scholarly journals A Study of Effect of Glycaemic Status on Pulmonary Function Test in Type 2 Diabetes Mellitus

2021 ◽  
Vol 10 (18) ◽  
pp. 1343-1346
Author(s):  
Basavaraj G.T ◽  
Mudassir Indikar ◽  
Malingaraya Negali
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pulmonary Function ◽  
Pulmonary Function Test ◽  
Pulmonary Complications ◽  
The Other ◽  
Duration Of Diabetes ◽  
Function Test

BACKGROUND Diabetes mellitus is a metabolic disorder precipitating micro vascular, macro vascular complications and peripheral vascular diseases. Pulmonary complications of diabetes mellitus have been poorly characterised. Glycaemic status has shown varied impact on lung functions. In type-2 diabetes there is resistance to insulin action and also inadequate insulin secretion. Diabetes mellitus is associated with morphological and functional abnormalities. Several studies have shown that diabetes is associated with impaired pulmonary function. Pulmonary complications of diabetes mellitus (DM) have been poorly characterised. Some authors have reported normal pulmonary functions and even concluded that spirometry is not at all necessary in diabetic patients. We wanted to highlight the evidence-based significance of spirometry. METHODS This cross-sectional study was done for a period of 1 year from September 2017 to July 2018. The study sample consisted of 50 type-2 diabetes patients and 50 controls. RESULTS A total of 100 subjects were included in the present study; 50 of them were diabetics and the other 50 were non-diabetic controls matched by age, sex and body mass index (BMI). The range of forced vital capacity (FVC) in diabetic group was from 1.36 litres, which is lesser than range in controls (2.06 litres). Forced expiratory volume (FEV1) / FVC ranged from 0.59 in diabetics compared to 0.84 in controls. Mean FVC value was higher in diabetics with a duration of diabetes of less than 5 years (2.72) as compared to those with diabetes of more than 5 years (2.03) with a P value of 0.0004 which is statistically significant. CONCLUSIONS Type 2 diabetes mellitus is associated with restrictive pattern of respiratory abnormality. As the duration of diabetes increases the restrictive profile was more prominent. There was inverse relation between glycaemic status and spirometric indices FEV1 and FVC. Thus, an intensive glycaemic management may reduce the risk of death through an improved ventilator function which is independent of the other beneficial effects. KEY WORDS Pulmonary Function Test, Type 2 Diabetes Mellitus, Glycaemic Status

scholarly journals Pulmonary function test in patients of type 2 diabetes mellitus

2019 ◽  
Vol 7 (6) ◽  
pp. 2240
Author(s):  
Amit Agarwal ◽  
Ankit Grover ◽  
Amresh Agarwal
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pulmonary Function ◽  
Pulmonary Function Test ◽  
General Medicine ◽  
Uttar Pradesh ◽  
Diabetic Patients ◽  
Function Test

Background: We are today witnessing a pandemic of diabetes mellitus (DM), globally and nationally. DM and its complications have become the most important contemporary and challenging health problems. Diabetes is not associated with any specific pulmonary symptom and hence periodic screening for lung disease is not done in diabetic patients. However, an extensive microvascular circulation and an abundant connective tissue in the lung raise the possibility that the lung may also be a target organ in diabetic patients. The aim and objectives were to study the pulmonary function of individual with type 2 diabetes mellitus patients by performing spirometry.Methods: Study included non-smoker diabetic patients, who had no history of respiratory disease, were selected for this study and undergone pulmonary function test by spirometry. The study was conducted at department of General Medicine Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India.Results: Present study, author found that there was significant derangement in the spirometric readings in the diabetic patients. The FEV1/FVC values further declines as the duration of diabetes increased.Conclusions: Spirometric values (FVC, FEV1, FEV1/FVC) were consistently lower in subjects with type 2 diabetes mellitus. The effect on FVC predicted % was found to be more pronounced in subjects whose duration of DM was more than 5 years.

