scholarly journals Recent Highlights of Research on miRNAs as Early Potential Biomarkers for Cardiovascular Complications of Type 2 Diabetes Mellitus

2021 ◽  
Vol 22 (6) ◽  
pp. 3153
Author(s):  
Agnieszka Bielska ◽  
Magdalena Niemira ◽  
Adam Kretowski
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Early Stage ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Diagnostic Methods ◽  
Artery Disease ◽  
Potential Biomarkers

Type 2 diabetes mellitus (T2DM) and its complications pose a serious threat to the life and health of patients around the world. The most dangerous complications of this disease are vascular complications. Microvascular complications of T2DM include retinopathy, nephropathy, and neuropathy. In turn, macrovascular complications include coronary artery disease, peripheral artery disease, and cerebrovascular disease. The currently used diagnostic methods do not ensure detection of the disease at an early stage, and they also do not predict the risk of developing specific complications. MicroRNAs (miRNAs) are small, endogenous, noncoding molecules that are involved in key processes, such as cell proliferation, differentiation, and apoptosis. Recent research has assigned them an important role as potential biomarkers for detecting complications related to diabetes. We suggest that utilizing miRNAs can be a routine approach for early diagnosis and prognosis of diseases and may enable the development of better therapeutic approaches. In this paper, we conduct a review of the latest reports demonstrating the usefulness of miRNAs as biomarkers in the vascular complications of T2DM.

Microvascular Complications of Type 2 Diabetes Mellitus

2020 ◽  
Vol 18 (2) ◽  
pp. 117-124 ◽  
Author(s):  
Charles Faselis ◽  
Alexandra Katsimardou ◽  
Konstantinos Imprialos ◽  
Pavlos Deligkaris ◽  
Manolis Kallistratos ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Sexual Dysfunction ◽  
Microvascular Complications ◽  
Diagnostic Methods ◽  
Laboratory Evaluation

Background: Type 2 diabetes mellitus (T2DM) is a chronic, non communicable, multisystem disease that has reached epidemic proportions. Chronic exposure to hyperglycaemia affects the microvasculature, eventually leading to diabetic nephropathy, retinopathy and neuropathy with high impact on the quality of life and overall life expectancy. Sexual dysfunction is an often-overlooked microvascular complication of T2DM, with a complex pathogenesis originating from endothelial dysfunction. Objective: The purpose of this review is to present current definitions, epidemiological data and risk factors for diabetic retinopathy, nephropathy, neuropathy and sexual dysfunction. We also describe the clinical and laboratory evaluation that is mandatory for the diagnosis of these conditions. Method: A comprehensive review of the literature was performed to identify data from clinical studies for the prevalence, risk factors and diagnostic methods of microvascular complications of T2DM. Results: Diabetic nephropathy and retinopathy affect approximately 25% of patients with T2DM; diabetic neuropathy is encountered in almost 50% of the diabetic population, while the prevalence of erectile dysfunction ranges from 35-90% in diabetic men. The duration of T2DM along with glycemic, blood pressure and lipid control are common risk factors for the development of these complications. Criteria for the diagnosis of these conditions are well established, but exclusion of other causes is mandatory. Conclusion: Early detection of microvascular complications associated with T2DM is important, as early intervention leads to better outcomes. However, this requires awareness of their definition, prevalence and diagnostic modalities.

scholarly journals ASSOCIATION OF HYPOTHYROIDISM WITH MICROVASCULAR COMPLICATIONS AMONG PATIENTS OF TYPE-2 DIABETES MELLITUS

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Krishan Kumar Meena ◽  
Praveen Sharma ◽  
Swati Srivastava ◽  
Uma Kumari Meena
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Vascular Complication ◽  
Cross Sectional ◽  
Type 2 Dm ◽  
Hypothyroid Patients

