scholarly journals Selective Autophagy in Hyperglycemia-Induced Microvascular and Macrovascular Diseases

Cells ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 2114
Author(s):  
Leena P. Bharath ◽  
Jack Donato Rockhold ◽  
Rachel Conway
Keyword(s):  
Metabolic Diseases ◽  
Microvascular Complications ◽  
Critical Role ◽  
Vascular Complications ◽  
Cellular Damage ◽  
Diabetic Patients ◽  
Selective Autophagy ◽  
Patients With Diabetes ◽  
And Function ◽  
Microvascular And Macrovascular Complications

Dysregulation of autophagy is an important underlying cause in the onset and progression of many metabolic diseases, including diabetes. Studies in animal models and humans show that impairment in the removal and the recycling of organelles, in particular, contributes to cellular damage, functional failure, and the onset of metabolic diseases. Interestingly, in certain contexts, inhibition of autophagy can be protective. While the inability to upregulate autophagy can play a critical role in the development of diseases, excessive autophagy can also be detrimental, making autophagy an intricately regulated process, the altering of which can adversely affect organismal health. Autophagy is indispensable for maintaining normal cardiac and vascular structure and function. Patients with diabetes are at a higher risk of developing and dying from vascular complications. Autophagy dysregulation is associated with the development of heart failure, many forms of cardiomyopathy, atherosclerosis, myocardial infarction, and microvascular complications in diabetic patients. Here, we review the recent findings on selective autophagy in hyperglycemia and diabetes-associated microvascular and macrovascular complications.

scholarly journals The Relationship between Frequently Used Glucose-Lowering Agents and Gut Microbiota in Type 2 Diabetes Mellitus

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
You Lv ◽  
Xue Zhao ◽  
Weiying Guo ◽  
Ying Gao ◽  
Shuo Yang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gut Microbiota ◽  
Metabolic Diseases ◽  
Short Chain Fatty Acids ◽  
Current Evidence ◽  
Diabetic Patients ◽  
Glucose Lowering ◽  
Patients With Diabetes ◽  
Gastrointestinal Side Effects ◽  
Underlying Mechanisms

Metabolic diseases, especially diabetes mellitus, have become global health issues. The etiology of diabetes mellitus can be attributed to genetic and/or environmental factors. Current evidence suggests the association of gut microbiota with metabolic diseases. However, the effects of glucose-lowering agents on gut microbiota are poorly understood. Several studies revealed that these agents affect the composition and diversity of gut microbiota and consequently improve glucose metabolism and energy balance. Possible underlying mechanisms include affecting gene expression, lowering levels of inflammatory cytokines, and regulating the production of short-chain fatty acids. In addition, gut microbiota may alleviate adverse effects caused by glucose-lowering agents, and this can be especially beneficial in diabetic patients who experience severe gastrointestinal side effects and have to discontinue these agents. In conclusion, gut microbiota may provide a novel viewpoint for the treatment of patients with diabetes mellitus.

scholarly journals To study levels of serum fibrinogen in type 2 diabetes mellitus and its association with diabetic microvascular complications

2017 ◽  
Vol 4 (1) ◽  
pp. 10
Author(s):  
Gurinder Mohan ◽  
Ranjeet Kaur ◽  
Aakash Aggarwal ◽  
Parminder Singh
Keyword(s):  
Diabetes Mellitus ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
High Serum ◽  
Diabetic Patients ◽  
Coagulation Disorder ◽  
Urine Albumin ◽  
Group A ◽  
Diabetic Microvascular Complications ◽  
Group B

Background: Diabetes mellitus is a hypercoagulable state associated with atherosclerosis leading to development of vascular complications, including microvascular complications.Methods: In our study a total of 60 diabetic patients with duration of diabetes more than 5 years, attending the OPD/ indoor of SGRDIMSR, Amritsar, Punjaqqb, India were included. They were divided in two groups, group A of 30 patients including diabetics with any of the three microvascular complications (diabetic nephropathy, diabetic retinopathy and diabetic neuropathy) and group B of 30 patients including diabetics without any microvascular complication. Group C comprised of 30 age and sex matched non-diabetic subjects who served as controls. Subjects with liver cirrhosis, malignancy or coagulation disorder were excluded. After taking the consent, detailed history taking and detailed physical examination and relevant investigations were done. The serum fibrinogen (hemostasis marker), HBA1C and UACR (urine albumin creatinine ratio) along with routine investigations were measured.Results: It was observed that serum fibrinogen levels were significantly higher in diabetic patients (266.16±54.73 mg/dl) as compared to non-diabetic controls (174.66±18.32 mg/dl); p <0.001.Further, serum fibrinogen levels were found to be significantly higher in diabetic patients with microvascular complications (293.43±51.09 mg/dl) as compared to those without microvascular complications (238.90±44.12); p<0.001.Conclusions: Significantly high serum fibrinogen level was found in diabetic patients as compared to controls and was in positive correlation with development of microvascular complications.

