scholarly journals Executive Function and Type 2 Diabetes: Putting the Pieces Together

2012 ◽  
Vol 92 (3) ◽  
pp. 454-462 ◽  
Author(s):  
Jason L. Rucker ◽  
Joan M. McDowd ◽  
Patricia M. Kluding
Keyword(s):  
Type 2 Diabetes ◽  
Executive Function ◽  
Executive Dysfunction ◽  
Time Sharing ◽  
Functional Impairments ◽  
Type 2 Dm ◽  
Increased Risk ◽  
Gait Abnormalities ◽  
And Function

The devastating impact of type 2 diabetes mellitus (DM) on vascular, renal, retinal, and peripheral nerve functions has been well documented. However, there is also evidence that older adults with this disease exhibit impairments in the planning, coordinating, sequencing, and monitoring of cognitive operations, collectively known as executive function. Although poorly understood, disturbances in executive function, particularly within the dimension of time sharing, may contribute to the gait abnormalities and increased risk for falls, functional impairments, and disabilities associated with type 2 DM. However, the relationships between executive function and functional abilities remain poorly understood in this population. Current neuropsychological research regarding the concept of executive function is presented here as a framework upon which to examine the integrity of this critical cognitive entity in adults with type 2 DM. The pathophysiological mechanisms thought to underlie diabetes-related executive dysfunction are explored, and the possible contributions of executive deficits to impairments in gait and function observed in older people with type 2 DM are summarized. Finally, a brief discussion of dual-task assessment and intervention strategies that may facilitate the care and rehabilitation of the growing population of patients with type 2 DM is provided.

THE EMERGENCE OF FRAILTY MAY LEAD TO A STATE OF BURNT OUT TYPE 2 DIABETES

2016 ◽  
pp. 1-6
Author(s):  
A.H. ABDELHAFIZ ◽  
L. KOAY ◽  
A.J. SINCLAIR
Keyword(s):  
Type 2 Diabetes ◽  
Β Cells ◽  
Risk Of Mortality ◽  
Vulnerable Patients ◽  
Increased Risk ◽  
History Of ◽  
The One ◽  
And Function ◽  
Glucose Dynamics

Ageing is associated with hyperglycaemic tendency due to the change in body composition leading to accumulation of visceral fat and increased insulin resistance on the one hand and reduced insulin secretion due to decreased number and function of the β-cells of the pancreas on the other. However, with the emergence of frailty there may be a tendency towards normoglycaemia or even hypoglycaemia due to malnutrition, weight loss and reduced physiologic reserve. This shift in glucose metabolism induced by frailty may change the natural history of type 2 diabetes from a progressive to a regressive course. Studies which showed increased risk of mortality with low HbA1c included frail patients in the lower HbA1c categories and healthier patients in the higher HbA1c categories suggesting that frailty is a possible confounding factor. Therefore, hypoglycemia may be a prognostic tool to identify vulnerable patients who may be at increased risk of mortality. The metabolic changes of insulin/glucose dynamics associated with frailty need further research.

Euglycemic Diabetic Ketoacidosis Associated With Sodium–Glucose Cotransporter Type 2 Inhibitors in Patients With Type 2 Diabetes Mellitus Receiving Oral Therapy

2017 ◽  
Vol 32 (2) ◽  
pp. 240-243 ◽  
Author(s):  
Ryan B. Dull ◽  
Mikayla L. Spangler ◽  
Emily L. Knezevich ◽  
Britney M. Lau
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Case Reports ◽  
Serious Adverse Events ◽  
Type 2 Dm ◽  
Sodium Glucose Cotransporter ◽  
Increased Risk

Introduction and Objective: Postmarketing reports and warnings of serious adverse events such as diabetic ketoacidosis (DKA) have raised concern regarding the safety of sodium–glucose cotransporter 2 inhibitors (SGLT2i). This report describes 2 cases of symptomatic SGLT2i-associated euglycemic DKA (euDKA) leading to hospitalization in patients with type 2 diabetes mellitus (DM) previously well controlled on oral medications. Case Reports: Subject 1 is a 55-year-old female admitted with euDKA precipitated by infection and managed with intravenous insulin. This case was notable for a delayed diagnosis of euDKA and lack of clinical improvement despite withholding dapagliflozin. Subject 2 is a 62-year-old male admitted with euDKA precipitated by infection. His clinical condition improved rapidly and euDKA responded to withdrawal of empagliflozin alone. Discussion: Applying the Naranjo adverse medication reaction probability scale to each case (subject 1 score = 3 points; subject 2 score = 4 points) suggests these are possible adverse reactions to SGLT2i. Data from randomized controlled trials suggest DKA events in adults with type 2 DM receiving SGLT2i are rare and similar to placebo. However, data from a large cohort suggest these events occur more frequently and are associated with a 2-fold increased risk of DKA. Conclusion: This class of medications may be associated with a higher real-world risk of DKA in adults with type 2 DM than previously reported. Patients prescribed these medications should receive vigilant assessment for features of traditional DKA as well as euDKA.