Introduction: Diabetes mellitus (DM) is common metabolic disorder leading to various complications including micro-vascular complication. Diabetes and thyroid dysfunction can result in abnormalities of one another, as both are strongly implicated in cellular metabolism.  Aim of study was to establish any association between hypothyroidism and micro-vascular complications in patients of type 2 DM. Material and Methods: This Hospital based Cross sectional analytical Study was included 80 Euthyroid and 80 hypothyroid patients of type 2 DM. These patients were subjected to fundus examination (for retinopathy), urine for spot albumin and creatinine ratio and routine microscopy (for nephropathy), clinical examination and NCV (for neuropathy). Results: Age of patients ranged from 30 – 80 years. Most patients had duration of Diabetes > 5 years. Diabetic retinopathy was found in 15% Euthyroid and 37.5% Hypothyroid diabetics (p=0.002). Neuropathy was more in Hypothyroid (35%) as compared to Euthyroid (12.5%) patients (p=0.003). Prevalence of Nephropathy was also significantly more (p=0.011) in Hypothyroids (60%) as compared to Euthyroid (38.75%). Conclusion: Significant association was found between hypothyroidism and micro vascular complications in type 2 Diabetes mellitus. Screening of diabetics for thyroid functions is essential to reduce morbidity. Keywords: Diabetes, thyroid, retinopathy, neuropathy, nephropathy

scholarly journals Assessment of Knowledge, Attitude and Practices of Medical Officers in Primary Health Centres Regarding Type 2 Diabetes Mellitus

2019 ◽  
Vol 20 (2) ◽  
pp. 63-67
Author(s):  
Jayaprakash S Appajigol ◽  
Manjunath Somappa Somannavar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Microvascular Complications ◽  
Diagnostic Methods ◽  
Primary Health ◽  
Primary Health Centres ◽  
Health Centres ◽  
Knowledge And Attitude

Background: Health education is an integral part of Type 2 diabetes mellitus (T2DM) management, as it can be prevented and controlled by the implication of appropriate interventions. The aim of the study was to assess the knowledge, attitude, and practice (KAP) of medical officers (MOs) in primary health centres (PHC) regarding T2DM. Materials and methods: The 104 medical officers (MOs) with an experience of £2 years of medical practice were included in the study. A self-completion questionnaire, designed to be completed within 10-15 minutes, was developed to analyse the KAP of the MOs regarding T2DM. Results: Among the 104 MOs, 14 had knowledge about the prevalence of T2DM in India. Among the risk factors, obesity (71), physical inactivity (31), family history (43), and hypertension (15) were identified by the MOs. The microvascular complications, including retinopathy (77), nephropathy (63), and neuropathy (49) were stated by the physicians. However, the physicians were less aware about the macrovascular complications. As few as 23 physicians included HbA1c test as one of the diagnostic methods, 43 physicians included HbA1c to monitor the glycemic levels. More than half (55) of the physicians prescribed appropriate medications for the treatment of T2DM. Conclusions: The MOs had considerable knowledge and attitude about T2DM, however due to lack of facilities at the PHCs, the practice of MOs in the management of T2DM is poor. Education programmes to expand the understanding of the MOs regarding T2DM and initiatives to advance the facilities at PHCs are essential to manage T2DM in India. Keywords: Type 2 Diabetes Mellitus J MEDICINE JUL 2019; 20 (2) : 63-67

scholarly journals Elevated levels of circulating microvesicles in coronary artery disease patients with type 2 diabetes and albuminuria: Effects of exercise training

2019 ◽  
Vol 16 (5) ◽  
pp. 431-439 ◽  
Author(s):  
Vibeke Bratseth ◽  
Gemma Chiva-Blanch ◽  
Rune Byrkjeland ◽  
Svein Solheim ◽  
Harald Arnesen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Type 2 Diabetes Mellitus ◽  
Coronary Artery ◽  
Exercise Training ◽  
Characteristic Curve ◽  
Vascular Complications ◽  
Artery Disease

Objective:Circulating microvesicles, released from activated/apoptotic cells, are involved in vascular complications and may be looked upon as biomarkers. Albuminuria is characteristic of disease progression in type 2 diabetes mellitus. We aimed to investigate quantitative and qualitative differences of circulating microvesicles in type 2 diabetes mellitus with and without albuminuria and whether 12-month exercise training influenced expression of circulating microvesicles.Methods:Coronary artery disease patients with type 2 diabetes mellitus (n = 75), of which 25 had albuminuria, were included. Annexin V+(AV+) circulating microvesicles were analysed by flow cytometry in citrated plasma. The exercise volume was 150 min per week.Results:In albuminuria patients, circulating microvesicles from endothelial-(CD146+/CD62E+/AV+) and endothelial-progenitor-(CD309+/CD34+/AV+) cells were significantly higher compared to those without ( p ⩽ 0.01, both). Receiver operating characteristic curve analysis of the endothelial circulating microvesicles shows an area under the curve of 0.704 (95% confidence interval: 0.57–0.84; p = 0.004). Albuminuria patients had more circulating microvesicles derived from activated leukocytes and monocytes and monocytes carrying tissue factor (CD11b+/AV+, CD11b+/CD14+/AV+, CD142+/CD14+/AV+, respectively, p ⩽ 0.05, all) and higher number of circulating microvesicles from activated platelets (CD62P+/AV+). Within exercising patients, circulating microvesicles from progenitor cells increased ( p = 0.023), however, not significantly different from controls.Conclusion:Coronary artery disease patients with type 2 diabetes mellitus and albuminuria had elevated number of circulating microvesicles from activated blood and vascular cells, rendering them as potential predictors of disease severity. The circulating microvesicles were limitedly affected by long-term exercise training in our population.

