scholarly journals Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 962 ◽  
Author(s):  
Bolla ◽  
Caretto ◽  
Laurenzi ◽  
Scavini ◽  
Piemonti
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Dietary Interventions ◽  
Ketogenic Diets ◽  
Patients With Diabetes ◽  
Intrinsic Complexity ◽  
Few Data ◽  
Reducing Carbohydrates

Low-carb and ketogenic diets are popular among clinicians and patients, but the appropriateness of reducing carbohydrates intake in obese patients and in patients with diabetes is still debated. Studies in the literature are indeed controversial, possibly because these diets are generally poorly defined; this, together with the intrinsic complexity of dietary interventions, makes it difficult to compare results from different studies. Despite the evidence that reducing carbohydrates intake lowers body weight and, in patients with type 2 diabetes, improves glucose control, few data are available about sustainability, safety and efficacy in the long-term. In this review we explored the possible role of low-carb and ketogenic diets in the pathogenesis and management of type 2 diabetes and obesity. Furthermore, we also reviewed evidence of carbohydrates restriction in both pathogenesis of type 1 diabetes, through gut microbiota modification, and treatment of type 1 diabetes, addressing the legitimate concerns about the use of such diets in patients who are ketosis-prone and often have not completed their growth.

Model estimates of the results of diabetes patients using modern glucometers with tri-color technology for displaying test results

2019 ◽  
pp. 81-89
Author(s):  
Larisa Dmitrievna Popovich ◽  
Svetlana Valentinovna Svetlichnaya ◽  
Aleksandr Alekseevich Moiseev
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Economic Benefits ◽  
Test Results ◽  
Self Monitoring ◽  
Patients With Diabetes ◽  
The Impact

Diabetes – a disease in which the effect of the treatment substantially depends on the patient. Known a study showed that the use of glucometers with the technology of three-color display of test results facilitates self-monitoring of blood sugar and leads to a decrease in glycated hemoglobin (HbAlc). Purpose of the study: to modeling the impact of using of a glucometer with a color-coded display on the clinical outcomes of diabetes mellitus and calculating, the potential economic benefits of reducing the hospitalization rate of patients with diabetes. Material and methods. Based on data from two studies (O. Schnell et al. and M. Baxter et al.) simulation of the reduction in the number of complications with the use of a glucometer with a color indication. In a study by O. Schnell et al. a decrease of HbA1c by 0.69 percent is shown when using the considered type of glucometers, which was the basis of the model. Results. In the model, the use of a glucometer with a color-coded display for type 1 diabetes led to a decrease in the total number of complications by 9.2 thousand over 5 years per a cohort of 40 thousand patients with different initial levels of HbA1c. In a cohort of 40 thousand patients with type 2 diabetes, the simulated number of prevented complications was 1.7 thousand over 5 years. When extrapolating these data to all patients with diabetes included in the federal register of diabetes mellitus (FRD), the number of prevented complications was 55.4 thousand cases for type 1 diabetes and 67.1 thousand cases for type 2 diabetes. The possible economic effect from the use of the device by all patients with a diagnosis of diabetes, which are included in the FRD, estimated at 1.5 billion rubles for a cohort of patients with type 1 diabetes and 5.3 billion rubles for patients with type 2 diabetes. Conclusion. Improving the effectiveness of self-monitoring, which is the result of the use of glucometers with color indicators, can potentially significantly reduce the incidence of complications in diabetes and thereby provide significant economic benefits to society.

scholarly journals The diurnal variation of bone formation is attenuated in adult patients with type 2 diabetes

2019 ◽  
Vol 181 (3) ◽  
pp. 221-231 ◽  
Author(s):  
Katrine Hygum ◽  
Jakob Starup-Linde ◽  
Torben Harsløf ◽  
Niklas Rye Jørgensen ◽  
Bolette Hartmann ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Bone Formation ◽  
Bone Turnover ◽  
Diurnal Variation ◽  
Repeated Measures ◽  
Procollagen Type ◽  
Patients With Diabetes

