scholarly journals 2232

2017 ◽  
Vol 1 (S1) ◽  
pp. 25-25
Author(s):  
Rocco Ferrandino ◽  
Girish Nadkarni ◽  
Priti Poojary ◽  
Aparna Saha ◽  
Bart Ferket ◽  
...  
Keyword(s):  
Nearest Neighbor ◽  
Kidney Injury ◽  
Sensitivity Analyses ◽  
Diabetic Patients ◽  
Primary Analysis ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetics ◽  
Increased Risk

OBJECTIVES/SPECIFIC AIMS: In June 2016, the FDA cautioned against the use of SGLT-2 inhibitors because of increased risk of acute kidney injury (AKI) after 101 cases of AKI were reported between March 2013 and October 2015. This study seeks to determine risk of AKI associated with SGLT-2 inhibitors in a large cohort of type 2 diabetic patients. METHODS/STUDY POPULATION: Retrospective cohort study including SGLT-2 inhibitor users and nonusers in the Mount Sinai Chronic Kidney Disease Registry between January 2013 and September 2016. SGLT-2 inhibitor users and nonusers were type 2 diabetics with new SGLT-2 inhibitor prescription after January 2013 and an outpatient visit between 2013 and 2015, respectively. Subjects were propensity matched by nearest neighbor method based on demographics, comorbidities, laboratory values, medications, estimated glomerular filtration rate (eGFR), and length of follow-up. The primary end point was AKI (defined by KDIGO laboratory algorithm) occurring during the follow-up period. RESULTS/ANTICIPATED RESULTS: In total, 372 SGLT-2 inhibitor users [mean age 63 years; 205 (55%) men] and 372 [mean age 63; 194 (52%) men] nonusers were included in the primary analysis. Proportions of AKI events defined by KDIGO criteria in users and nonusers were 4.0% and 10.0%, respectively. Adjusted odds ratio for AKI was 1.00 (95% CI, 0.28–2.62). Median peak serum creatinine measurements during AKI events for user and nonuser groups were 1.60 (IQR 1.36–1.78) and 1.88 (IQR 1.55–2.44) (p=0.02), respectively. Sensitivity analyses yielded similar results. DISCUSSION/SIGNIFICANCE OF IMPACT: These findings suggest that there is no evidence of increased odds of AKI in SGLT-2 inhibitor users compared with propensity-matched nonusers with type 2 diabetes.

SARS-COV-2 in type 2 diabetic patients: Possible roles of exercise training as a medicine

2021 ◽  
Vol 17 ◽  
Author(s):  
Mehdi Kushkestani ◽  
Mohsen Parvani ◽  
Yaser Kazemzadeh
Keyword(s):  
Moderate Intensity ◽  
Diabetic Patients ◽  
The Novel ◽  
Compensatory Mechanisms ◽  
Moderate Intensity Exercise ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetics ◽  
Increased Risk ◽  
Complications Rate

: SARS-COV-2 is the novel type of beta coronavirus that was first seen in December 2019 in Wuhan, China. Type 2 Diabetics are one of the groups most vulnerable to SARS-COV-2 and its associated complications. Many factors such as medication, pathophysiologic-induced compensatory mechanisms, and alterations in protein expression and immune system function can all contribute to severe outcomes in diabetics. In this review article, we first described the possible mechanisms of increased risk and more severe complications rate of SARS-COV-2 in diabetic patients. Secondly, we discussed the crucial roles of exercise in diabetic patients and in balancing of RAS system (ACE2/ACE). Finally, we showed the possible roles of acute and chronic exercise in reducing SARS-COV-2 severe outcomes in diabetics in accordance with the latest evidence. We concluded that regular exercise (especially moderate-intensity exercise) can play immune enhancing, anti-inflammatory, anti-oxidation roles and can balance ACE2/ACE ratio (decreasing ANG2 levels) in diabetic subjects.

scholarly journals Relação entre o Tratamento com Metformina e o Desenvolvimento de Hiperlactacidemia no Serviço de Urgência

2014 ◽  
Vol 27 (2) ◽  
pp. 196 ◽  
Author(s):  
Daniela Guelho ◽  
Isabel Paiva ◽  
Francisco Carrilho
Keyword(s):  
Lactate Concentration ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Independent Predictive Factor ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Type 2 Diabetics ◽  
Increased Risk ◽  
Blood Gas Analyses

