scholarly journals Relação entre o Tratamento com Metformina e o Desenvolvimento de Hiperlactacidemia no Serviço de Urgência

2014 ◽  
Vol 27 (2) ◽  
pp. 196 ◽  
Author(s):  
Daniela Guelho ◽  
Isabel Paiva ◽  
Francisco Carrilho
Keyword(s):  
Lactate Concentration ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Independent Predictive Factor ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Type 2 Diabetics ◽  
Increased Risk ◽  
Blood Gas Analyses

<strong>Introduction:</strong> In type 2 diabetic patients treated with metformin the development of hyperlactacidemia or even lactic acidosis seems to result from an acute precipitating event. This study aims to assess the prevalence and relative risk of hyperlactacidemia in diabetic patients admitted in the Emergency Room, the predictive factors for high lactate concentration and the influence of hyperlactacidemia in patients’ prognosis.<br /><strong>Material and Methods:</strong> Transversal observational study including patients observed between June and October 2012: 138 type 2 diabetics, 66 treated with metformin, and 83 non-diabetic patients. Studies’ variables: age, sex, cause of admition, blood pressure, drugs, personal history, analytical study (biochemistry and arterial blood gas analyses with lactate) and destination. Statistical analysis was performed using SPSS 21.0®.<br /><strong>Results:</strong> Mean lactate concentration and hyperlactacidemia prevalence were significantly higher in diabetic patients (2.1 ± 0.1mmol/L vs 1.1 ± 0.1mmol/L, p &lt; 0.001 and 39.1% vs 3.6%, p &lt; 0.001, respectively) and in those under metformin compared to other diabetics (2.7 ± 0.2 mmol/L vs 1.6 ± 0.1 mmol/L, p &lt; 0.001 and 56.9% vs 23.3%, p &lt; 0.001, respectively). Diabetics on metformin presented a 25-fold increased risk of hyperlactacidemia (OR = 25.10, p &lt; 0.05). Creatinine was the only independent predictive factor for lactate<br />concentrations (B = 1.33, p &lt; 0.05). Patients with hyperlactacidemia had 4.4 times higher odds of being hospitalized or dying (OR = 4.37, p &lt; 0.05). When hospitalized, they had longer hospitalization periods (21.66 ± 5.86 days vs 13.68 ± 5.33 days, p &lt; 0.001) and higher rate of deaths (12.5% (n = 4) vs 4.3% (n = 2), p &lt; 0.05).<br /><strong>Conclusion:</strong> There was an increased risk of hyperlactacidemia in patients with type 2 diabetes, particularly for those under metformin. Serum creatinine represented the only independent associated factor of lactate concentration. The presence of hyperlactacidemia was associated with worse prognosis.

SARS-COV-2 in type 2 diabetic patients: Possible roles of exercise training as a medicine

2021 ◽  
Vol 17 ◽  
Author(s):  
Mehdi Kushkestani ◽  
Mohsen Parvani ◽  
Yaser Kazemzadeh
Keyword(s):  
Moderate Intensity ◽  
Diabetic Patients ◽  
The Novel ◽  
Compensatory Mechanisms ◽  
Moderate Intensity Exercise ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetics ◽  
Increased Risk ◽  
Complications Rate

: SARS-COV-2 is the novel type of beta coronavirus that was first seen in December 2019 in Wuhan, China. Type 2 Diabetics are one of the groups most vulnerable to SARS-COV-2 and its associated complications. Many factors such as medication, pathophysiologic-induced compensatory mechanisms, and alterations in protein expression and immune system function can all contribute to severe outcomes in diabetics. In this review article, we first described the possible mechanisms of increased risk and more severe complications rate of SARS-COV-2 in diabetic patients. Secondly, we discussed the crucial roles of exercise in diabetic patients and in balancing of RAS system (ACE2/ACE). Finally, we showed the possible roles of acute and chronic exercise in reducing SARS-COV-2 severe outcomes in diabetics in accordance with the latest evidence. We concluded that regular exercise (especially moderate-intensity exercise) can play immune enhancing, anti-inflammatory, anti-oxidation roles and can balance ACE2/ACE ratio (decreasing ANG2 levels) in diabetic subjects.