Objective Bone turnover has a diurnal variation influenced by food intake, incretin hormones, the sympathetic nervous system and osteocyte function. The aim of the study was to compare diurnal variation in bone turnover in patients with diabetes and controls. Design A clinical 24-h study with patients with type 1 diabetes (n = 5), patients with type 2 diabetes (n = 5) and controls (n = 5). Methods Inclusion criterion: age >50 years. Exclusion criteria: diseases/medication that affect bone metabolism or recent use of incretin-based drugs. We drew blood samples hourly during the day and every 3 h during the night. We served an identical diet on all study days. We used repeated-measures one-way ANOVA to compare the levels of the investigated markers, and we quantified the effect of time by comparing group mean standard deviations. Results The bone formation marker procollagen type 1 N-terminal propeptide showed a significant interaction between time and group (P = 0.01), and the mean standard deviation was lower in patients with type 2 diabetes compared with controls (P = 0.04) and patients with type 1 diabetes (P = 0.02). Other markers of bone formation and resorption showed significant effect of time. Levels of glucagon-like peptide-2, glucose-dependent insulinotropic peptide and sclerostin only showed significant effect of time (all P values 0.01), but levels of sclerostin tended to being highest in type 2 diabetes and lowest in controls. Conclusions The diurnal variation in bone formation is attenuated in patients with type 2 diabetes. This is not explained by changes in incretin hormone levels, but possibly mediated by sclerostin.

scholarly journals Cohort profile: the Funen Diabetes Database—a population-based cohort of patients with diabetes in Denmark

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e035492
Author(s):  
Kasper Adelborg ◽  
Péter Szentkúti ◽  
Jan Erik Henriksen ◽  
Reimar Wernich Thomsen ◽  
Lars Pedersen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Geographical Area ◽  
Population Based ◽  
Haemoglobin A1c ◽  
Patients With Diabetes

PurposeDetailed population-based data are essential to understanding the epidemiology of diabetes and its clinical course. This article describes the Funen Diabetes Database (FDDB). The purpose of the FDDB was to serve as a shared electronic medical record system for healthcare professionals treating patients with diabetes. The cohort can also be used for research.ParticipantsThe FDDB covers a geographical area of almost 500 000 Danish inhabitants. It currently includes 3691 patients with type 1 diabetes, 19 085 patients with type 2 diabetes, 292 patients with other types of diabetes and 5992 patients with an unknown type of diabetes. Patients have been continuously enrolled from general practitioners and endocrinology departments in the Funen area in Denmark since 2003. Patients undergo a clinical work-up at their first diabetes contact and during follow-up visits. The information collected includes type of diabetes contact, blood pressure, height, weight, lifestyle factors (smoking, exercise), laboratory records (eg, haemoglobin A1c and cholesterol levels), results from foot examinations (eg, pulse, cutaneous sensitivity and ankle brachial index), results from eye examinations (eg, degree of retinopathy assessed by retinal photo and eye examination), glucose-lowering drugs and diabetic complications.Findings to dateThe FDDB cohort was followed for a total of 212 234 person-years up to 2016. A cross-sectional study described the prevalence of diabetic retinopathy and its associated risk factors. The clinical outcomes of patients with type 1 diabetes, type 2 diabetes and latent autoimmune diabetes in adults have been assessed. Linkage to population-based medical registries with complete follow-up has enabled the collection of extensive continuous data on general practice contacts, diagnoses and procedures from hospital contacts, medication use and mortality.Future plansThe FDDB serves as a strong data resource that will be used in future studies of diabetes epidemiology with focus on occurrence, risk factors, treatment, complications and prognosis.

scholarly journals Evaluation of calcium level in patients with diabetes mellitus according to the examination in the mobile medical center (Diamodule)

2021 ◽  
Vol 23 (4) ◽  
pp. 382-388
Author(s):  
Anna V. Zheleznyakova ◽  
◽  
Victoriya L. Volodicheva ◽  
Olga K. Vikulova ◽  
Alexey A. Serkov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Serum Calcium ◽  
Calcium Level ◽  
Medical Center ◽  
Patients With Diabetes