<strong>Introduction:</strong> In type 2 diabetic patients treated with metformin the development of hyperlactacidemia or even lactic acidosis seems to result from an acute precipitating event. This study aims to assess the prevalence and relative risk of hyperlactacidemia in diabetic patients admitted in the Emergency Room, the predictive factors for high lactate concentration and the influence of hyperlactacidemia in patients’ prognosis.<br /><strong>Material and Methods:</strong> Transversal observational study including patients observed between June and October 2012: 138 type 2 diabetics, 66 treated with metformin, and 83 non-diabetic patients. Studies’ variables: age, sex, cause of admition, blood pressure, drugs, personal history, analytical study (biochemistry and arterial blood gas analyses with lactate) and destination. Statistical analysis was performed using SPSS 21.0®.<br /><strong>Results:</strong> Mean lactate concentration and hyperlactacidemia prevalence were significantly higher in diabetic patients (2.1 ± 0.1mmol/L vs 1.1 ± 0.1mmol/L, p &lt; 0.001 and 39.1% vs 3.6%, p &lt; 0.001, respectively) and in those under metformin compared to other diabetics (2.7 ± 0.2 mmol/L vs 1.6 ± 0.1 mmol/L, p &lt; 0.001 and 56.9% vs 23.3%, p &lt; 0.001, respectively). Diabetics on metformin presented a 25-fold increased risk of hyperlactacidemia (OR = 25.10, p &lt; 0.05). Creatinine was the only independent predictive factor for lactate<br />concentrations (B = 1.33, p &lt; 0.05). Patients with hyperlactacidemia had 4.4 times higher odds of being hospitalized or dying (OR = 4.37, p &lt; 0.05). When hospitalized, they had longer hospitalization periods (21.66 ± 5.86 days vs 13.68 ± 5.33 days, p &lt; 0.001) and higher rate of deaths (12.5% (n = 4) vs 4.3% (n = 2), p &lt; 0.05).<br /><strong>Conclusion:</strong> There was an increased risk of hyperlactacidemia in patients with type 2 diabetes, particularly for those under metformin. Serum creatinine represented the only independent associated factor of lactate concentration. The presence of hyperlactacidemia was associated with worse prognosis.

Effectiveness of Dulaglutide in the Real World and in Special Populations of Type 2 Diabetic Patients

2020 ◽  
Vol 105 (7) ◽  
pp. e2617-e2625 ◽  
Author(s):  
Mario Luca Morieri ◽  
Vera Frison ◽  
Mauro Rigato ◽  
Michele D’Ambrosio ◽  
Federica Tadiotto ◽  
...  
Keyword(s):  
Body Weight ◽  
Real World ◽  
Disease Duration ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Body Weight Reduction ◽  
Background Population ◽  
Glucagon Like Peptide 1

Abstract Context In randomized controlled trials (RCTs) on type 2 diabetes (T2D) patients, the glucagon-like peptide-1 (GLP-1) receptor agonist (GLP-RA) dulaglutide reduced HbA1c and body weight, but generalizability of such findings to real-world T2D patients is challenging. Objective We evaluated effectiveness of dulaglutide in routine clinical practice, especially in subgroups of patient that are underrepresented in RCTs. Design Retrospective multicenter study. Setting Diabetes outpatient clinics. Patients and intervention All consecutive patients who initiated dulaglutide between 2015 and 2018. Main outcome measures Changes in HbA1c and body weight were assessed up to 30 months after baseline. Effectiveness was analyzed in patient subgroups according to: prior use of GLP-1RA, persistence on treatment and dose, age, sex, disease duration, renal function, obesity, cardiovascular disease, or concomitant use of insulin or sulphonylurea. Results From a background population of 83,116 patients, 2084 initiated dulaglutide (15.3% switching from another GLP-1RA), 1307 of whom had at least 1 follow-up visit. Overall, dulaglutide reduced HbA1c by 1.0% and body weight by 2.9 kg at the end of observation. These effects were more pronounced in GLP-1RA-naïve patients and in those with shorter disease duration. Improvement in HbA1c was highly significant and consistent across all subgroups, including those aged ≥ 75 years, nonobese, or with chronic kidney disease. Body weight declined in all subgroups and significantly more with the 1.5-mg versus 0.75-mg dose. Conclusions In real-world T2D patients, effectiveness of dulaglutide on HbA1c and body weight reduction was highly consistent and significant even in subgroups of patients poorly represented in RCTs.

