scholarly journals Acarbose Treatment and the Risk of Cardiovascular Disease in Type 2 Diabetic Patients: A Nationwide Seven-Year Follow-Up Study

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Jui-Ming Chen ◽  
Cheng-Wei Chang ◽  
Ying-Chieh Lin ◽  
Jorng-Tzong Horng ◽  
Wayne H.-H. Sheu
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Diabetic Patients ◽  
Cvd Risk ◽  
Type 2 Diabetic Patients ◽  
Acarbose Treatment ◽  
Underlying Mechanisms ◽  
Type 2 Diabetic

Objective. To investigate the potential benefits of acarbose treatment on cardiovascular disease (CVD) in patients with type 2 diabetes by using nationwide insurance claim dataset.Research Design and Methods. Among 644,792 newly diagnosed type 2 diabetic patients without preexisting CVD in a nationwide cohort study, 109,139 (16.9%) who had received acarbose treatment were analyzed for CVD risk. Those with CVD followed by acarbose therapy were also subjected to analysis.Result. During 7 years of follow-up, 5,081 patients (4.7%) developed CVD. The crude hazard ratio (HR) and adjusted HR were 0.66 and 0.99, respectively. The adjusted HR of CVD was 1.19, 0.70, and 0.38 when the duration of acarbose use was <12 months, 12–24 months, and >24 months, respectively. Adjusted HR was 1.14, 0.64, and 0.41 with acarbose cumulative doses <54,750 mg, 54,751 to 109,500 mg, and >109,500 mg, respectively.Conclusion. In patients with type 2 diabetes without preexisting CVD, treatment with acarbose showed a transient increase in incidence of CVD in the initial 12 months followed by significant reductions of CVD in prolonged acarbose users. After the first CVD events, continuous use of acarbose revealed neutral effect within the first 12 months. The underlying mechanisms require further investigations.

scholarly journals Follow-up and treatment pattern during Ramadan and evaluation of the outcome of Ramadan fasting on clinical, biochemical and metabolic parameters in patients with type 2 diabetes mellitus: a realworld, multi-center, prospective observational study

2020 ◽  
Vol 11 (1) ◽  
pp. 30-38
Author(s):  
Nazmul Kabir Qureshi ◽  
Nazma Akter ◽  
Zafar Ahmed
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Prospective Observational Study ◽  
Treatment Pattern ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Ramadan Fasting ◽  
Type 2 Diabetic

Background: There are variable effects of Ramadan fasting on clinical and biochemical variables of diabetic people. Anti-diabetic agents are often adjusted during this time to reflect changes in lifestyle. The study was conducted to understand the diversity of follow-up, treatment pattern, clinical, and biochemical outcome of Ramadan fasting among type 2 diabetic patients who observed Ramadan fast. Methods: This real-world, multi-center, prospective, observational study was conducted at the diabetes outpatient department of National Healthcare Network (NHN) Uttara Center of Bangladesh Diabetic Somity (BADAS), Dhaka, Bangladesh and outpatient department of MARKS Hormone and Diabetes clinic, MARKS Medical College &Hospital in Dhaka, Bangladesh upon randomly selected type 2 diabetic patients, recruited 1 to 12 weeks prior to the Ramadan and followed up till 12 weeks post-Ramadan period. Finally, a total of 271 participants completed satisfactory follow up. Data was collected before, during, and after Ramadan using a set of questionnaires in a face to face interview. Results: The majority (80.1%) of participants received pre-Ramadan education, counseling, adjustment of medication and other direction to help them cope with Ramadan fasting. A significant reduction of weight, body mass index (BMI)) and blood pressure were reported after Ramadan fast (p<0.001). None of the studied participants experienced severe hyper/hypoglycemia or acute complications requiring hospitalization or an emergency room visit. Metformin was the commonest prescribed anti-diabetic medication. Premixed insulin was the commonest insulin regimen during study period. Three most commonly adjusted oral anti-diabetic drugs were gliclazide, glimepiride, metformin and insulin doses were also adjusted. Mean of fasting and prandial capillary blood glucose decreased from pre-Ramadan period to post-Ramadan period (P<0.05). HbA1c decreased during post-Ramadan period compared to pre-Ramadan visit (P=0.13). A significant reduction in the triglyceride level was observed during post-Ramadan follow up (P< 0.05). Conclusion: The study revealed that a safe fasting can be observed with proper pre-Ramadan work-up. Ramadan fasting resulted into significant reduction of weight, BMI, blood pressure, lipid profile and improved glycemic status in patients with type 2 diabetes. Birdem Med J 2021; 11(1): 30-38

scholarly journals Diabetic retinopathy as an independent predictor of subclinical cardiovascular disease: baseline results of the PRECISED study

2019 ◽  
Vol 7 (1) ◽  
pp. e000845 ◽  
Author(s):  
Rafael Simó ◽  
Jordi Bañeras ◽  
Cristina Hernández ◽  
José Rodríguez-Palomares ◽  
Filipa Valente ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Diabetic Retinopathy ◽  
Characteristic Curve ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Subclinical Cardiovascular Disease ◽  
Type 2 Diabetic ◽  
Subclinical Cvd