scholarly journals High Bodyweight Variability Increases Depression Risk in Patients With Type 2 Diabetes Mellitus: A Nationwide Cohort Study in Korea

2021 ◽  
Vol 12 ◽  
Author(s):  
Ji Hyun An ◽  
Kyung-do Han ◽  
Jin-Hyung Jung ◽  
Juhwan Yoo ◽  
Maurizio Fava ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Obese Patients ◽  
Type 2 Dm ◽  
Increased Risk ◽  
Quartile Group ◽  
New Onset

Objectives: Although obesity is associated with increased risk for depression in patients with type 2 diabetes mellitus (DM), the relationship between body weight variability (BWV) and depression remains poorly studied. This study was to investigate the incidence of depression in patients with type 2 DM according to their BWV.Methods: Intraindividual variation in body weight were measured in the nationwide, population-based retrospective cohort of 540,293 patients with type 2 DM from the Korean national health insurance system between 2009 and 2010. The diagnoses of new-onset depression occurring until the end of 2017 were ascertained. Risk of new-onset depression was examined using multivariate-adjusted Cox proportional hazards regression analysis by BWV quartile.Results: 93,149 (17.2%) patients developed new-onset depression for the follow up. BWV was significantly associated with an increased risk of depression after adjusting for confounding factors. The highest BWV quartile group had a hazard ratio (HR) of 1.17 (95% CI 1.15–1.19) compared to the lowest BWV quartile group as a reference. Obese patients in the highest BWV quartile group showed 12% increased risk of depression (HR 1.12, 95% CI 1.09–1.15) while non-obese patients in the highest BWV quartile group showed 20% increased risk of depression (HR: 1.20, 95% CI: 1.17–1.23) compared to their respective lowest BWV quartile groups.Conclusion: A higher BWV was significantly associated with an increased risk of depression in patients with type 2 DM. Thus, BWV may serve as an indicator for early detection of depression in type 2 DM patients.

scholarly journals Cholesterol levels and development of cardiovascular disease in Koreans with type 2 diabetes mellitus and without pre-existing cardiovascular disease

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Mee Kyoung Kim ◽  
Kyungdo Han ◽  
Han Na Joung ◽  
Ki-Hyun Baek ◽  
Ki-Ho Song ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Cox Regression ◽  
Reference Group ◽  
Density Lipoprotein ◽  
Type 2 Dm ◽  
Increased Risk

Abstract Background The aim of the present study was to identify a threshold for the cholesterol level at which the risk of cardiovascular disease (CVD) begins to increase in people with type 2 diabetes mellitus (DM). Methods Using the Korean National Health Insurance Service database, 2,077,135 people aged ≥ 40 years with type 2 DM who underwent regular health checks between 2009 and 2012 were included. Subjects with previous CVD were excluded. Cox regression analyses were performed to estimate the risk of CVD for each low-density lipoprotein cholesterol (LDL-C) group using the < 70 mg/dL as the reference group. Results There were 78,560 cases of stroke (3.91%), and 50,791 myocardial infarction (MI, 2.53%) during a median follow-up of 7.1 years. Among participants not taking statins, LDL-C levels of 130–159 mg/dL and ≥ 160 mg/dL were significantly associated with the risk of MI: the hazard ratios (HRs) (95% confidence interval) were 1.19 (1.14–1.25) and 1.53 (1.46–1.62), respectively. Among participants taking statins, all categories of LDL-C level ≥ 70 mg/dL were significantly associated with increased risk of stroke and MI. Conclusions We identified an increased risk of CVD in people with an LDL-C level ≥ 130 mg/dL among individuals with type 2 DM not taking statins. The risk of CVD was significantly higher in those taking statins with an LDL-C level ≥ 70 mg/dL.

scholarly journals Comorbidity between Type 2 Diabetes and Depression in the Adult Population: Directions of the Association and Its Possible Pathophysiological Mechanisms

