Impaired deformability and association with density distribution of erythrocytes in patients with type 2 diabetes mellitus under treatment

2020 ◽  
Vol 76 (1) ◽  
pp. 73-83
Author(s):  
Takeshi Arita ◽  
Toru Maruyama ◽  
Taku Yokoyama ◽  
Michinari Hieda ◽  
Mitsuhiro Fukata ◽  
...  

BACKGROUND: Disturbed microcirculation is related to diabetic complications, and erythrocyte deformability is a critical factor regulating microcirculation. OBJECTIVES: To know the relationship between the impaired deformability and density profile in diabetic erythrocytes. METHODS: We recruited patients with type 2 diabetes (n = 15, diabetic group) and age- and sex-matched non-diabetic subjects (n = 15, control group). Erythrocyte density (ED) profile was obtained by the phthalate ester separation technique. ED distribution was fitted by sigmoidal curve, yielding specific gravity of phthalate ester allowing passage of half erythrocytes population (ED50) and slope factor. Erythrocyte deformability was estimated by our specific filtration technique. RESULTS: Diabetic group showed significantly (p < 0.001) higher HbA1c and fasting blood glucose concentration. Erythrocyte deformability in diabetic group was impaired as compared with that in control group (p < 0.001) and proportional to HbA1c (p = 0.009). However, ED50 and the slope factor in diabetic group did not differ from respective parameters in control group. CONCLUSIONS: This study demonstrated that erythrocyte deformability was impaired in diabetic patients even under treatment. HbA1c up to 7.5% is concluded not to alter the erythrocyte density but to impair the deformability, which might be a warning to clinicians for prevention of diabetic complications.

Author(s):  
Takeshi Arita ◽  
Taku Yokoyama ◽  
Shohei Moriyama ◽  
Mitsuhiro Fukata ◽  
Kei Irie ◽  
...  

Aims: Hemorheologic and microvascular dysfunction are interdependent in type 2 diabetic patients. However, exact mechanisms explaining this interaction remains unclear. This study aimed to investigate the impairment of erythrocyte deformability under concurrent recording of electrocardiogram (ECG), since heart-rate-corrected QT interval (QTc interval) prolongation reflects autonomic and microvascular dysfunction in diabetic patients. Methodology: The erythrocyte deformability was investigated on the day of digital ECG recording in diabetic (n = 215) and control (n = 88) groups of outpatients using specific filtration technique. Significant contributors to the erythrocyte deformability were analyzed by multivariate analysis. Results: Difference of mean erythrocyte deformability in the diabetic vs. control group did not reach the statistical significance, but the difference was significant in comparison of diabetic smokers vs. non-smokers and of diabetic patients with vs. without diabetic complications. Impaired diabetic erythrocyte deformability was dependent mostly on the glycated hemoglobin (HbA1c), and negative correlation between QTc interval and the deformability was marginal. Conclusions: Erythrocyte deformability was not necessarily impaired in diabetic patients under the intensive antidiabetic medication. However, this deformability was impaired in diabetic smokers and diabetic patients with clustering of complications. Future studies are required for hemorheologic and microvascular interaction leading to the impaired diabetic microcirculation.


Author(s):  
Siddharth Suresh ◽  
Sharwak Ramlan ◽  
Gangadhara Somayaji ◽  
Nimalka Sequeira

<p class="abstract"><strong>Background:</strong> Diabetes mellitus causes pathophysiological changes at multiple organs. Brainstem Evoked Response Auditory (BERA) represents a non-invasive tool to detect diabetes related sensorineural hearing loss. The aim was to assess diabetes related central auditory pathway involvement using BERA.</p><p class="abstract"><strong>Methods:</strong> The study comprises two groups, (i) Diabetic group (n=15), (ii) Control group (n=15). The controls were matched for age and sex with the study group. BERA was done for all these patients after detailed clinical examination and relevant blood investigations.  </p><p class="abstract"><strong>Results:</strong> There was significant latency differences found in wave III, V and interpeak latencies I-III, III-V and I-V between control and study groups at 70 dBnHL and 80 dBnHL. At 90 dBnHL the diabetic group demonstrated significant latency differences in waves I, III and V and interpeak I-III, III-V and I-V compared to controls. The duration of DM was 5-10 years in 8 patients (53.3%) out of which 7 subjects (87.5%) had prolonged BERA. 7 patients (46.6%) were diabetic for more than 10 years of which all patients (100%) had prolonged latencies.</p><p><strong>Conclusions:</strong> The wave I latency was found non significant which suggests that the pathway from 8<sup>th</sup> nerve to cochlear nucleus is not affected in diabetic patients. The delay in latencies III and V and interpeak latencies I-III, III-V and I-V in diabetic patients compared to the controls suggests brainstem and midbrain involvement. So the study suggests that BERA helps in early detection of central neuronal axis involvement in type-2 diabetes mellitus. </p>


