scholarly journals Usage of plasmapheresis in combined therapy of diabetics

1994 ◽  
Vol 40 (5) ◽  
pp. 13-16
Author(s):  
Ye. I. Sokolov ◽  
S. V. Podachina ◽  
V. I. Zabotnov ◽  
Ye. B. Zanina
Keyword(s):  
Diabetes Mellitus ◽  
Blood Plasma ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Erythrocyte Membranes ◽  
Side Reactions ◽  
Type I ◽  
Patients With Diabetes ◽  
Insulin Dependent

Clinical observations have repeatedly proved that myocardial infarction in patients with diabetes mellitus (DM) is much more difficult, gives greater mortality, its complications such as acute heart failure, arrhythmia, and relapses are more often observed. The basis of the atherosclerotic process both in diabetes and without it, the main place is given to hyperlipoproteinemia (hypercholesterolemia, hypertriglyceridemia and hypoalpha-cholesterolemia). Most patients with severe type I diabetes mellitus (insulin-dependent, IDDM) and type II diabetes mellitus (non-insulin-dependent, NIDDM) showed an increase in plasma levels of low and very low density lipoprotein cholesterol (cholesterol-LDL and cholesterol-VLDL, respectively) and a decrease high density lipoprotein cholesterol (HDL-C; anti-atherogenic factor). The use of lipid-lowering drugs for the correction of hyperlipoproteinemia in patients with diabetes is often ineffective or the effect obtained is short-term in nature, side reactions often develop. In recent years, in order to reduce the level of lipids in blood plasma (coronary heart disease, familial hypercholesterolemia, etc.), extracorporeal methods aimed at massive removal of the plasma lipid pool have begun to be used. According to the authors, the rapid and massive removal of atherogenic lipid fractions from plasma contributes to the release of the steroid from the tissue pool. In the pathogenesis of the development of vascular complications in patients with IDDM and NIDDM, a significant place is given to dysfunction of erythrocyte membranes. Functional disorders are directly dependent on violations of the structure of membrane lipids. Changes in the structure of the lipid bilayer of the erythrocyte membrane in patients with diabetes contribute to increased microviscosity of membranes, reduced deformability, and hinder their passage through the microcirculation system, which can be the cause of tissue hypoxia and one of the links in the pathogenesis of angiopathy in patients with diabetes. The aim of this work was to study the possible correction of the lipid spectrum of blood plasma and erythrocyte membranes in patients with diabetes when the plasmapheresis method is included in the complex therapy.

scholarly journals Inverse Association between High-Density Lipoprotein Cholesterol and Adverse Outcomes among Acute Ischemic Stroke Patients with Diabetes Mellitus

Biomedicines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1947
Author(s):  
Guoliang Hu ◽  
Yuesong Pan ◽  
Mengxing Wang ◽  
Xia Meng ◽  
Yong Jiang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Ischemic Stroke ◽  
High Density Lipoprotein ◽  
Acute Ischemic Stroke ◽  
High Density Lipoprotein Cholesterol ◽  
Recurrent Stroke ◽  
Density Lipoprotein ◽  
Adverse Outcomes ◽  
Lipoprotein Cholesterol ◽  
Patients With Diabetes

A low high-density lipoprotein cholesterol (HDL-C) level is an identified risk factor for cardiovascular diseases. However, results on the association between HDL-C levels and adverse outcomes in diabetic status still remain limited and controversial. Herein, we evaluated the association between HDL-C levels and adverse outcomes among acute ischemic stroke (AIS) patients with diabetes mellitus. The cohort comprised 3824 AIS patients with diabetes mellitus (62.7 ± 10.5 years; 34.2% women) from the Third China National Stroke Registry (n = 15,166). Patients were classified into five groups by quintiles of HDL-C. The outcomes included recurrent stroke and major adverse cardiovascular events (MACEs) within 1 year. The relationship between HDL-C levels and the risk of adverse outcomes was analyzed by Cox proportional hazards models. Patients in the lowest quintile of HDL-C had a higher risk of recurrent stroke (hazard ratio (HR) 1.59, 95% confidence interval (CI), 1.12–2.25) and MACEs (HR 1.53, 95% CI, 1.09–2.15) during 1-year follow-up compared with those in the highest quintile of HDL-C. There were linear associations between HDL-C levels and the risks of both recurrent stroke and MACEs. Low HDL-C levels were associated with higher risks of recurrent stroke and MACEs within 1 year in AIS patients with diabetes mellitus.

scholarly journals REVIEW: Efficacy and Mechanisms of Action of Statins in the Treatment of Diabetic Dyslipidemia

2006 ◽  
Vol 91 (2) ◽  
pp. 383-392 ◽  
Author(s):  
Henry N. Ginsberg
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Trials ◽  
Evidence Synthesis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Mechanisms Of Action ◽  
Lipoprotein Cholesterol ◽  
Very Low Density Lipoprotein ◽  
Low Density ◽  
Patients With Diabetes

