Homocysteine metabolism in diabetes

2007 ◽  
Vol 35 (5) ◽  
pp. 1175-1179 ◽  
Author(s):  
E.P. Wijekoon ◽  
M.E. Brosnan ◽  
J.T. Brosnan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Risk Factor ◽  
Plasma Level ◽  
Major Focus ◽  
Patients With Diabetes

An increase in the plasma level of Hcy (homocysteine), an intermediate in the catabolism of methionine, has been identified as a risk factor for many diseases including CVD (cardiovascular disease). CVD is the major cause of death in patients with diabetes mellitus. Therefore the study of Hcy metabolism in diabetes mellitus has been a major focus of current research. Studies conducted in our laboratory were able to show that in both Type 1 and Type 2 diabetes with no renal complications, the plasma Hcy levels were lower than in controls. In Type 1 diabetes, increased activities of the trans-sulfuration enzymes were the major cause for the reduction in plasma Hcy. In Type 2 diabetes, BHMT (betaine:homocysteine methyltransferase) was also observed to play a major role in the increased catabolism of Hcy in addition to the trans-sulfuration enzymes. We were also able to demonstrate the direct effect of insulin and the counter-regulatory hormones on the regulation of cystathionine β-synthase and BHMT, which accounts for the changes in the activities of these two enzymes seen in diabetes mellitus.

Model estimates of the results of diabetes patients using modern glucometers with tri-color technology for displaying test results

2019 ◽  
pp. 81-89
Author(s):  
Larisa Dmitrievna Popovich ◽  
Svetlana Valentinovna Svetlichnaya ◽  
Aleksandr Alekseevich Moiseev
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Economic Benefits ◽  
Test Results ◽  
Self Monitoring ◽  
Patients With Diabetes ◽  
The Impact

Diabetes – a disease in which the effect of the treatment substantially depends on the patient. Known a study showed that the use of glucometers with the technology of three-color display of test results facilitates self-monitoring of blood sugar and leads to a decrease in glycated hemoglobin (HbAlc). Purpose of the study: to modeling the impact of using of a glucometer with a color-coded display on the clinical outcomes of diabetes mellitus and calculating, the potential economic benefits of reducing the hospitalization rate of patients with diabetes. Material and methods. Based on data from two studies (O. Schnell et al. and M. Baxter et al.) simulation of the reduction in the number of complications with the use of a glucometer with a color indication. In a study by O. Schnell et al. a decrease of HbA1c by 0.69 percent is shown when using the considered type of glucometers, which was the basis of the model. Results. In the model, the use of a glucometer with a color-coded display for type 1 diabetes led to a decrease in the total number of complications by 9.2 thousand over 5 years per a cohort of 40 thousand patients with different initial levels of HbA1c. In a cohort of 40 thousand patients with type 2 diabetes, the simulated number of prevented complications was 1.7 thousand over 5 years. When extrapolating these data to all patients with diabetes included in the federal register of diabetes mellitus (FRD), the number of prevented complications was 55.4 thousand cases for type 1 diabetes and 67.1 thousand cases for type 2 diabetes. The possible economic effect from the use of the device by all patients with a diagnosis of diabetes, which are included in the FRD, estimated at 1.5 billion rubles for a cohort of patients with type 1 diabetes and 5.3 billion rubles for patients with type 2 diabetes. Conclusion. Improving the effectiveness of self-monitoring, which is the result of the use of glucometers with color indicators, can potentially significantly reduce the incidence of complications in diabetes and thereby provide significant economic benefits to society.

scholarly journals Plasma Level of Urate among Sudanese with Type 2 Diabetes in Khartoum state, Sudan.

2014 ◽  
Vol 2 (12) ◽  
pp. 24-29
Author(s):  
Salma Hussein Elhassan ◽  
Bader Eldien Hassan Elabid ◽  
Sara osman Yousif
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Risk Factor ◽  
Plasma Level ◽  
Lipid Profile ◽  
Diabetic Patients ◽  
Plasma Urate