Background. Diabetes mellitus (DM) is characterized by multiple risk factors for the combined development of disorders of phosphorus-calcium metabolism, due to more frequent overweight, decreased renal filtration function and vitamin D deficiency in this category of patients. Aim. To assess the level of calcium in blood serum and its correlations with parameters of carbohydrate metabolism, body mass index (BMI) and renal function in patients with type 1 and type 2 diabetes. Materials and methods. The object of the study: adult patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) ≥18 years old who underwent examination in Diamodule (n=294) in 2019 in the Voronezh region, who were additionally tested for serum calcium. The examination at the mobile medical center includes: assessment of anthropometric data (height, weight, BMI), biochemical data of blood lipids and creatinine levels with calculation of glomerular filtration rate (GFR-EPI), albuminuria and the albumin/creatinine in a single portion of urine, measurement of glycated hemoglobin (HbA1c), blood pressure, electrocardiogram, consultation with a cardiologist, ophthalmologist, specialist of the Diabetic Foot office, diabetologist. All biochemical parameters was carried out using commercial kits on a biochemical express analyzer Spotchem EZ ArkraySP-4430. Determination of HbA1c, albuminuria, albumin/creatinine was performed by immunochemical method on a DCA Vantage analyzer. Data analysis was carried out using the Statistica v.13.3 software package (TIBCO Software Inc., USA). The results are presented as medians and quartiles [25; 75], the level of reliability is taken as p<0.05. Results. Hypocalcemia (serum calcium level less 2.15 mmol/L) was detected in 88.3% of patients with T1DM and 73.6% of patients with T2DM. The level of serum calcium in T1DM was 1.96 [1.83; 2.07], in T2DM – 2.04 [1.97; 2.16] (p<0.001) with significant differences in GFR: in T1DM 69.6 [57.8; 82.5], with T2DM 50.5 [44.1; 59.9] (p<0.001). We observed correlation between GFR and calcium level r=-0.3 (p<0.05,). GFR<60 ml/min/1.73 m² was observed in 30.5% of T1DM patients, in 75.0% of T2DM. The HbA1c in T1DM was 8.7% [7.7; 9.8], in T2DM – 8.3% [6.8; 9.4] (p=0.01). Obesity was revealed in T1DM in 12.3%, in T2DM in 71.4%; the median BMI in T1DM was 25.5 kg/m2 [21.9; 28.4], in T2DM – 33.2 kg/m2 [29.7; 37.9]. There was correlation between BMI and calcium level r=0.26 (p<0.05). Conclusion. The results of the study revealed a high prevalence of hypocalcemia among patients with diabetes, the most pronounced in type 1 diabetes. In the presence of a correlation between calcium and GFR, there was a high incidence of hypocalcemia in patients with T1DM, even in the absence of a significant decrease in GFR, which may indicate to additional risk factors. Since the assessment of the level of calcium is not included in the list of standard clinical examination, it is recommended to include this parameter and conduct regular screening in risk groups, which include patients with diabetes. More extensive research is needed to analyze the factors.

Cardivascular Risk Profile in Patients with Diabetes and Acromegaly or Cushing’s Disease – Analysis from the DPV Database

2018 ◽  
Vol 128 (02) ◽  
pp. 104-110 ◽  
Author(s):  
Katharina Warncke ◽  
Sebastian Kummer ◽  
Peter Herbert Kann ◽  
Dominik Bergis ◽  
Esther Bollow ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Cushing’S Disease ◽  
Cushing's Disease ◽  
Dipeptidyl Peptidase 4 ◽  
Number Of Patients ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Patients With Diabetes

Abstract Background Although diabetes is a common complication of acromegaly or Cushing´s disease, there are only few detailed studies with a focus on cardiovascular risk, metabolic control or diabetes therapy. Here, we provide a comprehensive characterization from the longitudinal DPV (Diabetes Patienten Verlaufsdokumentation) registry. Methods Patients from the registry≥18 years of age with diabetes and acromegaly or Cushing´s disease were compared to patients with type 1 diabetes or type 2 diabetes using the statistical software SAS 9.4. Results Patients with diabetes and acromegaly (n=52) or Cushing’s disease (n=15) were significantly younger at diabetes onset (median age 50.1 and 45.0 vs. 59.0 years in type 2 diabetes; both p<0.05). Dyslipidemia was common in both diseases (71.0% and 88.9% vs. 71.8% in type 2 diabetes; n.s.), while hypertension was most frequent in acromegaly (56.8% vs. 20.9% in type 1 diabetes, p<0.00001). 36.5% of patients with acromegaly and 46.7% with Cushing´s disease receive insulin, compared to 50.4% with type 2 diabetes. Oral antidiabetic drugs were used in 36.5% of patients with acromegaly and 40% with Cushing´s disease, with a predominance of biguanides and dipeptidyl peptidase-4 inhibitors. HbA1c was well controlled in both groups (median 7.0% and 6.5%; vs. 7.2% in type 2 diabetes). Conclusion Patients with acromegaly are at a high risk for cardiovascular disease, reflected by dyslipidemia and hypertension. A high proportion of patients with diabetes in acromegaly or Cushing´s disease receives insulin. Based on a multicenter register, a sufficient number of patients with rare forms of diabetes can be analyzed.