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Line Iden Berge ◽  
Trond Riise
Keyword(s):  
Type 2 Diabetes ◽  
Adult Population ◽  
Structure And Function ◽  
Comorbid Conditions ◽  
Pathophysiological Mechanisms ◽  
Increased Risk ◽  
Brain Structure And Function ◽  
Common Etiology ◽  
And Function

Type 2 diabetes and depression are regarded as comorbid conditions, and three possible directions of the association between the diseases can underlie this observation of comorbidity. First, common etiology can increase a person’s risk of both diseases; second, persons with type 2 diabetes have increased prevalence or risk of future development of depression; or third, persons with depression have increased prevalence or risk of development of type 2 diabetes. This review gives an overview over possible pathophysiological mechanisms for each of the directions of the association between type 2 diabetes and depression and further discusses epigenetics as an additional, direction independent approach. We argue that unspecific pathophysiological mechanisms involved in the stress response might, at least to some extent, explain each of the directions of the association between type 2 diabetes and depression, while changes in brain structure and function among persons with diabetes and possible increased risk of development of type 2 diabetes after use of antidepressant agents could represent more disease specific mechanisms underlying the comorbidity.

scholarly journals Diabetes Onset at 31–45 Years of Age is Associated with an Increased Risk of Diabetic Retinopathy in Type 2 Diabetes

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Wenjun Zou ◽  
Lisha Ni ◽  
Qianyi Lu ◽  
Chen Zou ◽  
Minjie Zhao ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Onset Age ◽  
Patient Age ◽  
Diabetes Onset ◽  
Type 2 Dm ◽  
Patient Âgé ◽  
Increased Risk ◽  
Department Of Ophthalmology

Abstract This hospital-based, cross-sectional study investigated the effect of age of diabetes onset on the development of diabetic retinopathy (DR) among Chinese type 2 diabetes mellitus (DM) patients. A total of 5,214 patients with type 2 DM who were referred to the Department of Ophthalmology at the Shanghai First People’s Hospital from 2009 to 2013 was eligible for inclusion. Diabetic retinopathy status was classified using the grading system of the Early Treatment Diabetic Retinopathy Study (ETDRS). Logistic and hierarchical regression analyses were used to identify independent variables affecting the development of DR. Upon multiple logistic regression analysis, patient age at the time of diabetes onset was significantly associated with development of DR. Further, when the risk of retinopathy was stratified by patient age at the onset of diabetes, the risk was highest in patients in whom diabetes developed at an age of 31–45 years (odds ratio [OR] 1.815 [1.139–2.892]; p = 0.012). Furthermore, when patients were divided into four groups based on the duration of diabetes, DR development was maximal at a diabetes onset age of 31–45 years within each group. A diabetes onset age of 31–45 years is an independent risk factor for DR development in Chinese type 2 DM patients.

scholarly journals Plasma Atherogenic Index in Type 2 Diabetes Mellitus Patients

2020 ◽  
Vol 15 (2) ◽  
pp. 204-205
Author(s):  
Most. Sarmin Sultana ◽  
Yasmin Akhter ◽  
Mimi Parvin ◽  
Lubna Naznin ◽  
Md Mahbub Ul Alam ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Personal Data ◽  
Armed Forces ◽  
Atherogenic Index ◽  
Cross Sectional ◽  
Type 2 Dm ◽  
Increased Risk

Introduction:Atherogenic index of plasma (AIP) is defined as log of TG to HDL-C ratio. People with high AIP have a higher risk for coronary heart disease (CHD) than those with low AIP. AIP is useful in predicting atherogenecity. Objectives:  To determination of AIP among the study subjects and find out the prevalence of AIP among type 2 diabetes mellitus (DM) patients. Materials and Methods: This cross sectional study was conducted at Armed Forces Institute of Pathology (AFIP) from November 2014 to October 2015. The study included 300 type 2 DM patients belonging to the age group 30-60 years. Fasting plasma glucose (FPG), HDL-C, TG were estimated. The AIP was calculated as log (TG/HDL-C) using the Czech online calculatorof atherogenic risk. Personal data and history of co-existing medical conditions were collected by data collection sheet. Data were analyzed by SPSS version 18.0. Results: Among 300 study subjects the AIP were found in the range of “increased risk” in 298(99.3%) and “low risk” in 02(0.7%). In this study mean FPG was 9.81±3.08 mmol/L and mean AIP was 0.73 ± 0.23A and significant positive correlation between FPG and AIP (r = 0.123, p < 0.05) was observed. Conclusion: The study revealed that AIP is significantly higher in type 2 DM patients. So, patients with type 2 DM should be followed up with AIP regularly. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 204-205

scholarly journals Skeletal Muscle and Metabolic Health: How Do We Increase Muscle Mass and Function in People with Type 2 Diabetes?