Autologous Skin Fibroblast and Keratinocyte Grafts in the Treatment of Chronic Foot Ulcers in Aging Type 2 Diabetic Patients

2011 ◽  
Vol 101 (1) ◽  
pp. 55-58 ◽  
Author(s):  
Matteo Monami ◽  
Maria Vivarelli ◽  
Carla Maria Desideri ◽  
Giulio Ippolito ◽  
Niccolò Marchionni ◽  
...  
Keyword(s):  
Healing Time ◽  
Lower Limbs ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Consecutive Series ◽  
Type 2 Diabetic Patients ◽  
Skin Cell ◽  
Type 2 Diabetic

Background: We assessed the tolerability and efficacy of autologous skin cell grafts in older type 2 diabetic patients with chronic foot ulcers. Methods: Treatment with Hyalograft 3D and Laserskin Autograft was proposed to a consecutive series of type 2 diabetic patients older than 65 years affected by long-standing (&gt;6 months) foot ulcers with an area greater than 15 cm2. Ulcer healing rates and measurements of ulcer area were determined monthly for 12 months. Results: Seven patients with 12 ulcers, nine of which received the described treatment, were enrolled. During 12-month follow-up, all of the ulcers healed except one. In the remaining eight ulcers, the median healing time was 21 weeks (interquartile range, 4–29 weeks). Conclusions: Autologous skin cell grafts are feasible, well tolerated, and apparently effective in the treatment of diabetic ulcers of the lower limbs in advanced age. Age did not seem to moderate healing times. (J Am Podiatr Med Assoc 101(1): 55–58, 2011)

scholarly journals Evaluation of selected trace elements in the Moroccan type 2 diabetic patients

2019 ◽  
Vol 8 (1) ◽  
pp. 78
Author(s):  
Naoual El Omri ◽  
Fadwa Mekouar ◽  
Naoufal Assoufi ◽  
Abdelkhalek Maaroufi ◽  
Jihane Smaali ◽  
...  
Keyword(s):  
Trace Elements ◽  
Hdl Cholesterol ◽  
Control Group ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetics ◽  
The Status ◽  
Normal Metabolism ◽  
Serum Trace Elements

Background: Several trace elements have been implicated in the etiology of type 2 diabetes, they can influence the onset or pathogenesis of diabetes in various ways including disruption of normal metabolism of glucose and insulin. The purpose of this work is to evaluate the serum status of copper, zinc, selenium, chromium and manganese in Moroccan type 2 diabetics compared to control group.Methods: Blood samples from 100 type 2 diabetics and 90 control subjects were analyzed for blood glucose, glycated hemoglobin (only for diabetics), lipid status and serum trace elements concentrations.Results: Glucose and triglyceride values were statistically higher in diabetics; while those of HDL-cholesterol were lower. Concentrations of zinc, selenium, chromium, and manganese were lower in diabetics compared to controls. In contrast, copper concentrations were higher.Conclusions: The status of trace elements is impaired in type 2 diabetics compared to a control group.

scholarly journals Awaking Blood Pressure Surge and Progression to Microalbuminuria in Type 2 Normotensive Diabetic Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Michelangela Barbieri ◽  
Maria Rosaria Rizzo ◽  
Ilaria Fava ◽  
Celestino Sardu ◽  
Nicola Angelico ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cox Regression ◽  
Blood Pressure Monitoring ◽  
Adult Patients ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Pressure Surge

Background. We investigated the predictive value of morning blood pressure surge (MBPS) on the development of microalbuminuria in normotensive adults with a recent diagnosis of type 2 diabetes.Methods. Prospective assessments of 24-hour ambulatory blood pressure monitoring and urinary albumin excretion were performed in 377 adult patients. Multivariate-adjusted Cox regression models were used to assess hazard ratios (HRs) between baseline and changes over follow-up in MBPS and the risk of microalbuminuria. The MBPS was calculated as follows: mean systolic BP during the 2 hours after awakening minus mean systolic BP during the 1 hour that included the lowest sleep BP.Results. After a mean follow-up of 6.5 years, microalbuminuria developed in 102 patients. An increase in MBPB during follow-up was associated with an increased risk of microalbuminuria. Compared to individuals in the lowest tertile (−0.67±1.10 mmHg), the HR and 95% CI for microalbuminuria in those in the highest tertile of change (24.86±6.92 mmHg) during follow-up were 17.41 (95% CI 6.26–48.42);pfor trend <0.001. Mean SD MBPS significantly increased in those who developed microalbuminuria from a mean [SD] of 10.6[1.4]to 36.8[7.1],p<0.001.Conclusion. An increase in MBPS is associated with the risk of microalbuminuria in normotensive adult patients with type 2 diabetes.

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