scholarly journals Targeting risk factors: a feasible way for prevention of vascular complications in type 2 diabetes mellitus

2012 ◽  
Vol 15 (4) ◽  
pp. 103-108
Author(s):  
Irina Vladimirovna Kononenko ◽  
Olga Mikhailovna Smirnova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Large Scale ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Controlled Evaluation ◽  
Multifactorial Approach ◽  
Glucose Lowering Therapy

The article addresses challenges in the prevention of microvascular complications in type 2 diabetes mellitus (T2DM) and discusses necessity of multifactorial approach to management of these conditions. We present results of a large-scale ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation) trial that elucidates the combined influence of antihypertensive and of intensive glucose-lowering therapy on the risk of development of micro- and macrovascular complications of T2DM

scholarly journals An Association of Fasting C-Peptide Levels and Vascular Complications in Chronic Type 2 Diabetes Mellitus Patients

2021 ◽  
Author(s):  
T Thippeswamy ◽  
Nirmal Nithin ◽  
Prathima Chikkegowda
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Protective Role ◽  
Macrovascular Complications ◽  
C Peptide ◽  
Peptide Level

Introduction: Numerous biochemical markers are being used in clinical practice for the prediction and prognostication of vascular complications among non diabetic individuals. Of late, fasting C-peptide levels is being investigated for its possible role in the prediction and protection of vascular complications of diabetes. It is also being explored for its protective role in prevention of vascular complications among patients with diabetes mellitus. Aim: The present study was undertaken with an objective to assess the strength of association of fasting C-peptide levels in the development of microvascular and macrovascular complications. Materials and Methods: An observational cross-sectional study involving 100 subjects with Type 2 Diabetes mellitus (T2DM) having an objective evidence of vascular complications were included into the study. The study period was 18 months from October 2017 to September 2019. After an overnight fasting of atleast 12 hours, C-peptide level estimation was done by Electro-Chemiluminescence Assay (ECLA) method. Results: The overall mean fasting C-peptide level among subjects with microvascular complications (0.73±0.55 ng/mL) was significantly decreased compared with subjects having macrovascular complications (2.44±0.72 ng/mL, with p-value being <0.001). Among microvascular complications, the mean fasting C-peptide level was least in subjects with diabetic retinopathy (0.64±0.35 ng/mL). Among patients with macrovascular complications, preserved C-peptide levels were observed in subjects with ischemic heart disease (2.35±0.75 ng/mL). Conclusion: Fasting serum C-peptide levels are significantly reduced among subjects with chronic T2DM having microvascular complications when compared to macrovascular complications. Also, with preserved serum levels, fasting C-peptide might have a protective role in the prevention of macrovascular complications among subjects with diabetes mellitus.

scholarly journals The importance of combined glycemic control in patients with type 2 diabetes mellitus

2010 ◽  
Vol 56 (5) ◽  
pp. 43-51
Author(s):  
I V Kononenko ◽  
O M Smirnova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Plasma Glucose ◽  
Diabetic Complications ◽  
Microvascular Complications ◽  
Full Range ◽  
Vascular Complications ◽  
Target Values