Author(s):  
Shah Namrata Vinubhai ◽  
Pardeep Agarwal ◽  
Bushra Fiza ◽  
Ramkishan Jat

Background: Serum ferritin is known as an index for body iron stores also as an inflammatory marker and it is influenced by several disease. We were looking for a correlation between HbA1c and S. Ferritin in type 2 DM. Methodology: The present study a total of 150 participants were enrolled of which 100 were confirmed cases of Type 2 Diabetes Mellitus and rest 50 age and sex matched healthy subjects constituted the control group. All were screened for HbA1c, Fasting blood sugar, Post prandial blood sugar and S.Ferritin. Results: A highly significant variation and positive correlation was observed with respect to S.Ferritin and HbA1c levels. Mean S.Ferritin was high in the subgroup with poor glycemic control. Conclusion: The fasting, post prandial sugar levels, HbA1c and S.Ferritin were significantly higher in the diabetic subjects. This study shows a positive correlation between HbA1c and S. Ferritin levels. So we can conclude that in diabetic patients S. Ferritin may serve as an independent marker of poor glycemic and metabolic control. Keywords: Serum ferritin, Type 2 Diabetes Mellitus, HbA1c.


2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Freda Lalrohlui ◽  
Souvik Ghatak ◽  
John Zohmingthanga ◽  
Vanlal Hruaii ◽  
Nachimuthu Senthil Kumar

AbstractOver the last few decades, Mizoram has shown an increase in cases of type 2 diabetes mellitus; however, no in-depth scientific records are available to understand the occurrence of the disease. In this study, 500 patients and 500 healthy controls were recruited to understand the possible influence of their dietary and lifestyle habits in relation with type 2 diabetes mellitus. A multivariate analysis using Cox regression was carried out to find the influence of dietary and lifestyle factors, and an unpaired t test was performed to find the difference in the levels of biochemical tests. Out of 500 diabetic patients, 261 (52.3%) were males and 239 (47.7%) were females, and among the control group, 238 (47.7%) were males and 262 (52.3%) were females. Fermented pork fat, Sa-um (odds ratio (OR) 18.98), was observed to be a potential risk factor along with tuibur (OR 0.1243) for both males and females. Creatinine level was found to be differentially regulated between the male and female diabetic patients. This is the first report of fermented pork fat and tobacco (in a water form) to be the risk factors for diabetes. The unique traditional foods like Sa-um and local lifestyle habits like tuibur of the Mizo population may trigger the risk for the prevalence of the disease, and this may serve as a model to study other populations with similar traditional practices.


Author(s):  
Venkataiah Gudise ◽  
Bimalendu Chowdhury

Abstract Background Type 2 diabetes in obese (≥ 25 and ≥ 30 kg/m2) patients is the foremost cause of cardiovascular complications like stroke, osteoarthritis, cancers (endometrial, breast, ovarian, liver, kidney, colon, and prostate), and vascular complications like diabetic neuropathy, diabetic and retinopathy, and diabetic nephropathy. It is recognized as a global burden disorder with high prevalence in middle-income nations which might lead to a double burden on health care professionals. Hence, this review emphasizes on understanding the complexity and vital signaling tracts involved in diabetic complications for effective treatment. Main body Type 2 diabetes in overweight patients induces the creation of specific ROS that further leads to changes in cellular proliferation, hypothalamus, and fringe. The resistin, TLR4, and NF-κB signalings are mainly involved in the progression of central and fringe changes such as insulin resistance and inflammation in diabetic patients. The overexpression of these signals might lead to the rapid progression of diabetic vascular complications induced by the release of proinflammatory cytokines, chemokines, interleukins, and cyclooxygenase-mediated chemicals. Until now, there has been no curative treatment for diabetes. Therefore, to effectively treat complications of type 2 diabetes, the researchers need to concentrate on the molecular mechanisms and important signaling tracts involved. Conclusion In this review, we suggested the molecular mechanism of STZ-HFD induced type 2 diabetes and the vital roles of resistin, TLR4, and NF-κB signalings in central, fringe changes, and development diabetic complications for its effective treatment. Graphical abstract


