Reduced exercise arteriovenous O2 difference in Type 2 diabetes

2003 ◽  
Vol 94 (3) ◽  
pp. 1033-1038 ◽  
Author(s):  
James C. Baldi ◽  
James L. Aoina ◽  
Helen C. Oxenham ◽  
Warwick Bagg ◽  
Robert N. Doughty
Keyword(s):  
Type 2 Diabetes ◽  
Cardiac Output ◽  
Bicycle Ergometer ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Ergometer Exercise ◽  
Maximal Cardiac Output ◽  
Type 2 Diabetic ◽  
Bicycle Ergometer Exercise

Maximal O2 consumption (V˙o 2 max) is lower in individuals with Type 2 diabetes than in sedentary nondiabetic individuals. This study aimed to determine whether the lowerV˙o 2 max in diabetic patients was due to a reduction in maximal cardiac output (Q˙max) and/or peripheral O2 extraction. After 11 Type 2 diabetic patients and 12 nondiabetic subjects, matched for age and body composition, who had not exercised for 2 yr, performed a bicycle ergometer exercise test to determine V˙o 2 max, submaximal cardiac output, Q˙max, and arterial-mixed venous O2 (a-v̄ O2) difference were assessed. Maximal workload, V˙o 2 max, and maximal a-v̄ O2 difference were lower in Type 2 diabetic patients ( P < 0.05). Q˙max was low in both groups but not significantly different: 11.2 and 10.0 l/min for controls and diabetic patients, respectively ( P > 0.05). Submaximal O2 uptake and heart rate were lower at several workloads in diabetic patients; respiratory exchange ratio was similar between groups at all workloads.V˙o 2 max was linearly correlated with a-v̄ O2 difference, but not Q˙max in diabetic patients. These data suggest that a reduction in maximal a-v̄ O2 difference contributes to a decreasedV˙o 2 max in Type 2 diabetic patients.

scholarly journals Nitric oxide modulation of renal and cardiac hemodynamics in type 2 diabetes

2002 ◽  
pp. 687-694 ◽  
Author(s):  
M Dalla Vestra ◽  
D Sacerdoti ◽  
G Bombonato ◽  
P Fioretto ◽  
G Finucci ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Type 2 Diabetes ◽  
Cardiac Output ◽  
Diabetic Nephropathy ◽  
Renal Plasma Flow ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Control Subjects ◽  
Type 2 Diabetic

OBJECTIVE: To evaluate endothelial function in type 2 diabetic patients with and without diabetic nephropathy. METHODS: We studied the effects of systemic infusion of the nitric oxide (NO) synthase inhibitor NG-monomethyl-l-arginine (L-NMMA) on cardiovascular and renal hemodynamics in six type 2 diabetic patients with microalbuminuria (D2-MA), six type 2 diabetic patients with normoalbuminuria (D2-NA) and five control subjects. Both type 2 diabetic patients and control subjects had mild arterial hypertension. RESULTS: L-NMMA infusion decreased the cardiac index in all groups. A reduction in glomerular filtration rate (GFR) and an increase in filtration fraction were observed only in controls. Renal plasma flow decreased in controls and D2-NA patients and renal vascular resistance increased in all groups. CONCLUSIONS: The effect of L-NMMA on cardiac output was similar in controls and type 2 diabetic patients with and without diabetic nephropathy. In contrast, the effect on GFR was impaired in both diabetic groups, suggesting that glomerular NO homeostasis is altered in type 2 diabetes. Moreover the discrepancy, in diabetic patients, between cardiac and renal effects during L-NMMA infusion suggests that the modulation of glomerular hemodynamics is independent from NO-regulated cardiac output.

scholarly journals Impact of a Booklet about Diabetes Genetic Susceptibility and Its Prevention on Attitudes towards Prevention and Perceived Behavioral Change in Patients with Type 2 Diabetes and Their Offspring

