scholarly journals Type 2 Diabetic Sepsis Patients Have a Lower Mortality Rate in Pioglitazone Use: A Nationwide 15-Year Propensity Score Matching Observational Study in Taiwan

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Ming-Shun Hsieh ◽  
Sung-Yuan Hu ◽  
Shu-Hui Liao ◽  
Chia-Ming Chang ◽  
Vivian Chia-Rong Hsieh ◽  
...  

Background. Pioglitazone use via the PPARγ agonist in sepsis patients is inconclusive. It was based on a great number of animal studies. However, except for information from animal studies, there are merely any data of human studies for reference. Methods. This study was conducted by a unique database including 1.6 million diabetic patients. From 1999 to 2013, a total of 145,327 type 2 diabetic patients, first admitted for sepsis, were enrolled. Propensity score matching was conducted in a 1 : 5 ratio between pioglitazone users and nonusers. Multivariate logistic regression was conducted to evaluate the adjusted odds ratios (aORs) of hospital mortality in pioglitazone users. Further stratification analysis was done and Kaplan–Meier plot was used. Results. A total of 9,310 sepsis pioglitazone users (defined as “ever” use of pioglitazone in any dose within 3 months prior to the first admission for sepsis) and 46,550 matched nonusers were retrieved, respectively. In the multivariate logistic regression model, the cohort of pioglitazone users (9,310) had a decreased aOR of 0.95 (95% CI, 0.89–1.02) of sepsis mortality. Further stratification analysis demonstrated that “chronic pioglitazone users” (defined as “at least” 4-week drug use within 3 months) (3,399) were more associated with significant aOR of 0.80 (95% CI, 0.72–0.89) in reducing sepsis mortality. Conclusions. This first human cohort study demonstrated the potential protective effect of chronic pioglitazone use in type 2 diabetic sepsis patients.

KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 614-619 ◽  
Author(s):  
Sayama Hoque ◽  
MA Muttalib ◽  
Md Imtiajul Islam ◽  
Parvin Akter Khanam ◽  
Subhagata Choudhury

Background: Retinopathy is the leading cause of blindness in persons with diabetes. Strict monitoring and maintenance of normal blood glucose specially HbA1c and prevention of different risk factors can prevent and delay the diabetic retinopathy. The purpose of the study was to explore the factors influencing or related to the development of the diabetic retinopathy with spcial concern to the HbA1c levels.Materials and Methods: We studied 400 type 2 diabetic patients in this cross-sectional study which was conducted in the out-patient department of BIRDEM hospital, Bangladesh. The randomly selected patients were evaluated for the presence of retinopathy through the review of their registered diabetic guide book. We included sociodemographic information, blood pressure, anthropometry (height, weight, BMI) and lipid profile of the patients. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used Student's t-test, Chi-square test and logistic regression analysis to determine and quantify the association of diabetic retinopathy with various risk factors specially HbA1c.Results: 400 type 2 diabetic patients (male 166 and female 234) were studied. The prevalence of retinopathy was 12.3%; male 12.7%, female 12.0%. Increasing HbA1c categories above 7.0% were significantly associated with increased prevalence of retinopathy (4.2 vs 12.3 vs 18.1%;c2 = 12.529, p < .01). Logistic regression models of univariate analysis showed that the risk of retinopathy at HbA1c categories >7.0% was (OR = 3.22; 95% CI: 1.12-9.25) and the risk was strongly increased at the HbA1c categories 8% (OR = 5.07; 95% CI: 1.90-13.50). Advanced age (OR = 2.92; 95% CI: 1.44-5.91), longer duration of diabetes (OR = 3.08; 95% CI: 1.49-6.37), presence of hypertension (OR = 2.42; 95% CI: 1.14-5.16), FBG (OR = 1.139; 95% CI: 1.036-1.251), blood glucose 2 hours ABF (OR = 1.124; 95% CI: 1.046-1.207) and SBP (OR = 1.033; 95% CI: 1.011-1.056) had significant association with retinopathy.Conclusions: HbA1c categories >7.0% is an important risk factor for the development of retinopathy. Poor glycaemic control, advanced age, longer duration of diabetes, hypertension are other significant risk factors of diabetic retinopathy.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 614-619


KYAMC Journal ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 662-667 ◽  
Author(s):  
Md Imtiajul Islam ◽  
Sayama Hoque ◽  
Rehana Khatun ◽  
Md Zulfikar Ali ◽  
Md Saiful Islam ◽  
...  