scholarly journals 2232

2017 ◽  
Vol 1 (S1) ◽  
pp. 25-25
Author(s):  
Rocco Ferrandino ◽  
Girish Nadkarni ◽  
Priti Poojary ◽  
Aparna Saha ◽  
Bart Ferket ◽  
...  
Keyword(s):  
Nearest Neighbor ◽  
Kidney Injury ◽  
Sensitivity Analyses ◽  
Diabetic Patients ◽  
Primary Analysis ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetics ◽  
Increased Risk

OBJECTIVES/SPECIFIC AIMS: In June 2016, the FDA cautioned against the use of SGLT-2 inhibitors because of increased risk of acute kidney injury (AKI) after 101 cases of AKI were reported between March 2013 and October 2015. This study seeks to determine risk of AKI associated with SGLT-2 inhibitors in a large cohort of type 2 diabetic patients. METHODS/STUDY POPULATION: Retrospective cohort study including SGLT-2 inhibitor users and nonusers in the Mount Sinai Chronic Kidney Disease Registry between January 2013 and September 2016. SGLT-2 inhibitor users and nonusers were type 2 diabetics with new SGLT-2 inhibitor prescription after January 2013 and an outpatient visit between 2013 and 2015, respectively. Subjects were propensity matched by nearest neighbor method based on demographics, comorbidities, laboratory values, medications, estimated glomerular filtration rate (eGFR), and length of follow-up. The primary end point was AKI (defined by KDIGO laboratory algorithm) occurring during the follow-up period. RESULTS/ANTICIPATED RESULTS: In total, 372 SGLT-2 inhibitor users [mean age 63 years; 205 (55%) men] and 372 [mean age 63; 194 (52%) men] nonusers were included in the primary analysis. Proportions of AKI events defined by KDIGO criteria in users and nonusers were 4.0% and 10.0%, respectively. Adjusted odds ratio for AKI was 1.00 (95% CI, 0.28–2.62). Median peak serum creatinine measurements during AKI events for user and nonuser groups were 1.60 (IQR 1.36–1.78) and 1.88 (IQR 1.55–2.44) (p=0.02), respectively. Sensitivity analyses yielded similar results. DISCUSSION/SIGNIFICANCE OF IMPACT: These findings suggest that there is no evidence of increased odds of AKI in SGLT-2 inhibitor users compared with propensity-matched nonusers with type 2 diabetes.

scholarly journals Evaluation of selected trace elements in the Moroccan type 2 diabetic patients

2019 ◽  
Vol 8 (1) ◽  
pp. 78
Author(s):  
Naoual El Omri ◽  
Fadwa Mekouar ◽  
Naoufal Assoufi ◽  
Abdelkhalek Maaroufi ◽  
Jihane Smaali ◽  
...  
Keyword(s):  
Trace Elements ◽  
Hdl Cholesterol ◽  
Control Group ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetics ◽  
The Status ◽  
Normal Metabolism ◽  
Serum Trace Elements

Background: Several trace elements have been implicated in the etiology of type 2 diabetes, they can influence the onset or pathogenesis of diabetes in various ways including disruption of normal metabolism of glucose and insulin. The purpose of this work is to evaluate the serum status of copper, zinc, selenium, chromium and manganese in Moroccan type 2 diabetics compared to control group.Methods: Blood samples from 100 type 2 diabetics and 90 control subjects were analyzed for blood glucose, glycated hemoglobin (only for diabetics), lipid status and serum trace elements concentrations.Results: Glucose and triglyceride values were statistically higher in diabetics; while those of HDL-cholesterol were lower. Concentrations of zinc, selenium, chromium, and manganese were lower in diabetics compared to controls. In contrast, copper concentrations were higher.Conclusions: The status of trace elements is impaired in type 2 diabetics compared to a control group.

scholarly journals Evaluation of Ischemia-Modified Albumin and C-Reactive Protein in Type 2 Diabetics with and without Ketosis

2012 ◽  
Vol 7 ◽  
pp. BMI.S9060 ◽  
Author(s):  
Shao-gang Ma ◽  
Yao Jin ◽  
Wen Hu ◽  
Feng Bai ◽  
Wen Xu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Patients ◽  
C Reactive Protein ◽  
Type 2 Diabetic Patients ◽  
Ischemia Modified Albumin ◽  
Protein Levels ◽  
Reactive Protein ◽  
Diabetic Ketosis ◽  
Type 2 Diabetics