Effect of Type 2 Diabetes Mellitus on Pulmonary Function

2014 ◽  
Vol 122 (06) ◽  
pp. 322-326 ◽  
Author(s):  
H. Huang ◽  
Q. Guo ◽  
L. Li ◽  
S. Lin ◽  
Y. Lin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pulmonary Function

scholarly journals Development of Type 2 Diabetes Mellitus Phenotyping Framework Using Expert Knowledge and Machine Learning Approach

2016 ◽  
Vol 11 (4) ◽  
pp. 791-799 ◽  
Author(s):  
Rina Kagawa ◽  
Yoshimasa Kawazoe ◽  
Yusuke Ida ◽  
Emiko Shinohara ◽  
Katsuya Tanaka ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Machine Learning ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Expert Knowledge ◽  
The Other ◽  
Learning Approach ◽  
Research Subjects ◽  
Machine Learning Approach

Background: Phenotyping is an automated technique that can be used to distinguish patients based on electronic health records. To improve the quality of medical care and advance type 2 diabetes mellitus (T2DM) research, the demand for T2DM phenotyping has been increasing. Some existing phenotyping algorithms are not sufficiently accurate for screening or identifying clinical research subjects. Objective: We propose a practical phenotyping framework using both expert knowledge and a machine learning approach to develop 2 phenotyping algorithms: one is for screening; the other is for identifying research subjects. Methods: We employ expert knowledge as rules to exclude obvious control patients and machine learning to increase accuracy for complicated patients. We developed phenotyping algorithms on the basis of our framework and performed binary classification to determine whether a patient has T2DM. To facilitate development of practical phenotyping algorithms, this study introduces new evaluation metrics: area under the precision-sensitivity curve (AUPS) with a high sensitivity and AUPS with a high positive predictive value. Results: The proposed phenotyping algorithms based on our framework show higher performance than baseline algorithms. Our proposed framework can be used to develop 2 types of phenotyping algorithms depending on the tuning approach: one for screening, the other for identifying research subjects. Conclusions: We develop a novel phenotyping framework that can be easily implemented on the basis of proper evaluation metrics, which are in accordance with users’ objectives. The phenotyping algorithms based on our framework are useful for extraction of T2DM patients in retrospective studies.

Effect of Type 2 Diabetes Mellitus and diabetic medication on Pulmonary Function

2021 ◽  
Vol 17 ◽  
Author(s):  
Alaa M. Hammad ◽  
Waleed Qirim ◽  
Ameen Alassi ◽  
Dana Hyassat
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Pulmonary Function ◽  
Disease Duration ◽  
Linear Regression Analysis ◽  
Forced Expiratory Volume ◽  
Control Group

Background: Type 2 diabetes mellitus (T2DM) is a chronic condition with an impairing effect on multiple organs. Numerous respiratory disorders have been observed in patients with T2DM. However, T2DM e ect on pulmonary function is ff inconclusive. Aims: In this study, we investigated the effect of T2DM on respiratory function and the correlation of glycemic control, diabetes duration and insulin intake. Methods: 1500 patients were recruited for this study, 560 having T2DM for at least a year were included in the final data, in addition to 540 healthy volunteers. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory flow at 25-75% (FEF 25-75%), as well as FEV1/FVC ratio values were measured. Results: A two-sample t-test showed that z-scores produced by Al-Qerem et al.’s equations for FEV1, FVC, and FEF 25-75% were significantly lower for the T2DM group than the control group (p < 0.01). FEV1/FVC ratio in T2DM group were significantly higher (p < 0.01). Multiple linear regression analysis found that glycemic control represented by HbA1c as well as disease duration were negatively associated with pulmonary function (p < 0.01). However, insulin intake was found to have no significant correlation with the pulmonary function. Conclusion: T2DM was linked to reduced pulmonary function and was consistent with a restrictive ventilation pattern. HbA1c as well as disease duration were independent risk factors for reduced pulmonary function.

scholarly journals The result of treadmill test in asymptomatic type 2 diabetes mellitus

2017 ◽  
Vol 3 (6) ◽  
pp. 166 ◽  
Author(s):  
Anil Shrinivasrao Joshi ◽  
Chandrakant Gunaji Lahane ◽  
Akshay Arvind Kashid
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Early Detection ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Duration Of Diabetes ◽  
Asymptomatic Patients ◽  
Cardiovascular Morbidity And Mortality