scholarly journals Plasma osteoprotegerin levels are associated with glycaemic status, systolic blood pressure, kidney function and cardiovascular morbidity in type 1 diabetic patients

2006 ◽  
Vol 154 (1) ◽  
pp. 75-81 ◽  
Author(s):  
Lars Melholt Rasmussen ◽  
Lise Tarnow ◽  
Troels Krarup Hansen ◽  
Hans-Henrik Parving ◽  
Allan Flyvbjerg
Keyword(s):  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Systolic Blood Pressure ◽  
Kidney Function ◽  
Vascular Complications ◽  
Diabetic Patients ◽  
Diabetic Vascular Complications ◽  
Patients With Diabetes ◽  
Type 1 Diabetic Patients

Objective: The bone-related peptide osteoprotegerin (OPG) has recently been found in increased amounts in the vasculature in diabetes. It is produced by vascular smooth muscle and endothelial cells, and may be implicated in the development of vascular calcifications. OPG is present in the circulation, where increased amounts have been observed in patients with diabetes. In this study, we examined whether plasma OPG is associated with the glycaemic and vascular status of patients with type 1 diabetes. Methods: Two gender-, age- and duration-comparable groups of type 1 diabetic patients either with (n = 199) or without (n = 192) signs of diabetic nephropathy were studied. Plasma OPG was determined by an ELISA. Results: The plasma OPG concentration was significantly higher in patients with nephropathy than those without (3.11 (2.49–3.99) vs 2.57 (2.19–3.21) (median (interquartiles), ng/ml), P < 0.001). Plasma OPG correlated with haemoglobin A1c (HbA1c), systolic blood pressure and age in both groups and, in addition, with kidney function in the nephropathic group. These correlations remained significant in multivariate models. In addition, we found that plasma OPG concentrations were increased among patients with cardiovascular diseases (CVD), both in the normoalbuminuric and the nephropathic groups. The differences between nephropathic and normoalbuminuric, as well as subgroups with and without CVD, could largely be ascribed to changes in HbA1c, age, systolic blood pressure and creatinine. Conclusion: OPG is associated with glycaemic control and CVD in patients with type 1 diabetes, compatible with the hypothesis that OPG is associated with the development of diabetic vascular complications.

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.

To Study the Frequency of Albuminuria in Diabetics Brought in with Stroke: A survey at Tertiary Care Hospital

2021 ◽  
Vol 15 (6) ◽  
pp. 1302-1304
Author(s):  
A. Malik ◽  
A. Akhtar ◽  
F. F Jang ◽  
M. Uthman
Keyword(s):  
Ischemic Stroke ◽  
Economic Status ◽  
Strong Predictor ◽  
Microvascular Complications ◽  
Strong Association ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
College Hospital ◽  
Patients With Diabetes

Background: Albuminuria is thought to be a separate risk factor for stroke. A strong association between diabetes related albuminuria and stroke has been published in the international literature. Albuminuria being a sign of endothelial dysfunction, atherosclerosis is a strong predictor of strokes. Aim: To investigate the albuminuria as a predictor of stroke in diabetics in our population. Study design: Observational study. Place and duration of study: This study was done in the Department of Neurology, Sharif Medical & Dental College/Hospital, Lahore from January to August 2019. Methodology: One hundred and fifty diabetic patients having ages 25 to 75 years presented with stroke were enrolled in this study. Demographics (age, sex, residence and socio-economic status) of the included population and types of stroke were recorded on study proforma after getting brain CT of each patient. Urine for albuminuria was examined under microscope. Results: In this study (63%) were males and 37% were females with M:F ratio 2.54:1. Major portion of the patients (43%) were ages between 25-45 years mean±SD 51.62±8.45. Ischemic stroke was found in 114 (76%) hemorrhagic in 24(16%) and undetermined in 12(8%) patients respectively. Albuminuria was found in 72(48%) patients, Group A 40(69%) had ischemic stroke, 10(17%) had hemorrhagic and 8(14%) had undetermined stroke. Conclusion: It is concluded that is strong relation between microvascular complications with macrovascular complication of diabetes (i.e. albuminuria with stroke). The stoke patients with diabetes has more frequency of albuminuria as compared to non diabetics. Keywords: Albuminuria, T2DM, Stroke, Hemorrhagic.

scholarly journals Endothelial Progenitor Cells in Diabetic Microvascular Complications: Friends or Foes?

