Association of RASGRP1 Polymorphism with Vascular Complications in Chinese Diabetic Patients with Glycemic Control and Antihypertensive Treatment

2020 ◽  
Author(s):  
Wei Zhang
Keyword(s):  
Glycemic Control ◽  
Antihypertensive Treatment ◽  
Vascular Complications ◽  
Diabetic Patients

scholarly journals Usage of diuretics among diabetic-hypertensive patients

2014 ◽  
Vol 6 (2) ◽  
pp. 14-17
Author(s):  
Rajeshwari Shastry ◽  
M.R. Prabha Adhikari ◽  
Sheetal D. Ullal ◽  
Shashidhar Kotian
Keyword(s):  
Glycemic Control ◽  
Tertiary Care ◽  
Vascular Complications ◽  
Cross Sectional Study ◽  
Drug Combinations ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Aggressive Approach ◽  
Hypertensive Patients ◽  
Treatment Of Hypertension

Background: Hypertension is more common in diabetics than in non-diabetic patients. An aggressive approach to the diagnosis and treatment of hypertension in patients with diabetes is required in order to substantially reduce the incidence of both macro-vascular and micro-vascular complications. The role of diuretics in the treatment of hypertension as first line or second line drugs is a provoking debate, hence we studied the usage of diuretics and their effects on BP and glycemic control among diabetic-hypertensive patients.Methods: This cross sectional study was carried out for a period of six months in a tertiary care teaching hospital. Patients’ details such as age, gender, height, weight, comorbid diseases, blood pressure, eGFR along with duration of diabetes and hypertension and drugs prescribed for hypertension were noted. Data were analyzed using descriptive statistics.Results: A total of 336 diabetic-hypertensiveswith a mean age of 64.55±9.51 years were included. Fortyfive patients were on diuretics,two (4.4%) of whom were on diuretic monotherapy, 16 (35.6%) on two drug combinations (Diuretic + ACEI or ARB), 21 (46.7%) on three drug combinations (diuretics + ARB & BBs or diuretic + ACEI & BB or diuretic + ARB &CCB) and six (13.3%) were on four drug combinations (diuretics + ARB, CCB & BB). Among the patients on diuretic combination therapy BP was well controlled in 23 (51%) patients and the glycemic control was comparable to those not on diuretics.Conclusion: In the present study the usage of diuretics was consistent with the guidelines. About 13% of diabetic-hypertensive patients were on diuretic treatment. The control of BP in patients on diuretics was not satisfactory, but there was no worsening of glycemic control compared to other antihypertensive therapy. This shows that low dose thiazides in combination with other antihypertensives can be safe in diabetic-hypertensive patients however their efficacy needs further scrutiny. DOI: http://dx.doi.org/10.3126/ajms.v6i2.10582Asian Journal of Medical Sciences Vol.6(2) 2015 15-18

Abstract P253: Relation Between Microvascular Function and Large Artery Stiffness in African American Diabetic Patients

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Ajibola M Adedayo ◽  
Ayobami Eluwole ◽  
Fasika Tedla ◽  
Arye Kremer ◽  
Nicole Mastrogiovanni ◽  
...  
Keyword(s):  
African Americans ◽  
Glycemic Control ◽  
Vascular Complications ◽  
Microvascular Dysfunction ◽  
Microvascular Function ◽  
Reactivity Index ◽  
Entire Group ◽  
Diabetic Patients ◽  
Large Artery ◽  
Artery Stiffness

Rationale: Diabetes is highly prevalent among African Americans and poses a higher risk for vascular complications in this population. Although socioeconomic factors are well known to influence outcomes, true biologic differences in risk factor vulnerability have been suggested. Vascular complications have been traditionally viewed as either macrovascular (myocardial infarction and stroke) or microvascular (retinopathy, nephropathy, and neuropathy). Better glycemic control is known to improve microvascular but not macrovascular complications. In recent years, there has been a growing appreciation that microvascular dysfunction may promote large artery disease and vice versa. Given this notion of vascular “cross-talk” and since subclinical dysfunction is known to precede target organ damage, the objective of this study was to determine whether subclinical microvascular dysfunction is related to large artery stiffness. Methods: A total of 141 patients with type II diabetes were recruited from our outpatient clinics over a 6 month period. Medical information was obtained via patient interview and electronic medical record review including laboratory results. Microvascular function was assessed by the vascular reactivity index (VRI), which assesses changes in digital temperature before and after release of arterial cuff occlusion (VENDYS 5000BC DTM system Endothelix, Inc.). Large artery stiffness was assessed by carotid-femoral pulse wave velocity (PWV) using applanation tonometry (Sphygmocor, Atcor Inc.). Results: Mean age was 60 + 8 years, 64% were female. 80% had hypertension and 90% had dyslipidemia. 15% had chronic kidney disease. Mean HbA1C levels were 8.1 + 2.2%. For the entire group, VRI was significantly correlated with PWV (r=.27, p=.002). On multivariate analysis, VRI was independently associated with PWV (β=-1.0, p=.001) and a trend towards an association with HbA1c (β =.07, p=.09) after adjusting for traditional cardiovascular risk factors. Conclusions: Among African Americans with diabetes, subclinical microvascular dysfunction is significantly correlated to large artery stiffness and possibly to glycemic control. Further study is needed to clarify mediating factors of these relationships.