Background: Macrovascular complications cause much of the serious morbidity and mortality in patients with diabetes. The aim of the study was to determine the prevalence and risk factors of different macrovascular complications among type 2 diabetic patients.Materials and Methods: We studied two fifty cases of type 2 diabetic patients in this cross-sectional study which was conducted in the out-patient department of BIRDEM hospital, Bangladesh. The randomly selected patients were evaluated for the presence of coronary heart diseases (CHD), stroke and peripheral vascular diseases (PVD) through the review of their registered diabetic guide book. We included sociodemographic information, blood pressure, anthropometry (height, weight, body mass index) and lipid profile of the patients. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used logistic regression analysis to determine and quantify the association of CHD, stroke and PVD with various risk factors. Results: Two hundred and fifty cases of type 2 diabetic patients (male 129 and female 121 were studied. The prevalence of macro-vascular complications was 28.8%. Among them CHD was 21.2% (95% CI: 16.13- 26.27%), stroke in 8.4% (95% CI: 4.96-11.84%) and PVD in 7.2% (95% CI: 4-10.4%). Logistic regression models showed that macrovascular complications were more common in females; the risk increased significantly with age, longer duration of diabetes, lacking of physical exercise, presence of hypertension, HbA1c, Fasting Blood Glucose (FBG) and blood glucose 2 hours ABF.Conclusions: CHD is the most common macrovascular complication among type 2 DM patients. Advanced age, longer duration of diabetes, hypertension, poor glycaemic control, lacking of physical exercise etc. are significant risk factors of macrovascular complications in type 2 diabetic patients.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 662-667


2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Kaori Kitaoka ◽  
Akiko Takenouchi ◽  
Ayaka Tsuboi ◽  
Keisuke Fukuo ◽  
Tsutomu Kazumi

Urinary albumin/creatinine ratio (ACR) was measured at baseline and after a median follow-up of 6.0 years in 161 patients with type 2 diabetes. Intrapersonal means and SD of HbA1c, systolic BP, fasting, and postmeal plasma glucose (FPG and PMPG, resp.) and serum triglycerides (FTG and PMTG, resp.) were calculated in each patient during the first 12 months after enrollment. Associations of these variables with nephropathy progression (15 patients with progression of albuminuric stages and 5 with ACR doubling within the microalbuminuric range) were determined by multivariate logistic regression analysis providing odds ratio with 95% confidential interval. Patients with nephropathy progression, compared with those without nephropathy progression, had higher HbA1c (p<0.01). They also had higher means and SD of FPG (bothp<0.05), FTG (bothp<0.05), and PMTG (p=0.001). Multivariate logistic regression analysis demonstrated that SD-FPG (1.036, 1.001–1.073,p=0.04) and PMTG (1.013, 1.008–1.040,p=0.001) were significant predictors of progression of nephropathy even after adjustment for mean FPG and SD-FTG, age, sex, BMI, waist circumference, diabetes duration and therapy, means and SDs of HbA1c, PPG, FTG and systolic BP, baseline ACR, smoking status, and uses of antihypertensive and lipid-lowering medications. Consistency of glycemic control and management of postmeal TG may be important to prevent nephropathy progression in type 2 diabetic patients.


2021 ◽  
Vol 7 (2) ◽  
pp. 1-4
Author(s):  
Olatunde Olayanju ◽  
Victory Edem ◽  
Chika Okwor ◽  
Gabriel Odok ◽  
Nnaemeka Awah

Objective: Diabetes mellitus is associated with increased prevalence of oral diseases for which reactive oxygen species have been implicated. The saliva contains protective antioxidants which statutorily curtail these destructive oxygen molecules. A functional compromise of the antioxidants may precipitate oxidative stress leading to the increased oral disease susceptibility. However, salivary markers of oxidative stress have not been sufficiently studied in the diabetics. Methods: A total of 166 adults were recruited for this study. They comprised of 95 Type 2 diabetic patients and 71 healthy non-diabetic controls. About 3 ml of unstimulated saliva samples were collected from participants and processed, levels of salivary H2O2, NO and MDA were measured using spectrophotometry method and compared between the two groups. Data was analysed using t-test, logistic regression and receiver operating characteristics (ROC) with statistical significance set at p<0.05. Results: Salivary H2O2 (p=0.024) and NO (p=0.002) were significantly higher in the diabetic patients when compared to the healthy non-diabetic control group. Binary logistic regression showed that patients with Type 2 diabetic mellitus are more likely to have elevated salivary H2O2 (OR= 1.013; p=0.025) and NO (OR=1.016; p=0.003) levels. ROC analysis showed statistically significant performance of salivary NO levels in distinguishing between T2DM patients and healthy controls. Conclusions: Higher levels of oxidative stress markers including salivary H2O2 and NO in the diabetic groups could be a pointer to the characteristic high prevalence of oral diseases in diabetes mellitus, given that oxidative stress predisposes to disease vulnerability. This calls for increased attention to oral health in diabetes management to minimise co-morbidity.


KYAMC Journal ◽  
2017 ◽  
Vol 8 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Sayama Hoque ◽  
MA Muttalib ◽  
Md Imtiajul Islam ◽  
Parvin Akter Khanam ◽  
Nasrin Akter ◽  
...  