Background: Type 2 diabetes mellitus is an independent risk factor for cardiovascular disease and the risk for cardiovascular disease is increased three to four fold in type 2 diabetes mellitus as compared to non-diabetic population. Hyperuricaemia has been reported to be a potential risk factor for cardiovascular disease in type 2 diabetes mellitus. The objective of this study was to assess the plasma level of urate in Sudanese patients with type 2 diabetes in comparison with apparently healthy (non-diabetic) volunteers as controls.Methods: This is a descriptive, cross- sectional and hospital-based study conducted during the period from March to May 2011 in Jabir Abu Elez diabetic center and Nurein medical center, both in Khartoum state, Sudan. The study group included 52 NIDDM cases and 30 healthy controls of either sex matched for age and gender. Fasting venous samples were collected from both cases and controls. Serum levels of uric acid, and lipid profile were assayed using commercial reagent kits from Biosystem Company.Results: In the current study there was a significant increase in plasma urate in type 2 diabetic patients as compared to the control group. There was a significant increase in lipid profile with exception to high density lipoprotein which was significantly reduced. There was insignificant correlation of plasma urea, and lipid profile with both; body mass index and the duration of diabetes.Conclusion: Hyperuricemia is significantly associated with type 2 diabetes mellitus and can increase the morbidity and mortality of diabetes if not managed in time. Elevated plasma urate levels are associated with increased risk of cardiovascular mortality in type 2 diabetes.

scholarly journals Evaluation of calcium level in patients with diabetes mellitus according to the examination in the mobile medical center (Diamodule)

2021 ◽  
Vol 23 (4) ◽  
pp. 382-388
Author(s):  
Anna V. Zheleznyakova ◽  
◽  
Victoriya L. Volodicheva ◽  
Olga K. Vikulova ◽  
Alexey A. Serkov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Serum Calcium ◽  
Calcium Level ◽  
Medical Center ◽  
Patients With Diabetes

Background. Diabetes mellitus (DM) is characterized by multiple risk factors for the combined development of disorders of phosphorus-calcium metabolism, due to more frequent overweight, decreased renal filtration function and vitamin D deficiency in this category of patients. Aim. To assess the level of calcium in blood serum and its correlations with parameters of carbohydrate metabolism, body mass index (BMI) and renal function in patients with type 1 and type 2 diabetes. Materials and methods. The object of the study: adult patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) ≥18 years old who underwent examination in Diamodule (n=294) in 2019 in the Voronezh region, who were additionally tested for serum calcium. The examination at the mobile medical center includes: assessment of anthropometric data (height, weight, BMI), biochemical data of blood lipids and creatinine levels with calculation of glomerular filtration rate (GFR-EPI), albuminuria and the albumin/creatinine in a single portion of urine, measurement of glycated hemoglobin (HbA1c), blood pressure, electrocardiogram, consultation with a cardiologist, ophthalmologist, specialist of the Diabetic Foot office, diabetologist. All biochemical parameters was carried out using commercial kits on a biochemical express analyzer Spotchem EZ ArkraySP-4430. Determination of HbA1c, albuminuria, albumin/creatinine was performed by immunochemical method on a DCA Vantage analyzer. Data analysis was carried out using the Statistica v.13.3 software package (TIBCO Software Inc., USA). The results are presented as medians and quartiles [25; 75], the level of reliability is taken as p<0.05. Results. Hypocalcemia (serum calcium level less 2.15 mmol/L) was detected in 88.3% of patients with T1DM and 73.6% of patients with T2DM. The level of serum calcium in T1DM was 1.96 [1.83; 2.07], in T2DM – 2.04 [1.97; 2.16] (p<0.001) with significant differences in GFR: in T1DM 69.6 [57.8; 82.5], with T2DM 50.5 [44.1; 59.9] (p<0.001). We observed correlation between GFR and calcium level r=-0.3 (p<0.05,). GFR<60 ml/min/1.73 m² was observed in 30.5% of T1DM patients, in 75.0% of T2DM. The HbA1c in T1DM was 8.7% [7.7; 9.8], in T2DM – 8.3% [6.8; 9.4] (p=0.01). Obesity was revealed in T1DM in 12.3%, in T2DM in 71.4%; the median BMI in T1DM was 25.5 kg/m2 [21.9; 28.4], in T2DM – 33.2 kg/m2 [29.7; 37.9]. There was correlation between BMI and calcium level r=0.26 (p<0.05). Conclusion. The results of the study revealed a high prevalence of hypocalcemia among patients with diabetes, the most pronounced in type 1 diabetes. In the presence of a correlation between calcium and GFR, there was a high incidence of hypocalcemia in patients with T1DM, even in the absence of a significant decrease in GFR, which may indicate to additional risk factors. Since the assessment of the level of calcium is not included in the list of standard clinical examination, it is recommended to include this parameter and conduct regular screening in risk groups, which include patients with diabetes. More extensive research is needed to analyze the factors.