ObjectiveDetection of subclinical cardiovascular disease (CVD) has significant impact on the management of type 2 diabetes. We examined whether the assessment of diabetic retinopathy (DR) is useful for identifying patients at a higher risk of having silent CVD.Research design and methodsProspective case–control study comprising 200 type 2 diabetic subjects without history of clinical CVD and 60 age-matched non-diabetic subjects. The presence of subclinical CVD was examined using two parameters: (1) calcium coronary score (CACs); (2) composite of CACs >400 UA, carotid plaque ≥3 mm, carotid intima–media thickness ratio >1, or the presence of ECG changes suggestive of previous asymptomatic myocardial infarction. In addition, coronary angio-CT was performed. DR was assessed by slit-lamp biomicroscopy and retinography.ResultsType 2 diabetic subjects presented higher CACs than non-diabetic control subjects (p<0.01). Age, male gender, and the presence of DR were independently related to CACs >400 (area under the receiver operating characteristic curve (AUROC) 0.76). In addition, an inverse relationship was observed between the degree of DR and CACs <10 AU. The variables independently associated with the composite measurement of subclinical CVD were age, diabetes duration, the glomerular filtration rate, microalbuminuria, and the presence of DR (AUROC 0.71). In addition, a relationship (p<0.01) was observed between the presence and degree of DR and coronary stenosis.ConclusionsThe presence and degree of DR is independently associated with subclinical CVD in type 2 diabetic patients. Our results lead us to propose a rationalized screening for coronary artery disease in type 2 diabetes based on prioritizing patients with DR, particularly those with moderate–severe degree.

scholarly journals Nephroprotective effect of dapagliflozin in type 2 diabetes mellitus: A potential role of Klotho protein

2021 ◽  
pp. 11-18
Author(s):  
I. Topchii ◽  
P. Semenovykh ◽  
V. Galchiskaya ◽  
K. Savicheva
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Sglt2 Inhibitor ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Klotho Protein ◽  
Type 2 Diabetic

Abstract. The present study aimed to investigate the dynamics of clinical and laboratory parameters and serum Klotho protein level in patients with diabetic kidney disease using nephroprotective therapy combined with an inhibitor of the sodium-glucose cotransporter 2 (SGLT2) dapagliflozin. Methods. A total of 76 type 2 diabetic patients with diabetic nephropathy (DN) were examined in this prospective study. Control group - 20 healthy subjects. 53 patients received a standard course of treatment, which included metformin, renin-angiotensin-aldosterone system blockers and statins. In addition to standard therapy, 23 patients have been prescribed the SGLT2 inhibitor dapagliflozin 10 mg per day. The treatment follow-up period was six months. Klotho concentration was determined by an enzyme-linked immunosorbent assay. Results. The development of DN in type 2 diabetic patients was accompanied by a significant decrease in soluble Klotho protein in comparison with controls and patients without nephropathy. During follow-up, Klotho protein level was changed significantly in the group of DN patients with albuminuria. Standard therapy resulted in Klotho concentration increase by 14% compared to pre-treatment values; a more demonstrative increase in the Klotho level was found in the dapagliflozin group (almost 23%). Conclusions. SGLT2 inhibitor treatment resulted in a significant increase of pleiotropic serum protein Klotho in patients with type 2 diabetes and diabetic kidney disease.

scholarly journals American Ginseng Extract (Panax quinquefoliusL.) Is Safe in Long-Term Use in Type 2 Diabetic Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Iva Mucalo ◽  
Elena Jovanovski ◽  
Vladimir Vuksan ◽  
Velimir Božikov ◽  
Željko Romić ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
American Ginseng ◽  
Diabetic Patients ◽  
Cvd Risk ◽  
Type 2 Diabetic Patients ◽  
Double Blind ◽  
Ginseng Extract ◽  
Type 2 Diabetic

Aim. The objective of the present study was to test the safety of supplementation with the American ginseng (AG) interventional material as an adjunct to conventional therapy (diet and/or medications) in type 2 diabetes, using a double-blind, randomized, placebo-controlled, parallel design.Methods. Each participant received either AG (10% ginsenosides) or placebo capsules (500 mg/meal = 3 g/day) for a period of 12 weeks. Outcomes included measures of safety including kidney function (urates and creatinine), liver function (AST and ALT), and haemostatic function (PV and INR).Results. Seventy-four participants with well-controlled type 2 diabetes (sex: 28 M and 46 F, age: 63 ± 9.5, BMI: 32 ± 5, and HbA1c: 7 ± 1.3), randomized to either intervention (n=35) or control (n=39) group, completed the study. There was no change in any of the measures of safety between treatments from baseline. The number or severity of adverse events did not differ between the AG intervention and placebo.Conclusion. Following 12 weeks of supplementation with AG, safety was not compromised in a high cardiovascular disease (CVD) risk population of patients with type 2 diabetes. This demonstrated that safety is noteworthy, as reviews have continuously warned of possible adverse effects of ginseng consumption.

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 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.

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