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Masakazu Nishigaki ◽  
Eiko Sato ◽  
Ryota Ochiai ◽  
Taiga Shibayama ◽  
Keiko Kazuma
Keyword(s):  
Type 2 Diabetes ◽  
Genetic Susceptibility ◽  
Behavioral Change ◽  
Behavioral Changes ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
The Patient’S View ◽  
Self Administered Questionnaire ◽  
Type 2 Diabetic

Background. Offspring of type 2 diabetic patients are at a high risk of type 2 diabetes. Information on diabetes genetic susceptibility and prevention should be supplied to the offspring.Methods. A six-page booklet on diabetes genetic susceptibility and prevention was distributed to 173 patients who ere ordered to hand it to their offspring. The patients answered a self-administered questionnaire on booklet delivery and attitudinal and behavioral changes toward diabetes and its prevention in themselves and their offspring.Results. Valid responses were obtained from 130 patients. Forty-nine patients had actually handed the booklet. Booklet induces more relief than anxiety. From the patient's view, favorable attitudinal and/or behavioral changes occurred in more than half of the offspring who were delivered the booklet.Conclusion. The booklet worked effectively on attitudes and behaviors toward diabetes and its prevention both in patients and their offspring. However, the effectiveness of patients as information deliverers was limited.

Awareness of Complications in Diabetic Patients - Study in a Tertiary Care Centre in Kerala

2021 ◽  
Vol 8 (37) ◽  
pp. 3334-3338
Author(s):  
Satish Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Type 2 Diabetic Patients ◽  
Complications Of Diabetes ◽  
Type 2 Diabetic

BACKGROUND Type 2 diabetes mellitus is common in the Indian population and awareness regarding the disease and its complications is low among the patients with diabetes. There is lack of studies regarding awareness of complications of diabetes among type 2 diabetic patients. The purpose of this study was to assess the awareness of diabetic complications among type 2 diabetic patients. METHODS This is an institutional based observational study. The sample comprised of 150 adult patients with type 2 diabetes mellitus who underwent treatment in the Department of Medicine, Medical College Kottayam and the patient’s age ranged from 18 - 77 years. RESULTS Majority of patients were in the age group 38 to 57 and the sample comprised of 56 % males and 44 % female patients. Out of 150 patients involved in the study, 120 patients (80 %) were aware of the complications of diabetes mellitus. Among the male patients, 70 (83.33 %) and among females, 50 (75.75 %) were aware of the complications in diabetes. In the study sample, 92 (61.33 %) were aware of the foot problems, 120 patients (80 %) were aware of renal complications, 91 patients were aware regarding eye problems of diabetes, 38 (25.33 %) regarding development of hypertension, 62 (41.33 %) regarding heart attack, 42 (28 %) patients were aware regarding development of stroke and 78 patients (52 %) had awareness regarding occurrence of recurrent infections. CONCLUSIONS Awareness regarding diabetes and its complications is fairly good among the diabetic patients in Kerala. Awareness regarding all complications of diabetes was higher among males than females. Providing awareness to type 2 diabetic patients by various educational programs may be of further help to prevent complications and to decrease the mortality and morbidity in type 2 diabetes patients. KEYWORDS Awareness, Diabetes

scholarly journals Increased Urine IgM and IgG2Levels, Indicating Decreased Glomerular Size Selectivity, Are Not Affected by Dalteparin Therapy in Patients with Type 2 Diabetes

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Ole Torffvit ◽  
Majid Kalani ◽  
Jan Apelqvist ◽  
Björn Eliasson ◽  
Jan W. Eriksson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Physiological Saline ◽  
Diabetic Patients ◽  
Size Selectivity ◽  
Type 2 Diabetic Patients ◽  
Once Daily ◽  
Urinary Levels ◽  
Glomerular Size ◽  
Type 2 Diabetic