Context: The Adult Treatment Panel III recommends 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, or statins, as first-line lipid-altering therapy for all adult patients with diabetes mellitus. This is based on the well-characterized efficacy and safety profiles of this class of agents as well as several clinical trials demonstrating that statin treatment reduces the risk of cardiovascular events. Evidence Acquisition: This review provides an overview of the effectiveness and mechanisms of action of statins in patients with diabetes mellitus using small efficacy trials and large clinical outcomes trials as well as studies of the effects of statins on apolipoprotein B (apoB) metabolism. Evidence Synthesis: The major findings presented are a review of mechanistic studies of selected subjects with diabetes mellitus and dyslipidemia and a compilation of results from large-scale clinical trials of patients with diabetes. Conclusions: Statins are highly efficacious as low-density lipoprotein cholesterol-lowering agents and have more modest effects on very low-density lipoprotein triglyceride and high-density lipoprotein cholesterol levels. The effects of statins on plasma lipids and lipoproteins result from their ability to both increase the efficiency with which very low-density lipoprotein and low-density lipoprotein are cleared from the circulation and reduce the production of apoB-containing lipoproteins by the liver. Additional investigations are needed to clarify the mechanisms by which statins reduce apoB secretion from the liver.

scholarly journals Control of Risk Factors for Cardiovascular Disease Among Adults with Previously Diagnosed Type 2 Diabetes Mellitus: A Descriptive Study from a Middle Eastern Arab Population

2012 ◽  
Vol 6 (1) ◽  
pp. 133-140 ◽  
Author(s):  
Jawad A Al-Lawati ◽  
Mohammed N. Barakat ◽  
Ibrahim Al-Zakwani ◽  
Medhat K. Elsayed ◽  
Masoud Al-Maskari ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Risk Factor ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Cvd Risk

Background: Despite the high burden of type 2 diabetes mellitus (T2DM) in Oman, there are scarce data from a nationally representative sample on the level of glycaemia and other cardiovascular (CVD) risk factor control. Objective: To estimate the proportion of patients with T2DM at goal for glycaemia and CVD risk factors using the National Diabetes Guidelines (NDG) and the American Diabetes Association (ADA) clinical care guidelines; and to assess the quality of selected services provided to patients with T2DM. Methods: A sample of 2,551 patients (47% men) aged ≥20 years with T2DM treated at primary health care centers was selected. Patient characteristics, medical history and treatment were collected from case notes, Diabetes Registers and computer frameworks including the use of the last 3 laboratory investigations results and blood pressure (BP) readings recorded in 2007. Results: The overall mean age of the cohort was 54±13 years with an average median duration of diabetes of 4 (range 2 to 6) years. Over 80% of patients were overweight or obese (body mass index (BMI) of ≥25 Kg/m2). Sixty-nine percent were on oral anti-diabetic medication, 52% on anti-hypertensives and 40% on lipid lowering drugs. Thirty percent of patients were at goal for glycosylated haemoglobin level (<7%), 26% for BP (systolic/diastolic <130/80 mmHg), 55% for total cholesterol (<5.2 mmol/l), 4.5% for low-density lipoprotein cholesterol (<1.8 mmol/l), 52% for high-density lipoprotein cholesterol (>1 mmol/l for men, >1.3 mmol/l for women), and 61% for triglycerides (<1.7 mmol/l). Over 37% had micro-albuminuria and 5% had diabetic nephropathy. Conclusion: Control of hyperglycaemia and other CVD risk factor appears to be suboptimal in Omani patients with T2DM and need to be addressed in the triad of patient, physician and health system.

P1018LIPID PROFILES AND RISK OF MAJOR ADVERSE CARDIOVASCULAR EVENTS IN CKD AND DIABETES: A NATIONWIDE POPULATION-BASED STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Yeonhee Lee ◽  
Sehoon Park ◽  
Soojin Lee ◽  
Min Woo Kang ◽  
SangHyun Park ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Density Lipoprotein ◽  
Population Based ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Major Adverse Cardiovascular Events ◽  
Linear Association ◽  
All Cause Mortality ◽  
Patients With Diabetes ◽  
The Impact

Abstract Background and Aims The association of lipid parameters with cardiovascular outcomes and the impact of kidney function on this association have not been thoroughly evaluated in chronic kidney disease (CKD) patients with diabetes. Method We reviewed the National Health Insurance Database of Korea, containing the data of 10,505,818 subjects who received routine check-ups in 2009. We analyzed the association of lipid profile parameters with major adverse cardiovascular events (MACEs) risk and all-cause mortality in a nationally representative cohort of 51,757 lipid-lowering medication-naïve patients who had CKD and diabetes. Results Advanced CKD patients with eGFR &lt;30 mL/min/1.73 m2 (n=10,775) had lower serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) but higher non-HDL-c levels and triglyceride (TG) to HDL-c ratios. There was a positive linear association between serum LDL-c and MACE risk in both early and advanced CKD patients (P &lt;0.001 for trend). A U-shaped relationship was observed between serum LDL-c and all-cause mortality (the 4th and 8th octile groups; lowest hazard ratio [HR] 0.96, 95% confidence interval [CI] 0.87-1.05 and highest HR 1.14, 95% CI 1.04-1.26, respectively). A similar pattern remained in both early and advanced CKD patients. The TG/HDL-c ratio categories showed a positive linear association for MACE risk in early CKD (P &lt;0.001 for trend), but this correlation disappeared in advanced CKD patients. There was no correlation between the serum TG/HDL-c ratio and all-cause mortality in the study patients. Conclusion The LDL-c level predicted the risk for MACEs and all-cause mortality in both early and advanced CKD patients with diabetes, although the patterns of the association differed from each other. However, the TG/HDL-c ratio categories could not predict the risk for either MACEs or all-cause mortality in advanced CKD patients with diabetes, except that the TG/HDL-c ratio predicted MACE risk in early CKD patients with diabetes.

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