Background: Diabetes is the leading cause of chronic kidney disease which ultimately results end-stage renal disease (ESRD).Objectives: The purpose of the study was to explore the factors influencing or related to the development of the diabetic nephropathy with specific concern to the HbA1c (glycosylated hemoglobin) levels.Methods: Four hundred type 2 diabetic patients (male 166 and female 234) were studied and were evaluated for the presence of nephropathy through the review of their registered diabetic guide book. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used Student's ttest,?2-test and logistic regression analysis to determine and quantify the association of diabetic nephropathy with various risk factors specially HbA1c.Results: The prevalence of nephropathy was 24.0%; male 27.1%, female 21.8%. Increasing HbA1c categories above 7.0% were significantly associated with increased prevalence of nephropathy (15.8 vs 22.8 vs 30.7%; ?2 = 8.590, p = .013). Logistic regression models of univariate analysis showed that the risk of nephropathy was strongly increased at the HbA1c categories 8% (OR = 2.35; 95% CI: 1.30-4.25). Advanced age (OR = 3.8; 95% CI: 2.21-6.53), longer duration of diabetes (OR = 4.05; 95% CI: 2.31-7.10), lacking of physical exercise (OR = 1.93; 95% CI: 1.20-3.10), presence of hypertension (OR = 4.62; 95% CI: 2.42-8.83), fasting blood glucose (OR = 1.139; 95% CI: 1.054-1.231), blood glucose 2 hours after breakfast (OR = 1.088; 95% CI: 1.028-1.152), systolic blood pressure (OR = 1.049; 95% CI: 1.030-1.069) and diastolic blood pressure (OR = 1.061; 95% CI: 1.026-1.097) had significant association with nephropathy.Conclusion: HbA1c categories >7.0% is an important risk factor for the development of nephropathy.KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 21-26


2020 ◽  
Author(s):  
Feng Bin ◽  
Guidong Xu ◽  
Kangyun Sun ◽  
Nannan Zhang ◽  
Bimin Shi

Abstract Background: The prevalence of peripheral artery disease (PAD) is obviously increased in diabetic patients. Existing evidences show that cysteine-rich angiogenic inducer 61 (Cyr61), a 40 kD secreted protein, plays important roles in regulating cellular physiological processes. Recent studies have demonstrated a significant correlation between serum Cyr61 levels and atherosclerosis. However, the relationship between Cyr61 levels and PAD in type 2 diabetic patients remains obscure.Methods:. A total of 306 subjects with type 2 diabetes were recruited. The extent of PAD was determined by using the Fontaine classification, which defines four stages. We analyzed Cyr61 serum levels by ELISA in patients with and without PAD at Fontaine’s stage II, III, or IV. Logistic regression models were used to examine the independent association of Cyr61 with PAD.Results: Out of the 306 patients enrolled in this study, 150 patients were free from PAD, while 156 had clinically significant PAD. In PAD patients, the prevalences of Fontaine classification stage II, III and IV were 48.7%, 32.1%, and 19.2%, respectively. Patients with more advanced PAD had significantly higher Cyr61 (P for trend <0.001). The prevalence of PAD on the basis of severity increased with ascending Cyr61 quartiles (all P for trend <0.001), and the severity of PAD was positively correlated with Cyr61 quartiles (r=0.227, P=0.006). The association of Cyr61 levels with PAD remained after adjusting for major risk factors in a logistic regression analysis.Conclusions: Our results demonstrated that Cyr61 was significantly increased in type 2 diabetic patients with PAD and that Cyr61 levels were positively associated with disease severity. It could be a promising biomarker and further studies are needed to assess its clinical utility.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Anna Beata Sobol-Pacyniak ◽  
Wiesław Szymczak ◽  
Paulina Kwarta ◽  
Jerzy Loba ◽  
Tadeusz Pietras

Objectives. The aim of the study was to examine factors which determine stress coping styles in type 2 diabetic (T2D) patients, with regard to selected demographic variables, clinical diabetes-related variables and selected psychical variables (anxiety level and assessment of depressive disorders).Methods. 50 T2D patients, aged 59.9 ± 10.2 years were assessed by Coping Inventory for Stressful Situations (CISS), Spielberger State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI). In the statistical analysis simple and multivariable logistic regression models were used.Results. Variables significantly increasing the selection risk of stress coping style different from preferred task-oriented strategy in a simple logistic regression model are: hypoglycemia within three months prior to the research: odds ratio (OR) = 6.86 (95% confidence interval (CI) 1.25–37.61), taking antidepressants or neuroleptics: OR =15.42 (95% CI 2.42–98.33), severe depression in Beck’s scale: OR = 84.00 (95% CI 6.51–1083.65), high state-anxiety level: OR = 9.60 (95% CI 1.08–85.16), and high trait-anxiety level: OR = 18.40 (95%CI 2.96–114.31), but in a multivariable model, diagnosed depression is the strongest factor: OR = 32.38 (95% CI 4.94–212.13).Conclusions. In T2D patients, the strategy to cope with stress appears to be mostly influenced by psychical predisposition.


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