Overview To investigate whether serum ischemia-modified albumin or C-reactive protein is reliable for predicting type 2 diabetic patients with ketosis. Approach One hundred and four diabetic patients, 48 with diabetic ketosis, and 33 controls were enrolled in the study. Serum ischemia-modified albumin and C-reactive protein were measured and evaluated for their ability to distinguish diabetic ketosis. Results Compared to the controls, the ischemia-modified albumin and C-reactive protein levels were higher in patients with diabetic ketosis and type 2 diabetes at the baseline. The levels of ischemia-modified albumin were higher in patients with type 2 diabetes than in the controls. C-reactive protein and ischemia-modified albumin levels were reduced after insulin treatment. The level of ischemia-modified albumin was an independent risk marker for diabetic ketosis ( OR = 1.085, P = 0.008, 95% CI: 1.022–1.152). Receiver operating characteristic curves revealed that the areas under the curve were 0.917 for the modified albumin and 0.357 for C-reactive protein. Conclusion This study indicates that ischemia-modified albumin was significantly associated with diabetic ketosis and was more sensitive than C-reactive protein in reflecting diabetic ketosis.

scholarly journals Synergistic Effect of the MTHFR C677T and EPHX2 G860A Polymorphism on the Increased Risk of Ischemic Stroke in Chinese Type 2 Diabetic Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Liang Ma ◽  
Yongwei Jiang ◽  
Xiaomu Kong ◽  
Meihua Yan ◽  
Tingting Zhao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Mthfr C677t ◽  
Combined Effect ◽  
Control Group ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Increased Risk ◽  
The Relationship ◽  
Control Study

The aim of this study was to investigate the relationship between the combined effect of MTHFR C677T (rs1801133) and EPHX2 G860A (rs751141) polymorphism and ischemic stroke in Chinese T2DM patients. This case-control study included a total of 626 Chinese T2DM patients (236 T2DM patients with ischemic stroke and 390 T2DM patients without ischemic stroke). The rs1801133 and rs751141 were genotyped using real-time polymerase chain reaction. Statistical analysis was performed with SPSS 17.0. Results showed that the combined effect of MTHFR TT and EPHX2 GG or GA + AA genotype has a higher risk of ischemic stroke compared with the control group (combined effect of MTHFR CC and EPHX2 GA + AA genotypes; OR = 3.46 and OR = 3.42, resp.; P=.001 and P=.002, resp.). The A allele showed marked association with a lower risk of ischemic stroke in patients with the lowest Hcy levels under additive, recessive, and dominant genetic models (OR = 0.45, OR = 0.11, and OR = 0.44, resp.; P=.002, P=.035, and P=.008, resp.), which was not observed in medium or high Hcy level groups. In conclusion, the T allele of rs1801133 and the G allele of rs751141 may be risk factors of ischemic stroke in the Chinese T2DM population.

scholarly journals Analysis of serum leptin levels as a biomarker in metabolic syndrome in type 2 diabetic patients in Okhla industrial area

2019 ◽  
Vol 7 (11) ◽  
pp. 4340
Author(s):  
Juhi Aggarwal ◽  
Niharika Singh ◽  
Mayur Kumar
Keyword(s):  
Metabolic Syndrome ◽  
Lipid Profile ◽  
Blood Sugar ◽  
Fasting Blood Sugar ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Increased Risk ◽  
Study Results ◽  
Type 2 Diabetic

Background: Metabolic syndrome is a progressive disorder which includes a wide array of disorders i.e. central obesity, hypertension, dyslipidemia, hyperglycemia, and insulin resistance. In patients with metabolic syndrome there is an increased risk of mortality due to coronary heart disease, stroke, vascular dysfunction etc. Obesity is one of the most crucial epidemics of modern times and hormone leptin plays an important role in regulation of body weight and energy balance.Methods: A total of 355 individuals were selected from the OPD, Department of general medicine at ESIC hospital, Okhla and it comprised of 196 males and 159 females suffering from type 2 diabetes mellitus with metabolic syndrome. The data was collected over a year i.e. June 2018 to July 2019. After baseline clinical and anthropometric evaluation, Fasting Blood Sugar (FBS), Post Prandial Blood Sugar (PPBS), lipid profile, Insulin (fasting), and leptin levels of the patients were analyzed.Results: Blood sugar fasting, blood sugar post prandial, lipid profile, leptin and insulin levels were increased significantly in female patients as compared to male patients with type 2 diabetic patients and metabolic syndrome.Conclusions: Based on the study results, it was found that leptin correlate significantly with metabolic syndrome and could be used as a biomarker for the early detection of the disease.