2020 ◽  
Author(s):  
Ebaa Al-Ozairi ◽  
Dalal Alsaeed ◽  
Dherar Alroudhan ◽  
Nia Voase ◽  
Amal Hasan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Resistance Exercise ◽  
Muscle Mass ◽  
Glycated Haemoglobin ◽  
Current Data ◽  
Primary Role ◽  
Increased Risk ◽  
And Function

Abstract Background Whilst skeletal muscles’ primary role is allowing movement, it has important metabolic roles, including in glycemic control. Indeed, evidence indicates that low muscle mass and function are associated with an increased risk of type 2 diabetes, highlighting its importance in the development of metabolic disease. Methods In this mini-review, we detail the evidence highlighting the importance of muscle in type 2 diabetes and the efficacy of resistance exercise in improving glycemic control alongside our approach to increase uptake of such exercise in people with type 2 diabetes. This summary is based in the authors’ knowledge of the filed supplemented by a Pubmed search using the terms “muscle,” “glycemic control,” “HbA1c,” “type 2 diabetes,” and “resistance exercise.” Results The main strategy to increases muscle mass is to perform resistance exercise and, although the quality of evidence is low, such exercise appears effective in reducing Glycated Haemoglobin (HbA1c) in people with type 2 diabetes. However, to increase participation we need to improve our understanding of barriers and facilitators to such exercise. Current data indicate that barriers are similar to those reported for aerobic exercise, with additional resistance exercise specific barriers of looking to muscular, increase risk of cardiovascular event, having access to specialized equipment and knowledge of how to use it. Conclusions The development of simple resistance exercises that can be performed anywhere, that use little or no equipment and are effective in reducing HbA1c will be, in our opinion, key to increasing the number of people with type 2 diabetes performing resistance exercise.

scholarly journals Correlation Between Onset of Diabetes Mellitus and Nitric Oxide Levels in Patient with Type 2 Diabetes Mellitus

2018 ◽  
Vol 4 (1) ◽  
pp. 8
Author(s):  
Theosobia Grace Orno ◽  
Mansyur Arif ◽  
Irfan Idris
Keyword(s):  
Nitric Oxide ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cross Sectional ◽  
Type 2 Dm ◽  
Increased Risk ◽  
Significant Difference ◽  
Onset Of Diabetes

Type 2 diabetes mellitus (DM) is associated with increased risk of endothelial dysfunction if it lasts a long time without control. This study aims to connect the Onset of Diabetes Mellitus (DM) with Nitric Oxide levels in patients of type 2 diabetes mellitus. The study used cross-sectional study method. The samples were 86 subjects, consisting of 38 subjects of Type 2 DM controlled and 48 subjects of Type 2 DM uncontrolled. The results of the Kruskal-Wallis statistical test showed no significant difference between the Onset of DM and Nitric Oxide levels in the categories of 4-6 years (19.4 ± 10.1), 7-9 years (17.3 ± 9.3) and 10-12 years (13.3 ± 8.5) (p=0.06). Furthermore, the Spearman correlation test revealed a negative correlation between the Onset of DM and Nitric Oxide level in patients with Type 2 DM with and without control (r =-0.217). The level of Nitric Oxide (NO) can consider as a predictor of long-term complication in patients with type 2 DM.

Clinic attendance and health outcomes of youth with type 2 diabetes mellitus

2015 ◽  
Vol 27 (3) ◽  
pp. 271-274 ◽  
Author(s):  
Elizabeth Rose Pulgarón ◽  
Jennifer Hernandez ◽  
Heather Dehaan ◽  
Anna Maria Patiño-Fernandez ◽  
Adriana Carrillo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Outcomes ◽  
Medical Care ◽  
Clinic Attendance ◽  
Type 2 Dm ◽  
Increased Risk ◽  
Hba1c Levels

Abstract This study assessed whether clinic attendance was related to health outcomes for youth with type 2 diabetes mellitus (type 2 DM). Medical records of pediatric patients with type 2 DM were retrospectively reviewed. Clinic attendance was much more infrequent than recommended by physicians, and 42% of the sample withdrew from medical care. Patients who had a history of not showing during appointments had higher HbA1c levels than those who attended regularly scheduled visits; however, contrary to our hypotheses, average number of clinic visits was not associated with HbA1c levels or zBMI. Given the increased risk for health complications, new strategies are needed to keep patients engaged with medical care.

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