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Cai-Guo Yu ◽  
Ning Zhang ◽  
Sha-Sha Yuan ◽  
Yan Ma ◽  
Long-Yan Yang ◽  
...  
Keyword(s):  
Progenitor Cells ◽  
Endothelial Progenitor Cells ◽  
Microvascular Complications ◽  
Microvascular Disease ◽  
Diabetic Patients ◽  
Endothelial Progenitor ◽  
Vascular Abnormality ◽  
Diabetic Microvascular Complications ◽  
Angiopoietin 2 ◽  
And Function

Despite being featured as metabolic disorder, diabetic patients are largely affected by hyperglycemia-induced vascular abnormality. Accumulated evidence has confirmed the beneficial effect of endothelial progenitor cells (EPCs) in coronary heart disease. However, antivascular endothelial growth factor (anti-VEGF) treatment is the main therapy for diabetic retinopathy and nephropathy, indicating the uncertain role of EPCs in the pathogenesis of diabetic microvascular disease. In this review, we first illustrate how hyperglycemia induces metabolic and epigenetic changes in EPCs, which exerts deleterious impact on their number and function. We then discuss how abnormal angiogenesis develops in eyes and kidneys under diabetes condition, focusing on “VEGF uncoupling with nitric oxide” and “competitive angiopoietin 1/angiopoietin 2” mechanisms that are shared in both organs. Next, we dissect the nature of EPCs in diabetic microvascular complications. After we overview the current EPCs-related strategies, we point out new EPCs-associated options for future exploration. Ultimately, we hope that this review would uncover the mysterious nature of EPCs in diabetic microvascular disease for therapeutics.

scholarly journals Application of artificial intelligence in prediction of cardiovascular complications in patients with diabetes mellitus type 2: A protocol of systematic review

2021 ◽  
Author(s):  
Hengameh Ferdosian ◽  
◽  
Hadi Zamanian ◽  
Sayed Ali Emami ◽  
Elahe Sedighi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Microvascular Complications ◽  
Cardiovascular Complications ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Review Question

Review question / Objective: The aim of this systematic review is to evaluate AI-based models in identifying predictors of cardiovascular events and risk predtion in patients with diabetes mellitus type2. Condition being studied: T2DM patients have an increased risk of macrovascular and microvascular complications, lead to decreased quality of life and mortality. Considering the significance of cardiovascular complications in these patients, prediction of such events would be important. Different traditional statistical methods(such as regression) and new AI-besed algorithms are used to predict these complications in diabetic patients.

scholarly journals Sclerodactyly and Diabetic Complications among Egyptian Adolescent Type 1 Diabetic Patient

2019 ◽  
Vol 7 (23) ◽  
pp. 4004-4009
Author(s):  
Soha M. El Dayem ◽  
Abo El Magd El Bohy ◽  
Ahmed A. Battah
Keyword(s):  
Diabetic Complications ◽  
Clinical Laboratory ◽  
Microvascular Complications ◽  
Glycosylated Hemoglobin ◽  
Vascular Complications ◽  
Diabetic Patients ◽  
Skin Thickness ◽  
Laboratory Assessment ◽  
Limited Joint Mobility

BACKGROUND: One of the common complications of diabetic patients is sclerodactyly which is considered as a part of limited joint mobility. AIM: To assess sclerodactyly in adolescent type 1 diabetics and to detect its relation to other diabetic complications. METHODS: Sixty-three diabetics and 60 controls were studied. Clinical, laboratory assessment, ultrasonography of the skin, carotid artery intima-media thickness (cIMT) & renal colour duplex were done for all participants. RESULTS: Sclerodactyly was positive in 12 (19%) of diabetics. Patients with sclerodactyly had a significantly thickened skin compared to patients without sclerodactyly and controls, P = 0.0001. Male diabetics had significantly thickened skin (p = 0.0001). Diabetic patients with sclerodactyly had significant higher systolic blood pressure (p = 0.03), cholesterol (p = 0.05) and triglyceride (p = 0.004) and lower HDL-c (p = 0.04). Skin thickness had a significant positive correlation with age of diabetic patients (p = 0.02), waist/height ratio (p = 0.04), glycosylated hemoglobin (p = 0.03), albumin/creatinine ratio (p = 0.03), and cIMT (p = 0.03). CONCLUSION: Ultrasound easily diagnoses sclerodactyly. Diabetic patients had a high prevalence of sclerodactyly with increased macrovascular and microvascular complications. Sclerodactyly may be a marker for diabetic vascular complications. Frequent follow up of diabetic patients for early detection of sclerodactyly in uncontrolled diabetic patients is recommended. It could be an alarming sign for microalbuminuria, hypertension, hyperlipidaemia and atherosclerosis.