Fifty-four type 2 diabetic patients with neuroischemic foot ulcers were randomised to treatment with 5000 IU of dalteparin, (n=28), or physiological saline, (n=26), once daily until ulcer healing or for a maximum of 6 months. Thirty-three patients had normo-, 15 micro-, and 6 macroalbuminuria. The urinary levels of IgM and IgG2were elevated in 47 and 50 patients, respectively. Elevated urinary levels of IgM and IgG2indicate decreased glomerular size selectivity. Urine IgM levels were associated with IGF-1/IGFBP-1 and IGFBP-1 levels. Dalteparin treatment increased urinary levels of glycosaminoglycans (P<0.001) and serum IGFBP-1 (P<0.05) while no significant effects were seen in any of the other studied parameters. In conclusion, dalteparin therapy in patients with type 2 diabetes had no effects on urinary levels of albumin, IgM, or IgG2despite significantly increased glycosaminoglycans in urine. Elevated urinary levels of IgM and IgG2might be more sensitive markers of renal disease than albuminuria in patients with type 2 diabetes and antihypertensive therapy.

scholarly journals A study of prevalence of microalbuminuria in recently detected type 2 diabetes and its relation to hypertension, dyslipidaemia and obesity

2020 ◽  
Vol 11 (5) ◽  
pp. 38-43
Author(s):  
Shrikrishna V Acharya
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Nephropathy ◽  
Screening Tool ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Group 2 ◽  
Type 2 Diabetic ◽  
Group 1 ◽  
New Onset

Background: Microalbuminuria is one of the earliest markers of diabetic nephropathy, and if not recognized and treated early it may lead to diabetic nephropathy resulting in chronic renal failure. Aims and Objective: The aim of the current study was to find out the prevalence of microalbuminuria among newly detected Type 2 diabetic patients and also compare prevalence of microalbuminuria in patients with or without hypertension, dyslipidaemia and obesity. Materials and Methods: In this retrospective study, we analysed 90 patients with new onset type 2 diabetes mellitus. We divided the patients into two groups, group 1 with comorbidities like hypertension, dyslipidaemia and obesity (50 patients) and group 2 without comorbidities (40 patients). We analysed urinary microalbumin level in all patients and compared the prevalence of microalbuminuria between group 1 and group 2. Results: In our cohort of 90 patients, urinary microalbuminuria was found in 30 patients (33.3%). When we divided these nephropathy patients to group1 and group 2, we observed that group 1 with comorbidities had higher percentage of nephropathy patients i.e 24 out of 50(48%). Group 2 with 40 patients had only 6 patients with microalbiminuria ie 6 out of 40(15%). Incidence of microalbiminuria was higher in patients with hypertension, dyslipidaemia and obesity. Conclusions: We conclude that incidence of microalbiminuria is much more common in newly diagnosed type 2 diabetes. We also conclude that hypertension, obesity and hypercholesterolemia are risk factors for nephropathy and urinary microalbuminuria appears to be much more sensitive than serum creatinine as screening tool to detect diabetic nephropathy.

scholarly journals Effects of sodium-glucose co-transporter 2 (SGLT2) inhibition on renal function and albuminuria in patients with type 2 diabetes: a systematic review and meta-analysis

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3405 ◽  
Author(s):  
Lubin Xu ◽  
Yang Li ◽  
Jiaxin Lang ◽  
Peng Xia ◽  
Xinyu Zhao ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
Diabetic Patients ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Type 2 Diabetic Patients ◽  
Sglt2 Inhibition ◽  
Type 2 Diabetic