The contribution of intensive control of glycemia to the reduction of the risk of microvascular complications of type 2 diabetes mellitus is known perfectly well whereas its influence on the development of macrovascular complications remains to be clarified and remains a subject of debates. Bearing in mind that hyperglycemia is a key pathogenetic factor triggering formation of diabetic complications, it is necessary to identify characteristics of carbohydrate metabolism to be taken into account when choosing therapeutic strategies and to determine their target values. Control of the HbA1c level remains the most accessible and informative tool for the assessment of the efficiency of long-term compensation of type 2 diabetes mellitus. However, this method is not altogether free from limitations that can hamper its clinical application. The fasting glycemia level does not completely reflect the quality of DM2 treatment. There is potential relationship between high postprandial plasma glucose levels and the development of vascular complications. Also, it has been shown that variability of glucose concentration may be an important risk factor of diabetic complications. Measurement of the full range of glycemic parameters including fasting plasma glucose level, HbA1c and postprandial glycemia gives an idea of the general picture of the course of the disease necessary for the choice of the treatment strategy.

scholarly journals ENDOTHELIAL DYSFUNCTION IN TYPE 2 DIABETES. Review

2019 ◽  
Vol 15 (1-2) ◽  
pp. 80-86
Author(s):  
O.P. Chernobrivtsev ◽  
S.V. Zyablitsev ◽  
T.I. Panova ◽  
Yu.O. Panchenko
Keyword(s):  
Nitric Oxide ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Endothelial Dysfunction ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
No Synthase ◽  
Modern Concept

Relevance. The problem of systematization and refinement of modern concepts of the pathogenesis of endothelial dysfunction (EDF) and its role in the development of microvascular complications of type 2 diabetes mellitus (T2DM) is relevant due to the lack of pathogenetic treatment nowadays, which would include endothelial dysfunction. Objective: to conduct an analytical review of the results of scientific research on the mechanisms of EDF in T2DM, with the aim of proposing an integrated modern concept of the pathogenesis of EDF. Materials and methods. Review of scientific publications in the international electronic scientific databases of PubMed, Embase and Scopus for keywords for the entire available period (1982-2019). Results. The article provides modern data on the modern concept of the pathogenesis of EDF and its role in the development of microvascular complications in T2DM. The pathogenesis of EDF in type 2 diabetes mellitus is based on the following key mechanisms: impaired synthesis of the endothelial fraction of nitric oxide (NO) due to inhibition of the activity of endothelial NO synthase (eNOS); decreased bioavailability of NO because of oxidative stress; activation of the formation of Endothelin-1 (ET1) and expression of endothelin receptors with a predominance of vasoconstriction; inflammation, which is supported by the synthesis of pro-inflammatory cytokines and causes the expression of inducible NO synthase (iNOS), which stimulates the synthesis of a significant amount of NO, which enters into free radical reactions with the formation of cytotoxic products. Conclusions. The pathogenesis of endothelial dysfunction is impaired nitric oxide synthesis. Endothelial dysfunction, as an integral mechanism, underlies in the core mechanisms the development of vascular complications in type 2 diabetes.

scholarly journals Correlation between atherogenic factors in complicated and uncomplicated type 2 diabetes mellitus

2020 ◽  
Vol 7 (7) ◽  
pp. 1083
Author(s):  
Rajdeepak V. S. ◽  
Rekha G. ◽  
Jayashree S. C.
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Glucose Production ◽  
Poor Glycemic Control ◽  
Complications Of Diabetes

Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization and increased glucose production. The vascular complications of DM are subdivided into microvascular (retinopathy, neuropathy, nephropathy) and macrovascular complications (coronary artery disease, peripheral vascular disease, cerebrovascular disease). There is an observed disparity between various vascular complications of diabetes and the atherogenic factors.Methods: The patients with type 2 diabetes mellitus attending outpatient and inpatient departments in Dr. B. R. Ambedkar Medical College and hospital, from September 2014 to September 2016 were selected for this study. All patients were subjected to detailed history, physical examination and laboratory investigations with respect to complications of diabetes mellitus.Results: In this study, 76% of the patients had poor glycemic control with elevated HbA1c >7%. 38% of patients had normal BMI. 36% of patients were overweight and 26% were obese. 62% of patients were either overweight or obese. Hypercholesterolemia was seen in 26% of patients with poor glycemic control. Hyperhomocysteinemia was present in 38% of patients with microvascular complications and 33% of patients with macrovascular complications.Conclusions: Type 2 diabetes mellitus showed a strong correlation between glycemic status and incidence of diabetes complications. Hypercholesterolemia and hyperhomocysteinemia have added to the increased incidence of complications as additional factors in metabolic derangements as a consequence of poor glycemic control.

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