scholarly journals To study association of Neutrophil- Lymphocyte ratio with vascular complications in Type-2 Diabetes

2021 ◽  
Vol 12 (8) ◽  
pp. 16-22
Author(s):  
Shilpa Tumkur Andane Gowda ◽  
Shahari Hegde Kusumakar ◽  
Raveendra Kodur Ramamurthy ◽  
Rohith Maraludevanapura Govindaiah
Keyword(s):  
Type 2 Diabetes ◽  
Vascular Complications ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Medical College ◽  
Increased Risk ◽  
Significant Difference

Background: Diabetes is a pro-thrombotic state associated with increased risk of atherosclerosis and inflammation. Neutrophil lymphocyte ratio (NLR) provides information about early and subclinical inflammation and thus may act as a prognostic marker for vascular complications in type 2 diabetes. Aims and Objective: To analyze the correlation between Neutrophil- Lymphocyte ratio in diabetics with and without vascular complications. Materials and Methods: A total of 111 patients admitted in Victoria hospital and Bowring & Lady Curzon hospital attached to Bangalore Medical College and Research Institute from NOV 2018 to MAY 2020 were studied. The data was collected according to the proforma in terms of history, clinical examination and the necessary investigations. NLR was observed in type 2 diabetic patients and was compared in those with complications and without complications. Results: The NLR was higher in diabetics with vascular complications compared to those without complications, 2.8 ± 0.7 fl versus 6.8 ± 3.1 fl (P< 0.001), respectively. In this study, Mean N (%), In No Vascular Complications was 61.7 ± 10.6 and with vascular complications was 79.9 ± 9.5. Mean L (%) in No Vascular Complications was 23.7 ± 5.8. Mean N (%), In No Vascular Complications was 61.7 ± 10.6 and with vascular complications was 79.9 ± 9.5. There was a significant difference in mean N (%) mean L (%) and NLR in comparison with respect to Complications. Conclusion: This study showed significantly higher NLR in diabetic patients with vascular complications. Hence, NLR can be used as a simple parameter to assess the vascular complications in diabetes.

scholarly journals The Relationship Between Adiponectin Serum Level and Coronary Artery Disease in Type 2 Diabetic Patients

2021 ◽  
Author(s):  
Zahra Mazloum Khorasani ◽  
Saeed Choobkar ◽  
Ramin Khameneh Bagheri ◽  
Mina AkbariRad ◽  
Abdollah Firoozi
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Serum Level ◽  
Demographic Data ◽  
Diabetic Patients ◽  
Type 2 Diabetics ◽  
Increased Risk ◽  
Artery Disease

Adiponectin is an adipocytokine that has a higher serum level in healthy people. In type 2 diabetes, insulin resistance, hypertension, MI, and dyslipidemia, the serum level of adiponectin is lower than 4 µg/mL. Adiponectin is proved to have a protective role against atherosclerotic changes where its low serum levels in type 2 diabetes can lead to the progression of atherosclerotic lesions. In this study, we aimed to survey the possible effects of adiponectin in the development of coronary artery disease in type 2 diabetics. Thirty diabetic cases with coronary artery disease, 30 diabetic cases without known coronary artery disease, and a group of 30 healthy volunteers, all of them were between 18-65-year-old, were entered ourstudy. We gathered demographic data by performing a physical examination followed by filling a checklist and a set of laboratory tests. All the groups were sex and age-matched (P=0.284 and P=0.163 respectively). CAD group had the lowest HBA1C (P<0.001). Both LDL and HDL were also lower in the CAD group (P<0.001). Adiponectin was also lower in the CAD group when compared to other groups (P<0.008) or when compared with only normal diabetics (P<0.002). We found a correlation between adiponectin and HDL (r=0.348, P=0.008), suggesting each unit of reduction in serum level of adiponectin could increase the chance of coronary artery disease by 38% in diabetics. In this study, we showed that the lower serum level of adiponectin is correlated with an increased risk of coronary artery disease in type 2 diabetics.

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