Aim To evaluate the effects of sodium-glucose co-transporter 2 (SGLT2) inhibition on renal function and albuminuria in patients with type 2 diabetes. Methods We conducted systematic searches of PubMed, Embase and Cochrane Central Register of Controlled Trials up to June 2016 and included randomized controlled trials of SGLT2 inhibitors in adult type 2 diabetic patients reporting estimated glomerular filtration rate (eGFR) and/or urine albumin/creatinine ratio (ACR) changes. Data were synthesized using the random-effects model. Results Forty-seven studies with 22,843 participants were included. SGLT2 inhibition was not associated with a significant change in eGFR in general (weighted mean difference (WMD), −0.33 ml/min per 1.73 m2, 95% CI [−0.90 to 0.23]) or in patients with chronic kidney disease (CKD) (WMD −0.78 ml/min per 1.73 m2, 95% CI [−2.52 to 0.97]). SGLT2 inhibition was associated with eGFR reduction in short-term trials (WMD −0.98 ml/min per 1.73 m2, 95% CI [−1.42 to −0.54]), and with eGFR preservation in long-term trials (WMD 2.01 ml/min per 1.73 m2, 95% CI [0.86 to 3.16]). Urine ACR reduction after SGLT2 inhibition was not statistically significant in type 2 diabetic patients in general (WMD −7.24 mg/g, 95% CI [−15.54 to 1.06]), but was significant in patients with CKD (WMD −107.35 mg/g, 95% CI [−192.53 to −22.18]). Conclusions SGLT2 inhibition was not associated with significant changes in eGFR in patients with type 2 diabetes, likely resulting from a mixture of an initial reduction of eGFR and long-term renal function preservation. SGLT2 inhibition was associated with statistically significant albuminuria reduction in type 2 diabetic patients with CKD.

scholarly journals Sodium-Glucose Cotransporter-2 Inhibitor (SGLT2i) as a Primary Preventative Agent in the Healthy Individual: A Need of a Future Randomised Clinical Trial?

2021 ◽  
Vol 8 ◽  
Author(s):  
Dan Xu ◽  
Owain Chandler ◽  
Cleo Wee ◽  
Chau Ho ◽  
Jacquita S. Affandi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Diabetic Patients ◽  
Atherosclerotic Cardiovascular Disease ◽  
Healthy Individuals ◽  
Type 2 Diabetic Patients ◽  
Sodium Glucose Cotransporter ◽  
Type 2 Diabetic

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a relatively novel class of drug for treating type 2 diabetes mellitus (T2DM) that inhibits glucose reabsorption in the renal proximal tubule to promote glycosuria and reduce blood glucose levels. SGLT2i has been clinically indicated for treating T2DM, with numerous recent publications focussing on both primary and secondary prevention of cardiovascular and renal events in Type 2 diabetic patients. The most recent clinical trials showed that SGLT2i have moderately significant beneficial effects on atherosclerotic major adverse cardiovascular events (MACE) in patients with histories of atherosclerotic cardiovascular disease. In this review and analysis, SGLT2i have however demonstrated clinically significant benefits in reducing hospitalisation for heart failure and worsening of chronic kidney disease (CKD) irrespective of pre-existing atherosclerotic cardiovascular disease or previous heart failure history. A meta-analysis suggests that all SGLT2 inhibitors demonstrated the therapeutic benefit on all-cause and cardiovascular mortality, as shown in EMPAREG OUTCOME study with a significant decrease in myocardial infarction, without increased stroke risk. All the above clinical trial recruited type 2 diabetic patients. This article aims to postulate and review the possible primary prevention role of SGLT2i in healthy individuals by reviewing the current literature and provide a prospective overview. The emphasis will include primary prevention of Type 2 Diabetes, Heart Failure, CKD, Hypertension, Obesity and Dyslipidaemia in healthy individuals, whom are defined as healthy, low or intermediate risks patients.

Prevalence of Dry Eye Disease in Type 2 Diabetic Patients and its Association with Diabetic Retinopathy

2021 ◽  
Vol 15 (11) ◽  
pp. 3269-3272
Author(s):  
Darikta Dargahi Shaikh ◽  
Tehmina Imdad ◽  
Safdar Ali ◽  
Fayaz Ali Kalhoro ◽  
Sajida Parveen Shaikh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Dry Eye ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Department Of Ophthalmology ◽  
Type 2 Diabetic