2021 ◽  
pp. 14-18
Author(s):  
Pankaj Kumar Singh ◽  
Dhaval Kumar Bhadja ◽  
Mohit Bhatnagar ◽  
Mandeep Joshi ◽  
Shreya Verma

Background and aim: The present study was conducted to evaluate serum Magnesium and lipid prole in diabetic patients and to nd out any correlation between serum magnesium and lipid prole in diabetic patients and its association with complications. Material and Methods: In the present study, 70 diagnosed Type 2 diabetes mellitus patients aged >30 years attending Diabetic Outpatient and Inpatient Department at Vivekananda Polyclinic giving their consent for inclusion were considered to be included in the study as Cases. Results:In present the study, mean S. magnesium levels of patients with diabetic complications were found to be signicantly lower (1.09±0.22 mg/dl) as compared to that of patients in whom no diabetic complications were seen (2.19±0.71) and this difference was signicant statistically.Conclusions: In the diabetic population correlations of serum magnesium and Total cholesterol, triglyceride, LDL and VLDL were Mild while HDL was of moderate level. Among controls correlations of Serum Magnesium with Total cholesterol, triglyceride, LDL, VLDL, and HDL were found to be weak and not found to be statistically signicant.


2016 ◽  
Vol 9 (5) ◽  
pp. 234
Author(s):  
Zahra Heidari ◽  
Zahra Sepehri ◽  
Aleme Doostdar

<p>In addition to known risk factors, the role of different micronutrients such as selenium in diabetes incidence has been proposed. Some previous studies have shown an association of selenium deficiency and type 2 diabetes mellitus, while other studies have not confirmed such a relationship. The aim of this study was to evaluate serum level of selenium in patients with Type 2 diabetes compared with the control group. This cross-sectional study was carried out on patients with type 2 diabetes in Zahedan, southeastern Iran. One hundred newly diagnosed type 2 diabetic patients were evaluated for serum selenium level. One hundred subjects from the general population who had normal fasting blood sugar levels were selected as the control group. The control group subjects were matched in pairs with each of patients on the basis of sex, age (± one year), and body mass index (±1). Serum level of selenium was determined by spectrometry method. Results were compared using t-test. The mean serum level of selenium in patients was 94.47±18.07 µg/L whereas in control group was 142.79±23.67 µg/L. The mean serum level of selenium was significantly different between the two groups (P&lt;0.001). Serum levels of selenium in diabetic patients with significant difference statistically were lower than the control group. In order to evaluate serum level of selenium in patients with diabetes, studies with larger sample size are required. Likewise, prospective studies along with selenium supplementation and investigating its effect on incidence of diabetes are accordingly needed.</p>


2020 ◽  
Vol 20 (2) ◽  
pp. 833-840
Author(s):  
Erhan Onalan ◽  
Yusuf Doğan ◽  
Ebru Onalan ◽  
Nevzat Gozel ◽  
Ilay Buran ◽  
...  

Backround: Elabela (ELA) is a hormone that is secreted at high levels in the kidneys of a healthy adult. This study aims to investigate whether serum ELA levels of patients with Type 2 Diabetes vary with the severity of renal damage. Methods: Our study included 50 healthy control subjects and 100 diabetic patients, who were categorized into groups based on urine albumin/creatinine ratios (ACR). Patients included in the study were assigned to four groups: Group 1 (healthy control), Group 2 (ACR<29mg/g), Group 3 (ACR=30-299 mg/g), and Group 4 (ACR>300 mg/g normal or high serum creatinine). Physical examination findings, demographic characteristics of the study group were recorded, and serum ELA levels and other laboratory parameters were assessed using appropriate methods. Results: The results of the study indicated that ELA levels determined in healthy individuals gradually decreased through stages of normal albuminuria, microalbuminuria, and macroalbuminuria. Moreover, ELA had a significant negative corre- lation with LDL-C (r=-0.201, p=0.014), glucose (r=-0.437, P<0.001), retinopathy (r=-0.222, P=0.006), serum BUN (r=- 0.161, P=0.049), and a positive correlation with eGFR (r=0.250, P=0.002). Conclusions: The fact that ELA levels are higher in healthy individuals compared to diabetic patients without microalbu- minuria, and higher in diabetic patients without microalbuminuria compared to patients with advanced albuminuria and kidney damage, suggests that the ELA level can be an important clinical prognostic variable and even a promising agent for the treatment of diabetic nephropathy patients. Keywords: Elabela, diabetes, diabetic kidney disease, albuminuria.