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">To study the prevalence of silent myocardial ischaemia in asymptomatic patients with type 2 DM</span>.</p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The present study was conducted in the Govt. Medical College and Hospital Aurangabad. During December 2012 to November 2014 with 50 patients. It was two year cross sectional study with the patients of asymptomatic type 2 diabetes mellitus without clinical and electrocardiographic evidence of coronary artery disease. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">12 (24%) out of 50 subjects had positive TMT. It correlated with years of duration of diabetes (9 positive TMT cases with duration of diabetes more than 10 years). 5 (25%) out of 20 had serum cholesterol levels &gt;240, Number of positive TMT were higher in patients with LDL &gt;160 [5 (25%) out of 20]</span>.</p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Diabetic patients are at very high risk for cardiovascular morbidity and mortality. Early detection of IHD is very important so that pharmacological therapy, which may improve outcome, can be established. Tread mill exercise TMT being a non-invasive test with high safety, has an important role in early detection of IHD. It is recommended that TMT should be a part of routine management in asymptomatic patients with type II DM. </span></p>

scholarly journals Assessing the Prevalence and Predicting Factors of an Abnormal Gated Myocardial Perfusion SPECT in Asymptomatic Patients with Type 2 Diabetes

2021 ◽  
Author(s):  
Elinaz Hosseinzadeh ◽  
Mohammadali Ghodsirad ◽  
Toktam Alirezaei ◽  
Maryam Arefnia ◽  
Mahasti Amoui ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Male Gender ◽  
Silent Myocardial Ischemia ◽  
Duration Of Diabetes ◽  
Predicting Factors ◽  
Asymptomatic Patients ◽  
History Of

Abstract IntroductionConsidering the significant prevalence of silent myocardial ischemia and its related morbidity and mortality in asymptomatic type two diabetic patients, it is not well known whether early screening with MPI is cost-effective. However, predicting factors are not elucidated. Materials and MethodsThis was a cross-sectional study including 63 asymptomatic patients with type 2 diabetes mellitus (T2DM), with normal ECG and ejection fraction. Patients with any history of documented valvular, congestive or ischemic heart disease, renal or hepatic failure were excluded. At first all patients were interviewed and checked for risk factors and then patients underwent a two-day rest/stress 99mTc-MIBI gated MPI SPECT. Data was assessed by QPS/QGS and 4DM software and evaluated by a nuclear medicine specialist with summed stress score (SSS) of more than 4 defined as CAD. ResultsThere were 42 females (67%) and 21 males (33%), with a mean age of 61.33 ± 6.98 years and 7.97 ± 4.86 years history of T2DM. CAD was detected in 26 (41.3%) patients and was significantly associated with male gender, smoking, requiring insulin therapy and EF (P-value = 0.019, 0.046, 0.05, 0.033, respectively). A significant association was found between the duration of diabetes, especially when >15y, and the probability of having CAD.. Multivariable logistic regression revealed that smoking; male gender and diabetes duration were the strongest independent predictors of abnormal MPI results.ConclusionWe found a high (46%) prevalence of abnormal stress MPI SPECT in patients with type 2 diabetes mellitus, despite being asymptomatic. Asymptomatic patients with a history of smoking, long duration of diabetes, being under insulin treatment and male gender might benefit from MPI for early detection of silent ischemia.

scholarly journals Walking Speed is the Sole Determinant of Mild Cognitive Impairment in Japanese Patients with type 2 Diabetes Mellitus

2020 ◽  
Author(s):  
Noritaka Machii ◽  
Akihiro Kudo ◽  
Haruka Saito ◽  
Hayato Tanabe ◽  
Mariko Iwasaki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Walking Speed ◽  
Japanese Patients ◽  
Duration Of Diabetes ◽  
Skeletal Mass