scholarly journals An analytical study of the prevalence and prescribed pattern vascular complication for type II diabetic patient in Indian tertiary care hospitals

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 310-314
Author(s):  
Satya Preethi ◽  
Beeraka Chandra Sekhar ◽  
Pandiyan K R ◽  
Rajkumar R
Keyword(s):  
Glycemic Control ◽  
Lifestyle Modification ◽  
Patient Adherence ◽  
Microvascular Complications ◽  
Tertiary Care ◽  
Blood Glucose Control ◽  
Vascular Complications ◽  
Vascular Complication ◽  
Diabetic Patients ◽  
Diabetic Vascular Complications

Diabetes mellitus (DM) is a common metabolic disorder. It is associated with complications which will affect the quality of life. Failure to control elevated blood sugar or inadequate treatment of diabetes could cause many complications.  A prospective observational study is used to assess the prevalence of diabetic vascular complications in 105 types of II diabetic patients. A date was collected regarding patient's demographic and clinical characteristics. Based on our study criteria, males were more when compared to females in getting vascular complications & also. Complications were more prominent in the age group of 50-65years. Of all microvascular complications, Nephropathy was major, whereas, in macro-vascular complications, CAD was prominent. Poor glycemic control and a long length of ailment appear to be the most significant danger factors for these complexities. Doctors assume a significant function to endorse hostile to diabetic meds and Pharmacist plays a sharp task to assess the medicine design so as to accomplish fruitful treatment. The currently anti-diabetic drugs are effective, but a lot of factors such as patient adherence, education related to diabetes, lifestyle modification, cost and type of medication have an association with glycemic control. The commonly prescribed anti-diabetic drug was Insulin. Metformin was the most preferred drug both as monotherapy and combination therapy.  Although polypharmacy was observed, drug utilization pattern can be rational owing to a higher prevalence of complications. Minimization of the occurrence of complications should be courage by early diagnosis, intensive blood glucose control and rational drug selections.

scholarly journals Glycosylated hemoglobin as a predictor for the occurrence of macroangiopathic complications in diabetic patients from bihor county

2013 ◽  
Vol 20 (4) ◽  
pp. 395-400
Author(s):  
Ioana Andra Vlad ◽  
Amorin Remus Popa
Keyword(s):  
Glycemic Control ◽  
Independent Predictor ◽  
Glycosylated Hemoglobin ◽  
Vascular Complications ◽  
Glycemic Variability ◽  
Macrovascular Complications ◽  
Diabetic Patients ◽  
Vascular Events ◽  
Independent Predictive Factor ◽  
Hba1c Variability

Abstract Background and Aims: Prospective studies showed that long-term hemoglobin A1c (HbA1c) levels correlate directly with the risk of developing and progression of diabetic complications. The aim of the study was to evaluate the correlation between metabolic control and HbA1c variability with macrovascular complications and assess the role of HbA1c as an independent predictive factor for the occurrence of macrovascular complications in diabetic patients from Bihor County, Romania. Material and method: The study was conducted for a 5 years period (2007-2011) and included 321 diabetic patients with no evidence of macroangipathic complications. During the follow-up all the major vascular events were recorded. Results: At the end of the study a total of 85 chronic macrovascular complications were reported. Distribution plots show significantly higher incidence of vascular complications in patients in the group with poor glycemic control. Multivariate analysis showed that HbA1c can be considered an independent predictor of atherosclerotic complications as well as atherosclerotic complications risk score. The variability of HbA1C was not an independent predictor for macroangiopathic complications (p=0.78). Conclusions: Overall glycemic control was the most important factor in the progression of atherosclerosis but we could not rule out that glycemic variability might play a role in the development of complications in type 2 diabetes mellitus (T2DM) patients.

scholarly journals Ischemia-Modified albumin level in type 2 diabetes mellitus—Preliminary report