2020 ◽  
Author(s):  
Xiaomeng Sun ◽  
Jia Liu ◽  
Guang Wang

Abstract Background: This study was to research the efficacy of fenofibrate in the treatment of microalbuminuria in the patients with type 2 diabetes mellitus (T2DM) and hypertriglyceridemia. Methods: Type 2 diabetic patients (56) with microalbuminuria and hypertriglyceridemia aged 30 to 75 were randomly divided into the fenofibrate treatment group(n=28) and the control group (n=28) for 180 days. Urinary microalbumin /creatinine ratio (UACR) and other metabolic parameters were compared at baseline, during treatment and after treatment. Results: After 180 days, the reduction of levels of fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) in two groups were no differences. In treatment group, uric acid (UA) (296.42 ± 56.41 vs 372.46 ± 72.78), triglyceride (TG) [1.51(1.17, 2.06) vs 3.04(2.21, 3.29)], and UACR [36.45 (15.78,102.41) vs 129.00 (53.00, 226.25)] were significantly decreased compared with the baseline. The high-density lipoprotein cholesterol (HDL-C) levels were significantly increased (1.22 ± 0.26 vs 1.09 ± 0.24) compared with the baseline. The decrease in UACR [-44.05(-179.47, -12.16) vs -8.15(-59.69, 41.94)]in treatment group was significantly higher compared with the control group. The decrease in UACR was positively associated with the decreases in TG ( r = 0.447, P = 0.042) and UA ( r = 0.478, P = 0.024) after fenofibrate treatment. Conclusion: In the patients with hypertriglyceridemia and type 2 diabetes mellitus, fenofibrate can improve microalbuminuria and do not increase the deterioration of glomerular filtration rate


2021 ◽  
Vol 12 ◽  
Author(s):  
Fuyao Yu ◽  
Bing He ◽  
Li Chen ◽  
Fengzhe Wang ◽  
Haidong Zhu ◽  
...  

ObjectiveSkeletal muscle fat content is one of the important contributors to insulin resistance (IR), but its diagnostic value remains unknown, especially in the Chinese population. Therefore, we aimed to analyze differences in skeletal muscle fat content and various functional MRI parameters between diabetic patients and control subjects to evaluate the early indicators of diabetes. In addition, we aimed to investigate the associations among skeletal muscle fat content, magnetic resonance parameters of skeletal muscle function and IR in type 2 diabetic patients and control subjects.MethodsWe enrolled 12 patients (age:29-38 years, BMI: 25-28 kg/m2) who were newly diagnosed with type 2 diabetes (intravenous plasma glucose concentration≥11.1mmol/l or fasting blood glucose concentration≥7.0mmol/l) together with 12 control subjects as the control group (age: 26-33 years, BMI: 21-28 kg/m2). Fasting blood samples were collected for the measurement of glucose, insulin, 2-hour postprandial blood glucose (PBG2h), and glycated hemoglobin (HbAlc). The magnetic resonance scan of the lower extremity and abdomen was performed, which can evaluate visceral fat content as well as skeletal muscle metabolism and function through transverse relaxation times (T2), fraction anisotropy (FA) and apparent diffusion coefficient (ADC) values.ResultsWe found a significant difference in intermuscular fat (IMAT) between the diabetes group and the control group (p&lt;0.05), the ratio of IMAT in thigh muscles of diabetes group was higher than that of control group. In the entire cohort, IMAT was positively correlated with HOMA-IR, HbAlc, T2, and FA, and the T2 value was correlated with HOMA-IR, PBG2h and HbAlc (p&lt;0.05). There were also significant differences in T2 and FA values between the diabetes group and the control group (p&lt;0.05). According to the ROC, assuming 8.85% of IMAT as the cutoff value, the sensitivity and specificity of IMAT were 100% and 83.3%, respectively. Assuming 39.25ms as the cutoff value, the sensitivity and specificity of T2 value were 66.7% and 91.7%, respectively. All the statistical analyses were adjusted for age, BMI and visceral fat content.ConclusionDeposition of IMAT in skeletal muscles seems to be an important determinant for IR in type 2 diabetes. The skeletal muscle IMAT value greater than 8.85% and the T2 value greater than 39.25ms are suggestive of IR.


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