Prevention of Vascular Complications in Diabetes Mellitus Patients: Focus on the Arterial Wall

2018 ◽  
Vol 17 (1) ◽  
pp. 6-15 ◽  
Author(s):  
Mojca Lunder ◽  
Miodrag Janić ◽  
Mišo Šabovič
Keyword(s):  
Diabetes Mellitus ◽  
Arterial Wall ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Vascular Wall ◽  
Current Treatment ◽  
Macrovascular Complications ◽  
Major Adverse Cardiovascular Events ◽  
Protective Effects ◽  
Microvascular And Macrovascular Complications

In Diabetes Mellitus (DM), hyperglycaemia and insulin resistance progressively lead to both microvascular and macrovascular complications. Whereas the incidence of microvascular complications is closely related to tight glycaemic control, this does not apply to macrovascular complications. Hyperglycaemia influences many interweaving molecular pathways that initially lead to increased oxidative stress, increased inflammation and endothelial dysfunction. The latter represents the initial in both types of vascular complications; it represents the “obligatory damage” in microvascular complications development and only “introductory damage” in macrovascular complications development. Other risk factors, such as arterial hypertension and dyslipidaemia, also play an important role in the progression of macrovascular complications. All these effects accumulate and lead to functional and structural arterial wall damage. In the end, all factors combined lead to the promotion of atherosclerosis and consequently major adverse cardiovascular events. If we accept the pivotal role of vascular wall impairment in the pathogenesis and progression of microvascular and macrovascular complications, treatment focused directly on the arterial wall should be one of the priorities in prevention of vascular complications in patients with DM. In this review, an innovative approach aimed at improving arterial wall dysfunction is described, which may show efficacy in clinical studies. In addition, the potential protective effects of current treatment approaches targeting the arterial wall are summarised.

Circulating Platelet-Leukocyte Aggregates as a Marker of Microvascular Lesions in Diabetic Patients.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3965-3965
Author(s):  
Ismail Elalamy ◽  
Tahar Chakroun ◽  
Francoise Robert ◽  
Chantal Lecrubier ◽  
Fabienne Elgrably ◽  
...  
Keyword(s):  
Type Ii Diabetes ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Inflammatory Cells ◽  
Vascular Lesions ◽  
Diabetic Patients ◽  
Type I ◽  
Flow Cytometry Assay ◽  
Thrombotic Diseases ◽  
Circulating Levels

Abstract Introduction: Evolution of diabetes is associated with multiple disorders including metabolic, cellular and blood disturbances leading to various vascular complications (micro-and macro-angiopathies). Increased circulating levels of platelet-leukocyte aggregates (PLA) have been described in several thrombotic diseases. Material and Methods: In this study, we have evaluated the circulating PLA in diabetic patients and we have investigated whether they may be linked to the vascular complications currently occurring during diabetes evolution. Using flow cytometry assay, we have quantified PLA percentages in 65 diabetics (37 males/28 females, 57 ± 11 years old) including 20 patients with type I and 45 with type II diabetes, and 25 healthy subjects (15 males/10 females, 44 ± 9 years old). Labelling approach using specific monoclonal antibodies permitted us to identify platelet-polymorphonuclear aggregates (PPA) and platelet-monocyte aggregates (PMA). Results: We have observed a significant increase of PPA and PMA levels in diabetics (22 ± 12% and 45 ± 18%, respectively) compared to control subjects (7 ± 4% and 19 ± 10%, respectively). However, both PPA and PMA values were similar in the two types of diabetes and they were not correlated to the disease duration. Circulating PPA and PMA percentages were significantly enhanced in diabetics with vascular lesions (n=37; PPA: 24 ± 13%; PMA: 50 ± 18%) than in diabetics without vascular lesions (n=28; PPA: 18 ± 8%; PMA: 38 ± 15%). Patients with PPA > 18% and /or PMA > 38% had a more important vascular thrombotic damage (OR: 6; 95%; IC: 1.6; 23). The increased PMA circulating percentage seems to be more specific for micro-retinopathy occurrence (OR: 19, 95% IC: 2.3; 154). The rare patients with elevated PMA percentage and without vascular lesions have a shorter duration of diabetes (7 ± 5 years) than patients presenting retinopathy lesions (16 ± 11 years). Conclusion: Together our findings established a relationship between increased circulating PLA rate, particularly that of PMA, and the incidence of microvascular complications in diabetic patients. In addition, they reinforce the concept that pro-inflammatory cells are involved in diabetic retinopathy pathogenesis.

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