scholarly journals Correlations between Iron Metabolism Parameters, Inflammatory Markers and Lipid Profile Indicators in Patients with Type 1 and Type 2 Diabetes Mellitus

2020 ◽  
Vol 10 (3) ◽  
pp. 70
Author(s):  
Nadezhda N. Musina ◽  
Tatiana V. Saprina ◽  
Tatiana S. Prokhorenko ◽  
Alexander Kanev ◽  
Anastasia P. Zima
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Lipid Profile ◽  
Density Lipoprotein ◽  
Reactive Protein ◽  
Inflammatory Status ◽  
Patients With Diabetes

This study aims to establish relationships between inflammatory status, ferrokinetics and lipid metabolism in patients with diabetes mellitus. Subclinical inflammation was assessed by levels of high-sensitive C-reactive protein, tumor necrosis factor-α and erythrocyte sedimentation rate. Iron metabolism parameters included complete blood count, serum iron, transferrin and ferritin. Metabolic status assessment included lipid profile, glycated hemoglobin and microalbuminuria measurement. As a result of the study it was possible to establish both general (universal) and diabetes mellitus (DM) type-dependent relationships between the parameters of lipid profile and metabolic control in DM. High-density lipoprotein cholesterol (HDL-C) levels negatively correlated with microalbuminuria (r = −0.293; p ˂ 0.05 for type 1 diabetes and r = −0.272; p ˂ 0.05 for type 2 diabetes). Ferritin concentration positively correlated with triglyceride level (r = 0.346; p ˂ 0.05 for type 1 diabetes and r = 0.244; p ˂ 0.05 for type 2 diabetes). In type 1 diabetes, a negative correlation was discovered between estimated glomerular filtration rate (eGFR) and LDL-C (r = −0.480; p ˂ 0.05), very low-density-lipoprotein cholesterol (VLDL-C) (r = −0.490; p ˂ 0.05) and triglycerides (r = −0.553; p ˂ 0.05), and a positive one between C-reactive protein concentration and triglyceride level (r = 0.567; p ˂ 0.05). Discovered relationships between lipid profile indices, inflammatory status and microalbuminuria confirmed mutual influence of hyperlipidemia, inflammation and nephropathy in diabetes patients. Obtained results justify the strategy of early hypolipidemic therapy in patients with diabetes mellitus to prevent the development and progression of microvascular complications.

ROLE OF PROINFLAMMATORY CYTOKINES IN PATHOGENESIS OF ARTHROPATHIES IN PATIENTS WITH DIABETES MELLITUS

2020 ◽  
Vol 73 (11) ◽  
pp. 2476-2481
Author(s):  
Valeriya L. Orlenko ◽  
Maria H. Kravchuk
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Proinflammatory Cytokines ◽  
Joint Damage ◽  
Tnf Α ◽  
Patients With Diabetes

The aim: Of our work was to study the level of proinflammatory cytokines in patients with diabetic arthropathy and to investigate their possible effect on the development of this complication. Materials and methods: 118 patients were examined, which were divided into groups by type of diabetes, the presence and severity of diabetic arthropathy. The content of IL-1, TNF-α, IL-6 and receptors to S IL-6-R in serum was determined by immunoassay. Results: In patients with diabetic arthropathy, levels of TNF-α (with type 1 diabetes 44.5%, type 2 diabetes 42.9%) and IL-6 (with type 1 diabetes 52.1%, with diabetes 2 types by 64.4%) significantly increased. There is a direct correlation between the severity of joint damage and the level of TNF-α and IL-6. For IL -1, receptors for S IL-6-R have not been detected. Conclusions: The chances of detecting arthropathy with type 1 diabetes with increasing TNF levels increase by 1.7 times, with an increase in IL-6 by 1.5 times. For type 2 diabetes, it is 1.8 and 1.3 times, respectively. Thus, TNF-α and IL-6 may be markers of the presence and progression of arthropathy in patients with diabetes mellitus

Correlation of Waist to Calf Circumference Ratio and Carotid Intima Media Thickness in Diabetes Mellitus

2020 ◽  
Vol 16 ◽  
Author(s):  
Harish A Rao ◽  
Prakash Harischandra ◽  
Srikanth Yadav
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Calf Circumference ◽  
Media Thickness