scholarly journals Correlations between Iron Metabolism Parameters, Inflammatory Markers and Lipid Profile Indicators in Patients with Type 1 and Type 2 Diabetes Mellitus

2020 ◽  
Vol 10 (3) ◽  
pp. 70
Author(s):  
Nadezhda N. Musina ◽  
Tatiana V. Saprina ◽  
Tatiana S. Prokhorenko ◽  
Alexander Kanev ◽  
Anastasia P. Zima
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Lipid Profile ◽  
Density Lipoprotein ◽  
Reactive Protein ◽  
Inflammatory Status ◽  
Patients With Diabetes

This study aims to establish relationships between inflammatory status, ferrokinetics and lipid metabolism in patients with diabetes mellitus. Subclinical inflammation was assessed by levels of high-sensitive C-reactive protein, tumor necrosis factor-α and erythrocyte sedimentation rate. Iron metabolism parameters included complete blood count, serum iron, transferrin and ferritin. Metabolic status assessment included lipid profile, glycated hemoglobin and microalbuminuria measurement. As a result of the study it was possible to establish both general (universal) and diabetes mellitus (DM) type-dependent relationships between the parameters of lipid profile and metabolic control in DM. High-density lipoprotein cholesterol (HDL-C) levels negatively correlated with microalbuminuria (r = −0.293; p ˂ 0.05 for type 1 diabetes and r = −0.272; p ˂ 0.05 for type 2 diabetes). Ferritin concentration positively correlated with triglyceride level (r = 0.346; p ˂ 0.05 for type 1 diabetes and r = 0.244; p ˂ 0.05 for type 2 diabetes). In type 1 diabetes, a negative correlation was discovered between estimated glomerular filtration rate (eGFR) and LDL-C (r = −0.480; p ˂ 0.05), very low-density-lipoprotein cholesterol (VLDL-C) (r = −0.490; p ˂ 0.05) and triglycerides (r = −0.553; p ˂ 0.05), and a positive one between C-reactive protein concentration and triglyceride level (r = 0.567; p ˂ 0.05). Discovered relationships between lipid profile indices, inflammatory status and microalbuminuria confirmed mutual influence of hyperlipidemia, inflammation and nephropathy in diabetes patients. Obtained results justify the strategy of early hypolipidemic therapy in patients with diabetes mellitus to prevent the development and progression of microvascular complications.

Homocysteine metabolism in diabetes

2007 ◽  
Vol 35 (5) ◽  
pp. 1175-1179 ◽  
Author(s):  
E.P. Wijekoon ◽  
M.E. Brosnan ◽  
J.T. Brosnan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Risk Factor ◽  
Plasma Level ◽  
Major Focus ◽  
Patients With Diabetes

An increase in the plasma level of Hcy (homocysteine), an intermediate in the catabolism of methionine, has been identified as a risk factor for many diseases including CVD (cardiovascular disease). CVD is the major cause of death in patients with diabetes mellitus. Therefore the study of Hcy metabolism in diabetes mellitus has been a major focus of current research. Studies conducted in our laboratory were able to show that in both Type 1 and Type 2 diabetes with no renal complications, the plasma Hcy levels were lower than in controls. In Type 1 diabetes, increased activities of the trans-sulfuration enzymes were the major cause for the reduction in plasma Hcy. In Type 2 diabetes, BHMT (betaine:homocysteine methyltransferase) was also observed to play a major role in the increased catabolism of Hcy in addition to the trans-sulfuration enzymes. We were also able to demonstrate the direct effect of insulin and the counter-regulatory hormones on the regulation of cystathionine β-synthase and BHMT, which accounts for the changes in the activities of these two enzymes seen in diabetes mellitus.