Diabetes is a risk factor for mild cognitive impairment (MCI) and dementia. However, how the clinical characteristics of type 2 diabetic patients with MCI are linked to sarcopenia and/or its criterion remain to be elucidated. Japanese patients with type 2 diabetes mellitus were categorized into the MCI group for MoCA-J (the Japanese version of the Montreal cognitive assessment) score &lt;26, and into the non-MCI group for MoCA-J &ge;26. Sarcopenia was defined by a low skeletal mass index along with low muscle strength (handgrip strength) or low physical performance (walking speed &lt;1.0 m/s). Univariate and multivariate-adjusted odds ratio models were used to determine the independent contributors for MoCA-J &lt;26. Among 438 participants, 221 (50.5%) and 217 (49.5%) comprised the non-MCI and MCI groups, respectively. In the MCI group, age (61 &plusmn; 12 vs. 71 &plusmn; 10 years, p &lt; 0.01) and duration of diabetes (14 &plusmn; 9 vs. 17 &plusmn; 9 years, p &lt; 0.01) were higher than those in the non-MCI group. Patients in the MCI group exhibited lower hand grip strength, walking speed, and skeletal mass index, but higher prevalence of sarcopenia. Only walking speed (rather than muscle loss or muscle weakness) was found to be an independent determinant of MCI after adjusting for multiple factors, such as age, gender, BMI, duration of diabetes, hypertension, dyslipidemia, smoking, drinking, eGFR, HbA1c, and history of coronary heart diseases and stroke. In subgroup analysis, a group consisting of male patients aged &ge;65 years, with BMI &lt;25, showed a significant OR for walking speed. This is the first study to show that slow walking speed is a sole determinant for the presence of MCI in patients with type 2 diabetes. It was suggested that walking speed is an important factor in the prediction and prevention of MCI development in patients with diabetes mellitus.

scholarly journals P1028EFFECTS OF CANAGLIFLOZIN ON MAJOR ADVERSE CARDIOVASCULAR OUTCOMES IN PATIENTS WITH DIFFERENT BASELINE LEVELS OF TYPE 2 DIABETES MELLITUS DISEASE SEVERITY: RESULTS FROM THE CANVAS PROGRAM

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Tamara Young ◽  
Jing-wei Li ◽  
Amy Kang ◽  
Hiddo Heerspink ◽  
Carinna Hockham ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Disease Severity ◽  
Cardiovascular Outcomes ◽  
Oral Glucose ◽  
Glucose Lowering ◽  
Duration Of Diabetes ◽  
Event Rates

Abstract Background and Aims Patient with type 2 diabetes mellitus (T2DM) included in trials of sodium-glucose cotransporter 2 inhibitors are heterogeneous in terms of disease severity. We assessed the effects of canagliflozin compared to placebo on cardiovascular and renal outcomes in the CANVAS program according to severity of T2DM as indicated by intensity of treatment, duration of diabetes and glycaemic control. Method We compared effects on major adverse cardiovascular events ([MACE], defined as cardiovascular death, non-fatal myocardial infarction or non-fatal stroke) according to three indicators of T2DM severity at study baseline: number of oral glucose lowering treatments or insulin therapy (0-1, 2, 3+, insulin), duration of diabetes (&lt;10, 10-16, &gt;16 years) and HbA1c (&lt;7.0, 7.0-7.5, 7.5-8.0, 8.0-8.5, 8.5-9, &gt;9.0%). We also assessed effects on other pre-specified cardiovascular outcomes, and an adjudicated composite of end-stage kidney disease, renal death or sustained 40% decline in estimated glomerular filtration rate. We assessed for constancy of hazard ratios across subgroups by fitting an interaction term that tested for linear trend. Results Of 10,142 participants in the CANVAS Program, 1011 experienced a MACE during a mean follow-up of 3.6 years. Event rates for MACE were higher in those with longer duration of diabetes and higher HbA1c at baseline. The effect of canagliflozin on MACE in the overall population (HR 0.86, 95 % CI 0.75-0.97) was consistent irrespective of the number of glucose lowering treatments (p=0.509), duration of diabetes (p=0.174) and baseline HbA1c (p =0.314). Effects were also consistent across different levels of T2DM disease severity for all other outcomes studied. Conclusion Higher event rates were observed in those with longer disease duration and higher HbA1c. The proportional risk reductions achieved with canagliflozin were comparable regardless of diabetes duration, number of therapies or HbA1C at baseline.

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