Introduction: Diabetes mellitus is a well-known risk factor for cardiovascular disease, because of the accelerated process of atherosclerosis. Obesity is an established risk factor and has gained immense importance in recent studies as an important risk factor for clinical cardiovascular disease, yet the fundamental component stays unclear. Calf circumference is another form for lean mass and peripheral subcutaneous fat and is inversely associated with occurrence of carotid plaques (CP). Multiplicative and opposite effects of both Calf Circumference (CC) and Waist Circumference (WC) in event of CP suggest that the two measures should be taken into account commonly while assessing vascular risk profile. Aim & Objective: To ascertain if waist to calf circumference ratio (WCR) is a marker of Carotid atherosclerosis in patients with type 2 diabetes mellitus. To asses s the correlation between waist to calf circumference ratio and carotid intima media thickness (CIMT ) in patients with Type 2 diabetes. Materials and methods: A cross sectional study at Hospital affiliated to Kasturba Medical college Mangalore from Sept 2016 to Sept 2018 . Method of study: Patients with type 2 DM as per ADA criteria, age >18years are recruited for the study. Results and discussion: In our study with 150 population 25 patients had carotid atherosclerosis and 20 patients had CIMT>1.1. The waist circumference in patients with CA is in the range of 93.07 and 99.85 & the CC in patients with CA is in the range of 29.49 to 31.25. The WCR in patients with CA is in the range of 3.12 to 3.26. The difference was statistically significant with a p value of <0.05. In our study it was found that WC and WCR correlated well with carotid atherosclerosis, and surprisingly calf circumference also correlated with carotid atherosclerosis but not as significant as both WC and WCR. Conclusion: To conclude, in our population based study of 150 subjects we found that carotid atherosclerosis is significantly more in people with increased waist calf circumference ratio. WCR may be a new, useful and practical anthropometric index that facilitates the early identification of diabetic subjects with high risk for cardiovascular disease. Validation of this finding in individual populations is required. Future studies should test the association of calf circumference with carotid intima media thickness and carotid plaques using better measures than ultrasound such as magnetic resonance imaging. Further research focusing on underlying mechanisms in the role of lean mass and peripheral fat mass is required.

scholarly journals Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 962 ◽  
Author(s):  
Bolla ◽  
Caretto ◽  
Laurenzi ◽  
Scavini ◽  
Piemonti
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Dietary Interventions ◽  
Ketogenic Diets ◽  
Patients With Diabetes ◽  
Intrinsic Complexity ◽  
Few Data ◽  
Reducing Carbohydrates

Low-carb and ketogenic diets are popular among clinicians and patients, but the appropriateness of reducing carbohydrates intake in obese patients and in patients with diabetes is still debated. Studies in the literature are indeed controversial, possibly because these diets are generally poorly defined; this, together with the intrinsic complexity of dietary interventions, makes it difficult to compare results from different studies. Despite the evidence that reducing carbohydrates intake lowers body weight and, in patients with type 2 diabetes, improves glucose control, few data are available about sustainability, safety and efficacy in the long-term. In this review we explored the possible role of low-carb and ketogenic diets in the pathogenesis and management of type 2 diabetes and obesity. Furthermore, we also reviewed evidence of carbohydrates restriction in both pathogenesis of type 1 diabetes, through gut microbiota modification, and treatment of type 1 diabetes, addressing the legitimate concerns about the use of such diets in patients who are ketosis-prone and often have not completed their growth.

scholarly journals Impact of diabetes type on treatment and outcome of patients with peripheral artery disease

2018 ◽  
Vol 15 (6) ◽  
pp. 504-510 ◽  
Author(s):  
Lars Richter ◽  
Eva Freisinger ◽  
Florian Lüders ◽  
Katrin Gebauer ◽  
Matthias Meyborg ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Type 1 Diabetes Mellitus ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Artery Disease