Objective: To determine the prevalence of dry eye disease in type 2 diabetic patients and its correlation with retinopathy Materials and Methods: A cross-sectional study was conducted in the Department of Ophthalmology, Chandka Medical College & Shaheed Mohtarma Benazir Bhutto Medical University Larkana, from 1st April 2021 to 30th September 2021. Consecutive 100 patients with type 2 diabetes mellitus (DM) who attended outpatient department were included as per inclusion-exclusion criteria. Results: The patients were mostly female (58%) with a female-to-male ratio of 1.38:1. Most patients (43%) were under 50, followed by 51–60. (34 %). The overall mean age was 54.26 10.06. More than half (63%) of patients had diabetes for up to 5 years. The patients had a 42 percent frequency of DES. Mild, moderate, and severe dry eye were diagnosed in 21%, 16%, and 5% of individuals. Longevity and poor diabetes control exacerbated the disease. Conclusions: Type 2 DM patients' age, but not their gender, was found to be a significant predictor of DES. Dry eye was found to be more common among diabetics with poor control of their condition. In patients with type 2 diabetes, the age, but not the gender, was substantially linked to DES. Keywords: Type 2 diabetes, Dry eye disease, Diabetic retinopathy, Meibomian gland dysfunction.

scholarly journals CNDP1, NOS3, and MnSOD Polymorphisms as Risk Factors for Diabetic Nephropathy among Type 2 Diabetic Patients in Malaysia

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Mohd Jokha Yahya ◽  
Patimah Binti Ismail ◽  
Norshariza Binti Nordin ◽  
Abdah Binti Md Akim ◽  
Wan Shaariah Binti Md Yusuf ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Diabetic Nephropathy ◽  
Manganese Superoxide Dismutase ◽  
Multiplicative Model ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic ◽  
Mode Of Inheritance

Type 2 diabetes mellitus (T2DM) is associated with a high incidence of nephropathy. The aim of this study was to investigate the association of a genetic polymorphism of carnosinase (CNDP1-D18S880and -rs2346061), endothelial nitric oxide synthase (NOS3-rs1799983), and manganese superoxide dismutase (MnSOD-rs4880) genes with the development of diabetic nephropathy among Malaysian type 2 diabetic patients. A case-control association study was performed using 652 T2DM patients comprising 227 Malays (without nephropathy = 96 and nephropathy = 131), 203 Chinese (without nephropathy = 95 and nephropathy = 108), and 222 Indians (without nephropathy = 136 and nephropathy = 86). DNA sequencing was performed for theD18S880ofCNDP1, while the rest were tested using DNA Sequenom MassARRAY to identify the polymorphisms. DNA was extracted from the secondary blood samples taken from the T2DM patients. The alleles and genotypes were tested using four genetic models, and the best mode of inheritance was chosen based on the leastpvalue. Thers2346061ofCNDP1was significantly associated with diabetic nephropathy among the Indians only with OR = 1.94 and 95% CI = (1.76–3.20) and fitted best the multiplicative model, whileD18S880was associated among all the three major races with the Malays having the strongest association with OR = 2.46 and 95% CI = (1.48–4.10), Chinese with OR = 2.26 and 95% CI = (1.34–3.83), and Indians with OR = 1.77 and 95% CI = (1.18–2.65) in the genotypic multiplicative model. The best mode of inheritance for bothMnSODandNOS3was the additive model. ForMnSOD-rs4880, the Chinese had OR = 2.8 and 95% CI = (0.53–14.94), Indians had OR = 2.4 and 95% CI = (0.69–2.84), and Malays had OR = 2.16 and 95% CI = (0.54–8.65), while forNOS3-rs1799983, the Indians had the highest risk with OR = 3.16 and 95% CI = (0.52–17.56), followed by the Chinese with OR = 3.55 and 95% CI = (0.36–35.03) and the Malays with OR = 2.89 and 95% CI = (0.29–28.32). The four oxidative stress-related polymorphisms have significant effects on the development of nephropathy in type 2 diabetes patients. The genes may, therefore, be considered as risk factors for Malaysian subjects who are predisposed to T2DM nephropathy.

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