ROLE OF PROINFLAMMATORY CYTOKINES IN PATHOGENESIS OF ARTHROPATHIES IN PATIENTS WITH DIABETES MELLITUS

2020 ◽  
Vol 73 (11) ◽  
pp. 2476-2481
Author(s):  
Valeriya L. Orlenko ◽  
Maria H. Kravchuk
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Proinflammatory Cytokines ◽  
Joint Damage ◽  
Tnf Α ◽  
Patients With Diabetes

The aim: Of our work was to study the level of proinflammatory cytokines in patients with diabetic arthropathy and to investigate their possible effect on the development of this complication. Materials and methods: 118 patients were examined, which were divided into groups by type of diabetes, the presence and severity of diabetic arthropathy. The content of IL-1, TNF-α, IL-6 and receptors to S IL-6-R in serum was determined by immunoassay. Results: In patients with diabetic arthropathy, levels of TNF-α (with type 1 diabetes 44.5%, type 2 diabetes 42.9%) and IL-6 (with type 1 diabetes 52.1%, with diabetes 2 types by 64.4%) significantly increased. There is a direct correlation between the severity of joint damage and the level of TNF-α and IL-6. For IL -1, receptors for S IL-6-R have not been detected. Conclusions: The chances of detecting arthropathy with type 1 diabetes with increasing TNF levels increase by 1.7 times, with an increase in IL-6 by 1.5 times. For type 2 diabetes, it is 1.8 and 1.3 times, respectively. Thus, TNF-α and IL-6 may be markers of the presence and progression of arthropathy in patients with diabetes mellitus

scholarly journals Cytokine units of immunoregulation of diabetic-associated osteoarthritis

2020 ◽  
Vol 2 (12) ◽  
pp. 126-134
Author(s):  
V.L. Orlenko
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Joint Damage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Common Complication ◽  
Metabolic Inflammation ◽  
Tnf Α ◽  
Patients With Diabetes

Joint damage in patients with diabetes mellitus (DM) is a common complication and is associated with the induction of metabolic inflammation against the background of increased catabolic processes in various joint structures. The aim of our study was a study of the levels of proinflammatory cytokines in the serum of patients with diabetes-associated osteoarthritis. Materials and methods. We examined 118 patients, who were divided into groups according to the type of diabetes, the presence and severity of diabetic arthropathy. The content of IL-1α, IL-6, S IL-6-R receptors, TNF-α, osteoprotegerin (soluble TNF-α receptor) in blood serum was determined by enzyme-linked immunosorbent assay. Results Among the examined patients, diabetic arthropathy was diagnosed in more than 70% of patients with diabetes of both types. In patients with diabetic arthropathy, levels of TNF-α (44.5% in type 1 diabetes, 42.9% in type 2 diabetes) and its soluble osteoprotegerin receptor (74.1% in type 1 diabetes) were significantly increased. Type 2 diabetes by 52.9%, as well as IL-6 (with type 1 diabetes by 52.1%, with type 2 diabetes by 64.4%) There is a direct correlation between the severity of joint damage and the level of TNF-α , osteoprotegerin and IL-6. For IL-1, S IL-6-R receptors such changes were not detected.The chances of detecting arthropathy with increasing levels of TNF-a in type 1 diabetes increase by 1.7 (OR = 1, 70 ; DI 1,19-2,44) times, at D 2 type - 1.8 times (OR = 1.78; DI 1.21-1.2.61), with an increase in IL-6 in type 1 diabetes increase by 1.5 (OR = 1.47; DI 1.08 -1.98) times, with type 2 diabetes - 1.3 times (OR = 1.34; DI 1.03-1.74), with elevated levels of osteoprotegerin diabetic arthropathy is 2.3 times more common in patients with type 1 diabetes (OR = 2.33; DI 1.42-3.82) and 1.6 times in patients with type 2 diabetes (SHR = 1.55; DI 1.14-2.10). Conclusions. Thus, TNF-α, osteoprotegerin, and IL-6 may serve as markers of the presence and progression of joint damage in patients with diabetes.

Causes of diabetic ketoacidosis: type 1 diabetes versus type 2 diabetes

2017 ◽  
Author(s):  
Marwa Omri ◽  
Rayene Ben Mohamed ◽  
Imen Rezgani ◽  
Sana Mhidhi ◽  
Aroua Temessek ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis
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