2008 ◽  
Vol 24 (6) ◽  
pp. 311-317 ◽  
Author(s):  
Agnieszka Piwowar ◽  
Maria Knapik-Kordecka ◽  
Maria Warwas
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Vascular Complications ◽  
Diabetic Patients ◽  
Good Glycemic Control ◽  
Ischemia Modified Albumin ◽  
Control Subjects

Aim:The main goal of the present study was the evaluation of ischemia-modified albumin (IMA) in patients with type 2 diabetes mellitus and estimation of its connection with vascular complications, glycemic control, hypertension, dyslipidemia and obesity.Methods:In 76 diabetic patients and 25 control subjects, a plasma level of IMA by manually performed, spectrophotometric Co(II)-albumin binding assay was determined. Other parameters such as glucose, fructosamine, HbA1c, total cholesterol and its fractions (HDL, LDL), triglicerydes were estimated by routine methods.Results:Diabetic patients had significantly higher level of IMA in comparison with control subjects. There were not significant differences between groups with various states of vascular complications although the lowest concentration of IMA was observed in patients with microangiopathy. Patients with poor glycemic control had higher IMA level in comparison with these with good glycemic control. Significant correlation was observed between IMA and HbA1c. Among the risk factors, only blood pressure and LDL showed a weak relationship with IMA level.Conclusions:Our results revealed, for the first time, higher level of IMA in diabetic patients which confirms that it may be of non-cardiac origin. We can suggest that the albumin molecule in plasma of diabetic patients is modified in the chronic hypoxia conditions provoked mainly by hyperglycemia and oxidative stress in diabetes.

scholarly journals Epigenetic Changes in Endothelial Progenitors as a Possible Cellular Basis for Glycemic Memory in Diabetic Vascular Complications

2015 ◽  
Vol 2015 ◽  
pp. 1-17 ◽  
Author(s):  
Poojitha Rajasekar ◽  
Christina L. O’Neill ◽  
Lydia Eeles ◽  
Alan W. Stitt ◽  
Reinhold J. Medina
Keyword(s):  
Glycemic Control ◽  
Vascular Complications ◽  
Disease Process ◽  
Diabetic Patients ◽  
Negative Consequences ◽  
Diabetic Vascular Complications ◽  
Endothelial Progenitors ◽  
Glycemic Memory

The vascular complications of diabetes significantly impact the quality of life and mortality in diabetic patients. Extensive evidence from various human clinical trials has clearly established that a period of poor glycemic control early in the disease process carries negative consequences, such as an increase in the development and progression of vascular complications that becomes evident many years later. Importantly, intensive glycemic control established later in the disease process cannot reverse or slow down the onset or progression of diabetic vasculopathy. This has been named the glycemic memory phenomenon. Scientists have successfully modelled glycemic memory using variousin vitroandin vivosystems. This review emphasizes that oxidative stress and accumulation of advanced glycation end products are key factors driving glycemic memory in endothelial cells. Furthermore, various epigenetic marks have been proposed to closely associate with vascular glycemic memory. In addition, we comment on the importance of endothelial progenitors and their role as endogenous vasoreparative cells that are negatively impacted by the diabetic milieu and may constitute a “carrier” of glycemic memory. Considering the potential of endothelial progenitor-based cytotherapies, future studies on their glycemic memory are warranted to develop epigenetics-based therapeutics targeting diabetic vascular complications.

Modern insulin therapy with insulin analogues detemir and aspart in children and adolescents: The problems and solutions

2013 ◽  
Vol 59 (6) ◽  
pp. 80-86
Author(s):  
T L Kuraeva
Keyword(s):  
Glycemic Control ◽  
Insulin Therapy ◽  
Children And Adolescents ◽  
Human Insulin ◽  
Vascular Complications ◽  
Insulin Analogues ◽  
Diabetic Patients ◽  
Problems And Solutions ◽  
Basal Bolus

DCCT (Diabetes Control and Complications Trial) study showed that intensified insulin therapy associates with significant reduction both of development and progression of vascular complications compared to conventional insulin therapy in type 1 diabetic patients. Modern algorithms of diabetes treatment in children and adolescents reflect the need to achieve and maintenance of glycemic control as closely as possible to normal level. Insulin analogues have improved pharmacokinetic and pharmacodynamic properties, and also have less variability than human insulin. So they have more physiologic and predictable profile actions and, therefore, provide the possibility to achieve optimal glycemic control with low risk of hypoglycemia. Current review demonstrates the benefits of basal-bolus therapy with insulin analogues detemir (Levemir) and aspart (NovoRapid) and advantages of insulin NovoRapid in the continuous subcutaneous insulin infusion (CSII) compared with human insulin in children and adolescents with type 1 diabetes mellitus.

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