adenosine triphosphatase and Ca/sup 2 +/-uptake ability in the absence and presence of calmodulin was significantly depressed in the diabetic myocardium relative to controls. These results did not appear to have been influenced by the minimal sarcoplasmic reticular and mitochondrial contamination of this membrane preparation. Hence, it appears that the sarcolemmal Ca/sup 2 +/ pump is defective in the diabetic myocardium and may be involved in the altered Ca/sup 2 +/ transport of the heart during diabetes mellitus.

  20. [Type 2 diabetes mellitus and cardiovascular risk factors: is comprehensive treatment required?].

    PubMed

    Nadal, Josep Franch; Gutiérrez, Pedro Conthe

    2013-09-01

    Diabetes mellitus, especially type 2, is a metabolic disease involving the coexistence of several cardiovascular risk factors. Affected patients are therefore at high cardiovascular risk (2-3 times higher than that of men in the general population and 2-6 times higher than that of women). Cardiovascular disease is the main cause of death in the diabetic population, followed by cancer. Cardiovascular risk cannot be compared between diabetic patients and persons who have already shown one or more manifestations of cardiovascular disease (such as myocardial infarction). Single risk factors should be evaluated in combination with other risk factors and a person's cardiovascular risk should be individually assessed. Cardiovascular risk assessment in patients with diabetes through current calculations methods is complex because their ability to predict risk in individuals is very low. Studies such as that by Steno have demonstrated the validity of a comprehensive strategy to control all the risk factors present in persons with type 2 diabetes mellitus, which can reduce the development of micro- and macrovascular complications and mortality by almost 50%. The present article reviews each of the classical cardiovascular risk factors (hypertension, dyslipidemia, smoking, obesity, sedentariness) in relation to diabetes, as well as their recommended targets and the benefits of their control. In view of the above, a comprehensive approach is recommended to control the multiple risk factors that can coexist in persons with type 2 diabetes mellitus. PMID:24444518