Background: The prevalence of diabetes mellitus and its associated complications such as peripheral artery disease is increasing worldwide. We aimed to explore the distinct impact of type 1 diabetes mellitus and type 2 diabetes mellitus on treatment and on short- and long-term outcome in patients with peripheral artery disease. Methods: Retrospective analysis of anonymized data of hospitalized patients covered by a large German health insurance. Assessment of patient’s characteristics (comorbidities, complications, etc.) and outcome using multivariable Cox regression and Kaplan–Meier curves. Results: Among 41,702 patients with peripheral artery disease, 339 (0.8%) had type 1 diabetes mellitus and 13,151 (31.5%) had type 2 diabetes mellitus. Patients with diabetes mellitus had more comorbidities and complications than patients without diabetes mellitus ( p < 0.001). Type 1 diabetes mellitus patients exhibited the highest risk for limb amputation at 4-year follow-up (44.6% vs 35.1%, p < 0.001), while type 2 diabetes mellitus patients had higher mortality than type 1 diabetes mellitus (43.6% vs 31.0%, p < 0.001). Conclusion: Although the fraction of type 1 diabetes mellitus among patients with peripheral artery disease and diabetes mellitus is low, it represents a subset of patients being at particular high risk for limb amputation. Research focused on elaborating the determinants of limb amputation and mortality in peripheral artery disease patients with diabetes mellitus is warranted to improve the poor prognosis of these patients.

scholarly journals Clinical significance of intramammary arterial calcifications in diabetic women

2004 ◽  
Vol 61 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Zorica Milosevic ◽  
Jelica Bjekic ◽  
Stanko Radulovic ◽  
Branislav Goldner
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Control Group ◽  
Duration Of Diabetes ◽  
Diabetic Macroangiopathy ◽  
Indirect Sign ◽  
Significant Difference

Background. It is well known that intramammary arterial calcifications diagnosed by mammography as a part of generalized diabetic macroangiopathy may be an indirect sign of diabetes mellitus. Hence, the aim of this study was to determine the incidence of intramammary arterial calcifications, the patient?s age when the calcifications occur, as well as to observe the influence of diabetic polineuropathy, type, and the duration of diabetes on the onset of calcifications, in comparison with nondiabetic women. Methods. Mammographic findings of 113 diabetic female patients (21 with type 1 diabetes and 92 with type 2), as well as of 208 nondiabetic women (the control group) were analyzed in the prospective study. The data about the type of diabetes, its duration, and polineuropathy were obtained using the questionnaire. Statistical differences were determined by Mann-Whitney test. Results. Intramammary arterial calcifications were identified in 33.3% of the women with type 1 diabetes, in 40.2% with type 2, and in 8.2% of the women from the control group, respectively. The differences comparing the women with type 1, as well as type 2 diabetes and the controls were statistically significant (p=0.0001). Women with intramammary arterial calcifications and type 1 diabetes were younger comparing to the control group (median age 52 years, comparing to 67 years of age, p=0.001), while there was no statistically significant difference in age between the women with calcifications and type 2 diabetes (61 years of age) in relation to the control group (p=0.176). The incidence of polineuropathy in diabetic women was higher in the group with intramammary arterial calcifications (52.3%) in comparison to the group without calcifications (26.1%), (p=0.005). The association between intramammary arterial calcifications and the duration of diabetes was not found. Conclusion. The obtained results supported the theory that intramammary arterial calcifications, detected by mammography could serve as markers of co-existing diabetes mellitus and therefore should be specified in radiologic report in case of their early development.

scholarly journals Microalbuminuria as an independent risk factor for heart failure in the elderly patients with type 2 diabetes mellitus

2020 ◽  
Vol 49 (2) ◽  
Author(s):  
Enisa Karić ◽  
Zumreta Kušljugić ◽  
Enisa Ramić ◽  
Olivera Batić- Mujanović ◽  
Amila Bajraktarević ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Diabetes Mellitus Type 2 ◽  
Independent Risk Factor ◽  
The Elderly ◽  
Diabetes Mellitus Type ◽  
Patients With Diabetes

Introduction:The study evaluated of microalbuminuria as a predictor of heart failure in patients with diabetes mellitus type 2.Materials and methods:The prospective study conducted in a period of time from 01-Feb-2007 to 01-Feb-2010.The study included 100 patients with type 2 diabetes, who had diabetes longer than 5 years. All subjects (average age 66 ± 10 years, 33% male, 67% female) were tested for the presence of microalbuminuria, and 50 patients had microalbuminuria. The second group comprised 50 patients without of microalbuminuria with diabetes mellitus type 2.Results:In the patients with microalbuminuria and diabetes mellitus were found 22% of heart failure and 6% in the second group. Average time to the occurance of heart failure in the first group was 32,5 months, in the second group was 35,3 months.Conclusions:The results show that microalbuminuria is an independent risk factor for heart failure in patients with diabetes mellitus type 2 and microalbuminuria. Patients without microalbuminuria had 3,7 less likely to development heart failure compared to patients with microalbuminuria and diabetes mellitus.

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